Vetsulin® (porcine insulin zinc suspension) 10 mL vials and 2.7 mL cartridges should be shaken thoroughly until a homogeneous, uniformly milky suspension is obtained. Foam on the surface of the suspension formed during shaking should be allowed to disperse before the product is used and, if required, the product should be gently mixed to maintain a homogeneous, uniformly milky suspension before use. Clumps or white particles can form in insulin suspensions: do not use an insulin vial or cartridge if visible clumps or white particles persist after mixing thoroughly.
Taking the proper steps to prepare VetPen® is critically important and must be done before each injection. It is essential to ensure that the VetPen is ready to use and helps ensure that a new needle is being used, the insulin is mixed properly, and VetPen and the needle are working properly. See VetPen Instructions for Use leaflet or administration video for information on preparing VetPen.
Using a U-40 insulin syringe or VetPen, administer the injection subcutaneously, 3/4 to 2 in (2–5 cm) from the dorsal midline, varying from behind the scapulae to the mid-lumbar region and alternating sides.
To help your clients prepare and administer Vetsulin to their dogs, there are resources available that guide them step-by-step through the process:
- Administration guide for using syringes
- Administration video for using syringes
- VetPen Instructions for Use leaflet
- Administration video for using VetPen
In dogs, the initial recommended 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, and ketonuria)
- Avoiding hypoglycemia (blood glucose <50 mg/dL)
- 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.
Hypoglycemia is a major concern. To help avoid it:
- 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
This helps to avoid overdosing particularly during initial stabilization.
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 would receive 10 IU of Vetsulin once daily or 7 IU of Vetsulin administered twice daily. See product label for more information.
For long-term management dosage, click here.