Pancreatic hormone

Initiate its action by binding to cell surface receptors that stimulate the formation of glycogen in liver, lipid from fatty acid and protein from amino acids

• Adjunctive treatment of diabetic ketacidosis, uncomplicated diabetes Mellitus, adjunctive therapy of hyperkalemia
  
  

Insulin preparations-

• Regular nsulin
• Neutral protamine hagedorn (NPH)
• Lente insulin
• Ultralente insulin
• Vetsulin
• Protamine zinc insulin (PZI)
• Glargine insulin (Lantus)

Dosage

Cat @

• Short - acting regular insulin . Treatment of ketoacidosis : 0.2 unit / kg IM initially , then 0.1 unit / kg IM every hour until glucose level is less than 300 mg / dL and then continue with 0.25-0.4 unit / kg SQ q6h
• NPH not recommended for cats , but has been used at 0.25 units / kg SQ q12h or 1-3 units per cat SQ q12h
• Protamine zinc recombinant human insulin ( ProZinc ) : Start with 0.2-0.7 units / kg every 12 hours SQ . Adjust dose to achieve nadir of glucose of 80-150 mg / dL .
• PZI insulin : Initial dose is 0.5 unit / kg SQ and then once or twice daily ( usually twice is needed ) with subsequent doses adjusted to produce desirable glucose levels , usually no higher than 3 units per cat . Final adjusted dose for most cats is 0.9 ( 0.4 ) unit / kg .
• Glargine insulin : Start with 0.5 unit / kg q12h SQ . Some cats can be managed with once - daily dosing , but twice daily is preferred . Adjust dose via monitoring . If treating diabetic ketoacidosis , one may start with glargine insulin administered intramuscularly , then switch to SQ injections for maintenance
• Detemir insulin : Use same dosage regimen as for glargine insulin 

DOG @

• Short - acting regular insulin . Treatment of ketoacidosis for dogs 3 kg : 1 unit / animal initially , then 1 unit / animal q1h ; for dogs 3-10 kg : 2 units / animal initially , then 1 unit / animal q1h ; and for dogs > 10 kg : 0.25 unit / kg initially , then 0.1 unit / kg q1h IM . 
• NPH for dogs < 15 kg : 1 unit / kg q12-24h SQ ( adjust dose with monitoring ) dogs > 25 kg : 0.5 unit / kg q12-24h SQ ( adjust dose with monitoring ) . 
• Vetsulin : Initial dose 0.5 unit / kg , once or twice daily , SQ . Adjust dose ( increase or decrease of 25 % of dose ) by monitoring .
• PZI human recombinant : Can be used as an alternative to beef / pork PZI insulin . Start with 0.5 units / kg , SQ q12h . Median dose in well - controlled dogs is 0.9 units / kg ( range 0.4-1.5 units / kg ) SQ q12h 
• Glargine insulin : Start with 0.3 units / kg SC q12h . Then monitor glucose to adjust dose . The dose range in well - regulated dogs is 0.32-0.67 units / kg q12h SQ .
• Detemir insulin : 0.12 units / kg , SQ , q12h , ( adjust dose as needed ) . Because of small dose in dogs , a specific diluent may be needed to obtain accurate dose in small dogs .

• Ruminants: 200 IU total dose   SC
• Horse: 0.15 unit/kg, 12 hrs, IM SC

• Episodes of hyperglycemia
• Lipo dystrophic reaction occurs at injection site
• Don't use without ability to monitor glucose in animals because of risk of hypoglycemia
• Don't mix regular insulin with insulin containing zinc --- prolong absorption

• Overdose - Hyporglycemia
• Insulin induced hyperglycemia
• Insulin antagonism/resistance
• Local reaction

• Inj. Prozinc 10 ml (40 units/ml) 
• Inj. Lantus (insulin glargine rDNA insulin) 100 units per ml