Veterinary Medicine - May 2008 - (Page c10) Figure 1. Vetsulin (Intervet, a part of Schering-Plough) These data suggest that treatment of diabetic dogs with bovine insulin could lead to anti-insulin antibody production. While anti-insulin antibodies should not develop in newly diagnosed diabetic dogs that are administered Vetsulin, it is possible that dogs initially treated with bovine insulin may have cross-reactivity with the porcine insulin product. Seven owners recorded the following observations about the injection site on the home monitoring forms: swollen, painful, sore, and a bleb under the skin. The following clinical observations occurred in the eld study following treatment with Vetsulin: hematuria, vomiting, diarrhea, pancreatitis, nonspeci c hepatopathy or pancreatitis, development of cataracts, and urinary tract infections. They may be directly attributed to the drug or may be secondary to the diabetic state or other underlying conditions in the dogs. During 1995 to 2001, the following adverse reactions in 19 dogs treated with Vetsulin were reported to Intervet: destabilization (de ned as lack of adequate regulation), lack of expected e cacy, edema of the head and neck, development of a brous lump at the injection site, hypoglycemia, and death following administration of typical doses and overdosage. Safety In the Vetsulin eld e ectiveness and safety study, 66 dogs were treated with Vetsulin. Sixty-two dogs were included in the assessment of safety. Hypoglycemia with or without associated clinical signs occurred in 35.5% (22/62) of the dogs at various times during the study. If present, clinical signs of hypoglycemia were generally mild in nature (e.g., weakness, lethargy, stumbling, falling down, depression). Disorientation and collapse were reported less frequently and occurred in 16.1% (10/62) of the dogs. Two dogs had a seizure, and one dog died during the seizure. Although never con rmed, the presumptive cause of the seizures was hypoglycemia. In the rest of the dogs, hypoglycemia resolved with appropriate therapy and adjustments in insulin dosage. 10 Syringe selection To avoid dosing errors when administering Vetsulin to dogs, it is important to use a U-40 syringe. The use of a syringe other than a U-40 syringe will result in incorrect dosing. Some dog owners may attempt to purchase syringes and insulin from their local human pharmacies, which only carry U-100 syringes and do not stock Vetsulin. Using a U-100 syringe with U-40 insulin would result in a dog receiving 2.5 times less insulin than required. Human insulins are formulated at a concentration of 100 U/ml. If clients use a U-40 syringe with a U-100 insulin preparation, they would be injecting 2.5 times the amount of insulin necessary, which could result in fatal hypoglycemia. Most human pharmacists are not aware of Vetsulin or the U-40 syringes recommended for use with this product.
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