Another Diabetic Miniature Schnauzer

[djalbo]

Re: Another Diabetic Miniature Schnauzer

One question. I'm a little vague on what "insulin resistance" means. Does that mean that no amount of insulin is effective or does it mean you have to up the dosage by a certain factor, like 1.5X or 2X, to get the same amount of effect?

[djalbo]

Re: Another Diabetic Miniature Schnauzer

Thought I'd mention, in case you didn't know, Novolin-N (it's Novolin-N that you bought?) requires a different syringe than Vetsulin.

Vetsulin is a U-40 insulin and requires a U-40 syringe for proper measuring. Novolin-N is a U-100 insulin and requires a U-100 syringe. Did you get the Novolin-N from Walmart for $25/vial?

Craig

Thanks Craig - I was wondering about that. I did get the Novolin-N from Walmart for $24.88 exactly and I did inquire about the syringe but they said the needle was no different than the box of U-40's I already had. Is this critical?

Actually, I just did a quick Google search and it looks like to convert the U-40 to U-100, I would need to use 2.5X the amount of U-40. So for 4 units prescribed for a U-100, i would need to use 10 units of a U-40 syringe. Does this sound right?

[Joan]

Re: Another Diabetic Miniature Schnauzer

Thanks Craig - I was wondering about that. I did get the Novolin-N from Walmart for $24.88 exactly and I did inquire about the syringe but they said the needle was no different than the box of U-40's I already had. Is this critical?

Actually, I just did a quick Google search and it looks like to convert the U-40 to U-100, I would need to use 2.5X the amount of U-40. So for 4 units prescribed for a U-100, i would need to use 10 units of a U-40 syringe. Does this sound right?

NO, that is not correct.

the U100 is much more concentrated, if you are using a U40 syringe for a U100 insulin, you must DIVIDE
by 2.5! so 4 units becomes about 1.5. You cannot trust that the Walmart employees know the difference between U40 and U100. It is much safer (and easier) to have the correct syringe. At Walmart you can get a box of 100 syringes (U100) for about $12. Put the U40s at the back of a cupboard or throw them out to eliminate any errors. Sorry, but this is so important. If you gave your pup 10 units on a U40, it would be the equivalent of 25 units of a U100 insulin.

[CraigM]

Re: Another Diabetic Miniature Schnauzer

Thanks Craig - I was wondering about that. I did get the Novolin-N from Walmart for $24.88 exactly and I did inquire about the syringe but they said the needle was no different than the box of U-40's I already had. Is this critical?

Actually, I just did a quick Google search and it looks like to convert the U-40 to U-100, I would need to use 2.5X the amount of U-40. So for 4 units prescribed for a U-100, i would need to use 10 units of a U-40 syringe. Does this sound right?

I think you have it backwards. If you MUST use a U40 syringe to inject 4 units of Novolin-N (U100) you would divide 4 by 2.5 and fill the U40 syringe to an estimated 1.6. Way too hard to see/measure. I wouldn't mess around, go back to Walmart and get U100 syringes: only about $12 for 100.

The nice thing about the U100 syringes is they can come with a short 8mm length needle. Most who use Novolin-N would get:
30 or 31 gauge
3/10 ml capacity
8 mm length

So, these syringes are thinner and shorter than the U40s you are probably using. Your pup will likely enjoy the thinner needle! The pharmacy tech you spoke with had probably never heard of the U40 syringe, because they aren't used by any(?) human insulins.

Using the wrong syringe is just asking for someone to make a mistake. When I switched from Vetsulin to Novolin years ago, I taped up the remaining U40 syringes and put them into the back of a cabinet to get out of the way! Finally, I just sent them to a member that stayed with Vetsulin.

Craig

[djalbo]

Re: Another Diabetic Miniature Schnauzer

NO THAT IS NOT CORRECT!!!

the U100 is much more concentrated, if you are using a U40 syringe for a U100 insulin, you must DIVIDE by 5! so 4 units becomes less than one.

Yes, you are correct. I realized that after seeing all the 2.5X conversions online were for U-40 insulin in a U-100 syringe, not the other way around.

[djalbo]

Re: Another Diabetic Miniature Schnauzer

I think you have it backwards. If you MUST use a U40 syringe to inject 4 units of Novolin-N (U100) you would divide 4 by 2.5 and fill the U40 syringe to an estimated 1.6. Way too hard to see/measure. I wouldn't mess around, go back to Walmart and get U100 syringes: only about $12 for 100.

The nice thing about the U100 syringes is they can come with a short 8mm length needle. Most who use Novolin-N would get:
30 or 31 gauge
3/10 ml capacity
8 mm length

So, these syringes are thinner and shorter than the U40s you are probably using. Your pup will likely enjoy the thinner needle! The pharmacy tech you spoke with had probably never heard of the U40 syringe, because they aren't used by any(?) human insulins.

Using the wrong syringe is just asking for someone to make a mistake. When I switched from Vetsulin to Novolin years ago, I taped up the remaining U40 syringes and put them into the back of a cabinet to get out of the way! Finally, I just sent them to a member that stayed with Vetsulin.

Craig

Good advice about just getting the U-100 syringes. Can I ask you why you switched from Vetsulin to Novolin? And what breed of dog do you have? Thanks again!

[CraigM]

Re: Another Diabetic Miniature Schnauzer

Good advice about just getting the U-100 syringes. Can I ask you why you switched from Vetsulin to Novolin? And what breed of dog do you have? Thanks again!

Annie, my Lhasa Apso, was started on Vetsulin like many dogs were in 2008. I'm loosing track of the timeline, but about a year into Annie's diabetes Vetsulin was removed from sale in the U.S. I don't remember the exact reason, but everyone was switched to other insulins. I guess it was about 3 years later, Vetsulin was reintroduced into the U.S. Some folks returned to Vetsulin, but many just remained with Novolin-N because of the much lower cost and our pups were doing fine.

Dosage for Annie was the same on either insulin (using their respective syringe).

Craig

[labblab]

Re: Another Diabetic Miniature Schnauzer

Hi again, Douglas. Just checking back in hopes of seeing an update on Cooper. Surely hope you guys are doing OK.

Marianne

[MomofGus]

Re: Another Diabetic Miniature Schnauzer

How is your Cooper doing? Hope to see an update.

[djalbo]

Re: Another Diabetic Miniature Schnauzer

Yes, sorry. Been distracted at work. Cooper is doing better now that we have upped his Novolin-N to 7-8 units twice a day. Not drinking nearly as much water and not having accidents. His glucose curve is much improved. Thank you all for your help. I will say that he has not really shown much improvement otherwise. He is still blind, moves slowly and sometimes is in a dazed and confused mode but I'm chalking that up to his age. He is still a shadow of his former self but as long as he seems content, sleeps comfortably and eats well, I'll take that.

[djalbo]

Re: Another Diabetic Miniature Schnauzer

Another update. I now know why Cooper's condition and attitude had not improved much even though his diabetes is much more under control. For the past week or so, Cooper's eyes have gotten progressively worse, to a point where they were getting awfully painful to him. He would sit droopy headed with his head off to the side and literally would not move from that position no matter how much prodding. There was quite a bit of goopy discharge coming out and his eyes were so swollen, especially his right eye, that his eyelids were essentially sealed shut. We tried neomycin eye drops and cream but that didn't seem to help.

I took him in to see the vet and even she was surprised how bad it had gotten in such a short time. Just trying to flush out the eye took quite awhile and once his eyeball was revealed, it was so red, scarred and cloudy that she was afraid glaucoma had set in.

Just to remind you from an earlier post, this whole downward spiral started about a year ago when Cooper suddenly went blind in March of 2016. We never really knew why it happened and he seemed otherwise pretty normal. No signs of diabetes back then (not until this November) or cushings disease or anything else that usually precedes blindness, so we tentatively diagnosed it as SARDs, which seems to be what you call it when no other explanation works. Though his eyes didn't look noticeably bad back then and his pupils would still dilate and respond to light, there obviously was something going on with his eyes either because of heredity or some other cause that was making it more and more degenerative over time.

In any event, my vet suggested enucleation surgery to remove the eyeballs which at first, sounds horrible but my vet said it's a pretty common procedure and that dogs usually respond very well to it, particularly if they are in pain due to glaucoma or some other eye trauma. So that's what we are doing. Since Cooper was already blind, there didn't seem to be much to lose and his quality of life has been so diminished this winter after being diagnosed with diabetes that the only other alternative it seemed was to put him down. He was sleeping all day and rather uncomfortably at that so I couldn't just let status quo continue as he was getting more and more miserable.

I'll let you know how he progresses from here. I'm just hoping to get back half of what he used to be just a year ago it seems. I know he'll never be that frisky, run beside and then run ahead of me schnauzer that I remember him as but to see him comfortable and happy again would be enough.

If any of you have any insight or similar stories regarding eye degeneration or its causes, please let me know.

[MomofGus]

Re: Another Diabetic Miniature Schnauzer

I'm so sorry to read of Cooper's eye problems. At least you know now what has been going on. I'm going to think positive here and believe that once he has the surgery and removal that he will adjust and begin to feel much better. Poor little guy. I believe there is another dog here who has had at least one eye removed, but I don't remember who it was, and he was doing fine and adjusting quite well.

Just remember that after his surgery, his sugar may become unstable again. It may improve, it may worsen. You'll have to monitor and adjust accordingly. I'll be thinking of both of you. Keep us posted on his progress. Hopefully, someone will chime in here that has had similar situation.

[jesse girl]

Re: Another Diabetic Miniature Schnauzer

there has been quite a few posts on the subject of eye removal and the ones i have read all have been success stories

[djalbo]

Re: Another Diabetic Miniature Schnauzer

It's now been a little less than a week since Cooper had his enucleation surgery in which his eyeballs were removed and he is without a doubt 1000% more comfortable. It was rather shocking to see his eyelids sewn shut when I picked him up and I thought for sure there would be a period of recovery but he was noticeably better from the get-go and he has just gotten stronger. It is pretty amazing how adaptable dogs can be. There's definitely a kick back in his step though he is still pretty cautious about where he goes. His appetite is almost too good and he has put back on some pounds, which is good since he was skin and bones not that long ago, from 22 lbs down to 14 lbs and probably back up to about 20 lbs. Though I don't have an in-house diabetes monitor, we've settled into a routine of about 7 units of Novolin twice a day and that seems to be working.

Though the little guy isn't a puppy anymore, I'm optimistic he'll even run again on the grass when better weather rolls around. It's nice to have your old friend back with some resemblance to the good old days. When I think just a week ago, I was ready to put him down, you have to appreciate the times you have left with them.

[CraigM]

Re: Another Diabetic Miniature Schnauzer

It's now been a little less than a week since Cooper had his enucleation surgery in which his eyeballs were removed and he is without a doubt 1000% more comfortable. It was rather shocking to see his eyelids sewn shut when I picked him up and I thought for sure there would be a period of recovery but he was noticeably better from the get-go and he has just gotten stronger. It is pretty amazing how adaptable dogs can be. There's definitely a kick back in his step though he is still pretty cautious about where he goes. His appetite is almost too good and he has put back on some pounds, which is good since he was skin and bones not that long ago, from 22 lbs down to 14 lbs and probably back up to about 20 lbs. Though I don't have an in-house diabetes monitor, we've settled into a routine of about 7 units of Novolin twice a day and that seems to be working.

Though the little guy isn't a puppy anymore, I'm optimistic he'll even run again on the grass when better weather rolls around. It's nice to have your old friend back with some resemblance to the good old days. When I think just a week ago, I was ready to put him down, you have to appreciate the times you have left with them.

Nice report!

Although Annie is always (well, almost always) on a leash when outside, she surprises me sometimes wanting to run. Sort of funny: a blind dog pulling me across the yard!

Anothing "fun" thing to do with a blind pup is to play hide-n-seek! Of course I whistle, or squeak her toy, to help her find me. Then lots of hugs and praise.

Craig