12/22 Furball +10=263 AMPS=270 +8.25=238 PMPS=257

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Hi Carla, sometimes I get a lot of air in the syringe the first draw. It's annoying. I have to use 3.0 reading glasses AND a magnifying glass to examine my syringe after the draw to make sure I can see insulin in the syringe and not just air.

Glad that Furball is her happy purrry self. :bighug:
 
carfurby said:
I'm not sure what you mean by that. I use calipers to measure my dose.
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Before I draw out of the pen (6u) I dial in 6 units on the pen and push the plunger as if it had a needle on it. Then as I draw out the 6 units the pressure is equalized. The plunger in the pen must move down as you draw out. Even with small doses occasionally you would have to push the pen plunger as the cumulative effect would be the same as larger doses.
 
Annoying air bubbles! I hope they stop or you're done with that pen soon anyway. Glad Furball is happy and purry, paws crossed for blue today! :cat:
 
MyTitan said:
Before I draw out of the pen (6u) I dial in 6 units on the pen and push the plunger as if it had a needle on it. Then as I draw out the 6 units the pressure is equalized. The plunger in the pen must move down as you draw out. Even with small doses occasionally you would have to push the pen plunger as the cumulative effect would be the same as larger doses.
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I've never done that. I just draw the insulin out and the plunger moves down on it's own. That's not possible with doses that aren't a full unit any way.

Stacy & Asia said:
Annoying air bubbles! I hope they stop or you're done with that pen soon anyway.
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Unfortunately it's mostly full. I'm wondering if I got a bad pen.
 
I had a pen of Lantus that no matter what I tried I was getting mostly air. I ended up tossing that pen after spending too much time trying to get a good dose from it.

Work the juice Furball!
 
carfurby said:
Yesterday: http://www.felinediabetes.com/FDMB/...ps-265-10-5-294-pmps-320.188363/#post-2093045

Furball was happy & purry this morning. I'm pretty sure I got a good shot in this morning. The first time I drew it, half of it was air. I'm wondering if it could be the pen.

I'm not sure what you mean by that. I use calipers to measure my dose.
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The pen, before we deconstruct it for syringe use, has a dial that measures how much insulin you want to give your cat. You turn the dial to the amount of insulin you want to give. . It's not considered to be very accurate.

Glad furballs's happy and purry. Hope she goes downward for you.
 
carfurby said:
I've never done that. I just draw the insulin out and the plunger moves down on it's own. That's not possible with doses that aren't a full unit any way.
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By doing that you have a negative pressure in the pen all the time and air will try to get in all the time to equalize the pressure. Even if you dial in 1-2 units every couple days, try to keep positive pressure in the pen , then air won't be trying to get in. Just a suggestion
 
I got to leave work early and caught the low yellow.

MyTitan said:
By doing that you have a negative pressure in the pen all the time and air will try to get in all the time to equalize the pressure. Even if you dial in 1-2 units every couple days, try to keep positive pressure in the pen , then air won't be trying to get in. Just a suggestion
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Thanks for the suggestion. I may try it. I've been through several pens and not had this problem. I don't know what is going on.
 
carfurby said:
I've never done that. I just draw the insulin out and the plunger moves down on it's own
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Me too. Never "dialed".

The syringes I use have been great as of late. For the first year I fought air bubbles off/on but now the plastic is "slicker" and clearer and they draw beautifully.
 
LizzieInTexas said:
Me too. Never "dialed".

The syringes I use have been great as of late. For the first year I fought air bubbles off/on but now the plastic is "slicker" and clearer and they draw beautifully.
Click to expand...

Never dial either (though I'm not an old hand). Wondering if the bubble issues is coming from the syringe rather than the pen...
 
Stephanie & Quintus said:
In human studies I actually read it was more accurate and consistent with the pen than syringes -- unless my tired brain is tricking me.
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My former vet - a genius surgeon and a woman who kept up on everything, stated, "I worry about the accuracy of the pen." I suspect that humans have more difficulty reading the syringe, given that so many of them have Type 2 diabetes that usually onsets at around the same time that cataracts begin to form. This is pure speculation on my part.
 
LizzieInTexas said:
It was the syringes here because I used viles for the first 8 months or so and then went with the cartridges/pens. It wasn't until I got a new batch of syringes that the issue resolved.
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According to a longish thread here, the syringes are often inaccurate, with variances large enough to interfere with accurate dosing. I think several who were involved in that thread were using calipers.
 
@Kathy and TiTi one thing that might come into play with cats is that with the pen, you really need to keep it "in there" for a good 5-10 seconds. Even with complacent Quintus I often ended up with a drop of insulin still oozing out of the pen after the shot. Less of an issue with humans as they will just stay put for however long the needle needs to stay in.
 
LizzieInTexas said:
Me too. Never "dialed".

The syringes I use have been great as of late. For the first year I fought air bubbles off/on but now the plastic is "slicker" and clearer and they draw beautifully.
Click to expand...
There's significant difference between the BD syringes, and the Walmarts' specials. Wish I could afford the BD syringes all the time.
 
Stephanie & Quintus said:
oh, found this: "Using the pen needles with pens is known to be more accurate than syringes at small doses (less than 5 units)."

in the sticky http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/
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@Kathy and TiTi

Your quote is for dosing in whole units. See the parts I have bolded below.

USING PEN NEEDLES WITH AN INSULIN PEN:
  • When dosing cats, there can be more negatives to using pen needles with an insulin pen than positives:
    • Inability to administer doses in increments of 0.25 - 0.50 units with pens.
    • Forgetting to "prime" the pen prior to each use will result in a smaller dose than intended. Priming the pen involves wasting 2 units of insulin for every shot.
    • One must keep the pen needle in for 5 - 10 seconds after the shot or you'll run the risk of not administering a full dose (can be tough with some cats).
    • Manufacturers do not recommend refrigerating an in-use pen. Therefore, shelf life may be shortened to 28 days (Lantus) and 42 days (Levemir).
    • Some FDMB members have reported shots administered from insulin pens are more uncomfortable than from a syringe (?)
 
@carfurby yes, obviously you can't do smaller than one unit with the pen, but that's not a question of accuracy, it's a question of what increments you can measure. Accuracy would be the error/uncertainty on the measurement. ie if you measure 1ui with the pen, how close are you really going to be to 1ui? and then with the syringe? I think I recall seeing somewhere that with the pen, the uncertainty tends to be repeatable, which means that even if you're getting (say) 0.95 instead of one, you're more likely to be getting 0.95 each time.
 
I dislike the pens. The old cartridges were much easier to draw from. Unfortunately you can no longer get Lantus or Levemir in cartridges in the US. They are still available in Canada.
Carla, I think you might have a bad pen. Can you smell insulin when the pen is not in use? I had one of those once, took it back to the pharmacy, and eventually got a replacement, free.

Now, just to add to the fun of this discussion: Rusty got a fur shot this morning :cat:. No fat on the cat means no room for error under the skin!

Merry Christmas, Carla! Furball, let's see some green for Christmas, OK?
 
carfurby said:
@Kathy and TiTi

Your quote is for dosing in whole units. See the parts I have bolded below.

USING PEN NEEDLES WITH AN INSULIN PEN:
  • When dosing cats, there can be more negatives to using pen needles with an insulin pen than positives:
    • Inability to administer doses in increments of 0.25 - 0.50 units with pens.
    • Forgetting to "prime" the pen prior to each use will result in a smaller dose than intended. Priming the pen involves wasting 2 units of insulin for every shot.
    • One must keep the pen needle in for 5 - 10 seconds after the shot or you'll run the risk of not administering a full dose (can be tough with some cats).
    • Manufacturers do not recommend refrigerating an in-use pen. Therefore, shelf life may be shortened to 28 days (Lantus) and 42 days (Levemir).
    • Some FDMB members have reported shots administered from insulin pens are more uncomfortable than from a syringe (?)
Click to expand...

I loathed the pens for all the reasons you have stated. And for one more reason - holding the needle of the pen in TiTI for 10 seconds resulted in a naked circle in her fur. The circle is still there, 3 1/2 years later, and it is the exact diameter of the pen I used. I then learned how to take the pen apart and use it like a vial. However, the pens are pricier then the vials, and since TiTI is a high dose kitty , I had no reason left to use a pen.
 
Ella & Rusty & Stu(GA) said:
Carla, I think you might have a bad pen. Can you smell insulin when the pen is not in use? I had one of those once, took it back to the pharmacy, and eventually got a replacement, free.
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Yes, I can smell insulin when the pen is not in use. Maybe I need to take it back to the pharmacy, but it's been a while since I got it. They may not replace it. I didn't need it right away.
 
Merry Christmas!!! Good luck with the increase.

I know you’ve done SLGS for years but it looks to me like Furball has some glucose toxicity. If there is a way to not hold doses longer than seven days, I wouldn’t if her nadirs are above 150, which they have been.

In fact, with your experience and the fact that she is back from remission, if you are doing curves every five days and she needs an increase, I’d suggest giving it to her then instead of waiting.
 
@Marje and Gracie Merry Christmas to you and Mike and your family!

Thanks for the advice. I just discovered my pen that I've been using for the last month is bad. I think that has been causing her wonky numbers from not getting a consistent dose. Hopefully I'll see some improvement in her numbers with the new pen.
 
carfurby said:
@Marje and Gracie Merry Christmas to you and Mike and your family!

Thanks for the advice. I just discovered my pen that I've been using for the last month is bad. I think that has been causing her wonky numbers from not getting a consistent dose. Hopefully I'll see some improvement in her numbers with the new pen.
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Thank you, Carla. I hope all of you also have a great Christmas. :bighug::bighug:

I don’t see how a leaky pen would cause any issues with dosing. If the insulin is clear and doesn’t have floatie’s, it could be just that you are losing insulin out of the pen but it doesn’t affect drawing the dose.

However, my bigger point was holding doses too long :):)

MyTitan said:
Before I draw out of the pen (6u) I dial in 6 units on the pen and push the plunger as if it had a needle on it. Then as I draw out the 6 units the pressure is equalized. The plunger in the pen must move down as you draw out. Even with small doses occasionally you would have to push the pen plunger as the cumulative effect would be the same as larger doses.
Click to expand...

This is not necessary. I used a pen and drawing with syringes for 5-1/2 years and never messed with dialing in the dose on the pen to equalize pressure. I seldom had bubble issues. You don’t need to push the pen plunger...you never need to touch it....if you are drawing with syringes. It’s different if you are using the pen needle...but see below.

If you have bubbles in the syringe, it’s usually due to the way you drew the dose. Sometimes pens get bubbles in them if they are dropped or moved around a bit but that doesn’t affect the insulin. If you draw the bubble from the pen into the syringe, you will have bubbles in your syringe.

Kathy and TiTi said:
My former vet - a genius surgeon and a woman who kept up on everything, stated, "I worry about the accuracy of the pen." I suspect that humans have more difficulty reading the syringe, given that so many of them have Type 2 diabetes that usually onsets at around the same time that cataracts begin to form. This is pure speculation on my part.
Click to expand...
I would never use the pen plunger/dial adjustor to dial in a dose and I never did. It isn’t necessary if you are using a syringe. The dial a dose is only if you are using pen needles like humans use. You would not be able to dial in a dose less than 1u unless you use a pen made for a child.
Stephanie & Quintus said:
oh, found this: "Using the pen needles with pens is known to be more accurate than syringes at small doses (less than 5 units)." in the sticky http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/
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That information is for humans. You need to read the rest of the sticky regarding small doses we give to cats and Carla also provided additional info above. I know you don’t use the pen needles but I wouldn’t want someone to read that quote and think using it for cats is the best way to go. It’s not.
 
carfurby said:
Yes, I can smell insulin when the pen is not in use. Maybe I need to take it back to the pharmacy, but it's been a while since I got it. They may not replace it. I didn't need it right away.
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It's worth a try. If you bought a 5 pack it would be impossible to take one back immediately. You wouldn't know it was defective until you used it.
 
Kathy and TiTi said:
According to a longish thread here, the syringes are often inaccurate, with variances large enough to interfere with accurate dosing. I think several who were involved in that thread were using calipers.
Click to expand...
I use calipers. Have for quite a while. These are the syringes I use. $11.17/100.

https://www.adwdiabetes.com/product/16367/carepoint-vet-u-100-pet-syringe-31g-half-unit

They have changed something with them and I rarely get air bubbles any more and if I do they are easily resolved.
 
Stephanie & Quintus said:
Calipers seem the way to go, though I'm not exactly sure what they are or how they work!
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Here is Marjes instructions on calipers (with video)
http://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/

Here is how we got set up.

http://www.felinediabetes.com/FDMB/...262-pmps-232-2-202-4-186.170988/#post-1865365


ETA - using calipers you are accomplishing consistently accuate dosing based on measurements if an instrument vs. inconsistencies in lines on a syringe. It is more the dosing consistency that is the important factor.
 
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