Possible bounce. Lower dose?

Hi. We have been doing our first curve today, and the numbers have been wacky. I posted on the main forum earlier, and it was suggested that Mia might be bouncing. If the upcoming PMPS is lower than +10 was (which was lower than +8), this is really going to look like a bounce. So.. I have come to the ProZinc experts for dosing help. The vet has me giving 2 units daily, but I think she should not have had me jump to that (from 1 unit). So, for her PM shot, should I go ahead and drop? If so, should I drop to 1.5 or lower? (I have the syringes that only have whole units, so I would be going by sight for the .5.) I do not have a lot of data yet since I just started home testing a few days ago, and I do not want to 'mess' with her dose if that is not appropriate, but this curve looks wrong.

Any advice anyone can give quickly would be appreciated since I have to make a call on this in less than an hour. Thank you.

 

tagging a couple of members that are experienced with Prozinc. Hopefully they will be on before you need to shoot


@Yong @Kris & Teasel

 

Thank you!

 

It's very hard to say. The curve numbers look like bouncing. Why not try eyeballing 1.5 u tonight and tomorrow to see if that calms her down. It certainly won't hurt her.

 

Thank you. That feels like the right call to me, so appreciate having someone with more experience confirm.

 

PMPS = 378; gave 1.5 unit
+6.5 = 348

I do not understand why it did not drop more than that.

 

Don't worry. Bounces can take a few cycles to clear and kitty's body is still getting used to the extra hormones. I know it's hard and we all want our kitttys to be stable right away, but just give it time.

 

AMPS = 456

'Don't worry?' I am afraid I am failing at that, miserably. I have been reading about Somogyi effect and can see why you suggested that this was a bounce. It was just so unexpected and rather an odd coincidence that our first curve just happened to start at the point it did. I hope dropping to 1.5 is low enough.

I get more angry at the vet every day. I can see why so many people here have taken matters into their own hands. I just wish testing was not so 'traumatic' for Mia. She was already a skiddish girl, and this makes her more nervous. Also, even though I know it is for her good, I feel terrible every time. Her poor little ears are red around the edges. I was able to get a good look at them in the sun yesterday, and I am hitting in the 'sweet spot' with my tests, so I do not think I am doing it incorrectly, but they look pitiful.

 

I know, it's so easy for us to say Don't Worry! It's harder to do. Trust me, I know!!!

If dropping to 1.5 isn't enough, we can go lower. We've done it before, and we can do it again if needed!

Do you have a testing routine down? Do you give bribes...er...treats every single time? Do you use neosporin (gel, not cream) on her ear? I know it's tough and upsetting, but they really get used to it. Gypsy used to come racing into the kitchen when she heard me pick up the lancet box...trust me, she wouldn't if it was bad! It really shouldn't hurt much...from what I understand they don't have very many nerve endings at the edge of their ears, so they feel pressure but not much pain. If you give us some details about your testing routine we might be able to help you figure out how to make it less upsetting for her.

Is there anything we can do to help? Even if you just need to vent, we're here for ya!

Here's something you can read that might help you feel better: Dear Mom. I've had to read it many times!

 

I started a previous thread about testing.

Thanks for the link. That is probably pretty accurate.

 

Ouch! Yes my kitty's ears looked a lot like your description-and are probably sensitive. Poor girl. to give them a break I used the whole length of the ear. You don't just have the tiny bit at the top you can use, you can use both sides from just the little fold right over to the other side.
I also found it really good to use a round make up pad and then hold it firmly between my finger and thumb over where I poked to cut down on the bruising. And I do think your kitty's ears sound bruised just like a Tempests were, don't panic! You will get better at it and I don't even leave a mark now when I test.

 

I also use more length of the whole ear and not just the sweet spot . I've also noticed that it seems orange and buff orange kitties seem to bruise more easily. I think of it like fair skinned people, like the Irish . They're more likely to bruise more than a darker skinned person who has thicker skin. Seems a little true with kitties, white and oranges are fair skinned and thinner skin . I could be completely wrong, of course! But I really feel like I hear about more lighter kitties who bruise easier than the darker ones. In addition to the Neosporin, firmly hold the poked spot between your fingers and thumb for a few seconds

 

Teasel's ears are white on the outer edges and they do appear pink when I've had to do a lot of testing. I put some Polysporin (I'm in Canada) with pain relief on occasionally. I always apply firm pressure to the poke spot after testing. I don't like doing anything to hurt him but in my mind I know I'm doing a really important thing that keeps him safe.

 

Hi. After the curve on Sunday, I dropped Mia's dose to 1.5 that evening. Yesterday, I only got pre-shot tests and both were high, in 400s. This morning, her AMPS was 286 (which I liked better) but her +6 was higher at 371. Does this still look bounce related? I plan to hold at 1.5 units and see how things go this evening and tomorrow, but I am open to feedback.

I want to add that I feel slightly less horrible about the testing.. slightly. The last couple of times, she seems to be bleeding better (as you all said would happen), and I am getting a little more confident about the way I prick her.

 

I just gave Mia 1.5 u. This will be her 6th cycle on that dose. Her numbers remain fairly high and have been pretty flat the last several tests. The ProZinc protocol says to consider a dose increase if that occurs, BUT I know that if she did have a bounce, her numbers will be odd for a few days. I want to give her system a chance to level out, so I think I need to keep at 1.5 for now. After today, it seems that it will have been long enough that the bounce should have cleared (everything I have seen says up to 3 days). So, maybe I will need to adjust the dose if this keeps up? I am scared to go back to 2 u, and I cannot really do between 1.5 and 2 with these syringes.

If you experienced folks (@Yong @Kris & Teasel and/or anyone ) would take a look at her spreadsheet and give me your thoughts, I would greatly appreciate it. Thank you.

 

I think she could use a little bump up in her dose. Her numbers are high enough that you can try 2.0 u but I'd look for some syringes with half unit marks if possible. If you can't find U40s with those then switch to U100s and the conversion chart to dose. You'll have tons more options in fractions.
http://www.felinediabetes.com/insulin-conversions.htm

 

Even with that nice cycle overnight of 28 July, that blue still had some wiggle room. If you are not comfortable trying the 1.75U on your current syringes, I agree with Kris that she's probably OK to try 2.0U again. You've got your testing routine in play now so you're keeping her safe

 

+6 was 140 WOO HOO! I think I will stick at 1.5 for a bit since things are finally moving.

 

I really do not understand these numbers. We were finally back to the expected pattern of pre-shot being higher then mid-cycle lower. The numbers were still staying too high though, so for her evening dose, I bumped up to just barely under 2 u. Just checked her +6 and it went up from PMPS rather than down. What am I doing wrong? (Should I have posted a new thread instead of using this one? Is this the right place for this vs the main forum?)

 

I'm pretty sure someone with more experience than me will jump in but to me it looks as though when Mia hits a blue her body really isn't used to it and she bounces. I think in time and as she becomes more regulated you will get better numbers and more yellows/blues and everything will become more stable. I don't see anything to worry about, but I do get it's frustrating when you want to see results.

You are doing extremely well, all you need is a little time.

 

Looks like bouncing to me too...that high flat cycle is a classic sign of it.

 

So, was I right to move her from 1.5 to just under 2 or should I have held at 1.5? Determining dosing is hard when the things I read say bouncing can mean either the dose is too high or it is too low.

 

Eh. Bouncing is HARD to dose on. Generally speaking, bouncing doesn't mean the dose is too high or too low. All it means is that the dose that day dropped the cat lower than she is USED to. We've seen bouncing when cats go into yellows if they're sitting in reds or blacks at preshot.

With bouncing, it's best to increase based on your nadir numbers (and only count those numbers that don't seem high and flat). I think I would have increased only by 0.25 though. You want to see if you can calm the bouncing some by doing much smaller increases. Do you have u100 needles by chance? You can dose in much smaller increments with them.

Bouncing is unfortunate, but it happens. We've had some SUPER bouncy kitties on here. I think I may have told you before, but we had one cat a few years back who bounced for over 2 years...then one day, he started heading down the scale and bounced his way right into remission! So it can happen.

 

As the parent of a very bouncy kitty I learned to look almost exclusively at nadir BGs over several cycles to evaluate a dose. Yes, the BGs were often complicated by bounce numbers but I learned to look past them - not easy but lots of data helps.

 

I agree with the others, looks like she's bouncing from those blues that her body isn't used to seeing . If you gave just under 2.0U, you can mark that as S2.0 in the units column which is what we call a skinny

 

Thanks, I was not sure how to mark that.

 

We were at 1.5 and now I am doing just under 2, so I am thinking that probably is pretty close to 1.75ish. I do not have u100 needles, but it sure is looking like I am going to need them.

No, please..just, no.

 

That was meant to be comforting. Usually it's not NEARLY that bad. Cass is remembered because he was such a different kitty for all his bouncing...but honestly, the bouncing can smooth out over time. And you learn how to adjust doses for your particular cat with any bouncing that does occur. It's not that surprising to see her bouncing at higher numbers. Hopefully she'll smooth out as she moves down.