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Old 05-09-2010, 10:49 AM
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Default From Frajul93 - help re dose on NPH

Hi! about 1 weeks ago I switched my 13 1/2 yr old Lasa Ahpso from Vetulin to Novilin N and not by choice only because they discontinued the Vetsulin.

His levels we about 120 and he was do really good on the Vetsulin.

We are now using the Novilin N and the he was getting 15 units of the Vetsulin in the U40 needles and they only started him out at 6 units of the Novilin N?

The very 1st day I gave him the Novilin N at 7:30 am and at 3:30 took him in for a glucose test his levels were at 67 so they decreased it to 5 units told me to do that at 7:30 pm and again in the morning and bring him back the next day same time.

Since then his levels have been up to 350? I have been in almost everyday they only increase it 1 unit each time and his levels are not going down at all. We are only up to 11 units now. I have to lock him in the kitchen because he is peeing all over and drinking a ton of water.

I relizied after reading comments made by others on here that they are in the same position. I kept thinking that he is NOT getting enough insuline this whole time. I feel so bad for him you can just see him failing. I am really thinking just to up the dosage myself and watch him. Why would the vet start out so low? I understand he dose not want him to go into shock but really don't you think they should just increase it to up a bit? I am so upset. Hopefully you can help. Thanks so much.

Frajul93
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Old 05-09-2010, 10:54 AM
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Default Re: From Frajul93 - help re dose on NPH

There was a protocol issued, erroneously I think, that suggested cutting WAY back on the insulin dose when switching to Vetsulin. Dr. Nelson from UC Davis later came out in an online seminar and said to cut the dose "a few units" and we have been recommending around 20%.

But given that you dog had such low blood sugar, it seems that a larger starting dose could have been a problem.

Your dog desperately needs a curve. Spot checks really don't tell you anything because a dog's response to food and insulin varies so much from dog to dog. We have dogs here whose lowest blood sugar is at mealtime and we have dogs here whose lowest blood sugar is 6 hours after injection.

Their response to a new insulin can change the lowest poiint of the blood sugar to a different time.

Is the vet willing to do a curve?

Would you be interested in learning to home test?

Rebound is a possibility so please take a look at this page: http://www.caninediabetes.org/pdorg/hypoglycemia.htm

The only way to answer your questions and whether he is going through rebound would be to do a curve.

Natalie
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Old 05-09-2010, 01:24 PM
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Default Re: From Frajul93 - help re dose on NPH

Hi! Natalie's given you some great advice so I just wanted to say welcome!

How much does your dog weigh?
What type of diet is he on?

Take care,
Patty
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Old 05-09-2010, 01:40 PM
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Default Re: From Frajul93 - help re dose on NPH

Just a quick comment. Annie is a Lhasa and made the switch several months ago. She had been getting 6.5 to 7 units (twice per day) of Vetsulin, now seems to be doing VERY well on 7.5 units (twice per day) of NPH.

I made the switch myself, told the vet my plans, and he said "go for it". Started her at 6iu, and made ˝iu increases every 4 days. Went as high as 8iu, but thought I was seeing "rebound", so reduced to 7˝iu and have been at 7˝iu for over a month. Her fasting numbers are usually in the 80 - 140 range.

Home testing is the key!

Craig & Annie
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Old 05-09-2010, 04:33 PM
frajul93@verizo frajul93@verizo is offline
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Default Re: From Frajul93 - help re dose on NPH

Hi and thanks so much! The vet did do a curve just the other day. Do you mean cutting the dose back 20% of the NPH when you 1st start?
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Old 05-09-2010, 04:40 PM
frajul93@verizo frajul93@verizo is offline
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Default Re: From Frajul93 - help re dose on NPH

Thanks so much for the info. The vet did do a curve a few days ago. And do you mean cut back 20% when you start the NPH?
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Old 05-09-2010, 04:43 PM
frajul93@verizo frajul93@verizo is offline
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Default Re: From Frajul93 - help re dose on NPH

Hi Patty and thanks! My dog weighs 28 pounds and he eats Blue dog food I just switched him to that.
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Old 05-09-2010, 04:44 PM
frajul93@verizo frajul93@verizo is offline
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Default Re: From Frajul93 - help re dose on NPH

Patty, he also eats 3 times a day 1 with his insuline in the morning and a snack around 4 and the again at 7:30 with his next dose of insuline.
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Old 05-09-2010, 04:58 PM
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Arrow Re: From Frajul93 - help re dose on NPH

Hi, and a big welcome to you!

Yes; we've been discussing ways to change from Vetsulin to Novolin or Humulin here on the forum, and it seems recommended to drop the dose by about 20 t0 25% when making the change.

It seems odd that your dog was on 15 units of Vetsulin; yet a dose of 6 units of Novolin dropped him to 67 - I'm not following well here. But perhaps the reading was a fluke, or, part of something else going on, such as rebound, though that seems unlikely to me.

So, you say your vet did a curve the other day. Can you get the numbers from your vet, and post them here?

That would really help us track, and help you with your dog.

Let me encourage you to work on learning to test your dog's glucose levels yourself. You'll get all KINDS of help here on the forum, learning to do that. It takes a little time and practice to learn, and we will all hold your hand while you do!

Being able to test your dog yourself lets you keep a close eye on the glucose levels, and make adjustments as needed. And the group here on the forum wlll also help with suggestions for adjustments.

I'm deeply trusting you'll be very, very glad you joined us!

I'm looking forward to your next report, and sending you and your Lhasa Apso my very best wishes! Your dog is around the same age mine is.

But weighs more; mine is under 20 pounds.

Sun, 9 May 2010 16:57:36 (PDT)
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Old 05-09-2010, 05:28 PM
frajul93@verizo frajul93@verizo is offline
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Default Re: From Frajul93 - help re dose on NPH

Thanks so much. How do you figure out 20-25% when using the new needles? We went from u 40 to u 100's what would be the recommended dose? I figured like 19 units in the u 100's? Not sure if that is correct. And Yes I will get the numbers from the vet and post them. I am not sure why his level's were so low on the 1st test? I am really confused on that too. I will also look into getting a test kit for home and that will help too. My poor dog also has Cushion's and is hypo thyroid. He has really been through alot and so have I. I am really glad I joined too. Thanks again. Julie
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