How long is insulin usable? Good mid-price insulin?

We went to the new vet today (and really liked them, but it helped coming here first and being more prepared) and he upped Arnold's insulin to 2u BID. He was very nice and was very supportive on what I'd learned this past week and my testing his levels at home etc. He said he's transitioning his patients to NPH from the Vetsulin b/c the others are so pricey. Let's be honest, that does play a part sometimes. That being said, I priced out Lantus at one place the other day and it was $160! He then said you really don't want to use insulin for more than about 2 mos, then you get a new vial. Is that right? I can't afford $80/mos for insulin, I just can't. :? I read NPH isn't a good choice, is there something better w/out spending $160 every 2 mos, if in fact you can only use it that long?

 

I know that both Lantus and Levemir come in cartridges or pens, so you get 5 in a pack. The pack costs more than a vial, but each cartridge lasts the length of time a vial would last (talking shelf life - with normal kitty doses, it can take a long, long time to use up even a cartridge, if shelf life weren't an issue). So the cost per day actually comes out pretty inexpensive, even though the upfront cost is high.

I think that I've read the new ProZinc lasts a very long time - long enough that you can use the whole vial. So again, price per day comes out pretty low.

For any insulin, you need to think about cost per day rather than only the upfront cost. When you add in how well cats normally react to that insulin, the conclusion can be very different from what you would think when you only look at how much stuff costs the day you buy it.

 

Thanks. Yeah, I'm not worried so much about up front cost, we can handle that. It's just that I'm not sure how long other insulins last so I just can't be spending that kind of $$$ every 2-3 mos, kwim? We've only ever done Vetsulin (since we've only done this for a week, lol) and the last vet didn't even give us a time line for how long it lasts so now we're already looking at getting new insulin in April and I know we won't even be 1/2 way done w/ this vial, but it'll have been 2 mos then.

 

If we stay on our current dose, it looks like we'd go through a pen of Lantus in 3 mos. Can I use it for 3 mos? Then there are 5 pens right, so 15 mos? 10 mos at least right? That's $16/mos. I can do that if that's the best out there. I'm just too new at this to know what are good options.

 

Someone else can point out how long you get with the 5 pens...

I'd ask your vet why the heck he is transitioning his clients to an even less suitable insulin for cats...with PZI and lantus well documented in literature as being better! It makes no sense to me and I'd be really concerned about his advice...

And with N, while your cat might be one who does well on it, if it turns out not to be a good choice your relative savings may go up in smoke.

 

Thanks. He said that's what he was moving to, but had no problems w/ us getting something else and going to get it elsewhere if needed. He was still way more helpful than the people were last week at the other vet! He made sure I knew what to do for hypos (which I learned here and have the info printed out) and wanted us to wait for Arnold's other needs (vaccines and teeth) till he's doing well. We'll talk about it more next time I see him.

 

Lantus is more fragile than Levemir.

Lantus would probably break down before 3 months, but I haven't used it myself.

I went straight from PZI to Levemir. We have used Levemir for 10 months now, and are able to use the 3ml pen cartridges to the last drop --- since our dose is a nice low 0.75 units BID, each cartridge lasts about 4 months.

You might be able to buy one or two cartridges from someone here at FDMB.

When I bought my 5-pack last April, there was someone that needed insulin but couldn't afford to buy a whole 5-pack. I sold her 2 of my 5 pack, and now I'm on the last one -- so I'll need to buy more in about 6 weeks.

Look in the SUPPLY CLOSET forum - sometimes people will post extra supplies there --- you can also post there saying you need some insulin but want to buy just a cartridge or two.

My 5-pack of Levemir cost $145 last year from Canada (US dollars), so each cartridge was approx $30 each. I've heard that the price has gone up since then.

Insulin needs to be shipped cold -- not too much of a problem this time of year in the northern hemisphere except it shouldn't freeze. Overnight shipping is best.

 

Hi,
I am a user of Lantus and purchased my from Walmart for $100 (10 ml vial). I know others have experience with it not lasting very long, however we are so careful with it and it has lasted 9 months. We keep it refrigerated in a padded container so it never gets jarred and also never blow air or insulin back into the vial. You have to be a little wasteful by pulling out enough insulin and then getting rid of the extra into the sink--not back into the vial. this has worked wonderfully for us. I did consider PZI recently only because of it being more stable and a little less expensive.
Good luck.
Tammy

 

ProZinc is the new insulin that came out in November 09. I switched from vetsulin and have been very pleased, but I have never used either of the L's. I paid $85/10ml vial at my vet, which is a really good price, some folks have been quoted $120. $90 is probably fair.

The website is Prozinc.us and has good information. It was created just for cats, and is FDA approved, and is suppose to be good to the last drop if handled reasonably well. I dropped mine and it was OK, but don't let it get frozen or exposed too much light. This goes for any insulin, I'm sure.

It is a longer duration insulin than vetsulin, which means it keeps bg controlled throughout the cycle and into the next. This was the biggest difference I saw when we switched, no more drastic up and downs.

I'm guessing you would do well with L's or Prozinc... and if you stay really on top of it.. maybe you'll get him OTJ :lol:

 

I do notice that the Vetsulin doesn't seem to work long, but then again at his current dose it's not working much at all. We just got DH's bonus check so I'm thinking I'll call the vet tomorrow and ask for something else since we have the $$$ now and I don't see the point in getting things going well w/ Vetsulin only to have to switch in a month, kwim. Now to decide.

 

Hey Jennifer, there is some Lantus posted in The Supply Closet for $20 per cartridge

Here is the link:
viewtopic.php?f=15&t=4502&p=57340#p57340

 

Thanks. I think I decided on Levimir. Today Arnold was lower than normal and I still gave him 2u and now I can't leave him! I was going to go to the store and when I checked at +2 he was only 101 so we're just waiting at home w/ him to make sure he doesn't get too low. Ugh.

 

I know these results are NOT typical... As others said, I am very careful with the insulin. My Lantus is always kept in the refrigerator, never shaken or dropped, new needles each time, etc.

Chloe is a low-dose kitty when she needs insulin at all. She is mostly diet-controlled, except ocasionally will get into some dry and then I will have to give her about 1/2 unit SID or BID for a day or two as needed until I get her back into the nondiabetic range. a LITTLE insulin goes a L O N G way with her...

That being said, the Lantus we are using is 12 months old and still packing quite a punch for Ms. Chloe.

 

When I noticed last night that you jumped straight from 1 to 2 units, I wondered if you were going to have a problem. That's a 100% increase. I would watch the numbers very closely today, and not give 2 units tonight when you are asleep. Depending on what happens today, you may want to try a "fat" 1u or 1.25u. Start low, go slow..... this is a powerful drug, and vetsulin is especially erratic these days. On my last vetsulin bottle I saw random numbers that were WAY lower than they had been in years on the stuff. Be careful
.
You are coming up on + 4 or +5 I think. Do you have high carb food around just in case? Keep posting and don't be afraid to ask for help if you need it.

 

Thanks. We had to put off shopping for a while to watch his levels. I had to take my daughter for her 1yr appt so I had to leave him, but not till I got some of his old wet food out. I came back and he had licked all the gravy up and not eaten any of the food. :smile: He was then at 235 at +7 after being in the 70s earlier. Ahhhhh, the joys of this trip. I should've known better than to give 2u since his # was only 222 this morning.

 

Kept checking in to see ... glad he was fine. What are you going to do tonight?

<2u?

 

Once Vetsulin is activated (the rubber top punctured) you're looking at roughly 30 days. We always saw BG numbers rising by Day 26. We started buying the 2.5ml vials (instead of the 10ml) so we were not tossing as much.

I got 6 weeks out of our first Lantus SoloStar 3ml cartridge... and it might have even lasted longer but we started having health issues. Don't know if it was the Lantus pooping-out, or the healther matters that caused the BG rise at that time.

 

Normally,cats will get no more than 10 hours of duration out of a single dose.

 

I don't know what I'll do. Maybe just go back to 1 for tonight. He did fine w/ 2 last night as far as I can tell, but his #s were a lot higher PMPS than they were this AMPS. His PMPS is going to be off tonight since I just saw him in there trying to lick the last leftovers out of his bowl. He's not due to eat and get his shot for another almost 2 hrs. We'll get the hang of it. The vet's office called this morning to check on him and I completely forgot to ask about new insulin! I was just so shocked they called to ask about him. I like them.

 

thats great that you have a concerned vet.

Maybe you could split the difference tonight, (depending on the PMPS) and go for something between 1 and 2u.
Doesn't vetsulin sometimes have a second nadir within the cycle when the crystal bound portion is absorbed? Or does it just poop out around 8 hrs? Keep an eye for that.

Maybe the snack will stimulate his pancreas to do something on its own, and your number wont be that bad at PMPS. hoping....

 

No clue. From the testing we've done, it seems it just stops. We've only been doing this a week so you could tell me about anything right now and I'd believe you. ;-)

 

Vetsulin does have a second peek. See:
http://www.vetsulin.com/vet/AboutVet_Ph ... etics.aspx

 

We used Vetsulin for 2 1/2 years, and I don't recall ever having a second nadir. Hard, fast drop (within 3-4 hours) then back up. (Picture a giant check mark). When I got the dose right, nadir would look more like a ladle. I was never fortunate enough to see the second peak shown in the link Larry provided.

 

PMPS was 296 so I gave 1.5u.

 

You are in a data collecting mode, so get some info tonight and try to hold that dose for awhile, if safe of course (similar ps numbers)

and work on changing that insulin,
read read read, so you are ready sooner than later.

Larry, from that link I was able to read the letter sent out to vets. Pretty interesting that some vets are still selling it to feline patients....