HUGE Bounce - Concerned

Discussion in 'Prozinc / PZI' started by Greg and Goma & Friends, Jan 11, 2018.

  1. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    This is a tremendous bounce and I am very concerned after a relatively peaceful day and evening. Am preparing to give am insulin 2.5U but again, concerned at how high this is. We did just return from the vet an hour ago. AMPS 617 - She hasn't seen this in quite some time - Thoughts - Guidance - What is going on here...

    UPDATE - Okay I did another reading with a new strip and new blood. This one says 365
    Now what? I just fed her like a minute ago.

    2ND UPDATE - Third reading reflects 444 -

    Testing Control Strip = 144

    Meter set correctly to code on bottle (07)
     
    Last edited: Jan 11, 2018
  2. Djamila

    Djamila Well-Known Member

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    That is an icky number, for sure! A high bounce isn't unexpected after that long low cycle. Kitties can sometimes be quite dramatic. However, I think given her blood work yesterday, the infection is a likely culprit. Is she on daily antibiotics, or did she get a shot? Does the vet have any ideas on the type of infection? And of course the third possibility is vet stress, although Goma is there enough, and yesterday didn't seem to stay high after, so that seems like the least likely option.

    One of the things we try to keep in mind is to not worry about a single number. Pay more attention to the trends. So I would stay with the 2.5u dose, and let's see what she does. Hopefully this is just a strange moment and she'll get back to her normal ranges soon.
     
  3. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Understood - I updated my post a couple of times reflecting different readings - What do you think about those?

    She is having antibiotics through the subcutaneous injection once a day that includes vitamins and liver meds in addition to 100 ml fluid.
     
    Last edited: Jan 11, 2018
  4. Djamila

    Djamila Well-Known Member

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    365 and 444 are technically within meter variation. I know it seems like a huge range. But those are both much better than the 617, so that's good to see. I would probably put the 444 into the spreadsheet since it's the middle number.
     
  5. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Any ideas about why the meter initially reflected the high(er) number (617). When making decisions I would like to have more faith in the instruments I am using. I went through this previously and tested the meter on another cat. The meter was fine and test this morning using control fluid showed okay number.

    Thanks for your patience and the continuing education.
     
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  6. Djamila

    Djamila Well-Known Member

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    Sometimes you just get a wonky test strip. Or too much or too little blood. When I get an unexpected number, I often do exactly what you did - test again. If the second test is close, then I know it was right. If the second test is way off (as yours was), I do the third test and figure out which of the first two is more accurate. I wish the numbers were more accurate too. Unfortunately, this is the best way have for now. The AT2 is probably the most accurate meter out there, and even it (as you have seen) can be less than precise. Try not to worry about it too much. Tonight for example, any of those three numbers still results in the same treatment - 2.5u. So despite the large variation, the decision remains the same. I try to remind myself of that when I get a little crazy about a particular number. :confused:
     
  7. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Okay thank you for your usual thorough response. Note to Self - Don't go crazy about a particular number
     
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  8. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    And besides, @Kris & Teasel forewarned me about a mighty bounce. Guess I wasn’t realizing it would be this mighty.
     
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  9. Djamila

    Djamila Well-Known Member

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    Wow, Goma had a nice cycle today! Look at that pretty blue! :cool:
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, nice cycle! Given the lows yesterday, a bounce that got her stuck up in the rafters was expected but it didn't happen. That blue is lovely. Look at the difference in your SS compared to December! :smuggrin:
     
  11. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Hoping this can continue. Heaven knows she needs a respite from everything going on. The difference can be directly attributed to members of the FDMB such as yourself.
     
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  12. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Looks good now, started a bit shaky and I hope she can continue in this peaceful mode for a while to give her a break. She's been through enough.
    Thanks for your help.
     
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  13. Rachel

    Rachel Well-Known Member

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    She’s really looking lovely and getting into those healing numbers can only help!
     
  14. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Unfortunately it didn't last - pmps of 545 puts her back in black which I have grown to detest as does she.
     
  15. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Ended quite roughly - pmps of 545. Sigh....I feel terrible for her.
     
  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If it makes you feel any better, that number is within the allowed 20% meter variance of the AMPS - essentially the same range. Focus on trends, not individual numbers.
     
  17. FurBabiesMama

    FurBabiesMama Well-Known Member

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    I hate to see high pre-shot numbers too, but I try to remind myself to focus on the good things. The longer they stay in good numbers, the better. So, even if they are high by pre-shot, if they spent several hours before that in good numbers, it was a good cycle. They are diabetic, they do have high BG, that is why we are giving them the insulin. So, the high pre-shot is a reminder of that.. think of where they would be without the insulin. (I am talking to myself as much as to you. :))
     
  18. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    I'll learn hopefully sooner than later.
     
  19. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thanks for getting me to keep things in perspective. So much going on lately I tend to forget.
     
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  20. Critter Mom

    Critter Mom Well-Known Member

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    I feel for both of you because I can remember the way my heart used to sink if Saoirse had a high PS value, especially after a run of better numbers.

    :bighug::bighug::bighug:

    I don't know whether this might help but any time you get a preshot on the higher side have a look at the first line of Goma's spreadsheet. Today's PMPS may have been 545 but it sure beats the 700s she was running in a month ago at the start of her treatment. Fingers and paws crossed that a month from now Goma's numbers will be showing even more improvement - and she will be feeling much better for it!

    We all wish we had magic wands to make our little fur babies better immediately but alas! such wands don't exist. :( Studying the numbers to remind ourselves of the positive progress being made is probably the only thing we can do to help manage our own impatience for them to be fully well again. Hang in there; your girl is definitely heading in the right direction. :)


    Mogs
    .
     
  21. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    This definitely helps. Thank you.
     
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  22. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This bouncing action of Goma's can continue for several cycles after that low cycle. She's still doing better than she was. The hope is that it'll calm down and allow you to see the real effect of the 2.5 u dose again. If she stays high-ish we'll likely recommend a dose increase to get her moving again. Just letting you know what might be ahead ... :)
     
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Wow! Love that blue at +9.25! :)
     
  24. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Very curious what her AMPS was for 1/14. Hmmm....
     
  25. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thanks for watching - AMPS will be taken in about an hour.
     
  26. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Appreciate the monitoring - Goma is in great hands with FDMB - Hope we have a good AMPS in about an hour.
     
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  27. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Disappointing at 452, but I kind of anticipated it this time.
     
  28. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    As noted with @FurBabiesMama a disappointing 452. But I kind of thought this would be the direction. Had also fed her at +9.25.
    Would have taken more tests this morning but between exhaustion and a shortage of lancets - sigh....
     
  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    She's doing fine. It's not a black. ;)
     
  30. Djamila

    Djamila Well-Known Member

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    The pre-shot numbers are the last thing to come down. But look how fast she is clearing those bounces now! And really, they have already come down so far since the beginning! Goma is making remarkable progress. :)
     
  31. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thanks for the info about the pre-shot numbers being last to lower. Thanks to her guardian angels at FDMB she is becoming a whole new cat. She now sleeps in a more conventional cat style and is without a doubt much more comfortable.
     
  32. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thank goodness for the non-black number. She rests so much more comfortably now and doesn't appear to go into panic mode anymore in regards to food - just a healthy appetite.
     
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  33. Djamila

    Djamila Well-Known Member

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    Oh I’m so glad to hear that! That’s even more important than the numbers - that she is starting to feel better!
     
  34. Critter Mom

    Critter Mom Well-Known Member

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    Me, too! :D

    (((Goma)))


    Mogs
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  35. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Goma's bounces don't seem to last too long. I see that low-ish pink today on your SS. I think we'll be suggesting an increase to 2.75 u in the near future. :)
     
  36. Djamila

    Djamila Well-Known Member

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    Yup, I agree with Kris. She's looking pretty stable at this point, and her nadirs are need to come down a bit more.
     
  37. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Will need to see the pmps. I am sorry, I do not understand the point of increasing doses when she has trouble balancing where she is at this point. I am totally new to all this, but it appeared the last time I increased prematurely I (Goma) got bit pretty bad.
     
  38. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Not sure I understand the increase suggestion at this time. Still bouncing like crazy. I know I am new and don't understand a thing about all this but I am just unsure at this point. For some reason, this last bounce took some of the spark out of her.
     
    Last edited: Jan 16, 2018
  39. Kris & Teasel

    Kris & Teasel Well-Known Member

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    What we're doing is looking at your data to see how low a dose has taken Goma once she's finished bouncing. We evaluate several cycles at a dose. A bounce shows as a skyrocketing of numbers (up into black in Goma's case) and we look for evidence of that ending as shown by a return to more typical numbers - eg. pinks. Bouncing is very frustrating and it can make it difficult to properly evaluate a dose. To assess a dose we look at how low that dose has taken Goma within several cycles of being at that dose and we ignore the bounce inflated cycles.

    To assess a dose you have to look at both pre shot BG levels and nadir levels. If a cat is a bouncer more weight has to be given to nadir levels in the dose assessment because the pre shot numbers are often inflated (as a reaction to the lower nadir - a facet of the bouncing issue). The nadir is important because you want to avoid a dose that takes her too low but you want to see good numbers in the high dark green to low blue range. The hope is that the high pre shot numbers will come down over time but nothing is guaranteed with a bouncy cat. As hard as it is, if your kitty is a bouncer you have to learn to judge doses by looking past that. All this takes time to learn. And it's complicated by the fact that a dose that dropped her low a week or two ago might not do that again. FD and dosing are dynamic, not static, processes. If she's left too long at an ineffective dose (based on nadirs in the previous days) it becomes harder to get her coming down again. The high BG dulls the body's response to the insulin.

    Ultimately, you hold the syringe and have the final say on what dose you give her. We can only give advice. :)
     
  40. Djamila

    Djamila Well-Known Member

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    Yes to everything Kris said. So here is the pattern:

    1/11 AM good
    1/11 PM high
    1/12 AM good
    1/12 PM high
    1/13 AM high
    1/13 PM good
    1/14 AM high
    1/14 PM good
    1/15 AM good
    1/15 PM high
    1/16 AM high (?) she nadirs late, so not sure on this one yet

    The good cycles have blues as a low number for the cycle. Those are the cycles we look at - and at how quickly she moves from a high to a good cycle. Many cats will go good-high-high-high-high.... and then finally get another good cycle. Goma is moving quickly from goods to highs which is a great sign. The goods are also pretty consistent at this point - mid-blue. So far she's being nice and predictable, which is great. The mid-blues are good, but they could be better, which is why Kris suggested a little bump in insulin.

    You are right that she could end up with a low cycle when you make the increase, but then she'll most likely settle back down, and hopefully with a slight improvement in the nadirs, and hopefully with the effect of starting to pull the PS numbers down a little lower at the same time.

    One strategy you could try if this all makes sense, but just makes you nervous, is to increase in teeny tiny increments. We call them fat and skinny doses. So you don't go all the way from 2.5u to 2.75u at once - instead you go to 2.5u, and then just a teeny bit more for a couple of cycles (a fat 2.5), then a bit more than that (a skinny 2.75), and finally the 2.75. On the spreadsheet then you would type it in as 2.5F, 2.75S, and then 2.75.

    And as Kris said, it is always up to you if you want to try this or not. You know Goma the best, and we are always here to support you and walk with you no matter what decision you make. I definitely believe in mama-sense/papa-sense and will trust that you are always making the best decision.
     
  41. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Understand and appreciate the explanation/rationale. I'm just not that smart... - tonights pmps is 583 (I took four readings (poor Goma) since I now don't trust the meter I am using. (I have ordered another for backup anyway) I got a 583, 536, 389, 601. Going with the high 500 (583) which was the first reading, the 389 was probably from blood that had set for a minute or so. I will probably not test again until 8 - 9 hours have passed. Please address the time to increase when it appears most effective. She is still in the middle of this bounce apparently.
     
  42. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    As I mentioned to Kris, I appreciate the thorough explanations and rationale but unfortunately I just don't have the smarts to analyze the way I used to. Today's pmps was high at 583 so the bounce continues apparently. I have already taken a good look at the syringe to figure a likely point of 2.75. As also mentioned, if it isn't too much trouble, since you all are monitoring, let me know when it appears most appropriate.
     
  43. Rachel

    Rachel Well-Known Member

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    It's nothing to do with being smart! We've been here for years and studied thousands of spreadsheets...and over time we've developed a better sense of patterns and what kitties usually will and won't do. Also, it's a lot easier to look at someone else's SS and discern patterns...when it's your own cat, it's harder since you are so scared of making a wrong decision. Even after I started to feel comfortable with making my own decisions, I used to come on here daily and ask what others thought. I didn't want to make the wrong decision and I was always afraid I wasn't reading the data right.

    We're here and happy to help!
     
  44. Critter Mom

    Critter Mom Well-Known Member

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    @scs islander -

    How is Goma's appetite, and how is her weight?

    In particular, does she need to gain weight?

    If yes to the previous question, is she very underweight or slightly underweight? (Body condition chart.)


    Mogs
    .
     
  45. Critter Mom

    Critter Mom Well-Known Member

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    It really helps to have a good sounding board, Rachel. :)

    (No pun intended! ;) )


    Mogs
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  46. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Hi. Just a comment.. The AlphaTrak is the most accurate meter you can have for testing her. I am glad you explained that the 389 was taken on 'old' blood, because that would have been the only reading out of the four that I would have said was way out of line. Having a backup meter is a great idea though!

    For what it's worth, I agree with the other ladies. I would increase the dose. I would do it at an AM dosing just because it is easier to monitor more during the day time. And, I would probably just go to a 'fat' 2.5, putting the plunger of the syringe just over the 2 unit line. My baby was a bouncy ball for months, and I found that very small dosing increases held consistently for several cycles worked best to calm things. It's so good to see Goma's progress. I know you are a ball of nerves and probably cannot appreciate it as much as we 'outsiders' can. :)
     
  47. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Also, I am unsure why she continues to bounce when she has been at the same dose for a long time now. That is what I meant in the other thread about not getting it...I just can't seem to even express correct thoughts now.
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, to fat and skinny doses for bouncy cats. I do it all the time with my rubber ball of a kitty. If you have half unit marks on your syringes, just nudge the flat top of the plunger up to but barely touching the bottom (relative to the syringe needle) of the 2.5 u line - no daylight between the plunger top and the 2.5 u line. You'll get good at these over time.

    As Rachel said, it's nothing to do with being smart and everything to do with looking at many, many SSs. ;)
     
  49. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Dynamic, not static ... living systems are complex and insulin is part of one of the most complex systems in the body, the endocrine system.
     
  50. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Her body is used to consistently very high numbers. Relatively speaking, she has spent very little time in 'good' numbers. She is not used to those numbers. You can see on the spreadsheet that a bounce happens every time she hits the blues. She then goes high and stays pretty flat in the pinks for 1 to 2 cycles. At least it is only 1 to 2 cycles! The more she gets into good numbers, the more used to it she will become, and the bouncing should calm down.
     
  51. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Goma has a great appetite - Ravenous actually - Her weight now is about 6.6 lbs (3.3kg). When I brought her home from the vet she was 2.23 kg (about 4.4 lbs). She was a 1 on the body condition chart. I now put her at a 3. I am actually glad you asked because I am becoming concerned that I am overfeeding her and could be contributing to the problem and not helping. All she gets is the export version of ff (mon petite) pate and 20 grams of hand ground chicken that has been lightly boiled in plain water. Initially the advice was to let her eat as much as she wants. She'd eat all day I think if I let her. But I do ensure no food 2 hours before amps and pmps.
    To answer the question, I think she needs an additional kg to be ideal.
     
  52. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    But you do have to know what you are looking at...Some day there will be an idiots guide to all this and I'll be first in line.
     
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  53. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    I guess it goes with the saying I can't see the forest for the trees.
     
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  54. FurBabiesMama

    FurBabiesMama Well-Known Member

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    This is great! :joyful:
     
  55. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    May I ask how you prepare the home-cooked chicken breast and bone broth? I have been making 20 gm balls of hand ground chicken from breast meat light boiled in plain water. I'd like to come up with more variety for her.
     
  56. FurBabiesMama

    FurBabiesMama Well-Known Member

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    I cook the chicken breast like this (except no salt and pepper): https://www.thekitchn.com/how-to-co...ry-time-cooking-lessons-from-the-kitchn-36891
    Here is info on bone broth: https://healthypets.mercola.com/sites/healthypets/archive/2013/12/02/pet-bone-broth.aspx
    I put chicken drumsticks in a stock pot and barely cover with water then add a couple of tablespoons of apple cider vinegar and let it set for maybe 30 minutes. Then, I simmer it for about 24 hours. I have to add a little bit of water at a point or two during that time, but never more than just enough to keep the bones just barely covered. Once it is done, I strain out the bones, meat, skin with a colander. then pour it through filter to make sure there not any tiny pieces left in it (I use a permanent coffee filter.) As it cools, I skim the fat off the top. I freeze it in ice cube trays so it will stay fresh longer. I keep a Ziploc freezer bag with the cubes in it and can pop one in the microwave anytime I need some.
     
  57. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Oh, and... I keep a chicken breast in the refrigerator. I tear off a chunk and microwave it just a few seconds then hand shred it when I want to give them some. I keep a few cooked breasts in the freezer so that when the one I am using starts to run out, I can pull out another.
     
  58. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thank you so much for sharing this. I am going to give it a go when the dust begins to settle. What happens with the meat? (Obviously I am not a cook either)
     
  59. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Be sure to watch the video about making bone broth. You definitely do not have to use whole drumsticks with meat on them, I just do because it is easier for me. In the early stage of cooking, just after the meat is cooked, I pull some out to give the girls as a treat, but once it gets past that point, it gets nasty. Once it is done cooking, I just strain everything, including meat, out. My way actually wastes a lot of meat.. again, this is just easier for me.
     
  60. Critter Mom

    Critter Mom Well-Known Member

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    Great to hear that Goma's regaining weight and has a good, strong appetite. :) (Anti-jinx!)

    The general rule is not to restrict access to food if a diabetic kitty needs to regain weight, with the exception of the two hour period before each preshot test. If a kitty isn't yet regulated it can't make full use of the food eaten so while Goma still needs to put weight on you should have no worries about overfeeding her. Just monitor her progress against the body condition chart and check her weight regularly. When she gets back to ideal weight you can gradually reduce the amount fed to a maintenance amount. Indeed, as her regulation improves you'll most likely find that the ravenous hunger (polyphagia) will reduce as her body starts properly utilising the nutrients she consumes.

    As Goma's weight gets back to normal there is a possibility that it might help make her a little less bouncy (her system will be more resilient). Time and testing will tell. :)


    Mogs
    .
     
    Last edited: Jan 16, 2018
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  61. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    I sincerely appreciate all the information and guidance you and everyone else is providing to assist me in the decision making process. Someday hopefully I will figure it out and maybe even be able to help someone else.
     
    Last edited: Jan 17, 2018
  62. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Well, will you look at that green?!! How did you feel when you saw it? :);) Certainly no need to change the dose right now.
     
  63. Djamila

    Djamila Well-Known Member

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    Goma! Look at her go!!! :D:D:D Goma says, "No thank you, on that increase. I can do it myself!" :cat:
     
  64. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Surprised I readily admit, a bit worried, and then ecstatic. Was satisfied with the blue later on and am hopeful for pmps in about 45 minutes.
     
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  65. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    She had a really good run this go around. From yellow early this morning to pink (amps) to green to blue. However pmps is back to black. Took three readings again because she was just acting so darn playful (which is a complete turnaround), I couldn't believe it would be 583. Second reading reflected 489 and third 544 which is what I am recording. Gave injection so I am hoping once it takes hold, she will once again get some low, soothing numbers. Apparently the bounce continues. But I am grateful, as I am sure she is, now for the longer period of rest her body got. This really is a totally different cat from a month ago. Wish I could figure out what is going on in the afternoons.
     
    Last edited: Jan 17, 2018
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  66. Djamila

    Djamila Well-Known Member

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    I would expect she will stay a little higher this cycle since she isn't used to those green numbers yet. Don't worry though if that is what happens, that's just how this works. She'll show you more of those nice healthy numbers soon enough. I'm so so so happy to hear that she's playing and feeling better now! Sleep well!
     
  67. Greg and Goma & Friends

    Greg and Goma & Friends Member

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    Thank you for the reassurance that all remains ok. Now I think I will sleep better. Hope you have a great day.
     
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  68. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    Happy dance for the 79! :D
     
  69. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Repeat this to yourself any time the meter gives you a high reading. ;) And give yourself a big pat on the back for doing such a great job of looking after her. :)

    After the nadir this AM cycle I had a suspicion that Goma would do a bit of a ...


    [​IMG]


    Your girl did not disappoint me. :rolleyes:

    ;)


    Mogs
    .
     
  70. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Remember that time in those healing numbers is good and allows her pancreas a break...bouncing is unfortunate but exactly what we all expected...and it doesn’t take away from the good numbers earlier!
     
    Critter Mom likes this.
  71. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    You're doing great and she's doing great! Seeing a happy kitty is your reward for all this. :smuggrin:
     

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