Switching from Vetsulin to NPH

[amberiu99]

I was wondering if anyone else would be interested in documenting their switch from Vetsulin to NPH on the forum? I plan on doing that and creating a set of documents to pass along to vets once I am through the switch and back to regulation. I want to pass along information to vets that do not have as much experience with diabetes and making the adjustments necessary during this kind of switch. We have a really unique opportunity right now to document massive switching and the ramifications for veterinarians. It is unusual that so many people would be switching at once.

I think that vets focus on not having patients go too low, but sometimes they do not consider the risks of consistently high Bg such as ketoacidosis and long-term effects on organs and future regulation for dogs.

If you are willing to document your progress, please list food type and amount, exercise, insulin amounts before, during, and after the switch, any curves, spot checks, etc.

I will begin to post my information here as we move forward, but I am also going to keep documentation that I can put together in one place. I hope that I can help others who will be going through this process.

It is important to note that each dog responds differently to different insulins. I do not want anyone to think that I am recommending to be agressive in your change. For me, I know my dog, I know what I have seen with him in the past, and I am positive that starting him from ground 0 to get him re-regulated was not the right thing to do for him. Even though I was positive, I still had conversations with my vets to discuss my course of action. I certainly recommend everyone else doing the same.

Best of luck if you are switching!

[BestBuddy]

Buddy had a very non eventful switch from Caninsulin to NPH. He had been regulated for around four years and all of a sudden (other medical problems) the Caninsulin only lasted around 6 hours so we decided to try NPH.
Buddy's food consisted of around 150g of Science Diet Light canned and about 50g of kibble twice a day with injections. He was on 4.8iu of Caninsulin (12 in a U100 syringe).

Now for the non event.....
One Friday evening Buddy was given his normal food and 4.8iu of Caninsulin.
Saturday morning he was given 4iu of NPH and his normal food and apart for the odd 1/2iu change with other problems (UTI,eye infection,ears etc.) this is how he stayed for the next few years before he passed away.

Buddy's food continued to be the same and he was around 5kg. We noticed the first day that the NPH was lasting the 12 hours and BG numbers stayed between 100-250. Within 2-3 days the BG was about 70-190 and continued mostly the same from then on.

I'm glad I didn't start too low on the NPH but we had the advantage of really knowing Buddy and that 4-5iu worked well regardless of the type. Home testing gave me peace of mind.

So for us it was no big deal and I hope those changing have it the same way.

Jenny

[CraigM]

Jenny (and all others),

I'm a little "slow" in figuring the change-over

Do I understand correctly that you gave 4.8IU of Caninsulin in a U40 syringe, and then 4IU of NPH in a U100 syringe?

I still have 2 vials of Vetsulin, but may shift before I start the last vial. Annie will have her yearly vet visit next month and want to have some facts to discuss with the Doc..

Craig

[BestBuddy]

Hi Craig,

I will try (I am not very good at it) to explain about the insulin.

One unit of Vetsulin/Caninsulin is the same as one unit of NPH or any other insulin. It is the volume of liquid that goes into making that one unit that makes it a U40 or a U100.I believe that U40 means 40iu per ml and U100 is 100iu per ml so you would need more liquid of the u40 (2.5 times to be exact) to match the U100 units.

I always talk about insulin in units regardless of what number I fill the syringe because I always used U100 syringes with Canisulin and it was the marker 12 on the U100 syringe but we were giving 4.8 units of insulin so when I changed to NPH it was marker 4 on the U100 syringe which was a true 4 units.

Jenny

[CraigM]

Thanks Jenny.

[mnfila]

Amberiu99,
I'm brand new to this site thanks to you! You pic of your baby puts me in your category. My girl is around 135lbs so... We are just making the switch to nph from vetsulin and the first night was not so good. G.G. was way high and considering we've just been battling a UTI from high sugar, we don't want to stay this way. Any help/advice you can give me from your experience would be highly invaluable. Thanks!!

[CarolW]

Maybe I can give you some ideas, but we'd need more detail from you before we could get specific. I gather you're testing your dog (G.G.?) - using a glucometer? And she weighs 135 pounds? Curious; is she a Fila Brasiliero (wild guess - grin!)? Or what? How old is she? When was she diagnosed with diabetes? What was her Vetsulin dose, and what NPH dose did you change to?

Have you discussed this in detail with your vet? If so, what does your vet say? If not, I think it would be worth having a discussion. If your VET has been doing BG-testing, rather than you, could you get those test results and post them here? Your vet should provide the results without any problems. And if you have been doing the testing, can we see her most recent curves? and/or spot checks?

You might read through the Sticky thread here on protocol for making the change. It seems to be generally agreed that because the curve shape may (likely, will) change with the change of insulin, the safest thing to do is cut the number of units by 20 to 25%. At first, it was suggested to start from scratch, as though the dog had never had insulin before, but that seems to have changed as time went by, which I think is fortunate.

I'm VERY sympathetic with your desire that G.G. shouldn't run high; on the other hand, that's FAR safer than letting her get too low!

You can expect it will take at least three days for G.G. to adapt to the new insulin, so that you see its true effects. Actually, my vet says, better, a week and better yet, two weeks. But my vets wouldn't raise the dose for at least three days, more likely a week, or perhaps two weeks, depending on BG (blood glucose) test results.

All that said, my Kumbi started out on Novolin-NPH insulin, and we never changed the type nor brand that he's on. So I don't personally have any experience with changing types ot insulin You will though, if you look around the forum, find various posts from people who have made the same kind of change you're beginning.

If you're able to test, yourself, with a glucometer, I'd do that; say, at least three spot-checks daily - perhaps at fasting, a.m. and p.m., and at what might be expected to be approximate peak time for NPH insulin - maybe 6 to 8 hours after the morning injection.

Are you feedng and injecting 12 hours apart? That's a standard kind of protocol for any insulin.

I WOULD like to encourage you, and let you know that if you take things step-by-step, without rushing, you should get good results in relatively little time, always assuming G.G. takes well to the NPH insulin, and doesn't have any bad reactions to it.

So, now waiting till we hear more from you! I'll be here watching, and cheering you on!

Fri, 23 Apr 2010 11:35:06 (PDT)

[Patty]

mnfila,
I started a thread just for G.G. on the forum here http://k9diabetes.com/forum/showthread.php?t=1822 so we can keep track of her info in one place.
Welcome!
Patty

[marydog]

We are going in the middle of this week to switch Mary, 12 years old from Caninsulin to NPH. She was diagnosed with diabetis in July 2009. Right now we are giving her 8 units of Caninsulin. Vet told don't give Mary Caninsulin for 2 days (to shake off Caninsulin) and then start with 9 units of NPH. I'm afraid do not give her insulin for 2 days and another concern is about 9 units. I read that dose of NPH should be lower then Caninsulin dose. Would somebody give me other opinions or share own experience. Thank you.

[BestBuddy]

Hi Marydog,

My Buddy changed from Caninsulin to NPH. He was on 4.8iu of Caninsulin (marker 12 in U100 syringe) and we used Caninsulin one day and the next day (normal injection time) gave 4iu of NPH.

Buddy had been diabetic for many years and we felt confident that we could check his reaction so didn't reduce the amount much to start. Many start 25% lower just to be safe. I'm not sure I agree stopping insulin for so long before starting NPH because those BG numbers will just keep rising and make it that much harder.

Make sure you have the right syringes for the insulin.

Jenny