8/30 Zeus AMPS 187 dosing & effectiveness

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knolet

Member Since 2012
I have a couple of questions for the group. First, I am using the vials of Lantus, I know many people recommend the pens, but I wasn't able to convince the vet.... Anyway, for those that also use a vial, how long is it good? I had used the prior vial for 3.5 months. I do keep it refrigerated, and treat it carefully. I've read anywhere between one month up to six months. One of our vets said four months and the other said six. And I have read some posts that say they use until they get wonky numbers. Just curious what others have experienced.

Second question, it has been suggested to me that we might want to try an experiment with Zeus, and try dosing him once per day at 1.5u for a week. The reason being that she is thinking the Lantus is working for 18 hours in Zeus, rather than a 12 hour cycle. I know Lantus is supposed to be dosed twice per day, and then there is the shed issue. But I also know that ECID :smile: and I have seen some odd dosing routines that have worked for others here.

Any thoughts?

I did just increase to 2u Bid a couple of days ago, and the numbers have come down a bit, so I am very happy with that. I think it is making Zeus feel strange though, he didn't want to sit still this morning for his test.

Have a great day all :smile:
 
If you go by what the manufacturer tells you, an opened container of Lantus is good for 28 days. I can't speak directly for the vials but many people here will use their insulin until they start to get wonky numbers or see crystals in the insulin. I don't know that I'd go beyond 3 mos. with a vial, though. I get about 40 days from a pen.

I'll be honest, I don't see an 18 hour cycle with Zeus. There are some days when his nadir is later but that's normal. The nadir isn't a fixed point. Gabby's nadir is usually at +3 or +4. There are also days when it's at +6 or +8. Even with cats that typically have a late nadir, they are still dosed twice a day. I think if you switch to once a day dosing, you're going to lose considerable time since the insulin depot will largely be depleted, there won't be duration, and you'd be giving less total insulin (i.e., you're now dosing 1.75u twice a day or 3.5u daily and you're proposing to drop the dose to 1.5u daily). Bottom line, though, is that I do not see an extended duration in Zeus' case.
 
~O) ~O)
I have the vial too, started on July 10. I planned on watching to see when I felt it was losing it's effectiveness. ( of course, I dropped it
last night, twice :twisted: ) But I am preparing myself that I might need some by the 3 month mark. Mainly because I'm more than 1/4
thru it ( I overload it so I can shoot out enough to get the bubbles out so I waste some)

I would not go to once a day. That's not how lantus works and those who have done that get no where, they just have a higher number cycle on the absent shot side. And then how can their numbers even out. That would really make a cat feel off, I would think.
You are starting to see some progress so I wouldn't waste precious time doing that.

And the not sitting still could very likely be he is feeling a lot better than he was and he's ready to move on. My girl feels that way.
She's playing and able to jump more now and who wants to have their ears messed with and be still.
When they were feeling so bad, they didn't have the spunk and as they start feeling good ( getting down in lower numbers makes them feel
much better) , then they get their mojo back. Does that make sense?
 
We used vials for a year. Ours never lasted more than about 40 days and that was being super super careful with them. Hopefully you will get more out of them, but we would end up throwing half out each time so we switched to pens. It took some convincing for my vet as well. He did a lot of research on his own before he would do it.
 
Sienne and Gabby said:
If you go by what the manufacturer tells you, an opened container of Lantus is good for 28 days. I can't speak directly for the vials but many people here will use their insulin until they start to get wonky numbers or see crystals in the insulin. I don't know that I'd go beyond 3 mos. with a vial, though. I get about 40 days from a pen.

I'll be honest, I don't see an 18 hour cycle with Zeus. There are some days when his nadir is later but that's normal. The nadir isn't a fixed point. Gabby's nadir is usually at +3 or +4. There are also days when it's at +6 or +8. Even with cats that typically have a late nadir, they are still dosed twice a day. I think if you switch to once a day dosing, you're going to lose considerable time since the insulin depot will largely be depleted, there won't be duration, and you'd be giving less total insulin (i.e., you're now dosing 1.75u twice a day or 3.5u daily and you're proposing to drop the dose to 1.5u daily). Bottom line, though, is that I do not see an extended duration in Zeus' case.
i agree with sienne. I'm really not seeing 18 hours cycles either.

however, just a note...
having one cycle overlap the next is eventually what you want to see happen. overlap will cover the first part of the cycle before the next shot "kicks in". this is what leads to the long flat cycles lantus is known for. overlap is your friend. :mrgreen:

as to longevity when using lantus vials... many have used vials until the last drop or as long as 6 months. others haven't been so lucky. imho, checking your insulin for the tell-tale signs described below becomes important as your vial becomes older.

From the STICKY: LANTUS & LEVEMIR - INFO, PROPER HANDLING, & STORAGE:

HOW DO YOU KNOW WHEN YOUR INSULIN IS NO LONGER GOOD?

  • When you lose regulation for no reason.
  • If you see any hint of "floaties"/"tiny particles"... discard the insulin.
  • If insulin is cloudy or discolored, or if rubber stopper is cracked... replace insulin immediately.
  • The manufacturer of Lantus recommends discarding the insulin after 28 days of use (in-use, unrefrigerated, for humans).
    However, many Lantus users have been able to use a vial/cartridge/pen for as long as six months.
  • The manufacturer of Levemir recommends discarding the insulin after 42 days of use (in-use, unrefrigerated, for humans).
    Many Levemir users have been able to use a vial/pen for four to six months... some to the last drop.
  • Opened Lantus and Levemir vials, cartridges, and pens can last longer than many FDMB members seem to think. Some caregivers of diabetic cats have used Lantus/Levemir down to the last drop. Lantus users from the German Katzen Forum have reported using opened Lantus for up to six months and Levemir up to four months if kept refrigerated and handled properly. Lantus is NOT as fragile as we once thought.

    From two of the leading researchers in the field of lantus use with feline diabetics, Jacquie S. Rand BVS, DVS and Rhett D.Marshall BVS (University of Queensland, Brisbane, Australia):

    "Glargine should be refrigerated because it has a shelf life of 4 weeks once opened and kept at room temperature. We have found that opened vials kept refrigerated can be used for more than 6 months. If using an insulin pen, the manufacturer recommends that once a vial of insulin is used, the pen be kept at room temperature because temperature changes associated with refrigeration alter the volume administered by the pen."
    http://www.uq.edu.au/ccah/index.html?page=43599&pid=0

    We use U100 syringes to draw Lantus from cartridges and pens. We do NOT use needle tips which can be attached to the pens to administer insulin. Therefore, refrigeration will not alter the volume administered by the pen apparatus. Refrigeration combined with the use of syringes to draw insulin (versus using the needle tip made for the pen) from the opened pen has been found to extend it's life well beyond the 28 days suggested by the manufacturer.
  • Unopened Lantus is good until the expiration date stamped on the box if refrigerated and handled properly.
 
Thanks everyone. I wasn't seeing an 18 hour cycle either, but didn't know if I was just missing it. I was a little shocked about the suggestion to shoot once per day. I am actually giving 2u now bid, so a total of 4u in a 24 hour period. I wasn't proposing making the switch to 1.5u once per day, just wanted to see what others thought of the idea. As you mentioned I am just starting to get some good numbers and I don't want to jeopardize that in any way.

Thanks again for taking time to look over Zeus' spreadsheet. I appreciate all comments and suggestions.
 
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