Syringes and air bubbles

[Sheila and Minky]

I am using the needles recommended on here from Amazon (Ulticare) but they have recently changed in quality. I am drawing up way more air bubbles from the Lantus pen that I cannot get rid of. We aren't supposed to inject the insulin back into the pen. I have tried tapping the syringe. I have tried ejecting some out. I have tried pulling extra and getting rid of a bit. It is making me really frustrated and mad. Anything I can do to not draw up so many air bubbles?

 

[CORKY]

I am using the needles recommended on here from Amazon (Ulticare) but they have recently changed in quality. I am drawing up way more air bubbles from the Lantus pen that I cannot get rid of. We aren't supposed to inject the insulin back into the pen. I have tried tapping the syringe. I have tried ejecting some out. I have tried pulling extra and getting rid of a bit. It is making me really frustrated and mad. Anything I can do to not draw up so many air bubbles?

@Bron and Sheba (GA)

 

[Christie & Maverick]

Since you are drawing up from a pen, are you starting out with the plunger flush to zero line? The pen works on negative pressure.

 

[Sheila and Minky]

Since you are drawing up from a pen, are you starting out with the plunger flush to zero line? The pen works on negative pressure.

Yes starting at 0. What does the negative pressure mean? Am I not supposed to start at 0?

 

[Christie & Maverick]

Okay good, just thought I’d check, since some members have started with vials, where you actually inject air into the vial before drawing out insulin. If you look at your pen, you’ll see that as you draw out insulin, it slowly moves the rubber stopper down (no empty space between insulin and rubber stopper) vs. with a vial are insulin comes out the empty space is replaced by air. The only times I’ve had serious issues with bubbles is when I’m getting down to the last bit of the pen cartridge.

Another question for you, are you holding the cartridge upright and drawing out the insulin from underneath?

 

[Sheila and Minky]

This is a fairly new pen, but these syringes also are bouncing back forcing insulin back into the pen if I let go of the bottom part. I have stopped letting go and pulling out the needle right away before that happens as I don't want the insulin going back into the pen. I really hate these syringes now. I draw out the insulin from underneath. Is that maybe what I am doing wrong?

 

[Christie & Maverick]

Sounds like you are doing everything correctly, boy those syringes would drive me crazy too. I’ve has some small bubbles occasionally with my BD ultra fine syringes but usually drawing up a little extra and tapping, then gently turning the plunger to squeeze out the extra gets rid of them. I wonder if you could maybe try that?

 

[Sheila and Minky]

Sounds like you are doing everything correctly, boy those syringes would drive me crazy too. I’ve has some small bubbles occasionally with my BD ultra fine syringes but usually drawing up a little extra and tapping, then gently turning the plunger to squeeze out the extra gets rid of them. I wonder if you could maybe try that?

Maybe. What are the details of your syringe? Maybe I can try those.

 

[Christie & Maverick]

I use these ones, although you can also get them in 6mm which is just a smaller needle.

 

[SmallestSparrow]

Hi Sheila—I highly recommend BD syringes also for a couple of reasons. Well at least 3: in theory made in US (company was a bit evasive when I asked but box says made in US…my vet joked when i mentioned that that perhaps only boxes were made here. The least bubbles so far and I’ve tried six brands. I sort of think these may be the ones I used decades ago with Erik also. And for me at least the thinnest marked lines so I can estimate 0.25 between the half unit lines.

mine are the half unit ones. Also the hub on this is smooth, some of the other brands the needle hub is a bit raised which is fine for most cats but Methos has thin fragile skin and I think the times the insulin leaked the hub may have opened the skin a bit.

 

[SmallestSparrow]

Re ulticare their syringes are made in one of two places overseas.
If the lot number begins with an “A” it’s made in Korea-this was the first brand I used and had bubbles but not bad. I got them from my vet and they were whole units.
When I ordered them in half units they were a lot that began with “B” and I felt they were worse. Those are made in China.
Carepoint Vet were better (made in Korea).
Eli Medical were about the same as Carepoint and I liked that they were individually wrapped but only came in 12mm length needles—made in Vietnam

yes my supply closet is full of syringes I don’t like

 

[SmallestSparrow]

Also for bubbles in the tip of the syringes (not at the plunger end) I’ve had the best luck getting rid of those if I pull the plunger down a bit (suck in a bit more air) so the bubble gets larger/consolidates/maybe breaks tension..not sure—then push up. Otherwise sometimes the insulin seemed to move around the bubble leaving it stubbornly at the tip

 

[Sheila and Minky]

Also for bubbles in the tip of the syringes (not at the plunger end) I’ve had the best luck getting rid of those if I pull the plunger down a bit (suck in a bit more air) so the bubble gets larger/consolidates/maybe breaks tension..not sure—then push up. Otherwise sometimes the insulin seemed to move around the bubble leaving it stubbornly at the tip

Do you pull the plunger down after you take it out of the pen to draw in more air?

 

[SmallestSparrow]

Do you pull the plunger down after you take it out of the pen to draw in more air?

I use a vial. So I do waste insulin as I draw up a bit extra, remove needle from vial, then get rid of bubbles and any extra insulin. (So once needle is out then I draw back on plunger to consolidate bubbles at tip)

I feel ok with the waste as I’m not confident enough to use a vial to the very lost drop, after 2 months im already wondering if it’s old and that’s why he’s not responding. After paying for Bexacat and vetoryl I’m over any sticker shock on insulin.

edit: for those wondering Vetoryl at his current dose is usually about $250/mo and I think Bexacat was around $120/month. So insulin feels not so shocking but of course I’m not adding in the cost of test strips, lancets, etc. Then of course his inhaler (before I discovered Canadian pharmacies) was $380 for one

it’s a good thing I can live without meat

 

[Sheila and Minky]

I use a vial. So I do waste insulin as I draw up a bit extra, remove needle from vial, then get rid of bubbles and any extra insulin. (So once needle is out then I draw back on plunger to consolidate bubbles at tip)

I feel ok with the waste as I’m not confident enough to use a vial to the very lost drop, after 2 months im already wondering if it’s old and that’s why he’s not responding. After paying for Bexacat and vetoryl I’m over any sticker shock on insulin.

edit: for those wondering Vetoryl at his current dose is usually about $250/mo and I think Bexacat was around $120/month. So insulin feels not so shocking but of course I’m not adding in the cost of test strips, lancets, etc. Then of course his inhaler (before I discovered Canadian pharmacies) was $380 for one

it’s a good thing I can live without meat

*sending hugs*

 

[Sheila and Minky]

Re ulticare their syringes are made in one of two places overseas.
If the lot number begins with an “A” it’s made in Korea-this was the first brand I used and had bubbles but not bad. I got them from my vet and they were whole units.
When I ordered them in half units they were a lot that began with “B” and I felt they were worse. Those are made in China.
Carepoint Vet were better (made in Korea).
Eli Medical were about the same as Carepoint and I liked that they were individually wrapped but only came in 12mm length needles—made in Vietnam

yes my supply closet is full of syringes I don’t like

The box starts with A, but these syringes are horrible.

 

[Sheila and Minky]

Hi Sheila—I highly recommend BD syringes also for a couple of reasons. Well at least 3: in theory made in US (company was a bit evasive when I asked but box says made in US…my vet joked when i mentioned that that perhaps only boxes were made here. The least bubbles so far and I’ve tried six brands. I sort of think these may be the ones I used decades ago with Erik also. And for me at least the thinnest marked lines so I can estimate 0.25 between the half unit lines.

mine are the half unit ones. Also the hub on this is smooth, some of the other brands the needle hub is a bit raised which is fine for most cats but Methos has thin fragile skin and I think the times the insulin leaked the hub may have opened the skin a bit.

Where do you get these? I looked on Amazon but couldn't seem to find them...

 

[Christie & Maverick]

Hi Sheila- hope you don’t mind if I make an observation, since I peeked at Minky’s SS. Since you are following SLGS I would have taken a reduction with that 73 on Nov 16th. Again, just an observation . Hope you also got the air bubble quandary figured out.

 

[SmallestSparrow]

Where do you get these? I looked on Amazon but couldn't seem to find them...

Let me look for a receipt and get back to you

 

[SmallestSparrow]

Where do you get these? I looked on Amazon but couldn't seem to find them...

https://www.adwdiabetes.com/product...g_QG4O5SC6gfqIY9Z-z3mA4O0KSpIOkezJgAZMK7bUN2I

I’m not happy they charge shipping. They do give a tiny discount if you sign up for repeat delivery and when you first visit the site there’s a discount offer for your email address. If you google “bd half unit U100” you might find cheaper…if so please tell me

 

[Sheila and Minky]

Hi Sheila- hope you don’t mind if I make an observation, since I peeked at Minky’s SS. Since you are following SLGS I would have taken a reduction with that 73 on Nov 16th. Again, just an observation . Hope you also got the air bubble quandary figured out.

I haven't updated the spreadsheet; my life is chaos right now. I did end up giving her 1.75 starting this week. I did not figure out the syringe issue yet. I went to Walmart today and got a set of 10 syringes both Relion and BD Veo which are 6mm, 3/10 mL, and 31 gauge, but I just noticed the BD ones Walmart sold me don't have 1/2 unit markings I am going to go look at the link @SmallestSparrow gave me above. I really got a good set of claw marks on my hands today from Minky not wanting the needle. She even in swatting the needle yesterday bent the needle 90 degrees. It is a miserable experience for both of us right now.

 

[Christie & Maverick]

You are doing a great job for Minky, I’m sorry she is being feisty. One thing to try if you aren’t doing this already is to give insulin while her head is in the food bowl and she is eating. That can be an easy distraction.

 

[SmallestSparrow]

really got a good set of claw marks on my hands today from Minky not wanting the needle. She even in swatting the needle yesterday bent the needle 90 degrees. It is a miserable experience for both of us right now

im so sorry minky is so um spirited. She’s probably faster and more agile than my boy but I give him his shots when he’s lying on his side and im kneeling behind him at his back. So all the pointy things are pointed away from me so he’d have to twist/flip …I think approaching a cat from their belly side gives them the upper hand (idk if that’s what you do). If you can’t picture what I’m describing I’ll take a picture of how I set him up.

Edit: as i tried to describe this I realized I shoot one side (left side) with me at his belly. So I guess it may only help half the time. I’m lucky he’s a good sport. Left side gets done at 3 am so I’m half asleep then!

 

[Cal & Candy]

I am using the needles recommended on here from Amazon (Ulticare) but they have recently changed in quality. I am drawing up way more air bubbles from the Lantus pen that I cannot get rid of. We aren't supposed to inject the insulin back into the pen. I have tried tapping the syringe. I have tried ejecting some out. I have tried pulling extra and getting rid of a bit. It is making me really frustrated and mad. Anything I can do to not draw up so many air bubbles?

We're also using Amazon Ulticare syringes and a Lantus pen with no issues. Currently dosing 1.0U. Each time before drawing a dose I set the pen to 1 and click the button on the top to advance the plunger. We're about 40U into the current pen and have almost no air in the pen. If you're dosing something other than an even number of U, for example 2.5U, click in 2U one time and 3 the next.

If you've got a lot of air in the pen, you could try picking up a Lantus needle, holding the pen with the needle pointing up, and clicking until the air is purged.

 

[Sheila and Minky]

We're also using Amazon Ulticare syringes and a Lantus pen with no issues. Currently dosing 1.0U. Each time before drawing a dose I set the pen to 1 and click the button on the top to advance the plunger. We're about 40U into the current pen and have almost no air in the pen. If you're dosing something other than an even number of U, for example 2.5U, click in 2U one time and 3 the next.

If you've got a lot of air in the pen, you could try picking up a Lantus needle, holding the pen with the needle pointing up, and clicking until the air is purged.

I can't tell you how much I love this post--I didn't realize you needed to advance it!! I still have an air bubble but I can't get rid of it without insulin spraying all over the place. I will start doing this though and I think it will make a difference. Thank you!!

 

[Cal & Candy]

Try turning the pen with the air bubble up, insert an empty syringe into the seal and see if you can pull the air out. If the syringe's plunger wants to pull back towards the tip, then you still have a vacuum in the pen. Advance the Lantus pen's plunger 5 or 10U and try again. Optionally, when you think that you've equalized the pressure in the pen, keep the Lantus tip up, remove the plunger from the syringe and use the Lantus' mechanism to push out the remaining air.