FineDosing

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diggydog

Member Since 2010
Hi All,

I know this is a cat forum but i am hoping you all dont mind trying to help me out with my dog!
Alfie started using Levemir 6weeks ago and has been doing ok on it but we are having some trouble getting his dose correct. He needs somewhere between 0.5 and 1 unit. The links to measureing out 1/10th unit dont seem to be working and we are really finding it very hard to be consistant with his dose. \i am a member of a dog diabetes forum but we are the only Levemir users so they cant offer any help on getting the small doses.

Thanks very much

Allison & Alfie
 
Hi Allison,

Thanks for posting here about your sweet doggie Alfie.

For micro dosing Levemir for my sugarcat Paul-Kyle, I use the U-100 syringes from WalMart...they are 31gauge, 8mm size with the HALF UNIT marks...I use the short needle, but I don't know if it is different for dogs- they may require the long needle?

Again, not knowing about sugar dogs much, I just want to verify that you are using lev and it is in fact a U-100 insulin...I am making suggestions based on that information so if it is different, please verify BEFORE you act on any of it.

Anyhow, the half unit marks make it pretty easy to microdose b/c the first measuring line is .5u ( the actual first line is .0, the next short line is .5, the next long line is 1.0, etc...this is specific to the WM brand- other brands may have different length lines?)

To measure less than .5u, we pull the insulin to the .5u mark and then release small bubbles of insulin accordingly....so if you want to shoot .4u, measure to the .5u and let out one bubble of insulin.

Same if you want to shoot say .8u then we pull the insulin to the 1.0u line and let out 2 bubbles of insulin.

There are measuring tools to be precise, but most of us are able to just do as described above.

Allison, I'd like to visit the doggie diabetes site you refer to if you wouldn't mind linking us....we often have folks stop by and ask if there is a similar site for dogs...would love to be able to post a link from someone who has actully been there and found the site useful! Thanks.

Also curious if you hometest Alphie yourself or if you leave the testing to the vets...it sounds like you hometest if you are aware that your dog needs fine tuned doses, but I am curious to know for sure.

Thanks for visiting! let us know if we can help any further, please!
 
Hi Melissa,

Thanks for your reply!
It is Levemir we are using and its a U-100
We are using the BD micro fine 0.3 cc U-100 with half unit markings. Everytime I try to let out a "bubble" of insulin to fine tune the dose I end up letting out nearly half a unit - perhaps I just need more practice?

I do home test Alfie - I live in scotland and its almost unheard of over here for owners of both diabetic dogs and cats to home test but the web site I found has helped me with home testing and too many other things to mention. I cant rate the web site enough - its been a life saver for Alfie and I and provided so much information that my vet just didn't mention or know about.

Check it out at www.k9diabetes.com/forum
Not sure if that worked but you can google k9diabetes and get it from there. Sorry I am a bit rubbish with computers!
I know there have been a few people looking for resourses on cats on there so sounds like it could be an idea to add a link between both forums.

Thanks

Allison & Alfie
 
Hi Allison, it's nice to see you here. Alfie is one lucky doggy to have you!!!

I also find it difficult to use fine dosing and like you, believe that the 'perfect' lev dose for my cat is somewhere between .5 and 1 unit. Using the syringes that have half unit markings, i try my best to get the black plunger exactly between the half marking and the full unit marking.

I use GNP syringes from Hocks.com http://hocks.com/Merchant5/merchant.mvc ... de=A982316
 
Hi, Allison - welcome!

The trick to getting the small "bubbles" (I call them drops) of insulin out is to slowly twist the plunger - like you are screwing it into the barrel.

My Beau ended up on .05u for several weeks as he was going off insulin. And it was a b*tch to draw those doses, but I practiced it. I just used an old syringe and some water. I drew to 1u and twisted, slowly to get a drop the size of the head of a straight pin, or the "oh" in newsprint type (approximately). I practiced until I could get 10 drops from 1u and 5 drops from .5u. Then I went on to estimate HALF of one of those drops, but it sounds like you just need to do the .1u size drops, right?

It does take practice and maybe a strong pair of reading glasses. I have bifocals that I have to take off to see the drops and the fine incremental movement of the plunger in the barrel.

I hope that helps.
 
Hi Allison,
I would like to recommend a particular syringe brand for fine doses - the GNP one Michele mentioned and provided the link for. I think Sheila uses those too and she KNOWS fine dosing!

I used to use the BD brand syringes. I had Gandalf at the University of IL vet hospital for treatment a couple years ago when we suspected hyperthyroidism. He had to stay over and I gave them our syringes to use with the Levemir pen. The vet on his case mentioned to me how difficult it was to get the air bubble out and suggested I try different brands of syringes that seemed easier to use. I did so and am very happy with the GNP brand.

The vet explained the reason the bubbles are such a concern is that with very small doses, even a small bubble displaces the insulin in the barrel, so even with the plunger lined up properly, the actual amount of insulin is way less percentage wise than you think it is.

Also, the GNP brand offers half unit marked syringes, which are a godsend for anyone needing to dose in increments.

There was a study done by a board member of different syringes and the BD brand performed very poorly, sometimes being off by almost a half unit. She used a very small type scale to weigh the actual amount of insulin pushed out of each syringe. It was posted on the old version of the FDMB board: http://www.felinediabetes.com/phorum5/r ... 22,1462377

Although the GNP brand were not on that study, most of us here give small doses and we rely on these syringes. My only beef with them is that their line markings aren't always consistent, so I use an external measuring device. http://www.qcinspect.com/images/Micrometer.jpg

This is how I use the device: http://s5.photobucket.com/albums/y161/F ... tructions/

Hope we helped!
 
Yes, I use the GNP syringes. I order them through Hocks, linked at the top of the page (in a green box), but I don't know if they ship overseas.

Also, I always pull the plunger down and push it back up before I insert it into the cartridge. I have found it hangs up a bit if I don't and I have to "yank" on it. With the small doses that leads to over drawing the dose too much.
 
Thanks so much to everyone who replied.
I looked at the GNP syringes but they don't ship them overseas, which is not so good but we will try and make it work with the BD syringes as so far thats the only kind I can find to buy here in the UK.
Going to spend the next few days trying out fine doses until I get it right - if I cant work it then I will look into getting a micro meter thingy.
Its interesting to read through some of your stories and compare them with the dog stories on the k9diabetes forum, so many of our issues are similar across the species, treatments vary quite a bit tho between them. The most obvious things is how much we love our fur babies and our commitment to doing the best we can for them, cat or dog.
I cant express my thanks enough for all your advice and help for Alfie. He still views cats as his enemy - somethings will never change but I will remind him often when he is better regulated that its because of cats that he is doing better ;-)
 
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