With TR, how do you determine the nadir when your cat bounces a lot; if nadirs in each cycle are way different for more than the recommended cycles?
I think there's a common misconception abut nadirs lately... "nadir" is how low the dose takes kitty.
One will not see a true nadir every single cycle when a kitty is bouncing. The cycle in which kitty drops lower than the other cycles is where you'll see a distinguishable nadir. Then the wave repeats... high (bounce), crest of the wave (flat high), breaking of the bounce (wave dropping), drop to low... and repeat. These waves of action initially last 3 days or 6 cycles. Eventually, when kitty becomes tightly regulated, the bouncing stops and cycles become rather flat with barely a discernible nadir.
IMHO, caregivers should pay less attention to each and every cycle and pay more attention to "waves of action".
How do you determine when it's time for an increase in that case?
Initially, for reasons of safety, you'll want to wait for the bounce to break before increasing the dose. Once you've collected enough data to understand how one's cat responds to the insulin used, one might increase prior to the bounce breaking if overall the range is too high. For example, if kitty remains in high numbers (200s, 300s or greater) why wait around for the bounce to break before increasing the dose because you already know kitty will require more insulin? However, one thing you don't want to do is increase the dose when the bounce is breaking. The reason is when the bounce is breaking there's already momentum created. Add more insulin to that slide to lower numbers and kitty might drop harder and faster than you had planned.
Is it better to use the go slow method for a bouncy cat?
In a word, no. In most cases it requires more insulin to lessen or stop bounces. Holding doses for longer periods of time opens the door for
glucose toxicity to set in. The guidelines in TR generally allow for dose adjustments every 3 days (6 cycles)... less chance of glucose toxicity setting in.
Recommended reading:
Cat on a Pogo Stick Discussion: Increase, maintain or lower the dose to stop bouncing?
I am using AT2 meter with an approx. 30 diff from human meter.
Don't count on there always being a 30 point difference. The differences between a meter calibrated for pets and one that's calibrated for humans is smaller at lower ranges and greater in high ranges. You'll find using "30" across the board is not accurate. When using an AT2, the number you'll want to be concrened with is the reduction point of 68.
I try to use 70 for decreasing.
68 is the BG number recommended for taking reductions when following the TR Protocol seen on this forum by Dr. Jacquie Rand. Dr. Rand is one of the top researchers in feline diabetes and was also instrumental in getting the TR Protocol published.
This morning, Andy went from 80 to 102 within 1 hr. He could have dropped below 70 or just bounced - how would I know?
Don't concern yourself with "could haves". Look for what happened... be on the lookout. Catch it the next time around.
Should I be testing more often after a certain # etc?
Personally, I tested more often if I was looking at a fast drop or lower numbers... initially less than 100... gradually down to 60 - 70... eventually I felt comfortable going to bed or going out in the mid-50s, but that took some time and after some heavy-duty data collection. As you collect more data, you'll have a better idea of when and how often to test.
ETA: I am so slow at typing!!! Wendy said much the same in fewer words!
