Dog on glargine insulin

RE: Dog on glargine insulin

Andrew Kent — Wed, 06 Sep 2017 17:07:16 GMT

[quote user="Martin Atkinson"]

Perhaps the nameless coward who gave me one star would like to own up and explain why they thought my post was so worthless and if their experience of treating diabetics is so vast they could offer better advice.

[/quote]

I've given you 5 stars to try to balance it out :-)

There is nothing that is not useful/helpful in your post!

RE: Dog on glargine insulin

Martin Atkinson — Wed, 06 Sep 2017 12:07:10 GMT

RE: Dog on glargine insulin

Bob Russell — Wed, 06 Sep 2017 11:39:32 GMT

Many thanks for the advice, really helpful!

The previous history does suggest a poor response to lente insulin hence the change to glargine.

Glucose curve did appear to be almost peakless but at a higher level than it should be. Owners are going to increase the dose slightly, redo the fructosamine in about a month. Will keep you informed.

Thanks

RE: Dog on glargine insulin

Andrew Kent — Wed, 06 Sep 2017 09:30:25 GMT

Hi Bob,

The evidence supporting the use of glargine in dogs is fairly limited but some of the evidence that does exist suggests that the percentage of dogs that are well controlled is lower for glargine than other insulins. So it would not be my first choice in this species.

Equally, whilst glargine in humans is described as peakless - in dogs there does seem to be a nadir but the timing is very variable (up to 12 hours) which can make adjustments/timing challenging.

Personally unless there was a good reason to use this insulin or it was used because other insulins had failed unless things improve soon I would revert to lente insulin.

Andy

RE: Dog on glargine insulin

Bob Russell — Wed, 06 Sep 2017 09:07:09 GMT

Bloods were done every hour. Minor changes only with the blood levels with a very, very slight dip about 2 hours after insulin.

Not at all clear why this insulin was chosen in the first place. I will go for a small increase in dose and recheck.

RE: Dog on glargine insulin

Martin Atkinson — Tue, 05 Sep 2017 17:13:55 GMT

I'm not familiar with Glargine in dogs but my experience with cats has been generally positive. What I have found is that you get a much flatter curve with lower peaks and shallower troughs. But those raw figures don't tell us much, was the nadir 16-17? I will perform a test every hour after the first 2 hours until I'm satisfied the curve is stable. There is a danger you will miss an overswing if you do it less frequently however there is less likelihood of an overswing with Glargine. I would also never rely on one curve there are far too many variables and margins of error in client technique/compliance so I wouldn't rush onto changing anything. Fructosamine may help but I'd like to see the curve first.

Its also difficult to answer at what dose an overswing is likely without knowing historic glucose readings but recommended starting dose is 0.5iu/kg if serum glucose is >20mmol/l and 0.25iu if < 20 so 5iu bid is not an excessive dose for an 11kg dog