Insulin Control
Read More About Monitoring & Controlling Feline Diabetes
Insulin Resistance
From Stress, Infections and Obesity
Stress or infections (urinary tract infections, pyoderma) can lead to a decline in the sensitivity of target tissues to insulin. Obese animals have reduced insulin sensitivity.
From Other Hormones
Endogenous or exogenous hormones may reduce the effects of insulin. When treating an animal for diabetes mellitus, medication with progestogens should be discontinued immediately. Intact queens should be spayed.
If animals are being treated with corticosteroids, alternatives to this treatment should be sought. If this is not feasible, efforts should be made to minimize the corticosteroid dose.
See the following graph for an example of a blood glucose curve in a case of insulin resistance. Insulin was injected at time=0 hours.
To solve this, investigate cause, eg, Cushing’s disease, hyperprogesteronism, owner issues, injection issues, or use of the wrong type of syringe. Also consider Somogyi overswing, which can present as persistent hyperglycemia for a few days following the hypoglycemic event.
Blood Glucose Curve
See the following graph for an example of a blood glucose curve in a case of rapid metabolism of insulin. Insulin was injected at time=0 hours. The results of a glucose curve in a dog experiencing Somogyi overswing may be similar.
Blood glucose measured in mg/dL
Rapid Metabolism of Insulin
If the duration of action of insulin is less than desired (10–12 hours for twice-daily administration; 20 hours for once-daily administration), rapid metabolism of insulin should be considered.
The solution is to change to a longer-acting preparation.
Blood Glucose Curve
Blood glucose measured in mg/dL
Resources to Help Clients Monitor Care
Help Your Practice Manage Diabetes Mellitus
Check out these tools and resources to help manage feline diabetes.
Blood Glucose Curve Generator
Create a blood glucose curve to monitor and evaluate diabetes treatments.
Client Discharge Form
Create a customized, printable form for clients about their new diagnosis.
Diabetes Resources
Access online tools and more to support staff and pet parents.
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Read More About Monitoring & Controlling Feline Diabetes
Important Safety Information:
Vetsulin® should not be used in dogs known to have a systemic allergy to pork or pork products. Vetsulin is contraindicated during periods of hypoglycemia. Keep out of reach of children. As with all insulin products, careful patient monitoring for hypoglycemia and hyperglycemia is essential to attain and maintain adequate glycemic control and prevent associated complications. Overdosage can result in profound hypoglycemia and death. The safety and effectiveness of Vetsulin in puppies, breeding, pregnant, and lactating dogs has not been evaluated. See package insert for full information regarding contraindications, warnings, and precautions.
References:
1. Martin GJ, Rand JS. Pharmacology of a 40 IU/ml porcine lente insulin preparation in diabetic cats: findings during the first week and after 5 or 9 weeks of therapy. J Feline Med Surg. 2001;3(1):23–30. 2. Vetsulin® (porcine insulin zinc suspension) [Freedom of Information Summary]. Millsboro, DE: Intervet Inc.; 2008. 3. Data on file, Merck Animal Health. 4. Graham PA, Nash AS, McKellar QA. Pharmacokinetics of porcine insulin zinc suspension in diabetic dogs. J Small Anim Pract. 1997;38(10):434–438. 5. Martin GJ, Rand JS. Pharmacokinetic and Pharmacodynamic Study of Caninsulin in Cats with Diabetes Mellitus. 2000: Internal Study Report. 6. Feldman EC, Nelson RW. Canine and Feline Endocrinology and Reproduction. 3rd ed. St. Louis, MO: Saunders; 2004:539–579. 7. Tennant B, ed. BSAVA Small Animal Formulary. 4th ed. Gloucestershire, UK: British Small Animal Veterinary Association; 2002. 8. Feldman EC, Nelson RW. Canine and Feline Endocrinology and Reproduction. 3rd ed. St. Louis, MO: Saunders; 2004:486–538. 9. Reusch C. Feline diabetes mellitus. In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine. 7th ed. St. Louis, MO: Saunders; 2010:1796–1816. 10. Nelson RW. Canine diabetes mellitus. In: Ettinger SJ, Feldman EC, eds. Textbook of Veterinary Internal Medicine. 7th ed. St. Louis, MO: Saunders; 2010:1782–1796. 11. Burgaud S, Riant S, Piau N. Comparative laboratory evaluation of dose delivery using a veterinary insulin pen. In: Proceedings of the WSAVA/FECAVA/BSAVA congress; 12–15 April 2012; Birmingham, UK. Abstract 121. 12. Burgaud S, Guillot R, Harnois-Milon G. Clinical evaluation of a veterinary insulin pen in diabetic dogs. In: Proceedings of the WSAVA/ FECAVA/BSAVA congress; 12–15 April 2012; Birmingham, UK. Abstract 122. 13. Burgaud S, Guillot R, Harnois-Milon G. Clinical evaluation of a veterinary insulin pen in diabetic cats. In: Proceedings of the WSAVA/FECAVA/BSAVA congress; 12–15 April 2012; Birmingham, UK. Abstract 45. 14. Davison LJ, Walding B, Herrtage ME, Catchpole B. Anti-insulin antibodies in diabetic dogs before and after treatment with different insulin preparations. J Vet Intern Med. 2008;22:1317-1325. 15. Banfield State of Pet Health 2016 Report. p 12-13.