Did my vet give me wrong dosing for Vetsulin?

[theplayer11]

17kg dog, was told to start with 10 units TWICE a day.Vetsulin website states .5 units/kg ONCE a day which would be 8.5 units....or 25% less if given twice a day, or 6.37. It's been a week, going back for blood/glucose reading on Monday. No signs of low blood sugar, but Vetsulin recommended starting dose has me now confused. He was not sick when started, blood glucose of 535. His water intake has decreased just a tad, not a lot, about 40 ounces a day. He was urinating at night, but not since he started the insulin.
thoughts?

[k9diabetes]

Re: Did my vet give me wrong dosing for Vetsulin?

The answer is sort of yes and no. Though the Vetsulin guidelines in Canada and the UK call for a once daily rather high dose, the guidelines in the US have been amended to something that I think is more reasonable.

I absolutely would give Vetsulin twice a day but I would give less of it.

I like starting with no more than 1/4 unit per pound, which is 1/2 unit per kilogram. So in your dog's case, I'd like to see the insulin started at 7 units twice a day. That's a little less than 1/2 a unit per kg.

It sounds like your dog might be doing okay on 10 units twice a day, which would be a very reasonable settled-in dose worked up to gently from 7 units with monitoring.

But to know whether the dose is okay, you would need more than a single reading. You need to have a serial blood glucose curve done, either at the vet or by testing his blood sugar at home with a meter. That's a reading right before breakfast and insulin and then another reading at least every 2 hours through dinner and insulin, longer if possible.

You have to base the insulin dose on the LOWEST the blood sugar goes.

So if the blood sugar as 400 to 600 all day, an increase in insulin would be warranted. But if the blood sugar started at 600, dropped to 150, and then went back to 600, you can't increase the insulin dose because the 150 will likely go lower still.

Natalie

[CraigM]

Re: Did my vet give me wrong dosing for Vetsulin?

Yes, that is a little more than the normal starting dosage, but probably not dangerous. Generally, the starting dosage is just that: a starting dosage. After a week or so, the blood glucose (BG) would be evaluated and the insulin would probably be increased. Another week and another evaluation, then another insulin increase. Some pups end up near 1 unit per kg, or more. My Annie weighs about 8 kg (18 pounds) and gets about 7 units, so you can see she is nearly 1 unit per kg.

I see Natalie has given a good answer. As she said, home blood testing is probably the best way to adjust his insulin. Most pups accept blood testing without much fuss (it's the human that gets nervous).

Craig

[theplayer11]

Re: Did my vet give me wrong dosing for Vetsulin?

Yes, that is a little more than the normal starting dosage, but probably not dangerous. Generally, the starting dosage is just that: a starting dosage. After a week or so, the blood glucose (BG) would be evaluated and the insulin would probably be increased. Another week and another evaluation, then another insulin increase. Some pups end up near 1 unit per kg, or more. My Annie weighs about 8 kg (18 pounds) and gets about 7 units, so you can see she is nearly 1 unit per kg.

I see Natalie has given a good answer. As she said, home blood testing is probably the best way to adjust his insulin. Most pups accept blood testing without much fuss (it's the human that gets nervous).

Craig

she gets 1 unit per kg..twice a day or once?

[CraigM]

Re: Did my vet give me wrong dosing for Vetsulin?

she gets 1 unit per kg..twice a day or once?

Twice a day. She gets about 7 units twice a day, which is just a little less than 1 unit per kg. Of course she didn't start at this dosage, but probably took several months with small increases every week or two (I can't say what she was truly started at because for her first year as a diabetic my wife did the injections).

REALLY recommend you consider home blood testing. The handheld meters are very inexpensive, especially if bought online like from Amazon and will tell RIGHT NOW if his BG is too low. There are many brands, many on the forum like the One Touch Ultra http://www.amazon.com/Touch-Ultra2-G...ne+touch+ultra

Craig