Long acting insulin

RE: Long acting insulin

Bill Nolan — Fri, 01 Jun 2018 06:41:26 GMT

[quote user="Adebowale Ajao DVM, PGCertSAM, MRCVS"]dog tends not to eat in the morning.[/quote]

I've seen this quite a few times, and heard of it from other vets even more. A medicine specialist advised me that often dogs develop hyper acidity / reflux oesophagitis (previously known as billous vomiting), and therefore have reduced morning appetite.

She advised 1 mg/kg omepreazole and 0.5 mkg metoclopramide SID given just before bedtime (9-11pm) +/- giving the evening meal later in the day. Managed to get quite a few on my patients eating their morning meal more regularly.

RE: Long acting insulin

Lucy Fleming — Thu, 31 May 2018 08:26:20 GMT

Well, my n=1 is that it has stabilised his diabetes (eventually) though I think diet switching made a big difference as well.

It's actually currently the least of his worries alongside chronic pancreatitis, arthritis, CKD and suspected "IBD-type disease"...

RE: Long acting insulin

Kate Richardson — Wed, 30 May 2018 18:24:29 GMT

[quote user="Lucy Fleming"]

I did think about it, but had heard good things about glargine from a number of feline vets. I didn't have that much experience with pro-zinc at that stage and the last thing I wanted was to change from one, go through all the attempts to re-stabilise on a new insulin, only to find that one wasn't persisting that well either! (I might also have been influenced by the fact that, at that point I think I had 2 ProZinc cats on the go and 50% of them were doing terribly!) Now I would probably quite happily go to ProZinc.

[/quote]

fair points. I must admit I’ve had little personal experience with Lantas despite Being feline orientated, but Prozinc is much superior to caninsulin, one of my recent remission cases was one I changed from caninsulin to Prozinc.

RE: Long acting insulin

Lucy Fleming — Wed, 30 May 2018 16:11:12 GMT

RE: Long acting insulin

Kate Richardson — Wed, 30 May 2018 11:02:51 GMT

Lucy Fleming out of curiosity why did you go straight to Lantus rather than trying pro-zinc?

“I skipped pro-zinc for the case I have on Lantus, as I changed him from caninsulin, which was lasting about 5 minutes! I use pro-zinc first line for all my newly diagnosed diabetic cats now, and have been impressed as well. “

RE: Long acting insulin

Cool — Wed, 30 May 2018 10:32:58 GMT

Many thanks for your comments everyone.

RE: Long acting insulin

Lucy Fleming — Thu, 24 May 2018 15:23:06 GMT

I've got 2 on it at the moment... one was only recently diagnosed and is on a tiny tiny dose...I'm torn between hoping he goes into remission (was picked up quite early in the disease process I think, and he is already becoming impossible to curve here, and won't be possible for owners to curve him) and almost hoping he doesn't as I don't think his owners will handle the uncertainty well! The other seems to be doing surprisingly well, his owners curve him at home but never tell me what any results are, and also seemingly change the dose at random .

I did have one that was uncontrolled even on very high doses, but I was suspicious of something else underlying with him, possibly acromegaly. He's subsequently been PTS.

I skipped pro-zinc for the case I have on Lantus, as I changed him from caninsulin, which was lasting about 5 minutes! I use pro-zinc first line for all my newly diagnosed diabetic cats now, and have been impressed as well.

RE: Long acting insulin

Kate Richardson — Thu, 24 May 2018 12:27:18 GMT

Martin Atkinson Lucy Fleming was directed at both of you, but I guess may be a consideration in dogs, although have no personal experience.

Prozinc is first line treatment for me. Last 3 cats I have put onto it, 2 have gone into remission within 6 months. 1 of which was the perfect diabetic owner, home glucose monitoring etc, the other was less compliant (owner, not cat). 3rd cat is very stable with lovely glycaemic control. So I am pleased so far.

RE: Long acting insulin

Martin Atkinson — Thu, 24 May 2018 10:30:22 GMT

[quote user="Kate Richardson"]

[quote user="Lucy Fleming"]

[quote user="Martin Atkinson"]I've always used glargine as a twice daily dose in cats. [/quote]

Good point Martin! I still use it twice daily, just find it lasts longer than caninsulin.

[/quote]

have you tried Prozinc yet?

[/quote]Is that question for me or Lucy and do you mean for dogs or cats?

I'm using it for one diabetic cat largely because the owner is hopeless at adhering to the storage protocol and kept using Caninsulin for way over a month. Unfortunately it just gave them licence to keep using the Prozinc for even longer and as they are totally unreliable in terms of general compliance and monitoring (they are diabetic themselves so you'd think they'd know better but looking at them doubt their own compliance and diet is well controlled!) I can't draw any conclusions.

RE: Long acting insulin

Kate Richardson — Thu, 24 May 2018 06:45:40 GMT

[quote user="Lucy Fleming"]

[quote user="Martin Atkinson"]I've always used glargine as a twice daily dose in cats. [/quote]

Good point Martin! I still use it twice daily, just find it lasts longer than caninsulin.

[/quote]

have you tried Prozinc yet?

RE: Long acting insulin

Lucy Fleming — Wed, 23 May 2018 23:22:35 GMT

[quote user="Martin Atkinson"]I've always used glargine as a twice daily dose in cats. [/quote]

Good point Martin! I still use it twice daily, just find it lasts longer than caninsulin.

RE: Long acting insulin

Martin Atkinson — Wed, 23 May 2018 13:28:06 GMT

[quote user="Lucy Fleming"]

I don't have experience of it in dogs, but have a feline patient on glargine (ultralente) and we just get it through our wholesaler. Trade name is Lantus.

[/quote]

Although it is long acting in humans, I've always used glargine as a twice daily dose in cats. Like Lucy I've not used in dogs. Long acting insulins given once daily in dogs are more likely to lead to higher doses and episodes of hypoglycaemia.

[quote user="Adebowale Ajao DVM, PGCertSAM, MRCVS"]

Is anyone aware of any long acting insulin for dogs on the market please? preferrably protamine zinc or ultralente insulin and are these available with the regular wholesalers? Needed for a dog whose owner is struggling with b.i.d insulin injections as dog tends not to eat in the morning. Thanks in advance

[/quote]In view of the above I would instruct the owner to reduce the evening meal so the dog is hungry in the morning, or reduce the morning dose but bid is best.

RE: Long acting insulin

Lucy Fleming — Wed, 23 May 2018 12:01:40 GMT

I don't have experience of it in dogs, but have a feline patient on glargine (ultralente) and we just get it through our wholesaler. Trade name is Lantus.

RE: Long acting insulin

Thomas Johnson — Wed, 23 May 2018 11:49:36 GMT

[quote user="Adebowale Ajao DVM, PGCertSAM, MRCVS"]Is anyone aware of any long acting insulin for dogs on the market please? preferrably protamine zinc or ultralente insulin and are these available with the regular wholesalers? Needed for a dog whose owner is struggling with b.i.d insulin injections as dog tends not to eat in the morning. Thanks in advance[/quote]

I think Boehringer have some information on the use of Prozinc in dogs so it may be worth giving them a call.