Just wanted to add a note for everyone (don't mean to pick on you!!!) b/c I see a trend that concerns me. I think we have developed some collective confusion with sliding scales and dose reductions on lower PSs.
Here's how I see it:
The idea of the no-shoot is to set the limit where you make *some* sort of dose change, either reduce the dose for safety & data-gathering purposes, or wait/retest. We suggest newbies (or not-so-newbies without a lot of data on lower PSs) start with a 200 no-shoot as this gives a nice margin for error compared to the hard no-shoot of 150.
So that means that any number above the no-shoot is fair game for the full dose. If we had a concern that the full dose would be risky at something like a 250 or a 300 PS, then we would set the no-shoot there. If the no-shoot is 200, that means full dose on anything from 200 and up, and below 200 is a choice of reduced dose or wait/retest. (Exception is no-shoot of 150 where lowered dose (vs. wait/retest) is *not* recommended unless you have a lot of experience & data and a very predictable cat.)
Sliding scale on the other hand is for cats who do not seem to respond well to one steady dose, or where we can see clear differences in their reactions on different PSs, or where the bean has a scale where they are actually hitting green nadirs on many shots (like Sueandsamwise) and the scale lets you aim for that perfect nadir from any PS while protecting you from overdoing it.
Things that *don't* make sense to me:
- Reducing doses on PSs above the no-shoot, unless you have concluded your dose is too high overall. I've seen reductions lately on PSs like a 210, or wait & retest on something like a 210, and it doesn't make sense to me. The idea of the 200 no-shoot is if you see a 200 or a 201, SHOOT.
- Using a sliding scale when you don't have clear reasons to go that route and aren't hitting green nadirs anyhow.
- Using a sliding scale that is overall too conservative and keeps the cat always in higher #s.
Now all that said, I certainly don't begrudge anyone lowering a dose for safety or for data gathering, and when you have something like tonight's big drop from the AMPS to the PMPS there is some reason to speculate that the dose might be too high b/c that's a heck of a lot of progress in PSs from just one shot.
But on the other hand, I think sometimes people are losing good opportunities by not capitalizing on any breakthroughs or progress, b/c it seems like we are always lowering the dose as soon as we get any better PS. I know that I for one am someone who did that, and I know it delayed Bix getting regulated. He only got regulated once I got up the courage to just shoot the doses & close my eyes and go nailbite_smile . I can tell you I cringed big time the first few times I shot enough insulin (intentionally), and hovered like a crazy-woman, worried I had overdone it. But that's what worked. And no amount of undershooting ever did anything for him.
This is where I think PZI-land really suffers from not having a protocol. The Ls just spell it out for people and so I don't think there is as much "bravery" factor - you just shoot what the directions tell you too. With PZI, somehow it seems scarier I think - maybe it's the bigger drops, maybe it's the lack of a protocol, maybe it's the wonky times when a dose reduction helps and that throws us into that thinking pattern, hoping a reduction will work for other cats too. I know all those things affect me too, not trying to point any fingers here.
Ok, stepping off the soapbox.

Final word, I don't mean to sound critical and I don't want to pressure anyone into shooting more insulin than they feel is safe, NEVER do that! I just want to be sure we aren't underdosing by being overly cautious. With so many kitties around these days with a ketone history, it seems like it needed a little soapbox time.
