Re: New Member too - question on changing to NPH

[danagirl]

Hi,
New here also as far as a member but have been reading a lot of the threads.
I to am concerned about the Vetsilyn and my vet so far has a "wait until we get closer to running out stance" my dog is almost 12 so I am concerned about switching the insulin. From what I gather the NPH seems the the best one to go with but how do you convert to that. Dana is currently on 33 units (with a U40 syringe) twice daily. i have not found a conversion but may have just missed it
Any input would be appreciated.

[k9diabetes]

Re: New Member too - question on changing to NPH

Hi Danagirl,

Welcome to the forum!

I copied your question to its own thread so folks can answer you directly.

The switchover usually involves a small reduction in units of insulin in each injection. I personally prefer starting NPH at 3/4 of the units of Vetsulin you were giving. Some might even suggest starting closer to the dose...

I guess Dana is a big dog. At 33 units, I would start NPH at at least 24-25 units - that's 75% of 33. And then monitor and raise it up as needed. Depending on if you home test, you might be able to start somewhat higher... 28-30. But I wouldn't personally do that without home blood glucose testing and careful monitoring the first couple of days.

Most dogs need about the same number of units but it varies from dog to dog.

I would just set aside your old syringes and not try to use them with NPH. That way you can just fill the new syringes to the proper mark to deliver the right number of units.

One nice thing about NPH is you have many many more syringe choices and smaller needles available. You can buy them where you buy the insulin, which you get from the pharmacy rather than from the vet.

You will need somewhat larger syringes than we used. We got by with 3/10cc syringes but they max out at 30 units so you would need 0.5cc syringes.

Natalie

[danagirl]

Re: New Member too - question on changing to NPH

Yes Dana is a big girl...92 # black lab.
Thank you for the input, I do testing at home myself so I will do the change carefully.
Needless to say I am very anxious about making sure it goes easy for her

[CarolW]

Re: New Member too - question on changing to NPH

Yes Dana is a big girl...92 # black lab.
Thank you for the input, I do testing at home myself so I will do the change carefully.
Needless to say I am very anxious about making sure it goes easy for her

Danagirl - adding my welcome! I believe if you think of this change as a bit like starting out from scratch, with one big difference - you have experience testing BG levels! - you'll be just fine.

I agree with Natalie's suggestions. Yeah; your dog is pretty big! Just make sure, when you buy the insulin, also to buy the correct syringes. You'll find you're injecting a LOT less fluid than you did with the Vetsulin. To see how different, have a look here, and go through the first set of pages, where "Vetsalin" represents Vetsulin, and "Novalin" represents Novolin - or its similar counterpart, Humulin.

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

Just keep using the NEXT buttons above the main pictures on the pages, to go to the next page. (You can also go backward, or also, skip around, and if you get lost, use the UP buttons to go back to the main index page, where you can choose where to go next.)

The purpose there is to give an idea of how concentration and volume of fluid differ, between Vetsulin and Novolin (or Humulin) NPH insulins.

There are no activity profile illustrations in those pages; I haven't had time to do them yet, but am considering doing something of the sort eventually. I don't really need to, though, because that information is available elsewhere.

By "activity profile," I mean indications of how the insulins typically work - that is, how (in timing) they start to work (onset), how long they might go on working before being used up (duration), and a range of time in which they are likely to be working hardest (peak).

It's a bunch of silliness in there - on purpose, to take the stress out! But the drawings there, in the measured diagrams, are pretty well to scale, so that will give you the idea.

Wed, 30 Dec 2009 06:15:05 (PST)

[danagirl]

Re: New Member too - question on changing to NPH

Thanks for the info Carol I am going to start in a few weeks when I have a long weekend to monitor her
By the way what kind of dog is yours...very cute.
I will get Dana's photo up once I figure all that stuff out, I am techno-challenged

[CarolW]

Re: New Member too - question on changing to NPH

Good idea to wait till you have a long weekend so you can monitor. I do like to watch with care even when I change a dose - on which I ALWAYS ask my vet's advice, even though theoretically, I could perfectly well do it myself. But my vet really knows my dog, inside-out, so to speak, so is aware of any possible complications - well, Kumbi (knock on wood) doesn't seem to have any.

He's an Australian Terrier - big for his breed, and I like that, because the bones are thicker and stronger than they are on the standard-size Australian Terriers. There are pictures of Kumbi all over my site (Coherent Dog).

I think to put up photos, you go to the User Control Panel, and check the listings there, down the left side of the page. I can't remember specifcally how to do it, but I surely would like to see a photo of Dana. I ADORE Labs! But - they're too big for me; I'm old, small, and scrawny!

And I, too, am techo-challenged for anything I'm not quite intimately familiar with! (Had a LOT of help starting out with my web site.)

I'll be watching for your news of how things go for you and Dana. I find this forum just fascinating to read - the organization is so useful - one thread for each dog. I keep sending people here at least to read, and I guess some join. It's a real education to read here.

Wed, 30 Dec 2009 20:23:36 (PST)

[danagirl]

Re: New Member too - question on changing to NPH

I really have found this site very helpful.
My vet is good but I am worried about the casual stance to make a change. Yesterday they suggested a different brand which I cannot remember but was grossly expensive. I would use it for my girl of course if necessry but I think there are other people who would probably have to put down their dog if that was the only choice.
I will keep you posted and Happy New Year to all!

[ladysmom06]

Re: New Member too - question on changing to NPH

Hi Danagirl,

Just wanted to welcome you and Dana to the board. How is Dana doing?

[CarolW]

Re: New Member too - question on changing to NPH

I really have found this site very helpful.
My vet is good but I am worried about the casual stance to make a change. Yesterday they suggested a different brand which I cannot remember but was grossly expensive. I would use it for my girl of course if necessry but I think there are other people who would probably have to put down their dog if that was the only choice.
I will keep you posted and Happy New Year to all!

Was it, perhaps, Lantus? I think one or two dogs here are on Lantus. It's VERY expensive stuff. Most dogs do really well on NPH insulin - either Novolin-N (sold by Walmart, I understand, as "Relion"), or on Humulin-N.

A very few dogs are allergic to NPH insulin.

What I'm wondering is, whether your vet would cooperate with a change to NPH insulin (Novolin, Relion, or Humulin). You can buy those insulins in pharmacies; instead of getting them from your vet. A few pharmacies may want a vet prescription for them, but many sell them without prescription.

You would also have to buy the correct syringes, because you can't use Vetsulin syringes for these other insulins. Vetsulin syringes measure U-40 insulin (40 units per ml), and syringes for NPH insulins (and Lantus too) measure U-100 insulin (100 units per ml).

Thu, 31 Dec 2009 06:32:47 (PST)

[Margaret Boyle]

Re: New Member too - question on changing to NPH

I really have found this site very helpful.
My vet is good but I am worried about the casual stance to make a change. Yesterday they suggested a different brand which I cannot remember but was grossly expensive. I would use it for my girl of course if necessry but I think there are other people who would probably have to put down their dog if that was the only choice.
I will keep you posted and Happy New Year to all!

Hallo there,

I just wanted to say welcome to you and Dana, I will follow your thread.


All the Very Best for 2010

[danagirl]

Re: New Member too - question on changing to NPH

Hi
Well I asked my vet again about changing over to NPH but was told there is enough Vetsylin around until April and they are researching the options more. I am still looking into the options I have at pharmacies around here. I am more interested in being proactive on this issue than waiting.

I went to the merry measure web site, it was great, very informative in a no stress manner.

I will keep you posted, thanks for the all the input

[BestBuddy]

Re: New Member too - question on changing to NPH

If you are getting good results with Vetsulin I wouldn't worry about making a change until it was necessary.

If you do need to change then I would suggest that you push for NPH because there are already many dogs on it doing well and it seems to be a very good insulin as well for dogs.

There are enough stresses with having a diabetic pet that I would put the insulin change on the back burner until you need to make a decision.

Jenny

[danagirl]

Re: New Member too - question on changing to NPH

Jenny,

Thanks for your post. It helped me put things in perspective.
She is doing well on the Vetsulin. I am assuming I will have to change sooner or later so I want to make it as easy as possible on her. I will definitely try to work with my vet to go to NPH since it does seem to be working for many dogs

[SamtheCorgi]

Re: New Member too - question on changing to NPH

Hi Danagirl,

Welcome to the forum!

I copied your question to its own thread so folks can answer you directly.

The switchover usually involves a small reduction in units of insulin in each injection. I personally prefer starting NPH at 3/4 of the units of Vetsulin you were giving. Some might even suggest starting closer to the dose...

I guess Dana is a big dog. At 33 units, I would start NPH at at least 24-25 units - that's 75% of 33. And then monitor and raise it up as needed. Depending on if you home test, you might be able to start somewhat higher... 28-30. But I wouldn't personally do that without home blood glucose testing and careful monitoring the first couple of days.

Most dogs need about the same number of units but it varies from dog to dog.

I would just set aside your old syringes and not try to use them with NPH. That way you can just fill the new syringes to the proper mark to deliver the right number of units.

One nice thing about NPH is you have many many more syringe choices and smaller needles available. You can buy them where you buy the insulin, which you get from the pharmacy rather than from the vet.

You will need somewhat larger syringes than we used. We got by with 3/10cc syringes but they max out at 30 units so you would need 0.5cc syringes.

Natalie

Hi,
Trying to make sure I am understanding all the information. I read that Vetsulin is a DILUTED insulin and Novo N is more concentrated. But 1u of Vetsulin in a 40cc syringe is EQUAL to 2.5u in a 100cc syringe.

when I say EQUAL, that is in VOLUME only correct? not effectiveness. so if I were to be giving 15units of Vetsulin in a 40cc syringe an equal amount of Novolin N in the 100cc syringe would be (15x2.5) 37.5u ?? I think the flaw here in my thinking is that it only applies to Vetsulin and it is equal in VOLUME only. Is there any meaningful conversion of effectivity??? 15u of Vetsulin (40ccsyringe) is generally considered to be as EFFECTIVE as XXu of Novolin N (in the 100ccsyringe)? Make sense what I ask??

So when referencing above:
"The switchover usually involves a small reduction in units of insulin in each injection. I personally prefer starting NPH at 3/4 of the units of Vetsulin you were giving. Some might even suggest starting closer to the dose...

I guess Dana is a big dog. At 33 units, I would start NPH at at least 24-25 units - that's 75% of 33. And then monitor and raise it up as needed. Depending on if you home test, you might be able to start somewhat higher... 28-30. But I wouldn't personally do that without home blood glucose testing and careful monitoring the first couple of days.

Most dogs need about the same number of units but it varies from dog to dog."

I want to clearly understand the correlation. SO, If I were considering changing the 15u of Vetsulin (which wasn't controlling Sam's BG well to begin with) to Novo N what is the units of Novo N in 100syringe?? The specialist I am working with started us off at 7u of Novo N in the 100 syringe. I can understand being conservative, but it seems to do nothing and Sam's glucose is over 500 at times, not even readable on the meter!!! We are generating a curve, but I don't want Sam to suffer such HIGHS and wanting to learn more about what is a safe approach, avoiding hypo but narrowing in on healthier/lower BGs sooner.

So given the dilute vs concentrate and unit of measure difference, "Some might even suggest starting closer to the dose" What does that mean???
Closer to the equivalent volume?? so 1u of vetsulin is 2.5u of NovoN? but then how to account for the "dilute" versus "concentrate" factors between the two!!

Comments welcomed, confused!!! Thanks!!!