Re: 6/16Max AMPS 359 +10=114 PMPS 134
Elise
Well I am frustrated because I wrote you a long post this morning after the initial one I did and I'm not seeing it. I was having board problems this morning but I was sure it went through. Guess I should have looked back on your condo to make sure. I'll try to remember what I said.
So I need to see the bounce cleared before I increase, right?
I guess I wasn't very clear and I'm sorry. For someone who is experienced as you are, tests a lot, and can manage low numbers, you don't have to wait for the bounce to clear to increase the dose. What I didn't do a good job of saying was that if you increase the dose before the bounce clears, you'll need to really watch him closely because bounce clearing cycles can get quite active + you would then have extra insulin on board. I've had this happen and it's nothing you can't handle but you should just be aware bounce clearing + dose increase cycles can run low.
So how do I keep him from diving?
This is the challenging part. Especially because patterns can change the longer they are on a dose. But I'd start with looking very closely at his SS. Look for patterns on when he clears bounces. Is it overnight? Is it every third cycle? Is there a clue that he's going to clear such as a high before a break? If you can spot any of these patterns, then the next time you think he's going to clear a bounce, test a little more.
Test every half hour and feed if going down? I know it will be trial and error but what is the maximum point drop I should try to avoid when I start this?
Again, a challenge. No one wants to test every half hour if he's in the 300s or high 200s but for our champion divers, some of them can drop 100 mg/dL an hour when clearing a bounce. And I also think it is an ECID thing for what kind of drop causes a cat to bounce. For example, if I test Gracie at AMPS and then at +2 and she's come down more than meter variance, I know she's going to have an active cycle. So then I might test at +3 to see how much she's coming down. Let's say she came down 60 mg/dL in those two hours. If I test at +3, then I know how fast she "might" have been coming down. Maybe it was 60 in one hour. If she's 150 or below and coming down 30-35 mg/dL an hour, I up the carbs to a higher low carb food because that's fast enough to trigger a bounce in her. If she's coming down faster, I'll feed something a little more substantial even at the risk of keeping her higher. A good example is yesterday morning. She was at 172 at AMPS and 107 at +2. I gave her a good portion of 10% (trader joe's) because that's actually my big gun for her. It brought her up to 117 which was ok because then she was ready to onset at a higher number and when she did, she came down more slowly.
Unfortunately, the biggest challenge is learning what works for Max. It took us a long time to figure it out for Gracie and find the right food. And then after a year, that food started making her vomit. So we went through a difficult early spring trying out a lot of different foods until I found the TJ's food.
:lol: :lol: :lol: I just read Julie's post about arm-wrasslin'. So on the dose......as I said the other day, you have to decide how aggressive you want to be. Raising the dose with
a nadir in the 50s is very aggressive. So it has to boil down to how aggressive you want to be. You have the experience but I want you to make the decision because you are doing this alone. I don't want you to have a cycle where he's clearing the bounce and he's got extra insulin and you are fighting him all day long just because I suggested you raise the dose. It's absolutely fine to leave the dose and let the numbers come to you. You have to be the one to decide. I do tend to be more aggressive with Gracie because Mike is here 1/2 the time and he's an enormous help. There are two of us to manage any low numbers and two of us to discuss the best feeding strategy. So think about it, look at his SS, and decide what
you think is best and you can handle.
FWIW, I agree 150% with Julie on the YA. I do not believe any dry food is zero carbs. And you have no idea if that is the as-fed or DMB. I liken it to labeling of trans fats. Any food with less than 0.5g of trans fat can say it has 0. But it doesn't. If I had an anorexic cat and all it would eat was dry food, I'd go for the YA because it's probably lower in carbs than any other. If you can be a bit patient, I might try getting rid of the YA in his diet first before I fatten the dose. See if that is the problem. (Of course, if you've been feeding it all along, it probably isn't).
Does all that make sense?
