In response to the recent FDA product alert regarding Vetsulin®, the American Animal Hospital Association (AAHA) has consulted with three expert veterinary members of the AAHA Diabetes Guidelines Task Force and Intervet/Schering-Plough Animal Health about how to best serve the health needs of diabetic pets.

Vetsulin® is the trade name of porcine insulin zinc suspension in the United States, and is marketed in Canada and other countries under the trade name Caninsulin®. Every country has its own regulatory agency that governs product alerts such as this. Currently, no other country’s agency has issued a product alert. It is important to note that the product has not been recalled. This alert will allow the thousands of diabetic pets receiving Vetsulin to have a safe, gradual transition to a new insulin medication.

Intervet/Schering-Plough Animal Health has advised AAHA that it is working with the FDA to resolve this issue. Until the issue is resolved, there will be an unspecified amount of time where Vetsulin supply may become limited or unavailable. Therefore, Intervet/ Schering-Plough Animal Health recommends that veterinarians closely monitor their diabetic patients receiving Vetsulin for a delay in the onset of action, a delay in peak activity and an overall extension of the duration of activity, as well as signs of hyperglycemia or hypoglycemia. All new diabetic patients should be started on non-Vetsulin insulin products. For current diabetic patients using Vetsulin, staggering patient appointments will help ensure smooth and gradual transitions from Vetsulin to a new insulin product.

Dr. Richard Nelson of the University of California at Davis, and Drs. Deb Zoran and Audrey Cook of Texas A&M University, expert veterinary members of the AAHA Diabetes Guidelines Task Force, have developed and approved the following recommendations on how to transition your diabetic patients:

For dogs, use the human recombinant NPH insulin at an initial dosage of 0.25 IU/kg twice daily, and adjust insulin based on clinical response and glucose measurements. You will be starting over with diabetic regulation when you switch to a new insulin product.

For cats, you can use a long-acting insulin such as the human recombinant PZI (ProZinc™, Boehringer Ingelheim, which is scheduled to be available the week of November 16, 2009) or insulin glargine (Lantus®, Aventis Pharmaceuticals). Start with 1 IU per injection twice a day. The starting dose will be the same for both the PZI and glargine. Then, proceed to adjust the insulin dose based on clinical response and glucose measurements. You will be starting over with diabetic regulation when you switch to a new insulin product.

In addition to transitioning from Vetsulin, veterinarians need to be vigilant about using the appropriate syringe for the new insulin for each pet. This is necessary to ensure that patients receive the proper dosage of the new insulin product.

We hope that these recommendations will be useful for you when considering how to approach this situation with your diabetic patients. We encourage you to report any adverse event with the Vetsulin product to Intervet/Schering-Plough Animal Health’s technical services department at 800/224-5318.The American Animal Hospital Association will post updated information about the alert to www.aahanet.org as it becomes available.

11/16/09