? Help ... Super Bouncy Cat

My kitty Luna is on Lantus and when she first started we were doing well ... mostly yellows, blues and some greens. Now she is always in the pink/red at pre-shot and she drops FAST to blue and sometimes green. Lately it seems like the window of time she is staying in good ranges is shorter and shorter. She can't seem to handle being in the low 100's for long before she bounces right back into the 300's or 400's. I am at a loss for what to do. Some days I think I need to increase but when I see her go from 400's to the mid/low 100's in two hours I really don't think that is a good idea. Do I increase, decrease ... keep it the same? I just feel like I'm failing her as her numbers get worse and worse.

I've taken the advice here to feed more often to "feed her curve" so now she is getting fed at AM pre-shot, +2, +6, PM pre-shot, +3 (luckily she loves to eat) but nothing is changing. She eats FF classics and if her BG is really low I let her have some Purina DM dry food but that is usually only 1-2x a week. I'm starting to wonder if another insulin like Levemir would be better for her. I read that many cats don't drop as fast on it.

 

Are you following TR or SLGS? I’m not sure what to tell you because I need help all the time too. I know that will be one of the first questions asked by an experienced member.

 

I was originally following vet's advice, then doing SLGS but I'm testing enough to be doing TR. I am trying TR but admit I have freaked out when I see her BG in the 70's (human meter) at +3 and reduced by .25 the last time that happened even though TR says not to unless it is under 50. I think her nadir is early (around +4/+5) but I honestly don't know because she bounces so much. I feel like she just starts rising once she hits blue for a few hours. I understand that it will go back up before her next shot but when it is doubling by the hour back up to 400+ at pre-shot that seems like her liver is dumping glucose.

 

Silver did that all the time too. Eventually they will stop bouncing. I am doing SLGS.

 

If you have the time and the desire to page through 6.5yrs of Gabby's spreadsheet, you'll see she was bouncy and would have very dramatic dives (400 to 40s and back to 400 in a cycle). It's frustrating and for some time, I thought I was doing something wrong. I wasn't. The first thing to remember is that bounces are normal. Most of us have no idea how long our cats were in diabetic numbers. When a cat's body gets used to being in diabetic numbers, their system adjusts and treats those higher numbers as the new "normal." Technically, this is called glucose toxicity. It also happens if your hold a dose that isn't getting your cat into normal or more normal numbers. Back in Dec., you were holding doses longer than you needed to. So, if your cat is used to higher numbers, when the numbers drop, the cat's liver and pancreas assume this is dangerous and glycogen and counterregulatory hormones are dumped into the blood stream -- or, your kitty bounces.

The basic strategy is to keep doing what you're doing. If you're going to follow TR, you should reduce the dose when numbers drop below 50. ANY time a cat drops below 40, the dose reduction is immediate. Ultimately, the bouncing will slow down as Luna becomes more used to lower numbers. If you look at Gabby's SS, she also would drop like a rock early in the cycle. I kept good records of how I was steering the curve with food - the info is in the Comments section. I also tested early and often because she was prone to early dives and had an early nadir. I would encourage you to get a +2 test and decide if you need to intervene with food.

What % carb food are you giving Luna? It may be that her drops will soften if you use a slightly higher carb food and give her frequent, small meals. I fed Gabby at PS, +1, and +2 and sometimes I routinely fed at +3, as well. Front loading the cycle with food, especially spreading the meals out may also help.

Ultimately, what will help with bouncing is to get as much insulin into your cat as you can and propping the numbers up with food. I would wait before you try this until you're comfortable with handling low numbers. It takes some practice and a good deal of confidence.

 

I follow TR. I freaked out too when Diamond hit his first green mid-cycle. Freaked our even more when he had a blue pre shot. I would come here and ask for advice. Now I know I shoot no mater what the number and I ask advice before changing the dose. If you change the dose up and down too frequently it will be very hard to get her regulated. I'm going to tag a few people to see if they can help you out.
@Stacy & Asia @Kris & Teasel @Stephanie & Quintus

 

Thank you so much! I am constantly worried that I am doing something wrong so this made me feel a lot better. I was following the vet's advice up until January based on curves I would send her. She really didn't encourage me the change the dose and didn't like Luna's nadir being below 175. I now realize that was probably to be safe but not really the best thing to do for her. I will definitely take a look at Gabby's spreadsheet. Luna is eating Fancy Feast Classics which I understand is a pretty low carb food. She does tend to drop lower at night so I get scared when she is under 100 at only +3. It only happens randomly and I can't stay up all night every night to check her BG. I will try to do better with more testing at night though when I increase her dose. All of your advice is very helpful

 

I would check the carbs in what you're feeding. You're correct, the FF Classics are low carb. There may be a flavor that's a little higher in carbs. If you're usually feeding say 4%, you may want to see if using a food that's 6 - 7% flattens things out a bit.

I also hope you have some high carb food stocked up. The FF Gravy Lovers is a good option if you need to steer numbers up should they get into dose reduction range.

 

Sienne gave you some great advice. Bouncing just happens until it doesn't. It may calm down the more time Luna spends in normal numbers. The reduction from 1.5 to 1.25 didn't do you any favors. I know it's scary to see those greens, but bringing the dose down when it's unwarranted is only going to make things worse. If you do TR, you can't feed any dry, the protocol was written for feeding wet food only, it's a safety issue.

Asia liked to drop fast and early on Lantus. If it's possible to get a +1 and +2 for a bit, find out when onset is, and if you see a big drop (say 70 points in an hour or more), I would feed that drop to try to slow it down.

You're doing well testing, keep asking questions and learning the finer points and I think you'll see some changes for Luna.

 

Thank you! I know I shouldn't have reduced from 1.5 to 1.25 because I'm not seeing any greens now. It is just scary seeing her go so low early in the night and wonder if she will be okay in the morning when I can't stay up and test all night. I am going to increase her back up to 1.5 tomorrow and start testing more often at +1 and +2. Not feeding her dry food isn't a problem at all. I was occasionally giving her some Purina DM dry food but she prefers her Fancy Feast classics.

 

You are right ... the chart I have says that FF Classics are 2-4% carbs. I have Purina DM wet food that was prescribed by the vet that is about 6%. She was eating that when first diagnosed and was actually having much better numbers. I wonder if I caused all this bouncing by taking her off of it and switching to FF. I may try giving her that in combination with the FF to see if it helps keep her numbers more stable. Thank you!!!

 

It is scary at first, we've all been there. You don't need to stay up all night, once you figure out about where her nadir is at night, you can plan accordingly and either set an alarm to catch that or, like you did the other night, you can feed high carb or Karo to make sure she goes up, you just want to make sure she doesn't go right back down when the sugar wears off. If you know about where her nadir is, you will know when she starts to rise typically. It looks like her nadir is around +4 in the day, it may be similar at night. If you get one overnight test in a different place for a few days, it should fill in some blanks and help you figure it out without losing much sleep.

Keep up the good work, bouncing can be frustrating, but at some point you accept it and enjoy a little break!

 

Yo Luna!! We know it's a lot of fun, but stay off the trampoline!! All that bouncing isn't necessary at all and you're worrying your mamabean!!