Switching From Vetsulin to Humulin N

[Autumn]

Re: Switching From Vetsulin to Humulin N

Hi Farmsrock
It's difficult enough to have this diagnosis of our dogs. Sorry you had a vet that was so unkind. That is ridiculous. Maybe she was trying to cover her own shortcomings.

When we had difficulties with our vet, I felt so lost. It took us a while to find the right vet, but it's great now! Thankful for this forum. When you find the vet you will feel so much better too. You are taking excellent care of your dog!

I hope you find a vet that takes great care soon!
Anna

[Autumn]

Re: Switching From Vetsulin to Humulin N

Hi Natalie
You wrote: Human meters typically read the blood sugar somewhat lower than actual

This is great news to me!! I had assumed it was the other way. I have not had an opportunity to check against vet's office meter yet.

[farmsrock]

Re: Switching From Vetsulin to Humulin N

Thanks, everyone, again.

I actually did not call a new vet yesterday because I was up almost all night Monday with Licorice and I was so tired I couldn't think straight. She was really fussy, wouldn't come upstairs when it was convenient, then had to go outside to pee, then had to do this, and then I couldn't fall back asleep. So I figured I need a day or two to get more sleep so I could approach this better.

Tomorrow I am taking her in to the current vet - I know - dumb - but until I talk with the new possible vet's office, I have to see about her hematoma which is just back to the original state. I have a spray for the leg ulceration but I think she's going to need antibiotics anyway. It's just hard with coordinating visits with work schedules - I really can't take time off of work at this point. But the current vet will know I know what she said last weekend to my husband. HA

On the Novolin N, I have gotten two readings so far in the low 400s, so that was promising to me. Only into it 3 days so far. I am going to raise it tomorrow 1 unit. The green bean addition to the dog food is working, but I still want to think about a homemade food diet, if that's saves money.

That's good info to know about the meters and how to understand the differences. Thanks for that tip. And, I will talk with the new vet, when that happens, about the thyroid - the current vet never mentioned it and I have sometimes wondered if it shouldn't be re-checked. Thanks for the links, Kathy.

Will keep you posted. Thanks again for all of the advice.

[k9diabetes]

Re: Switching From Vetsulin to Humulin N

Thought I'd look around about ear hematomas...

From VetInfo4Dogs (a site I'm very fond of). The information there is getting older as I don't think anything new has been added in a while but he's good at explaining things quickly and simply. http://www.vetinfo.com/dhematoma.html

There are two major problems with ear hematomas. 1) They seem to hurt pretty badly in some cases. In others this doesn't appear to be true. 2) They cause scarring when they heal that can crumple the ear. This is not just a cosmetic issue because if the crumpling obstructs or alters the ear canal it can lead to a situation in which ear infections are very hard to control.
So we recommend surgery to relieve the pain as quickly as possible when the ear seems to hurt a great deal and when the hematoma is large enough that it really looks like it won't heal without significant scarring, even with medical treatment.
We are perfectly willing to treat hematomas medically if neither of these things is a problem.

Surgery usually involves making an incision on the inner aspect of the ear and draining the blood, removing any blood clots that are left and then suturing the two sides of the ear together by putting sutures all the way through it, in a "mattress" pattern. Sometimes it is possible just to place a drain and massage the blood out of the ear daily until it heals.
Medical treatment is accomplished by giving a cortisone product, such as prednisone, to control the itching and scarring and waiting for the ear to heal, which might take a month or more. It may be necessary to use an antibiotic at the same time and it is always important to identify and eliminate any underlying cause, such as fleas or ear mites.

[farmsrock]

Re: Switching From Vetsulin to Humulin N

Thanks for the information - I did research ear hematomas on the web (as my vet never gave me any information on it until the THIRD visit, which is typical). The ear 'crinkling' never bothered me; I was more concerned with pain and any other possible effects if we let it go.

So I took Licorice in last Thursday for a recheck because the ear was filling up again. The vet said this was unusual (of course, that's my world), and she would rather just leave it alone, which is what I was thinking. I wanted to hear that the ear would not 'burst' if it filled up all the way, and she said she had never seen that happen. She also said it might take months for it to totally go down, and it was not really blood that was filling the cavity (my concern, as if it were internal bleeding of some sort), but blood serum - like bloody blister. So that was good information. Finally.

The good news is that the hematoma is dissipating at this point, not increasing, and Licorice seems to be tolerating it, as if it is not all that painful. Both good things.

At that visit, I extracted (like a bad tooth) some more information about dosage on the new insulin. It just drives me nuts that this vet won't freely give information and tips. As her numbers have been in the 500s and 600s, the vet said it was OK to increase the dosage 2 units at a time every 3-5 days until I hit in the 200s. That felt reasonable. I am not waiting 5 days, though. Licorice is up to 14 units now. For 3 days at 12 units she was consistently in the 400s, which is the first time she hasn't been a yo-yo on BG numbers.

On trying to find a new vet, the one I had in mind actually charges more for an office visit, and more for the food I am using. I figure then that everything will cost more, so I am still searching.

The new 'last straw' on my current vet was the order I placed for a larger bag of the food last Thursday. They said it would arrive on Monday. Tuesday came and no call. I called them and was told it hadn't arrived. End of sentence. No offer to call the distributor and find out what's going on. This is in addition to the fact that they know I use the food and are not making a concerted effort to keep ANY size of the stuff in stock. It took me 5 repeated questions to finally get out of the person I talked with that she was unable to call anyone because no one else was in the office at the time (well before closing time) and she didn't know how. Ridiculous. So I thanked her and hung up. And today is Thursday and they have yet to call me. It was pretty obvious I was upset about the situation, and no one has taken charge of the situation. As an aside, the last visit last Thursday turned interesting when I started to walk out of the clinic after 20 minutes of waiting AND being told that "Dr. X wasn't running late. She just has patients to see." As if I was chopped liver. So I said I would figure something else out, and started to leave, and lo and behold, I was ushered into a room. What do you expect from a practice that believes their patient's owner 'gets confused' when they haven't given that owner all of the information?

Today I called Purina, got a list of vets who carry the food in my area, and confirmed with Purina that all of the bags are in stock. I told them that there may be a problem with the distributor, not to mention the vet. I found a vet that has the food in stock, and will go over there and talk to them about possibly switching to their practice when I buy the food.

If this whole saga wasn't wearing me down, it would be funny. :-)

[k9diabetes]

Re: Switching From Vetsulin to Humulin N

I'm so glad the hematoma is getting better!

I hope you can find a vet who will work with you. The vet previous to the one we have now is a nice person and overall I was fairly happy with the care she provided. But I was very unhappy with the office staff at the front desk. And, as I told her when dealing with a problem with them, the office staff are a large part of my experience in her office. Just for the sort of things you have had problems with - buying an AlphaTrak, buying food, prescriptions. In their case it wasn't so much inept as very cold emotionally and our being treated like our presence was an annoyance. And when they did make a mistake when ordering the AlphaTrak, the person who did it refused to take responsibility for it or the cost of the error. After the literally thousands of dollars I'd spent there, I was annoyed that I was expected to pay for her mistake.

So eventually the office staff are what drove me to find a new vet.

I was fortunate that we had visited quite a few specialists who gave me referrals as quality of care was my main priority. We were fortunate - we found a vet who I trust implicitly in terms of medical advice and who has a great staff.

Natalie

[snow]

Re: Switching From Vetsulin to Humulin N

(snippies by snow)

Today I called Purina, got a list of vets who carry the food in my area, and confirmed with Purina that all of the bags are in stock. I told them that there may be a problem with the distributor, not to mention the vet. I found a vet that has the food in stock, and will go over there and talk to them about possibly switching to their practice when I buy the food.

If this whole saga wasn't wearing me down, it would be funny. :-)

Hey, do you live near Central Maryland? I'm unemployed and have some free time. Why don't you take me to the old vets or better yet send me over there to pick up some food <g>

snow
ps could you post bail for me if necessary

[k9diabetes]

Re: Switching From Vetsulin to Humulin N

Ha! You know, Snow, you might have a great idea for a home-based business!

Natalie

[farmsrock]

Re: Switching From Vetsulin to Humulin N

Snow and Natalie,
You gave me my laugh for the day!
I actually live in Texas. You probably wouldn't have to post bail anyway. This is a state where churches and businesses have to post signs if they don't want them to bring guns inside.

I think I am going to switch over to the vet where I got the food yesterday. I had a long talk with his staff (he's on vacation this week, so they had lots of time to talk - HA), and figure it's worth a shot. They said I wouldn't have to repeat the blood panel as it was recent - that will save me money. Supposedly, the old vet should be able to fax the records at my request, so I don't have to go back. But I am guessing she will charge me a big fee to do that, as that is her pattern. So we shall see.

Interestingly, when I picked up the food, the staff immediately gave me the rebate form for the 'campaign' that is going on with Purina. My current vet's staff was clueless there was even a rebate (I had to tell them). Now these offices are very close to each other, so I have to assume they use the same distributor.

And, to top it off, it's been over a week since I ordered the food, and no one has yet to call me about it. They saw me buy, for a Lab, a dinky 8 lb bag last week to tide me over, so they have to know (if they think) that it wouldn't last long. Their general attitude is 'out of sight out of mind'. I personally think it's a matter of training, that the vet has not impressed upon them the need to know their clients, and go the extra mile. I also get the feeling when I am there that no one is willing or able to take charge of a situation - it's always someone else's responsibility and that person is never around, and so they stand around and wring their hands and say they don't know what to do.
Oh well, on to bigger and better things - maybe the new vet will be more helpful.

[k9diabetes]

Re: Switching From Vetsulin to Humulin N

You own the records at least as much as she does - your dog, your money - you're entitled to them and she should provide them for free and without hassle.

If the file is huge, as Chris' was, it is sometimes more reasonable to get mainly the most recent ones.

Be sure she gives you her notes in addition to the test results.

After Chris' early days as a diabetic, I started requesting copies of all of my pets' test results to keep on file. And periodically I also requested the records of the vet notes as there is often important information in there. That way, you can copy them for future vets, compare results over time, etc.

Perhaps you could tell her that you are easily confused and so would be so much better off if you had everything in writing!!

Natalie

[farmsrock]

Re: Switching From Vetsulin to Humulin N

Well, I faxed a request on Friday to the vet to have them fax the records to the new vet, which amazingly they did.

Saw the new vet today. He was most concerned at this point about all of the skin sores that are oozing, and he said that we have to clear those up, so back onto antibiotics. The old vet said those would resolve on their own once the BG levels stabilized, but this guy disagrees. He is having me do a BG test BEFORE I feed her not 30 minutes after, which is opposite of the old vet - who I am sure told me to test 30 minutes after and give the insulin then if the number is high (and it's always high).

The new vet wants me to stay at the current level of Novolin N (16 units/twice a day) and call him Thursday morning to see if the numbers have shown anything.

My 'jury' is still out on the new vet, but at least I don't have to deal with a clueless staff anymore - the new staff seems better. We shall see...

[We Hope]

Re: Switching From Vetsulin to Humulin N

I'm going to need to agree with your new vet because those with diabetes (with two legs and four legs) are more prone to developing infections than someone without the disease. They can also take longer to heal when there's surgery or a lesion. Even if the blood glucose is perfect and there's tight control, the infection risk is there because diabetes affects the immune system, which "fights off" infections.

Not long after diagnosis (but before regulation), Lucky had a cyst open up near the base of his tail. There was no infection, but to make sure it stayed that way, he got antibiotics.

Infections can sometimes be hidden, in that you get little or no outward signs that it's there--there are times the only sign that there's one someplace in the system are the high bg's, so it might be that there's some infection present which the antibiotics will take care of.

http://petdiabetes.wikia.com/wiki/Hidden_infection

http://petdiabetes.wikia.com/wiki/Di...ions.2FIllness

If that's the case, you might begin seeing lower bg's a bit after starting the antibiotics.

It sounds like you're on the right track now!

Kathy

[k9diabetes]

Re: Switching From Vetsulin to Humulin N

I like what I'm hearing so far.

Natalie

[Tikobird]

Re: Switching From Vetsulin to Humulin N

Hi everyone - I am brand new to this forum but what a gift that I found you! My 10 year old lab Dozer was diagnosed on Monday with diabetes. Reading Farmsrock posts I feel like I am reading my own story! I took him to the vet because he was off his feed & his right hind leg was weak - wouldn't even get up on the bed or couch anymore. My vet drew blood & found his glucose at 500. Said the leg weakness was more than likely arthritis. Sent us home & told us to have him fst & bring him back in the morning to re-test...which we did and he was at 350. We asked her to look into pills instead of injections so we took him home again only to get a call the next day that pills wouldn't work & they wanted him back on Wednesday for 3 days to monitor him and work out how much insulin he would need. Well we picked him up this afternoon and brought him home only to have his hind quarters collapsing now - not just weak and he has been sleeping soundly since coming home. I am hoping he is just exhausted due to 3 days of stress living at the vet (he's never been boarded before). I tried to get him to eat when we got home but he refused. I am anxious of what morning will bring as it will be my first time giving him his shot. Vet gave us a bottle of Humulin N and we're to give him 16 units and bring him back on Saturday to re-test. Reading all the posts I am concerned that we were not instructed to test him ourselves. I too am not all that thrilled with this vet. We moved to rural TN about 2 years ago and this vet is the closest to us (30 minutes away). I've been sitting here reading for about 2 hours and have learned so much more here than the vet told us. Thanks for letting me get this off my chest and for the wealth of information this forum shares!

[ozzi]

Re: Switching From Vetsulin to Humulin N

Hi and Welcome!

Like you, my vet didn't give me much more info than how to give a shot, and then left out many details!! When I asked her about home testing, she looked at me like I was crazy, and reluctantly showed me where to take blood from Ozzi's ear, a location where I have never been successful! It seems that not many vets bring up home testing, unless first brought up by the owners, so sadly, this is not unusual.

This is a GREAT place to be for the motivated doggie parent! You will find an incredible amount of information, help and support. You wrote that you have been reading for 2 hours, so I don't want to repeat things here, but if you have specific questions, PLEASE do ask.

You might want to start a "new thread" about Dozer, to keep all the information together. It would be helpful to know his weight, what he eats and how often, what his sugar was when he was discharged on 16 units Humulin-N, and if you are giving 16 units twice/day. Ozzi has had a lumbar neuropathy that caused hind-leg weakness and his weakness severely increased with high sugars. When his sugar started to come down, his hind leg weakness returned to baseline. That happened within a couple of days after starting insulin. I suspect you will see improvement. Is Dozer drinking and urinating less? You should see improvement there fairly quickly as well.

I wondered if Dozer had Xrays that showed arthritis? Did the hind leg weakness recently start or has he had that for a while? If it was recent and sudden, it sounds more like it's related to the diabetes and will clear with better sugars. Arthritis usually happens over time and is progressive...just something to keep in mind, especially if the hind leg weakness goes away quickly!

You might want to watch his ketones while his sugar is high. Make sure they are coming down (if he had ketones in his urine when diagnosed). You can get urine ketone sticks over the counter at any pharmacy, or WalMart. It's a helpful guide to make sure he is improving and his body is metabolizing the insulin.

Please do give us more info and ask the questions that you have!

Kevin