New Member too - question on changing to NPH

[SamtheCorgi]

Welcome to the forum!

I copied your question to its own thread so folks can answer you directly.

The switchover usually involves a small reduction in units of insulin in each injection. I personally prefer starting NPH at 3/4 of the units of Vetsulin you were giving. Some might even suggest starting closer to the dose...

Most dogs need about the same number of units but it varies from dog to dog.

Natalie

Hi,
Trying to make sure I am understanding all the information. I read that Vetsulin is a DILUTED insulin and Novo N is more concentrated. But 1u of Vetsulin in a 40cc syringe is EQUAL to 2.5u in a 100cc syringe.

when I say EQUAL, that is in VOLUME only correct? not effectiveness. so if I were to be giving 15units of Vetsulin in a 40cc syringe an equal amount of Novolin N in the 100cc syringe would be (15x2.5) 37.5u ?? I think the flaw here in my thinking is that it only applies to Vetsulin and it is equal in VOLUME only. Is there any meaningful conversion of effectivity??? 15u of Vetsulin (40ccsyringe) is generally considered to be as EFFECTIVE as XXu of Novolin N (in the 100ccsyringe)? Make sense what I ask??

So when referencing above:
"The switchover usually involves a small reduction in units of insulin in each injection. I personally prefer starting NPH at 3/4 of the units of Vetsulin you were giving. Some might even suggest starting closer to the dose...

I guess Dana is a big dog. At 33 units, I would start NPH at at least 24-25 units - that's 75% of 33. And then monitor and raise it up as needed. Depending on if you home test, you might be able to start somewhat higher... 28-30. But I wouldn't personally do that without home blood glucose testing and careful monitoring the first couple of days.

Most dogs need about the same number of units but it varies from dog to dog."

I want to clearly understand the correlation. SO, If I were considering changing the 15u of Vetsulin (which wasn't controlling Sam's BG well to begin with) to Novo N what is the units of Novo N in 100syringe?? The specialist I am working with started us off at 7u of Novo N in the 100 syringe. I can understand being conservative, but it seems to do nothing and Sam's glucose is over 500 at times, not even readable on the meter!!! We are generating a curve, but I don't want Sam to suffer such HIGHS and wanting to learn more about what is a safe approach, avoiding hypo but narrowing in on healthier/lower BGs sooner.

So given the dilute vs concentrate and unit of measure difference, "Some might even suggest starting closer to the dose" What does that mean???
Closer to the equivalent volume?? so 1u of vetsulin is 2.5u of NovoN? but then how to account for the "dilute" versus "concentrate" factors between the two!!

Comments welcomed, confused!!! Thanks!!!

[k9diabetes]

Re: New Member too - question on changing to NPH

There's typically only a very small difference in units of insulin dose between Vetsulin and Novolin N. I would drop a couple of units only from the 15 you were giving, especially since the blood sugar wasn't well controlled on that.

So I would raise his Novolin N dose to at least 10 units and perhaps more like 12 or 13 given how high his blood sugar is.

It depends a bit on why the Vetsulin wasn't working. It's possible he needed more than 15 units so 15 units of Novolin will have only about the same limited effect.

Or it could be his body didn't like the Vetsulin, in which case it's possible that a much smaller number of units of N will be effective. But so far that doesn't appear to be the case.

How much does Sam weigh?

i would ditch U40 syringes and go to the U100 syringes right away if you haven't already. The conversion just makes things more complicated.

As long as the insulin and syringe units match - Novolin N is U100 insulin so should be paired with U100 syringes, a unit on the syringe is a unit of insulin. Much simpler to think about.

The syringe / conversion is strictly a matter of the concentration of the fluid and thus how much fluid you give to deliver the appropriate number of units of insulin.

It's like pale Koolaid (Vetsulin) versus vibrant dark Koolaid (N). In a cup of Koolaid, there are fewer Koolaid crystals in the Vetsulin than in the N. So you need 2.5 cups of Vetsulin Koolaid to deliver the same number of crystals of Koolaid delivered by 1.0 cups of N Koolaid.

The two insulins are equally "potent" - they're just delivered by different quantities of fluid.

Make sense?
. . . . . . .

Some vets inappropriately limit how much insulin a dog can have based on their weight.

We have seen a few terriers, for example, that weighed around 22-23 pounds and needed 21 units of insulin per injection. They just needed more than average.

The most common dose is probably half a unit per pound / 1 unit per kilogram but there's huge variation from dog to dog.

So if you let us know how much Sam weighs, we can advise whether he's actually on a high dose or not.

Natalie