A pilot study comparing a protocol using intermittent administration of glargine and regular insulin to a continuous rate infusion of regular insulin in cats with naturally occurring diabetic ketoacidosis. (24th December 2014)

• Record Type: Journal Article
• Authors: Gallagher, Brandi R.; Mahony, Orla M.; Rozanski, Elizabeth A.; Buob, Sibylle; Freeman, Lisa M.
• Is Part Of: Journal of veterinary emergency and critical care. Volume 25:Number 2(2015:Mar./Apr.)
• Page Start: 234
• Page End: 239
• Publication Date: 2014-12-24
• Subjects: Veterinary emergencies -- Periodicals; Veterinary critical care -- Periodicals; 636.089
• DOI: 10.1111/vec.12269
• Languages: English
• ISSNs: 1479-3261

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="vec12269-sec-0010" sec-type="section"> <title>Objective</title> <p>The goal of this pilot study was to compare regular insulin administered by continuous rate infusion (CRI) to an approach using insulin glargine and regular insulin administered intermittently.</p> </sec> <sec id="vec12269-sec-0020" sec-type="section"> <title>Design</title> <p>Prospective randomized clinical trial.</p> </sec> <sec id="vec12269-sec-0030" sec-type="section"> <title>Setting</title> <p>University teaching hospital.</p> </sec> <sec id="vec12269-sec-0040" sec-type="section"> <title>Animals</title> <p>Sixteen cats with diabetic ketoacidosis (DKA).</p> </sec> <sec id="vec12269-sec-0050" sec-type="section"> <title>Interventions</title> <p>Cats with DKA were randomized to either low‐dose regular insulin CRI (CRI group; <italic>n</italic> = 8) or intermittent short‐ and long‐acting insulin injections (subcutaneous [SC] glargine plus intramuscular [IM] regular insulin; SC/IM group; <italic>n</italic> = 8).</p> </sec> <sec id="vec12269-sec-0060" sec-type="section"> <title>Measurements and Main Results</title> <p>Time of normalization of pH, bicarbonate, hyperglycemia, ketonemia, and appetite, as well as duration of hospitalization were recorded. Eleven of 16 cats (59%) survived to discharge, with no difference in survival between groups (<italic>P</italic> = 0.99). Times of resolution of hyperglycemia (<italic>P</italic> = 0.02) and ketonemia (<italic>P</italic> = 0.04), and normalization of pH (<italic>P</italic> = 0.04), and bicarbonate (<italic>P</italic> = 0.03) were significantly shorter in the SC/IM group. Cats in the SC/IM group also had a significantly shorter duration of hospitalization (SC/IM: median = 54 hr [range, 19–118 hr]; CRI: median = 111 hr [range, 58–271 hr]; <italic>P</italic> = 0.04). Time of first meal was not significantly different between groups.</p> </sec> <sec id="vec12269-sec-0070" sec-type="section"> <title>Conclusions</title> <p>Although further research is required, an approach using intermittent short‐ and long‐acting insulin injections appeared to be an effective option for treatment of DKA in cats.</p> </sec> </abstract>