08/02 Miho AMPS 243

PMPS 216
0.75u

she vomited bile at 2:30am and had diarrhea. Her stool is normal on raw food + baby food (mashed veg w/ a bit of chicken) I didn’t give them to her recently since her nadir had been high and gave her probiotics only, that might be the reason. I gave baby food + 5ml slippery elm and will give raw food as soon as it arrives. Her appetite is normal which is good

with the bile vomiting I’m planning to see the vet soon & requested GI panel testing
 
I’ve contacted the vet just then explained Miho’s bg had been unstable in the last few days and she asked me to check if the insulin at home is up to date. I’ve bought a box of glargine pens (optisulin solostar) on 6/30 but apparently they all expire at the same time after 28 days whether you use them or not.. so it may have been that I haven’t actually given an empty shot before it’s the insulin that wasn’t working properly. I was getting suspicious because her recent bg curve resembled a time before her 3rd DKA when she wasn’t getting enough insulin. (Bg maintaining on the higher side not dropping or increasing) I’m going to buy the vial & not the pen type this time and give it a go at the next insulin time
 
I really don't think there is a problem with the insulin. Do you keep it in the fridge? Most of use pens rather than vials and have used them for many months - often to the last drop without any issue. They last more than 28 days when refrigerated.

With a vial, if you drop it at home, it's going to break and you have nothing. A vial holds 1000 units and not many cats can use that much before it starts to lose efficacy and you end up throwing a lot of it away. A 5 pack of pens is a total of 1500 units, but each pen only holds 300 units so you can use each one down to the last drop while the other pens stay safely in the fridge and are good until the expiration date on the box (usually at least 2 years)...and if you drop a pen, you're much less likely to break it...but even if you did, you'd have extra's!

You want to get tests between shots to see how low she is going on the dose. Preshots are not an indication on how she is doing on a dose.
 
Pens kept in the fridge will last to the last drop. The 28 days is because people don’t store it in the fridge. I did have to discard vials after 6 months but used my pens until the last drop. You have caught bg at 77 and 42. The insulin is fine. You don’t dose based upon preshots as Bhooma said. Get a test each cycle between +4-7 to see how low it’s taking Miho.
 
Bandit's Mom said:
I really don't think there is a problem with the insulin. Do you keep it in the fridge? Most of use pens rather than vials and have used them for many months - often to the last drop without any issue. They last more than 28 days when refrigerated.

With a vial, if you drop it at home, it's going to break and you have nothing. A vial holds 1000 units and not many cats can use that much before it starts to lose efficacy and you end up throwing a lot of it away. A 5 pack of pens is a total of 1500 units, but each pen only holds 300 units so you can use each one down to the last drop while the other pens stay safely in the fridge and are good until the expiration date on the box (usually at least 2 years)...and if you drop a pen, you're much less likely to break it...but even if you did, you'd have extra's!

You want to get tests between shots to see how low she is going on the dose. Preshots are not an indication on how she is doing on a dose.
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Yeah I keep them in the fridge. The vial I’m getting is just one bottle which is 100 units (The photo isn’t showing up here for some reason..) It’s the same type of vial installed in the insulin pen so it doesn’t break. The hospital Miho was admitted at was kind enough to dispense it for us

I guess I am being extra cautious. There might not be anything wrong with insulin pens I have & you might think I have OCD or paranoia even lol It’s because my kitty had gone into DKA due to insulin not working properly back then so I want to eliminate as many possibilities as I can. The expiration date on the box is end of this year but each bottle of insulin lasts for 28 days upon opening or so I was told.


Yes I’m aware of that. I was talking about her bg remaining pretty much the same throughout the day. I’ll test her bg soon : )
 
tiffmaxee said:
Pens kept in the fridge will last to the last drop. The 28 days is because people don’t store it in the fridge. I did have to discard vials after 6 months but used my pens until the last drop. You have caught bg at 77 and 42. The insulin is fine. You don’t dose based upon preshots as Bhooma said. Get a test each cycle between +4-7 to see how low it’s taking Miho.
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Yeah I believe you & Bandit’s Mom. I guess I’m paranoid bc her bg had been unstable & was vomiting more often than usual @_@:confused:
 
Killua356 said:
Yeah I keep them in the fridge. The vial I’m getting is just one bottle which is 100 units (The photo isn’t showing up here for some reason..) It’s the same type of vial installed in the insulin pen so it doesn’t break. The hospital Miho was admitted at was kind enough to dispense it for us
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OK. I guess you mean a pen cartridge. Some of us use those as well.

49823503981_e7c9b23f0e_o.jpg



Killua356 said:
I guess I am being extra cautious. There might not be anything wrong with insulin pens I have & you might think I have OCD or paranoia even lol It’s because my kitty had gone into DKA due to insulin not working properly back then so I want to eliminate as many possibilities as I can. The expiration date on the box is end of this year but each bottle of insulin lasts for 28 days upon opening or so I was told.
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Totally understandable. I would worry as much if my kitty had been through DKA. Insulins lasts longer than 28 days. The tests for expiry were not done for longer since a pen lasts a human a month or less. I have used pens/cartridges for many months with no issues.


Killua356 said:
Bg 124 @+4.3

yay!! her bg had dropped as it normally would. ig the insulin I have is working fine ;_; thanks for the advice @tiffmaxee @Bandit's Mom !
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Excellent! Can you get another test around +6?
 
Bandit's Mom said:
OK. I guess you mean a pen cartridge. Some of us use those as well.

49823503981_e7c9b23f0e_o.jpg




Totally understandable. I would worry as much if my kitty had been through DKA. Insulins lasts longer than 28 days. The tests for expiry were not done for longer since a pen lasts a human a month or less. I have used pens/cartridges for many months with no issues.



Excellent! Can you get another test around +6?
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Yeah that’s the one! Vets here (Australia) called that a vial. ig that’s something different in the US? Sure I’ll post it separately : )
 
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