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Glargine Insulin For Cats

Tilly's Diabetes Homepage

Tilly's Diabetes Homepage

Home Story 6 important factors Blood glucose values The future? Links Guestbook About this site Disclaimer • see your vet and get his or her approval of this protocol before you start!!! • talk to your vet regularly about your cat's progress • see your vet immediately if your cat develops additional problems (e.g. ketones, hypoglycemia, vomiting, fever, bladder infections, etc) Read this first • this protocol was developed by lay people, including myself, who are members of the German Diabetes-Katzen Forum. It has since been published in the Journal of Feline Medicine and Surgery. • the majority of cats do very well on this protocol, some cats do not (generally these are hard-to-regulate cats) • it is more time-consuming than most other protocols, but still definitely doable if you work a regular full-time work week • it is more expensive than most other protocols, but costs can be reduced by e.g. buying glucose test strips from online pharmacies or reputable sellers at eBay • members of the German Diabetes-Katzen Forum buy 3 ml Lantus/Levemir cartridges, refrigerate them after opening and routinely use them for 6 months or more - when refrigerated, opened cartridges of these insulins are extraordinarily stable • you will need to test the blood glucose levels of your cat multiple times per day • you will need to know about hypoglycemia and be prepared to deal with it • you will need to test for ketones regularly to start with and know about ketoacidosis, but be aware that ketones don't occur once a cat is (and remains) properly regulated • you will need a brand-name glucometer made for human diabetics that measures whole blood (not plasma-equivalent) and which uses 0.6 µL of blood per test or less • you will need to use syringes which allow yo Continue reading >>

Diabetic Cats & Glargine Insulin

Diabetic Cats & Glargine Insulin

Glargine insulin is available with a prescription at local human pharmacies. Insulin syringes are also available for purchase at the pharmacy. Buy the 3/10cc syringes only. If there is a question, bring the purchased syringes to your veterinarian to verify that the correct unit syringes have been purchased prior to using them. Glargine insulin can be stored at room temperature for 30 days or can be kept refrigerated for 6 months. If your insulin is not clear in color and consistency then discard it and purchase a new vial immediately. Glargine insulin is given subcutaneously, which means under the skin via injection. You will receive a demonstration of how to do this by a doctor or technician, but may ask for assistance if uncomfortable initially. If your cat does NOT EAT, then do NOT GIVE insulin, as this may induce Hypoglycemia, which is explained below. Otherwise, if your cat is eating normally, you can continue administration normally. *Before beginning your cats new Diabetic Treatment Regime, read the following information. We encourage you to call or make an appointment to have any questions that you may have answered. When a cat is diabetic, it means that their naturally occurring insulin hormones are either not being produced or not working efficiently to utilize glucose. Glucose is the main energy source of the body and controls your cats basic metabolism. When the natural insulin is dysfunctional, you must use as artificial form to keep your cats body functioning normally. Glargine is one of the common insulins used in cats to perform this function. Glargine is also sold at pharmacies under the trade name Lantus. Glargine is a long acting insulin, meaning that it is absorbed by your cats body slowly over the course of the day. For this reason, the amount of G Continue reading >>

Lantus Coupon

Lantus Coupon

Use this FREE Lantus pharmacy coupon to get the lowest price on your pet's Lantus prescription. Our discount coupons are pre-activated and can be used at over 68,000 pharmacies nationwide to save up to 75% off your prescription medication. Print your coupon, it's pre-activated and ready for use. If you do not have a printer you can save or text the coupon to your phone. Present your pet drug coupon to the pharmacist when paying for your prescription. Lantus is the brand name for insulin glargine, an insulin analog made by Aventis. Lantus is a very long-acting insulin (lasting up to 24 hours in humans) that uses pH reactions to form micro-precipitates under the skin, which create a time-release action. Continue reading >>

2010 Aaha Diabetes Management Guidelines For Dogs And Cats

2010 Aaha Diabetes Management Guidelines For Dogs And Cats

Renee Rucinsky, DVM, ABVP (Feline) (Chair) | Audrey Cook, BVM&:S, MRCVS, Diplomate ACVIM-SAIM, Diplomate ECVIM-CA | Steve Haley, DVM | Richard Nelson, DVM, Diplomate ACVIM | Debra L. Zoran, DVM, PhD, Diplomate ACVIM | Melanie Poundstone, DVM, ABVP - Download PDF - Introduction Diabetes mellitus (DM) is a treatable condition that requires a committed effort by veterinarian and client. This document provides current recommendations for the treatment of diabetes in dogs and cats. Treatment of DM is a combination of art and science, due in part to the many factors that affect the diabetic state and the animal's response. Each animal needs individualized, frequent reassessment, and treatment may be modified based on response. In both dogs and cats, DM is caused by loss or dysfunction of pancreatic beta cells. In the dog, beta cell loss tends to be rapid and progressive, and it is usually due to immune-mediated destruction, vacuolar degeneration, or pancreatitis.1 Intact females may be transiently diabetic due to the insulin-resistant effects of the diestrus phase. In the cat, loss or dysfunction of beta cells is the result of insulin resistance, islet amyloidosis, or chronic lymphoplasmacytic pancreatitis.2 Risk factors for both dogs and cats include insulin resistance caused by obesity, other diseases (e.g., acromegaly in cats, hyperadrenocorticism in dogs), or medications (e.g., steroids, progestins). Genetics is a suspected risk factor, and certain breeds of dogs (Australian terriers, beagles, Samoyeds, keeshonden3) and cats (Burmese4) are more susceptible. Regardless of the underlying etiology, diabetic dogs and cats are hyperglycemic and glycosuric, which leads to the classic clinical signs of polyuria, polydipsia (PU/PD), polyphagia, and weight loss. Increased fat mobi Continue reading >>

Insulin Glargine

Insulin Glargine

Why has my veterinarian prescribed this medicine? Insulin glargine is a long-acting insulin used in cats with diabetes mellitus to help regulate blood sugar. How do I give this medication? "An overdose could seriously harm your cat." This medication is injected under the skin (subcutaneously) usually twice a day. Read the label carefully. Allow the medication to come to room temperature before injecting. This medication does not need shaking or swirling. Ensure your veterinarian has demonstrated the proper technique for withdrawing the insulin and proper injection technique. Do not dilute or mix glargine insulin with diluents or other medications. Measure the dose with reasonable care. Double-check the dose in the syringe. An overdose could seriously harm your cat. The dose is generally only a few units of insulin and the gradations on a syringe are tiny. Try to give this medication at about the same time each day. Do not give the pet more insulin than directed and do not give more often than directed. Try not to miss giving any doses. It is a good idea to keep two vials of insulin on hand, just in case one is broken or you run out over a weekend or holiday. Be aware of your pet's normal behavior. This will help determine when something is wrong. If your pet is not acting normal, suspect low blood sugar (hypoglycemia). You may wish to carry packets of honey, packets of sugar or a small bottle of corn syrup for emergency administration when leaving home with your pet. What do I do if I miss giving a dose? Give the dose as soon as possible. If it is almost time for the next dose, skip the missed dose, and continue with the regular schedule. NEVER give the cat two doses at once. How do I store this medicine? Keep this medicine out of reach of children. Store the insulin in Continue reading >>

Insulin For Cats

Insulin For Cats

Most diabetic cats will require insulin therapy as part of their treatment. Diet is also an important cornerstone of treatment for feline diabetes mellitus, and a few diabetic cats can be managed with diet alone, but the majority will require insulin. There are a variety of types of insulin available. Some are designed for human use but can be useful in pets, while others have been developed specifically for animal use. The natural insulins produced by cat and dog pancreatic cells have slightly different structures than the natural insulin produced by human pancreatic cells. Insulin types made for human use match the natural human insulin, and may not always be as effective in pets. With any insulin, the goal of treatment is to safely reduce or eliminate the symptoms of diabetes (weight loss with excessive thirst, urination and appetite). There is no ‘best’ insulin for all cats, but some are preferable to others. Many veterinary internal medicine specialists recommend glargine (Lantus®, made by Sanofi Aventis) as a first-line choice. Lantus® is a recombinant human insulin which is usually very effective in cats. In combination with an appropriate diet (canned cat food with less than 7% carbohydrates), glargine has the best chance of inducing a remission, meaning that the cat will no longer require insulin. Lantus® is typically dosed at 1 or 2 units twice daily (BID). In some cats it can be used once daily. Once daily administration is not as likely to induce remission—and won’t control the blood sugar very tightly—but is an option for families or cats who can’t do twice daily injections. The glargine product information for human use recommends replacing the vial every 28 days, but if kept refrigerated, the insulin is effective for cats for at least three Continue reading >>

Research Updates: Giving Glargine Insulin To Newly Diagnosed Diabetic Cats May Increase The Likelihood Of Remission

Research Updates: Giving Glargine Insulin To Newly Diagnosed Diabetic Cats May Increase The Likelihood Of Remission

Diabetic remission, defined as reversion from a hyperglycemic to normoglycemic state in a diabetic patient after discontinuing insulin therapy, has been reported in cats that first present with uncomplicated diabetes mellitus or for treatment of diabetic ketoacidosis. Authors of previous studies have suggested that the success of glycemic control or the type of insulin being administered may affect the remission rate. This study's goal was to determine and compare the likelihood of remission in cats with newly diagnosed diabetes mellitus when treated with glargine insulin, protamine zinc insulin (PZI), or Lente insulin given subcutaneously twice a day. In this nonrandomized, prospective study, 24 cats in which diabetes mellitus had been diagnosed within the preceding 24 hours were enrolled. Initial assessment included performing a physical examination, serum chemistry profile, urinalysis, and urine bacterial culture. Each cat's fructosamine concentration was also determined. All cats with serious concurrent diseases were excluded from the study. Enrolled patients included 21 cats with adequate food consumption and a lack of systemic signs that allowed immediate administration of one of the three subcutaneous insulins and three cats that required treatment with intravenous fluids and regular insulin before subcutaneous insulin administration could be started. Cats were distributed into the three insulin treatment groups with an attempt made to evenly match groups based on breed (Burmese vs. non-Burmese) and whether or not the cats had previously been given corticosteroids. The initial dose of subcutaneous insulin was between 0.25 and 0.5 IU/kg, as determined by the serum glucose concentration (< 360 mg/dl [< 20 mmol/L] vs. > 360 mg/dl, respectively). All cats were fed an Continue reading >>

Insulin Products Commonly Used In Dogs And Cats

Insulin Products Commonly Used In Dogs And Cats

Abbreviations: BG, blood glucose; NPH, Neutral Protamine Hagedorn; PZI, protamine zinc insulin; U, units. Additional Information on Available Insulin Products: Lente (U-40 porcine insulin zinc suspension; Vetsulin, Merck Animal Health) is an intermediate-acting insulin commonly used by the Task Force in dogs. It is FDA approved for use in dogs and cats. It has a close to 12 hr duration of action in most dogs and is useful for minimizing postprandial hyperglycemia. Glargine (U-100 human recombinant; Lantus, Sanofi) is a longer-acting insulin commonly used by the Task Force in cats because it has an adequate duration of action in most diabetic cats. Several studies have demonstrated that glargine is effective for controlling blood sugar levels in diabetic cats and achieving high remission rates.12 Glargine can also be used in dogs. It is a human analog insulin with modifications that provide variable solubility at different pHs. Glargine is soluble at a pH of 4.0, the pH at which it is supplied and stored, but in the neutral pH of the body’s blood or subcutaneous tissues it forms microprecipitates, facilitating slow absorption after injection. This results in rapid onset and long duration of action. Glargine is sometimes described as a “peakless” insulin, although peakless does not mean an absence of a nadir in cats but rather refers to glucose utilization rates.4 In dogs, a flat blood glucose curve (BGC) may be seen, so glargine can be referred to as a peakless insulin in that species.13 PZI (U-40 human recombinant protamine zinc insulin; ProZinc, Boehringer Ingelheim Animal Health) is considered by clinicians as a long-acting insulin, and is FDA approved for use in cats. In field studies in cats, mean time of the BG nadir was between 5 and 7 hr and the duration of Continue reading >>

Glargine Insulin For Veterinary Use

Glargine Insulin For Veterinary Use

Overview Therapeutic Class Synthetic insulin analogue Species Dogs and cats May Be Prescribed by Vets for: Diabetes Mellitus FDA Status: Glargine Insulin is commercially available as 100u/ml and 300u/ml. Search for available dosage forms Basic Information Glargine insulin is a synthetic insulin analogue that is used in human medicine as a long-acting, “peak-less” insulin. It is administered subcutaneously once a day in humans and maintains a constant systemic absorption profile for 24 hours. Additionally, a short-acting insulin may be used before meals to further optimize glycemic control. Glargine insulin is completely soluble at a low pH. When it is injected subcutaneously it forms a microprecipitate in the subcutaneous space. This allows for relatively constant and prolonged absorption. Glargine insulin cannot be mixed with other insulin because it would change the pH and the mechanism of absorption. Dogs and Cats Diabetes Mellitus is a relatively common metabolic disease seen in middle aged cats and dogs. Most dogs suffer from Type 1 diabetes, while cats usually have Type 2 diabetes. Type 3 diabetes may occur in either cats or dogs. In addition to treatment with insulin, the veterinary management of diabetes requires owner education, dietary management, and regular glucose testing. With appropriate management, most animals can live a normal lifespan. In healthy cats, the duration of action for glargine insulin is 23 +0.9 hours. Diabetic cats may be maintained on once-a-day injection, although some cats may be better controlled with twice-a-day injection. It appears that glargine insulin is particularly useful in the treatment of the newly diagnosed, diabetic cat as some of these cats are able to achieve a diabetic remission. Glargine insulin has not been as well Continue reading >>

The Skyrocketing Price Of Diabetes Medications For Cats

The Skyrocketing Price Of Diabetes Medications For Cats

Petful readers make great, well-informed pet caretakers. One way I know this is by the feedback I get from readers on my articles. For example, in July 2012, I wrote about feline diabetes and mentioned that one bottle of Lantus insulin — considered by many veterinarians to be the first insulin choice for diabetic cats — runs about $100. Well, an avid Petful reader wrote in to tell me he cannot find Lantus for under $185 a bottle for his diabetic kitty. He was correct. In the course of about a year and a half, the cost of Lantus has just about doubled! I had always advised my clients that Lantus was going to be expensive, but $20 a month is a lot different from $50. Clearly, I had some catching up to do. Like humans without very good prescription plans (me, for example), pet parents are at the mercy of greedy Big Pharma when it comes to filling human scripts such as insulin for their pets. Here are some simple facts about the cost of treating a feline diabetic today: Lantus (glargine) is, according to most specialists, the best choice for kitty diabetics. Newly diagnosed diabetic cats given Lantus as the first insulin have the best chance of remission. This means they may return to being a normal, non-diabetic cat. Lantus means easier control of diabetes, which translates to fewer trips to the vet, which translates to less money spent. Lantus is expensive, no matter how you cut it. The product will probably not be available as a generic for several more years. How Can I Get Lantus as Cheaply as Possible? A 10ml vial is good for at least 3 to 4 months, maybe longer if handled properly. Most cats require very little insulin, so some of the insulin will go to waste, even if it lasts for 6 months. Pharmacists may tell you that you can use the bottle only for one month. T Continue reading >>

Lantus Prices Squeeze Veterinarians And Owners Of Diabetic Cats

Lantus Prices Squeeze Veterinarians And Owners Of Diabetic Cats

At more than $200 a 10-ml vial, the world’s most prescribed insulin is priced at or beyond the threshold of what many cat owners are able or willing to pay. Veterinarians are fielding complaints from clients, leaving some practitioners facing the delicate and time-consuming prospect of re-regulating their feline patients on other insulins. Dr. Michael Mihlfried, of Athol, Idaho, has prescribed Sanofi's Lantus (insulin glargine) for the past four years. Licensed for use in humans, a 10-ml vial of Lantus holds 1,000 units of the long-acting insulin. Many veterinarians say it can last a cat owner for months given that a moderate dosage is 2 to 3 units twice daily. “It’s the insulin I reach for when there's a diabetic cat,” Mihlfried said. “Most of my remissions have come by using Lantus. I have one particular owner who has told me he absolutely can’t afford to use it any longer. The cat is 18 years old. We’re going to try ProZinc." Manufactured by Boehringer Ingelheim, ProZinc is one of a couple of insulins licensed in the United States for use in cats. It costs about $100 for a 10-ml vial containing 400 units. Vetsulin, manufactured by Merck Animal Health, is another veterinary-specific insulin. It costs around $40 for a 400-unit, 10-ml vial. How these products compare in price to Lantus can vary depending on the patient. Diabetic cats respond differently to treatments. Some veterinarians find that Lantus, approved by the U.S. Food and Drug Administration (FDA) for use in humans, works best in their diabetic feline patients. “All of my diabetics are on it,” said Dr. William Folger, a board-certified feline specialist in Houston. “It was $82 a bottle when it came out, roughly a decade ago. Then it went to $116 and $128. Now it’s being sold at Walgreen Continue reading >>

Using Glargine In Diabetic Cats

Using Glargine In Diabetic Cats

Rhett Marshall BVSc MACVSc The Cat Clinic 189 Creek Road, Mt Gravatt, 4122 Basic information Glargine must not be diluted or mixed with anything because the prolonged action is dependent on its pH Glargine has a shelf-life of 4 weeks after opening and kept at room temperature. Refrigeration prolongs its shelf-life and allows opened vials to be used for up to 6 months. The manufacturer however recommends discarding opened vials after 4 weeks When performing a blood glucose curve, samples probably only need to be taken every 4hrs over 12 hr in many cats (ie. 0h [before morning insulin], 4h, 8h and 12h after morning insulin) Dose changes should be made based on pre-insulin glucose concentration, nadir (lowest) glucose concentration, daily water drunk, and urine glucose concentration. Better glycaemic control is achieved with twice daily dosing rather than once daily More accurate dosing may be achieved using 0.3ml U-100 insulin syringes Indications for starting glargine All newly diagnosed diabetic cats (to increase chance of remission) Poorly controlled or unstable diabetic cats (glargine’s long duration of action is likely to benefit these cats) When SID dosing is desired or demanded (glycaemic control and remission rates are higher if glargine is dosed BID) Ketoacidosis – replaces regular insulin and can be used IM or IV When corticosteroid administration is required in cats at high risk of developing clinical signs of diabetes or cats in remission. For initial insulin dose, BG > 20mmol/L à start with 0.5U/kg ideal body weight twice daily (BID) BG < 20mmol/L à start with 0.25U/kg ideal body weight BID Blood glucose should be sampled every 3-4hrs for several days, either at home or in hospital. Dose reductions can be made (based on the blood glucose parameters in T Continue reading >>

How Do I Get Lantus Insulin Less Expensively?

How Do I Get Lantus Insulin Less Expensively?

November 2, 2013-- How do I get Lantus Insulin Less Expensively? DCIN receives this question a few times a week from US caregivers of diabetic cats. I am often amazed by the question because of the “good” insulins for diabetic cats, Lantus can be the least expensive per unit. The problem often lies in knowing how to find the insulin inexpensively. (The hints I give also apply to Levemir, another human insulin often used by diabetic cats.) Your vet gave you a prescription that probably read “U100 Glargine/Lantus 10ml vial.” Lantus is the brand name for the generic insulin Glargine. Lantus is an insulin for humans and is only available from a human pharmacy (although some vets do hold some in stock). The company Sanofi makes Lantus, and no other companies currently make a generic Glargine because Sanofi still has an international patent on the insulin. That may change in 2014, and by then Sanofi may have developed a “second-generation” Lantus that is patent protected. Lantus is a U100 insulin, which describes the concentration of the insulin in the liquid suspension. A 10ml vial is the insulin’s containment device. It is a small glass bottle with a rubber stopper at the end that you pierce with a syringe. At a US retail pharmacy, a 10ml vial of Lantus can cost about $180 to $200. WOWZA! That does seem cause for sticker shock. A 10ml vial of U100 insulin holds 1000 units of insulin. At $200/vial, that is a price of $.20/unit. If your cat gets 2 units of insulin twice a day, that is $.80/day for its insulin (if you could completely use a vial of Lantus insulin). It would cost less each day to give your cat its life-saving medicine that to buy a soda from a vending machine. However, the problem with buying Lantus in a 10ml vial is that, properly handled, Lantus Continue reading >>

Lantus

Lantus

Lantus glargine by Aventis long-acting analog U100 Special, pH 4 Line new molecular entity Also known as Glargine (generic) Similar to Levemir, PZI[1] ultralente, Ultratard (duration) Action in cats varies by animal onset variable, asymmetric peak 5-14h (4-20 h as per Nelson)[2] duration 9-24h (10-16 h as per Nelson)[3] Action in dogs onset inconsistent, peak 0.5 to 6 hours, inconsistent, duration about 13hr but inconsistent-beef/pork PZI has longer duration (10-16 h as per Nelson)[4][5][6] Use and Handling Type clear Shelf Life refrigerate, until date on package When opened 28 days at room temp, up to 6 months when stored in the refrigerator (2C to 8C)[7] In pen 28 days at room temp Notes protect from light and heat do not mix with other insulins do not dilute do not prefill syringe discard if precipitate or cloudiness discard if frozen Do not use intravenously[8] Do not use intramuscularly[9] Lantus is the brand name for insulin glargine, an insulin analog made by Aventis[10]. Lantus is a very long-acting insulin (lasting up to 24 hours in humans) that uses pH reactions to form micro-precipitates under the skin, which create a time-release action. Because of cats' faster metabolism, long-acting insulins like Lantus (and perhaps Levemir) are gaining a good reputation in veterinary research for regulating cats for a full 12 hours at a time, often better than some of their shorter-acting cousins. Proponents of Lantus in feline use point out that it lasts a full 12 hours in many cats, has a very gentle onset, a negligible peak, and (some claim) less chance of triggering hypo or rebound than faster-acting insulins. The famous Queensland University studies[11] showed that a simple protocol (in a 24-hour monitored, veterinary environment, with a Low-carb diet) could bring ma Continue reading >>

Lantus Glargine Insulin For Cats: Dosage And Side Effects

Lantus Glargine Insulin For Cats: Dosage And Side Effects

Lantus Glargine Insulin for Cats: Dosage and Side Effects Lantus Glargine Insulin for Cats: Dosage and Side Effects It is a man-made insulin that is used to treat people with type 1 and type 2 diabetes. Lantus refers to the brand name of insulin glargine and is produced by Sanofi-Aventis. Insulin glargine mimics the natural hormone produced by the beta cells and is used to control blood glucose levels. When injected under the skin, insulin glargine works in the body by helping glucose enter the muscle cells, so it can be converted into energy. Lantus is a long-acting insulin , which means that it takes several hours before it starts to work to reduce blood sugar levels and keeps working for a longer period. Insulin glargine, which is commonly used to treat people with diabetes mellitus, can also be used to treat diabetic cats . Diabetes in cats refers to a condition where the pancreas cannot produce enough insulin or the cats body becomes resistant to insulin. As a result, diabetic cats have high levels of blood sugar. Insulin glargine helps to treat diabetic cats by normalizing the level of blood glucose. Controlling blood glucose in diabetic cats is important because it can help to prevent the risk of other medical complications. Lantus is a long-acting insulin that should be administered subcutaneously using a syringe. Cats usually have a faster glucose metabolism hence they require long-acting insulin, such as Lantus, to help them regulate their blood sugar levels for up to 12 hours. Some experts argue that because insulin glargine lasts for too long, it may cause an overlap in some diabetic cats. On the other hand, cat owners have complained that it is difficult to time the next insulin injection because the action of the drug stops abruptly. It is important to no Continue reading >>

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