why does my lantus stop working

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karentigger

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hi tigger has been on lantus 2x a day started at 1 unit then 1.5, 2 and now 2.5 units twice a day. my problem is that after a little over 3 weeks she starts drinking a lot of water & then urinating a lot again. for the past 2 months this has happened & i bought a new bottle of insulin & then she went back to being regulated. i brought her to the vet they cheked urine no infectoin just a lot of sugar & they checked her of course she was high. i have checked her but not enough according to everybody on here. i do check her urine at home & right after about 3 weeks she goes high again. yesterday she was at 387 & pretty much same before i brought her into vet. i wanted to make sure nothing else was wrong. i know most say that insulin lantus can be used for 3 months so why am i only getting about 26 days out of it. it is kept in refrigerator on my door.i just got a prescription for the lantus pens. anybody know if i can give 2.5 units with the pens? i know they say it has to be given in whole units. also are the pens much different then using a syringe? i don't want to keep throwing out insulin vial every couple of weeks. my vet does not recommend the pen but i did get prescription. he said it was more difficult to regulate & with the 1/2 doses. please advise as i need to get her either new bottle insulin or get the pens. thanks also anybody use a syringe with the pen is this possible. this is all still pretty new to me & just trying to get tigger better.
 
Lantus 'lasts' about 2-3 months, maximum, before losing its potency. For
cats, you keep it refrigerated, draw the dose, then warm just the dose in the
syringe a little bit by holding it between your fingertips for a few minutes.

Get the pens. You get 3ml in each pen. Most pharmacies sell it 5 at a time (15ml total).
Some hospital pharmacies will sell you just one pen.

You will be able to use most of the 3ml in each pen before it goes bad....saving you lots of
money. Then open another pen (keep refrigerated until needed).

You use regular syringes with the pens (DO NOT purchase the pen needles, you won't need them).

Under the pen cap is a little rubber thingy you poke the insulin syringe in and draw your dose
just like from a vial.

There is a good discussion on handling and storing Lantus on the Lantus Insulin Support Group, here:

viewtopic.php?f=9&t=151
 
As far as the vials go, I've had mine for 5 months now and it's still ok. I heard it doesn't go past 6 so I'm starting to watch my cat's numbers more closely. If it's truly a bad vial, it may not have been stored properly at your pharmacist.

I've never used pens before but there are alot of fans out there.

I'm not experienced in giving dosage advice, but from what I do know, it might not be the vial. She may have moved too quickly on her next dose before the Lantus had a chance to do its thing. It usually takes 3-5 days and the changing the dose is based on her blood glucose at the lowest point in her cycle called nadir, give or take (I've been on the same dose for as long as a month). Lantus is data driven so the best way to find out is to test and track her blood glucose levels (you can see an example of my spreadsheet in my signature).

So what I'm saying is that she may have surpassed her optimal dosage. That's what happened to my cat. He was at 5u and still peeing like a fiend when I started him back down at 2 again.
 
As Karen noted, under the cap is the stopper and you use a regular syringe to draw insulin. Don't use the pen needles, just use a regular insulin syringe and draw whatever dose you need. Please also check the link that Karen gave you for storage and handling.

Lantus is a wonderful insulin, I use it for my own cats, but it needs to taken care of. We don't roll it or shake it to mix, we don't over draw insulin and then push the rest back in, we don't inject air into the vial or pen. So please check that link.
 
thanks this is making me crazy after reading! my vet actually told me make sure i am rolling the lantus for about 30 seconds at least not to shake but to roll it. when i was shown how to do it they also told me to start at a higher number & release back into the bottle. i always start at 5 & i used to start at 10 just to make sure that i was getting the exact dose for her. of course all the excess was going right back into the vial which explains why it stopped working on her. i even took her to a different vet for a second opinion. its sad that these vets never bothered to question me & they are the ones who taught me how to do it wrong. thanks going to keep reading for more information. i am going to still switch to the pens & just use the syringe.is it easy to get the stopper off. i did call my pharmacy & he told me i was not able to use a syrine that i would need the needles.
 
karentigger said:
thanks this is making me crazy after reading! my vet actually told me make sure i am rolling the lantus for about 30 seconds at least not to shake but to roll it. when i was shown how to do it they also told me to start at a higher number & release back into the bottle. i always start at 5 & i used to start at 10 just to make sure that i was getting the exact dose for her. of course all the excess was going right back into the vial which explains why it stopped working on her. i even took her to a different vet for a second opinion. its sad that these vets never bothered to question me & they are the ones who taught me how to do it wrong. thanks going to keep reading for more information. i am going to still switch to the pens & just use the syringe.is it easy to get the stopper off. i did call my pharmacy & he told me i was not able to use a syrine that i would need the needles.
Click to expand...

Many vets have assumed that the 'new' insulins like Lantus and Levimir should be handled the
same as the old PZI they used before.

Print out that link and educate your vet. Possibly some other kitty patients of his are
suffering because of his in-accurate instructions.

The pharmacy is wrong...they know nothing about using these insulins the way we do ( for cats, very
small doses).
 
I use the pens all the time, never need anything but a regular insulin syringe. My pharmacist is great, he asks me all kinds of questions so he can learn when other folks come in with cats on meds :) He too did not know how to use the pen until I showed him.
 
You may have already answered these questions, and they may not apply to Lantus. I've only used Pzi, so if this has already all been addressed, I apologize.
Is kitty eating dry food?
Have you read about rebound?
This was Callie Mae on PZI, but she was eating dry prescription food and was started out on 5u BID and kept getting her dose increased (by the vet) all the way up to 9u BID. The whole time, her water intake habits never changed. She would drink any water she could find. I wasn't getting anywhere with her.
Dropped her dose to 1u BID and switched her to wet food and over the next month we were micro dosing our way OTJ. Also, after the dose and diet change, she stopped drinking so much water.
Maybe it's similar with Lantus?
 
I think I've read here that you shouldn't store the insulin in the door area because with the opening/closing of the door the insulin gets bounced around more. See if storing it in one of the shelves helps.
 
I use both the vial and cartridge Lantus insulin, and I don't roll it, and I don't keep it in the frigde once opened. I use the same needle insulin syringe whether I am currently using the vial or the cartridge (in my case I use the BD Micro Fine + Demi 8 mm, 30 gauge, insulin syringe with half units).
And I've never used the same vial or cartridge for longer than 6 weeks, but haven't had the same problems of it stop working after 3 weeks. It has worked fine for me and Simba like this for 5 years.
 
thanks all ok got my lantus solarpens today- package of 5 . i just want to make sure i am doing this right. i opened the pen & just used my regular syringe the same ones i used with bottle of lantus. why does vet & pharmacy say you must use the needles not a syringe. i took the cap off & just put my syringe right through rubber stopper on top almost exactly like the vial of insulin. here i am thinking i am going to have to take bottle apart & thinking this is going to be complicated. hope i did it right. not sure why vet & walmart said that i need the needles as well not syringe. hope this works out better it is def more cost efficient. walmart also offers a discount when you purchase with no insurance which helps.
 
karentigger said:
thanks all ok got my lantus solarpens today- package of 5 . i just want to make sure i am doing this right. i opened the pen & just used my regular syringe the same ones i used with bottle of lantus. why does vet & pharmacy say you must use the needles not a syringe. i took the cap off & just put my syringe right through rubber stopper on top almost exactly like the vial of insulin. here i am thinking i am going to have to take bottle apart & thinking this is going to be complicated. hope i did it right. not sure why vet & walmart said that i need the needles as well not syringe. hope this works out better it is def more cost efficient. walmart also offers a discount when you purchase with no insurance which helps.
Click to expand...

It's because that's how people use them. A lot of folks don't even know that cats can have diabetes. So they assume you need the insulin for yourself or human family member.
:lol:
 
I used my most recent pen to the last drop, about four months. I am wondering, do you use a fresh syringe each time, and are you fanatical (as I am) about keeping bacteria out of the pen? (A pen works the same as a vial - put the needle in the little rubber stopper - that was already explained to you.) Just open the pen long enough to withdraw the insulin, then close the pen before you do anything else. Put it right back in the fridge. Don't let the needle touch anything before it goes into the pen; uncap it and withdraw the insulin at once. If the needle even touches your finger for a second, don't put it into the pen but take a new syringe.

The big difference between an opened pen and an unopened one (which will keep in the fridge until its expiration date) is bacteria. So keep them out!

Blessings!
 
By the way, you can get syringes with 1/2-unit markings from hocks.com. The "Good Neighbor Pharmacy" brand comes in 31 gauge (fine) and 5/16" needles (short) which are more comfortable for cats. I think most people on the board use them.

If this was already addressed, pardon me for reiterating it - I did skim a little through the other answers; so much to do, and have to check Sweeties' sugar now.

Blessings!
 
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