Caninsulin using 100IU syringes

Re: Caninsulin using 100IU syringes

Louise6732 — Sat, 30 Jun 2012 10:30:14 GMT

[quote user="Hannah Wynne Richards"] He said he needed wormers because his cat was loosing weight[/quote]

Why do owners think this is a) the only reason for weight loss b) pets don't need wormed if they're not losing weight/they haven't seen any signs of worms in the F+? Exasperating

[quote user="Utlendigur"]Bit like those companies who insist all their drugs are in the same colour/size packaging - great for branding, not so great for avoiding dispensing mistakes[/quote]

Has anyone else noticed how similar 'Emeprid' and 'Dimazon' are? And they're sitting side by side on our alphabetically arranged injectables shelf!

Re: Caninsulin using 100IU syringes

Bob Russell — Sat, 30 Jun 2012 10:29:59 GMT

I suspect the 40iu dose is a historic 'oddity'. When Caninsulin first came out human insulins were generally 40iu and very similar in manufacture (ie: bovine or porcine origin). The 40 units per ml confused a lot of people so when human insulin became almost entirely synthetic it was decided that a general change to 100 units per ml should be made.

Caninsulin is not synthetic (unless I am out of date) and has stayed 40 units partly because the injection volumes are more appropriate esp for cats but also the expense of altering licenses and production.

A little bit strange perhaps that all the licenced 100 unit/ml veterinary insulins (Insuvet) were withdrawn from the market leaving Caninsuiln as 'king' when the manufacturers merged!

I am sure the choice has nothing at all to do with the fact that there are no alternative syringes available so no competition and prices can be kept high. That would be profiteering and I have never heard of a veterinary pharmaceutical company profiteering from a near monopoly situation. They are far too angelic to do that!

Re: Caninsulin using 100IU syringes

Laurence Webb — Sat, 30 Jun 2012 09:48:11 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Mark Holmes"]They do think it through, lower concentration smaller patients easier more accurate dosing.[/quote]

Why isn't it 20 i.u./ml?

[/quote]

Presumably a compromise between a low concentration to allow accurate dosing of 1 or 2IU, but not so large a volume to make it impracticable for larger dogs. They could make 2 different concentrations but that would become very confusing and easy to give the wrong dose by mistake.

Re: Caninsulin using 100IU syringes

Hannah Wynne Richards — Sat, 30 Jun 2012 09:34:02 GMT

That's a client I would definitely sack

On the subject of doctors Man walked in off the street wanted worming tablets for his cat I politely explained it was a criminal offence for me to supply as his cat was not a patient He said he needed wormers because his cat was loosing weight and the pet shop wormers hadn't worked I said that it was probably something else and I had to see the cat-which turned out to be diabetic It turned out both the man and his wife were hospital consultants

Wynne

Re: Caninsulin using 100IU syringes

bob lehner — Sat, 30 Jun 2012 09:27:56 GMT

[quote user="Rajat"]Doctors (and nurses sometimes) are the worst clients. [/quote]

My GP tried to drain his dog's aural haematoma with a scalpel blade - got well bitten - ha ha.

Last week on call - 9.30 pm, 'phone rings (it says on the message 'In EMERGENCY call......'). Nice lady - 'I would like some advice please - my dog's ear is a bit red - is this an emergency or should I come down in the morning ? By the way my husband and I are both human doctors'.

Give me strength.....!

Re: Caninsulin using 100IU syringes

Evelyn Barbour-Hill — Sat, 30 Jun 2012 01:42:30 GMT

[quote user="Mark Holmes"]They do think it through, lower concentration smaller patients easier more accurate dosing.[/quote]

Why isn't it 20 i.u./ml?

Re: Caninsulin using 100IU syringes

Mark Holmes — Sat, 30 Jun 2012 01:19:37 GMT

[quote user="Lorna McHardy"]

It has always irritated me that caninsulin is 40iu/ml. I mean... why? Given that every other insulin bottle is 100iu/ml, and having two different syringes is a sure recipe for things to go wrong sometime, I really wonder whether manufacturers ever actually think about practicalities... they can't be THAT desperate to sell their own syringes, surely!

[/quote] They do think it through, lower concentration smaller patients easier more accurate dosing.

Re: Caninsulin using 100IU syringes

Evelyn Barbour-Hill — Fri, 29 Jun 2012 23:52:18 GMT

[quote user="Rajat"]Doctors (and nurses sometimes) are the worst clients.[/quote]

Ah, and the radiologist who Xrayed his cousin's cat when it was run over (conscious Xray of fractured pelvis, ah well, never mind), patronisingly pointed out the fractured ischium to me;

Me: Yes, and there's a sacroiliac separation.

He: Is there? Ah yes , well, of course, I'm not familiar with the anatomy............

Re: Caninsulin using 100IU syringes

Utlendigur — Fri, 29 Jun 2012 20:52:08 GMT

[quote user="Lorna McHardy"]It has always irritated me that caninsulin is 40iu/ml. I mean... why? Given that every other insulin bottle is 100iu/ml, and having two different syringes is a sure recipe for things to go wrong sometime,[/quote]

Maybe to make it easier to dose smaller patients? You don't get many 4kg humans

[quote user="Lorna McHardy"]I really wonder whether manufacturers ever actually think about practicalities...[/quote]

I doubt it. Bit like those companies who insist all their drugs are in the same colour/size packaging - great for branding, not so great for avoiding dispensing mistakes

Re: Caninsulin using 100IU syringes

Rajat — Fri, 29 Jun 2012 20:49:34 GMT

Doctors (and nurses sometimes) are the worst clients.

Examples:

Few weeks ago, I see a Golden retriever with an SVT. Thump puts him back in sinus rhythm, start Sotalol, dog improves, much more energetic, enjoying life. Reccommend a holter, doctor husband says, what's the point of all this?!

I reccommend a dental scale polish and examination under GA for my dentists middle aged cat. He is a (not so cheap) implant specialist and this is after spending nearly £4k on dental work with him (I know pricey, but fair bit of work, and previous 2 dentists nearly ruined my bollywood smile)

Says: Why, it is just going to come back(the gingivitis) no matter what you do....!

Doctor and girlfriend with cat in clinic- cat is passing small amounts of fresh blood. discussing colitis and the conversation turns to human colonic cancer- doctor says authoritatively, and somewhat dismissively- but cats dont get cancer do they, they just die of old age..!

Re: Caninsulin using 100IU syringes

Lorna McHardy — Fri, 29 Jun 2012 20:37:46 GMT

Re: Caninsulin using 100IU syringes

Evelyn Barbour-Hill — Fri, 29 Jun 2012 19:39:08 GMT

Ah when I were a lad we only had human insulins, which could be 20, 40, or 80 i.u./ml. And we used glass syringes which were all graduated for 20i.u./ml I think. So making and explaining the simple calculation was part of life.

Re: Caninsulin using 100IU syringes

Utlendigur — Fri, 29 Jun 2012 19:27:29 GMT

[quote user="Evelyn Barbour-Hill"]I made sure they understood the difference (which they did anyway, being either nurses or diabetics)[/quote]

That made me laugh, sorry! I had a case in a couple of weeks ago which had been verging on stable, then the owner came in kicking off because the dog had started peeing in the house again. Turned out she had decided to use (deceased?) granny's 100iu syringes for the caninsulin. Despite numerous varied explanations she just couldn't seem to grasp the concept of different concentrations of insulin and the consequence that the syringes were calibrated differently, or that she had reduced her dog's dose to 40% of what it should have been on (and therefore it was pupd again ) - just sat there with her arms crossed and that "you're just trying to con me" look on her face - she was a nurse.

Re: Caninsulin using 100IU syringes

Evelyn Barbour-Hill — Fri, 29 Jun 2012 19:17:43 GMT

See below.

Re: Caninsulin using 100IU syringes

Laurence Webb — Fri, 29 Jun 2012 19:12:59 GMT

[quote user="Becky Filby"]We had a similar client who refused to buy caninsulin syringes because he felt it was another money making scheme by a big corporate[/quote]To be fair, Caninsulin syringes are bloody expensive (Caninsulin £6.99 per 30 list price, 0.5ml 100IU/ml syringes £4.07 per 30 at NVS and probably much cheaper through a human wholesaler).

The conversion is fairly straight forward. Caninsulin is 40IU/ml. Standard insulin syringes are graduated at 100IU/ml. Simply multiply the number of units of Caninsulin you want to give by 2.5 to give the volume in 'human' units.

To avoid confusion I would tend to talk in terms of volume though - rather that saying 'Give 50 units on the syringe, which is really 20 units' I'd tell owners to give 0.5ml, which is marked 50 on a human syringe. Still open to confusion so not ideal, but certainly cheaper!

Re: Caninsulin using 100IU syringes

Evelyn Barbour-Hill — Fri, 29 Jun 2012 19:10:03 GMT

As far as I know a unit is a unit.

I have several clients who are used to 100 i.u. syringes and simply prefer them. I made sure they understood the difference (which they did anyway, being either nurses or diabetics) and they are quite happy to divide by 10 and multiply by 4. As long as they understand, I don't see a problem.

[quote user="Becky Filby"]he put the two syringes side by side and worked out roughly where 17iu on a caninsulin syring equated to on the others[/quote]

But that was just silly.

Re: Caninsulin using 100IU syringes

pjmontgo — Fri, 29 Jun 2012 19:08:40 GMT

I have worked out the volume of insulin in 1IU and instructed her to give that volume on the 100IU syringe (1iu of 40iu/ml is 0.025ml which equates to 2.5iu on 100iu syringe), she is redundant at the moment and therefore wants to save as much as possible. she is home ear pricking and ringing in with curves every 5 days at the moment. She isn't the kind of person I want to annoy but she is a google diabetes specialist!!

Re: Caninsulin using 100IU syringes

Becky Filby — Fri, 29 Jun 2012 18:45:59 GMT

We had a similar client who refused to buy caninsulin syringes because he felt it was another money making scheme by a big corporate. The dog was on 17iu bid at the time and he put the two syringes side by side and worked out roughly where 17iu on a caninsulin syring equated to on the others because there was quite a difference in volume. The dog was never that stable, but it was difficult to know whether that was all down to syringe inaccuracy or his refusal to come for regular check ups / glucose curves that were advised! He also had a bad habit of altering insulin dose himself based on whether the dog had pupd. Needless to say he ended up overdosing on occasions and spent more on hospitalisation for hypoglycaemia than he would have spent on the check ups and caninsulin syringes over the last couple of years.

Re: Caninsulin using 100IU syringes

bob lehner — Fri, 29 Jun 2012 18:42:44 GMT

Sounds like a recipe for endless confusion and nothing but trouble. Surely the cost savings on syringes must be minimal ?

I would politely tell her to wise up and follow the normal protocol.