Here in SoCal a drive-by has a different connotation. :lol:
OK the feeding thing is making a little more sense [to me] with the addition of the hoover civie. Just keep in mind that I'm coming from the perspective that my less-worries about low doses is
if the cat has food available. I had a feeling that the more carb thing would ultimately just push the numbers up for you - but only because you are at such a low dose and so close to the cusp. :smile:
On the goals thing I might have a multi-part for you on thins but I'll just share what's running though my head now.
The ultimate goal is important. But what is your current goal? If you had a goal to achieve tomorrow what would it be for him? Surely it would not be to keep him below 130? Between 130 and 80 are pretty tight tolerances for one the Ls let alone PZI.
What I usually recommend [and try to set for myself] are 'achievable' goals. Not say you can't achieve your ultimate goal but I'm the type who like to put one foot in front of the other rather than making the big leaps. I think this kind of goes back to my idea of "marginal improvements" too.
So this is what I suggest to help you get to your ultimate goal:
In your case, maybe pick a number like 190, 180, 170 or even 160 and see what kind of success you have with that - just keeping him blow a number like that. Don't freak if you cross your short term goal numbers - life happens and you will gather data and learn and be better the next time around. But what this will do is help you get more aggressive about numbers as he starts to go up. Then you can move that number down [perhaps in multiple steps] as you gain more confidence.
When I was working with H I kind of a multi-tier system set up. I had a "hard" ceiling I set of 300. So as those numbers started to go up and approach 300 I would get progressively more aggressive. I broke though 300 on a number of occasions but when I did having that set ceiling also helped me be more aggressive about getting the numbers back down. And when I say "aggressive" I'm talking more about making sure I was raising the dose [usually in smaller amounts] as the numbers went up - not making large increases in dose. If you are changing the dose every cycle you can get the dose up fairly quickly over a number of cycles.
Then I also had a soft ceiling of 200. My ideal was to keep him below 200 if that could work out. Occasionally when things were going right I set a super-soft ceiling of 150-160. :smile:
Dealing with H was different than many cats as he had appetite issues and we could go from eating great in the morning to full on multi-day food protest for days. So the insulin thing was a bit more of a roller coaster.
As for the low numbers and the yowling. Some cats just yowl. Some cat DO yowl when they are in hypo but yowling does not automatically = distress or hypo. It's kind of an ECID thing. I think it might have been you that said they tested their civie and it was like at low 40's? Whoever had that recommendation - that was golden. I think that will help you have a better idea of the "normal" and perhaps give you more confidence at the low end. 60-something is a great number if you can hit that every day and not end up having to intervene. But again we all have our personal comfort level and need to make the treatment work in our own lives as well as for the kitties.
I'm very happy that you are doing ".05u" increments. This is a big deal especially at the doe ranges you are in and will help you not make changes that get you into see-saw territory. You can make bigger changes if you like or you feel needed but just having that in your tool chest is a good thing. :thumbup
As for the home cooked you can read about it
here. If you want more help with it I can provide. I ultimately did not go with Dr. Pierson's recipe mainly because the nutritional values are unknown and as you know I'm a little "detail" oriented. :smile: Also the raw with bones diets tend to be higher in P but Dr. P's recipe tries to deal with this but again the ultimate nutrient breakdown is unknown. That said, many cats [including her own] supposedly do well with it. One could take the approach I took with the cooked and use raw instead which would cut down the time to prepare it by a whole lot. And one would not have to de-bone chickens either which is a major time issue with the raw with bones methods. Anyway, this is like one of my fav topics so I'll be happy to add more if it is something you are really interested in. I'm always trying to get people to switch over to the dark side and start cooking for their kitties. I just suggest reading as much as you can get your hands on about feline nutrition. You seem to be the investigative type so that's good. I put some links in the PZI sticky that are good detail-oriented nutrition links. I've thought about buying the SACN 5th ed but I don't see a super cheap used price on one that I can be confident is the 5th ed on amazon.
Seriously though I'd say keeping him under 160 is a soft goal and under 200 is a hard goal. At about 160 is when the diabetes symptoms (PU/PD, anorexia and sprinting around the house to lower BG) return in him.