Teddy's vomitting frequently after Lantus... suggestions?

Please advise:

Teddy was diagnosed in July (day of dental for severe stoma/gingivitis and extractions..surgery was cancelled and rescheduled to two weeks later when his BG was less than 200). It was believed his diabetes came from steroid injection given last October and would be temporary. He was started on Lantus 1 u. His blood sugars were coming down nicely to 144, 167, 150, 120. I was instructed to give 1/2 u and hold if under 150. My vet kept mentioning a "sliding scale chart" that would guide the doses. Lately, at time of next dose of Lantus, he's below 150...so I've held the Lantus...and rechecked at 5 or 6 hours and found him still under 150..so he got Lantus once a day for a few days. Now, he's back in the 220's and recently has climbed to 260's and this AM 336. and we've had trouble with vomiting through this. It's getting worse and seems to start right after the Lantus shot. He was vomitting very freqently when he was getting Lantus 1 u every 12 hours. Now, I dread giving him Lantus as he gorges himself, then vomits. This morning I didn't let him eat at all before Lantus and he hasn't vomitted. This newbie really needs help knowing how to manage the vomiting...what it's coming from and how to overcome it...and how to manage insulin doses. Is there a scale to use as a guideline for dose based on Blood glucose with Lantus? I also haven't taken the time to study how to do the insulin curve. Teddy's swelling in his mouth is also awful..extractions of all teeth but his canines didn't help the poor fellow.

 

Lantus is not given on any sliding scale and not once a day either.
Because of the shed, consistency is required.
Here's the links for info on Lantus - please read them and ask all questions you have:
Tight Regulation Protocol
LANTUS & LEVEMIR – INSULIN DEPOT –AKA- STORAGE SHED
Lantus&Levemir – Data Ready to Shoot Low Numbers

Testing regularly is good so that you know how Teddy is handling the insulin - testing just at shot times can be misleading as dosing is based on the nadir. If you can, it would be good to get a test or two around mid cycle to see how low he is going.
See below for example:
How to do a Curve
Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

I don`t know what others will have to say but the vomiting does not sound like it`s related to the insulin but more to do with the dental and other issues. I would be at the vet office wanting to know what`s up!
There have been a few people on the site who have dealt with complete dental removals, so hopefully then can say something.

With dosing on Lantus, most people decrease to micro dosing so you could well just need to go down to .5u or even less and then see how Teddy does - there`s plenty smaller doses than 1u and Teddy may settle down and be more stable.

For sure I`d have his mouth checked to see that he is healing well, and then the insulin to be a lesser dose could help as well.

 

Thank you for the links and other great teaching tools. I saw this before, but didn't "get" that this was THE protocol to be following to help Teddy go into remission. I'm greatly appreciative and now need to find the printer to print out these guidelines so I have it in front of me...my historically unsupportive spouse never hooked it up...but that's another forum somewhere!

As to the vomitting, I've taken him to the vet when it started. We thought it was from antibiotics, painkillers...etc and he was given one anti-emetic. That was a temporary solution. I did call the vet's office and ask for something for his vomitting..and I'm afraid my request has fallen to the wayside as his mouth and diabetes are always getting the discussion. His vomitting has been awful since Friday night and always associated with demands for food. We haven't fed him this morning, he's now quiet, and I have not rechecked his BG...it's soon to be +2, so I will check and see where we're at. I also thank you for explaining the +1, +2. I will be going to a conference for 4 days soon...not sure how I will manage his insulin then as I wouldn't trust my husband with the insulin.

 

hi, barbara, and welcome!

im too new to give advice, but we're on lantus, and have received a great amount of guidance here and from the lantus group.

there's a lot of experience here...hope to see you on the lantus forum

celi & binks