Diabetes in dogs is increasingly common – but is far from a death sentence. Article by Mary Straus and CJ Puotinen, published in the Whole Dog Journal, May 2012 Contents Introduction Complications Survival Statistics Treatment and monitoring Exercise It's an Effort Also see these related articles: Zachary, pictured above, lived a happy and healthy life for four years after being diagnosed with diabetes at age 11. Introduction For years public health officials have reported a diabetes epidemic among America’s children and adults. At the same time, the rate of diabetes in America’s pets has more than tripled since 1970, so that today it affects about 1 in every 160 dogs. But while many human cases are caused and can be treated by diet, canine diabetes is a lifelong condition that requires careful blood sugar monitoring and daily insulin injections. The medical term for the illness is diabetes mellitus (mellitus is a Latin term that means “honey sweet,” reflecting the elevated sugar levels the condition produces in blood and urine). Diabetes occurs when the pancreas is unable to produce sufficient insulin to metabolize food for energy, or when the body’s cells fail to utilize insulin properly. The pancreas's inability to produce insulin is known in humans as type 1 (formerly called juvenile or insulin-dependent) diabetes. This is analogous to the type that affects virtually all dogs. Dogs can also develop gestational diabetes during pregnancy. Type 2 (formerly adult onset) diabetes, which is the result of insulin resistance often linked to diet and obesity, is the most common form of diabetes in humans. Most diabetic cats have type 2 diabetes, but there is no evidence that this form occurs in dogs. Symptoms The classic symptoms of diabetes are excessive thirst, Continue reading >>
How Long Should Insulin Be Used Once A Vial Is Started?
Editor’s comment: The commentary by Dr. Grajower has such important clinical relevance that responses were invited from the three pharmaceutical companies that supply insulin in the U.S. and the American Diabetes Association, and all of these combined in this commentary. The commenting letter and individual responses were authored separately and are completely independent of each other. Diabetic patients treated with insulin, whether for type 1 or type 2 diabetes, are prone to often unexplained swings in their blood glucose. These swings can vary from dangerously low to persistently high levels. Most diabetic patients, and most physicians, will adjust insulin regimens so as to avoid hypoglycemia at the expense of hyperglycemia. Among the “textbook” reasons for variable glucose responses to any given insulin regimen are 1) site of administration, 2) exercise, 3) bottles not adequately mixed before drawing the insulin (for NPH, Lente, or Ultralente), and 4) duration of treatment with insulin (1). A new insulin was marketed by Aventis Pharmaceuticals about 1 year ago, insulin glargine (Lantus). The manufacturer seemed to stress that patients not use a started bottle of this insulin for >28 days (2). Two patients of mine highlighted this point. L.K. is a 76-year-old woman with type 2 diabetes, diagnosed at 55 years of age, and treated with insulin since age 56. Her insulin regimen was changed to Lantus at night together with Novolog before meals. She monitors her blood glucose four times a day. She used a bottle of Lantus until it ran out; therefore, a bottle lasted for 2 months. Her recent HbA1c was 7.6%. I retrospectively analyzed her home glucose readings by averaging her fasting blood glucose levels for the first 15 days of a new bottle and the last 15 days of tha Continue reading >>
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How To Save On Dog Insulin
Has your dog been newly diagnosed with diabetes and you're wondering how you are going to be able to afford a daily medication like insulin? Learn some ways you can save money on your dog's insulin and still have enough to buy them that new squeaky toy. Taking care of a diabetic dog can be a costly endeavor. Insulin -- the hormone that regulates glucose levels in the blood -- is the most important part of your dog’s treatment, and it can also be the most expensive. But it doesn’t have to be. Here we’ll share some tips for saving money on your dog’s insulin. Typical Insulin Costs for Dogs Insulin can cost anywhere from $30-$150. The price will vary depending on if you buy from your veterinarian, online, or with a pharmacy benefits plan. It will also depend on if you choose a brand name or generic drug. Buying at the Vet vs. Online Purchasing insulin from your veterinarian may seem like the most convenient option, but it is usually not the most cost-effective. This is because the majority of veterinarians and clinics markup their medications -- anywhere from 100% to 160% over wholesale prices. Most vets also charge a $5 to $15 dispensing fee.* Online retailers can keep prices low by buying in bulk and cutting out administrative costs. If you do order insulin online, it will require special overnight shipping, which can sometimes translate into high shipping costs. Insulin must be kept cold, so it requires special packaging and must arrive to its destination quickly. Despite this, buying online will probably still cost less than buying from your vet. Buying Brand Name vs. Generic If you are wondering what the difference is between brand name and generic drugs, the answer is: not much. Generic drugs have the same active ingredients and medicinal effects as their bra Continue reading >>
The True Cost Of Having A Diabetic Dog – Revisited
A reader commented on this post about The True Cost of Having a Diabetic Dog. After reading the article I thought I should make a few updates. It has been over a year and a half since I wrote that article, a lot has changed and I’ve learned a lot. Diabetes will be different for every dog. There are so many variables. Food, insulin production, metabolism, weight, etc… It is about finding the right combination of food, insulin, and exercise that works for your dog. Plus getting them down to the right weight. When I posted The True Cost of Having a Diabetic Dog Bender was overweight and my costs was roughly this for TWO months. 2 bag of W/D food 30lbs – $124 4 Vetsulin 10ml – $100 ($25/each) 124 needles – $14.26 (11.5 cents each) 10 testing strips – $10 ($1 each) Total: Roughly $250 for TWO months. As I became more aware of Bender’s diabetes and researched it I found ways to improve Bender’s diabetic regiment and cut costs without sacrificing. I learned that exercise plays a major role in managing diabetes. And also getting your dog down to a healthy weight. I learned that Hill’s Science Diet W/D was not the best food for diabetics (Many posts about it here). But at the time there wasn’t a good commercial food that didn’t cost the same or more as W/D so I started to make his own food. When that started to cost even more I searched for a good commercial food and found several natural foods, Wellness and Blue Buffalo (both healthy weight). With the switch I cut my cost down to $50. The next thing I found was Vetsulin was not stable, which is why it was pulled from the market. Since I’ve switched Bender to Humilin N I feel that it works much better than Vetsulin. He receives less insulin. His numbers are better and more constant. With Walmart’s ReliO Continue reading >>
What’s Behind Skyrocketing Insulin Prices?
Here’s a sticking point for diabetics: the cost of insulin more than tripled — from $231 to $736 a year per patient — between 2002 and 2013, according to a new analysis. The increase reflected rising prices for a milliliter of insulin, which climbed 197 percent from $4.34 per to $12.92 during the same period. Meanwhile, the amount of money spent by each patient on other diabetes medications fell 16 percent, to $502 from $600, according to a research letter published Tuesday in the Journal of the American Medical Association. “Insulin is a life-saving medication,” said Dr. William Herman, a coauthor of the analysis and a professor of epidemiology at the University of Michigan School of Public Health. “There are people with type 1 diabetes who will die without insulin. And while there have been incremental benefits in insulin products, prices have been rising. So there are people who can’t afford them. It’s a real problem.” The analysis also found that the cost of various widely used oral diabetes drugs either dropped in price or did not rise nearly as significantly as insulin. Metformin, for instance, which is available as a generic, fell to 31 cents in 2013 from $1.24 per tablet in 2002. And the newer class of diabetes drugs known as DPP-4 inhibitors rose 34 percent since becoming available in 2006. The researchers analyzed data from nearly 28,000 diabetes found in the Medical Expenditure Panel, a database on health care costs maintained by the US Department of Health and Human Services. About 1 in 4 people used insulin and two-thirds took a pill. Toward the end of the study period, a small percentage began taking new injectable medicines that are designed to complement pills. There have been previous efforts to track insulin prices in recent years, bu Continue reading >>
Dental Home Care
Dogs may be good for your heart Author: Edie Lau Publish Date: 5/29/2013 12:42:10 PM Five days a week, whatever the weather, Carmen Gale hikes the woods with her high-energy German shorthaired pointer, Pico. The more miles they go, the less she weighs. Since walking a dog became a regular part of her life six years ago, Gale figures sheâ€™s shed about 40 pounds. It isnâ€™t all due to a dog â€” sheâ€™s taken up running and cycling, as well â€” but a dog keeps her consistent. â€œWhen the dogâ€™s crying and carrying on, itâ€™s not like you get to make the decision to not go out,â€ said Gale, a 43-year-old aesthetician and mother of two living near Seattle. Galeâ€™s walking regimen with Pico may be on the more demanding side of the spectrum but sheâ€™s far from unique. Dog owners around the world long have been goaded by their pets into more exercise than they might otherwise get. And scientists have documented the effects. So much evidence has amassed about the potential health benefits of owning pets that a committee of the American Heart Association recently decided to review the science to see what the collective research shows. Their conclusion, laid out in an article published online this month in the journal Circulation, is this: Pet ownership, particularly dog ownership, probably is associated with a lower risk of cardiovascular disease, and may be a direct cause of lower risk. Although this may seem obvious to many a dog-walker, Glenn Levine, MD, a cardiologist at Baylor College of Medicine and the Michael E. DeBakey Medical Center in Houston who headed the Heart Association team reviewing the studies, said the evidence is based upon statistical correlations between people who own dogs and people who donâ€™t Continue reading >>
Buy Humulin N Nph - Prime Anabolics
Active ingredient: Insulin Isophane, Human Biosynthetic (rDNA origin) NPH Amount: 1 X 1 kit [5 x 3 mL Cartridges (100 IU/mL)] NPH human insulin (rDNA origin) isophane suspension U-100. Active substance: Insulin Isophane, Human Biosynthetic (rDNA origin) NPH 100 IU To be store in a dry place, protected from light, at a temperature of 15-25 C. Keep out of reach of children. Humulin N is an insulin that is slower to act and lasts longer than regular human insulin. Humulin N is available in the prefilled Humulin N KwikPen or in a Humulin N U-100 vial. Humulin N is injected under the skin. It should not be injected into muscle or veins. Doses of insulin are measured in units. U-100 insulins, including Humulin N, contain 100 units/mL. With the Humulin N U-100 vial, it is important to use a syringe that is marked for U-100 insulin preparations. If the insulin substance (the white material) remains at the bottom of the bottle after mixing, or If there are clumps in the insulin after mixing If you notice your insulin requirements changing, talk to your doctor. Be sure to read the Patient Information that comes with your Humulin N insulin. Also be sure to read the Instructions for Use for your Humulin N vial or KwikPen. To learn more about the Humulin N KwikPen. Pens and needles are for single-patient use only and should not be shared, even in healthcare facilities, as infection or disease can be spread from one person to another. Do not withdraw insulin from the pen using a syringe. Humulin N is used to treat people with diabetes for the control of high blood sugar. Important Considerations for Use for Humulin R U-100, Humulin N, and Humulin 70/30: Low blood sugar (hypoglycemia) is the most common side effect of insulin, including Lilly Humulin insulins. Signs of severe hypogly Continue reading >>
Buying Humulin R At A Pharmacy With No Prescription
Buying Humulin R at a pharmacy with no prescription Can you still do this? From what I have read only insulin analogs like Humalog require a prescription. A lot of information I have read supporting this is old, and I'm wondering if things have changed recently. Please give the specific store/pharmacy that you have had success purchasing from if possible. I think it depends on which state you live in I think it depends on which state you live in "In all states new, insulin analogs DO require a prescription. These include Humalog, Novolog, or Apidra, as well as Lantus." According to the site insulin that is non analog is sold without prescription in all states except Alaska and Virginia. Even though permitted, some pharmacies require an RX for both. Long acting insulin can be purchased without a prescription in many states just because it is so crucial for survival for diabetics. Arguing about a prescription when a diabetic just dropped their vial and shattered it. They are gonna give that person another vial or he will die Call your local pharmacy and say that you were gonna go on a camping trip with your diabetic friend and ask if you can pick one up. Also, syringes can be purchased too from pharmacies if you bring them an empty insulin vial showing that you need them. Edit: Keep in mind that pharmacies can refuse to sell to you as well even though laws state they need to. So make up a good story. Long acting insulin can be purchased without a prescription in many states just because it is so crucial for survival for diabetics. Arguing about a prescription when a diabetic just dropped their vial and shattered it. They are gonna give that person another vial or he will die Call your local pharmacy and say that you were gonna go on a camping trip with your diabetic frie Continue reading >>
Out Of Insulin, Too Early To Renew — What To Do?
It is not unusual for people to have difficulty keeping insulin from freezing or getting overheated. A patient, with type 1 diabetes for 17 years, had glucose that did not respond to his rapid-acting insulin as it usually does. He had two new vials in the refrigerator. He took a new vial out of his refrigerator earlier in the day, and started using it a few hours after he took it out. Had high post prandials that did not respond as usual to correcting. He had enough experience to wonder if perhaps something was wrong with his new insulin, so he thought he’d try another vial. He saw it was frozen. He had put the two vials at the back, where for many refrigerators it is colder. He thought back and wondered if the first vial looked any different, but remembered, he did not look closely at it. He then went to get a new prescription filled at his pharmacy, but was told insurance would not cover it at this date; it was too early. It was cost prohibitive for him to pay out of pocket ~$300.00/vial. He contacted a diabetes health care provider (hcp) who offered him two sample vials to cover him until his prescription would once again be covered. He corrected and his glucose lowered. Disaster averted! Not everyone has the luxury of having a hcp who has samples available in such a timely manner. If their hcp even had them, what if it were a weekend, or another time that the hcp did not have access to the samples? I reached out to certified diabetes educator, Laurie Klipfel, RN, MSN, BC-ANP, CDE, to see if she could offer any pearls of wisdom: “This was a recent discussion on an AADE list serve with many good suggestions. The best suggestion was asking the healthcare provider if samples were available. My next option would be to see if the insurance would make an exception unde Continue reading >>
Humulin N Vs. Novolin N: A Side-by-side Comparison
Diabetes is a disease that causes high blood sugar levels. Not treating your high blood sugar levels can damage your heart and blood vessels. It can also lead to stroke, kidney failure, and blindness. Humulin N and Novolin N are both injectable drugs that treat diabetes by lowering your blood sugar levels. Humulin N and Novolin N are two brands of the same kind of insulin. Insulin lowers your blood sugar levels by sending messages to your muscle and fat cells to use sugar from your blood. It also tells your liver to stop making sugar. We’ll help you compare and contrast these drugs to help you decide if one is a better choice for you. Humulin N and Novolin N are both brand names for the same drug, called insulin NPH. Insulin NPH is an intermediate-acting insulin. Intermediate-acting insulin lasts longer in your body than natural insulin does. Both drugs come in a vial as a solution that you inject with a syringe. Humulin N also comes as a solution you inject with a device called a KwikPen. You do not need a prescription to buy Novolin N or Humulin N from the pharmacy. However, you do need to talk to your doctor before you start using it. Only your doctor knows whether this insulin is right for you and how much you need to use. The table below compares more drug features of Humulin N and Novolin N. Humulin N Novolin N What drug is it? Insulin NPH Insulin NPH Why is it used? To control blood sugar in people with diabetes To control blood sugar in people with diabetes Do I need a prescription to buy this drug? No* No* Is a generic version available? No No What forms does it come in? Injectable solution, available in a vial that you use with a syringe Injectable solution, available in a cartridge that you use in a device called a KwikPen Injectable solution, available in Continue reading >>
3 Things Your Vet Might Not Tell You About Treating Your Diabetic Dog
According to the American Veterinary Medical Association, diabetes affects approximately one in every 500 dogs. Chuck, my senior Pug mix, was diagnosed with the disease shortly after I adopted him. He was 10 years old and severely overweight when he came from the shelter. Although I did get his weight down by 25 percent thanks to a lot of walks, all that extra heft undoubtedly contributed to the onset of his disease. (Please don’t let your dogs get fat, it’s so dangerous to their health!) When your dog is diagnosed with diabetes, there is a ton of information to learn. Yet, there are quite a few things you may just take at face value without even thinking to question. Trust me, don’t do that. Always be inquisitive. Here is what I learned by managing Chuck’s diabetes. 1. There are different types of insulin When Chuck got his first insulin prescription, it was for Humulin N. I went to Costco and paid $130 for a bottle that would last a month. Over the next few days, I did some research and discovered Chuck could be moved to Novolin N (a different type of insulin). This is an equally expensive drug, but I finally found it for $24.88 at my local Walmart. Never underestimate the value of shopping around. Pharmacies frequently have contracts with certain drug companies that affect which drugs they sell and how much they cost. When your dog is diagnosed, invest the time into exploring your medication options. When asked, Chuck’s vet didn’t even know there were two insulins (she just jotted down the one she knew about), and it took some independent research on my part to determine Chuck could be safely moved from one to the other (not all animals can or should, so be careful and only do it with medical supervision). 2. You can do blood glucose curves at home When t Continue reading >>
Is The Cost Of Insulin Sykrocketing?
There is a perception among some people who have to use insulin to control their diabetes that its cost is skyrocketing. Specifically, they say that during the 1990s the cost of insulin increased dramatically. Did it? The two pharmaceutical companies that sell insulin in the United States were obviously the first ones for us to ask. Neither one, however, would provide historical prices. ‘Insulin is a loss leader.’ Novo Nordisk acknowledged our repeated e-mail requests and voice messages but failed to respond. Eli Lilly and Company said that it had a policy of not providing historical sales or pricing data. That company did provide net wholesale prices and acknowledged that "Lilly has increased its price of insulin over the past ten years." Lilly emphasized, however, that the price increase of Humalog was "to better align its clinical value with other diabetes agents (orals and insulins)." In addition, Lilly noted that the average daily cost of treating diabetes is in line with or below the cost of treating other chronic illnesses. The net wholesale cost of a vial of Humalog is now $34.81, Lilly says. For a vial of Humulin it is $20.08. But the absence of comparison data might lead one to think that there's a fire of raging cost increases below this smoke of non-responsiveness. The issue is particularly troublesome in light of the fact that Lilly technically has a monopoly on retail insulin sales in the United States. Last year Lilly had an 84 percent share of the U.S. retail pharmacy market, according to IMS Health, the leading market research firm tracking the global pharmaceutical industry. Novo Nordisk had 16 percent. The Sherman Anti-Trust Act of 1890 generally defines a monopoly as having market share of more than 80 percent. So Lilly certainly has been in a po Continue reading >>
The Benefits Of Intranasal Insulin And How To Make It Legally At Home Without A Prescription
INTRANASAL INSULIN aka NASAL INSULIN aka INI “I have been using intranasal insulin (aka nasal insulin) for the past week or so, and am honestly shocked at its effectiveness. It seems to reduce the brain fog and neuroinflammation associated with my Sjogren’s syndrome.” -Sean P. (quoted with permission) Quick Summary Intranasal insulin improves mood, enhances memory, increases brain energy levels (ATP and phosphocreatine), significantly reduces neuroinflammation, protects against neuronal oxidative stress by restoring antioxidants and energy metabolism, treats Alzheimer’s, and possibly cures type 1 diabetes. Buy Novolin R legally over the counter in the U.S. without a prescription for $25 at Walmart. Buy Humulin R in Europe here: Humulin R. Buy Nasal Spray bottles here: Nasal Spray Bottle Nasal Spray Bottle (Swiveling Head) Read on to learn more benefits and how to try it at home today! The Benefits of Intranasal Insulin Intranasal insulin is far and away one of the best brain enhancers I’ve ever tried (I’ve only tested 500+ though!). Insulin nasal spray has been tested in over three dozen randomized, double-blind, placebo-controlled trials in humans and has been repeatedly shown to be extremely safe. R This is due to the fact that the nasal route of administration effectively bypasses the blood brain barrier and targets neuropeptides (like insulin) to the brain without substantial absorption into circulation. R This prevents nasal insulin from entering the bloodstream and makes it extremely safe (although there is always risk no matter what substance you are taking) since intranasal delivery directs the insulin into the brain, avoiding systemic side-effects. R Here is the path it follows from the nasal cavity to trigeminal and olfactory nerves and into the br Continue reading >>
Specific Insulin Info & Dosing Scales
There are many kinds of insulin available to use for our FD cats. Some perform much better than others and each has its idiosyncrasies. Sometimes we will have a choice when it comes to which insulin is prescribed by our vets; sometimes we won't. Whatever insulin, all insulin types have been proven to work with TR. The insulin types addressed in this sticky are PZI (compounded, ProZinc and Hypurin), Lantus, Levemir, NPH (Humulin N), Caninsulin/Vetsulin, please scroll down to for information on the specific insulin. It is advised to start TR / Insulin when you are available to monitor your cat’s BG frequently by performing frequent testing and/or curves for the first few days until you know how your cat processes their insulin. One of the important premises TR is built on is maintaining overlap between doses – meaning that the remnants of the prior shot are still working to keep the BG from rising very high, while the next shot approaches onset (when the insulin starts to work). Different insulin types have different durations -experienced members on forum will help guide you through the process of understanding the nuances of the insulin you are using to get maximum results. Insulin should be stored in the fridge at all times, in a protected spot on a less-used shelf, in a sturdy, padded container where it will not get knocked over. Do not store insulin on the door of your fridge to avoid excess jostling. Practicing TR we handle our insulin more often than when dosing twice a day. Handling your insulin gently and with care will prolong potency considerably. Dr. Hodgkins' Tight Regulation protocol was developed for use with bovine based PZI insulin but it has been proven over time that many insulin types work very well with TR. Please scroll down this page for explana Continue reading >>
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