reuben'smom said:
We are trying very hard to do everything right; the level of carbs in his food is still too low and I wonder: once they are adjusted would this Be the right dose with the correct nadirs --and maybe I should just Hurry Up already and get that done!? Does that make sense? Alexa&Reuben
Good morning Alexa!
A little feedback, if I may :smile:
(1) You *could* already have reduced Reuben's dose for this last PM cycle. He didn't bounce *right away* and give you a pink/red or even yellow pre-shot (which is *great* progress - compare it to the 8th of September, where he dipped into mid-range greens as well, but bounced into black!) and his dip into sub-50 on the preceding AM cycle would have justified you reducing the dose already.
Please reduce Reuben's dose to 2.0u for his next cycle.
(2) I'm wary of the word "correct" - because as Anne rightly emphasizes, both
nadir and
dose are
"moving targets" in the sense that what was the appropriate dose and visible nadir on Cycle A may be something different in Cycle B, or C, or D... You get the idea. If you can, try to think of your role in treating FD (including figuring out carb percentages, feeding schedules, dosing decisions, SS analysis) as that of an interpreter.
All of us dealing with FD, in fact, are a lot like interpreters. So much is about context. Yes, sometimes a word really means only one thing (the FD example would be, if a cat is in DKA, one MUST ALWAYS take it and treat it very seriously). But when it comes to nadirs, carbs, SS interpreting, well... Let's see if I can give you some examples.
Jill's cat Alex is so super-crazy-carb-sensitive that freeze-dried chicken can bump up her BG by twenty or thirty points - so for ALex, feeding HC for a dip to sub-50 is extra-hyper-overkill, whereas for many other cats, NOT feeding HC with low dips is dangerous and downright wrong.
Marje's cat Gracie has had a nadir at (+10), (+2), (+7) and (+5) on four
consecutive cycles (1-2 Jan 2012). That's why Jojo's mantra "KNOW THY CAT" really is a good one to bear in mind:
We're all interpreters of our cats' FD-Language, and they all speak individual dialects, and we realize and try to deal with the fact that here and there things will inevitably be lost in translation. Yes, (almost) all of us in LL refer to the TR Protocol to base our decisions on. Yes, the beans and cats here share certain vocabulary. But even with the protocol (which consists, notably, of
guidelines rather than immovable rules) words they share ("High Carb", for instance), the definition and deciding factors can vary immensely. We can think of those factors as
"appropriate" rather than "correct" if you will - for now, Reuben's "appropriate dose" is 2.0u, and the deciding factor is *his specific dip into sub-50* as a newly diagnosed cat with little experience in green numbers. Does this all make sense to you?
(3) Because of the aspects I just mentioned, the idea of hurrying up, or hurrying things along, is not the best way to look at things. I understand your motivation to want to get the food issues right and the bupe issues right and the dose issues right as soon as you can. But again,
remind yourself that what works today may not work tomorrow, or next week. Remember that you as Reuben's bean aren't the only one doing FD-interpreting. Old Mr. L has a say - while he may at first decide that "green" means "release lots and lots of glucagon and hormones because we're all in danger of hypo", he's learning more and more to interpret "green" as "oh, great, some time for the rest of the coloured wobbly things around me to heal, especially old Mr. P over there." Same colour, different interpretation, different meaning, different reaction. And there's
no way to force the speed of getting from the first response to the second response. Reuben's body decides that. That's why it's so important to remember to be flexible in one's thinking: because from one day to the next, Reuben's system may have decided that he's added a new definition to part of the FD-vocabulary.
(And as an aside - that's *also* what makes the task of those around here who give feedback, advice and input specific to indivdual cats/beans as complicated and oftentimes precarious as it is: because they see the need for guidance, and fulfil it, knowing that they do so as lay persons (albeit with years of experience in dealing with FD) who are, simply, not "there" with the cat/bean in question. I point this out to address the frustration that can sometimes arise in especially in newbies, when all they want is a definite answer, and it simply sometimes isn't possible to give one, or to give *only* one. Personally, I thank each and every person here who has so often been there for me with their input and guidance, no matter how complicated and precarious this may have been.)
(4) You also asked what his LC carbs percentage should be. There's no way to know for certain, of course, but personally I would try going up in little steps. One way to do this while *knowing* the carbs percentages is to used canned food that we have the data for, but since you're restricted in what you can buy in terms of cat food, it will be more of a guessing game. Still, *documenting* data is key. If you take one meal of home-made food as your basis, you can variously try adding a quarter tsp, half a tsp, 1 tsp, and so on, of whatever you are using as your carbs-addition. (You tried that chicken/rice option the other day - cooked rice may be an option? Did Ann/Tess have feedback for you what you can try?) Whatever you try to add as the carbs-upper, I would suggest you be consistent for several days (i.e. not rice one day, peas the next) to see how Reuben responds. And again, remember that Reuben's numbers are indicative of ongoing responses from his body - a sub-50 dip one cycle *may* cause a bounce the next cycle, or it may not, or it may make him bounce a little but clear it really quickly, allowing him to drop again right away... So you might not get the chance to test out one carbs-variety two cycle or two mornings in a row (because the first cycle coule be a "drop/reduction-earning"-cycle, whereas the next could be, well, lots of things - bounce cycle, no-bounce cycle, another drop cycle...) I'm afraid the only way is to try an option, note down what it was, try to interpret Reuben's response, and use that knowledge to decide your next option.
Apologies for rambling on like this! Hopefully, you'll find it useful all the same. Do come back with any questions or anything that seems unclear, and keep asking for feedback. You'll keep getting it from various directions, voices, approaches - another fun interpreting task for you :lol:
You are doing absolutely wonderfully! It is a delight to see a bean caring so deeply for their darling cat, and being so conscientious in trying to absorb and understand the language of FD! You rock like granite!
Hugs!
Jane
--- .05ml bupe
Since you didn't answer me after I kept reminding and it was on your list, I assumed it just wasn't helping him. I'm glad Jane pushed the point again and you tried the bupe again. I couldn't imagine why it wouldn't work for him. 
, good to hear he is feeling better. 
