Vetsulin Vs. Humilen PLEASE HELP!

[lad0628]

My vet has been out of vetsulin for over a week and telling me that they will probably get it in the following day. He has been on vetsulin for a year and a half. We cannot get it anywhere in two counties except the vet. i just talked to a new receptionist at the office who told me they have Humilen and Prozinc, but no vetsulin. They want me to bring him in for an ER visit to monitor his blood sugar overnight in order to see what dosage he needs in the Humilen. Does this seem right? I have enough vetsulin to get him through the night, but she "highly recommends" he come in now (5:00PM on a Sunday, hence the ER visit). I have the resources to cover the expense, but am starting to become suspicious of the vet considering the fact that there is always some problem getting the vetsulin. We have to start calling for it at least a week before they run out to make sure they have it. This time it didn't work. Any advice would be really appreciated.

[Patty]

Re: Vetsulin Vs. Humilen PLEASE HELP!

Hi and welcome. A tough spot to be in for sure. I would look at switching to Humulin NPH or Novolin NPH. Typically the recommendation is to cut back by 25% of the current dosage of insulin to start the new one.

Humulin N is a U100 insulin whereas Vetsulin is U40 (this has to do with the concentration levels) so you will need new syringes to match the Humulin N insulin that are U100.

A few questions:
Do you home test blood sugar with a meter? or urine sticks?
What is the current dose of Vetsulin?
How well regulated is your dog?
How much does your dog weigh?

Personally I would say if you don't know how well regulated your dog is or where the blood sugar usually is it would be worth it to take him to the ER for help and monitoring.

Otherwise if you can get a prescription for insulin and syringes you could switch at home.

Patty

[k9diabetes]

Re: Vetsulin Vs. Humilen PLEASE HELP!


Hi!

I emailed you too just in case that would get to you faster. This just repeats what I sent in the email...

There is no need to go to the emergency vet to switch to Humulin.

If your dog is fairly well regulated, reduce his dose by 25% and start him on Novolin NPH from Walmart, which is the least expensive, or Humulin NPH from any pharmacy at that 75% dose.

So if he’s on, just as an example, 40 units, you would reduce the dosage 10 units (25%) so start him on 30 units.

You will most likely have to increase it from there but that’s a safe starting point. Most dogs wind up on very similar numbers of units of NPH as they were on Vetsulin.

Your vet is having trouble getting Vetsulin because it’s no longer being sold in the U.S. Please see the Intervet site: http://vetsulin.com/vet/Vet_ProductAlert.aspx

for their many many advisories for ALL vets to transition ALL of their diabetic patients to other insulins because of the FDA alert that has ceased sales of Vetsulin here.

I’m quoting below from their most recent plea for all pets to be moved to other insulins. Novolin/Humulin NPH is the best choice for dogs.

Natalie

“February 22, 2010
Re: Vetsulin® Alert Update
Dear Doctor,
This letter is a follow-up to the “Vetsulin Alert/Importance of Diabetic Pet Transition” letter issued on November 30, 2009. In that communication, we emphasized the need to begin transitioning dogs and cats from Vetsulin to other insulin products as soon as possible. This need is driven by a limited supply that will deplete shortly, and an unknown date for replenishment of this product.
We want to remind you that Vetsulin supplies are continuing to deplete, and expediting the transition of your diabetic patients on Vetsulin to other insulin products is extremely important.

[k9diabetes]

Re: Vetsulin Vs. Humilen PLEASE HELP!

These two insulins are different concentrations and the syringes are sized and marked accordingly so it's very important that you get the right syringes for the new insulin and not use the old ones.

If you would like, you can call me. I will email you my phone number.

And please let us know whether you test blood sugar at home, what you plan to do regarding switching insulin... and we will help you. With more information we could be more helpful.

I really do not think an emergency vet stay is necessary. Everyone here has transitioned their dogs from NPH to Vetsulin on their own with a reduction in the number of units.

Natalie

[ozzi]

Re: Vetsulin Vs. Humilen PLEASE HELP!

Vetsulin is in very short supply and soon to become unavailable due to the FDA recall. Many here have switched from Vetsulin to Humulin-N or Relion Novolin-N successfully. Both of those insulins are NPH intermediate-acting insulins and are typically interchangeable. The Relion Novolin-N is available only at Sam's Club or Walmart. Humulin-N is available at any retail pharmacy. If you are in the US, you do not need a prescription for insulin, HOWEVER, you DO need a prescription for syringes, and as Patty pointed out, the NPH insulins use a different syringe: U 100 syringes. Novolin-N is about half the cost of Humulin-N, and typically has the same effect, so it's a good choice.

I'm not exactly sure why your vet wants you to bring your dog in to switch to NPH. I would ask to speak with the vet, not the receptionist, and talk about getting a prescription for the new needles and insulin (if not in the US). Patty's suggestion that people here usually start on a 25% decrease in dosage is correct and then you can regulate your dog from that point. It would really help if you home test, so you can monitor the blood glucose yourself.
Kevin

[CarolW]

Re: Vetsulin Vs. Humilin PLEASE HELP! (or Novolin)

Hi, and a big, fat welcome to you and your dog!

Sorry you're facing this somewhat sudden difficulty with not being able to get Vetsulin - apparently it was a surprise to you. I won't comment more on that (!) - except to say, not your fault.

There's a short explanation of concentration of these two different insulins - Novolin (or Humulin) and Vetsulin (or Caninsulin), here:

http://www.coherentdog.org/vek/merry...e.php#concentr

Because you're now forced to change, I think it might be useful to you to understand WHY you need different syringes, and also, why the volume of fluid you'll be injecting, with the new insulin (Humulin and Novolin are the same in this respect) - is far smaller, with the new insulin.

When you have time and feel more relaxed, you can page your way through a bunch of silly stories, beginning on that page, that should give you something fairly close to a kind of intuitive understanding of the need for different syrniges, and of how and why the fluid volume is different. It's all mostly just for fun.

I hope you'll be able to tell us more about your dog; that is, what's the dog's weight, when diagnosed - was that a year and a half ago?, and how his blood glucose levels have been monitored in the interim, or something about what they have been recently. If you don't have those figures, you could begin monitoring yourself, and if you'd like to do that (it's a GREATLY useful skill to have), we will help you learn to do it.

As long as you can keep a pretty good eye on your dog's blood glucose levels, you can do well while making the change from Vetsulin to either Novolin-N or Humulin-N insulin. (Another name for them is, Novolin-NPH, or Humulin-NPH.)

Most dogs are very easily changed from Vetsulin to NPH insulin, you'll be very glad to know!

I'll be here watching, and cheering you on!

There's no such thing as a stupid question; what's stupid is NOT to ask a question when you have one! Just yell any time for help.

Sun, 2 May 2010 16:13:00 (PDT)

[ozzi]

Re: Vetsulin Vs. Humilen PLEASE HELP!

Hi,
How are things going and what did you decide to do? I know you mentioned only having enough vetsulin for yesterday, so I'm hoping things got resolved without an ER visit. I feel badly that you were put in this situation and have my fingers crossed that everything is working out for you.
Kevin

[k9diabetes]

Re: Vetsulin Vs. Humilen PLEASE HELP!

I got an email from lad0628 - he spent the night at the hospital but is home now and they are working to switch him over. He started NPH today.

Natalie

[Patty]

Re: Vetsulin Vs. Humilen PLEASE HELP!

Good to hear

[CarolW]

Re: Vetsulin Vs. Humilen PLEASE HELP!

Thanks for the report, Natalie. lad0628 - please report when you have time and energy. We're rooting for you and your dog!

Mon, 3 May 2010 21:19:47 (PDT)

[lad0628]

Re: Vetsulin Vs. Humilen PLEASE HELP!

Hi everyone! thank you all so very, very much for your advice, support and time. I really appreciate it. The week has been crazy after the ER and finally getting the Humulin. Pepe seemed to start regulating on Thursday and Friday, but now his reading is up again. I am waiting another 2 hours to check him again and hoping for the best. Again, thank you all for your help and support!

[k9diabetes]

Re: Vetsulin Vs. Humilen PLEASE HELP!

I'm hoping we can help you work out a plan for testing and increasing (if needed) his insulin.

The more I thought about the results you emailed to me, the more I thought not only of rebound as a possibility but also potentially overlap of injections - that he could be getting more than 12 hours from one injection of NPH - just because he got really low numbers the day following that large injection on Thursday. Overlap of NPH is very very rare but stranger things have happened. I know of two very small dogs who could regulate with NPH once a day, which is even rarer.

The only way to know what's going on with him is a curve AFTER the insulin is reduced enough that you know there is no possibility of rebound and at least three days have passed since the last rebound.

So I'm anxious to hear more about how Pepe is doing! And a picture if possible!

Natalie

[Patty]

Re: Vetsulin Vs. Humilen PLEASE HELP!

Will be watching to hear news on Pepe

Patty