As many of you know, Vetsulin® was pulled from the market here in the U.S. in 2009 due to concerns about stability. After some new stability studies, Vetsulin® has once again achieved FDA approval and is back on the market, but there are some differences in labeling and shelf-life.
One of the biggest changes is that you have to SHAKE it prior to dosing. In order for the crystalline and aqueous portions of the insulin to combine well and achieve the appropriate pharmacokinetics, manual shaking is required. The goal is to produce a milky, homogenous suspension.
If you have patients that are doing well on their current insulin regimen, there is no need to switch. For patients who are not well regulated or for new canine diabetics, Vetsulin® can be considered a first-line option. The starting dose should be 0.25-0.5 U/Kg SC twice daily.