bubbasmom (GA)
Member Since 2022
Hello everyone. I need assistance with possibly restarting my boy on Lantus...
Bubba was diagnosed on Sep 27 2022. At the time of Dx: his CBGs were 25.77mmol/L, fructosamine was 350, urine glocuse was 1000mg/dL. No Hx of ketones, or DKA (I test with ketostix). No vomiting. BMs are good. No hematuria.
To provide some context... sorry for the long Hx, but I figure it's worth it to document what was tried..
On Sep 27, we started on 2U of caninsulin; after a week he became lethargic & lost his appetite. His dose was reduced by half, then titrated back up to 2U until Oct 24 - no home testing at this time.
On Oct 24, we started on 2U of lantus - within a few days he again became lethargic & lost his appetite - no home testing at this time.
On Nov 1, we installed a Libre sensor & re-started Lantus at 1U. While his #s did decrease during the day, they bounced in the evening.
On Nov 8, we increased to 1.5U of lantus. His #s were pretty okay during the day (from Nov 8-14), but still bounced in the evening. At the time, I wasn't aware of the reason for bouncing - now I do (liver rxn & pumping glycogen). At the time myself & his vet thought it was because lantus wasn't working to regulate Bubba, especially since he was still having peepee accidents on the floor & his appetite decreased to the point of sniffing food & walking away (my boy is a major foodie, so when he walks away from his favourites, I know something is wrong).
On Nov 14, we installed another Libre sensor. Bubba's fructosamine was 245 & urine glucose was 50mg/dL! My vet said his urine glucose "was still really high" before she sent me the urinalysis results, but going from 1000 to 50 is a significant improvement. With the various clinical signs & data, I should have stayed with lantus (hindsight is 20/20) - but I was ++ worried about inappetence & lethargy again, and during this time he was still peeing on the floor - because my boy did not look well when he was experiencing those Sx.
On Nov 15, we switched from lantus 1.5U to caninsulin 1.2U.
On Nov 21, we increased to 1.6U caninsulin.
On Nov 28, I started home testing! His #s were looking pretty okay after the increase from 1.2U to 1.6U caninsulin; but around Dec 21, he started going high all the time now. On Dec 26, he started having peepee accidents again.
On Dec 27, we increased to 1.8U caninsulin. Ever since then, he's been in the pinks & reds with no significant CGB decrease. Bubba's vet wanted to try this increase, before switching to ProZinc or referring him to an internal med specialist. She said b/c 1.8U isn't all that high, we can still work to titrate up the caninsulin dose until something "sticks". She is impressed with the spreadsheet/thinks it's a fantastic tool & is supportive of home testing.
Currently Bubba still experiences polyuria (although it has decreased slightly since his Dx) & ++ polydipsia. Some days he is ravenous, others more his baseline, or even not really hungry at all (like today) - he needed canned fish juice to stimulate his appetite.
Having said all that, IF I were to switch back to lantus (with or without the support of my vet), what do you all recommend the re-starting dose to be? Please have a look at my spreadsheet (specifically Nov/Dec 2022 tab for lantus Hx) and let me know of your thoughts on anything - dosing, clinical S&S, your own experiences, etc. Also,
OR, do I just wait out the caninsulin, titrate up the dose 0.25U or 0.5U at a time & hope something sticks soon?
I suppose I am panicking as I worry about my boy's weight: on Sep 27, his starting weight was 17.45lbs & on Dec 27 it was 15.16lbs. This time last year his weight was 18.37lbs (his heaviest was closer to 19lbs within the last few years). As well as his consistently higher #s lately.
Thanks for reading and for your input
https://docs.google.com/spreadsheets/d/1lqTm8ESOUq93x2dFowG7w0WzXaJyPElWAqgnr8B9Tys/edit?usp=sharing
Bubba was diagnosed on Sep 27 2022. At the time of Dx: his CBGs were 25.77mmol/L, fructosamine was 350, urine glocuse was 1000mg/dL. No Hx of ketones, or DKA (I test with ketostix). No vomiting. BMs are good. No hematuria.
To provide some context... sorry for the long Hx, but I figure it's worth it to document what was tried..
On Sep 27, we started on 2U of caninsulin; after a week he became lethargic & lost his appetite. His dose was reduced by half, then titrated back up to 2U until Oct 24 - no home testing at this time.
On Oct 24, we started on 2U of lantus - within a few days he again became lethargic & lost his appetite - no home testing at this time.
On Nov 1, we installed a Libre sensor & re-started Lantus at 1U. While his #s did decrease during the day, they bounced in the evening.
On Nov 8, we increased to 1.5U of lantus. His #s were pretty okay during the day (from Nov 8-14), but still bounced in the evening. At the time, I wasn't aware of the reason for bouncing - now I do (liver rxn & pumping glycogen). At the time myself & his vet thought it was because lantus wasn't working to regulate Bubba, especially since he was still having peepee accidents on the floor & his appetite decreased to the point of sniffing food & walking away (my boy is a major foodie, so when he walks away from his favourites, I know something is wrong).
On Nov 14, we installed another Libre sensor. Bubba's fructosamine was 245 & urine glucose was 50mg/dL! My vet said his urine glucose "was still really high" before she sent me the urinalysis results, but going from 1000 to 50 is a significant improvement. With the various clinical signs & data, I should have stayed with lantus (hindsight is 20/20) - but I was ++ worried about inappetence & lethargy again, and during this time he was still peeing on the floor - because my boy did not look well when he was experiencing those Sx.
On Nov 15, we switched from lantus 1.5U to caninsulin 1.2U.
On Nov 21, we increased to 1.6U caninsulin.
On Nov 28, I started home testing! His #s were looking pretty okay after the increase from 1.2U to 1.6U caninsulin; but around Dec 21, he started going high all the time now. On Dec 26, he started having peepee accidents again.
On Dec 27, we increased to 1.8U caninsulin. Ever since then, he's been in the pinks & reds with no significant CGB decrease. Bubba's vet wanted to try this increase, before switching to ProZinc or referring him to an internal med specialist. She said b/c 1.8U isn't all that high, we can still work to titrate up the caninsulin dose until something "sticks". She is impressed with the spreadsheet/thinks it's a fantastic tool & is supportive of home testing.
Currently Bubba still experiences polyuria (although it has decreased slightly since his Dx) & ++ polydipsia. Some days he is ravenous, others more his baseline, or even not really hungry at all (like today) - he needed canned fish juice to stimulate his appetite.
Having said all that, IF I were to switch back to lantus (with or without the support of my vet), what do you all recommend the re-starting dose to be? Please have a look at my spreadsheet (specifically Nov/Dec 2022 tab for lantus Hx) and let me know of your thoughts on anything - dosing, clinical S&S, your own experiences, etc. Also,
OR, do I just wait out the caninsulin, titrate up the dose 0.25U or 0.5U at a time & hope something sticks soon?
I suppose I am panicking as I worry about my boy's weight: on Sep 27, his starting weight was 17.45lbs & on Dec 27 it was 15.16lbs. This time last year his weight was 18.37lbs (his heaviest was closer to 19lbs within the last few years). As well as his consistently higher #s lately.
Thanks for reading and for your input
https://docs.google.com/spreadsheets/d/1lqTm8ESOUq93x2dFowG7w0WzXaJyPElWAqgnr8B9Tys/edit?usp=sharing
You’re in great hands, I can promise you that!
