Numbers going high for days after going low - rebound?

It seems that whenever Napoleon gets low numbers, his system fights back with high numbers for days after. I don't know what to think - is this rebound? Or just his liver fighting cause it is used to high numbers. If it is not too much to ask could someone take a peak at his spreadsheet linked below and give some insight. I don't know what to do, should I try lowering his dose, should I talk to the vet and have his dose increased? When he goes low he goes pretty low so I am afraid to up his dose for those days when he dips cause I am afraid it will make him crash. This is so very frustrating. He never gets a decent curve 2 days in a row.

 

Here there.

Do you get any sleep? Wow. You guys are doing a bang up job with the testing.

My first comment is that you are going to have to eliminate the crazy things like pancake syrup. Not sure if yours was the one but there was one PZI kitty who's grandmother fed it tater tots which are of course bad. The Pancake syrup made me think of the tater tots. Anyway it is a diabetic cat you are dealing with and their fur brain cannot comprehend the health consequences of pancake syrup - you have to just be extra careful and make sure they are not getting into any trash, dog food, civie food, neighbor's food, bread, pizza crusts, etc. Their DM makes them sugar seeking missiles. BTW the main ingredient in most pancake syrup is high fructose corn syrup which is the same ingredient in Karo which is the hypo toolkit rescue item. All they need is a little on their gums to make a difference.

I commend you going for going with your own gut feelings.

You are shooting under 200. The normal beginner no shoot number is 200. There are techniques for dealing with this like waiting and testing. You should post in the PZI group to get clarification on such techniques. Or there are other techniques related to sliding scale to deal with shooting below your set no shoot number. Anyway, you need to post in PZI to hopefully get input about your no shoot number.

You should also read the Start Low Go Slow literature that is linked in the PZI sticky. When you have a nadir of 57 the idea is that you should reduce your dose. Maybe not reduce your dose by the 1/2 unit it recommends but in your sitch maybe like .25u. There are other protocols for using PZI that you can ask about as well. PZI is so incredibly flexible we do not have a protocol that everyone uses, but we have some sample ones that can help guide your dosing. The SLGS is the primary go to one that most beginners are sent to though.

Overall 3u seems like a little too much to me. It is a useful dose in getting the numbers down but usually when the number start to go lower we back off on the dose a little.

Again, posting in PZI may help get eyes on this. I do not want to say no rebound is going on. Like today 5/13 I would have wanted to see what was going on +1 through +3.

Following along the other topics in PZI from the recent newbies should help a little too. And as always, the squeaky wheel get the grease in PZI Land. Your questions are always welcome there.

I'd really like to get some PZI eyes on your SS for input - especially before the weekend when the PZIers generally aren't watch as closely. As I mentioned to you earlier, since you are using a U100 insulin your ability to make small dosing changes is not as flexible as if you were using a U40 insulin with the U100 syringes. Did I post to your earlier about showing different micro variants in doses in U100 syringes with u100 insulin? I might try to 2.75u and stick with it a little while longer. And the also try to optimize thins by getting rid of the crazy pancake syrup and things that may be adding a little extra unknown to the whole situation - at least while you are trying to get your head around the regulation game.

I forgot if I asked you already if you guys were indoor only or if Napoleon goes outdoors?

 

Curious as to why you began with 2.5U? 1U would be the more appropriate beginning dose.

Gandalf was started on 3U of PZI when we began this journey. Once I found FDMB, I began over at 1U and discovered that approximately 1.5U worked much better.

1.5U is half as much as 3U. Get started on the PZI support group and begin over at 1U with their guidance. I'm sure you will be surprised. The dips you're seeing are typical of Somogyi rebound on PZI. And yes they can remain high for some time after the lows - it's all part of the process to protect the system from hypoglycemia.

http://petdiabetes.wikia.com/wiki/Somogyi_rebound

 

Vicky, this is a kitty with a keytone history. But [I've asked] it seems unknown at what dose the keytones tend to disappear...

Beyond testing for keytones, I forget if I recommended to the bean to get going with the LRS so she could have some extra way to combat them if they did show up.

 

Hi Gator and Vicky,

Thank you for your input. Here are some answers:

Gator - I will definitely post this over in PZI. And I do not sleep very much I will do anything to get this figured out for my little guy so I have been testing early, late and in between to figure this out. I agree about the syrup, we have a rule in this house if there is a dish in the sink it is rinsed completely clean. My husband thought he rinsed it completely, but did not and Napoleon got what was left. Napoleon is an indoor kitty, always has been. I have bookmarked the page for micro dosing you had provided to me also. Thank you for all of your help, it is so appreciated.

Vicky - Napoleon was started at 2U BID with this new insulin. That didn't seem to do anything, same results as with the subsequent higher doses. Maybe we are missing the mark and 1.5 BID will work for him too. He has never been begun his insulin under 2 units, so maybe that is the answer. I just started charting daily will the 2.5U BID.

Thank you both so much again for your guidance ;-)

 

Also not sure at what dose the ketones are eliminated.