1/21 GOBBLES PMPS 390 & ?

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TheBowHuntress

TheBowHuntress

Member Since 2012
Yesterday's Condo:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=87336

**my question is below, after 8 PM re: vet visit/bg numbers/insulin left out 12 hours last night**

I left Gobbles' insulin bottle out of fridge for 12 hours :( can I still use it to give him his 7:00AM shot? I went ahead and gave him his shot at 7:30 AM. Gobbles sniffled twice this AM; I am calling the vet to see if I can move his appointment from Wednesday until today and if I should get a new prescription.

One moderately sized clump of pee. One formed pile of poo. Keytones: Negative. Vet appointment @2 PM. Has sniffles (very moderate; hear 2x this morning). Sleeping less with more energy, is more sociable, average appetite, purred and preened!

He has a vet appointment at 2:00. Will update Condo when I return.
 
Re: HELP!!! Left Insulin Bottle Out ALL NIGHT

Shouldn't be a problem...
Glargine should be refrigerated because it has a shelf life of 4 weeks once opened and kept at room temperature.
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I interpret that to mean you've started the 4-week clock.... I'd use it for that long, unless of course you see evidence that it's losing effectiveness. I have no idea if it makes any difference now if you resume refrigerating it - maybe someone else knows?
 
Re: HELP!!! Left Insulin Bottle Out ALL NIGHT

I left mine out on the counter for about 5 hours one time, and then put it back in the refrigerator. I didn't have a problem with it afterwards. As Bruce said, you'll just have to watch the numbers to see if it lost any of its effectiveness.

Has anyone mentioned buying pens instead of the bottle next time? It is more expensive up front, but you can use the pens up until almost the last drop versus the vial that loses its effectiveness before you use the full bottle. I ended up tossing 2 half full bottles because they seemed to not be working anymore. Plus, if you leave a pen out and it goes bad, you still have fresh pens in the refrigerator.

Good luck,
Kathie
 
Re: HELP!!! Left Insulin Bottle Out ALL NIGHT

Hi Kat, I once left my vial out overnight on the counter when Maggie was first diagnosed. A call to my 24 hour Pharmacist said the vial was still okay. As to how long the rest of the shelf life I'm not sure. I hope others weigh in on it.
 
Re: HELP!!! Left Insulin Bottle Out ALL NIGHT

Ann & Maggie11 said:
Hi Kat, I once left my vial out overnight on the counter when Maggie was first diagnosed. A call to my 24 hour Pharmacist said the vial was still okay. As to how long the rest of the shelf life I'm not sure. I hope others weigh in on it.
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should i shoot? he's now 1/2 late on his 7 am shot
 
Re: HELP!!! Left Insulin Bottle Out ALL NIGHT

Oh yes, go ahead and shoot if you're worried the insulin is not okay. We didn't see your AMPS though on the subject line?
 
Re: HELP!!! Left Insulin Bottle Out ALL NIGHT

I would go ahead and shoot, and try to get some extra tests today if you can.
 
Re: AMPS 286 * Left Insulin Bottle Out ALL NIGHT (12 HOURS)

I put the bottle back in the refrigerator. Is that okay?
 
Re: AMPS 286 * Left Insulin Bottle Out ALL NIGHT (12 HOURS)

Hi Kat, I just called my 24 hour Pharmacy and asked about your vial. Yes, the insulin is still good for the 28 day period. You can refrigerate it even though it's been left out overnight.
 
Re: AMPS 286 * Left Insulin Bottle Out ALL NIGHT (12 HOURS)

Yes that is ok, I would just keep an eye on the numbers for the next couple of days to make sure the insulin hasn't lost it's potency. I would invest in the pens the next time around, they are most cost effective. Good luck!
 
Re: AMPS 286 * Left Insulin Bottle Out ALL NIGHT (12 HOURS)

Michelle & Scrabble said:
Yes that is ok, I would just keep an eye on the numbers for the next couple of days to make sure the insulin hasn't lost it's potency. I would invest in the pens the next time around, they are most cost effective. Good luck!
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I would like to know more about the pens. How are they used? Can you dial a dose? About how much are the pens vs. a vial of Lantus (I paid $139 for Gobbles/ vial)? How long do they last?
 
Re: AMPS 286 * Left Insulin Bottle Out ALL NIGHT (12 HOURS)

The pens are used just like a vial. You just stick the syringe in them like you would a vial. The dial feature is for humans. They come in a pack of 5 and they usually cost around $220-$240 depending on where you get them. I have used the pens until they are gone also which can be anywhere between 30-45 days. So definetly more cost effective than buying one vial.
 
Re: AMPS 286 * Left Insulin Bottle Out ALL NIGHT (12 HOURS)

Michelle & Scrabble said:
The pens are used just like a vial. You just stick the syringe in them like you would a vial. The dial feature is for humans. They come in a pack of 5 and they usually cost around $220-$240 depending on where you get them. I have used the pens until they are gone also which can be anywhere between 30-45 days. So definetly more cost effective than buying one vial.
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How do you measure the dosage?
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

It is the same exact thing as the vial. The dosage is still measured with the syringe. Basically the insulin is in the form of a pen and you just stick your syringe into it like you would a vial. make sense?
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

Michelle & Scrabble said:
It is the same exact thing as the vial. The dosage is still measured with the syringe. Basically the insulin is in the form of a pen and you just stick your syringe into it like you would a vial. make sense?
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Yes, I guess...but "pen" kind of confused me...I'm going to find a picture of one here (or google) and then maybe I'll know it....!!!!
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

Think of the pens as a smaller vial, that is the only real difference. We don't use the dial feature, just use your syringe the same way that you would with the bigger vial. I am on 65 days with the first pen, so much more economical.
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

I did that once too.. Put in the cupboard with the syringes instead of the fridge. It was fine for a few months until my pet sitter dropped it. But I did some math and reckoned that one night out the fridge works out to about a week off its potency if you keep it in the fridge from now on. Just keep an eye on it.
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

We use the pens as well. Our local Target pharmacy is willing to sell them to me one at a time, for $47 each. You have to call around and ask about that, though...not all pharmacies are willing to sell them indiviudually. And, if I bought the entire box at once, it would be more cost effective, but we usually can't swing that "up front investment", so we get them one at a time. We use every last drop in the pen before moving on to the next...I'd gestimate they last us close two 2 months. And, during the 5 day blackout after Sandy, we actually intentionally left the pen out of the fridge until the power came back on; it was fine and we were still able to use all of the insulin.

It does seem to be different for everybody...how long the juice lasts. "Technically", the manufacturer says 28 days from when you start it, but there are people here who get up to 4 months out of one vial. It's a matter of keeping an eye on the numbers...if they start getting wonky, then it's probaby time for new juice.
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

We haven't had a chance to stop by and welcome you. We used vials for about a year but I was always throwing at least half out. I couldn't get them to last longer than 45 - 60 days. We switched to pens and have used the very lost drop in them. It has been a huge savings. The vials were $125 and a box of pens at Sam's is $225. A little bit more up front but the box of pens will last us about 8 months and the vial was about 2 months. As far as the insulin still being good, I agree with everyone else that you will just have to watch Gobbles numbers.

Have a wonderful day and welcome again!
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

Hi guys .. glad everyone was able to answer your questions .. and I agree, pens are definitely more cost effective in the long run .. Have a great day guys!
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

I haven't had luck with the larger pharmacies (walgreens, CVS, walmart etc.) selling me a single pen. I was able to find a local smaller pharmacy who was willing though - they charge $53 a pen. It's a bit cheaper to buy the entire box but it's easier for me to swing $53 than $240 or so. I also figure if the power goes out I am not out an entire box potentially. Here in Missouri we can get some intense storms and I always think back to when our house was hit by a tornado and without power for nearly a week.
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Post Vet Visit Summary: My ReliOn Prime (203)vs. AlphaTrak (234). Gobbles was VERY STRESSED, SHAKING during visit. The vet and I both agreed that his BG was most likely a bit lower due to elivated "stress" level. I asked the vet which type of diabetes Gobbles has, and he said "Type 1". We discussed highs, lows and bounces that Gobbles is/was experiencing. He agreed that Gobbles' physical & emotion improvements are due to his better BG levels. He was sincere and commended me for the adjustments to insulin doses and felt confident that this is due to the changes and that Gobbles may well be on his way to being regulated. He said a few sniffles and the "pimple" near bottom of ear are not significant and to continue to treat same with triple antibiotic. If it doesn't heal up (and if the sniffles turn into more of a passing thing), to give him a call. Weight was 12.0 which was a few ounces more than last visit on 1/6/13. My home scale weighed him the same weight, on 1/17/13. He agreed to hold off on a fructosamine test. He examined his teeth and said he does not need dental at this time; there is no build-up of tartar and the gums look healthy. He also took a good luck on the tongue/on back of tongue and did not see any evidence of a granuloma. Regarding Lantus--he would like Lantus continued and the bottle I purchased on 11/24/12 is probably could for a couple of more months; when I told him I left the bottle out overnight, he told me "not to worry about, it will be fine and should still be potent", and that he, in fact, has left HIS bottle out overnight!!! I inquired about the Lantus pen, and he said to see first if I can find a pharmacy that is willing to sell one pen at a time, then stop in for the Rx. He said it's okay to treat Gobbles w/Advantage and to get one on my way out (well, I forgot to do that but will stop in later this week and buy one...dah). We discussed the skin biopsy; I mentioned that the area on his paw which was shaved in a small area for bloodwork on 1/7/13; he looked at the paw and noticed that the hair had grown back (dah...why didn't I think to do that) and he sees no further thinning of overall body, and said he did not feel a skin biopsy was in order at this time--to give it a chance. A follow up appointment was made for 2/25/13. Total charge--$59.00.
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Congrats on a good vet visit, minus the stress of course. :smile:
 
Re: 1/21 GOBBLES AMPS 286 *left bottle out all night*

Wendy&Tiggy said:
I did that once too.. Put in the cupboard with the syringes instead of the fridge. It was fine for a few months until my pet sitter dropped it. But I did some math and reckoned that one night out the fridge works out to about a week off its potency if you keep it in the fridge from now on. Just keep an eye on it.
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My vet said (see Post Vet visit below) not to worry about...and he agrees that its good for much longer than "28 days". I have kept the bottle in the fridge for 2 months thus far (first day was 11/24/12) and from what I've read, probably has about 2 months left in it. So I'm going to note keep an eye on his numbers and keep in mind that four months from when I purchased it will be on about 2/20th (and hopefully he is starting to regulate therefore wacky numbers may be very suggestive of loss of strength). I guess I'm not the only person who's done this--sounds rather common here at FD.com, so I don't think I'm such a scatter-brain..
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Using the pens:

Altho' they look very different than a vial, they work basically the same. There's a seal over the end of the pen cartridge just like that seal that was on the vial. When you remove that seal, there's the SAME rubber 'seal', just a bit smaller.

The biggest reason for not using the pen needles and dial is that they are not consistent - can be many drops different, 1 unit is not necessarily 1 unit. For humans this is no big deal but when doses are small like WE use, it's just not safe. I juggle KT's insulin by 3 different size drops, not units, to deal with his numbers.
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Glad you had a good vet visit with Gobbles!
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Just as an FYI, 80 - 95% of cats experience something that is similar to Type-2 diabetes. I'm not sure why your vet thinks Gobbles has Type 1 diabetes.
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Sienne and Gabby said:
Just as an FYI, 80 - 95% of cats experience something that is similar to Type-2 diabetes. I'm not sure why your vet thinks Gobbles has Type 1 diabetes.
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I asked him and he told me it was because Gobbles is insulin dependent. I don't know much about the difference so when I read your post, I googled it: According to 1-800-petmeds.com "What's the Difference Between Type 1 and Type 2 Diabetes in Dogs and Cats? Pets with Type 1 diabetes require insulin injections, but those with Type 2 diabetes do not need insulin. Instead, Type 2 diabetes is controlled with diet, weight loss, and oral medication. Dogs with diabetes (Type 1) must be treated with insulin. Cats develop both Type 1 and Type 2 diabetes and can be treated with insulin or an oral diabetes medication. The tendency to develop Type 2 diabetes is inherited so that many in the same family develop it. Type 2 diabetes is often associated with obesity -- http://www.1800petmeds.com/education/diabetes-in-dogs-cats-11.htm He may be wrong, but that's what he told me. Here's something I found at from at wikipedia: http://72.30.186.176/search/srpcach...f&icp=1&.intl=us&sig=leYGiDfZg99D._OrVXxxJg--Maybe there's confusion in the statement at wiki " 80-95% of diabetic cats experience something similar to type-2 diabetes? Let me know your thoughts on this; maybe he's confused between the two.
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Amanda said:
Glad you had a good vet visit with Gobbles!
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Thanks; he was impressed with the dosage changes (I told him I've had lots of help!), esp. when I told him Gobbles' latest improvement in physical and emotional conditions. I appreciate that he (like some vets AND human doctors) isn't trying to rip me off; it he was, he would have tried to talk me into more tests, skin biopsy, dental...etc. And he LISTENS to me his with undivided attention and knows I am being pro-active! I had a typed up list of questions, BG levels, condition, etc, etc, etc, and gave each of us a copy. And $59 for a check up and blood BG (and testing my meter vs. his) seems like a bargain.
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Yay! Thats a good vet visit. And I betchya you are teaching him a few things!

200 at the vet? Thats impressive! I would have thought if he was that stressed it would be a lot higher!
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Wendy&Tiggy said:
Yay! Thats a good vet visit. And I betchya you are teaching him a few things!

200 at the vet? Thats impressive! I would have thought if he was that stressed it would be a lot higher!
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I know...I was like "awesome!!!" Now take a look at the little joker's SS -- PMPS 390 ...and I would guestimate his BG at the vet (which was +7) was probably somewhere in the neighborhood of, say, 140?
 
Re: 1/21 GOBBLES PMPS 390

Take a look at Gobbles' SS and keep in mind that I LEFT HIS LANTUS OUT OVERNIGHT. The +7 reading was taken in the vet's office and Gobbles was so scared/stressed that the vet (and I) was impressed with his AlphaTrak reading of 234 (my ReliOn tested side by side @203) and we both agreed that those numbers were highly likely much higher than if I would of taken his BG at home, when he is not at all stressed. I was very worried that the insulin had lost potency/was no good because it was left out for 12 hours at 71 degrees. So is the the low AM +7 number indicative that the lack of refrigeration overnight (12 hours) did not necessarily lower the potency of the insulin? Or would I not know until PM (his evening shot was given at 7:15 pm EST) and his PMPS this evening was 390???????
 
Re: 1/21 GOBBLES PMPS 390

I seriously doubt the lack of refrigeration made any difference - you wont see it until the end of the insulins life which will be a little shortened. So I wouldnt even consider it and put it out your mind.

He may well have gone into green again if it hadnt been for vet stress.
 
Re: 1/21 GOBBLES PMPS 390

Wendy&Tiggy said:
I seriously doubt the lack of refrigeration made any difference - you wont see it until the end of the insulins life which will be a little shortened. So I wouldnt even consider it and put it out your mind.

He may well have gone into green again if it hadnt been for vet stress.
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you mean, by life, like in a few weeks? in all honesty, i'm scared that his BG will seriously spike...high...
 
Re: 1/21 GOBBLES PMPS 390 & an INTERESTING ?

I mean you will get 5 months out of it instead of 6 months. We are all saying its fine and you have noted it on your sheet so if we see weirdness a few months from now we will know why.
 
[url=http://www.catinfo.org/?link=felinediabetes:il43cdyk][b:il43cdyk]Feline Diabetes by Lisa Pierson said:
All cells in the body use glucose ("blood sugar") as their source of energy. However, in order for glucose to provide nourishment to the cell, the glucose must get inside the cell. Insulin, which is produced by the pancreas, is the substance that tells the 'front door' of the cell to open up in order to let the glucose inside. If this system is disrupted for any reason, the glucose cannot enter the cell and subsequently, the level of glucose increases in the blood stream (hyperglycemia) and the cells go 'hungry'.

There are two types of diabetes. Type 1 and Type 2. Type 2 is the more common form in both humans and cats.

Type 1 occurs when the beta cells of the pancreas are not able to produce enough insulin.

Type 2 is characterized by two problems. The first, as in Type 1, is a diminished ability of the pancreas to secrete insulin. The second issue is one of insulin resistance. In other words, the receptors on the cell wall that would normally open the door to the cell to let the glucose in when insulin 'knocks', stop 'listening' to the insulin. The cells 'resist' the signal that the circulating insulin is sending and the glucose is not transferred to the inside of the cell, resulting in an elevated blood glucose (hyperglycemia) and cellular 'starvation'. The elevated blood glucose, in turn, sends a signal to the pancreas telling it to secrete more insulin. The elevated insulin may somewhat override the insulin resistance resulting in more glucose entering the cells, but eventually the pancreas can become exhausted or 'burned out'.
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A cat with Type 1 diabetes will not go into remission. A cat with Type 2 diabetes can go into remission. Because a cat needs insulin is not how you differentiate. Further. oral diabetes medication is not indicated in cats. It will burn out the pancreas. Humans with Type 2 diabetes use insulin as do our cats. Unfortunately, either your vet is over simplifying or is not that knowledgeable about feline diabetes.
 
I have no idea--he's probably over-simplifying for me. He's not the vet that diagnosed the diabetes --the first vet got "fired" by me for several reasons, including that when Gobbles' diabetes showed up in bloowork (it was over 500) he would not put him on insulin; merely gave him "a little dose of insulin" while I was at the office, then basically forced me to buy DM cans & dry food (which bore stickers on them "no returns") , which he said should "clear up the diabetes"...quack...and I knew 100% nothing about diabetes at the time. After his dx and vet visit, I called my cousin who DID have a cat w/diabetes (her cat has sinced passed, at the age of 22) who immediately came over my house, gave me a glucometer, showed me how to test, referred me to a different vet and told me that I needed to register at FD.com because that's where SHE had so much help from:)
 
to your question about insulin lasting...

I used the same vial for 100 days and didn't notice any decrease in effectiveness... and i dropped it at least 3 times , left it on the counter
for many hours once and kept it in the door in the early days before Carl told me it shouldn't be in the door where it could get slammed around,
especially with kids around....
 
The info Sienne gave you is right on. There is no difference between humans and cats in the definition of Type 1 and Type 2 diabetes. I would add that in Type 1 diabetes, the beta cells cannot heal and that's why Type 1 diabetic cats cannot go into remission. In Type 2, they can.

When insulin gets "Toasty", you don't automatically see numbers get high. They usually become a little wonky instead.

Glad the vet visit went well!
 
I don't recall your cousin but I've been here for around 3.5 years. She may have pre-dated me. Unless, she used a screen name or she didn't use Lantus. If she used a different insulin or pre-dated me, someone like Jill may know her.
 
Sienne and Gabby said:
I don't recall your cousin but I've been here for around 3.5 years. She may have pre-dated me. Unless, she used a screen name or she didn't use Lantus. If she used a different insulin or pre-dated me, someone like Jill may know her.
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I believe it was vetsulin.
 
Re: *DUPLICATE- contained in Condo *IGNORE

I don't think you want to make the subject line of this first post *DUPLICATE* as the moderators might think you want it deleted.

I am guessing you wrote that because you edited your first post to add some things that were written in the posts below the first post? Is that right? I wasn't here yesterday, so I'm just assuming.
If that's right, then just take out the things that you added to your first post that are duplicates of what's included in the posts below, then change your Subject Line back to 1/21 GOBBLES PMPS 390 & ? ;-)
 
Re: 1/21 GOBBLES AMPS 286 +5~218 +7~203*STRESS @VET

Sienne and Gabby said:
Just as an FYI, 80 - 95% of cats experience something that is similar to Type-2 diabetes. I'm not sure why your vet thinks Gobbles has Type 1 diabetes.
Click to expand...
I was browsing the "Are you new & confused about our jargon?" glossary under the The Main FDMB Forum and found this re: type 1 and type 2 diabetes:

"Type I - Diabetes Where the body produces no insulin, also called Insulin Dependent Diabetes Melitus (IDDM), or juvenile onset diabetes. Insulin is required with a Type I cat. Type I cats are more susceptible to ketoacidosis. Oral medications will not work with Type I cats. Estimates are about 40% of diagnosed cats are Type I diabetics.
Type II - Diabetes Where the body still produces some insulin, but the insulin is unable to act properly to transfer blood glucose to the cells, also called NIDDM (Non IDDM). Type II diabetes can be mild, requiring only oral medications, to severe, requiring large amounts of insulin. Usually Type II is brought on by obesity in older cats, with high carb diets also suspected as a risk factor. Some cats progress from Type II to Type I as the diabetes progresses. About 60% of diabetic cats are Type II."

Then this information is outdated? I just thought that I would bring it to your attention :)
 
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