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Old 08-02-2009, 03:15 PM
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farmsrock farmsrock is offline
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Default Switching From Vetsulin to Humulin N

My dog has recently been diagnosed with diabetes. She is not responding to Vetsulin, plus it is way too expensive for us. So the vet switched us to Humulin N, but the dosage is nearly half of the Vetsulin dose. She has been on 15 units of Vetsulin, and the vet wants us to give her 8 units of Humulin N.

My husband does not understand why this would be. I told him that the vet tech said Humulin was 2.5 times stronger than Vetsulin. We realize that Vetsulin is a U-40 and Humulin N is a U-100, but he still does not understand. And I don't have a clue either.

Is the reason only because of the relative strengths of the different insulins? My husband can't believe that we would only give the dog that little bit of Humulin out of a U-100 needle. We bought 1cc/29 ga/1/2" needle length needles, which is the same as what we were using for the Vetsulin except for them being U-100 and not U-40.

This whole thing has been very confusing for us, a lot of which has to do with the vet not communicating with us properly, nor communicating properly with her staff. At times I think she is more interested in making money.

Any help you can give us would be appreciated.
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Old 08-02-2009, 03:57 PM
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k9diabetes k9diabetes is offline
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Default Re: Switching From Vetsulin to Humulin N

The vet tech is correct only technically... the NPH solution is 2.5 times more concentrated than the Vetsulin solution. There are 100 units of insulin in a mL of NPH and only 40 units in an mL of Vetsulin.


All that means is you give more fluid to give 15 units of NPH than you give to inject 15 units of Vetsulin.

Most dogs require about the same number of units when you switch. Vetsulin suggests, when switching a dog from NPH to Vetsulin, to reduce the dose about 25%. So that's what I would do when switching the other way... IF the dog is already fairly well regulated.

If the blood sugar is still extremely high when the switch is made, I might not decrease the number of units much or at all.

This whole thing has been very confusing for us, a lot of which has to do with the vet not communicating with us properly, nor communicating properly with her staff. At times I think she is more interested in making money.

Any help you can give us would be appreciated.
Sorry they were apparently confused about this and confused you as well.

We can help. Please fill us in with as much detail as you can.

Date diagnosed
Vetsulin once or twice a day?
NPH is given twice a day, yes?
how you're monitoring his regulation
results of any curves or other tests the vet has done.

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Old 08-02-2009, 08:18 PM
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farmsrock farmsrock is offline
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Default Re: Switching From Vetsulin to Humulin N

Well, I am finding that I get pretty sketchy information from the vet tech, and sometimes totally contradictory information as well. And then, the vet accuses me of getting confused. I am about to look for a new vet.

My dog is a 9 year old female Lab. She was diagnosed mid-June when I brought her in for a UTI, and the diabetes was diagnosed with bloodwork and urine samples. While I was still in shock, the vet pushed the home glucose monitoring system on me and the Vetsulin. Once I calmed down a little, I crunched numbers and discovered that it would cost over $3000 to treat her in this manner, if it was successful. The glucose strips alone would cost over $1000 a year and we just don't have that kind of money. And this was getting supplies from outside sources, etc. We cannot afford that, so I asked for a cheaper route. Which I think did not sit well with the vet. Too bad. She never gave me options or suggestions on cheaper places to get medicine, supplies, etc. In the past, she has literally ripped me off on dietary supplements, so I didn't expect any help from her this time.

My dog was on Nutro Large Breed Senior which she loved to eat. She was around 85 lbs. The vet switched her to Purina OM, and she hates it. In the last two weeks, she has been skipping meals, refusing to eat. She has dropped at least 10 lbs since mid-June. My dog is very sick. She has gotten sicker since she was diagnosed. Plus she has had an ear hematoma and a leg wound that she caused by licking and biting that required massive doses of antibiotics. The ear hematoma was drained on Friday, and I think the ear is filling up again, so I am at my wits' end.

At the start, we were able to get her glucose levels down in the 300s. Rarely below 200. This past week, if she gets in the 400s, with the Vetsulin, it's been a good day. This is monitoring twice a day. My meter has read HI a few times, which means that her numbers were over 750. One of my issues is that I am not able to monitor 3 times a day like a lot of people, and I can't stay home from work if she doesn't eat in the morning and wait until she does. We were doing the Vetsulin 15 IU 2x day, and the new insulin is the same number of doses, but only 8 units each time, which is not 25% less in my mind, but maybe I am still not understanding things.

I started the new insulin (actually Novolin N from Wal-Mart) tonight. I realize I made a mistake in buying the 1cc syringes because the vet wants me to start with 8 units of the new stuff which hard to do with that size. But I am not getting good advice from her or much help, so I am floundering, and I bought the same size as I was using with the Vetsulin, when I probably should have bought the 1/3cc. This is all so new to me. The vet gave me the number of another dog owner who has been doing this, but I can't say she was all that helpful. I felt as if I was supposed to know what to ask, instead of her telling me how she does it and giving me tips. Plus her situation is different from mine.

Plus my dog has arthritis, and her back legs are collapsing a lot, so I can't get her exercise, which I know would be a part of regular diabetes treatment protocol.

The vet wants to do a glucose curve one day. She has mentioned it once, but never followed up. Wanted to do it two weeks after the leg wound treatment. Then the ear thing came up, so I never scheduled it. I don't expect the vet to call and ask about a glucose curve. Yesterday, her staff called to ask how my dog was, right as my husband was driving her to get her compression bandage off from the ear drainage, a scheduled visit. That is how out of touch and out of communication this practice is. Just when you need help and time to process things, they aren't there for you. Driving me nuts.

I am at this point trying to give my dog a fighting chance with the resources we have. If we fail, I can at least say I tried. My husband is not liking the expense (even with insurance), so he is reaching his limit pretty fast, and I would like to show him some progress.

Thanks for your reply so quickly. I really appreciate it.
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Old 08-02-2009, 09:32 PM
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k9diabetes k9diabetes is offline
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Default Re: Switching From Vetsulin to Humulin N

Well, I do think you need a new vet, if only because the relationship with this one is so poor.

Relion NPH from Walmart is the best price there is for insulin. Be sure to get the Relion version instead of the name brand Novolin.

Also, you can get U100 syringes for a good price at Walmart. You definitely don't need a syringe larger than 3/10ths as you're giving so few units.

You will find NPH much much cheaper to use, precisely because of that "stronger insulin" concept. A 10mL bottle of Vetsulin costs more than a 10mL bottle of NPH from Walmart, so you save money right there.

Then there are 1,000 units of insulin in a 10ml bottle of NPH, while there are only 400 units of insulin in a 10mL bottle of Vetsulin. So the same size bottle of NPH will last 2.5 times longer. If she regulated on 15 units per injection, that's 30 units a day so a 10mL bottle of NPH will last a month.

As far as testing goes, she must have wanted you to test a LOT every day!

Home blood glucose testing is good and I do recommend it but how often any of us tests varies with schedules, how stable our dog's blood sugar is, cost... all kinds of things.

You don't need to use the AlphaTrak. I used a OneTouch Ultra and bought the strips at www.hocks.com. There are cheaper places online too - just have to be careful about handling and expiration dates.

A curve is needed but can be done at home.

No sense in even thinking about it though until some of the other stuff gets cleared up. Any pain/infection/inflammation raises blood sugar so most likely the hematoma and leg issues are driving up her blood sugar.

I think it's also possible that she's suffering from diabetic neuropathy, which is contributing to the hind leg weakness. This should clear once you get her blood sugar down and I would like to see it brought down at least to the 400s max as soon as that can be done. Most of the dogs I've seen with neuropathy have blood sugars in the 600s and 700s.

You also could go back to her original food and see how she does with it. The diabetic formulas often work well but they aren't absolutely necessary and sometimes you need them to eat consistently more than you need them to only eat the diabetic diet. You can add some fiber to the food she was eating, too, or make other tweaks to make it work better if you find it doesn't work well with her insulin.

It's probably just as well not to exercise her right now. Dogs are like Type 1 diabetics so exercise doesn't really help with blood sugar control and it can be a bit of a wild card as it can drastically change the blood sugar. So forget about exercise right now - let's work on getting her feeling good enough to want to exercise.

Don't give up on your girl. She can get regulated and we can help you work it out as affordably as possible. (And I'd really like to see a picture! )

Hang in there... I know it's really difficult when you have multiple issues and problems with the finances.

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Old 08-03-2009, 06:15 AM
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farmsrock farmsrock is offline
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Default Re: Switching From Vetsulin to Humulin N

This has been so helpful! I am going to look for a new vet. I am worried about her hematoma, because it is recurring and with her blood sugar so high, I don't know how she can fight it.

I was so shocked when I got the price on the Wal-Mart NPH - what a difference. And I am going to try to get Wal-Mart to switch out the needles as I have only used two so far, maybe they will do that for me. It's such a learning curve (especially with no help from the vet).

Right now I am kind of stuck with the AlphaTrak because I purchased it, and feel I need to 'get my money's worth', but if we can get her numbers under control I will look for a cheaper alternative. In my vulnerability, she ripped me off on that, too. I could have gotten it all cheaper by purchasing the items separately elsewhere. If you change to a different meter, do you have to do some number conversions? I thought I read that somewhere...

Today I added a handful of her old food, plus a few green beans,which she loves. That got her to eat, so I will keep tweaking. If I could go back to the old food, that would save some money as well. She loved it.

The vet did say to increase the insulin dosage one unit at a time every 3 days if she's not responding. I am checking her sugar twice a day right now. Sometimes it's not exactly every 12 hours because of my work schedule, but I am doing the best I can.
How do you add a picture to this? I can't figure it out!
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Old 08-03-2009, 06:49 AM
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Autumn Autumn is offline
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Default Re: Switching From Vetsulin to Humulin N

Hi Farmstock
We just switched from Vetsulin to Humulin N since last Tuesday. The vet just increased her dose 2 units today. I'm fairly new myself, so my post isn't advice, just what we have been experiencing. There are some similarities in our situations.

It is not fun seeing those numbers so high. Although, I keep telling myself it's the adjustment period, temporary and hopefully soon we'll be at good numbers.
Good information to know re: price and Walmart. We spent too much on the first vile of Humulin. Going to Walmart next time is certain.

We tried green beans on Saturday. I snuck them in and she ate them.

We recently switched our vet this month. It was due to so much contradictory information too. It was too confusing and I was so insecure with treatment. This forum is where I learned everything. I learned more here in a few days than months from the vet. As much as I liked our vet and hated to leave his offfice, we had to. It took time but we found another vet. We are more secure and enjoy open communication. It's good to have someone partner with us, to work with home testing and answering all questions clearly.

I wish you and your dog success with the NPH switch.

Last edited by Autumn; 08-03-2009 at 07:06 AM. Reason: I write too much ;)
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Old 08-03-2009, 07:07 AM
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We Hope We Hope is offline
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Default Re: Switching From Vetsulin to Humulin N

Adding a photo:

On the top of the board there are links. Go to the one at far left, "User CP" and click it. This opens your Control Panel.

When in it, take a look at the links on the left. Clicking "Edit Profile Picture" will let you add a photo to your profile; you're able to upload a photo from your hard drive for it.

For an Avitar pic, click "Add Avitar" also at the left of the links in the Control Panel--this does the same thing--lets you upload a photo as your avitar which is seen every time you post.

If you have problems with either of these, please let Natalie or me know and we'll get the photo online for you.

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Old 08-03-2009, 07:20 AM
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Patty Patty is offline
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Default Re: Switching From Vetsulin to Humulin N

Hi Farmsrock!
You've gotten a lot of great information and it can all be a bit overwhelming to sort through...I just wanted to add my Ali had an ear hematoma last year that required surgery to drain.

Do you have any idea the reason behind the leg wound and hematoma? Is the leg wound a hot spot or lick granuloma?

Ali has allergies that caused inflammation to her ear then was hit by a wayward door causing it to fill with blood. Allergies/inflammation can definitely cause higher blood sugars as Natalie said.

What type of medication and ear solution are you using? Some have a steriod component to them and will raise blood glucose (bgs). Massive amounts of antibiotics can also cause overgrowth of yeast, which in the ear can cause them to itch and shake their head, causing inflammation/trauma to the vessels, causing them to burst and fill the ear - quite a vicious cycle.

A good probiotic can help prevent yeast overgrowth in the body. Here's one I've recommended: http://www.forresthealth.com/store/V...100-vcaps.html My vet here also recommends the Culterelle brand (which you can get in drug stores) but it has milk product in it I believe so I couldn't use it with Ali. I know it's an added expense but I'm a firm believer after Ali's extended antibiotic use.

Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~
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Old 08-03-2009, 08:11 PM
Lunarhamster Lunarhamster is offline
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Default Re: Switching From Vetsulin to Humulin N

Dear Farmsrock,

I know exactly what you are going through, I am in the same boat. I wonder what the deal is with these damn Vets. I am disgusted with the advice I have been given, the money grubbing crap they have put me through.

Keep really good records Farm, get every single test, blood test, everything from your last Vet. When you go to a new one, they will immediately want to re test for this and for that, I am on Vet #4 and every time I take her in they want to do the same crap the last one did, if her BG's are over 400 they will want to "admit" your dog and keep her overnight, they will want to put her on IV fluids, that will cost you mere $700.00, then you will pick up your dog the next day, and her BG levels will shoot right back up and you will ONLY be $700 poorer and no better off than when you brought the dog in, unless there are keytones in the urine, then I might think a bit different. But my dog has never had the keytones and I have been taken to the cleaners.

I didn't fall for the Alpha Trak, but my Vet tried pretty hard. I am using the Reli On meter and strips, cheapest one I can find, but for me, they are 100 low from the alpha trak, so I factor that in.

I switched to Humulin N about a month ago, her Bg's are still high all the time, the only time they drop is around 6-7pm, right when I am getting ready to feed her again, she has lost all of her vision, her back legs are very weak and she sleeps a lot. I wonder if your dog may not have arthritis, and it is due to the diabetes?????

I am three months in and I am still fighting for my Mandy, don't give up Farm, everyone here is great and they will help, I am new but I share your disgust with the advice given by Vets, I'm angry I know, but there is NO reason for these people to torture us financially when we are dealing with our sick dogs, not to mention our economy. I am taking control now, those Vets have done nothing for my dog.

Good luck and keep fighting!!
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Old 08-03-2009, 09:41 PM
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k9diabetes k9diabetes is offline
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Default Re: Switching From Vetsulin to Humulin N

Human meters typically read the blood sugar somewhat lower than actual. It varies from meter to meter and dog to dog how much. For medium to large dogs I like the OneTouch Ultra and for small dogs I like the Freestyle.

In our case the OneTouch Ultra was 30-40 points low through a wide range of blood sugars and that seems to be pretty common. But no one can predict what you will get.

Eventually, you will want to check a new meter against a lab value at the vet but that can wait. For now, use the meter to tell you generally if the blood sugar is medium, high, or normal to low and a general idea of how much difference there is between lowest and highest.

You can often get something like a OneTouch Ultra mini for free or nearly free and then all you pay for are the strips. These mini meters are new so I haven't seen them used as much but with no investment to buy it, what the heck!

I had four meters at one point... an AlphaTrak, two OneTouch Ultras, and a Freestyle... five actually cuz I had an Accucheck Advantage, which was a good meter but required a lot of blood so I never used it. I paid next to nothing for any of them.

Lately the deals I see are all on the mini meters.


ADDED: I did pay for the AlphaTrak - got it through the vet and paid too much for it. Their lack of interest in giving me a good price was one of a handful of issues that convinced me to leave that vet. But the others I got rebates for all or nearly all of the cost of the meter.

Over time, it's the strips that are the big expense.

Last edited by k9diabetes; 08-04-2009 at 08:52 AM. Reason: Additional info / clarification
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