Page 211 - ONLINE PROCEEDING BOOK WSAVA 2017
P. 211

An Urban Experience
Table 2: Parameters for changing insulin dosage and frequency based on blood glucose measurements when using lente or NPH insulin in diabetic cats.
Blood Glucose Variable
Recommendation
Use an initial dose 0.5 U/kg of lean body weight BID if blood glucose is > 360 mg/dL (> 20 mmol/L) and 0.25 U/Kg BID if glucose < 360 mg/dL (> 20 mmol/L).
If pre-insulin blood glucose concentration is <210mg/dL (< 12mmol/L)
With-hold insulin and check for diabetic remission provided cat treated for a minimum of 2 weeks; otherwise reduce dose
If pre-insulin blood glucose concentration is 211-250mg/dL (13 - 16mmol/L)
Total dose should be no more than 1U/cat bid
If nadir blood glucose concentration is < 54mg/dL (<3mmol/L)
Dose should be reduced by 50 %
If nadir blood glucose concentration is 54-90mg/dL (3 – 5mmol/L)
Dose should be reduced by 1U if poor control of clinical signs of diabetes; dose should remain the same if exemplary control of clinical signs
If nadir blood glucose concentration is 91-180mg/dL(6 – 9mmol/L)
Dose should remain the same
If nadir blood glucose concentration is >180mg/dL(> 10mmol/L)
Dose should be increased by 1U
If nadir blood glucose concentration occurs within 3 hours of insulin administration, or blood glucose returns to baseline within 8 hours
Change to longer acting insulin (ie. Glargine, detemir or PZI)
If the nadir blood glucose concentration occurs at 8 hours or later
Once daily administration may be used, although twice daily administration at a reduced dose is preferred
KEYWORDS, feline diabetes, diabetic remission, insulin, glargine
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