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  #11  
Old 11-08-2010, 12:14 AM
AlisonandMia AlisonandMia is offline
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Default Re: Switching from Vetsulin to NPH

I share your concerns about what is in effect not treating the diabetes for two days - this could result in diabetic ketoacidosis which can be fatal or at least very unpleasant for the dog and expensive for the owner to treat. I don't believe any type of "washout" between the two types of insulin is needed or recommended.

Dogs are typically transitioned from Vetsulin/Caninsulin to NPH by simply giving the last dose of Vetsulin in the evening one day and starting the NPH the next day. Most dogs seem to end up on the same number of units per dose of NPH as they were having of the Vetsulin but just be on the safe side it has been recommended that you start the NPH at a dose about 25% lower than the dose of Vetsulin and then work your way up as necessary.

The most important thing in the transition though is to make sure you have the right syringes. Vetsulin is more dilute than NPH so it is vital that the correct syringes are used with NPH - otherwise you risk inadvertently od'ing! With NPH you need 100 U syringes whereas with Vetsulin you use 40 U syringes.

Alison
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  #12  
Old 11-08-2010, 06:23 AM
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Patty Patty is offline
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Default Re: Switching from Vetsulin to NPH

I definitely agree with Jenny and Alison. If you give the regular shot of Caninsulin in the evening, you can start with the NPH in the morning. But I would reduce the dose by 25% (so if you're giving 8u Caninsulin, you'd give 6u NPH to start), and work you're way back up.

The different insulins can create a different curve or peaking action which is the reason for the initial decrease.

I would also ask for the U100 - 31 gauge, 3/10cc short needle syringes with 1/2 unit marks.

We've had many here switch and can help you through the process if you'd like

Patty
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  #13  
Old 11-08-2010, 07:29 AM
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CarolW CarolW is offline
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Arrow Re: Switching from Vetsulin to NPH

I'm a very visual person, so to understand the differences with UNITS (which is the proper measurement for any insulin) and MARKS on the syringe barrel - which shows WHY you need to change syringes when you change insulins (unless you want to go through calculations), I made a series of diagrams showing how the VOLUME of fluid for Caninsulin (or Vetsulin - same stuff) is far greater for one UNIT than is the volume of insulin for NPH insulin - that would be, say, Novolin-N or Humulin-N - not the same, but very similar.

With a fair bit of time and some patience, you could browse through my rather silly stories concerning measurements of these two insulins - Vetsulin (or Caninsulin - same stuff), and Novolin-N (or Humulin-N, so similar that usually the differences are negligible).

If you actually browse through those pages in order, you SHOULD end up with a rather intuitive understanding of UNITS and VOLUME, which helps protect against accidents caused by, say, using the wrong syringes. It's possible to UNDER-dose by using U-100 syringes with U-40 insulin. But using U-40 syringes with U-100 insulin (Novolin-N, Humulin-N, or their ReliOn versions from Walmart), can easily just kill a dog - who would then be getting 2.5 times as much insulin as should be injected.

I read about some error somewhere with a recall (I think it was on this forum), where syringes were marked incorrectly; that is, a box of U-100 syringes, if I remember right, contained a number of U-40 syringes. On the surface, if you don't look closely, the two different kinds of syringes look rather similar, though when giving small doses, I'd think the caretaker would notice s/he's drawing up a LOT more insulin if using U-40 syringes when the proper syringes are U-100. But you'd only notice that if you had been using U-100 syringes for some time before; if you're NEW to the change, you might not be aware.

I think we had a situation like that here on the forum, where a vet told the caretaker s/he could use U-40 syringes with NPH (U-100) syringes. It was, I think, sometime in the past year or so that this happened.

Mon, 8 Nov 2010 06:28:50 (PST)
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  #14  
Old 11-08-2010, 10:26 AM
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Default Re: Switching from Vetsulin to NPH

Marydog, I copied your question and these threads to a new thread so you can have one of your own.

http://www.k9diabetes.com/forum/showthread.php?t=2265

Hoping to hear more about Mary,

Natalie
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  #15  
Old 11-09-2010, 08:23 AM
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CarolW CarolW is offline
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Arrow Re: Switching from Vetsulin to NPH

Oh, Olga - and MaryDog, you lovely creature, you!

I TOTALLY agree with NOT letting insulin wash out! YES - with changing to the NPH NOW - no going two days without insulin!

As I check your posts, I see that perhaps you're in Canada, as I am, too. That Medi-Cal food worked really well for Kumbi, and ALSO did for my elder dog, Kwali. (We used the Medi-Cal Fibre Formula, which is quite similar to their Weight Control.) And the syringes are just great - you got exactly what I used. My first box was 30-gauge needles, same brand - BD, but the pharmacist, on my second box, happened to hand me exactly the ones you're using, and I used those ever since. Just love them, and Kumbi did, too.

http://www.coherentdog.org/vek/syringes1.php

There are detailed pictures there; they are partly intended to assist people who want to use them with Caninsulin or Vetsulin, to take advantage of the shorter, thinner, needle - so much more comfortable for the dog - therefore also for the human! You can just ignore the remarks about conversions, because with your new NPH insulin, your syringes are MATCHED to the insulin - no conversions needed. That was the same for Kumbi and me. I made conversion remarks to benefit another list, where lots of people were wanting help with it.

I do have a VERY detailed step-by-step description of giving injections to a diabetic dog, and maybe you're one of the people who, as I do, thrive on absolutely excruciating detail! If so, you could leaf through these pages, starting here:

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

I should add that lots of people just find that kind of detail excruciatingly confusing, so don't worry if that happens to you; just skip on past. You can always go back there later if you want to. Lots of my silly jokes in there, too. I have a habit of laughing at diabetes; partly, my vet taught me to laugh!

I never changed insulins for Kumbi, because he started on that same Novolin GE isophane (NPH) insulin you have for Mary, and he had that all his life. He did so well on it that we only had occasional minor dose changes, usually, seasonal, till toward the end of his life, as cancer invaded his system (but we didn't know it was cancer).

Anyway, Kumbi was very stable on it, and I believe would have been, also, had he been on Humulin-N. I found it a very easy insulin to work with, and was glad I never had to cope with Caninsulin, because of the various possibilities for fluctuation in glucose levels.

I'm glad you're posting, and will look forward to your further reports! Kumbi, from the Bridge, takes the liberty of sending you and Mary greetings, and Kwali joins him, as she refuses to be left out! Now Camellia is joining them too, saying, "I don't have diabetes and hope I never get it, but if I do, I'll be safe!" (And I jump in and say, "Camellia, your breed-ancestors, the delightful Bichons, seem often to get diabetes, but I haven't seen Havanese mentioned on the forums.")

Tue, 9 Nov 2010 07:22:47 (PST)
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