ProZinc 40 IU/ml Suspension for Injection for Dogs

If the animal owner is to administer the veterinary medicinal product, suitable training/advice
should be provided by the prescribing veterinarian before using for the first time.
Dosage:
The veterinarian should re-evaluate the animal at appropriate intervals and make adjustments
to the treatment protocol, for instance dose and dosing regimen, until adequate glycaemic
control has been attained.
Any dose adjustment (i.e. increase of dose) should be in general performed after several days
(e.g. 1 week) since full action of insulin requires an equilibration phase. Dose reductions due to
observed hypoglycaemia or suspected Somogyi effect (rebound hyperglycaemia) may be of
50% or higher (potentially including a temporary pause of insulin administration).
Once adequate glycaemic control is achieved intermittent glucose monitoring should be
performed, especially when there is a change in clinical signs, and further adjustments in the
insulin dose might be necessary.
General guidance:
Dosing should be individualised and based on the clinical presentation of each patient.
To achieve optimal control of diabetes mellitus, dose adjustments should primarily be based on
clinical signs. Blood parameters such as fructosamine, maximum blood glucose and decrease
of blood glucose concentrations in blood glucose curves conducted over a sufficient period of
time to determine a blood glucose nadir should be used as supporting tools.
Re-evaluation of clinical signs and laboratory parameters should be performed as recommended
by the attending veterinarian.
Initiation:
For initiation of treatment, the recommended dose is 0.5 to 1 IU insulin/kg bodyweight once daily
every morning (approx. every 24 hours).
For newly diagnosed diabetic dogs, a starting dose of 0.5 IU insulin/kg once daily is
recommended.
Management:
Adjustments of insulin dose on a once daily regimen, if required, should generally be done in a
conservative and gradual manner, (e.g. up to 25% increase/decrease of the dose per injection).
If insufficient improvement in diabetic control is observed after an adequate dose adjustment
period of 4 to 6 weeks on once daily treatment, the following options may be considered:
-
if dogs undertake increased physical activity, have a change of their usual diet or during
concomitant illness.
-
injection by one third (e.g. 12 kg dog being treated once daily with 12 IU insulin/injection
may be switched to 8 IU insulin/injection administered twice daily). The veterinary
medicinal product should be administered in the morning and in the evening, approx.
12 hours apart. Further adjustments of insulin dose on twice daily treatment may be
necessary.
Depending on the underlying cause (e.g. dioestrus-induced diabetes mellitus), dogs can develop
diabetic remission, although seldom. In those cases, sufficient endogenous insulin production
will be regained and the exogenous insulin dose will need to be adjusted or ceased.
Method of administration:
A U-40 syringe must be used.
The suspension should be mixed by gently rolling the vial prior to withdrawing each dose from
the vial.
The dose should be given concurrently with or immediately after a meal.
Particular care should be taken with regard to the accuracy of dosing.
The veterinary medicinal product should be administered by subcutaneous injection.
Avoid introduction of contamination during use.
After gently rolling the vial, veterinary medicinal product suspension has a white, cloudy
appearance.
A white ring may be seen in the neck of some vials, but this does not affect the quality of the
veterinary medicinal product.
Agglomerates (e.g. clumps) can form in insulin suspensions: do not use the veterinary medicinal
product if visible agglomerates persist after gently rolling the vial.