Objective—To evaluate and compare characteristics of a commercially manufactured protamine zinc insulin (PZI) product and PZI products obtained from various compounding pharmacies.
Sample—112 vials of PZI (16 vials of the commercially manufactured product and 8 vials from each of 12 compounding pharmacies) purchased over an 8-month period.
Procedures—Validated methods were used to analyze 2 vials of each product at 4 time points. Appearance, endotoxin concentration, crystal size, insulin concentration in the supernatant, pH, total insulin and zinc concentrations, and species of insulin origin were evaluated.
Results—All 16 vials of commercially manufactured PZI met United States Pharmacopeia (USP) specifications. Of 96 vials of compounded PZI, 1 (1 %) contained a concentration of endotoxin > 32 endotoxin U/mL, 23 (24%) had concentrations of insulin in the supernatant > 1.0 U/mL, and 45 (47%) had pH values < 7.1 or > 7.4; all of these values were outside of specifications. Several vials of compounded PZI (52/96 [54%]) did not meet specifications for zinc concentration (0.06 to 0.1 mg/mL for 40 U of insulin/mL, 0.075 to 0.12 mg/mL for 50 U of insulin/mL, and 0.15 to 0.25 mg/mL for 100 U of insulin/mL), and total insulin concentration in 36 [38%] vials was < 90% of the labeled concentration.
Conclusions and Clinical Relevance—Only 1 of 12 compounded PZI products met all USP specifications in all vials tested. Use of compounded PZI insulin products could potentially lead to serious problems with glycemic control in veterinary patients.
To evaluate the effects of a single dose of orally administered gabapentin in alleviating stress at a veterinary visit in privately owned dogs.
22 healthy client-owned dogs (1.5 to 8.5 years old) were enrolled in this study.
Each dog received a 50-mg/kg oral dose of either gabapentin or placebo 2 hours before the beginning of each visit protocol. The dog’s behavioral responses were coded from recorded video clips during a 5-minute-long standardized physical examination and pre– and post–physical examination phases. The veterinary technician separately rated each greeting behavior at each visit. Physiological variables during veterinary visits (ie, eye surface temperature and salivary cortisol concentrations) were also compared between the pre– and post–physical examination phases. The owner was queried 24 hours after a visit to determine the incidence of adverse events.
The greeting test score, eye surface temperature, and cortisol concentrations did not differ substantially between the gabapentin and placebo treatment groups. Lip licking frequency during the physical examination phase was significantly lower in the gabapentin treatment group than in the placebo group (P = 0.001). Lip licking frequency during the pre– and post–physical examination phases was also significantly lower in the gabapentin treatment group than in the placebo treatment group (P = 0.004). No serious adverse events were reported by the owners following gabapentin treatment.
Results showed that the 50-mg/kg dose of gabapentin was well tolerated without serious adverse effects in healthy dogs. Further studies are recommended of dogs with documented stress in response to a veterinary visit.