Insulin: Detemir

What is detemir insulin?

Detemir insulin is an injectable medication used in cats and dogs. It is used to lower blood sugar level and for long-term maintenance therapy of diabetes mellitus.

Its use is off label (extra label) in veterinary medicine. Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. 

In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label.

How do I give my pet detemir insulin?

• Detemir insulin comes in injectable form (vial and injection pen).
• Injections are given subcutaneously (under the skin).
• Use only U100 syringes with detemir insulin.
• This medication should be given at the same time every day.
• This medication should be given after a meal. Do not give this medication if your pet is not eating and consult your veterinarian for further instructions.
• Follow injection instructions provided by your veterinary team. Ensure the correct dose is drawn and given each time. Do not shake or roll the medication.
• Contact your veterinarian if you encounter difficulty in drawing up the medication or giving the injections.
• Give this medication to your pet for the entire time prescribed by your veterinarian; do not stop giving this medication suddenly.

This medication should start to take effect within 1–2 hours.

What if I miss giving my pet the medication?

A single missed dose can cause temporary signs, but it is usually not life-threatening. Contact your veterinarian as soon as possible for advice on when to give your animal’s next dose. Never double-up on doses as this will cause an overdose. If you cannot reach your veterinarian and your animal is eating and acting normally, give your animal the usual dose at the next regularly scheduled time.

Are there any potential side effects from detemir insulin?

Detemir insulin may cause the following side effects:

• Lumps or thickening of skin at injection site
• Signs of high blood sugar (e.g., excessive thirst, frequent urination, increased appetite)

Serious adverse reactions are rare, but may occur. If any of the following signs develop, stop giving detemir insulin and contact your veterinarian immediately:

• Signs of low blood sugar, such as weakness, lack of energy, lethargy, stumbling or difficulty walking, behavior changes, muscle twitching, seizures (convulsions), and/or unresponsiveness
• An allergic reaction, such as irregular breathing, rash, fever, puffiness and swelling around the face

Drug sensitivities can develop over time with repeated exposure. Your pet may have no reaction after the first few doses, but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment.

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This long-acting insulin can last for up to 15 hours.

Are there any risk factors for this medication?

DO NOT USE detemir insulin in:

• Animals that are allergic to any component
• Animals that are not eating
• Animals that are showing signs of low blood sugar or have confirmed low blood sugar (hypoglycemia)
• Dogs weighing less than 10 kg (22 lb)

If you suspect your pet’s blood sugar level is low, contact your veterinarian immediately. Hypoglycemia is a potentially fatal emergency.

Are there any drug interactions I should be aware of?

The following medications should be used with caution when given with detemir insulin:

• Albuterol, terbutaline
• Certain medications used for sedation (e.g., acepromazine, dexmedetomidine, xylazine)
• Clonidine
• Estrogens, Progestins
• Fluoxetine, monoamine oxidase inhibitors (MAOIs)
• Medications used to treat heart conditions and/or control blood pressure (e.g., ACE inhibitors [ACEIs], acetylsalicylic acid, angiotensin receptor blockers [ARBs], beta-blockers, calcium channel blockers, digoxin, disopyramide, diuretics, reserpine)
• Oral glycemic control medications (e.g., glipizide)
• Sulfonamides, Fluoroquinolones
• Thyroid hormones

Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking before starting any new treatment.

Is any monitoring needed with this medication?

• When starting detemir insulin, your veterinarian will monitor baseline blood work and urinalysis to check organ function and for urinary tract infections.
• Close monitoring of blood sugar levels and overall health (e.g., appetite, energy, thirst, weight) is required. Consult with your veterinarian for specific recommended monitoring for your pet.
• At home, monitor for any side effects such as those noted above. If any occur, stop using the medication and contact your veterinarian.

How do I store detemir insulin?

• Unopened vials and pens should be refrigerated. Do not freeze.
• Opened vials and pens may be refrigerated or stored at room temperature, away from direct sunlight and heat. Discard 42 days after first use.
• Discard medication if cloudy or discolored.
• Follow your veterinarian’s recommendations on disposal of used sharps.
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet's weight and symptoms.