Home Management of Cats and Dogs With Diabetes Mellitus: Common Questions Asked Veterinarians and Clients
Home Management of Cats and Dogs With Diabetes Mellitus: Common Questions Asked Veterinarians and Clients
Home Management of Cats and Dogs With Diabetes Mellitus: Common Questions Asked Veterinarians and Clients
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HOME MANAGEMENT OF
CATS AND DOGS WITH
DIABETES MELLITUS
Common Questions Asked by
Veterinarians and Clients
Arnold N. Plotnick, MS, DVM, and Deborah S. Greco, DVM, PhD
From the Department of Clinical Sciences, College of Veterinary Medicine and Biomedical
Sciences, Colorado State University, Fort Collins, Colorado
Feline insulin differs from bovine insulin by one amino acid, from
pig insulin by three amino acids, and from human insulin by four amino
acids. Beef, beef/pork, and human insulin are all acceptable for home
management. Long-acting beef/pork insulin (Ultralente Iletin I, Eli Lilly
Co, Indianapolis, IN) works well in cats. See article entitled "Insulin
Therapy" by Greco et al of this issue.
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injections are more likely to pierce through the skin causing insulin to
be deposited on the skin surface rather than subcutaneously. A potential
disadvantage of the interscapular area is that it is an area of low
vascularity. Also, long or thick hair coats make injections more difficult.
Clients are more likely to mistakenly deposit insulin below the hair but
not into the subcutaneous tissue. Shaving a small (1 in X 1 in) square
of hair from the thorax, abdomen, or over the left or right hip area helps
delineate a target for the more timid owner. The owner should be
instructed to rotate the injection site.
If an owner pierces through the skin and injects some (or all) of the
insulin onto the skin, they should be advised not to attempt to guess
how much insulin went subcutaneously. Instead, they should just skip
that dose and give the normal dose at the next appropriate time. An
occasional underdosing is harmless; overdosage may have serious conse-
quences.
One common reason for diabetic animals to present with hypoglyce-
mia is that the pet has been given a double dose of insulin as a result of
miscommunication between family members or caretakers. Owners
should be instructed to designate one family member as the primary
person responsible for administering the insulin, with clear communica-
tion regarding who is the secondary caretaker if the primary person is
unable to administer insulin on a particular day(s).
Cats are more difficult to regulate for several reasons. Cats are
easily prone to stress and have a well-developed fight or flight response.
A eat's physiologic response to stress can elevate its blood glucose to
more than 300 mg/ dL. Cats in multi-cat households and sick cats in
general often shQw stress-related hyperglycemia, which can make regu-
lating them difficult. Regulation of glycemic control based on serial
glucose curves obtained in a hospital setting is affected by the stress of
boarding, inconsistent diet, and possible presence of the sight, sound,
and smell of dogs in their vicinity.
Some cats require fairly small amounts of insulin for regulation. It
is not unusual to have a small cat remain unacceptably hyperglycemic
on 2 U of insulin, yet become dangerously hypoglycemic when increased
to 3 U. In this situation, it is recommended that 100 U / mL insulin
formulations be diluted 1:9 to yield a 10 U / mL concentration. This
makes it possible to give incremental doses accurately. (Diluents and
vials may be obtained directly from the insulin manufacturers on re-
quest. Diluted insulin has a shelf life of 30 d ays. Sterile saline or lactated
Ringer's solution is not an appropriate diluent, except in emergencies.)
HOME MANAGEMENT OF CATS AND DOGS WITH DIABETES MELLITUS 759