title: Intramuscular glargine with or without concurrent subcutaneous administration for treatment of feline diabetic ketoacidosis.
abstract: OBJECTIVE
  To describe treatment response and outcome in 15 cats with diabetic ketoacidosis (DKA) initially stabilized with glargine administered intramuscularly (IM) with or without subcutaneous (SC) glargine.
  
  
  METHODS
  Fifteen cats diagnosed with DKA were initially administered IM glargine (1-2 U) and in most cats (12/15 cats) this was combined with SC glargine (1-3 U). This was followed by intermittent IM glargine as required at intervals of 2 or more hours (range 2-22 h) and SC glargine (1-2 U) every 12 hours.
  
  
  RESULTS
  All 15 cats survived and were discharged from hospital (median 4 d; range 2-5 d) and one-third (5/15) of cats subsequently achieved remission (median time 20 d; range 15-29 d). Complications included hypokalemia and hypophosphatemia, which were likely the result of DKA therapy rather than glargine treatment specifically.
  
  
  CONCLUSIONS
  This study demonstrates that glargine administered IM is an effective treatment for DKA in cats, and may provide an alternative to regular insulin. The same vial used for initial treatment of DKA can then be used for subsequent management with SC glargine injections. Future prospective randomized controlled trials evaluating clinical outcomes in cats with DKA using different types and routes of administration of insulin are warranted. A prospective randomized controlled trial is required to compare outcomes for IM and IV administration of glargine and regular insulin in DKA cats with or without SC glargine.
authors.affiliation: Centre for Companion Animal Health, School of Veterinary Science, The University of Queensland, QLD, 4072, Australia.
authors.forename: Rhett D
authors.initials: RD
authors.lastname: Marshall
authors.forename: Jacquie S
authors.initials: JS
authors.lastname: Rand
authors.forename: Marcus N
authors.initials: MN
authors.lastname: Gunew
authors.forename: Victor H
authors.initials: VH
authors.lastname: Menrath
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000188:drug therapy*; D002415:Cats; D016883:Diabetic Ketoacidosis / Q000188:drug therapy / Q000662:veterinary*; D004359:Drug Therapy, Combination; D005260:Female; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies
chemical_list: D049528:Insulin, Long-Acting; D000069036:Insulin Glargine