Advise pet owners not to reuse VetPen needles. After a single use, needles should be disposed of in approved sharps or biohazard containers. Watch the video and use the step-by-step instructions below to teach your clients how to use Caninsulin VetPen. Before the first use, it is important to remove any air from the cartridge priming to avoid injecting air and ensure accurate dosing.
NOTE: if your clients have an unsteady hand or poor eyesight, they can use the release button and dose selector adaptors. Advise your clients to always check the number of units left in the cartridge. Insulin requirements may change suddenly even after a long period of stability because of any of the following concurrent factors:. Vets should re-evaluate dogs with diabetes at appropriate intervals and adjust the dose based on clinical signs, urinalysis and glucose curve results.
Following adjustment, wait to re-evaluate until the new dose has been given for a minimum of 3 days, unless evidence of hypoglycaemia appears. This will result in the disappearance of most of the dog's clinical signs, which is the main goal of therapy. Re-evaluate your canine patients a minimum of 3 days after starting Caninsulin porcine insulin zinc suspension :.
For example, if a dog receives 20 IU of Caninsulin once daily, the new dose would be 15 IU twice daily. If ideal stabilisation has not been achieved, it is suggested to first investigate the cause of poor regulation: e.
When clinical signs disappear and the owner is happy with the situation, the main goals of therapy have been achieved. Refer to the Caninsulin Datasheet for further information. Good glycaemic control is dependent upon a controlled and consistent dietary intake. The dietary requirements of a dog with diabetes is highly variable — the diet must be tailored to each individual dog, ensuring that food offered is palatable and will be readily eaten 6.
Obese dogs require reduced caloric intake, either through feeding a calorie-restricted diet or by feeding a reduced quantity of the normal diet. Increasing physical activity will also be beneficial in obese dogs. Conversely, underweight dogs may require calorie-rich diets such as pediatric or convalescent diets.
Meals should be timed so that the absorption of glucose from the gastrointestinal tract coincides with peak action of the administered insulin. This will minimise fluctuations in blood glucose concentrations and thus episodes of hyperglycaemia or hypoglycaemia. It is important for owners to remember that dietary consistency is critical — both the type and amount of food given, as well as feeding times, should be as similar as possible each day. Fibre-rich diets have been shown to slow the postprandial glucose surge in dogs, which consequently improves glycaemic control 6.
Give the first meal two-thirds of the daily amount prior to the morning Caninsulin injection. This allows your client to see that their dog is feeling well and eating normally before the insulin is given. The first meal half of the daily amount is given just before the morning Caninsulin injection.
The second meal the remainder of the daily amount is usually given about hours later, prior to the second Caninsulin injection. Caninsulin is available in two presentations, to enable vets and owners to discuss what might be right for them:. This method is more accurate that the traditional needle and syringe approach and is easy to use 7,8. Caninsulin is also available in 2. This first period allows the dog and owner to become accustomed to the injections and related their concerns and challenges to the clinic team.
Incorrect storage of insulin or poor injection technique can affect insulin therapy. Ask owners to demonstrate how they inject their pet, and ask the following:. See Proper Handling and Storage and delivery of Caninsulin for more information. Antibodies may be directed either against the insulin or against other foreign proteins in the preparation. The presence of anti-insulin antibodies is common and does not usually lead to poor regulation.
Antibody production is less likely if homologous insulin has the same structure as the recipient is given, e. Once the maintenance dose has been established and the dog is stable, a long-term management program must be implemented.
The aim is to minimise variations in insulin requirement. This includes monitoring to detect underdosage or overdosage of insulin, and adjustment of dose, if required. Careful monitoring during maintenance will help limit most of the chronic problems associated with diabetes. Various approaches to maintenance have been described. Urine glucose checking at home should only be used where appropriate, such as when hypoglycaemia is suspected and a negative morning glucose would indicate an insulin overdose Dogs should be checked by a vet every 2 to 4 months more often if there are problems for general health and absence of clinical signs , urine glucose and blood glucose as required and indicated by the general health check and owner diary.
Adjustments to the insulin dose must be based on full analysis of clinical data and a series of blood glucose measurements. The use of progestogens in dogs suffering from diabetes mellitus should be avoided. Ovariohysterectomy should be considered for entire bitches.
Stress and irregular exercise must be avoided. Care must be taken with the use of corticosteroids. It is important to establish a strict feeding schedule in consultation with the owner that is consistent and avoids too many fluctuations and changes It is extremely important that owners can recognise the signs of hypo- or hyperglycaemia and respond appropriately.
Polyuria, polydipsia, and polyphagia in combination with weight loss, poor condition, loss of hair or hirsutism and lethargy are the most common clinical signs of hyperglycaemia and require administration of insulin to restore blood glucose levels to an acceptable range.
However, these clinical signs may also be present as a result of a rebound hyperglycaemia secondary to a hypoglycaemic episode Somogyi overswing. While a blood glucose curve can help differentiate between insufficient insulin dosing and Somogyi overswing, the results can be confusing if the rebound hyperglycaemia persists for a few days and may not be associated with the time of insulin administration. Evaluating weight changes in the patient can help shed some light on this issue.
If the dog is losing weight and exhibiting clinical signs of diabetes mellitus, the insulin dose may be insufficient. If the dog is gaining weight but continues to have clinical signs consistent with diabetes mellitus, the insulin dose may be excessive, and causing Somogyi overswing.
The signs of hypoglycaemia may occur suddenly and can be life-threatening, so it is important owners are very aware of these and know how to respond. If not treated, these can lead to convulsions, coma and, eventually, can be fatal.
Advice should be sought from the medicine prescriber. Use Medicines Responsibly. All rights reserved. Loading subscription preferences Your subscriptions. Bookmark this. Posted by Kameron Carlson on 20th Apr Your pet has been diagnosed by your veterinarian with diabetes mellitus sugar diabetes!
Now what? Diabetes can be a difficult and unpredictable disease to manage. By employing the techniques below the treatment can be made less frustrating. Most dogs are Type 1 diabetics. This means that special cells in a gland called the pancreas are no longer producing insulin. It is necessary for survival and must be given by injection.
Insulin needs to be refrigerated; always be aware of the expiration date on the vial. So there are units in a 10 cc vial. Prices vary considerably so shop around. Syringes used must be calibrated for U insulin. If your veterinarian opts for this insulin make sure he or she provides syringes calibrated for U Regulation: This refers to the process performed by your vet involving the checking of blood sugar levels at certain times during the day to determine the correct dose for your dog.
Fluctuating insulin requirements are common, and management of these patients can be frustrating. Treatment is supportive, and a pancreatic biopsy is required to confirm suspicions of pancreatitis.
Obesity and Hyperlipidemia Mobilization of fat stores via lipolysis occurs in patients with relative insulin deficiency. Many dogs with hyperlipidemia do not have concurrent DM, but in those dogs that have diabetes and an additional cause of hyperlipidemia hypothyroidism, hyperadrenocorticism, idiopathic hypertriglyceridemia , insulin resistance can become a problem.
A 24 hour fasting triglyceride level is necessary to confirm a diagnosis of hypertriglyceridemia. If the triglyceride level remains elevated despite treatment of underlying disorders and diet therapy, drug therapy such as niacin or gemfibrozil can be considered. Obesity causes carbohydrate intolerance and hyperinsulinemia in dogs. Insulin resistance as a result of obesity is due to down regulation of insulin receptors, reduced receptor binding affinity, and post-receptor defects in intracellular glucose metabolism.
Chronic carbohydrate intolerance leads to chronic hyperglycemia which impairs insulin secretion by beta cells, down regulates glucose transport systems, and interferes in post-receptor activity. The effects of obesity and glucose toxicity are reversible, and insulin sensitivity will improve with treatment. Neoplasia The most common types of cancers that have been associated with development of insulin resistance in veterinary medicine include lymphoma and mast cell tumors.
Other tumor types have also been associated with development of insulin-resistant diabetes mellitus. Renal disease Patients with concurrent renal disease and diabetes mellitus are at risk for both prolonged duration of insulin effect and insulin resistance. This puts them at risk of development of both hypo- and hyperglycemia. The polyuria and polydipsia associated with renal failure can be confused with signs of poorly regulated diabetes, making monitoring of disease at home more difficult as well.
Management of diabetes in patients with concurrent renal disease can be an exercise in frustration, and owners should be preemptively warned of difficulties associated with treatment of these diseases concurrently.
In conclusion, insulin resistance is a common problem in diabetic veterinary patients. Frequently encountered causes for insulin resistance include infection, obesity and concurrent endocrine disease. However, any illness that increases circulating levels of counter regulatory hormones cortisol, glucagons, catecholamines, and growth hormone can contribute to development of insulin resistance.
Management of diabetes can be challenging, and often requires a balance of dietary management, insulin therapy, and diagnostic testing for evaluation of both diabetic control and underlying etiologies of insulin resistance. Find your nearest SAGE center. Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.
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