The Savvy VetTech

Insulin Selection and Administration Summary for Vet Techs

by Cathy Barnette - September 23, 2020 at 8:35 AM
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If you work as a vet tech in small animal general practice, you will become familiar with the treatment of canine and feline diabetes. While there are several interspecies differences in the management of diabetes, there’s also a key similarity between dogs and cats: the need for insulin.

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Types of Insulin 

There are several different types of insulin that are commonly used in veterinary medicine. Although the veterinarian is responsible for deciding which insulin to prescribe for a given patient, it’s important for vet techs to also have a basic understanding of different insulin types. This knowledge will help you answer client questions and work alongside the veterinarian to troubleshoot issues with diabetic control. 

There are 5 types of insulin that are commonly used for the long-term treatment of diabetic pets: 

Insulin Type

Brand Name

Species

FDA approved?

Duration of Action

Comments

Glargine (long-acting)

Lantus®

Cats

(Dogs)

No

Cats: 

12-24 hrs

Dogs: 

12-20 hrs

Recommended by AAHA Diabetes Task Force as first-choice insulin for cats.

Rarely used in dogs. Available as U-100 and U-300, but only U-100 should be used in pets. 

Detemir (long-acting)

Levemir®

Cats

(Dogs)

No

Cats: 

12-24 hrs

Dogs: variable

Rarely used in dogs, due to extreme potency (requires very low doses). U-100

PZI (long-acting)

Prozinc®

Cats

(Dogs)

Cats only 

Cats: 

8-24 hrs

Dogs: 

8-12 hrs

Rarely used in dogs, but may be helpful in some cases. U-40

Lente (intermediate-acting)

Vetsulin®

Cats

Dogs

Cats and dogs

Cats: 

8-14 hrs

Dogs: 

10-24 hrs 

Recommended by AAHA Diabetes Task Force as first-choice insulin for dogs. 

Shake well before administration.U-40

NPH (intermediate-acting)

Novolin®

Humulin®

Dogs

(Cats)

No

Dogs: 

4-10 hrs

Not recommended in cats due to a short duration of action in that species. U-100

*Information adapted from the AAHA Guidelines on Diabetes Management1

Although the AAHA Guidelines on Diabetes Management recommend first-choice insulin options for both dogs and cats, it is important to keep in mind that the optimal insulin for each pet may vary from these recommendations. Sometimes that is due to medical considerations (for example, a pet does not respond well to a particular insulin), while other times it may be due to client financial constraints. Regardless of the reason, there are often situations in which the veterinarian may recommend an insulin other than Lantus® or Vetsulin®.

How to Administer Insulin 

When a pet is diagnosed with diabetes, the client must be shown how to administer insulin at home. This demonstration is often performed by a vet tech. In many cases, the client is given the opportunity to practice giving insulin injections in the veterinary clinic, by injecting their pet with small amounts of saline. 

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When demonstrating insulin administration to clients, clearly demonstrate each step:

  1. Mix the insulin. While Vetsulin® should be mixed by shaking, all other insulins should be mixed by gently rolling the bottle in your hand. 
  2. Uncap the insulin needle and draw up the prescribed dose of insulin. 
  3. If there is an air bubble in the syringe, remove it. (Demonstrate for clients how to flick the syringe and expel an air bubble!)  
  4. Use your non-dominant hand to pinch and lift loose skin on the pet’s neck or back. (The back of the neck may be easier for beginners, but it’s best to vary the injection location from day to day.) 
  5. Insert the needle into the loose skin, parallel to the body and the skin fold that has been created (to avoid hitting muscle or going all the way through the skin and getting air)
  6. Draw back on the plunger and look for air or blood. If the syringe fills with blood, discard it and start over. If it fills with air, remove the air bubble and inject again.
  7. Discard the syringe in a sharps container. 

If something goes wrong and the owner is unsure whether the pet received the full dose of insulin, they should not give more insulin!  Missing a single dose of insulin is unlikely to have serious consequences, while a double dose can cause life-threatening hypoglycemia. 

Keep it Simple

A diagnosis of diabetes can be overwhelming for many clients. Between the medical consequences of this condition and adjusting to daily insulin administration, the initial “start your pet on insulin” visit can easily feel like information overload! Make a conscious effort to keep your explanations as simple as concise as possible, while also providing written materials that clients can reference at home. 

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References

  1. American Animal Hospital Association. Insulins commonly used in dogs and cats. 
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About Cathy Barnette

Cathy Barnette is a practicing small animal veterinarian, freelance writer, and contributor to XPrep Learning Solutions. She is passionate about both veterinary medicine and education, working to provide helpful information to veterinary teams and the general public. In her free time, she enjoys spending time in nature with her family and leading a Girl Scout troop.

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