Zini E, Padrutt I, Macha K, Riederer A, Pesaresi M, Lutz T A, Reusch C E
Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; Istituto Veterinario di Novara, Strada Provinciale 9, 28060 Granozzo con Monticello, NO, Italy; Department of Animal Medicine, Production and Health, University of Padova, viale dell'Università 16, 35020 Legnaro, PD, Italy.
Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland.
Vet J. 2017 Jan;219:60-64. doi: 10.1016/j.tvjl.2016.12.006. Epub 2016 Dec 15.
The aim of this study was to examine the safety and reliability of a research-grade implantable pump for controlled delivery of insulin glargine in cats. For this purpose, a small telemetrically controlled drug delivery pump with a refillable reservoir was implanted into the subcutaneous tissues of the dorsal neck in 10 clinically healthy cats. The reservoir was filled with insulin glargine, and the pump was programmed to deliver four boluses of 0.25 IU/kg, 2-3 weeks apart. As a control, insulin glargine (0.25 IU/kg) was injected SC. Blood glucose and plasma insulin glargine concentrations were measured before each bolus and SC injection and for 8 h afterward. Cats were monitored for signs of discomfort. Pumps were easily implanted and well tolerated by all cats. The experiment was completed in five of 10 cats. In four, the pump failed because of technical reasons; another cat developed severe hypoglycaemia attributable to insulin leakage. Overall, plasma insulin glargine increased after six of eight (75%) initial boluses and after one of 16 (6%) successive boluses. Glucose decreased after seven of eight (88%) initial boluses and after four of 16 (25%) successive boluses. Only the first bolus significantly increased plasma insulin glargine (P = 0.008) and decreased glucose (P = 0.008). Of 20 SC injections, 10 (50%) increased plasma insulin glargine (P <0.001) and 12 (60%) decreased glucose (P <0.001). The pump did not cause discomfort in cats, but life-threatening hypoglycaemia occurred in one. Frequent device problems suggest that the pump needs improvements. Because successive boluses did not increase plasma insulin glargine, this type of insulin may not be appropriate with the pump.
本研究的目的是检验一种用于在猫体内控制甘精胰岛素递送的研究级可植入泵的安全性和可靠性。为此，将一个带有可再填充储液器的小型遥测控制给药泵植入10只临床健康猫的颈背部皮下组织。储液器中填充甘精胰岛素，泵被设定程序每隔2 - 3周递送4次0.25 IU/kg的推注剂量。作为对照，皮下注射0.25 IU/kg的甘精胰岛素。在每次推注和皮下注射前以及之后8小时测量血糖和血浆甘精胰岛素浓度。监测猫是否有不适迹象。泵易于植入，所有猫对其耐受性良好。10只猫中有5只完成了实验。4只猫的泵因技术原因出现故障；另一只猫因胰岛素泄漏发生严重低血糖。总体而言，8次初始推注中的6次（75%）和16次连续推注中的1次（6%）后血浆甘精胰岛素升高。8次初始推注中的7次（88%）和16次连续推注中的4次（25%）后血糖降低。只有第一次推注显著提高了血浆甘精胰岛素水平（P = 0.008）并降低了血糖（P = 0.008）。在20次皮下注射中，10次（50%）提高了血浆甘精胰岛素水平（P <0.001），12次（60%）降低了血糖（P <0.001）。该泵未给猫带来不适，但有一只猫出现了危及生命的低血糖。频繁的设备问题表明该泵需要改进。由于连续推注未提高血浆甘精胰岛素水平，这种胰岛素可能不适用于该泵。
