New York State Department of Health Emergency Medical Technician - Basic Curriculum Aspirin Administration by Emergency Medical Technicians HISTORY The New York State Emergency Medial Advisory Committee and the New York State Department of Health have approved Emergency Medical Technician – Basics (EMT-B) to administer aspirin to those patients who are classified as “cardiac re
Caninsulin® is for use in animals only. Keep out of reach of children. PORCINE INSULIN ZINC INJECTION (Mfr. Std.)
Seek medical attention immediately if accidental injection occurs. For Veterinary Use Only
What to tell/ask your veterinarian before using Caninsulin® ?
• The signs of DM you have observed.
• What tests might be done before Caninsulin® is prescribed.
• The importance of spaying, if your pet is an 40 I.U./ML
• The importance of consistent daily injections, an appropriate and Owner Information about Caninsulin®
consistent diet, weight control, exercise and home monitoring of your pet's condition. • How often your pet may need to be examined by your veterinarian. Caninsulin® is for the control of hyperglycemia associated with
• The risks and benefits of using Caninsulin®. diabetes mellitus in dogs and cats.
Tell your veterinarian if your pet has ever had the following • Side effects when receiving other insulin products • Digestive upset (vomiting and/or diarrhea) This summary contains important information about Caninsulin®. You • Liver disease
should read this information before you start giving your pet Caninsulin® and review it on a regular basis. This sheet is provided only • Underactive thyroid (Hypothyroidism) as a summary and does not take the place of instructions from your • Cushing's Syndrome (Hyperadrenocorticism) veterinarian. Talk to your veterinarian if you do not understand any of this information or if you want to know more about Caninsulin® . • Any medical problems or allergies that your pet has now or has had. What is Caninsulin®?
• All medicines that you are giving your pet or plan to give your pet, Caninsulin® is an aqueous suspension of porcine (pork) insulin. Insulin is including those you can get without a prescription. a hormone produced by the pancreas (a large gland that lies near the stomach). This hormone is necessary for the body's correct use of How to give Caninsulin® to your pet?
Doses of insulin are measured in units. Caninsulin contains 40 units/mL of insulin (1 mL = 1cc). Use Caninsulin® with U-40 syringes only. Use
What is Diabetes mellitus?
of a syringe other than a U-40 syringe will result in incorrect dosing. It
Diabetes mellitus (DM) occurs when a pet has inadequate levels of or should be administered according to your veterinarian's
an abnormal response to insulin. DM is common in middle age and instructions.
older pets. Daily insulin injections are usually necessary to treat DM. Your veterinarian will determine the amount of insulin needed (based Caninsulin® may help your pet effectively use food, aid in maintaining an on the weight of your pet, clinical signs such as water consumption, acceptable blood sugar (glucose) level, and reduce or eliminate and laboratory results), instruct you on proper storage and handling, clinical signs commonly seen in pets with DM. Diabetes mellitus may show you how to draw the insulin from the bottle, and instruct you cause some or all of these signs or changes in your pet: on how to administer the injection. Once you can do this correctly, your veterinarian will provide you with everything you need to care for your pet at home. Caninsulin® should be administered with a U-40 insulin syringe according to the following instructions: Preparing the Dose:
• Cloudy eyes and vision loss (Diabetic cataracts) • Remove the Caninsulin® bottle from the refrigerator and mix by Untreated or improperly regulated diabetes mellitus may lead to changes gently inverting the bottle (do not shake). in the acidity of the blood (diabetic ketoacidosis) with dehydration, • Carefully remove the cap from the needle. vomiting, weakness, depression, coma and death. • Using a U-40 insulin syringe, pull the plunger back to draw air into the syringe to equal the Caninsulin® dose. What kind of results can I expect when my pet is on Caninsulin® for
• Insert the syringe into the bottle and inject the air into the bottle. Diabetes mellitus?
• Turn the bottle and syringe upside down. Making sure the tip of Although Caninsulin® is not a cure for DM, it can help control or the needle is in the Caninsulin®, withdraw the correct dose into eliminate many of the complications associated with the disease (such as excessive thirst, urination, and weight loss) and prevent • Before removing the needle from the bottle, check the syringe development of life threatening ketoacidosis. for any air bubbles. If bubbles are present, hold the syringe • Response varies from pet to pet but can be quite dramatic. straight up and tap its side until the bubbles float to the top. • In most pets, improvement can be seen within a few days. Push them out with the plunger and withdraw the correct dose. • If Caninsulin® is discontinued or not given as directed, the signs of • Remove the needle from the bottle, being careful to not inject Diabetes mellitus will likely return and life-threatening complications such Giving the injection:
Who should not receive Caninsulin®?
• Injections should be given just under the skin (subcutaneously) • Pets known to have a systemic allergy to pork or pork products. 2-5cm (3/4-2 inches) from the midline of the back (middle of • Pets that have stopped eating or have greatly decreased your pet’s back running from tail to head), varying from just appetite (anorexia), pets that are vomiting, pets that show signs behind the shoulder blade to slightly in front of the hipbone. of extreme drowsiness or fatigue (lethargy) and/or pets showing • The injection site should be alternated between your pet’s left signs of severe ketoacidosis, should not receive Caninsulin® until stabilized with appropriate supportive therapy. • Using your free hand, pinch up a fold of skin, insert the needle into the center of the fold as instructed by your veterinarian, and certain endocrine diseases may counter the effect of insulin. and push the plunger in as far as it will go. Other medications may also interfere with your pet’s response to • Pull the needle out being careful to not inject yourself. insulin. Tell your veterinarian about all the medicines you have • Dispose of the syringe in an appropriate manner given your pet in the past, and any medicines that you are planning to give with Caninsulin®. This should include other medicines that you can get without a prescription. Your veterinarian may want to check What are the possible side effects that may occur during
that all of your pet’s medications can be given together. Caninsulin® therapy?
The most common side effect experienced with Caninsulin® therapy is What do I do in case my pet receives more than the prescribed
hypoglycemia (low blood sugar). Hypoglycemia can be caused by: amount of Caninsulin®?
If your pet is given too much Caninsulin®, severe (life-threatening) hypoglycemia (low blood sugar) can result. Contact your veterinarian immediately. If your veterinarian is not available, seek other veterinary advice at once. Your pet may need to be hospitalized for observation or treatment. • Change in the body’s need for insulin • Diseases of the adrenal, pituitary, or thyroid gland, or What do I do if my pet receives less than the prescribed dose,
or I miss an injection?
• Interaction with other drugs (such as progestogen or • A missed or inadequate dose may cause temporary recurrence of signs (such as excess thirst and urination) but is not life-threatening. Signs of hypoglycemia may occur suddenly and can include: • Contact your veterinarian as soon as possible for advice on • If you cannot reach your veterinarian and your pet is eating and acting normal, give your pet the usual dose at the next regularly What do I do in case my pet shows signs of hypoglycemia?
How do I store Caninsulin®?
• If your pet is unconscious or having a seizure, this is a
Caninsulin® should be stored in an upright position under refrigeration medical emergency. Take your pet to your veterinarian
• If your pet is conscious, rub approximately 1 tablespoon of corn syrup or honey on your pet’s gums. When it is able to swallow, What else should I know about Caninsulin®?
give corn syrup or honey by mouth until your pet is alert This sheet provides a summary of information about Caninsulin®. If you enough to eat. Feed its usual meal and contact your have any questions or concerns about Caninsulin®, talk to your Other side effects that can be seen include loss of effectiveness It is important that your veterinarian periodically evaluate your pet’s and local or systemic allergic reactions. It is important to contact response to Caninsulin® at regular checkups that include blood glucose your veterinarian immediately if you think your pet has a medical monitoring. Your veterinarian will best determine if your pet is responding problem or side effect from Caninsulin® therapy. In particular, please contact your veterinarian if your pet shows any of the following: Additional information can be found at www.Caninsulin.com • Excessive water consumption for more than 3 days • Excess urination (including need to urinate at night for a pet that usually sleeps through the night or inappropriate urination in the house) • Weakness, seizures, or severe mental depression • Behavioural change, muscle twitching, or anxiety • Signs of a bladder infection (small, frequent urinations,
straining, blood in the urine)
• Swelling of the head or neck
What else can I do to keep my pet’s blood sugar stable?
• Your pet’s diet should be consistent and appropriate. A
nutritionally complete, dry or canned pet food should be fed in
consistent amounts at the same times each day or, at the
discretion of your veterinarian, be available continuously.
• “Treats” and changes in diet should generally be avoided
unless recommended by your veterinarian.
• Your veterinarian will advise you on how much and when to
feed your pet based on the response to Caninsulin®.
• Your pet’s exercise should remain consistent. Consult with your
veterinarian if you expect a major change in activity.
• Develop a schedule with your veterinarian for regular
evaluations of your pet’s diabetes.
Can Caninsulin® be used with other medications?
Progestogen (such as megestrol) and glucocorticoids (such as
cortisone, prednisone, dexamethasone, triamcinolone) should be
avoided during Caninsulin® therapy. Progestogen, glucocorticoids,
BACKGROUND INFORMATION EMS System description (including Suburban EMS that responds to both emergency and non-emergency calls urban/rural setting) Vehicle Type/response capabilities 2 person paramedic level transporting service Proximity to and level/type of facilities 30 minutes to the attending physician’s office 15 minutes to community hospital DISPATCH INFORMATION Nature of th