| Caninsulin Insulin |  Caninsulin is derived from porcine insulin, which is chemically identical to the insulin found in dogs. It has an intermediate period of activity, meaning that it can suit once or twice daily treatment regimes for diabetes mellitus. It is important that your vet performs the appropriate blood tests and tailors a treatment protocol which suits your individual dog or cat.
It is important to note that the concentration of Caninsulin is different from all other types of insulin available on the market. (This was done to make it easier to give the smaller doses often needed compared with human treatments.) This means that only Caninsulin syringes are suitable for use with Caninsulin (calibrated at 40 international units per ml) and human syringes (calibrated at 100 international units per ml) should not be used because they will not give the stated dose. For more information on treatment, see below:
| | | | Caninsulin Insulin | Syringes 0.5ml » Box of 30
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£9.28
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£10.04
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The basic rules for successful treatment of diabetes mellitus in dogs and cats revolve around correct, consistent feeding and a regular, consistent daily routine. Suitable diets are lower in carbohydrate and higher in fat and protein than many commercial diets. An animal on a once-daily injection of insulin should receive about one third of the daily food ration at the same time as the injection, then the main meal of the day should be given to coincide with the peak activity of that injection, which is usually about 8 hours later. Animals on twice daily injections can be fed more evenly through the day which tends to suit cats much better. Dogs and cats show a very poor response to the tablets used for some types of diabetes in people (the oral hypoglycaemics) and so insulin injections every day are the only real option.
If the amount of insulin given is too low, then your dog or cat will have an excessive thirst and may lose weight. There will also be a significant risk of other problems, such blindness. (Due to diabetic cataracts in dogs, or diabetic retinopathy in cats.) If too much insulin is given, your pet will feel unwell and might well suffer a hypoglycaemic episode (a "hypo") which can cause weakness, staggering and trembling, occasionally leading to fitting, coma and even and death. (If this is happening, it can quickly be rectified by giving a little glucose or honey by mouth.) DO NOT give extra insulin! Hence It is important to have regular blood tests to monitor how well treatment is working. With care it is usually possible to treat dogs or cats very successfully for years. It is also interesting to note that a fair proportion of cats will only suffer from diabetes temporarily, and spontaneous recovery does sometimes happen. Recovered cats no longer require insulin injections, as long as they are maintained on a suitable diet. Caninsulin is not licensed for use in cats, but there are currently no licensed treatments for diabetes in cats. Caninsulin is found by vets to work very well in cats.
Below is the product datasheet. This has been provided by the manufacturer and should always be provided with the medication. Introduction 
Company name: Intervet / Schering-Plough Animal Health
Address: Walton Manor
Walton
Milton Keynes
MK7 7AJ
Telephone: 01908 685685 (Customer Support Centre)
Telephone: 0370 060 3380 (Switchboard)
Fax: 01908 685555
Email: support.uk@intervet.com
Website: www.intervet.co.uk
Presentation
Suspension for injection containing 40 IU per ml of highly purified
porcine insulin, approximately 30% of which is amorphous zinc insulin
and 70% crystalline zinc insulin.
Methyl parahydroxybenzoate. 0.1% w/v is present as a preservative.
Uses
Caninsulin is an intermediate acting insulin product containing porcine
insulin, which is structurally identical to canine insulin. It is
indicated in cases of diabetes mellitus (insulin deficiency) in dogs and
cats, where the required blood levels are achieved by using an
individually adjusted dose of Caninsulin.
Dosage and administration
An insulin-syringe with insulin unit markings for a 40 IU/ml solution must be used.
Caninsulin should be administered once or twice daily, as appropriate,
by subcutaneous injection. Alternate the injection site daily. Invert
the vial a few times before use until a homogenous suspension is
obtained.
A once daily injection is sufficient to reduce the blood glucose
concentration in most diabetic dogs. However, the duration of action may
vary, making it necessary to administer the insulin dose twice daily to
some diabetic dogs.
In diabetic cats, it is necessary to administer Caninsulin twice daily.
The dose depends on the degree of deficit in the animal's own insulin production and is therefore different in each case.
Stabilisation phase
Dog: Insulin therapy is initiated with the starting dose of 0.5 to 1.0 IU/kg bodyweight once daily, rounded down to the lowest entire number of units.
Subsequent adjustment to establish the maintenance dose should be made
by increasing or decreasing the daily dose by approximately 10%
according to the evolution of the diabetes clinical signs and to the
results of serial blood glucose measurement. Alterations in dose should
not normally be made more frequently than every 3 days.
The duration of insulin action as determined by blood glucose curve, may
require treatment to be administered twice daily. In such cases, the
dose per injection must be decreased by 25% so that the total daily dose
is less than doubled. For example for a 10 kg dog receiving 5 IU once daily,
the new dose (rounded down to the nearest whole unit) would be 3 IU per
injection initially. The new doses should be administered at 12-hour
intervals. Further dose adjustments should be made progressively as
previously explained. Following switching to twice daily dosing, it is
recommended that the clinical signs and blood glucose response be
monitored closely.
To achieve a balance between the generation of glucose and the effect of
the product, feeding should be synchronized with the treatment and the
daily ration divided into two meals. The composition and quantity of the
daily food intake should be constant. In dogs treated once daily, the
second meal is usually fed at the time of peak insulin effect. In dogs
treated twice daily, feeding coincides with Caninsulin administration.
Each meal should be fed at the same time each day.
Cat: The initial dose is 1 IU or 2 IU
per injection based on the baseline blood glucose concentration, as
presented in the following table. Cats require twice daily
administration.
Cat blood glucose concentration
| Starting dose per cat
| <20 mmol/l or < 3.6 g/l (<360 mg/dl)
| 1 IU twice daily
| �20 mmol/l or � 3.6 g/l (�360 mg/dl)
| 2 IU twice daily
|
The starting dose should not exceed 2 IU per injection.
The composition and quantity of the daily food intake should be constant.
Subsequent adjustment to establish the maintenance dose should be made
by increasing or decreasing the daily dose according to the results of
serial blood glucose measurement. Alterations in dose should not
normally be made more frequently than every week. Increments of 1 IU per
injection are recommended. Due to the day-to-day variation in the blood
glucose response, and the variations in insulin responsiveness that are
seen with time, larger or more frequent increases in dose are not
recommended.
Maintenance phase in dogs and cats
Once the maintenance dose has been reached and the animal is stabilised,
a long term management program needs to be established. The aim should
be to manage the animal in such a way as to minimize the variations in
its insulin requirement. This includes clinical monitoring to detect
under or over dosage of insulin and adjustment of dose if required.
Careful stabilisation and monitoring will help to limit the chronic
problems associated with diabetes, including cataracts (dogs), fatty
liver (dogs and cats), etc.
Follow up examinations should be performed every 2-4 months (or more
often if there are problems) to monitor the animal�s health, the owner�s
records and biochemical parameters (like blood glucose and/or
fructosamine concentration). Adjustments to the insulin dose should be
made based on interpretation of the clinical signs supported by the
laboratory results.
Somogyi overswing, also called rebound hyperglycaemia, is a response to
an overdose of insulin insufficient to cause, potentially fatal,
hypoglycaemia. As hypoglycaemia begins to develop, a hormonal response
is triggered which results in the release of glucose from hepatic
glycogen stores. This results in rebound hyperglycaemia which may also
manifest as glycosuria for part of the 24-hour cycle. There is a danger
that the Somogyi overswing is interpreted as a requirement for increase
in the insulin dose rather than a decrease.
This can be avoided by basing decisions on serial blood glucose measurements rather than single point measurements.
The ability of pet owners to recognize the signs of hypo- or hyperglycaemia and respond appropriately is very important.
For any information about this veterinary medicinal product, please
contact the local representative of the marketing authorisation holder.
Contra-indications, warnings, etc
The product must not be administered by the intravenous route.
The product is a medium duration insulin and is not intended for the
treatment of animals with severe acute diabetes presenting in a
ketoacidotic state.
Local injection site reactions have been reported rarely in dogs and
very rarely in cats. These reactions are usually mild and reversible. In
very rare cases, allergic reactions to porcine insulin have been
reported.
In the cat diabetic remission is possible.
Before the product is administered owners should be instructed to have a
box of powdered glucose at home. Signs of hunger, increasing anxiety,
unstable locomotion, muscle twitching, stumbling or sinking in the rear
legs and disorientation indicate progression of hypoglycaemia and
requires immediate administration of glucose solution and food to
restore blood glucose levels.
Polyuria, polydipsia and polyphagia in combination in chronic cases with
weight loss, general bad condition, loss of hair or abnormal furry coat
and lethargy are the most common clinical symptoms of hyperglycaemia
and require administration of insulin to restore blood glucose levels to
the normal range.
The use of progestagens (oestrus inhibitors) in patients suffering from
diabetes mellitus should be avoided. Stress and irregular extra exercise
must be avoided. Care must be taken with the use of corticosteroids.
Ovariohysterectomy may have to be considered.
It is important to establish a strict feeding schedule in consultation
with the owner which will include a minimum of fluctuations and changes.
Administration of the product must be carried out by an adult responsible for the welfare of the animal.
The use of the product is not contra-indicated during pregnancy or
lactation but requires close veterinary supervision to account for
changes in metabolic requirements during this period.
Changes in insulin requirements may result from administration of
substances which alter glucose tolerance, such as corticosteroids,
thiazide diuretics, progestogens, amitraz and alpha-2 agonists, such as
medetomidine, dexmedetomidine, xylazine. Monitoring of glucose
concentrations should be used to adjust the dose accordingly. Similarly,
changes in diet or exercise may alter insulin requirements.
User warnings
Accidental self-injection can provoke clinical signs of hypoglycaemia
and there is a low possibility of an allergic reaction. In case of
accidental self-injection seek medical advice immediately and show the
package leaflet to the doctor.
Withdrawal period
Not applicable.
For animal treatment only. Keep out of reach and sight of children.
Pharmaceutical precautions
Before opening, store upright and refrigerated between +2 and 8°C.
Protect from light. Do not freeze. After first opening, either store
refrigerated between +2 and 8°C or not above 25°C.
Following withdrawal of the first dose, use the product within 28 days.
Disposal advice
Dispose of used packaging in the household refuse. Unused product should
be returned to the veterinary surgeon or a local pharmacy.
Legal category
POM-V
Packaging Quantities
Box with 5 or 10 glass vials of 2.5 ml.
Box with 1 glass vial of 10 ml.
Not all pack sizes may be marketed.
Further information
Nil.
Marketing authorisation number
Vm 01708/4244.
|  | Customers who purchased these items also purchased |   | | -
Syringes for use with Caninsulin products
-
Complete with needles
- For use with Caninsulin only
-
Syringes for use with Caninsulin products
-
Complete with needles
- For use with Caninsulin only
Below is the product datasheet. This has been provided by the manufacturer and should always be provided with the medication.
Introduction Company name: Intervet / Schering-Plough Animal Health
Address: Walton Manor
Walton
Milton Keynes
MK7 7AJ
Telephone: 01908 685685 (Customer Support Centre)
Telephone: 0370 060 3380 (Switchboard)
Fax: 01908 685555
Email: support.uk@intervet.com
Website: www.intervet.co.uk
Presentation
Suspension for injection containing 40 IU per ml of highly purified porcine insulin, approximately 30% of which is amorphous zinc insulin and 70% crystalline zinc insulin.
Methyl parahydroxybenzoate. 0.1% w/v is present as a preservative.
Uses
Caninsulin is an intermediate acting insulin product containing porcine insulin, which is structurally identical to canine insulin. It is indicated in cases of diabetes mellitus (insulin deficiency) in dogs and cats, where the required blood levels are achieved by using an individually adjusted dose of Caninsulin.
Dosage and administration
An insulin-syringe with insulin unit markings for a 40 IU/ml solution must be used.
Caninsulin should be administered once or twice daily, as appropriate, by subcutaneous injection. Alternate the injection site daily. Invert the vial a few times before use until a homogenous suspension is obtained.
A once daily injection is sufficient to reduce the blood glucose concentration in most diabetic dogs. However, the duration of action may vary, making it necessary to administer the insulin dose twice daily to some diabetic dogs.
In diabetic cats, it is necessary to administer Caninsulin twice daily.
The dose depends on the degree of deficit in the animal's own insulin production and is therefore different in each case.
Stabilisation phase
Dog: Insulin therapy is initiated with the starting dose of 0.5 to 1.0 IU/kg bodyweight once daily, rounded down to the lowest entire number of units.
Subsequent adjustment to establish the maintenance dose should be made by increasing or decreasing the daily dose by approximately 10% according to the evolution of the diabetes clinical signs and to the results of serial blood glucose measurement. Alterations in dose should not normally be made more frequently than every 3 days.
The duration of insulin action as determined by blood glucose curve, may require treatment to be administered twice daily. In such cases, the dose per injection must be decreased by 25% so that the total daily dose is less than doubled. For example for a 10 kg dog receiving 5 IU once daily, the new dose (rounded down to the nearest whole unit) would be 3 IU per injection initially. The new doses should be administered at 12-hour intervals. Further dose adjustments should be made progressively as previously explained. Following switching to twice daily dosing, it is recommended that the clinical signs and blood glucose response be monitored closely.
To achieve a balance between the generation of glucose and the effect of the product, feeding should be synchronized with the treatment and the daily ration divided into two meals. The composition and quantity of the daily food intake should be constant. In dogs treated once daily, the second meal is usually fed at the time of peak insulin effect. In dogs treated twice daily, feeding coincides with Caninsulin administration. Each meal should be fed at the same time each day.
Cat: The initial dose is 1 IU or 2 IU per injection based on the baseline blood glucose concentration, as presented in the following table. Cats require twice daily administration. | Cat blood glucose concentration | Starting dose per cat | |
<20 mmol/l or < 3.6 g/l (<360 mg/dl) |
1 IU twice daily | |
≥20 mmol/l or ≥ 3.6 g/l (≥360 mg/dl) |
2 IU twice daily |
The starting dose should not exceed 2 IU per injection.
The composition and quantity of the daily food intake should be constant.
Subsequent adjustment to establish the maintenance dose should be made by increasing or decreasing the daily dose according to the results of serial blood glucose measurement. Alterations in dose should not normally be made more frequently than every week. Increments of 1 IU per injection are recommended. Due to the day-to-day variation in the blood glucose response, and the variations in insulin responsiveness that are seen with time, larger or more frequent increases in dose are not recommended.
Maintenance phase in dogs and cats
Once the maintenance dose has been reached and the animal is stabilised, a long term management program needs to be established. The aim should be to manage the animal in such a way as to minimize the variations in its insulin requirement. This includes clinical monitoring to detect under or over dosage of insulin and adjustment of dose if required. Careful stabilisation and monitoring will help to limit the chronic problems associated with diabetes, including cataracts (dogs), fatty liver (dogs and cats), etc.
Follow up examinations should be performed every 2-4 months (or more often if there are problems) to monitor the animal’s health, the owner’s records and biochemical parameters (like blood glucose and/or fructosamine concentration). Adjustments to the insulin dose should be made based on interpretation of the clinical signs supported by the laboratory results.
Somogyi overswing, also called rebound hyperglycaemia, is a response to an overdose of insulin insufficient to cause, potentially fatal, hypoglycaemia. As hypoglycaemia begins to develop, a hormonal response is triggered which results in the release of glucose from hepatic glycogen stores. This results in rebound hyperglycaemia which may also manifest as glycosuria for part of the 24-hour cycle. There is a danger that the Somogyi overswing is interpreted as a requirement for increase in the insulin dose rather than a decrease.
This can be avoided by basing decisions on serial blood glucose measurements rather than single point measurements.
The ability of pet owners to recognize the signs of hypo- or hyperglycaemia and respond appropriately is very important.
For any information about this veterinary medicinal product, please contact the local representative of the marketing authorisation holder.
Contra-indications, warnings, etc
The product must not be administered by the intravenous route.
The product is a medium duration insulin and is not intended for the treatment of animals with severe acute diabetes presenting in a ketoacidotic state.
Local injection site reactions have been reported rarely in dogs and very rarely in cats. These reactions are usually mild and reversible. In very rare cases, allergic reactions to porcine insulin have been reported.
In the cat diabetic remission is possible.
Before the product is administered owners should be instructed to have a box of powdered glucose at home. Signs of hunger, increasing anxiety, unstable locomotion, muscle twitching, stumbling or sinking in the rear legs and disorientation indicate progression of hypoglycaemia and requires immediate administration of glucose solution and food to restore blood glucose levels.
Polyuria, polydipsia and polyphagia in combination in chronic cases with weight loss, general bad condition, loss of hair or abnormal furry coat and lethargy are the most common clinical symptoms of hyperglycaemia and require administration of insulin to restore blood glucose levels to the normal range.
The use of progestagens (oestrus inhibitors) in patients suffering from diabetes mellitus should be avoided. Stress and irregular extra exercise must be avoided. Care must be taken with the use of corticosteroids. Ovariohysterectomy may have to be considered.
It is important to establish a strict feeding schedule in consultation with the owner which will include a minimum of fluctuations and changes.
Administration of the product must be carried out by an adult responsible for the welfare of the animal.
The use of the product is not contra-indicated during pregnancy or lactation but requires close veterinary supervision to account for changes in metabolic requirements during this period.
Changes in insulin requirements may result from administration of substances which alter glucose tolerance, such as corticosteroids, thiazide diuretics, progestogens, amitraz and alpha-2 agonists, such as medetomidine, dexmedetomidine, xylazine. Monitoring of glucose concentrations should be used to adjust the dose accordingly. Similarly, changes in diet or exercise may alter insulin requirements.
User warnings
Accidental self-injection can provoke clinical signs of hypoglycaemia and there is a low possibility of an allergic reaction. In case of accidental self-injection seek medical advice immediately and show the package leaflet to the doctor.
Withdrawal period
Not applicable.
For animal treatment only. Keep out of reach and sight of children.
Pharmaceutical precautions
Before opening, store upright and refrigerated between +2 and 8°C. Protect from light. Do not freeze. After first opening, either store refrigerated between +2 and 8°C or not above 25°C.
Following withdrawal of the first dose, use the product within 28 days.
Disposal advice
Dispose of used packaging in the household refuse. Unused product should be returned to the veterinary surgeon or a local pharmacy.
Legal category
POM-V
Packaging Quantities
Box with 5 or 10 glass vials of 2.5 ml.
Box with 1 glass vial of 10 ml.
Not all pack sizes may be marketed.
Further information
Nil.
Marketing authorisation number
Vm 01708/4244.
Below is the product datasheet. This has been provided by the manufacturer and should always be provided with the medication.
Introduction Company name: Intervet / Schering-Plough Animal Health
Address: Walton Manor
Walton
Milton Keynes
MK7 7AJ
Telephone: 01908 685685 (Customer Support Centre)
Telephone: 0370 060 3380 (Switchboard)
Fax: 01908 685555
Email: support.uk@intervet.com
Website: www.intervet.co.uk
Presentation
Suspension for injection containing 40 IU per ml of highly purified porcine insulin, approximately 30% of which is amorphous zinc insulin and 70% crystalline zinc insulin.
Methyl parahydroxybenzoate. 0.1% w/v is present as a preservative.
Uses
Caninsulin is an intermediate acting insulin product containing porcine insulin, which is structurally identical to canine insulin. It is indicated in cases of diabetes mellitus (insulin deficiency) in dogs and cats, where the required blood levels are achieved by using an individually adjusted dose of Caninsulin.
Dosage and administration
An insulin-syringe with insulin unit markings for a 40 IU/ml solution must be used.
Caninsulin should be administered once or twice daily, as appropriate, by subcutaneous injection. Alternate the injection site daily. Invert the vial a few times before use until a homogenous suspension is obtained.
A once daily injection is sufficient to reduce the blood glucose concentration in most diabetic dogs. However, the duration of action may vary, making it necessary to administer the insulin dose twice daily to some diabetic dogs.
In diabetic cats, it is necessary to administer Caninsulin twice daily.
The dose depends on the degree of deficit in the animal's own insulin production and is therefore different in each case.
Stabilisation phase
Dog: Insulin therapy is initiated with the starting dose of 0.5 to 1.0 IU/kg bodyweight once daily, rounded down to the lowest entire number of units.
Subsequent adjustment to establish the maintenance dose should be made by increasing or decreasing the daily dose by approximately 10% according to the evolution of the diabetes clinical signs and to the results of serial blood glucose measurement. Alterations in dose should not normally be made more frequently than every 3 days.
The duration of insulin action as determined by blood glucose curve, may require treatment to be administered twice daily. In such cases, the dose per injection must be decreased by 25% so that the total daily dose is less than doubled. For example for a 10 kg dog receiving 5 IU once daily, the new dose (rounded down to the nearest whole unit) would be 3 IU per injection initially. The new doses should be administered at 12-hour intervals. Further dose adjustments should be made progressively as previously explained. Following switching to twice daily dosing, it is recommended that the clinical signs and blood glucose response be monitored closely.
To achieve a balance between the generation of glucose and the effect of the product, feeding should be synchronized with the treatment and the daily ration divided into two meals. The composition and quantity of the daily food intake should be constant. In dogs treated once daily, the second meal is usually fed at the time of peak insulin effect. In dogs treated twice daily, feeding coincides with Caninsulin administration. Each meal should be fed at the same time each day.
Cat: The initial dose is 1 IU or 2 IU per injection based on the baseline blood glucose concentration, as presented in the following table. Cats require twice daily administration. | Cat blood glucose concentration | Starting dose per cat | |
<20 mmol/l or < 3.6 g/l (<360 mg/dl) |
1 IU twice daily | |
≥20 mmol/l or ≥ 3.6 g/l (≥360 mg/dl) |
2 IU twice daily |
The starting dose should not exceed 2 IU per injection.
The composition and quantity of the daily food intake should be constant.
Subsequent adjustment to establish the maintenance dose should be made by increasing or decreasing the daily dose according to the results of serial blood glucose measurement. Alterations in dose should not normally be made more frequently than every week. Increments of 1 IU per injection are recommended. Due to the day-to-day variation in the blood glucose response, and the variations in insulin responsiveness that are seen with time, larger or more frequent increases in dose are not recommended.
Maintenance phase in dogs and cats
Once the maintenance dose has been reached and the animal is stabilised, a long term management program needs to be established. The aim should be to manage the animal in such a way as to minimize the variations in its insulin requirement. This includes clinical monitoring to detect under or over dosage of insulin and adjustment of dose if required. Careful stabilisation and monitoring will help to limit the chronic problems associated with diabetes, including cataracts (dogs), fatty liver (dogs and cats), etc.
Follow up examinations should be performed every 2-4 months (or more often if there are problems) to monitor the animal’s health, the owner’s records and biochemical parameters (like blood glucose and/or fructosamine concentration). Adjustments to the insulin dose should be made based on interpretation of the clinical signs supported by the laboratory results.
Somogyi overswing, also called rebound hyperglycaemia, is a response to an overdose of insulin insufficient to cause, potentially fatal, hypoglycaemia. As hypoglycaemia begins to develop, a hormonal response is triggered which results in the release of glucose from hepatic glycogen stores. This results in rebound hyperglycaemia which may also manifest as glycosuria for part of the 24-hour cycle. There is a danger that the Somogyi overswing is interpreted as a requirement for increase in the insulin dose rather than a decrease.
This can be avoided by basing decisions on serial blood glucose measurements rather than single point measurements.
The ability of pet owners to recognize the signs of hypo- or hyperglycaemia and respond appropriately is very important.
For any information about this veterinary medicinal product, please contact the local representative of the marketing authorisation holder.
Contra-indications, warnings, etc
The product must not be administered by the intravenous route.
The product is a medium duration insulin and is not intended for the treatment of animals with severe acute diabetes presenting in a ketoacidotic state.
Local injection site reactions have been reported rarely in dogs and very rarely in cats. These reactions are usually mild and reversible. In very rare cases, allergic reactions to porcine insulin have been reported.
In the cat diabetic remission is possible.
Before the product is administered owners should be instructed to have a box of powdered glucose at home. Signs of hunger, increasing anxiety, unstable locomotion, muscle twitching, stumbling or sinking in the rear legs and disorientation indicate progression of hypoglycaemia and requires immediate administration of glucose solution and food to restore blood glucose levels.
Polyuria, polydipsia and polyphagia in combination in chronic cases with weight loss, general bad condition, loss of hair or abnormal furry coat and lethargy are the most common clinical symptoms of hyperglycaemia and require administration of insulin to restore blood glucose levels to the normal range.
The use of progestagens (oestrus inhibitors) in patients suffering from diabetes mellitus should be avoided. Stress and irregular extra exercise must be avoided. Care must be taken with the use of corticosteroids. Ovariohysterectomy may have to be considered.
It is important to establish a strict feeding schedule in consultation with the owner which will include a minimum of fluctuations and changes.
Administration of the product must be carried out by an adult responsible for the welfare of the animal.
The use of the product is not contra-indicated during pregnancy or lactation but requires close veterinary supervision to account for changes in metabolic requirements during this period.
Changes in insulin requirements may result from administration of substances which alter glucose tolerance, such as corticosteroids, thiazide diuretics, progestogens, amitraz and alpha-2 agonists, such as medetomidine, dexmedetomidine, xylazine. Monitoring of glucose concentrations should be used to adjust the dose accordingly. Similarly, changes in diet or exercise may alter insulin requirements.
User warnings
Accidental self-injection can provoke clinical signs of hypoglycaemia and there is a low possibility of an allergic reaction. In case of accidental self-injection seek medical advice immediately and show the package leaflet to the doctor.
Withdrawal period
Not applicable.
For animal treatment only. Keep out of reach and sight of children.
Pharmaceutical precautions
Before opening, store upright and refrigerated between +2 and 8°C. Protect from light. Do not freeze. After first opening, either store refrigerated between +2 and 8°C or not above 25°C.
Following withdrawal of the first dose, use the product within 28 days.
Disposal advice
Dispose of used packaging in the household refuse. Unused product should be returned to the veterinary surgeon or a local pharmacy.
Legal category
POM-V
Packaging Quantities
Box with 5 or 10 glass vials of 2.5 ml.
Box with 1 glass vial of 10 ml.
Not all pack sizes may be marketed.
Further information
Nil.
Marketing authorisation number
Vm 01708/4244.
Below is the product datasheet. This has been provided by the manufacturer and should always be provided with the medication.
Introduction
Company name: Intervet / Schering-Plough Animal Health
Address: Walton Manor
Walton
Milton Keynes
MK7 7AJ
Telephone: 01908 685685 (Customer Support Centre)
Telephone: 0370 060 3380 (Switchboard)
Fax: 01908 685555
Email: support.uk@intervet.com
Website: www.intervet.co.uk
Presentation
Suspension for injection containing 40 IU per ml of highly purified porcine insulin, approximately 30% of which is amorphous zinc insulin and 70% crystalline zinc insulin.
Methyl parahydroxybenzoate. 0.1% w/v is present as a preservative.
Uses
Caninsulin is an intermediate acting insulin product containing porcine insulin, which is structurally identical to canine insulin. It is indicated in cases of diabetes mellitus (insulin deficiency) in dogs and cats, where the required blood levels are achieved by using an individually adjusted dose of Caninsulin.
Dosage and administration
An insulin-syringe with insulin unit markings for a 40 IU/ml solution must be used.
Caninsulin should be administered once or twice daily, as appropriate, by subcutaneous injection. Alternate the injection site daily. Invert the vial a few times before use until a homogenous suspension is obtained.
A once daily injection is sufficient to reduce the blood glucose concentration in most diabetic dogs. However, the duration of action may vary, making it necessary to administer the insulin dose twice daily to some diabetic dogs.
In diabetic cats, it is necessary to administer Caninsulin twice daily.
The dose depends on the degree of deficit in the animal's own insulin production and is therefore different in each case.
Stabilisation phase
Dog: Insulin therapy is initiated with the starting dose of 0.5 to 1.0 IU/kg bodyweight once daily, rounded down to the lowest entire number of units.
Subsequent adjustment to establish the maintenance dose should be made by increasing or decreasing the daily dose by approximately 10% according to the evolution of the diabetes clinical signs and to the results of serial blood glucose measurement. Alterations in dose should not normally be made more frequently than every 3 days.
The duration of insulin action as determined by blood glucose curve, may require treatment to be administered twice daily. In such cases, the dose per injection must be decreased by 25% so that the total daily dose is less than doubled. For example for a 10 kg dog receiving 5 IU once daily, the new dose (rounded down to the nearest whole unit) would be 3 IU per injection initially. The new doses should be administered at 12-hour intervals. Further dose adjustments should be made progressively as previously explained. Following switching to twice daily dosing, it is recommended that the clinical signs and blood glucose response be monitored closely.
To achieve a balance between the generation of glucose and the effect of the product, feeding should be synchronized with the treatment and the daily ration divided into two meals. The composition and quantity of the daily food intake should be constant. In dogs treated once daily, the second meal is usually fed at the time of peak insulin effect. In dogs treated twice daily, feeding coincides with Caninsulin administration. Each meal should be fed at the same time each day.
Cat: The initial dose is 1 IU or 2 IU per injection based on the baseline blood glucose concentration, as presented in the following table. Cats require twice daily administration. | Cat blood glucose concentration | Starting dose per cat | |
<20 mmol/l or < 3.6 g/l (<360 mg/dl) |
1 IU twice daily | |
≥20 mmol/l or ≥ 3.6 g/l (≥360 mg/dl) |
2 IU twice daily |
The starting dose should not exceed 2 IU per injection.
The composition and quantity of the daily food intake should be constant.
Subsequent adjustment to establish the maintenance dose should be made by increasing or decreasing the daily dose according to the results of serial blood glucose measurement. Alterations in dose should not normally be made more frequently than every week. Increments of 1 IU per injection are recommended. Due to the day-to-day variation in the blood glucose response, and the variations in insulin responsiveness that are seen with time, larger or more frequent increases in dose are not recommended.
Maintenance phase in dogs and cats
Once the maintenance dose has been reached and the animal is stabilised, a long term management program needs to be established. The aim should be to manage the animal in such a way as to minimize the variations in its insulin requirement. This includes clinical monitoring to detect under or over dosage of insulin and adjustment of dose if required. Careful stabilisation and monitoring will help to limit the chronic problems associated with diabetes, including cataracts (dogs), fatty liver (dogs and cats), etc.
Follow up examinations should be performed every 2-4 months (or more often if there are problems) to monitor the animal’s health, the owner’s records and biochemical parameters (like blood glucose and/or fructosamine concentration). Adjustments to the insulin dose should be made based on interpretation of the clinical signs supported by the laboratory results.
Somogyi overswing, also called rebound hyperglycaemia, is a response to an overdose of insulin insufficient to cause, potentially fatal, hypoglycaemia. As hypoglycaemia begins to develop, a hormonal response is triggered which results in the release of glucose from hepatic glycogen stores. This results in rebound hyperglycaemia which may also manifest as glycosuria for part of the 24-hour cycle. There is a danger that the Somogyi overswing is interpreted as a requirement for increase in the insulin dose rather than a decrease.
This can be avoided by basing decisions on serial blood glucose measurements rather than single point measurements.
The ability of pet owners to recognize the signs of hypo- or hyperglycaemia and respond appropriately is very important.
For any information about this veterinary medicinal product, please contact the local representative of the marketing authorisation holder.
Contra-indications, warnings, etc
The product must not be administered by the intravenous route.
The product is a medium duration insulin and is not intended for the treatment of animals with severe acute diabetes presenting in a ketoacidotic state.
Local injection site reactions have been reported rarely in dogs and very rarely in cats. These reactions are usually mild and reversible. In very rare cases, allergic reactions to porcine insulin have been reported.
In the cat diabetic remission is possible.
Before the product is administered owners should be instructed to have a box of powdered glucose at home. Signs of hunger, increasing anxiety, unstable locomotion, muscle twitching, stumbling or sinking in the rear legs and disorientation indicate progression of hypoglycaemia and requires immediate administration of glucose solution and food to restore blood glucose levels.
Polyuria, polydipsia and polyphagia in combination in chronic cases with weight loss, general bad condition, loss of hair or abnormal furry coat and lethargy are the most common clinical symptoms of hyperglycaemia and require administration of insulin to restore blood glucose levels to the normal range.
The use of progestagens (oestrus inhibitors) in patients suffering from diabetes mellitus should be avoided. Stress and irregular extra exercise must be avoided. Care must be taken with the use of corticosteroids. Ovariohysterectomy may have to be considered.
It is important to establish a strict feeding schedule in consultation with the owner which will include a minimum of fluctuations and changes.
Administration of the product must be carried out by an adult responsible for the welfare of the animal.
The use of the product is not contra-indicated during pregnancy or lactation but requires close veterinary supervision to account for changes in metabolic requirements during this period.
Changes in insulin requirements may result from administration of substances which alter glucose tolerance, such as corticosteroids, thiazide diuretics, progestogens, amitraz and alpha-2 agonists, such as medetomidine, dexmedetomidine, xylazine. Monitoring of glucose concentrations should be used to adjust the dose accordingly. Similarly, changes in diet or exercise may alter insulin requirements.
User warnings
Accidental self-injection can provoke clinical signs of hypoglycaemia and there is a low possibility of an allergic reaction. In case of accidental self-injection seek medical advice immediately and show the package leaflet to the doctor.
Withdrawal period
Not applicable.
For animal treatment only. Keep out of reach and sight of children.
Pharmaceutical precautions
Before opening, store upright and refrigerated between +2 and 8°C. Protect from light. Do not freeze. After first opening, either store refrigerated between +2 and 8°C or not above 25°C.
Following withdrawal of the first dose, use the product within 28 days.
Disposal advice
Dispose of used packaging in the household refuse. Unused product should be returned to the veterinary surgeon or a local pharmacy.
Legal category
POM-V
Packaging Quantities
Box with 5 or 10 glass vials of 2.5 ml.
Box with 1 glass vial of 10 ml.
Not all pack sizes may be marketed.
Further information
Nil.
Marketing authorisation number
Vm 01708/4244.
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