? Insulin Rebound?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Jasper Blue and Jay, Apr 11, 2019.

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  1. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    insulin rebound extreme fluctuations in blood sugar levels owing to overreaction of the body's homeostatic feedback mechanisms for control of glucose metabolism. When exogenous insulin is given, the hypoglycemia triggers an outpouring of glucagon and epinephrine, both of which raise the blood sugar concentration markedly. Although the patient may actually have periods of hypoglycemia, urine and blood glucose tests will show hyperglycemia. - taken from https://medical-dictionary.thefreedictionary.com/insulin rebound

    Does anyone who has done a lot of reading on insulin rebound know what this means?

    "Although the patient may actually have periods of hypoglycemia, urine and blood glucose tests will show hyperglycemia."

    My cat has been constantly having symptoms of hypo but his numbers are never that low when I test him. I decided it was just his body reacting to the insulin kicking in because it's usually around that time, or nadir.

    But now I'm trying to figure out what this sentence means...are they saying that while in a rebound the blood glucose tests could show higher numbers than they are? I think I'm reading too much into it... perhaps they mean just ...overall... the tests will show hyperglycemia... it's just confusing because the language is;

    Actually = hypoglycemia, "tests will SHOW" = hyperglycemia.

    Which leads one to believe... what is ACTUALLY happening, is hypoglycemia, though the tests will SHOW hyperglycemia...

    I'm going to keep reading on it.
     
  2. Jasper Blue and Jay

    Jasper Blue and Jay Member

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    Mar 15, 2019
    Another page says this:

    "The pet may be a bit less responsive to the same dose the next shot, from those other hormones"

    and

    "Repeated overdose with long-acting insulins can even cause high, flat numbers all day long."

    Which would make it *seem* like more insulin is needed...when it's not.

    https://petdiabetes.fandom.com/wiki/Somogyi_rebound
     
  3. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    Hi,
    I think it just another way to talk about bouncing.
    you guys had low 53 number (which is not Hypo, btw) on March 29 - at amps +7, then 84 (super nice) at +8 and by +11 he was above 200 - started to bounce because his liver got scared by the 53 and produced hormones to counteract (perceived) Hypo. Jasper stayed in Green for a couple of hours (as they put it "period of hypoglycemia")- but If you took his urine sample at +7 BG 53 you most likely would get High glucose in urine - a Hyperglycemia symptom. The "Hypo" period was too short to stop Jasper throwing glucose into the urine. It takes hours to clear the urine off glucose.His BG went up pretty quickly and you were getting high BG test by +11 - another Hyperglycemia symptom.
    IMHO That's how they come to say that even if cat periodically reaches low numbers for short period of time it is counteracted by such powerful mechanisms that the cat appears to be Hyper all of the time regardless of reaching low BG level.
    Does it make sense?
    I am not saying that my cat is overdosed exactly...but she has a lot of Hypo like numbers and then bounces and goes high and often flat and then clears the bounce. If she is overdosed just a little it does not make her always high flat.
    Take a look at her SS - I check urine for glucose daily.
    Good example maybe on 3/20: AMPS +9 Negative for urine glucose with BG 177; only 4 hours later PMPS +2 BG just above 200 and the glucose started to pour into the urine and continue so - by the next day AMPS the urine glucose even get higher and 12 hours later - the highest mark on the vial even though BG was only 174 at the time of the test. I hope this helps a little.



    @Jasper Blue and Jay
     
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  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    We call this bouncing. Bouncing is caused by too fast a drop in the BSL, too big a drop in the BSL or dropping lower than the cat has been used to because he has been in high numbers and his body has got used to it. When any of there things happen, the body can panic and think it has to save itself and dumps glucose and regulatory hormones into the system and this in turn shoots the BSL sky high. Bounces can last from 1 to 6 cycles. Is is very common especially in a newly diagnosed cat and there is nothing you can do but wait it out.


    During the cycles following the beginning of the bounce, the cat does not respond much if at all to the dose of insulin but remains high until the glucose and hormones disappear. Some cats only bounce for a short time, some bounce for months and some bounce all the way to remission.

    Yes, we often see high numbers which can be caused by too large a dose. You will see us often saying ‘ too much insulin can look like not enough’ and ‘ we all need to buy patience pants when dealing with feline diabetes’ because it is a marathon not a race
     
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  5. Tanya and Ducia

    Tanya and Ducia Well-Known Member

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    Feb 25, 2017
    And another thing - what's overdose anyway?
    For my dear vet being below 100 on human meter is Karo like emergency.
    He would be too happy to have Ducia BG always around 200 on human meter.o_O I got it - he thinks liability. But I cannot allow it BC as you can see in the SS Ducia throws glucose into urine at BG as low as 170 human meter. I want her always below this level but the vet thinks "overdosed".(That's why he cannot see her SS - for his own sanity sake.) Same thinking type of vets write the articles like you've cited above. :rolleyes: It's tricky act to balance all of it together but you'll get there.
     
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