Vet says increase Lantus from 1U to 1.5U. Is that too fast?

My vet advised me today to raise Noodle's Lantus dose from 1.0U to 1.5U. Isn't that too fast a jump? Poor Noodle is not showing any real progress in his BG numbers even though he acts great, eats fine, not to excess. If I didn't know he was diabetic, I wouldn't suspect it except for the BG numbers and moderate sugar in his urine. He has been ketone-free for several days after showing trace ketones earlier. I would really appreciate opinions on the next dosing change. Thanks so much everyone!

Christi

 

Re: Vet says increase Lantus from 1U to 1.5U. Is that too fa

I am not experienced enough to give dosing advice, but the tight regulation protocol recommends a .25-.5u increase based on the numbers you're seeing. The start low, go slow would have you hold the dose for another 3 days before adjusting, but would recommend a .5u increase at that time if your numbers stay about the same. Overall, it seems to me like the vet's recommendation is totally reasonable since the numbers have been so consistently high with enough time for the shed to adjust, but again, I'm not officially advising that, just passing on what the protocols would lead you to.

 

Re: Vet says increase Lantus from 1U to 1.5U. Is that too fa

Usually, we recommend only increasing in .25u increments. With kitties that have high flat numbers and/or ketones, however, .5u increments are suggested. So, yes, it was good of you to question a .5u increase, but as Katie said above, in this scenario, it's actually not a bad idea.

I would leave it up to what you feel most comfortable doing. Do you think you'll be around enough these next three days to test more if need be? If so, increase by .5u. If not, then only increase by .25u. Either way, an increase is needed. ;-)

 

Re: Vet says increase Lantus from 1U to 1.5U. Is that too fa

Thank you KPassa and atajev,
I really appreciate your responding. Noodle seems to be kind of sensitive to increases--seems to need a day or two to settle in but I know we need to bring those numbers down. I am discouraged that we haven't seen any movement yet. I absolutely plan to stay home while I'm increasing his dose and keep a very close eye on him. Sometimes I have wondered if I might have a flat bottle of Lantus. It looks fine, no particles, cloudiness, etc. but it is 2 1/2 months old. It has been refrigerated the whole time and handled very gently. Do either of you know what the useable life of refrigerated Lantus is supposed to be? thanks so much!

Christi

 

Re: Vet says increase Lantus from 1U to 1.5U. Is that too fa

Most people can use a vial about 4-6 months before it conks out (keep it refrigerated and don't roll or shake it). I was able to use my vial of Lantus for 5 months before I preemptively switched to the Lantus pens. He really only needed an increase in his dose, so I'm sure I would have probably gotten at least another month out of the vial. Some people even report being able to use a vial up to a year, but for the majority of users, 6 months is usually end-of-life for a vial.

You're still on a relatively low dose with room to increase so I think your vial is probably still good. ;-)