Steve and Blue said:
What I meant about this 'route before' is when Blue was fairly low on the 28th of March and I gave him a full 3.0U dose which kind of bottomed him out that night. A few nights later the same thing happened but he didn't quite bottom out - but had some low numbers.
Ahhh, that route. One thing we often tell newbies is to start with a no-shoot of 200. Once you have some data on that, then you can move it down to 180, and with more data and comfort level you can lower it to 150. The difficulty comes in with ketones. Taking the slow & patient route is great, but if you have a ketone-prone cat you probably want to be more aggressive.
I like aggressive, but as mentioned some of those lows can make you lose some sleep!
Ultimately you are the holder of the syringe, so you have to do what feels safe to you. With Bix, I undershot many times, and when I got a lower PS I would reduce the dose WAY down. Then when his #s were sky-high after that
, next time I wouldn't reduce that far. Everyone was telling me to shoot more and I'm sure rolling their eyes at my timid shooting, but it was what I needed to do, so that's what I did. Thankfully Bix has never had ketone issues, or even really bad symptoms from the diabetes, so I had the luxury of doing that.
Tested Blue twice the last 24 hours - Ketone free! Right now Blue is as active as he has been since returning home from the emergency center.
Under this circumstance I'm shooting him another 1.2U at four hours past his regular AMPS - and hopefully I can get back on the usual schedule this evening. He was at 266 when I shot him. I was going to go more, but that big drip a few days ago is still too fresh. Don't want to risk hypo and/or rebound right now. I'll probably get more agressive next time.
I advocate for more aggressive dosing now because I learned from experience that the big reductions were counter-productive. But on the other hand, with the exception of during the switch to low-carb food, I never actually had doses that were too high, I was just scared of the low PSs.
Not sure what my point is :lol: except that there is no shame in lowering the dose to one you feel safe with, even if you suspect it won't be enough. Then you get some data, prove to yourself what works or doesn't work, and then use that knowledge to decide next time.
Yes those fluctuations have me second guessing - being conservative for right now. You have some good points in there. ;-)
I'm certainly no dosing expert, just like to share my long-winded 2c
. Honestly the cats I've seen do best here are the ones where their beans shoot on the aggressive side rather than on the timid side, which is one reason I've taken to giving more aggressive advice (combined with having followed along with some DKA crises that in some cases ended badly). I wouldn't take the hypo risk lightly, but I also wouldn't suggest that anyone repeat what I did - live in daily terror of it :lol: - and undershoot consistently.
I think I would have shot higher the last two times if that rebound thing hadn't happenedl. Don't want to go there again so quick.
He has never shown any clinical signs of hypo. Reading Dr. Hodgkin's Protocol she mentions that cats on this diet are much less likely to hypo. Is that pretty much the rule unless you vastly overdose? Also, does that protocol hold true for the current form of non-bovine PZI?
I've never really understood that, and I agree about not putting it to the test!!! Without a vast overdose though, when there is some degree of overshooting, cats seem to do just fine when their beans can manage it with feeding small amounts and testing until past the danger zone of peak/low #s. I wouldn't suggest anyone do it intentionally, but I wouldn't have a big fear of it either. Someone recently mentioned their civvie tested at 40-something (!!!), so it's hard to really know what #s are truly hypo. That LO you got is d*arned scary, but the upper 30s might just be borderline scary.
I usually shoot with a nadir in mind, and aim for the dose that I think will give me that nadir (I like 60 - good #, but some margin for error there). To some extent with PZI you can evaluate doses by the % drop from PS to nadir. With Bix, I liked PSs around 150 and nadirs around 50% of that. If the PSs were too low or the nadirs getting lower I would lower the dose a hair, if things started creeping up, I would raise a hair. He was more consistent though in his #s than most cats, so I guess I had it easy.
Nice numbers, I'm jealous.
I really hate to take away any progress at this point by changing doses and times, but what other options do I have w/o risking very high numbers overnight?
You won't lose progress necessarily by changing doses & times. Where you might lose progress is if he stays in high #s for a few days, it seems to get harder to get things back under control once you lose it. I wouldn't worry too much about 1 night of higher #s. I don't want to say anything that might jinx things :mrgreen: but my suspicion is if you can keep him in good #s for a few days you will find that his pancreas is helping out - it looks to me to be sputtering, but I'm definitely not an expert.
Sure glad i didn't up his dose this morning or there may have been some real drama around here - pays to be patient sometimes!
