Did I ruin my Lantus...?

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Bridget & Lord Nelson

Bridget & Lord Nelson

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Hi all, I'm a newb here and learning a lot. I just started my cat Nelson on Lantus last Friday. My vet said to roll , not shake the vial before inserting the syringe... however, now I find out thanks to FDMB that Lantus is fragile and isn't to be rolled at all! :o Uhh, have I ruined the whole vial? My vet also told me about urine testing, not BG, but Monday I got a glucometer especially since his appetite dropped off and I wanted to make sure he wouldn't go hypo, and Nelson's been steady between 180 and 203 (I know that actual BG is higher due to calibration--I have read that page) regardless of when I test him. I don't know what his BG was at the vet's office on Friday because all she told me was the urine test, which was 1000 on the stick. I'm still urine testing both for ketones (all negative) and so I can tell my vet I did that too and urine glucose levels have dropped since Sunday night. Nelson is also no longer living in the litter box and is no longer hungry 24/7 - is eating normally but has gone back to his old finicky self where if it isn't stirred quite right, isn't completely fresh, etc., he looks up at me and squeaks for me to fix it. I went home for lunch today and +6 was 181. I haven't started a spreadsheet yet but am keeping a measurement log. I so hope I didn't ruin the vial!!! Thanks!

PS - Nelson was put on 1 unit BID. I got nervous yesterday after his BG was below 200 AMPS and posted on the main part of the forum. I didn't give him his injection because I was afraid he might go too low while I was at work and I couldn't come home for lunch yesterday. One of the participants steered me over here, told me about the shed, etc. Nelson stayed at or below 200 yesterday and I resumed his Lantus this morning with a better understanding of how Lantus works. :-D
 
I don't think you ruined your lantus, however take a look and make sure it's clear, nothing floating in it and it's not cloudy - those are the telltale signs that it's bad.

Also, DO keep in fridge.

DO Not Shake, rattle or roll any more.

Do not inject air into the insulin or inject over draw into the insulin. Rather if you over draw, squirt the additional amount into the sink.

It's good that you are ketone testing and you are BG testing.

Now the next step is to start a spreadsheet and include it in your signature for all to see. Here are instructions:

How to set up spreadsheet
 
Hi & welcome to Lantus Land!

My vet told me the same thing when we started...roll the vial. I did that for over 2 weeks until I found out it was wrong! Maybe they give the same instructions for all of the insulins? :roll:

Can't advise you on your individual vial, but it didn't seem to affect mine at all. Just kept a watch out for floaties or cloudiness which have never appeared.

Glad to hear Nelson is feeling better already. :mrgreen:
What are you feeding him? A profile sheet would be great!!
 
I was feeding him Authority Chicken which according to Binky's chart is 6% carbs. I tried Wellness canned chicken but not all the cats liked it, while they all eat the Authority. For the price it seems to be a decent food, and PetSmart is literally around the corner from my house. Before he got sick he was eating a combination of that and Wellness Core dry. I know--dry is a no-no. But he used to be a Science Diet cat, up until 2 years ago when I realized that Hills foods are essentially kitty candy. When Nelson started losing weight and was hungry all the time several weeks ago I fed him almost exclusively wet since he was more interested in the wet and was eating as much as I could give him. He has lost weight before when we have kittens in the house because he is active playing with them. But this time he steadily lost weight for no apparent reason and didn't gain any back, to the point where he is too thin. That's why we took him to the vet.

The vet wanted me to feed him w/d. I had second thoughts which is what drove me to this forum... I posted over at the main part of the forum about this.

Thanks for the link to the profile.
 
lowb35 said:
:o Uhh, have I ruined the whole vial?
Click to expand...

Okay, here is the scope on rolling Lantus. I have a friend who is a pharmacist and I put her on the hot seat today to get all the info. Here is what she told me. Understand that this is how Lantis is is used for people, but I can't see it being different for a cat.

1. Yes, you should gently roll the insulin in your palm before extracting the dose. NEVER SHAKE! She explained that the gentle rolling will prevent the insulin to stick to the bottom of the vial
2. Use an alcohol swap or pad to clean the top of the vial before extracting the dose
3. Use a new syringe for each dose.
4. Keep refrigerated
5. Can be used until the expiration date as long as the liquid is clear, without floaties and the above procedures have been followed. This is not dependent on when you began to use the vial. I have seen that most people toss the vial or cartridge after 30 days even if there is insulin left. She didn't think this was necessary.


Hope that sheds some light on the subject.
 
msarobix said:
lowb35 said:
:o Uhh, have I ruined the whole vial?
Click to expand...

Okay, here is the scope on rolling Lantus. I have a friend who is a pharmacist and I put her on the hot seat today to get all the info. Here is what she told me. Understand that this is how Lantis is is used for people, but I can't see it being different for a cat.

1. Yes, you should gently roll the insulin in your palm before extracting the dose. NEVER SHAKE! She explained that the gentle rolling will prevent the insulin to stick to the bottom of the vial
2. Use an alcohol swap or pad to clean the top of the vial before extracting the dose
3. Use a new syringe for each dose.
4. Keep refrigerated
5. Can be used until the expiration date as long as the liquid is clear, without floaties and the above procedures have been followed. This is not dependent on when you began to use the vial. I have seen that most people toss the vial or cartridge after 30 days even if there is insulin left. She didn't think this was necessary.


Hope that sheds some light on the subject.
Click to expand...

Lantus (and Levemir) is NOT a suspension... like some of the other insulins. you do not roll the vial/cartridge/pen before use.

"if" you wipe the rubber stopper with an alcohol swab, make sure to let it air dry before inserting the needle of the syringe. be aware, wiping the rubber stopper with an alcohol swab *can* result in the rubber drying out or cracking. if this happens, toss the insulin.

most cartridges, vials, and pens can be used for 4 - 6 months before tossing. however, if the insulin becomes cloudy or you can see (you'll need a magnifying glass in most cases) any teensy-tiny crystals (sometimes called floaties) or if the insulin has frozen... toss it and open new insulin.

please review the proper handling instructions here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
 
About the length of time a container of Lantus will last, I can say from experience that mine no longer got results for Shadoe after using the same vial from Nov20/09 to Dec27/09. Progress stopped with the BG numbers, and they returned to pinks and reds, so it was decided to try a new container and see if it made a difference.
On the very first shot from the newly opened cartridge, Shadoe's numbers dropped down to some nice yellows and a blue!

I suppose an opened cartridge may last longer than 30days, but watch the numbers as well as for cloudiness.
 
I am glad you asked this question. Jill said not to use alcohol to wipe the rubber! I was going to start off that way because that is what we always did at the hospital. Thanks Jill flip_cat
 
msarobix said:
5. Can be used until the expiration date as long as the liquid is clear, without floaties and the above procedures have been followed. This is not dependent on when you began to use the vial. I have seen that most people toss the vial or cartridge after 30 days even if there is insulin left. She didn't think this was necessary.
Click to expand...

Just to clarify, an unopenedcartridge or vial can be used until the expiration date. Once opened, the insulin can be used anywhere up to a month or more. The manufacturer recommends that an opened container not be used more than 28 days. People have varying experiences with how long Lantus lasts. As Jill noted, some people have their Lantus last for up to 4 - 6 mos. I've tossed a cartridge after 2 weeks because it had lost potency.
 
Welcome to Lantus Land Nelson kitty and lowb35! (do u have a first name by the way ? lol)

Glad ur here with your kitty - you'll find a lot of handy info up in the stickies, good idea to read a few times to get use to how lantus works!

Hope to see u posting often! :)
 
My vet did the same thing when I started Lantus for Pippin, he said make sure to roll it and then inject air into the vial before drawing the insulin.......I did that for a while before I found this site and read not to, it was fine and that vial lasted a long long time so hopefully yours will too.
They are so used to the insulins used for pets that they dont know how to properly care for Lantus and other human insulins I think.
 
Deb and Pippin said:
My vet did the same thing when I started Lantus for Pippin, he said make sure to roll it and then inject air into the vial before drawing the insulin.......I did that for a while before I found this site and read not to, it was fine and that vial lasted a long long time so hopefully yours will too.
They are so used to the insulins used for pets that they dont know how to properly care for Lantus and other human insulins I think.
Click to expand...

Actually Deb, the Humulins are human insulins and they MUST be rolled...I THINK it's just Lantus and Levemir that don't have to be becuase, as Jill said, they are not suspensions. I remember rolling Vetsulin and PZI as well (for the VERY short time I tried them). :smile:
 
My first name is Bridget. So it's Bridget, Nelson, and the rest of the furry family as we have 12 civvies. And our home wouldn't be complete without my DH who the furries really love, even the semi-socialized ferals, because he is the bringer of turkey.

Well, I'm already consistently getting yellows and blues (BG in the office was 460+) so I guess I haven't ruined my vial yet. :mrgreen: Highest BG since I started testing earlier in the week was a 205 and the lowest so far a 175. I was feeling guilty about not swabbing the vial but I'm glad I was inadvertently doing the right thing.

This weekend I'll start a spreadsheet and a profile. We are getting ready to go live with a new computer system at work so it's been a bit hectic trying to run home to check on Nelson that I'm just glad that I've been logging everything in a notebook.
 
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