Worried About Viability of Insulin

Hi all,

Saoirse's BG was very high at PMPS this evening (>20 mmol/L cf. 14-16 pre-dose for most of her recent cycles). We did have a vet trip this afternoon for her latest B12 injection, but I still think her reading was too high for stress hyperglycaemia to be a factor (we had been back from the vets for hours and she didn't respond like that after Saturday's vet visit).

It was very cool in my flat overnight and consequently my fridge was much colder than normal this morning. I had a Caninsulin pen with a live cartridge and also a 10ml bottle of Caninsulin in the fridge. The cartridge had ice crystals in it but the normal vial looked OK. I used the vial for this morning's dose. Saoirse's nadir BG was as expected so I thought all was OK, but I'm wondering whether the crystalline portion of the Caninsulin might have been damaged and hence her BG went very high tonight.

I'm particularly concerned because Saoirse is due to start treatment with Lantus in the morning and the Lantus vial was in the fridge, too. It looked OK this morning, and again when I checked it just now (completely clear). I've got no idea of what Saoirse's BG is going to do on the new insulin so I won't be able to tell if there's a problem with the insulin. (She is due to start on 0.5 IU BID in the morning.) Essentially, I'll be working blind tomorrow with no way to know if Saoirse's response to the new insulin is in the right ball park.

Has this happened to anyone else? Any ideas of what I should do or what I could check? (Needless to say, I will speak to our vet in the morning about this but they don't open till after Saoirse's first dose of Lantus is due.)

Edit:

PMS+3 was OK (7.8) so the amorphous Caninsulin part is OK.

 

Freezing does damage the insulin. All you can do is to use it and see if it works.

 

Thanks for the reply, Larry. I want to keep Saoirse safe and I didn't want to give the Lantus if it wasn't OK to do so. I know every cat responds differently to the different insulins, but I really wish I had some rough idea of what kind of drop in BG I might get on a first dose of Lantus so I'd know if it was working. (If the vial isn't isn't OK, then I won''t be able to get a replacement until Wednesday because it needs to be ordered in.)

It's like being right back at the beginning of the Caninsuiln therapy (and very nearly as scary). nailbite_smile

 

It would not be unusual to only see a little drop on the first dose of Lantus. Lantus is a depot insulin so it builds up in the body for a few days for full effect.

 

Hi Larry,

Thanks for replying again, and sorry for the tardy response. My already dodgy nerves are getting more frayed at the moment (as you've probably noticed). It helps so much not to be alone with the worries.

Thankfully the Lantus is working. I'm running Saoirse's first curve at the moment. I had a picture in my mind that the Lantus drop on the first dose of 0.5 IU would not be very much but Saoirse went from AMPS of 16.9 down to 8.9 at +9.5 (Alphatrak). Saoirse's next dose is due at 20:00 local time (about 1 hour from time of posting). I think I'm looking at an all-nighter to monitor how my girl responds, especially after the 8-point drop on the first cycle. nailbite_smile

BTW, I think I found a possible explanation of why Saoirse's BG went so high last night. The Caninsulin vial was first used 30 days before. I had been using the pen cartridge to draw insulin for the previous few days so I didn't think to double-check the opening date for the vial when i discovered that the cartridge insulin had been damaged. I can't think of anything else that could have resulted in such a spike.