Another Diabetic Miniature Schnauzer

[labblab]

Douglas, what dose of trilostane were you giving Cooper? Depending upon the dosage, it's possible that a week's worth of medication may have a lingering oversuppressive effect on his cortisol production. Since the medication can lower aldosterone production in addition to cortisol, the balance of potassium and sodium in Cooper's system may also be unbalanced. But it will help us to know what dose you were giving him.

As far as his insulin, I have to defer 100% to the knowledgeable folks here.

Marianne

[djalbo]

0.13 ML orally every 12 hours though really only administered it for two days.

[labblab]

OK, if it was only for two days, the effect should not be long lasting.

As far as dosage, though, we need to know how many mg. of trilostane were suspended in each ml. of liquid in order to make the calculation. The Rx on the bottle label should list that information.

[djalbo]

Label says 50 mg/ml

[labblab]

Given Cooper's weight, that would be a reasonable dose, then, if he truly was Cushinoid. But obviously you know my doubts about that.

Thanks for all this info. I'm going to step aside now, though, so you can focus on the insulin issues with the group here. I really think that needs to be your top priority. I'll keep checking back, however, to see whether anything else develops on the Cushing's front.

Marianne

[djalbo]

One question. I'm a little vague on what "insulin resistance" means. Does that mean that no amount of insulin is effective or does it mean you have to up the dosage by a certain factor, like 1.5X or 2X, to get the same amount of effect?

[djalbo]

Originally Posted by CraigM

Thought I'd mention, in case you didn't know, Novolin-N (it's Novolin-N that you bought?) requires a different syringe than Vetsulin.

Vetsulin is a U-40 insulin and requires a U-40 syringe for proper measuring. Novolin-N is a U-100 insulin and requires a U-100 syringe. Did you get the Novolin-N from Walmart for $25/vial?

Craig

Thanks Craig - I was wondering about that. I did get the Novolin-N from Walmart for $24.88 exactly and I did inquire about the syringe but they said the needle was no different than the box of U-40's I already had. Is this critical?

Actually, I just did a quick Google search and it looks like to convert the U-40 to U-100, I would need to use 2.5X the amount of U-40. So for 4 units prescribed for a U-100, i would need to use 10 units of a U-40 syringe. Does this sound right?

[Joan]

Originally Posted by djalbo

Thanks Craig - I was wondering about that. I did get the Novolin-N from Walmart for $24.88 exactly and I did inquire about the syringe but they said the needle was no different than the box of U-40's I already had. Is this critical?

Actually, I just did a quick Google search and it looks like to convert the U-40 to U-100, I would need to use 2.5X the amount of U-40. So for 4 units prescribed for a U-100, i would need to use 10 units of a U-40 syringe. Does this sound right?

NO, that is not correct.

the U100 is much more concentrated, if you are using a U40 syringe for a U100 insulin, you must DIVIDE
by 2.5! so 4 units becomes about 1.5. You cannot trust that the Walmart employees know the difference between U40 and U100. It is much safer (and easier) to have the correct syringe. At Walmart you can get a box of 100 syringes (U100) for about $12. Put the U40s at the back of a cupboard or throw them out to eliminate any errors. Sorry, but this is so important. If you gave your pup 10 units on a U40, it would be the equivalent of 25 units of a U100 insulin.

[CraigM]

Originally Posted by djalbo

Thanks Craig - I was wondering about that. I did get the Novolin-N from Walmart for $24.88 exactly and I did inquire about the syringe but they said the needle was no different than the box of U-40's I already had. Is this critical?

Actually, I just did a quick Google search and it looks like to convert the U-40 to U-100, I would need to use 2.5X the amount of U-40. So for 4 units prescribed for a U-100, i would need to use 10 units of a U-40 syringe. Does this sound right?

I think you have it backwards. If you MUST use a U40 syringe to inject 4 units of Novolin-N (U100) you would divide 4 by 2.5 and fill the U40 syringe to an estimated 1.6. Way too hard to see/measure. I wouldn't mess around, go back to Walmart and get U100 syringes: only about $12 for 100.

The nice thing about the U100 syringes is they can come with a short 8mm length needle. Most who use Novolin-N would get:
30 or 31 gauge
3/10 ml capacity
8 mm length

So, these syringes are thinner and shorter than the U40s you are probably using. Your pup will likely enjoy the thinner needle! The pharmacy tech you spoke with had probably never heard of the U40 syringe, because they aren't used by any(?) human insulins.

Using the wrong syringe is just asking for someone to make a mistake. When I switched from Vetsulin to Novolin years ago, I taped up the remaining U40 syringes and put them into the back of a cabinet to get out of the way! Finally, I just sent them to a member that stayed with Vetsulin.

Craig

[djalbo]

Originally Posted by Joan

NO THAT IS NOT CORRECT!!!

the U100 is much more concentrated, if you are using a U40 syringe for a U100 insulin, you must DIVIDE by 5! so 4 units becomes less than one.

Yes, you are correct. I realized that after seeing all the 2.5X conversions online were for U-40 insulin in a U-100 syringe, not the other way around.