Abstracts

Davison LJ, Herrtage ME, Catchpole B. (2005)
Study of 253 dogs in the United Kingdom with diabetes mellitus.
Veterinary Record 156(15):467-471.

Abstract:
Clinical information and blood samples were collected from 253 dogs with naturally occurring diabetes mellitus. Over half of them were labrador retrievers, collies, Yorkshire terriers or crossbred dogs, and approximately 80 per cent of them were diagnosed between the ages of five and 12 years. The majority of the dogs were receiving insulin therapy once a day, but in the dogs receiving insulin injections twice a day there was a trend for lower serum fructosamine concentrations, suggesting better glycaemic control. The proportion of female dogs with diabetes was lower than in previous surveys. The disease was diagnosed more commonly in the winter months, a seasonal pattern also observed in human beings with diabetes, suggesting that similar environmental factors might be involved in the disease.

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Davison LJ, Ristic JME, Herrtage ME, Ramsey IK and Catchpole B.(2002)
Anti-Insulin Antibodies in Diabetic Dogs Treated With Two Different Insulin Preparations.
Proceedings 12th ECVIM-CA/ESVIM Congress 19-21 September 2002 Munich Germany, J vet Int Med 16(5):636-637

Abstract:

Anti-insulin antibodies (AIA) have been documented in diabetic dogs after insulin therapy. Their clinical significance is unclear. The aim of this study was to measure AIA in diabetic dogs treated with heterologous bovine insulin (Insuvet®lente, Schering Plough) or a homologous porcine insulin preparation (Caninsulin®, Intervet).

No difference in AIA concentration was identified between non-diabetic and Caninsulin® treated diabetic dogs.

In the Insuvet® treated group, however, antibodies to bovine and porcine insulin were detected in 53 of 90 cases (limit of detection of assay >0.3µg/ml). This was different to the control and Caninsulin® treated groups in which 5 of 90 and 12 of 90 respectively were positive for anti-bovine and anti-porcine insulin antibodies (p<0.01).

This study suggests that Insuvet® is more immunogenic than Caninsulin in the treatment of diabetic dogs.

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Graham PA, Nash AS and McKellar QA. (1997)
Pharmacokinetics of a porcine insulin zinc suspension in diabetic dogs.
Journal of Small Animal Practice 38(10):434-8.

Abstract:

Ten dogs with naturally occurring diabetes mellitus were injected with a highly purified porcine insulin zinc suspension at a dose according to their expected requirement. Plasma insulin and glucose concentrations were measured at two-hourly intervals over 24 hours following injection.

There were either one or two peaks in plasma insulin concentration: one at about 4 hours (mean 4.3 +/-1.3 [SD]) and another at about 11 hours (mean 11 +/- 1.85) after the injection. The second insulin peak was seen in only eight dogs. Persistence of elevated plasma insulin concentrations ranged from 14 to 24 hours (mean 17.4 +/- 3.65).

These results compare favourably with those published for other intermediate-acting insulin preparations used to treat canine diabetes mellitus and suggest that this preparation has useful properties for the successful management of many canine diabetics.

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Horn B and Mitten RW(2000)
Evaluation of an insulin zinc suspension for control of naturally occurring diabetes mellitus in dogs.
Australian Veterinary Journal 78(12):831-4.

Abstract:

A trial to evaluate duration of action of Caninsulin (an insulin zinc
suspension) in spontaneously occurring cases of canine diabetes mellitus and its suitability for once daily administration.

Eight client-owned dogs with diabetes mellitus were included in a prospective pilot study. All dogs had been treated with Caninsulin for a minimum of 2 months and were considered on clinical grounds to be adequately stabilised.

The dogs were hospitalised for a 24 hour period. Blood was collected every 2 hours via indwelling venous catheters for blood glucose determination.

Caninsulin administration once daily failed tomaintain glycaemic control for greater than 13 h in five of eight dogs. Acceptable blood glucose concentrations were maintained for 22 h and greater than 24 h in two others.
The results from one of the dogs were not used as the animal became distressed during hospitalisation.

It was concluded that most diabetic dogs may require twice daily administration of Caninsulin for satisfactory glycaemic control, but once daily administration may be adequate in some animals.

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McManus K and Playford M(2001)
Evaluation of an insulin-zinc suspension for control of naturally occurring diabetes mellitus in dogs.

Australian Veterinary Journal 78(12):831-4.

Abstract:

Correspondence written in reference to the clinical paper published in the December 2000 issue of the Australian Veterinary Journal on the use of insulin-zinc suspension for diabetes mellitus in dogs (Horn B and Mitten RW Evaluation of an insulin zinc suspension for control of naturally occurring diabetes mellitus in dogs. Australian Veterinary Journal 78(12):831-4.)

In the authors' experience, about 70% of dogs are stabilised and clinical signs eliminated on once-daily treatment with Caninsulin. They suggest that other factors should be taken into consideration when evaluating the 2000 clinical trial, such as patient selection criteria and evaluating the resolution of clinical signs on once daily Caninsulin treatment.

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Horspool LJI, Martin GJW and Rand JS(1999)
The efficacy of 40 iu/ml porcine lente insulin for the treatment of feline diabetes mellitus.
9th Annual Congress of the European Society of Veterinary Internal Medicine 14-16 October 1999, Perugia, Italy:186

Abstract:

Caninsulin®, a veterinary preparation of porcine lente insulin, is used commonly for the treatment of diabetes mellitus in dogs and cats in many countries. There has been a detailed study of its efficacy in the dog, but there are no detailed reports of the use of porcine lente insulin in cats. The aim of this study was to evaluate the efficacy of Caninsulin® in 25 cats with naturally-occurring diabetes mellitus over a treatment period of 1 year.

Cases were recruited from referrals to The University of Queensland Companion Animal Hospital. Initially, cats were stabilized with insulin in one week. Re-evaluation was performed at 2, 4, 8, 12, 26, and 52 weeks after initial discharge, and as required. Insulin dosage was adjusted on the basis of 2 hourly serial blood glucose measurements over 12 or 24 hours. Clinical parameters monitored included bodyweight, condition score, and food and water intake. Clinicopathological parameters monitored were mean blood glucose, J-index of glycemia, serum fructosamine, beta-hydroxybutyrate, cholesterol, triglycerides blanked for free glycerol, urine glucose, urine ketones, and urine specific gravity.

All cats showed marked clinical improvement following treatment. Insulin treatment was discontinued in 7/25 cats which achieved diabetic remission during the study. Three cats died or were euthanased during the study (2 non-diabetic causes, 1 unknown). Clinical and clinicopathological parameters improved during the study. All cats required twice daily administration of Caninsulin®, at a mean dose rate of approximately 0.6 IU/kg twice daily, (range 0.1-1.9 IU/kg twice daily). The peak of action of Caninsulin® on blood glucose occurred at around 5 hours post-injection.

Twice daily injection of Caninsulin® injection is an effective and safe treatment for feline diabetes mellitus. Dose rates should be titrated on an individual cat basis, depending on serial blood glucose measurements.

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Martin GJ and Rand JS(1999)
The pharmacokinetics of 40 IU/ml porcine lente insulin in diabetic cats
24th World Small Animal Veterinary Congress 23-26 September 1999, Lyon, France

Abstract

Introduction

The present study was carried out to calculate the pharmacokinetics of 40 IU/ml porcine lente insulin in diabetic cats.

Materials & Methods

The plasma disposition of 40 IU/ml porcine lente insulin (Caninsulin®, Intervet) was determined 3 days (n=10) after stabilisation commenced, and after 4 weeks (n=4) or 8 weeks (n=6) of treatment. Caninsulin® was administered subcutaneously at the dose rate established for each cat using serial blood glucose curves. Plasma insulin concentrations were determined using a commercially available radioimmunoassay. Pharmacokinetic parameters were calculated using non-compartmental methods.

Results

The peak plasma concentrations of Caninsulin® occurred at 1.7±0.2 hours (mean±SEM). The area under the plasma concentration versus time curve (AUC) was 257±34 µU.h/ml and the area under the first moment curve (AUMC) 982±173 µU.h2/ml. The mean residence time (MRT), a quantitative estimate of the persistence of Caninsulin® in each cat was 3.7±0.3 hours. The mean absorption time (MAT), calculated by comparing the MRT following the intravenous administration of porcine regular insulin and the MRT of Caninsulin®, was 2.8±0.3 hours. There were no statistically significant differences between the pharmacokinetic parameters calculated on Day 3 (n=10) and Weeks 4 and 8 (n=10). The lowest blood glucose concentration occurred at 4.0±0.4 hours after Caninsulin® administration. Insulin concentrations returned to baseline after 8.8±0.7 hours. The duration of action of Caninsulin® was 10.5±0.3 hours in cats. The bioavailability of Caninsulin®, compared with intravenously administered porcine regular insulin, was 46±6%.

Discussion/Conclusion

The relatively short duration of action of Caninsulin® means that it should be administered twice daily to diabetic cats.

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Martin GJ and Rand JS(2000)
The efficacy Of 40 iu/ml porcine lente insulin for the treatment of feline diabetes mellitus.
Journal of Veterinary Internal Medicine 14(2):233

Abstract

Caninsulin®, a veterinary preparation of porcine lente insulin, is used commonly for the treatment of diabetes mellitus in dogs and cats in many countries. There has been a detailed study of its efficacy in the dog, but there are no detailed reports of the use of porcine lente insulin in cats. The aim of this study was to evaluate the efficacy of Caninsulin® in 25 cats with naturally-occurring diabetes mellitus over a treatment period of 1 year.

Cases were recruited from referrals to The University of Queensland Companion Animal Hospital. Initially, cats were stabilized with insulin in one week. Re-evaluation was performed at 2, 4, 8, 12, 26, and 52 weeks after initial discharge, and as required. Insulin dosage was adjusted on the basis of 2 hourly serial blood glucose measurements over 12 or 24 hours. Clinical parameters monitored included bodyweight, condition score, and food and water intake. Clinicopathological parameters monitored were mean blood glucose, J-index of glycemia, serum fructosamine, beta-hydroxybutyrate, cholesterol, triglycerides blanked for free glycerol, urine glucose, urine ketones, and urine specific gravity.

All cats showed marked clinical improvement following treatment. Insulin treatment was discontinued in 7/25 cats which achieved diabetic remission during the study. Three cats died or were euthanased during the study (2 non-diabetic causes, 1 unknown). Clinical and clinicopathological parameters improved during the study. All cats required twice daily administration of Caninsulin®, at a mean dose rate of approximately 0.6 IU/kg twice daily, (range 0.1-1.9 IU/kg twice daily). The peak of action of Caninsulin® on blood glucose occurred at around 5 hours post-injection.

Twice daily injection of Caninsulin® injection is an effective and safe treatment for feline diabetes mellitus. Dose rates should be titrated on an individual cat basis, depending on serial blood glucose measurements.

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Martin GJ and Rand JS(2001)
Pharmacology of a 40 IU/ml porcine lente insulin preparation in diabetic cats: findings during the first week and after 5 or 9 weeks of therapy.
Journal of Feline Medicine and Surgery 3(1):23-30

Abstract

The aim of this study was to measure the pharmacokinetics and pharmacodynamics of subcutaneously injected 40 IU/ml porcine lente insulin preparation (Caninsulin, Intervet BV, The Netherlands) in diabetic cats. The pharmacological properties of the insulin in poorly controlled or untreated cats were compared with those after several weeks of treatment, to determine if improved diabetic stability altered the pharmacology of this insulin. In addition, the pharmacological properties of intravenously injected 100 IU/ml regular porcine insulin (Actrapid MC, NovoNordisk, Denmark) were measured.

Serial plasma samples were collected after subcutaneous injection of porcine lente insulin from 25 diabetic cats in the first week of admission to a 12-month diabetic treatment trial. Samples were also collected after 4 or 8 weeks of treatment, in those cats which had not achieved diabetic remission by this time. At this time, serial plasma samples were also collected from these cats after intravenous injection of porcine regular insulin. Plasma samples were assayed for glucose, anti-insulin antibodies were extracted using a PEG technique, and samples were assayed for insulin using an RIA kit with low sensitivity for endogenous feline insulin, but high sensitivity for exogenous porcine insulin in feline plasma.

Caninsulin injected subcutaneously in diabetic cats led to a peak insulin concentration in plasma after 1.7+/-0.1 h, and a nadir of blood glucose after 4.1+/-0.3 h. Insulin and glucose concentrations returned to baseline within 12 h. There was no significant change in the onset or duration of Caninsulin action between the first week of treatment and 5 or 9 weeks of treatment. Actrapid MC injected intravenously had a peak insulin at 0.36+/-0.03 h, and a nadir of blood glucose at 1.9+/-0.3 h. Insulin and glucose returned to baseline within 6 h.

It was concluded that Caninsulin injected subcutaneously has suitable pharmacological properties for the twice-daily treatment of diabetes mellitus in cats. In addition, Actrapid MC insulin injected intravenously has suitable pharmacological properties for injection every 4-6 h in diabetic cats.

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Michiels L.on behalf of the European Feline Diabetes Study Group (2000)
A clinical study of the efficacy and safety of Caninsulin in cats with uncomplicated diabetes mellitus: Preliminary results
In, Proceedings of the European Society of Veterinary Internal Medicine 10th Congress 14-16 September 2000, Neuchatel, Switzerland:pp. 32

Abstract

non-blinded, multicentre, open field trial has been conducted to assess the efficacy and safety of Caninsulin® (Intervet International, The Netherlands) in cats suffering from uncomplicated diabetes mellitus (UDM).

Cats with glucosuria, pre-treatment blood glucose concentration greater than 15mmol/l and fructosamine concentration greater than 380 mmol/l were included. Cats with suspected pancreatitis, endocrine disease, major organ failure or infection, or that had recently been treated with corticosteroids or progestagens were excluded. Cats were clinically evaluated at week 0 (Days 0-2), and at weeks 1, 3, 6, 9 and 12 (Day 1). Haematology, clinical chemistry (including serum thyroxine, fructosamine, triglyceride and cholesterol concentrations), urinalysis and urinary bacterial culture were obtained at admission. Fructosamine, total protein, albumin, lipase, triglycerides and cholesterol were measured at each recheck. A 12-hour glucose curve was performed at each examination. Caninsulin® was administered at a dose not greater than 0.5 IU/kg bodyweight twice daily with a maximum starting dose of 2 IU per cat in the first 3 weeks. Dosage adjustments were standardised using an algorithm. A stable diabetic cat was defined as healthy and interactive at home, with a normal appetite, stable body weight, water intake <100 ml/kg/day, blood glucose concentration of 4.5-26 mmol/l, fructosamine <500 mmol/L, with or without glucosuria, and without ketonuria.

Fifteen cats achieved the initial 12 weeks period. One cat ceased to require insulin after 9 weeks of treatment, whilst 14 cases were considered successfully treated although only 3 cats were classified as stable, according to the definition of the protocol. All cats were healthy and interactive at home. Twelve cats were represented with a normal appetite and stable body weight. Nine cats had a water intake <100 ml/kg/day, 9 had a blood glucose concentration of 4.5-26 mmol/l and four had fructosamine of <500 mmol/L. Glucosuria persisted and ketonuria was absent in all cases.

Although glucosuria and elevated fructosamine persisted in successfully treated cats, it appears that Caninsulin® is a safe and efficacious treatment for UDM in cats.

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Michiels L.on behalf of the European Feline Diabetes Study Group (2002)
The efficacy and safety of Caninsulin in cats with uncomplicated diabetes mellitus: Preliminary results
Journal of Small Animal Practice 43:xi

Abstract

A non-blinded, multicentre, open field trial was conducted to assess the efficacy and safety of porcine lente insulin in cats with uncomplicated diabetes mellitus (UDM) (no significant intercurrent disease). Cats (n=34) with glucosuria, pre-treatment blood glucose over 15mmol/litre, and fructosamine concentrations over 380 micromol/litre were evaluated prior to (week 0, days 0 to 2), and after (weeks 1, 3, 6, 9 and 12 to 16, day 1) treatment with porcine lente insulin (Caninsulin®; Intervet International). Insulin was administered at a dose rate of 0.5 or less IU/kg bodyweight twice daily (=2 IU/dose/cat in weeks 1 to 3). Dosage adjustments were made using an algorithm. Haematology, total thyroxine, clinical chemistry (including total protein, albumin, lipase, fructosamine, triglyceride and cholesterol concentrations), urinalysis, and urine bacterial culture were carried out in week 0. Clinical chemistry and a 12-hour glucose curve were performed at each examination. Diabetic clinical remission occurred in 5 cats during the initial 12 to 16 weeks. After the initial 12 to 16 weeks, 90 per cent of the cats had a water intake of less than 100 ml/kg/day, 83 per cent had a normal appetite and stable body weight, 55 per cent had blood glucose concentrations between 4.5 and 26 mmol/litre, and 37 per cent had fructosamine concentrations less than 500 micromol/litre. Not unexpectedly, glucosuria was present in a number of cats. No significant adverse effects occurred during treatment. Caninsulin appears to be both effective and safe in the treatment of UDM in cats.

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Martin GJ and Rand JS. (2007)
Control of diabetes mellitus in cats with porcine insulin zinc suspension.
Veterinary Record 161:88-94.

Abstract:
The required dose rate of porcine insulin zinc suspension to control the signs of diabetes mellitus in 25 cats was assessed, and their response to insulin treatment was investigated over 12 months. The cats required a median dose of 0·5 iu/kg bodyweight twice a day, and only two of the cats required doses higher than 1·0 iu/kg twice a day. Their lowest blood glucose concentration was on average significantly higher during the night than during the day. Seven of the cats went into diabetic remission during the study, and the control of the clinical signs in the others was either excellent or good by the end of the study.

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Martin GJ and Rand JS. (2007)
Comparisons of different measurements for monitoring diabetic cats treated with porcine insulin zinc suspension.
Veterinary Record 161:52-58.

Abstract:
Clinical measurements, including a subjective clinical score and water intake, and biochemical measurements, including blood glucose, fructosamine, beta-hydroxybutyrate, cholesterol, triglycerides, triglycerides corrected for free glycerol, glycerol and urine glucose were compared for monitoring diabetic cats treated with porcine insulin zinc suspension. The data were grouped by subjective clinical score and the sensitivity of each measurement in differentiating the grouped data was assessed. None of the measurements was able to differentiate between the ranked clinical score groups, but two-hourly measurements of blood glucose over 24 hours, water intake, urine glucose and fructosamine were useful in differentiating cats that subjectively had the water and food consumption and general appearance of a normal cat from cats in which the signs of diabetes were less well controlled. Measurements of plasma lipids were not well correlated with the other measurements. The measurements that were most closely correlated with apparently perfect clinical control were the J index, water intake and maximum and mean blood glucose concentrations. In practice, water intake, maximum blood glucose concentration, mean blood glucose concentration and urine glucose would be the most useful indicators of clinical control in diabetic cats treated with porcine insulin zinc suspension.

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Martin GJ, Rand JS and Hickey SA (2006)
Separation of serum glycated proteins by agarose gel electrophoresis and nitroblue tetrazolium staining in diabetic and normal cats
Veterinary Clinical Pathology 35(3):307-310

Abstract:

Background: The total glycated protein (fructosamine) concentration in serum consists mainly of glycated albumin and lipoproteins. Measurement of fructosamine is used to diagnose and monitor diabetes mellitus in cats.

Objective: The aims of this study were to measure glycated proteins in diabetic and healthy (nondiabetic) cats using a semiquantitative technique and to determine whether measurement of any of the fractions of glycated protein could be potentially advantageous for the diagnosis and monitoring of diabetic cats.

Methods: Serum samples from 6 cats with diabetes mellitus and 10 clinically healthy adult cats were assayed for total glycated protein using a nitroblue tetrazolium (NBT) fructosamine assay. Serum proteins were separated by agarose gel electrophoresis and stained with NBT to identify individual glycated proteins within the bands. Gels were scanned by densitometry at 525 nm and the glycated protein content was calculated with reference to the total glycated protein content of the sample.

Results: Diabetic cats with increased total fructosamine concentrations had higher concentrations of glycated albumin and glycated a- and b-lipoproteins compared with healthy cats. The concentration of glycated proteins in each of the fractions had a positive linear association with the total glycated protein content of serum, but there was large variation in the relative contributions of the 3 protein fractions to the total glycated protein concentration.

Conclusions: Based on the results of this study, measurement of individual glycated fractions does not seem to offer any potential diagnostic advantage over measurement of total glycated protein (fructosamine) concentration alone. In some diabetic and healthy cats, glycated lipoproteins formed the major part of the total glycated protein, whereas in other cats albumin was the major contributor.

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Reusch CE. (2005)
Monitoring and treatment of the diabetic cat Proceedings of ECVIM-CA 15th Annual Congress, 1-3 September 2005, Glasgow, Scotland. pp. 125-127.

Abstract:
Administration of insulin and dietary management are still the mainstays of treatment in diabetic cats. Good glycaemic control reverses the effect of high glucose on bets cells (glucose toxicity) and increases the chance of remission of diabetes. We usually start with a porcine zinc insulin of intermediate action (Caninsulin) twice daily. Time until adequate regulation is achieved is somewhere between 1 and 3 months. In a multicenter study 72% of the cats treated with Caninsulin were considered well regulated and 17% had gone into diabetic remission at the end of a study period of 4 months. Recently, insulin analogues have been developed in order to improve pharmacodynamic properties, e.g., absorption. In humans insulin glargine, a long acting synthetic insulin analogue is thought to be a peakless insulin with a long duration of action (> 24 hours). Glargine seems to have a shorter duration of action in cats than in humans and BID application is usually required. Insulin glargine does not seem to have obvious advantages over Caninsulin and is therefore not used as first line insulin in our hospital. Several studies show that using low-carbohydrate-high-protein diet results in better clinical control and increased rates of diabetic remission. In previous years our remission rate was 15-25% by using a high fibre diet. We recently were able to increase the percentage of remission to 45-50 by switching to a low carbohydrate-high-protein-diet.

Diabetes mellitus is a chronic disease, that requires continuing medical care and owner education to prevent acute complications and to enable adequate life quality. Until recently long-term management of diabetic cats relied on the owners observation of clinical signs and on periodic evaluation by a veterinarian. Cats which eat and drink normal and do not lose weight are usually well regulated. Blood glucose concentrations in well regulated cats range mostly between 15 mmol/l (prior to insulin) and 5 mmol/l (nadir), fructosamine then is either within the normal range or moderately to slightly elevated (up to 450 micromol/l). Serial blood glucose curves (BGCs) are necessary to assess insulin efficacy, glucose nadir, time of peak insulin effect, duration of the insulin effect, degree of fluctuations in blood glucose (BG) concentrations and to recognise the Somogyi phenomenon. Until recently, the vast majority of BGCs were performed in the hospital because most pet owners are unable to collect blood samples by venipuncture. In-hospital BGCs can be difficult to interpret or may even be useless. Measurement of capillary blood glucose (home monitoring, HM) has been part of the routine protocol for long-term management for diabetic cats in our clinic since 1999. Cat owners are introduced to HM about 3 weeks after starting therapy. About 70% of our cat owners are willing and able to perform HM. When blood glucose curves generated at home and in the hospital were compared with regard to treatment decisions, in about 60% of cases treatment decisions would have been the same. In 40% decisions would have been different, in some cases even completely contrary. We usually base our treatment decisions on the curves generated at home. The success of HM greatly depends on careful preparation and instruction of the owners. One of the major advantages of HM is that it enables frequent generation of BGC. In complicated cases, more than one curve can therefore be performed at home before a treatment decision is made.

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Monroe W, Laxton DJ and Robertson JL.(2001)
Efficacy and Safety of Caninsulin®, Purified Porcine Insulin for Treating Diabetic Dogs
19th ACVIM Forum Denver, Colorado, 23-26 May 200: Journal of Veterinary Internal Medicine 15:pp. 309 (#150)

Abstract

The purpose of this study was to determine the efficacy and safety of CANINSULIN®, a purified porcine insulin produced by Intervet Inc. for treating diabetic dogs.

Fifty-three dogs were treated with CANINSULIN® for 60 days after an initial dose determination period. TO evaluate efficacy, the study population mean blood glucose concentration from 12 hour glucose curves (glucose determined every 2 hours) performed at time 0 (prior to beginning insulin therapy), time 1 (end of dose determination period), time 2 (30 days after time1) and time 3 (60 days after time 1) were determined. The mean blood glucose nadir at times 0, 1, 2, and 3 was also evaluated. Clinicians judged if a patient's hyperglycaemia was under adequate glycaemic control based on improvement in clinical signs of diabetes (PU, PD, and ketonuria) and evaluation of 12-hour blood glucose curves determined at times 1, 2, and 3 compared to study time 0. Safety was evaluated based on serial histories, physical examinations, CBCs, serum chemistry profiles and urinalyses.

The mean 12 hour blood glucose concentration at time 0 was 370 mg/dl. This decreased to 151 mg/dl, 181 mg/dl, and 183 mg/dl at times 1, 2, and 3. Mean blood glucose nadir concentration was 307 mg/dl at time 0. This decreased to 92 mg/dl, 120 mg/dl, and 119 mg/dl at times 1, 2 , and 3. Compared to the time 0 incidence, polyuria had resolved in 96% (47/49), 82% (40/49), and 94% (46/49) of patients, and polydipsia had resolved in 96% (48/50), 86% (43/50), and 96% (48/50) of patients at times 1, 2, and 3.

Mean 12 hour blood glucose concentration and mean blood glucose nadir were substantially reduced, with most patient's judged to be under adequate clinical control at times 1, 2, and 3 compared to time 0. No unexpected side effects from treatment were observed.

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Monroe WE, Laxton DJ, Fallin EA and others(2005)
Efficacy and Safety of a Purified Porcine Insulin Zinc Suspension for Managing Diabetes Mellitus in Dogs.
19th ACVIM Forum Denver, Colorado, 23-26 May 200: Journal of Veterinary J Vet Intern Med 19:675-682.

Abstract

The objective of this study was to evaluate the safety and efficacy of a purified porcine insulin zinc suspension for treating dogs with uncomplicated diabetes mellitus.

Fifty-three dogs were treated for 60 days after an initial dose determination period. The means of the blood glucose concentrations during 12-hour glucose curves and the means of the blood glucose nadir concentrations during 12-hour glucose curves for all dogs were determined before beginning insulin therapy (time 0), at the end of the dose determination period (time 1), 30 days after time 1 (time 2), and 60 days after time 1 (time 3). Presence of polyuria, polydipsia, and ketonuria was determined at each time point. Adequacy of control of hyperglycemia was based on 12-hour blood glucose curves and improvement in clinical variables (results of physical examinations, historic information, polyuria, polydipsia, and ketonuria). Safety was evaluated by questionnaire, performance of physical examination, CBC, serum chemistry profile, and urinalysis. The means of the blood glucose concentrations during 12-hour glucose curves and the means of the blood glucose nadir concentrations during 12-hour glucose curves for all dogs at times 1, 2, and 3 were significantly lower compared with time 0 (P , .0001). There was a reduction in the proportion of dogs with polyuria, polydipsia, and ketonuria of 82, 86, and 80%, respectively. All of the dogs had adequate glycemic control at time 1, 66% at time 2, and 75% at time 3. At time 3, 66% of dogs required insulin injections q12h. Other than hypoglycemia, there were no important adverse effects of insulin administration. The insulin was safe and efficacious for reducing blood glucose and clinical signs in dogs with diabetes mellitus.

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Wess G, Reusch C

Capillary blood sampling from the ear of dogs and cats and use of portable meters to measure glucose concentration.

J Small Anim Pract. 2000 Feb;41(2):60-6

Abstract

Two new methods for collection of capillary blood from the ear of dogs and cats for the measurement of blood glucose concentration using portable blood glucose meters (PBGMs) are described. The first method uses a lancing device after pre-warming the ear, while the second employs a vacuum lancing device. Both methods generated blood drops of adequate size, although the latter method was faster and easier to perform. Accuracy of the two PBGMs was evaluated clinically and statistically. Although assessment of statistical accuracy revealed differences between the PBGMs and the reference method, all of the PBGM readings were within clinically acceptable ranges. Measurement of capillary blood glucose concentration is easy to perform, inexpensive and fast. It may be used by owners to determine blood glucose concentrations at home, and could serve as a new tool for monitoring diabetic dogs and cats.

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Casella M, Wess G, Reusch CE.

Measurement of capillary blood glucose concentrations by pet owners: a new tool in the management of diabetes mellitus. J Am Anim Hosp Assoc. 2002 May-Jun;38(3):239-45

Abstract

Recently a new method for capillary blood sampling from the ears of dogs and cats was described, which allows the measurement of glucose concentration by means of portable glucose meters. The authors of this report evaluated the suitability of this method for use by pet owners and the potential technical problems. The owners of seven healthy dogs and seven healthy cats were asked to perform two glucose curves (measuring blood glucose concentration every 2 hours for a total of 12 hours). All dog owners and three cat owners were able to perform a reliable blood glucose curve. The most frequently encountered problems were inadequate formation of a blood drop due to excessive digital pressure on the pinna, repeatedly depressing the plunger of the lancet device instead of allowing the negative pressure to slowly build up, and failure to fill the test strip up to the mark. The authors conclude that these steps of the procedure need to be stressed during technique demonstration and that home monitoring of blood glucose concentrations may serve as a new tool in the management of diabetic dogs and cats.

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Panciera DL, Thomas CB, Eicker SW, Atkins CE
Epizootiologic patterns of diabetes mellitus in cats: 333 cases (1980-1986).

J Am Vet Med Assoc. 1990 Dec 1;197(11):1504-8

Abstract:

Medical records from 333 cats with diabetes mellitus were studied retrospectively, using epidemiologic methods to determine the incidence of and risk factors for diabetes mellitus in this species. Abstracts were derived, using the Veterinary Medical Data Program with its 17 participating academic institutions in the United States and Canada. A reference population of 135,651 cats was derived from the same hospital population and time span (July 1980 to June 1986). The incidence of diabetes mellitus in cats was determined to be 2.45 cases/1,000 cat-years-of-risk during the 6-year study period. Breed had no detectable effect on risk for diabetes mellitus. In contrast, body weight, age, gender, and neutering had a significant (P less than or equal to 0.01) effect. Body weight of cats was categorized as being less than or greater than or equal to 6.8 kg. The higher body weight, probably indicating obesity, contributed a 2.2-fold increase in risk, even after adjustment for age and gender (adjusted odds ratio). The etiologic fraction for high body weight was 3.8%, suggesting that an estimated 3.8% of cases of diabetes mellitus was attributable to this factor alone. Over 50% of diabetic cats were greater than 10 years old, and the etiologic fraction for age greater than 7 years alone was 73.5%. Age was a significant (P less than 0.001) and the most important single risk factor for development of the disease in cats, with adjusted odds ratios of 8.3 and 14.4 for age 7 to 10 years and greater than 10 years, respectively.

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