Buzz Somogyi effect

This is my first post. My 15 year-old cat, Buzz, has had diabetes for about 5 months. After 4 hospitalizations since December and a seizure, his doctor thinks he has the Somogyi effect. He is on 1 unit of Lantus in the morning and at night. Has anyone had experience with this. I'm glad to be a part of this group.

 

I am not the best member to talk to you about this. But maybe I can help a bit until a more experienced member comes in. The general consensus that I've read on this site is that the Somogyi effect is not actually a thing that effects diabetic kitties. Often, simple bounce is what makes owners and vets think it's Somogyi.

Here's a simplified explanation of bounce. The cat's body is used to running on high sugar levels. When insulin drops the sugar levels, even if they are still high, the liver freaks out. "Help!" it shouts. "Our blood sugar is crashing! Release all the sugar!" Then the liver and pancreas dump stored sugar an raise the BGL high again.

Now, when you say Buzz has been hospitalized 4 times. Why exactly? Was Buzz going hypoglycemic? Blood sugar too low? Did Buzz have ketones?

Are you testing his blood sugar at home? Are you testing before giving insulin? Giving insulin if the BGL is too low can cause a hypo emergency. Have you gotten any mid-cycle BGL tests? If you are not home testing, I can't stress enough how much safer Buzz would be if you do. There's plenty of tips on home testing here. You don't even need a more expensive pet meter. I use a cheap ReliOn meter from Walmart and it works great.

What food are you feeding? Is is a low carb canned food diet, or a high carb prescription dry food?

Here's a link that will help you understand how best to help Buzz.

And here is a great place to start so that members here can help you.

 

Hi Melanie, welcome to FDMB!

The somogyi effect (commonly referred to as bouncing) is very common in our sugar cats, it's their body's defense mechanism to fight low (or at least perceived so) blood sugar. Happens a lot, my own kitty right now bounced last night, came back down, and is bouncing again. You just need to ride it out.

We're happy to help you out with Buzz, we just need his data to lend a hand! Think of it as us looking at his "doctor's chart". Could you fill out this info for us?

Do you home test?
If so do you have any blood glucose test numbers to share with us? Or if you have any from a vet glucose curve?
What brand food is he eating?
What were the hospitalizations for? Was the seizure from a hypoglycemic event?

You have already stated he's on 1 unit of Lantus, thanks so much, that's important information.

 

Well....not quite. Actually The Somogyi Effect isn't what we call bouncing. There was one study done on such a small sample of humans way back in the 1930s, and there haven't been any studies since to be able to replicate his findings. And to make things more interesting, his study was not based on newer insulins like Prozinc, Lantus and Levemir. We do find kitties bounce from reaching numbers they aren't used to, or dropping too quickly, but that is not the Somogyi effect as named by the researcher. The recommendation with Somogyi would be to drop the dose, which isn't what we would do with cats experiencing a bounce. @Sienne and Gabby (GA) knows much more than I do on this topic, but I think I have accurately hit the major points.

 

Hi Melanie and Buzz and welcome.

Somogyi was something that a Mr Somogyi saw in a very small number of diabetic people many many years ago.... I think in the 1930s. It was never proven and was never demonstrated in cats but the myth has persisted.
When a cat reacts by dumping stored glucose and regulatory hormones into the system from to a fast drop in BG or a drop into numbers he is no longer used to, we call it a bounce which can last for up to 6 cycles.
I am very concerned Buzz has had 4 hospitalisations and a seizure since December. That sounds as if the BG levels are not being monitored as they should be.

Are you home testing??
I would STRONGLY suggest you start home testing. It is not hard and Buzz will not hate you.
I am going to send you a link. Within the link you will find a lot of information and further links (food links, spreadsheet link, how to hometest link, hypo information link and others)
Please read it all carefully and print off useful information, especially the hypo information and put on your frig.
Please keep posting. We can definitely help you get sorted. Unless Buzz was sick with another disease he sound not have needed 4 trips to hospital or had a seizure.
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Bron

 

I'd be very interested to hear more about this. Bouncing and the somogyi effect have been used interchangeably regularly here and I haven't heard anything about them being two different things.

 

If I remember correctly @Sienne and Gabby (GA) explains Somogyi effect well.

 

"Chronic Somogyi Rebound," to the best of my knowledge and time on the board were never used equivalently. Somogyi was self-named after Michael Somogyi, MD in 1938. He did a very small study (38 people) who were experiencing lower BG levels at night resulting in hyperglycemia in the morning. A few noteworthy facts. The study was not published in a major journal -- it was published in a local, St. Louis medical bulletin. Thus, the rigors of peer review were likely not met. The study involved humans, not felines. It certainly did not involve depot-type of insulins or the current slate of insulin that is available. This Wikipedia article goes on to cite a study using continuous glucose monitoring that refutes the basic premise of Somogyi. I've also attached a paper looking at whether there was evidence of Somogyi in cats prescribed Lantus. There was no indication of Somogyi. As the Wiki article concludes, there is no evidence to support the existence of Somogyi. I'm always amazed that some smart person hasn't gone back and read the original research and eliminated this from veterinary textbooks. Instead, an urban myth is perpetuated.

 

Interesting. In that case what exactly are vets really referring to when they say somogyi effect? Bouncing? Dawn phenomenon?

This link from FD here talks about somogyi effect and it certainly sounds like bouncing so I can understand thinking the two are the same.
http://www.felinediabetes.com/concurrent-somogyi.htm

I haven't had a chance to read the whole article yet but I'll be sitting down today to read it.

 

@Panic - There are many old posts like the one you linked that need to be cleaned up, retired, etc. It is a huge job and one that Marje, Wendy, and I are trying to pay attention to.

 

Didn't realize it was outdated. That's good to know.

 

Hi Melanie and sugar kitty Buzz!

With 4 hospitalizations and seizures, the possibility of too high of a dose of insulin is a STRONG possibility.
Suspect hypoglycemia.

Could you tell us more please?