Panting and Humulin N

[s2infla]

I recently switched my 11 year old male Minpin to Humulin from Vetsulin. This new insulin is a higher concentration, so I adjusted his injections accordingly. His regular vet said to montior him. I have a pet glucose meter, but can't get a good stick. I monitor him by observation of excessive drinking, urination, confusion, inabilitiy to stand, etc.

Two days ago, we had a glucose crisis. I gave him a sugar shot of Kayro syrup in which he repsonded in 30 minutes and proceeded to eat hardily. Yesterday we resumed his regular injections. Today, Reggie is panting heavily and is clearly in some sort of distress. Other than panting, he is not demonstrating the usual symptons of either high or low glucose levels.

Short of taking him to the emergency vet and have his blood drawn, what might this excessive panting symptom be? Has anyone experienced this?

Thanks.

S2infla

[k9diabetes]

Re: Panting and Humulin N

Could you test his urine for glucose?

Please fill us in with some detail about the switch from Vetsulin to NPH...

Two injections a day?

How many units of Vetsulin were you giving per injection?

How many units of NPH are you currently giving per injection?

How much does he weigh?

Does he pant all day long or after injections, after meals...?

Panting could come from a lot of things so I do think it would be wise to get a blood sugar reading, maybe at the regular vet tomorrow. I could see it being related to high blood sugar, to an allergy to the insulin, to digestive upset, to pain of some kind.

Any past experiences with him panting that might give you an idea what it means in him?

Where have you tried to get blood for the meter?

Vets often suggest ears, which are actually difficult places to use for testing in most dogs.

If you take a look at the home testing tutorials page, you will see examples of many different places to test:
www.k9diabetes.com/bgtestvideos.htm.

You might also need a larger gauge of lancet. Some meters come with extremely fine lancets that are so fine they don't draw any blood.

I'll bet we could get you to the point where you can test his blood sugar if he will let you. Min Pins do have a reputation around her for being somewhat less than cooperative!

Natalie

[s2infla]

Re: Panting and Humulin N

...fill us in with some detail about the switch from Vetsulin to NPH...How much does he weigh?...Does he pant all day long or after injections, after meals...?...Any past experiences with him panting that might give you an idea what it means in him?...Where have you tried to get blood for the meter?...Min Pins do have a reputation around her for being somewhat less than cooperative!...

Thanks for your quick response, Natalie. MinPins less than cooperative, you say??! Oh, surely you jest! lolololol First, Reggie is doing much better. You have a nervous furbaby mom here -- I love my two rescue MinPins more than air, so I'm always on point and somewhat reactionary.

Okay, some answers to your questions.

• Vetsulin/40, 10 units twice daily; Humulin N/100, 15 units, 7/8 units, respectively. I did this on the recommendation of the pharmacist and the okay by the vet. Humulin is 2.5 times stronger than Vetsulin. We started Humulin last Thursday.
• Weight is 16 pounds. He's always been considered a large MinPin. This is down from his high of 24. His weight is under control. We've had a battle with that, first up, then frightenly low, and now nice and stable. He's looking buff. ;-D
• The panting only started today about mid-afternoon, seven'ish hours after meal and morning injection. He's not panting now, but his breathing is more labored than normal. Again, I could be just panicking on this.
• His previous panting was only related to heat. We live in oh so hot and humid Florida. I'm very mindful of keeping them both hydrated and cool. We stay in the A/C a lot.
• I've tried his ears, legs, and even his paws for a stick...w/o success, obviously. And Reggie has very large ears -- friends fly free on them. lol

I will definitely look at that tutorial and take him to the his normal vet tomorrow for a blood draw. I'll also pick up some urine sticks -- forgot all about them...OY!

Thanks again, Natalie -- you've calmed my nerves a wee-bit...as I said, I love'em more than air!

Sherry

[CarolW]

Re: Panting and Humulin N

HI Sherry, and a big, fat welcome to you and both your MinPins.

I'm still not clear on what you mean with respect to doses of insulin.

That is, you said:

[QUOTE] ....Vetsulin/40, 10 units twice daily; Humulin N/100, 15 units, 7/8 units, respectively.[\QUOTE]

Are you saying you're giving 15 units of Humulin-N in the morning, and 7/8 units in the evening?

What syringes are you using for the Humulin-N? Surely not the same ones you were using for Vetsulin, are you?

I'd like to encourage you to try using the inner, upper lip - rather, lining of the mouth - like the inside of the cheek - for testing blood glucose.

Since you indicate this dog isn't cooperative, you might find testing the "lip" a bit difficult, though if you take useful, calming positions (dog calming signals), your dog MIGHT permit you to do that.

The tricky part would be the folding up of the upper lip and holding it against the upper jaw - while your dog stays still enough for you to prick.

There's more information in a couple of places on my web site, though it's excruciatingly detailed, and takes a long time to read.

http://www.coherentdog.org/vek/bgtest.php

(and check out the "parts list" on that page)

Also:

http://www.coherentdog.org/vek/dogcoop.php

and, in particular, in that series:

http://www.coherentdog.org/vek/groomintable.php

More possibilities for the panting - once a dog's stress levels get raised, first, the dog gets adrenaline flowing. That usually subsides after about 15 minutes. But there remains, after that, a rather large dose of stress hormones, called cortisols. These take a LOT longer to subside than does the adrenaline, and as long as those stress hormones remain high, the dog will startle easily.

I'm going through this right now, with my non-diabetic, new dog, Camellia, who is on Day 9 as my dog. She and I together need lots of rest - lots of down-time - to allow those cortisol levels to subside. And every new startle will raise the levels again. This is true for all dogs.

With a diabetic dog, you are limited concerning how much rest you can allow, as you have, at least, the injections to manage, though those can be painless.

I'll be looking for your further reports and more information, and cheering you on!

Tue, 24 Aug 2010 17:42:21 (PDT)

[s2infla]

Re: Panting and Humulin N

...I'm still not clear on what you mean with respect to doses of insulin...But there remains, after that, a rather large dose of stress hormones, called cortisols...I'm going through this right now, with my non-diabetic, new dog, Camellia, who is on Day 9 as my dog...

Thanks for the welcome, Carol! I'm giving Reggie a total of 15 units of Humulin daily with 7 units in the morning and 8 units in the evening. That mathematically equates to reducing the previous amount by a factor of 2.5. And I am using the same syringes. I specifically asked the pharmacist about it, because it didn't make sense to me as the gauge of the needles are the same for U-40 and U-100. The strength of the insulin does make a difference, however. When I spoke to the vet, she told me to monitor Reggie and that's what I'm doing.

The cortisol is a good point...didn't think of that. Reggie rests a lot -- we're both old and like our rest! ;-D And I'll definitely check out those Web sites. The lip option is not a viable one -- I'll end up fingerless! lol

In any event, we're going to the vet tomorrow for a blood glucose check. I love this little angel too much and I'm not ready to let him go -- not quite yet...

And what type of dog is Camellia? If I had the resources, I'd have a bevy of MinPins...become a foster parent for IMPS.

I truly believe our animals are the physical manifestation of God's unconditional love. And I don't trust anyone who doesn't have a heart for animals, particularly dogs. Now, I'll admit to perhaps going overboard with my affection, but I do let my dogs be dogs -- it's the loving thing to do. I'm a big Cesar Milan fan and totally believe in being the pack leader and having healthy, balanced furbabies!

I'll keep y'all posted as to the vet visit tomorrow.

S2

[BestBuddy]

Re: Panting and Humulin N

I am a little concerned. If you are using the same needles that you used for Vetsulin you need to divide by 2.5 to get your Humulin dosage. So 10 units of Vetsulin would only be to the 4 unit marker in the same size syringe. Which syringes are you now using U100 or U40?

Jenny

[CraigM]

Re: Panting and Humulin N

Welcome to the forum. I think some of us are having trouble understanding what syringes you are currently using with the Humulin. Are you using the correct U-100, or the U-40 syringes that you had used with the old Vetsulin? If you are using the U-40 syringes, to what number are you filling the syringe?

[CraigM]

Re: Panting and Humulin N

Jenny and I are having the same worries from what we THINK you wrote.

You had been giving 20 units of Vetsulin per day with U-40 syringe?
Humulin-N is a U-100 insulin which is 2.5 times stronger.
To avoid confusion / mistakes you should use U-100 syringes.



If you are trying to use the old U-40 syringes (not recommended), you would divide 20 by 2.5 and get 8 units per day, or 4 units two times per day as Jenny stated.

Please verify what syringe you are using, and to what mark.

[s2infla]

Re: Panting and Humulin N

...If you are trying to use the old U-40 syringes (not recommended), you would divide 20 by 2.5 and get 8 units per day, or 4 units two times per day as Jenny stated...

Hi Jenny and Craig - I asked the pharmacist and checked with the vet before I proceeded. The U-40 and U-100 syringes are the same gauges and CC units. The reduction of units from Vetsulin-40 and Humulin 100 would be 25% less than what I was giving previously, which would be 7.5 twice daily. I give 7 in the morning and 8 at the evening meal as that is a larger meal.

Reggie is doing okay and not panting or demonstrating distress. But we are going to the vet tomorrow for a blood glucose level and to update the vet on his condition of the last few days.

Because Reggie's so dear to me, I have a tendency to panic. I just know panting can mean a lot of things, and other than regulating body temperature, it usually means some sort of stress.

I'll keep you posted. Thanks again!

S2

[k9diabetes]

Re: Panting and Humulin N

Hi S2,

This is really really critical to get worked out... are you still using the syringes you used with Vetsulin or did you change to U100 syringes when you changed to Humulin N?

Maybe you always used U100 syringes, which is where the confusion may lie.

U100 syringes come with an orange cap and can be purchased at any pharmacy.

U40 syringes usually either come from Vetsulin or can be bought at the pharmacy but are far less common. I believe even the ones from Vetsulin have a red cap, signifying that they are U40 syringes.

Plus it is marked on the box and probably the bag.

Needle size is unrelated to the syringe size.

Natalie

[k9diabetes]

Re: Panting and Humulin N

I think you're saying that you switched to U100 syringes and reduced the dose about 25%, which is the correct way to go about it. As long as you switched to U100 syringes when you switched to NPH, you are okay.

Sorry if we seem to be browbeating you but dogs have died because a veterinarian or an owner did not understand the syringe difference, resulting in a massive overdose. Some vets have mistakenly told people to use the same U40 syringes and to give the same amount of NPH in that mismatched syringe so the dog got 2.5 times more units of insulin than he was supposed to.

Hence our worry.

Natalie

[s2infla]

Re: Panting and Humulin N

...are you still using the syringes you used with Vetsulin or did you change to U100 syringes when you changed to Humulin N?...

Hey Natalie - I posted to a closed thread...don't know how I landed there, but basically it went like this...

I'm using the U-40 syringes after approval from the pharmacist and vet. I've reduced the units by 25%, which is 7.5 twice daily. I give 7 in the morning and 8 with the larger evening meal. Tomorrow, we're going to the vet for a blood glucose check and to update the vet on Reggie's condition. Thanks for all your input. I'll keep you posted.

I do have a question about uploading pics. I created a photo album and a profile pic. When does that appear, after a certain number of posts/status? That's usually how it works.

S2

[k9diabetes]

Re: Panting and Humulin N

Sherry,

I'm afraid you've been misled in the process of converting to NPH and Reggie is getting an overdose of insulin - I would actually give him some additional food tonight to make sure he doesn't crash!

And then his dose must be reduced and you need to switch to U100 syringes right away.

When you fill a U40 syringe to the 8 mark with NPH, you are giving your dog 20 units of insulin!

(all, please check my math)

So this is a crisis situation.

Do you have a pharmacy that's open late?

The easiest way to fix this problem is to get some U100 syringes before you give another injection.

Natalie

[k9diabetes]

Re: Panting and Humulin N

Re the closed thread, I did a few gymnastics and messed it up! So I had to do a few more gymnastics - sorry about that.

[k9diabetes]

Re: Panting and Humulin N

This becomes more of a crisis with every injection because his body copes by releasing some stored glucose to go with that insulin. But eventually his glucose reserves will be exhausted and he will become hypoglycemic with possibly lethal consequences since he is getting twice the insulin he needed with Vetsulin.

Natalie