Dosing Overview

Learn More About Dosing & Administration

Two Options

Administration information is useful to share with clients and hospital staff to ensure the proper amount of insulin is given.

Vetsulin^® (porcine insulin zinc suspension)

Vetsulin^® 10 mL vials and 2.7 mL cartridges should be shaken thoroughly until a homogeneous, uniformly milky suspension is obtained.
Syringe Administration Instructions

VetPen^®

Taking the proper steps to prepare VetPen^® is critically important and must be done before each injection.
VetPen^® Administration Instructions

Dosing Schedules

In dogs, the labeled starting Vetsulin dose is 0.5 IU insulin/kg of body weight. This dose should be given once daily concurrently with or right after a meal.

Veterinarians should reevaluate canine patients at appropriate intervals and adjust the dose based on clinical signs, urinalysis results, and glucose curve values until adequate glycemic control has been attained.

Achieving Effective Glycemic Control

The goals of managing canine diabetes mellitus include:

• Controlling the clinical signs of hyperglycemia (polyuria, polydipsia)
• Avoiding hypoglycemia
• Obtaining blood glucose curve values in the desired range:*
  • Dogs: 100–250 mg/dL over the course of the day, with a nadir between 100–150 mg/dL

*In the US clinical study, glycemic control was considered adequate if an acceptable blood glucose curve was achieved (ie, reduction in hyperglycemia and a nadir of 60–160 mg/dL), however, the Technical Services department believes that a nadir below 100 mg/dL in dogs may warrant a decrease in the dose.

Further adjustments in dosage may be necessary with changes in the dog’s diet, body weight, medications, or if the dog develops concurrent infection, inflammation, or other medical disorder.

Avoiding Hypoglycemia

Hypoglycemia is a major concern. To help avoid overdosing, particularly during initial stabilization:

• The dog’s body weight should be rounded down to the nearest whole kilogram.
• The calculated dose of insulin should be rounded down to the nearest whole unit.

Twice-Daily Dosage

• If the initial insulin duration of activity proves to be inadequate, begin twice-daily therapy.
• If twice-daily treatment is initiated, each of the 2 doses should be 25% less than the once-daily dose of Vetsulin^® required to attain an acceptable nadir.
  • For example, a 20-kg dog recieving 10 IU of Vetsulin once daily would be transitioned to 7 IU of Vetsulin administered twice daily. See product label for more information.

Help Your Practice Manage Diabetes Mellitus

View and download resources and tools that will assist your hospital, inform your team, and help with clients.

Learn More About Dosing & Administration

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.

^†Approximately one-third of dogs may be adequately regulated with once-daily dosing

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. 16. Behrend E, Holford A, Lathan P, Rucinsky R, Schulman R. 2018 AAHA Diabetes management guidelines for dogs and cats. J Am Anim Hosp Assoc. 2018; 54:1–21.