Full Time RVers - Newly diagnosed - Insulin stability?

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Barb M

Barb M

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Our Tigger is newly diagnosed and we will start him on insulin tomorrow.

However, we are full-time RVers and moving every 1-4 weeks.
We would prefer to use Lantus due to the ease of getting it anywhere/Walmart instead of a vet.

However, the handling instructions say it should not be shaken and the vet with whom we consulted had concerns about it's shelf life in the RV fridge.

We are wondering if Prozinc is more durable or if there are any RVers who can speak to the stability or methods of transport of either brand of insulin.

We'll get up to speed on this and get our dosage chart started tomorrow.
Thank you for your help.
 
The only way you'll really know is to try it and observe test data on how it is performing.
Place it on a stationary shelf in the fridge, maybe with some shock-absorbing padding to help keep it from jostling much.
 
Barb Mittelstaedt said:
However, we are full-time RVers and moving every 1-4 weeks.
We would prefer to use Lantus due to the ease of getting it anywhere/Walmart instead of a vet.

However, the handling instructions say it should not be shaken and the vet with whom we consulted had concerns about it's shelf life in the RV fridge.
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Just an FYI: Several years ago we had a full time RVer in the Lantus Group. They had a travel blog. They used Lantus successfully and didn't have any problems. IIRC, their kitty went into remission. I can't remember their names, but let me put out a few feelers to see if anyone else remembers.

@Libby and Lucy
@Sienne and Gabby
@Marje and Gracie
@Dyana
@CD and BigMac
 
Thank you very much for your responses!
That helps provide some perspective, and the bottom line is there's no way to know how anything will tolerate our conditions until we try.

We have four cats and some recent hefty vet bills so I was hoping to reduce the error rate.

It sounds like it will be fairly easy for us to get either from an online source if necessary so it will just come down to which works best for Tigger.
We may try Lantus and set up a padded container to see how it goes. We don't off roading in our bus-sized RV...but not all roads are smooth.
 
Barb Mittelstaedt said:
We don't off roading in our bus-sized RV...but not all roads are smooth.
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Ha! I remember the other RVers saying the same! :)

I've been searching for info, but I'm not coming up with the name of the RVing members. If I remember, I'l let you know.
At least you know Lantus is an option.

Good luck with whichever insulin you choose!
 
I met some RVers a couple of weeks ago with a sugar kitty. You weren't at Hunting Island state park recently by any chance?
 
Carl & Polly said:
I met some RVers a couple of weeks ago with a sugar kitty. You weren't at Hunting Island state park recently by any chance?
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We're in Port Aransas (Corpus Christi) TX for now, and we've been in TX since early November.
We're from WA so we're headed back West starting March 11th.
We hope to make our way to the East coast the 15-16 winter and spring....and Hunting Island looks like it should be on the list.
 
Not sure if this is who you were thinking of Jill, but Mary and her DH traveled with Oliver in an RV. I don't think they were full-time but went back and forth between two residences that were far apart...WI and FL maybe?

I can send Mary a PM. I'm not sure how often she checks in since Oliver is now in remission.
 
Marje and Gracie said:
Not sure if this is who you were thinking of Jill, but Mary and her DH traveled with Oliver in an RV.
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Oh gosh, I forgot about them. That wasn't who I was thinking of, but if you wouldn't mind sending her a PM, she might have some thoughts or ideas to share with Barb.
Thank you, Marje!
 
Barb
After I thought about it I realized it couldn't be you. The folks I met were using compounded PZI, and their kitty was close to being in remission, so the question about Lantus wouldn't have been logical.
That said, I feel fairly certain that any insulin could survive a life on the highways and byways. Lantus is more sensitive to being shaken than Prozinc might be. But it isn't like it's nitroglycerin. :). And RVs aren't likely to be going off road, like you said. If you do stray off road, you've got bigger problems to deal with than some insulin getting bounced around.

If you do visit the east coast, yeah, H.I. is a pretty sweet place to spend a few days or weeks! I live and work here, so I admit I'm biased!
 
Hi Barb,
Welcome aboard! I wanted to pop in and share that we jiggled Ollie and his liquid gold Lantus across the country for a year without any loss of effectiveness. He is in remission now, but i still carry his insulin vial with us. I think its like not getting rid of all your maternity clothes.
We're usually gone 2 weeks every month for work so his insulin spent a lot of time on the road and worked to perfection from start to last drop. All of Oliver's travels while he was using insulin were in our semi. (By the time we got the MH, he was in remission.) I think the tractor/trailer bounced around more than our MH so i believe your fridge with some small padding is going to be perfect.
I don't think you have to worry too much about your MH shaking your insulin. A little cushioning, finding the best spot in your fridge and you should be good to go. I have used paper towels, gel and finally cotton balls to make a cushy, shock absorbing bed for our vial. Are you using a vial or did you buy pens?
We used a vial and here's what we have done.
I put his vial in a water tight pill bottle with cotton balls at the bottom. That's so no liquid can get at it. Then that pill bottle goes in another container filled with cotton balls. My mind likes to think all the cotton balls will absorb any shocks and keep the Lantus from thinking its being "shaken". I put all the containers and cotton balls in the fridge overnight before i insert the vial, just to make sure the whole concoction is cool before inserting insulin.
I also have a little ( lunch sized, maybe 5"x5")soft sided cooler, just for insulin in case I have an issue with the MH fridge. My whole series of containers, being water tight can go in the cooler with ice if need be. (walmart camping department has lots of watertight containers)
I made one shock absorbing bed using gel beads I found in the floral dept at Walmart. You add water and they swell up. They are for holding flowers but now have a second life as insulin padding. I put them in baggies...double bagged, then into a tall container. I put my vial in its pill container in between the baggies with the gel and felt pretty confident that most of the road jiggle didn't transfer to Lantus vial.
You might ask your vet for a back up prescription. I always carry one, just on case. I was told they are good for a year from the date they are written so you wouldn't have to be on the phone trying to get one called in to where ever you are if you need to replace sweet Tiggers insulin.
We used the vial so I don't know about the pens - but our script allowed 3 refills. If you get it from Walmart, you'll be in their system and they can look up and refill your script anywhere in the country. (easy in, easy out of those parking lots)
Our MH is old so i worry about the temp at different spots in the fridge. I bought a little thermometer and moving it around, found that the best temp for his insulin is at the back on the right side of the second shelf in the fridge. I wanted to put it in the veggie drawer on the bottom, but that's the warmest part of our fridge. I'm sure you know, but don't use any spot in the door.
One other thing we did was to use an empty clorox wipes containers (a.k.a. any heavy duty plastic) for our used syringes and lancets. As it filled, i would bring it to the Walmart pharmacy and most times they would take my container and dispose of it for me. Not always, sometimes they would look at me like i had 3 heads, but most times they were happy to help.
I'm a little jealous of you being full time RVers! If we ever get to retire, i want to be you!!!! We have 3 cats who travel with us in the MH.

You go girl! You are in the very best place to take care of sweet little Tigger. These wonderful people guided us through every situation you can think of and are totally responsible for us being able to get Ollie into remission.
If there's anything you need, this is the spot.
xoxo Mary and Ollie
 
Thank you, @ecurie (Mary). Great info.

@Jill & Alex (GA) ...I know there is someone else, too, but I went through the OTJ list and infrequent posters list and couldn't come up with it. But you are right...we did have another traveling member.
 
Jill

I also remember them but can't remember the Beans names but wasn't the kitty Boris?

Mel and The Fur Gang
 
Thank you all for your help and insulin stability advice.

Prior to joining FDMB, we had a phone consult with Dr. Lisa Pierson from CatInfo.org. She insisted we join this community, and we're VERY glad we did. Your kindness and depth of understanding far exceeds what we've experienced with some of the "professionals" in which we've interacted.

Traveling around and trying to find a new reasonably priced good veterinarian in whatever town in which we're having cat issues is challenging.
The vet we found in Corpus Christi accepted that we had done our research and was very cooperative.

Tigger tested at 309 in the office and she was going to recommend Humulin-N insulin because that was what she normally used.
I asked her if we could use Prozinc, and she was willing to look up the dosage recommendations and prescribe that.

We ordered Prozinc last night from AlliVet.com for $90 for 10ml + shipping.
We decided to start with Prozinc because Lantus was $288 @ Walmart.
It sounds like we've got decent odds it will do the job for Tigger for a third the price.

Thank you again. We hope remission is in Tigger's future.
 
Welcome to the "Club". We have put together a protocol for ProZinc. It is in blue type in my signature. It will give you a game plan to get started. An advantage of it is that you are not set on a strict 12/12 schedule. That is ideal, at least at first, but ProZinc does allow flexibility. One of the things that is different about it is that it is a suspension insulin so you do need to roll it back and forth in your hands to mix it together before dosing. This also warms it up a little. (I never realized that this made a difference until once when I got a cold flu shot - ouch!)

We traveled often with Oliver. Not with an RV, but in pet friendly motels and VRBOs. He was very adaptable, as long as his meals were on time. :D
 
Sue and Oliver (GA) said:
Welcome to the "Club". We have put together a protocol for ProZinc. It is in blue type in my signature. It will give you a game plan to get started. An advantage of it is that you are not set on a strict 12/12 schedule. That is ideal, at least at first, but ProZinc does allow flexibility. One of the things that is different about it is that it is a suspension insulin so you do need to roll it back and forth in your hands to mix it together before dosing.
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Thank you very much. This answered several questions.
We're getting confusing readings on our first day but we'll get a bit more data before forming this into a question.
 
FYI: If you ever get a really funky test value, at odds with what you've been seeing, test again. Meters are not intended to provide lab-equivalent values!
 
BJM said:
FYI: If you ever get a really funky test value, at odds with what you've been seeing, test again. Meters are not intended to provide lab-equivalent values!
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Roger that. Our problem is we don't know what to expect as newbies. He was at 240BG at 10pm.
We were told to start with 1 unit, but we gave him his first dose of only 0.6 units to play it safe.

At 9am he was 50 on our new meter. We checked with our older meter and it was 56.
That surprised us so no AM shot today.
3pm feeding then 345BG @ 9pm + feeding + 0.8 shot at 9:50pm.
We'll see if that brings him down gently in the morning so we can give him another shot.
Baby steps. We're both kinda intimidated by this, and it sounds like too low BG is a scary situation.

We deeply appreciate this community, and your help/guidance.
 
That was a low pre shot number and definitely merited a no shot and, I'd suggest, a decrease in dose. The higher pmps you got later is likely both a bounce (when their body perceives a number lower than it is used to, it releases extra glucose resulting in a bounce to a higher number) and a reaction to 24 hours without a shot. I am a little concerned with your one unit dose for the 278 ( because .6 on a 240 gave you the low pre shot and possibly very low numbers prior in that cycle?). I hope you can monitor carefully today, starting with a +3 to see how his is doing (is he dropping fast?) and +6 to see that he is not too low, +8 to be sure he is not still dropping. It may be that the one unit will be fine; I just want you to keep an eye on him.

For reference, we consider a cat regulated if they are in the lower 200s at present and in double digits at nadir, but not below 40 which is approaching hypo territory). Higher 200s are very normal this early in the game as it takes awhile for his body to learn to use the insulin. Our usual advice with the low present would have been to lower the dose at the next pre shot (even if the number seemed a little high) and keep it at that lower dose for a few cycles. Our thinking is that, at first, you want to start low and go slow, raising the dose only if he seems to be consistently in higher numbers, and then raising by .2 or so.

Can you include in your spreadsheet (maybe at the top on caps) that your spreadsheet is from the bottom up. Most people put their current numbers at the bottom so the history is readily available. Your way is fine - we just need to know that when we are looking for numbers in a hurry, if you need help.
 
Thank you. I added the note to the top of the sheet. Thank you for the rebound reminder/warning.
We were not thinking about that when we gave him his 1.0 dose this morning. We tested at +3.5 and he was still at 283 so no crashing so far.
We'll check him again at +6. This is quite a process.
 
The temperature in our RV fridge varies quite a bit.
We've tested several locations and have tried to keep the insulin stored between 36-46f as per the instructions.

However sometimes it gets cold, and I'm assuming that will shorten the shelf life of the vial.

When we pull it out of the fridge it's cloudy, not clear.
Are we already screwed or is that typical?

150222.insulin.jpg
 
Cloudy should be all right. It's when you get floaties that we get concerned. And when it stops working.

And it seems to be working very well. I'd suggest too well. Shooting below 150 at first is pretty risky and can mean big bounces the next cycle. And you always want to be sure the number is rising, not falling so you aren't adding a new dose onto one that is still working. I think your higher numbers are most likely bounces from low numbers mid cycle. Make sense?

If he were mine, I wouldn't shoot below 180 (and then be sure he is rising) and shoot a lower dose like your .6 and be sure it is a cycle in which I can get a number 5-7 hours in to see how low it takes him. My guess is that it took him a couple weeks to really settle into the insulin and now he is dropping pretty rapidly. A time to be cautious with dosing and monitor carefully.
 
I'm pretty sure it is supposed to look cloudy. Just without "chunks or foaties", like Sue said.
 
Barb M said:
When we pull it out of the fridge it's cloudy, not clear.
Are we already screwed or is that typical?
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Hi Barb,

"ProZinc is presented as a cloudy, white suspension" according to this article:
http://www.ema.europa.eu/docs/en_GB...ment_report/veterinary/002634/WC500147213.pdf

There is also brief mention of a freeze/thaw test having been done, and I think the implication was that the insulin survived that test, but that the recommendation was still that the insulin shouldn't be frozen. (But I've looked back through the article and can't find that bit now. Maybe someone with better eyes than mine can spot it...)
.
 
Hi folks! I am going to be on the road for the next 9 months or more, and was happy to find this thread! And another that mentions keeping Prozinc in an ice chest on road trips.

I'm wondering if anyone can point me towards hard data? Are all insulins the same in regards to heat tolerance, or is PZI the same as Prozinc in that regard? Is prozinc extra fragile?

I'm worried because I have been using a laser temperature gun on the contents of my ice chest, and even insulin wrapped in an ice pack is often over the manufacturer's recommended max of 46F.

And I STILL have not got testing successfully going with Mehmet, so I am flying by the seat of my pants, here. He seems fine...

Now that I will be spending the next month or two getting him gradually used to life on the road, I do not want to reintroduce the annoying issue of ear poking. Especially since it has never yet resulted in blood enough to test.

So y'all can see why I am feeling anxious and guilty. Any advice or info you can provide would be much appreciated!
 
Hi Barb and Welcome! Being on the road would present some unique situations, but it sounds like you have a pretty good handle of the situation. Everyone on this forum is terrific and will help you whenever you need it. Happy travels and good luck to you and Tigger!
 
Hi Barb and welcome. We would like to help you with your testing. It is sooooo important to test in order to keep your kitty safe and to ensure that the insulin is working. I am going to give you a whole bunch of information for you to read. Please read and then post again on a new thread. We all can help you before you start on your trip.

Good Reading: This is a must read. It is an excellent 18 page informative document that covers feline health and nutrition and it is written by a vet. Don't take short cuts and read it all. www.catinfo.org

Home Testing: Here, we all home test. It is mandatory to understand how your kitty is reacting to the insulin and the dose. You will want to test before each shot and some additional test in between the 12 hour cycle. Another reason to home test is to keep your kitty safe. Find a place in your home where you will always perform the test and give lots of hugs before and after testing. There are many videos showing you how to test. Here is a picture of where you test on your kitty. http://s106.photobucket.com/user/chupie_2006/media/testingear/sweetspot.jpg.html

Here is another good link on Home Testing:http://www.felinediabetes.com/bg-home-test.htm

Meters:There are many meters. There is a pet meter called the Alpha Trak2 and human meters. Some use the pet meter because it is what the vets use so the numbers will match up. The meter and strips are expensive though. Most use human meters that can be purchased at any pharmacy. It typically reads a little lower than the pet meter but we have ways of compensating it. Many use Walmart's brand, Relion Micro or Relion Confirm, because it only needs a tiny drop of blood. They cost around $15 and the strips are around 35 cents each.

Lancets: These are used to poke the ear to get blood. There are many different sizes (gauges). It is recommended when you are first starting out to use a 26-28 gauge. Also, it would be a good idea to pick up Neosporin WITH pain reliever to apply on the edge of the ears and don't forget to alternate ears.

Spreadsheets: Our spreadsheet instructions are here. If you look at the signatures of the members here, you will see a link to their kitty’s spreadsheets. We keep track of all our tests. This is basically a place to collect data and help you to determine patterns, doses, etc. It also aids those that may be helping you to better understand your kitty.

Food: There are many reasons why we are here but one is due to feeding dry cat food which is high in carbs. You will want to consider changing your food to wet, low carb food. It is recommended to feed food that is under 10% carbs. Here is a list of cat food to choose from.food chartyou will note that the food with fish are lower in carbs however it is recommended that you only give fish once a week due to its mercury content. Many use Fancy Feast, 9 Lives, Friskies, etc. This list can also be found inwww.catinfo.org If you are already giving insulin and you have not transitioned to wet, low carb cat food, be sure to test while you are transitioning. This is because by changing to low carb food, it could decrease your kitty’s number by 100 points or more.

Hypo Kit: Always good to be prepared for possible hypo events which means that your cat has reached dangerously low numbers. It can be fatal, hence, the importance of home testing and collecting data in a spreadsheet. In each of the Insulin Forums are stickie’s labeled Hypo Links. Please print and post on your refrigerator so everyone in your household is aware of hypo symptoms. You will want to create your hypo kit that would include and not limited to; extra testing strips, honey/karo/maple syrup, high carb food, medium carb food, vet information, etc.

Ketones: Diabetic cats are susceptible to diabetic ketoacidosis (DKA). It is best to buy testing strips that will measure (if any) ketones in the urine. One brand is Ketostix which can be found at Walmart or any pharmacy. You will want to test periodically unless you continue to get high numbers, then it is suggested to test more frequently. Ketostix typically costs around $10.
Treats:It is always nice to have treats available for your kitty. Some use it after they have tested to reward. I like using Pure Bites. I have found it at Petsmart and other pet stores. It is freeze dried and the only ingredient is the meat i.e. chicken, duck, etc. If your cat likes it, then I would go to the dog section where it is cheaper than the cat package. It is bigger chunks but no problem in breaking it up. There is a link here somewhere that has a list of low carb treats but I don't have it right now.

Injections: Most folks here use one of these main insulins; Lantus, Levemir and Prozinc. Two hours prior to your insulin shot, you do not want your kitty to eat. Then you will test and then feed. It is best for your kitty to eat a little before your shoot. I shoot while he is eating. The reason why you do not want your kitty to eat two hours prior to your test is because food elevates BG numbers. So you do not want to dose based on a food influenced number. Here is a link on how to give injections.http://www.felinediabetes.com/injections.htm
 
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