Dose increase for Dweezil AMPS 342, 8+ 170

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monty_dweezil (GA)

monty_dweezil (GA)

Member Since 2014
Hello! First time posting in this section, but we've been on Lantus (Glargine) since diagnosis in mid December 2014.

My rather sparse spreadsheet will hopefully be of some assistance.

Our vet recommends Dweezil go back to 2 units twice a day based on the numbers of 342 at 14 hours after his last (PM) dose, and 170 seven hours after the next (AM) dose.

I'm a bit concerned this may be too great a jump from 1 unit but he did start on 2 units and did well on it.

Any help would be much appreciated!

PS. If i have not added in his reading of 170 for today it is because i cannot edit the spreadsheet on my phone right now.
 
Hello and welcome here. I see from your post on Health, that those numbers you have were taken at the vet and not at home. Tests at the vet can be greatly inflated by stress. My non diabetic kitty once tested over 210 at the vet one day and then 53 at home the next. Have you had any success doing getting any blood tests at home?

I'd encourage you to read all the Sticky Notes in this forum. People here use either the Start Low Go Slow Method or the Tight Regulation Protocol. Have a read and see which one might suit you. Both protocols require more blood testing than what I see on your spreadsheet. Lantus is dosed based on the nadir, or low point of the cycle, so we need to see more mid cycle tests to see how low the dose is taking Dweezil.

Without more data, I can't tell if 1.0 unit is too much, too little, or just the right amount of insulin. I suggest holding the 1.0 unit dose for a few days and getting some more test data in the middle of the cycles. In any case, going to 2.0 units is too big an increase. With nadirs between under 300, we'd only increase by 0.25 units, if Dweezil does need an increase. The high number you saw could be the result of bouncing (see the second post here).
 
Thank you.

He is hard to test at home, i must admit. I do plan to do more though.

I also agree that 2 units seems too big an increase based on only one nadir number obtained and i'm worried. I only gave him 1.25 tonight.

I actually think 1 unit is definitely not enough though. Since he went on that dose a month ago (reduced from his initial diagnosis dose of 2 units), he has been urinating and drinking more, losing a little weight again, and every urine glucose test we do (2-3 times a day) shows either the highest or second highest reading on the colour chart, and his litter tray smells of apple cider.
 
Yes, this is my plan. :)

I want to give 1.5 units for a week or two, do as many home tests as i can, and go from there.

We also do a lot of secondary testing. Water consumption, urine glucose readings, ketones, weight, demeanor, appetite, etc.

Sigh. The hardest thing is convincing my partner to only give 1.5. She is very much reliant on our vet's opinion and very resistant to going against it.
 
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I guess you haven't yet read either of the protocols yet then. Because Dweezil has had a number under 200 you shouldn't increase by more than .25 units under either protocol. The dose should then be held for 4-5 days under the tight regulation protocol or a week under start low go slow. Then adjust the dose based on BG test results.

Perhaps you could show your partner the protocols and other information too, if she learns about the disease it may help her to accept that vets aren't always the ones to provide the best advice in relation to insulin dosing. People around here have a lot more experience than they do ;)
 
I actually have read both protocols. The start low go slow one is the only real option we have given we cannot test frequently.

Given he started on 2 units, this was already not start low, go slow. Also considering his number at diagnosis was so high, i suppose they thought a higher dose might be better suited.

The syringes we have always used only have whole unit markers, no 0.25 or even 0.5. When we have done a 1.5 dose, it is eyeballed. I didn't even know we could generally buy the more precise needles here!
 
That's very frustrating for you :( Is there any chance you could get syringes that at least show the o.5 units.
 
I'm sure someone must sell them somewhere. I also hope that those syringes are the same type of needle that can go into the rubber tip of the vial of insulin.
 
You can't get syringes with half units marked in Australia but it's not as difficult as you might think to draw the appropriate doses. If you PM me your mobile and load up Whatsapp (if you don't already have it) I can forward you some pics and instructions that I did up for my mum. She didn't think she'd be able to do.25 unit dosing but she manages well now - she does use a magnifier but if your close up vision is good you won't need to. The trick to making sure you get the dose consistent is to make up a sample syringe with coloured water and use that to compare to your doses.

I don't know what you mean about the type of needle that can go into the rubber tip of the vial. You just need to make sure they're 3/10cc insulin syringes. I used BD Ultra-Fine 0.3ml short needle 31 gauge and was very happy with those
 
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