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Dosage adjustment

Changes in insulin requirements in diabetic dogs

Insulin requirements may change suddenly even after a long period of stability because of any of the following concurrent factors:

  • Inflammation or infection (eg, pyoderma, cystitis)
  • Altered exercise regimen
  • Weight loss or gain
  • Additional medications
  • Other illnesses or diseases (eg, renal failure, heart failure, Cushing’s disease, hypothyroidism)
  • Changes in progesterone concentrations caused by diestrus
  • Corticosteroid or progestogen administration

Veterinarians should reevaluate diabetic dogs at appropriate intervals and adjust the dose based on clinical signs, urinalysis results, and glucose curve results. Dose adjustments in the dog should be performed in increments of 10%. Following adjustment, wait to reevaluate until the new dose has been given for at least 5 to 7 days, unless evidence of hypoglycemia appears.

Aim to maintain blood glucose concentrations below the renal threshold for a substantial part of the day. This will result in the disappearance of most of the dog’s clinical signs, which is the main goal of therapy.

Monitoring and adjusting dose

Reevaluate your canine patients 5 to 7 days after starting Vetsulin® (porcine insulin zinc suspension).

  • Ask for owner’s overall impression of the dog’s progress, especially in regard to clinical signs of diabetes.
  • Reweigh the dog. Modify overall dosage of Vetsulin if significant weight gains or losses occur.
  • Sample blood glucose curve to determine if regulation has been achieved.
  • Dose adjustments based on the glucose curve generally should be performed in increments of 10%. Dose adjustment should be made no more frequently than every 5 to 7 days.
  • However, if the dog’s clinical signs persist and the blood glucose curve indicates a duration of activity of less than 14 to 18 hours, then twice-daily injections at 12-hour intervals may be indicated. When switching from once-daily to twice-daily therapy, the Vetsulin dose needs to be decreased by 25% (not 10%). For example, if a dog receives 20 IU of Vetsulin once daily, the new dose would be 15 IU twice daily.
  • Once regulated on Vetsulin, dogs should be rechecked every 2 to 4 months.

When clinical signs disappear and the owner is happy with the situation, the main goals of therapy have been achieved.