Summary of Information on Changing from Vetsulin to NPH

[k9diabetes]

The complete set of letters addressed to veterinarians is located at:

http://www.vetsulin.com/vet/Vet_ProductAlert.aspx

These are what should be printed for your veterinarian when addressing this issue.

[k9diabetes]

With Vetsulin returning to the U.S. market as of April 2013, I thought it would be good to bring this thread back up as far as how to change to a new insulin. Following are notes I pulled from Dr. Richard Nelson's webinar about how to switch a dog from Vetsulin to NPH. The same process applies when switching in the opposite direction.

I just finished listening to the web conference on changing insulins. Most of it was about what I expected and what we have talked about here.

Dr. Nelson addressed dogs and his feeling was that NPH is readily available, has a similar duration and action as Vetsulin, and has decades of successful use so it makes sense for that to be the insulin to switch to.

He said he has sometimes had success using Detemir in combination with Regular insulin as the response to the Detemir was apparently a pretty flat basal type response. But he says he doesn't like having to use two insulins at the same time because it decreases owners' willingness to keep up the treatment.

His goal for a well regulated dog is blood sugar mostly between 80 and 300 with an average for the day of 250 or less.

His recommendation for a starting dose when switching to NPH is to cut the dose "a few units" - from the examples he gave, he would reduce the dose about 20%, for all the reasons we have discussed... the insulin action may be different so best to start on the low end and work up.

Natalie

As we went through the switchover a couple of years ago from Vetsulin to NPH, we found that cutting the dose 20-25% generally worked well.

That assumes that the insulin you're switching from works well. If your dog is not responding much to the current insulin, then the goal of switching is finding an insulin that works better and you could need significantly less units of insulin per injection in that case. For those dogs, I suggest "starting over" with the recommended dose per weight of 1/5 to 1/4 unit per pound (assuming causes resistance to the effect of any insulin have been ruled out).

Natalie