ProZinc (Boehringer Ingelheim Vetmedica)
This long-acting, protamine zinc, human recombinant insulin is approved for use in cats. It has, in my experience, not been
more effective in controlling clinical signs of diabetes in dogs than intermediate-acting insulins.
A recent study showed that it significantly decreased 10-hour mean blood glucose and serum fructosamine concentrations over
a 60-day period in six dogs in which diabetes mellitus had been newly diagnosed as well as in 11 dogs previously treated with
other forms of insulin.2
This product is available only at a concentration of 40 IU/ml, so make sure you provide U-40 insulin syringes to owners. I
recommend an initial starting dose of 0.5 U/kg given subcutaneously twice a day.
Glargine (Lantus—Sanofi Diabetes), a modified, recombinant, long-acting insulin analogue, is approved for use in people. We
generally consider using basal insulins such as glargine and detemir (see below) in dogs with diabetes mellitus that are not adequately controlled with Lente or NPH insulin.
Insulin glargine significantly lowered blood glucose concentrations in 12 client-owned dogs receiving the insulin twice a
day in a recent study.3 This study concluded that insulin glargine is a potential and safe method of treatment in dogs with naturally occurring
diabetes mellitus when administered subcutaneously twice daily. It also pointed out that in some studies, the use of other
types of insulin in dogs appears to be more successful than using insulin glargine.
Insulin detemir (Levemir—Novo Nordisk) is a long-acting soluble insulin analogue capable of maintaining the basal level of
insulin in people. In contrast to glargine, detemir is a newer synthetic insulin analogue with a long duration of action through
modification of the insulin molecule. This modification facilitates reversible binding to plasma proteins, particularly albumin,
from where it is released slowly into plasma. The modification also prolongs self-association in the injection depot, which
prolongs absorption from subcutaneous tissue at the injection site and contributes to the long duration of action.
A recent study has shown that when administered to diabetic dogs, detemir has a greater effect and, thus, requires a lower
dose than NPH and glargine insulins.4 But it also has a higher risk of inducing hypoglycemia.
I generally start at a dose of 0.1 U/kg given twice a day in dogs that have not been well-controlled with NPH or Lente insulins.
David S. Bruyette, DVM, DACVIM, VCA
West Los Angeles Animal Hospital
West Los Angeles, Calif.
Veterinary Diagnostic Investigation and Consultation
1. Palm CA, Boston RC, Refsal KR, et al. An investigation of the action of Neutral Protamine Hagedorn human analogue insulin
in dogs with naturally occurring diabetes mellitus. J Vet Intern Med 2009;23(1):50-55.
2. Maggiore AD, Nelson RW, Dennis J, et al. Efficacy of protamine zinc recombinant human insulin for controlling hyperglycemia
in dogs with diabetes mellitus. J Vet Intern Med 2012;26(1):109-115.
3. Fracassi F, Boretti FS, Sieber-Ruckstuhl NS, et al. Use of insulin glargine in dogs with diabetes mellitus. Vet Rec 2012;170(2):52.
4. Sako T, Mori A, Lee P, et al. Time-action profiles of insulin detemir in normal and diabetic dogs. Res Vet Sci 2011;90(3):396-403.