Need advice on dose increase

[Grady'smom]

Hi all:
My boy Grady has been on Lantus 1 unit BID, which he started a month ago. He has been transitioned to a canned diet, currently Fancy Feast Classics. He went to the vet today for his one month follow up. As he has lost significant weight, I was very happy to learn he's put on 10 ounces! I know that's not much but considering how sick he was ( had a raging UTI) I think it's progress. We're getting better with home testing too. It was a tough start at first but I think we are making progress there too. His BG's pre shot run around 380, 3 hrs post around 350, 6 hrs post 369, 11 hrs post 387. I know there are gaps in there that we need to fill in and we are woking on it. The vet wants to increase his dose from 1 unit to 2 units BID. Based on what I've read here, I'm feeling very uneasy about that. I'm thinking 1.5 would make me more comfortable.

Any advice and/or opinions are most welcomed!

Thanks!!

 

[Thebudster77]

IMHO, If going to 1.5 instead of 2 makes you more comfortable then that is what I would do. It is also what I would do after going through the same experience with Jack. You can take a look at Jacks ss below.

I did not maintain 1.5 long enough to really evaluate its effects. It turns out that he needed a higher dose, but the next change was 2.0 to 3.0, which turned out to be too high over time.

The key is to then keep it consistent throughout the next 6 cycles and then take a look at his levels again. Unless of course the numbers go too low.

I have read that by only increasing by small increments, it avoids you skipping over what may be the optimal dose.

How long any dose remains effective is still somewhat of a mystery to me. It is not an exact science and how much the pancreas starts working again also factors into it. Thus the need for at home test which you are doing. That is so very important.

Kevin

 

[Lisa and Witn (GA)]

Do you have a spreadsheet with his readings you can share with us? It would be helpful to see what the readings average before advising a dose change. However, if an increase is needed, I agree, you only want to increase it by 1/4 to 1/2 unit. You will need to stay at that dose at least one week with regular testing before determining if you need to increase it again.

 

[Grady'smom]

Thank you Kevin and Lisa for your quick responses!

Unfortunately I do not yet have a spreadsheet to share. Grady and I have had some issues on the road to routine home testing so my measurements are a bit sporadic. We are getting better so I hope to have a spreadsheet up and running soon. Kevin I did look Jack's sheet and it was very helpful. Today, 7.5 hrs post shot he was 369. Based on the numbers I was able to give the vet ( highest 416, lowest 350) she feels he will be fine with two units.

Will keep you posted on what we decide to do and how it's working out.

Thanks again!

 

[Tisha's_Person]

Part of the issue with your vet may just be a reluctance to prescribe half unit doses. Our vet always prefers whole unit changes and she has been clear that it is because many people do not measure the half unit doses accurately. I usually just have to reassure her that I do have needles with half unit marking and I promise that I will be very careful in measuring the dose accurately.

 

[KPassa]

Welcome Linda and Grady!

Your instinct is right to not increase by whole units. How are things going on this current dose? If you would like to keep track of Grady's numbers, we all use this online spreadsheet since we can share it not only with each other for help and advice, but also with our vets. Please let us know how else we can help.

 

[Grady'smom]

Hello Kpassa!

Grady is doing much better, thanks for asking! His pre-shot BG's have gone down from the high 300's to 280 this morning. As its only been a few days since we upped his dose, I call that progress. The water consumption has slowed, his voracious eating has settled down, he's more alert and active. Overall, I"m pleased but still cautiously optimistic. Now, we just need to get him into a steady home test routine. We are both getting better at it and hope to start using the spreadsheet soon.

Grady and I thank you for your support and encouragement!!!

 

[KPassa]

That's fantastic news! :thumbup Isn't it great when you can tell they're starting to feel better? Please let me know if you need any help with ear-testing or getting the spreadsheet up and running.