? Andy back to Lantus - need review & help w dosing

[Yvonne & Andy &BJ (GA)]

Andy had been on Lantus for a few yrs doing "ok" but not great. He recently was to ER with a UTI and the practice switched him to Novolin. We were not comfortable with this change and decided to try Lantus again. Andy is a bouncer and has also been on pzi with less than great results. We saw how volatile the Novolin was for him and it scared us back to Lantus w/o consulting our vet. We have an appt next week and would really like to prove that Lantus is better for Andy. But we are having a hard time getting him stabilized.

Since he was already on Lantus up to 1.5u previous to his hospitalization, I would like to take him up to 1.75u tonight. Is that too soon? I try to follow the TR method but a week at 1.5u does not seem the answer at this point given his most recent nadir #'s. What am I missing here? Please, I am kind of desperate now with him, not knowing if we did the right thing.

 

[Mandy & Rex (GA)]

I'd hold it at 1.5u until you get more tests. I'm glad you started testing during the day. Lantus is not based on the pre-shot numbers. It is based on the nadir somewhere in the middle of the cycle. It's very important you keep up the mid-cycle tests so you know how low 1.5u is taking Andy. It takes at least 6 cycles to establish the depot. I count 5 cycles so far.

 

[Yvonne & Andy &BJ (GA)]

I'd hold it at 1.5u until you get more tests. I'm glad you started testing during the day. Lantus is not based on the pre-shot numbers. It is based on the nadir somewhere in the middle of the cycle. It's very important you keep up the mid-cycle tests so you know how low 1.5u is taking Andy. It takes at least 6 cycles to establish the depot. I count 5 cycles so far.

Thanks Mandy - I stopped recording on Andy's google spreadsheet after a few yrs with the best we could do. I don't have the day/curve numbers anymore but I copied a few recent months of the pre-shot data I was able to find. I.e., so have been doing the mid-cycle for yrs but just don't have the data available anymore. He tends to bounce when he drops too fast or when he gets under 200 but never was able to pinpoint anything on either scenario. He never has been consistent. My Big John is the exact opposite thank goodness.

 

[Mandy & Rex (GA)]

Thanks Mandy - I stopped recording on Andy's google spreadsheet after a few yrs with the best we could do. I don't have the day/curve numbers anymore but I copied a few recent months of the pre-shot data I was able to find. I.e., so have been doing the mid-cycle for yrs but just don't have the data available anymore. He tends to bounce when he drops too fast or when he gets under 200 but never was able to pinpoint anything on either scenario. He never has been consistent. My Big John is the exact opposite thank goodness.

Oh good to hear you have always done the mid-cycle tests. I'd wait to get that 6th cycle before increasing. Can you monitor the cycle you increase on?

 

[Yvonne & Andy &BJ (GA)]

Oh good to hear you have always done the mid-cycle tests. I'd wait to get that 6th cycle before increasing. Can you monitor the cycle you increase on?

Yes - tomorrow I can monitor. Mandy - the vets think his UTI was caused by not using the correct insulin. Prior to his UTI, his values were not really out of whack, fairly stable FOR HIM and the best he ever had. He was even responding better to lower doses. They did not look at his history, only treated in ER so naturally the practice uses Novolin and they put him on that. They do not use Lantus due to the cost. So I need to justify going back to Lantus with them. I appreciate your input! Thx again!

 

[Wendy&Neko]

So the spreadsheet in your signature is for Big John, not Andy? If you want suggestions for Andy's dose, any chance of at least entering the last two weeks of data? Should be at least that much data in the meter.

 

[Yvonne & Andy &BJ (GA)]

So the spreadsheet in your signature is for Big John, not Andy? If you want suggestions for Andy's dose, any chance of at least entering the last two weeks of data? Should be at least that much data in the meter.

The signature spreadsheet is for Andy and it is updated since he was in ER.