Vetsulin to Humulin

Greetings all!

I'm so glad I found this board! I'm looking forward to some experienced advise!

I have a 10 year old male kitty who has been on Vetsulin for the last two/three years. I recently moved and started up with a new vet. At that time I was told that Vetsulin was discontinued back in November! Hmm! Anyway... so the new vet says I should start him on "Humulin N" which I've been researching online and now have doubts about! A couple sites say it's not good for cats (drops the sugar too fast) and then others say it's okay. Another site recommends just going to Wal-Mart and getting Relion. Oy... we're so confused! :sad:

My other question is what size syringe do I use now?? I was getting the u-40 from the vet that went with the Vetsulin but now if I get Humulin N U-100, do I need to get matching needles? AND...

I was giving Buzz (the 10 year old male kitty) 5 units of Vetsulin... where should I start him on the new stuff... whatever that turns out to be???

As you can see... the more I read... the more confused and uncertain I've become!! LOL :smile:

Thanks in advance!

Lyte

 

Dosing isn't an area I know much about, but I do know that if you end up with a U100 insulin, you need U100 syringes. You get them from a human pharmacy, and they tend to be less expensive than the U40 syringes.

From what I've read, although Humulin N does work for some cats, it isn't the best, in the abstract. Those being recommended most are Lantus and Levemir (human insulins) and the new ProZinc (a veterinary insulin, designed specifically for cats, so your vet should be able to get information about it).

Relion is a Walmart brand name for certain blood glucose meters (also syringes, lancets, and other diabetic supplies). It's not an insulin.

You have been told correctly that Vetsulin is having problems and should be replaced with another insulin.

As I said, dosing is not my forte, so I'll leave your dosing questions for others.

 

In actuality, Relion Insulin is Walmart's brand of insulin. It is available as R, N (NPH) and 70%NPH, 30% regular. When changing insulin it is best to start at one unit bid unless the cat is on less than 1 unit bid or has a history of DKA. For the latter I would start at a dose closer to the present dose.

You must use U100 syringes fir N (NPH) since it is a U100 insulin. Vetsulin is a U40 insulin and can be used with either U40 or U100 syringes. For he latter a conversion factor is used. If you inject a U100 insulin with a U40 syringe filled to the one unit mark you will actually inject 2 1/2 units of insulin.

 

What you really want to know is the action profiles of each of these insulins, which is relatively well-known. see petdiabetes.wikia.com and look up each insulin to see its action profile (duration, peak, onset time).

http://petdiabetes.wikia.com/wiki/Insulins

From memory, though, (and you can easily back this up by looking through the various insulin groups here), Humulin N has more or less the same action profile as Vetsulin, so if you're having trouble with one, you won't have any more luck with the other. They both have, in an average cat, an average onset of 1-2 hours, peak in 4-6 hours, duration about 8 hours at most. They also both have a very steep and peaky curve, that is very effective around peak time but very ineffective at other times, making it hard to keep blood sugar steady.

What you want is something that's just the opposite -- slow onset, long duration, extended peak. Lantus (glargine) and Levemir (detemir) have these characteristics in cats. See http://www.tillydiabetes.net/en_6importantfactors.htm for lots of good info. There are excellent studies and evidence on that site for your vet to help convince him or her to prescribe one of those two insulins. They're both available in 3ml penfill cartridges usually from any local pharmacy. (The cartridges come in packs of 5 so cost a bit up front, but even out to a few pennies a day in the long run because they last forever.)

I hope this helps!

 

I am amazed at the vets who do this; IDEXX PZI gets discontinued and vets turn to vetsulin; vetsulin gets recalled and vets turn to N. This is going BACKWARDS in time instead of advancing the practice of treating feline diabetes. Ack. Ok, soap box over....

N has worked in some cats, but as mentioned there are much more suitable options for cats that vets should really know about and if you can do some research perhaps you can persuade your vet...

Jen

 

N works wonderful for DOGS...
Much more rare to find a cat that works well with it. I used it for years, but Bunny was more the rarity than the norm. I would ask vet about Lantus...you will still need U-100 needles, but it's a much more gentle insulin and should be easier for both you and your cat to transition.

 

Thanks all for your feedback! We appreciate it! I'm unclear about a couple of things (items in bold)...

"In actuality, Relion Insulin is Walmart's brand of insulin. It is available as R, N (NPH) and 70%NPH, 30% regular."

So... what's all those percentages mean? Do I want the R type... the N type? What does NPH mean?

Lantus (glargine) and Levemir (detemir) have these characteristics in cats.

Are these available at my local WalMart? I'm thinking it's much cheaper to get these "human" insulin than anything from a vet!

If you inject a U100 insulin with a U40 syringe filled to the one unit mark you will actually inject 2 1/2 units of insulin.

Okay, so if I was giving Buzz 4 units of Vetsulin in a U40 syringe, what dosage would be the equivalent in a U100 syringe?

I think that's it... thanks again for all your help!! :smile:

Lyte

 

You do NOT want R. It is a fast-acting insulin that for the most part should only be given during a hospital stay.

IMO, you should try Lantus, Levemir or BCP PZI before N. N also acts quickly, and for most cats doesn't last a full twelve hours in their system. I started on N, and I'll never forget how it dropped my Snickers over 300 points in two hours--I was lucky she didn't hypo. That big a drop, that quickly, doesn't feel good. The other insulins I mentioned have a smoother curve with longer duration.

 

I went to WalMart and was told Lantus and Levmir are prescription only.

I got the Relion N... what dosage do you think I should start Buzz at... he's about 12lbs? I also got the U100 needles.

Lyte

 

Just for information, Walmart's RelOn brand of N and R and 70/30 are not "Humulin" insulins. Humulin is the registered trademark of Eli Lilly's family of rDNA origin insulins.

 

No Larry, you are right, they are Human insulins..

but to answer the poster's question...

I'd start at one unit twice a day , and learn how to hometest so you can make accurate dosing decisions in partnership with your vet...