? Question about the efficacy of my Lantus pen

Ginger Cat

Ginger Cat

Member Since 2017
I recently switched my cat, Wally, from ProZinc, back to Lantus and had an unopened pen from when he was previously on Lantus. Expiration date is 8/2020. Given his recent consistently high numbers (after some lows on August 16th and a change in dosage), I'm wondering if the insulin is losing efficacy.

I have 2 pens on order from Mark's Marine but was concerned about how long it would take to get here given the issues with postal delivery these days. So - I went to Walgreen's this morning and bought a single pen.

Could you take a look at his spreadsheet and let me know if you think I should start the new pen or give him a few more days on the old one? Maybe I'm just too impatient for the depot to kick in.
 
The pen you have has been in the fridge the whole time? If so it’s good at least until the end of the month. Are you following TR?

I know with AT the reduction number is 68. What I don’t know is since it’s been over a year diabetic if it’s three times under like with a human meter it’s 3 in the 40’s I do think it appears an increase is needed. See what others say.
 
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tiffmaxee said:
The pen you have has been in the fridge the whole time? If so it’s good at least until the end of the month. Are you following TR?

I know with AT the reduction number is 68. What I don’t know is since it’s been over a year diabetic if it’s three times under like with a human meter it’s 3 in the 40’s I do think it appears an increase is needed. See what others say.
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Yes - the pen has been refrigerated the entire time. I'm currently following the SLGS so the reduction number is 90 although I did reduce when he was a bit higher because he was showing a decrease in his numbers.
 
You switched back to Lantus on 7/14? We also ask for more info in your subject line -- especially when your kitty was diagnosed, the meter you're using, anything else you think is important for us to know.

In general, it looks like you've been holding Wally's doses a bit longer than you need to. The concern is that glucose toxicity can develop when doses are held overly long. This basically means your cat starts to treat higher numbers like the new normal. I'd give some thought to increasing Wally's dose.
 
Looks like Wally is bouncing today. Since he started in the 400's last night and had a nice blue AMPS, it would have been good to see how low he went last night. Even though you see higher preshots, he could still come down low during the cycle. If at all possible, getting a before bed test every night will really help fill in the picture of what is happening. I also see a blank PMPS the night of the 20th. Was that a skip or just a missing entry? A skipped dose can also impact the depot.

Bottom line, it doesn't look to me like the pen is the issue.
 
Wendy&Neko said:
Looks like Wally is bouncing today. Since he started in the 400's last night and had a nice blue AMPS, it would have been good to see how low he went last night. Even though you see higher preshots, he could still come down low during the cycle. If at all possible, getting a before bed test every night will really help fill in the picture of what is happening. I also see a blank PMPS the night of the 20th. Was that a skip or just a missing entry? A skipped dose can also impact the depot.

Bottom line, it doesn't look to me like the pen is the issue.
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I just checked my spreadsheet and he did get 1.25. Sorry about that. I have been trying to get more post PM tests in, but I run a B&B and when I have guests, staying up very late (he gets his insulin at 9 am/pm) or getting up to do mid-checks after his PM shot is difficult. I have guests this weekend and that's why I didn't get any tests. I also wondered how low he went during the night/early hours, although he was acting perfectly fine when I got up to get breakfast ready.
 
Sienne and Gabby (GA) said:
You switched back to Lantus on 7/14? We also ask for more info in your subject line -- especially when your kitty was diagnosed, the meter you're using, anything else you think is important for us to know.

In general, it looks like you've been holding Wally's doses a bit longer than you need to. The concern is that glucose toxicity can develop when doses are held overly long. This basically means your cat starts to treat higher numbers like the new normal. I'd give some thought to increasing Wally's dose.
Click to expand...
I was told that with the SLGS to hold the dose for 7 days. He was diagnosed in 2017, started on ProZinc, did incredibly well and we thought he was going into remission, stopped his insulin for a week, and his numbers skyrocketed. Back on the ProZinc, then switched to Lantus, then back to ProZinc and now back to Lantus. Using an AT2 meter and PetSure strips (with AT2 strips as backup)
 
Even a +2 test is a good one to get at night, if you can swing it. If the +2 is quite a bit lower than the preshot, it's an indicative of a very active cycle.

Good to know on the 20th, looks like you've had 10 cycles in a row at this dose now. You did go up to 1.5 units on 8/13, just not sure why you dropped the dose back again. Reductions on SLGS are earned when they go below 90. Your goal is to try to get to a dose with nadirs between 90 and 149.
 
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