Is an icebox cool enough for insulin 24/7?

[Naio]

My cat is the diabetic in the family. I stored his insulin in a cooler for the first time, yesterday and last night, and was surprised how much warmer it was than the S&B fridge. Is it really going to be cold enough? I had it in there with ice packs and frozen food...which did not stay frozen.

Help???

[Dustytuu]

Before we got a 5th wheel with a good fridge. I kept my insulin in a very small cooler with ice packs when traveling. Worked for me. I have been on insulin most of my life.
We went full time about 8 years ago and when we travel my insulin stays cool in fridge while traveling. If weather is extremely hot we put the fridge on gas when traveling, but if not we leave the fridge door closed and it stays cool while on the road. We only travel about 200 miles a day so this is not a long time for fridge to be off.
My insulin is Novolog. Sometimes Humolog, whichever the insurance decides to pay for. And these insulin
are same. Just different manufacturers.

[Naio]

Thanks so much, especially Bobbo and Doug!!! I am grateful for your professional knowledge.

[garmp]

Opie431, I can feel for you. I am a diabetic also and had to adjust my life so I could still go camping. Even tried to get the doctor to write a prescription for a Yeti cooler to maintain a cold temp for my insulin. Didn't work, but was worth a try. Good luck & take care.

[wa8yxm]

A true Ice box is 33 degrees. this is generally cooler than the Residential fridge.. I store my insulin in an RV fridge (Usually around 35-40 and yes I monitor)

Insulin can be stored at room temp for a period of time.. Just what the period is depends on the type of insulin.. Your pharmicist can tell you the Room temp storage for YOUR insulin or you can go to community.compuserve.com/diabetes If that link will work for you (If not I have a longer verson) and the folks there will figure it out.

More information I do have.. lots and lots more. Learned the hard way on some and via tons of research on the rest.

[ol_Bombero-JC]

Forum (here) "RV Pet Stop" might be good for more info -
also -IIRC- there is a Vet on there who regularly chimes in.

~

[dturm]

In 37 years of practice, I've never had an animal with an infection due to insulin injection/contamination, and that's with inexperienced owners, lots of hair on the patients, and infrequent (never) bathing :).

The following is the Plumb's warning about care of veterinary insulin:

Plumb's wrote:
Stability/Storage

Manufacturers of insulin recommend that all insulin products be stored in the refrigerator but protected from freezing temperatures (do not store at temperatures <36°F (<2°C). Freezing may alter the protein structure, decreasing potency. Particle aggregation and crystal damage may be visible to the naked eye or may require microscopic examination. Higher temperature (>86°F; >30°C) extremes and direct exposure to sunlight should be avoided (such as might occur when insulin is stored in a car glove compartment or on a window sill), since insulin transformation products and fibril formation may occur. Manufacturers recommend a maximum of 30 days storage at room temperature (except for detemir, which is 42 days). The manufacturer’s label for ProZinc® does not contain a discard date for punctured vials other than the expiration date on the vial. Pet owners should be advised to visually inspect and discard any unused insulin if there are visual signs of contamination before each use.

While not seeing infections, I do notice pretty regularly a decrease in glucose control/regulation when getting down to the end of a bottle. Whether this is due to the date getting close to expiration, poor mixing during use over time resulting concentrations on insulin not consistent with label, or temp effects, I'm not sure. But, I'd recommend NOT to try to use every last drop in the bottle, but don't worry about the cooler or RV fridge.

Doug, DVM

[Opie431]

Yes, we camped for several weeks at a time with our diabetic child.

[TomHaycraft]

Guess I'm not alone, traveling with a diabetic dog. Chronic pancreatitis burned out the islet cells, just about 3 years ago. With a refrigerator that hovers around freezing ("slide" all the way down/warmer), my concern for the Humulin-N was too cold. Read the package insert, life has been much better maintaining it at room temp.

A Great Pyrenees at ~120 lbs, dose around 30 units twice daily, bottle is empty well within 30 days (unfortunately!).

[Bobbo]

Naio wrote:
Thanks, Bobbo!

Yes, kitty gets 2 units every 12 hours, so 250 days per bottle would be more than the 6 months I guesstimated :).

I wish they sold smaller bottles. Especially Prozinc, which IIUC is not approved for anything other than cats.

So, do you think that growth of contaminates is a more likely result of being at room temp than the insulin itself actually breaking down? And is watching for 'floaters' or clumps a reliable indicator? I'd hate to give kitty an abcess.

You can not tell either contamination or drug breakdown by looking at it. I would think the contamination would be the bigger risk, but you don't have to run either one. I would stick with 1 month at room temperature, or 3 months refrigerated for a vial, but never go past the vial's expiration date under any conditions. The drug does not immediately break down, but we can't guarantee its potency past that date. The 3 month period I quoted above is not founded on any science or evidence, just a time period that I would feel comfortable using the drug if kept cold.

Some insulins do come in 3ml vials. I don't know which insulin you are using, so I don't know if yours does. To get a 3ml vial, you will have to have it special ordered. Someone mentioned getting an insulin pen. An insulin pen only has 300 units per pen, so that may be an option. However, you have to buy 5 pens at a time, as that is how they are packaged. Again, I don't know which insulin you are using, so I can't tell you offhand if it is available as a pen. A pen would also simplify giving the insulin since you would not have to fool with syringes, just attach a needle to the end of the pen, dial in the dose, and inject. However, pens are SIGNIFICANTLY more expensive.

BTW, I looked up Prozinc. Since it is a Vet product, I have no personal knowledge of it. Note, however, that it is 40 units/ml rather than 100 units/ml, so dosing is different volumewise. A vial of Prozinc only has 400 units of insulin per vial.

A historical note. Back IN THE DAY, human insulin came in U-40 and U-80. That was 40 units/ml and 80 units/ml. You had to be real careful to buy the correct syringes as the wrong syringes would either double, or half, your dose. Then it was decided to standardize insulin strengths. U-100 insulin with 100 units/ml was created, and the other 2 strengths ceased to exist.

[tvman44]

I don't see why it would not be cool enough.

[Johno02]

I agree with Bobbo fully! Keep it cool! I go though a vial per week, so I don't have a problem and can understand yours. Bobbo, would she be any better off using pens, or can you get pump vials that are smaller??

[Naio]

Thanks, Bobbo!

Yes, kitty gets 2 units every 12 hours, so 250 days per bottle would be more than the 6 months I guesstimated :).

I wish they sold smaller bottles. Especially Prozinc, which IIUC is not approved for anything other than cats.

So, do you think that growth of contaminates is a more likely result of being at room temp than the insulin itself actually breaking down? And is watching for 'floaters' or clumps a reliable indicator? I'd hate to give kitty an abcess.

[Bobbo]

Pharmacist here.

Insulin for human use is good at room temperature for a month. That does not mean leave it in a parked car in August, but anything up to about 78 Fahrenheit is fine.

The label on the bottle should say that, but it is in very fine print.

I imagine that the reason the Vet told you that is, pets get very small doses of insulin, so a vial of insulin can last months. If it is stored refrigerated. If it is stored at room temperature, you may be throwing away a nearly full (expensive) vial every month.

A vial of insulin has 1000 units in it. You can divide that by the number of units your pet gets a day to see how many days that vial will last if kept cold.

One other thing. We normally recommend throwing away a vial of injectable medicine after a month. That is because of potential contamination of the contents when the stopper is punctured by the needle, and subsequent bacterial growth.

[Naio]

I did some googling for kind of insulin I use, Prozinc. The manufacturer says 36-46 degrees.

I put a temp gun on mine, but it had been with a fresh ice pack for a while and was much colder than when I got up this morning. 43 degrees. I tried the overnight ice pack I had taken off it on its coldest side: 60 degrees.

The thing is, a cat uses a much smaller dose than a human, so one vial should last 6 months.

But I found some users on other forums say they have done fine with Prozinc in a cooler.

Yipes, one more thing to worry about :(. I will order an AC cord for my car fridge -- that should help.