Stuck with expired Insulin

Discussion in 'Prozinc / PZI' started by G & I, Dec 10, 2017.

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  1. G & I

    G & I Member

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    Dec 8, 2017
    Brief update on the expiration date issue. Spoke with Vet last night and he has to order the insulin so I am stuck with what I have.

    Sorry all but I’m not doing very well at this and it appears all the cards are stacked against me.
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Hey! You're doing just fine! Use the insulin you have for now. Do you have any more data for your SS? I think a bump up to 1 unit twice a day is a good next step if you're willing.
     
    Last edited: Dec 10, 2017
  3. FurBabiesMama

    FurBabiesMama Well-Known Member

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    You are doing great! Give yourself a break. ;) I do not know how it works in Japan, but I do not get my Prozinc from the vet. I order it online and it is cold shipped overnight.
     
  4. Rachel

    Rachel Well-Known Member

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    You're doing wonderfully! Sometimes you just gotta go with the flow...we've all had our bumps in the road, and you can't control when the ProZinc gets here. :) I agree that a bump to 1 unit would be a good plan.

    Don't worry, we're here to help you! It's scary and hard sometimes, but you're not alone!
     
  5. G & I

    G & I Member

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    I'll try to look into that option. At this point, I'm really not to keen on relying on this vet, but he is the closest to me and I don't want to push him away for the sake of the other feline friends I have.

    I already dosed at 0.50 this morning at 0815. Thank goodness this went well this morning after a disaster last night.

    I do have another question if I may - If you will note my spreadsheet, last night the pre shot bg was 714. This morning the pre shot bg was 618. That seems to be a large drop though I recognize this is far too high. What would cause this?

    And, is it safe to increase the dosage on the same day? Or should I wait until tomorrow with the a.m. injection.

    Thanks to everyone here, Goma is appearing more relaxed and comfortable this morning. I am hoping nothing is going wrong, but I am thinking it is because she has been eating a lot whereas over the previous 10 - 14 days she was literally being starved. This is the first time I have seen food left in the bowl (albeit a very small amount). I have been feeding her every three hours and leaving the bowl there, but there was never anything left. I continue to feed her although the vet is still insisting this is wrong and I should be giving her small amounts.
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Hard to say. Explaining a single number can be almost impossible. I'd boost the dose to 1 unit tonight. No need to test a lot, just aim to get one in before bed if you can. You have a long way to go before getting to low BGs that require a lot of monitoring. Try not to worry about deviating from the vet's advice.
     
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  7. FurBabiesMama

    FurBabiesMama Well-Known Member

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    The numbers can vary quite a bit, but like you said, that is still really high. I am glad she is getting to eat! Poor baby. Maybe her number dropped a little just because she is not stressed over being starved. You should be okay to go up to a 1 unit dose whenever you are ready - the next shot time is fine, it does not have to be the next day.
     
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  8. G & I

    G & I Member

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    First off, thank you to all that responded giving me a definitely needed positive boost. The consensus appears to be a boost to 1 full unit.

    Kris and Teasel - I am willing just nervous as all... well you know.

    I'm getting push back from my better half in regards to feeding as it bends against the vet's will. I pointed out that his experience with this must be seriously lacking if he has a single vial of insulin and even it was expired. Two years is a long time in my book. Still waiting for a new vial and it appears it will be a few more days. He still will not let me know the cost. I am also trying to locate other sources.

    Unfortunately, I am having my own health issues and must leave Goma with the vet for a few hours tomorrow. I am concerned she will not be given the chance to eat. I do not want to increase the insulin until I can be with Goma to monitor. I found out that she was being left alone throughout the day and no one was in attendance at night while she was on an IV for over a week.

    Therefore, with the consensus I have received, I will commence increasing the dose to 1 unit on Thursday a.m. so I can be with her throughout. Do you think I need to perform bg tests often or would after 4 and 8 hours be sufficient. I realize I do not have much data to post yet.

    Rachel - Thanks for the confidence booster, greatly appreciated.

    Everyday I am more grateful to have found you all. For Goma's sake I wish I could have looked and found you all sooner.

    What a wonderful group!
     
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  9. Djamila

    Djamila Well-Known Member

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    I'm so sorry you're having health issues yourself. I hope you find quick healing!

    Would your better half be willing to spend some time reading here too? Maybe just read through the "sticky" posts at the top of the forum where it explains the protocol we use? The more information we have, the more comfortable we become managing treatment ourselves.

    Could Goma just stay home tomorrow while you're away? Then you could leave food out for her so she could eat. Or is the vet seeing her for something? If I remember right you have a thread out on Main too, so if you've already dealt with that you can just ignore that question :)

    I think Kris has given good advice to raise the dose, and it sounds like you have a good plan to do it on Thursday when you will be home. With the numbers you have so far, I would think a test around +4 or +6 would be sufficient. Goma will likely need a few more increases before she starts to get much of a response to the insulin. Of course, when you get a fresh vial you will want to be more careful again! You can always test more if Goma tolerates it well and if it makes you feel better about all of this! Some people prefer more testing and some less, so you can go with whichever you prefer.

    Hope everything goes well for you tomorrow!
     
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, I know exactly how this feels! After all, you're reading comments from a bunch of people you don't know on the Internet. A huge leap of faith is involved. If you read a lot of posts on here, you can get a feel for the level of expertise that's available for you - quite remarkable, really! :)

    I agree with Djamila's advice in her post. If you can leave Goma at home with food that's probably better for her. If you can get your spouse on board, at least with reading the info stickies her, that would be ideal. Many of us manage this alone but it would be a lot easier sometimes to have help from another person.

    Re cost of ProZinc: I can tell you it cost me $125 CAD when I was using it and the price in the US wasn't much lower. I have no clue what it'll be where you are though.
     
  11. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Great point about the single vial of expired insulin! Maybe if your better half reads just the AAHA guidelines alone, it will be a big clue that the vet might not know what he is talking about. (Just the fact that he does not want her to eat is enough to raise red flags. Would he starve a human diabetic??)

    Can Goma just say home, as the others have suggested? She would probably be more relaxed if she could stay home and have a bowl of food available in case she gets hungry. Unless there is something going on with her that you have not mentioned that requires constant monitoring, she should be fine. (Sounds like the vet's office does not really monitor her when she is there anyway.) I hope things go well with your health issues.

    It looks like, with your care, she has already seen a very slight improvement in numbers. I see that you got a reading in the 400s. I look forward to seeing how she does on 1 unit. +4, +6 and +8 are good test times. If you do not want to do that many tests, any of those times is good.
     
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  12. G & I

    G & I Member

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    Dec 8, 2017
    While my better half is fluent in conversing, her reading skills are not too good. In all fairness, my Japanese skills are horrible both conversational and reading(non existent). Still, my point must have struck a chord with her as when I got up to feed Goma early this morning, there was already a bowl of food available for her so she actually got an extra helping which was okay by me.

    The vet temporary stay went okay. I gave them food to provide Goma and when I arrived there was a bowl in her cage that showed she had consumed the food. So I am hoping they are beginning to listen. Goma is receiving fluids for a variety of problems that I am suspecting are a derivative of excessive steroid use when dealing with her skin problem. I am really against using steroids except in a life saving situation (I have another cat named Dude who had a heart attack). But they were prescribed by another vet working at this clinic who is no longer there thank goodness. Yet they continued to prescribe the steroids until I asked that they reduce to the point of not being given at all and find an alternative treatment. I have read somewhere (could be in this forum) where excessive steroid use can lead to diabetes.
    I have recorded the blood test results for today which leads to another question. I see the listing in the LABs tab and can see that what I am getting is no where near as thorough as that listing. I have recorded what they gave me. The urine test I am unsure what values to place in there. All I am seeing on the paper provided me are either
    -'s ,+'s and as in the case of glucose a +3.

    Brief background on Goma - Goma is a survivor and I've got to give her every chance I can. As a feral kitten she appeared with a group of other ferals and was eating when my wife noted a huge gash in her stomach (you could literally see the intestines). She rushed her to the vet and had her cleaned up and stitched. We monitored her in the house until she healed and then released her back to her group. (We attempted to find her a home as we do with all the ferals we have worked with but to no avail). Anyway, a few months later I returned from work and saw her under our steps. I called to her and she came out - with a broken leg...Back to the vet. Repaired and in the house for healing and rehab but I would not put her out again. Tempting the fates on a third attempt just didn't sit well. Anyway - Sorry to ramble but that is some info that probably is not pertinent.

    The one unit dosage will begin in the morning and I will test +4 and +8. If I see something really drastic at +4 I will perform more (at least that is my plan at the moment).

    Thanks again for the support.
     
  13. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Poor Goma has been through a lot! She is very fortunate that you have taken her in. I am glad to hear that your better half and the vet's office are cooperating with feeding her. :)
     
  14. G & I

    G & I Member

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    I have a feeling I am going to be charged a lot more than that. I've been reading through the posts as much as I can and certainly recognize an extremely high level of expertise, commitment and caring from everyone. It really is not that great a leap, just more of a worry/concern that I will mess it up.

    Thanks to all
     
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  15. G & I

    G & I Member

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    Dec 8, 2017
    I actually think my better half made sure they would feed her as she gave them a time that she HAD to be fed. Bless her heart.
     
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  16. G & I

    G & I Member

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    Dec 8, 2017
    Everything went better than expected with Goma's bloodwork reflecting improvement. And it appears that I am recovering as well.
    I thank you for the advice and will begin 1 unit dosage in the morning with tests at +4 and +8.
     
    Kris & Teasel likes this.
  17. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Yes, this is correct. In some cases, the diabetic kitty has been diet controlled (no insulin) once the steroids were reduced then stopped.

    I think that's a very comprehensive labs table and you might not have values for all of those tests. It's also possible the units of measurement might be different from what you see on your results sheet. You don't necessarily have to post Goma's test results.

    Good plan! Try not to worry. Do the dose increase and testing. Post here at any time for feedback and/or advice. :)
     
  18. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    We love reading little histories on the kitties here. Thank you for sharing a bit of Goma's story!

    Prozinc in my city (west coast USA) is around $160-170. You might also look into Lantus. It's an insulin that is used for human diabetics, so it might possibly be cheaper or more accessible for you. There is a very busy forum on here for folks who use that insulin. The dosing is a bit different, but there is ample research and information about it if the price works better.

    I'm so glad to hear that you are feeling better too! Best wishes on the dose increase tomorrow. What time do you inject, and which time zone are you in? We may be able to keep an eye out for you if we can calculate +4 in our local times.
     
  19. FurBabiesMama

    FurBabiesMama Well-Known Member

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    I think he mentioned 9:30 as his shot time in another post, and his spreadsheet says, "Japan Standard Time. This would be U S East Coast time plus 14 hours."
     
  20. G & I

    G & I Member

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    Dec 8, 2017
    I gave Goma the 1 unit injection at 0910 this morning (7:10 pm east coast time) so my first test will be at 1:00 pm JST which is 11:00 a.m. east cost US. While I have read the information on hypo can you give me any additional thoughts on signs I should be looking for? Goma was slowly lowering her rate on the 0.50 dosage so I hope I have not moved too quickly. To be honest I'm a nervous wreck now. You would think I would be calmer at my age, but this totally new territory for me. Goma appears to be sleeping comfortably I attribute to being home, fed, and warm.

    I actually read that Lantus is a very effective insulin that can also lead to remission. Not sure if my current vet will obtain it. ProZinc was only approved in Japan in 2016.
    Not sure I'm prepared to make a switch, would definitely need a lot of guidance from everyone prior to that.
     
  21. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Your nervousness will subside as time goes on. When in doubt about anything, post here. :)
     
  22. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Don't be a nervous wreck. You are doing great. Her numbers have been really high, so you really should not be at risk of hypo with the 1 unit dose.
     
  23. FurBabiesMama

    FurBabiesMama Well-Known Member

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    By the way, if you get a chance to add a photo of Goma, I would love to see her. :)
     
  24. Djamila

    Djamila Well-Known Member

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    Do humans need a prescription in Japan to get insulin? In some countries you can purchase Lantus OTC.

    At Goma's current numbers, it's very unlikely that she will have a hypo, but I do understand worrying over our kitties! We are here if you need anything, or even just need some reassurance! :bighug:

    Your +4 is in a couple of hours, so I'll still be awake here on the west coast and will try to keep an eye on your spreadsheet.
     
  25. G & I

    G & I Member

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    Dec 8, 2017
    Dosage increased to 1 unit at 0910 my time which is
    Okay - I am getting becoming a bit uptight now - Goma appeared glassy eyed and did not respond to me initially. I picked her up and immediately tested her and have found the bg actually increased to 629 I will post on spreadsheet. I gave her some food to see if she was okay and she gobbled it up. Does the cat "space out" at times when on insulin. Sorry -
     
  26. G & I

    G & I Member

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    Dec 8, 2017
    I'll take care of that shortly - I am not very computer literate anymore....So it takes me time. I am now taking Goma to the vet for fluid therapy. Will return in about an hour or so.

    Thanks for being there.
     
  27. Djamila

    Djamila Well-Known Member

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    Aug 1, 2015
    I haven't heard of glassy eyes being a side effect of insulin. Any chance she had recently woken up from a nap? One of my cats will wake up and sit staring blankly for awhile between naps.

    I promise the stress level gets better. It's hard at first but soon you will have lots of data on how Goma responds and will be able to relax more.
     
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