predictable performance that puts you in control

Transcription

1 predictable performance that puts you in control

2 You can rely on Caninsulin Treatment aim in diabetes Predictable performance Expectations of success are high with Caninsulin 1-5 a product you ve known and trusted to perform for over 20 years Both the 40 IU/ml strength of Caninsulin and unique precision of VetPen permits accurate dosing which helps reduce dosing error 6 Extensive support offered enables wrap-around care for both your canine and feline patients that puts you in control Caninsulin is the only veterinary insulin specifically designed and licensed for use in both dogs and cats It has a unique delivery device, the Caninsulin VetPen, for enhanced dosing accuracy and consistency compared to traditional needles and syringes 6 Available in multiple presentations, offering flexibility of use for all patient sizes and uses and reducing wastage from the discard of unused insulin Comes with a wide range of practice support services and materials to help you care for your patients, every step of the way Ideally blood glucose should fall below the renal threshold for as much of the day as possible to control signs. To achieve this, and to counter the risk of hypoglycaemia, treatment should aim for as long as possible to maintain blood glucose between: 5 mmol/l and approximately 12 mmol/l in dogs 5 mmol/l and approximately 16 mmol/l in cats Caninsulin is formulated for effective blood glucose control Caninsulin has a unique formulation, specifically designed for a rapid onset and sustained effect: 30% amorphous insulin fraction for rapid blood glucose-lowering effects 70% crystalline zinc insulin fraction for sustained effects Effects after one dose - two phases of activity deliver an early onset and sustained duration of action allowing control in dogs with once or twice daily treatment with Caninsulin. 1,2 This graph represents an example of how insulin and glucose concentrations may change following injection of Caninsulin. Hyperglycaemia Adequate regulation TWO COMPONENTS OF ACTIVITY PROVIDE CONSISTENT, PREDICTABLE EFFECT 1,2 Results seen after one administration Amorphous insulin peak Crystalline insulin peak Insulin concentration Blood glucose concentration Blood glucose (mmol/l) MEAN BLOOD GLUCOSE LEVELS IN DOGS AND CATS TREATED WITH CANINSULIN 2,7 Dogs Cats Average Adequate regulation Hypoglycaemia Time (hours) Study day Data adapted from Monroe et al 2 and Brianceau et al. 7 Blood glucose should ideally be between 5 mmol/il and 12 mmol/l in dogs and 16 mmol/l in cats. Caninsulin is the only veterinary insulin specifically designed and licensed for use in both dogs and cats This graph does not represent exact data; it serves as a general representation of the impact Caninsulin has on blood glucose concentrations.

3 Caninsulin in dogs Caninsulin in cats An ideal insulin for dogs Caninsulin is a porcine insulin, which is structurally identical to canine insulin This minimises the risk of anti-insulin antibodies as a potential cause of insulin resistance in dogs Clinical response to Caninsulin therapy is typically seen within a few weeks In a study, 60 days after dose determination: 2 Improvement of polyuria was seen in 94% of dogs Improvement of polydipsia was seen in 96% of dogs Achieving control Most dogs will require twice-daily dosing with Caninsulin to achieve control 1,2 Closest insulin match Caninsulin is of porcine origin which differs from the feline hormone at just three key amino acids making it the closest insulin match currently available for cats Improves clinical signs and remission rates Clinical response to Caninsulin therapy is seen in supporting studies: - In one study, within 3-4 months of commencing treatment around 60% of treated diabetic cats achieved good clinical stability and 15% achieved remission 3 - In other prospective studies, remission rates ranged between 28% and 56% in cats treated with Caninsulin, where diet was not controlled 4,5 Achieving control All cats require twice-daily dosing with Caninsulin to achieve control Twice daily insulin administration is recommended by experts in both dogs and cats as better glycaemic control is achieved One in three dogs may be adequately regulated with once-daily dosing 1,2 Caninsulin is a porcine insulin, structurally identical to canine insulin and the closest insulin match for cats currently available Caninsulin has a 40 IU/ml formulation more dilute insulin ensures easier dosing

4 Caninsulin VetPen for predictable performance Caninsulin VetPen is the first veterinary insulin pen designed specifically for use in diabetic dogs and cats. It allows precision dosing of small volumes of insulin, especially useful in cats and small dogs and is available in 8 and 16 IU sizes. Pen design reduces client injection fear Dial on 8 IU devices set in 0.5 unit increments for enhanced dosing accuracy and consistency compared to traditional needles and syringes 6 Silicon-coated, triple-sharpened needle for improved injection comfort Portable no need for refrigeration once in use Easy to handle less need for manual dexterity Winner of the Easy to Give International Cat Care award You re in control with VetPen Professionals see multiple benefits with VetPen We started transferring most clients onto VetPen after WebEx based training with MSD Animal Health veterinary nurses. I felt that consultations took less time and ran smoothly; people didn t seem as concerned or apprehensive about using the pen as they didn t have the anxiety of drawing up the insulin with a syringe to the correct dose before injecting their pet. With the pen they find it so much easier as they have the dial to set the correct dose, which is very accurate especially for small doses and half dosing. I ve found that by using the VetPen on newly diagnosed patients we see them become stable more quickly. Alicia Cleminshaw, RVN 86 % of veterinary surgeons who prescribe VetPen to their patients say they are satisfied or very satisfied with the device. 8 VetPen offers great advantages over conventional syringes Even trained laboratory technicians using normal diabetic U-40 syringes were found to deliver at least 20-25% more insulin than needed for a 1 IU dose. 6 Pet owners feel confident with VetPen Two years ago we adopted a 16-year-old cat called Sandy, who s diabetic. VetPen comes in a smart blue case and is very easy to use; also you have peace of mind knowing you re giving exactly the right dose each time. Sandy never seems to notice the needle going into his skin. Diabetic cat owner

5 Supporting you and your clients, every step of the way From diabetes awareness and diagnosis through to daily maintenance with insulin, you and your clients can benefit from the high quality Caninsulin and VetPen Practice Support at every step. Caninsulin VetPen Starter Kit: Caninsulin and VetPen Practice Support includes: Everything you need to start using VetPen just add the Caninsulin VetPen cartridges. Pet owner literature, including specific dog owner and cat owner support packs Caninsulin and VetPen related information resources for veterinary professionals: Diabetes in Cats OWNER MANUAL New Practice Diabetes Advisor training for UK veterinary professionals that now also includes VetPen training module: 63098/July14/NB/5k Quick Pen Components Guide Simple, illustrated diagram that shows Caninsulin VetPen components and accessories Diabetes in Dogs OWNER MANUAL 08/09/ : /July14/NB/5k _Owner_Man_CATS_Yellow-5.indd _Owner_Man_DOGS_Yellow-5.indd 2 Client Instruction Booklet Easy-to-follow, step-by-step instructions with photos that show clients how to load, use and store the pen Pet owner website: 08/09/ :49 Switching to VetPen Extensive online resources from syringes Diabetes Diary 63099/July14/NB/10k Vetpen offers many advantages over conventional syringes in the administration of Caninsuiln to your pet CARING FOR A DOG OR CAT WITH DIABETES? HELP AND ADVICE ARE JUST A CLICK AWAY _Diabetic_diary-4.indd 2 08/09/ : _VetPen Switching Guide for Owners-3.indd 1 Needle Remover Device that allows for safe removal of needles from the pen 10/09/ : MPOL_DL_leaflet-11.indd 1 15/09/ :05 Practice support literature, including Caninsulin Diabetes Stabilisation Protocol, Serial Glucose Curves Protocol, Call Back Request and Discounted Fructosamine Testing forms (also available to download from ), Nurse Presenter and Vet Detail Aid Practice waiting room literature, including waiting room poster, notice board and pet owner leaflet COULD YOUR PET It s more common than you think BE DIABETIC? > There are thought to be 1 million undiagnosed diabetic people in the UK go undiagnosed Full Hyperthyroid diagnosis/treatment-monitoring profile Total T4 level for diagnosis/monitoring Sample: 0.5ml serum Total T4, Urea, Creatinine, ALT, ALP, Phosphate, plus haematology (no differential), platelet count Sample: 1ml serum, 1ml EDTA, blood smear Only for Vidalta users Only for Vidalta users Diabetic Diagnostics with discounted testing for Caninsulin users: Fructosamine Basic Fructosamine Extra Diabetes in dogs & cats Weight loss despite constant hunger Lethargy and depression overweight pets or those over 6 years old Drinking too much water > Treated pets can live a long Excessive urination and happy life Fructosamine level for diagnosis/monitoring. Fructosamine level plus biochemistry profile offering a more Rewriting pet diabetes management comprehensive health screen for the diabetic pet. Profile includes Urea, Creatinine, ALP, ALT, Glucose, Phosphate, Total protein, Albumin, Globulin, A/G ratio, Sodium, Potassium, Na/K ratio. Sample: 1ml serum, 0.5ml flouride oxalate. Sample: 1ml serum Only 7.64 for Caninsulin users Feb2013/Ocean/2k Total T4 N.B. If monitoring treatment, Vidalta should be given consistently for at least 10 days prior to sampling. This information is brought to you by MSD Animal Health, manufacturers of Caninsulin. MSD Animal Health, Walton Manor, Walton, Milton Keynes MK7 7AJ Only for Caninsulin users WR A4 sheets and circles.indd 1 Protocol for producing serial glucose curves 04/08/ :45 N.B. Haemolysed samples cannot be tested for fructosamine - please submit sample in a spun gel serum tube or a plain tube with separated serum. Serial Glucose Curves Hypothyroid Diagnostics with discounted testing for Leventa users: Total T4 Only for Leventa users TSH Only for Leventa users T4 & TSH Only for Leventa users Sample: 1ml serum. HOSPITALISE PATIENT Full Wellness Profile Serial glucose curves are a useful tool in the initial stabilisation and protein, monitoring of diabetic dogs and cats, giving the most Urea, Creatinine, ALP, ALT, Cholesterol, Phosphate, Total assessment on which to base changes in insulin Albumin, Globulin, A/G ratio, Sodium, Potassium, Na/Kaccurate ratio plus therapy. They are vital in investigating the unstable diabetic. haematology (no differential), platelet count. FO L L O W NO RMA L O WNE R Sample: serum, EDTA, MA NA 1ml G E ME NT 1ml RE G I ME blood smear This chart shows the curve you would expect to find in the stable pet on Caninsulin once daily, as well as (overleaf) the four main problem scenarios. Blood Glucose Monitoring Chart Only for Leventa users COULD YOUR PET N.B. Take blood samples 4-6 hours after administration of Leventa. Tick if you would like a clinical pathology comment 7 BE DIABETIC? B L O O D SA MPL E PRI O R TO I NSUL I N* A ND FI RST FE E D Blood glucose curve in the stable diabetic dog Date Sample Taken by Surgery:... Pet Details predictable performance B L O O D SA MPL E TA KE N E V E RY 2 H O URS Pet s name: Flox20 (O R 4 H S O URS O V E RNIEG H T) FO R 2 4 SM H O URS Lab use ONLY Owner s name: Breed: Age: TA KE B L O O D SA MPL E E V E RY 2 H O URS FO R 1 2 H O URS, I N C A SE O F TWI C E D A I L Y D O SI NG Complete the details on both sides of this form and send the required samples to the address below. Prices valid until 31st March Prices exclude VAT at the current rate. Caninsulin VetPen An innovative insulin delivery device that drives convenience and compliance MSD_VetPen_OS_Folder_9.indd 1 Sex: Blood Glucose - mmol/l Date Received by Laboratory:... GL Number: control Weight: B L O O D SA MPL E H O URL Y I F SUSPE C T SO MO G Y I O V E RSWI NG Overweight 4 am 8 Frequency of administration (SID/BID): noon 4 8 midnight 4 8 Caninsulin 2 Yes Correct weight Please record time of injection(s) on the graph 35 Neutered: For further information, visit: No If your cat or dog displays any of these signs, then he or she could be suffering from diabetes. Feeding time (am/pm or ad libitum): 10 Body condition (please indicate): 5 For more information or to download a Treatment printable version of this form, visit 0 Caninsulin: Number of units of Submit to: Greendale Veterinary Diagnostics Lansbury Estate, Knaphill, Woking, Surrey GU21 2EW Tel: Fax: lab@greendale.co.uk Web: Time Underweight Sadly, many diabetic pets go undiagnosed. Older animals or those that are overweight are most at risk, but any pet may be affected. Caninsulin Diabetes Stabilisation Protocol Date: Tick relevant box for timescale used For further 24 Fortunately, a simple test can put your mind at rest. And even if your pet does have diabetes, then provided they receive the appropriate treatment, they can still lead a long and active life. Diabetes Training for Pet Owners STEP 1 DIAGNOSIS OF DIABETES MELLITUS STEP 2 CANINSULIN TREATMENT If your cat or dog displays signs indicated any of she could in this the be suffering leaflet, then he or from diabetes. Fortunatel y, a simple your mind test can at rest. soon does And put have even diabetes, if your the appropriat provided pet e treatment, they receive a long and active they can still life. Caninsulin VetPen ESTABLISHING A STARTING DOSE This leaflet Ask your vet for details, or pick up a leaflet. CATS: Initial dosing is 1IU or 2IU per injection based on the below baseline blood glucose. All cats require Caninsulin twice daily (see over for feeding advice). Cat blood glucose concentration For more information or to download a printable version of this form, visit _PPInsert_Glucose_Curves-3.indd 1 Extensive support offered enables wrap-around care for both your canine and feline patients <20 mmol/l or < 3.6 g/l (<360mg/dl) 1 IU twice daily >20 mmol/l or > 3.6 g/l (>360mg/dl) 2 IU twice daily Vet s name: Tel No: Fax No: urination water signs indicated in this leaflet, then he or????? Oct2014/???/?K 04/12/2014 This information is brought to you by: MSD Animal Health, This information is brought to you by: MSD Animal Health, manufacturers of Caninsulin and Caninsulin VetPenTM MSD Animal Health, Walton Manor For further information, contact your veterinary surgeon. Walton, Milton Keynes MK7 7AJ MSD Animal Health, Walton Manor Walton, Milton Keynes MK7 7AJ ALLOW 7 DAYS AFTER EACH DOSE ADJUSTMENT SA REASSESS THE ANIMAL This may not require a full blood glucose curve every time the pet is seen. A few samples taken around the expected nadir (aiming for 6-9mmol/l) may suffice in conjunction with clinical signs. SA /Dec14/NB/XX REPEAT STEPS 3-5 UNTIL THE ANIMAL IS STABLE Aim primarily for clinical stability - resolution of clinical signs - which usually indicates good glycaemic control _Caninsulin Client 6pp DL-3.indd 1 LONG TERM MONITORING Owner to monitor weight, appetite, drinking and general demeanour. Follow up examinations every 2-4 months are advised to monitor the animal s health, the owner s records and to assess the animal s biochemical parameters (such as blood glucose and fructosamine) _PPInsert_2pp_A4_ indd 1 lead a long and active life. manufacturers of Caninsulin and Caninsulin VetPenTM ADJUST DOSE This will allow time for the animal s blood glucose levels to reach a steady state after a dose adjustment and is a convenient practical interval. Do not alter the dose more frequently that every 3 days in dogs and 7 days in cats8. STEP 7 13:06 does have diabetes, provided they receive the appropriate treatment, they can still 15/12/ :38 STEP 6 tdiabetes your mind at rest. And even if your pet Use small incremental adjustments of 1 IU per injection for cats. Dose adjustments of approximately 10% per injection are appropriate for dogs. STEP 5.co.uk/pe Fortunately, a simple test can soon put Use a new vial of Caninsulin and ensure dose is administered by vet/nurse. Hospitalise animal and sample every 2 STEP 4 petonline she could be suffering from diabetes. PLOT BLOOD GLUCOSE CURVE STEP 3 Weight loss despite constant hunger Lethargy and depression Drinking too much water Excessive urination 1 dosing. 5 twice daily 6 7 In such8cases, the9 dose per 10injection11should be 12decreased by 25% so the total daily dose is less than doubled. Dosing should be twelve hours apart (see over for feeding advice). Hours from start of monitoring _Diabetes_Interpretation_Callback_GMChart-1.indd 1 16/12/ :45 VetPen TM contact your veterinary Walton surgeon. Keynes Manor MK7 7AJ MSD Animal Walton, Health, Milton 6pp DL-2.indd SA For more information or to download a printable version hours for at least 12 hours. In cats, consider home blood glucose curves plotted by owner using ear-prick sampling. of this form, visit This information MSD is brought Animal manufacturershealth, to you by: of Caninsulin For further and Caninsulin information, lin Client Carefully monitor on first day of treatment for signs of hypoglycaemia and assess initial response to insulin. Clinical signs evident in MAINTAIN INITIAL DOSE (UNCHANGED) FORthe 7-21 DAYSat the time animal of BG curve? (please tick) This will allow time for the animal s blood glucose levels to reach a steady state. Do not alter the dose more frequently than every 3 days in dogs and 7 days in cats8. Establish owner routine: Practice name: 16/01/ :10 Weight Lethargyloss despite constant Drinking and depressio hunger Excessive too much n more _Caninsu Twice daily of Caninsulin is often recommended by UK experts as best practice as it Timeadministration insulin administered: 12/11/ :26 appears to offer improved glycaemic control over insulin administered once daily1,2,3,4,6. An appropriate starting dose for dogs receiving Caninsulin twice daily would be IU/kg1,5,6,7. Time glucose curve started: tells you If your cat or dog displays any of the Starting dose per cat DOGS: In studies conducted with Caninsulin, 0.5 to 1.0 IU/kg bodyweight once daily has been shown to be an appropriate starting dose. The duration of insulin action as determined by a blood glucose curve may require Both the 40 IU/ml strength of Caninsulin and unique precision of VetPen permits accurate dosing which helps reduce dosing error5 es lead _Canin_Nurse_Pres-2.indd 1 n, visit: e.co.uk/p This information is supplementary to the summary of product characteristics. All other product information should be read in conjunction with the protocol /08/ :59 Expectations of success are high with Caninsulin 1-4 a product you ve known and trusted to perform for over 20 years Caninsulin_4pp_presenter_3.indd 1 COU LD YOU BE DIA R PET BET IC? informatio petonlin etdiabet B L O O D G L UC O SE L E V E L S PL O TTE D A G A I NST TI ME TO PRO D UC E C URV E * Always use a new vial of insulin when conducting a blood glucose curve Supporting your practice every step of the way Hyperthyroid Diagnostics with discounted testing for Vidalta users: PRACTICE STARTER PACK Item code: b Caninsulin VetPen that puts you in Travel Pouch Flexible pouch holds pen, needles, sharps remover, and insulin > It s especially common in Discounted Diagnostic Profiles Discounted endocrinology profiles for current users of Vidalta, Caninsulin and Leventa ONLY Blood glucose mmol/l 28 Needles A supply of VetPen needles to get clients started. These ultra-thin pen needles feature a silicone coating to minimize discomfort at injection > Imagine how many pets 13/11/ :35 12/12/ :24

6 MSD Animal Health a global leader in veterinary endocrinology Endocrine research and development heritage Dedicated technical support Solutions to common small animal endocrinopathies USEFUL CONTACTS Dedicated Caninsulin support from the Technical Product Support Team: Call , fax or vet-support.uk@merck.com Dedicated VetPen Training from our Practice Support Web Team: Call or AHUKPracticeSupport@merck.com to arrange your one-to-one web appointment

7 Caninsulin is the World s No.1 insulin for dogs and cats 9 Over 20 years of expertise and experience in the UK Excellent satisfaction rating by UK veterinary surgeons, scoring 8.5 out of 10 in a recent independent survey 8 References: 1. Fleeman LM, Rand JS and Morton JM. Pharmacokinetics and pharmacodynamics of porcine insulin zinc suspension in eight diabetic dogs. Vet Record 2009;164(8): Monroe WE, Laxton D, Fallin EA et al. Efficacy and safety of a purified porcine insulin zinc suspension for managing diabetes mellitus in dogs. J Vet Intern Med 2005;19(5): Michiels et al. Treatment of 46 cats with porcine lente insulin a prospective, multicentre study. Journal of Feline Medicine and Surgery (2008) 10, 439e Martin GJ and Rand JS. Control of diabetes mellitus in cats with porcine insulin zinc suspension. Vet Record 2007;161(3): Zini E, Hafner M, Osto M, Franchini M et al. Predictors of clinical remission in cats with diabetes mellitus. J Vet Intern Med 2010;24(6): Burgaud S, Riant S and Piau N. Comparative laboratory evaluation of dose delivery using a veterinary insulin pen. In: Proceedings of the WSAVA/FECAVA/ BSAVA Congress; 2012 April 12-15; Birmingham, UK; Abstract Brianceau P, Chester T, Smith A, Horspool L, Laxton D. Efficacy and safety of porcine insulin zinc suspension (izs-p) for reducing hyperglycemia and associated clinical signs in cats with diabetes mellitus. In: Proceedings of the ACVIM forum; 4 7 June 2008; San Antonio, TX. 8. Diabetes Global Market Research, UK - Bio sat, July CEESA data, Use medicines responsibly. For more information visit Caninsulin is indicated for the treatment of diabetes mellitus in cats and dogs. Caninsulin is an intermediate acting insulin product containing porcine insulin, which is structurally identical to canine insulin. Legal category POM-V. Please refer to the product packaging and leaflets for information about side effects, precautions, warnings and contra-indications. Caninsulin is the property of Intervet International B.V. or affiliated companies or licensors and is protected by copyrights, trademark and other intellectual property laws. Copyright 2015 Intervet International B.V. All rights reserved. Further information is available from the Caninsulin SPC and MSD Animal Health, Walton Manor, Walton, Milton Keynes MK7 7AJ Tel: vet-support.uk@merck.com SA-F /Jan15/NB/3k

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