For a newly diagnosed diabetic cat, glargine (Lantus) is the first-line insulin, started at 0.5 U/kg q12h if blood glucose (BG) is >360 mg/dL or 0.25 U/kg q12h if BG is <360 mg/dL, not to exceed 2 U per cat q12h regardless of body size. Protamine zinc insulin (PZI; ProZinc) is an acceptable alternative at 1–2 U per cat q12h. Both are dosed based on estimated ideal body weight, not actual weight. AAHA Clinical G…
On the first day of insulin treatment, monitoring is at the clinician's discretion and is performed solely to detect hypoglycemia — the dose must not be increased based on first-day BG values. If monitoring is elected, measure BG every 2–4 hours for cats on PZI and every 4 hours for cats on glargine, for 10–12 hours following administration. If BG falls below 150 mg/dL at any point during that window, reduce the insulin dose by 50%. AAHA Clinical G…
After the first day, the cat is managed as an outpatient with a scheduled recheck in 7–14 days. Immediate re-evaluation is warranted if clinical signs of hypoglycemia appear or if lethargy, anorexia, or vomiting develops. AAHA Clinical G…
Long-term dose titration targets a maintenance dose of approximately 0.5 U/kg q12h, with an acceptable range of 0.2–0.8 U/kg q12h. A ±2-hour window on each side of the 12-hour dosing interval and occasional missed doses are considered acceptable. AAHA Clinical G…
Adding the glucagon-like peptide-1 (GLP-1) analogue exenatide extended release (EER) at 200 µg/kg SC once weekly to glargine and a low-carbohydrate diet reduces glycemic variability and improves remission rates in newly diagnosed diabetic cats. Cats achieving remission on this combination had lower glycemic variability compared to those without remission. Journal of Vete…
| Insulin | Starting Dose | Max Starting Dose | Maintenance Range | Monitoring Interval (Day 1) |
|---|---|---|---|---|
| Glargine (Lantus) | 0.5 U/kg q12h (BG >360 mg/dL) or 0.25 U/kg q12h (BG <360 mg/dL) | 2 U/cat q12h | 0.2–0.8 U/kg q12h | q4h for 10–12 hr |
| PZI (ProZinc) | 1–2 U/cat q12h | 2 U/cat q12h | 0.2–0.8 U/kg q12h | q2–4h for 10–12 hr |
Would you like guidance on how to interpret serial BG curves or fructosamine values to decide when and by how much to adjust the insulin dose at follow-up rechecks?