PZI versus Lantus

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tonimarmalade

tonimarmalade

Member Since 2015
I am reading a book called YOUR CAT by avet named Elizabeth Hodgkins who says that an insulin called PZI is better for a diabetic cat because it's structure from cows or pigs is closer to a cat,s so it does a better job of regulating the cat and get him/her to make his own insulin again. However, both my vet here in Rehoboth, DE and my guide on the diabetic journey, Dr. Lisa Pierson prefer Lantus. Any information, thoughts, about these two insulins for diabetic kitties?
 
If you take a look at the Tight Regulation Sticky, there is an attachment at the end called Management of Diabetic Cats. This document represents some of the more current research on feline diabetes and discusses the various long lasting insulins used in cats. PZI used to be made from animals, but is no longer. Here is a quote from that paper, emphasis is mine:
PZI was removed from the human market in the 1990s.7 PZI has been used extensively in feline diabetes. For cats, animal origin preparations of PZI were discontinued in 2008 and have been replaced by human recombinant PZI, which has been shown to be equally effective in cats. PZI is also available from some compounding pharmacies in the United States, although the use of insulin from such a source is not recommended because of the possibility of variability in consistency and supply and the increased expense for the owner.
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Levemir is a third option for insulin for cats. Any of PZI, Lantus and Levemir are good insulins. I think it would be easier to go with what your vet supports. However, full disclosure here, I used Caninsulin for two months cause that's what my vet started us on. Bad choice, a locum vet got us on Lantus.
 
Thanks so much for the update. This book was published in 2007. I'll stick with Lantus. Am curious to know what brands and favors of canned food you feed your kitty. I have been using a combination of brands but sticking to Dr. Pierson,s guidelines of low carb(less than 10) and as high a protein as Iwish. I think maybe what Marmy eats and WHEN she eats affects her BG score so I think I might track what she eats and when and her scores and see if I find a pattern. Any opinions on that from anyone for this newbe?
 
PZI is still available in a compounded form and is 100% bovine in makeup. "Prozinc" is the recombinant human DNA one.

What you are seeing is Dr. Hodgkin's bias towards an insulin that she prefers over Lantus or Levemir. And her statement predates the latest research on those types of insulin. Her version of "tight regulation" works best with a "P" insulin rather than with an "L" insulin. The Hodgkin's TR protocol and the Roomp/Rand protocol are nowhere near alike.


That said, cats can go into remission on either of the "L's" as well as compounded PZI or Prozinc. Every cat responds differently to insulin. Unfortunately, there is no way of telling which one(s) will work best for your cat in advance.
 
I think maybe what Marmy eats and WHEN she eats affects her BG score so I think I might track what she eats and when and her scores and see if I find a pattern. Any opinions on that from anyone for this newbe?
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Absolutely, when and what she eats will influence her BG numbers. Usually within the first hour you would see the number go up as the digested food is turned into glucose and hits her bloodstream. Liquids, like gravy for instance, would probably show up more quickly as they would take less time to digest.
 
Since she eats several meals daily because she needs to gain some weight back and Dr. P. Said she prefers several little meals to 2 big ones because the numbers are less apt to spike, I guess I just go forward as I'm doing and let her eat when she is hungry which is frequently.
Thank you for your response.
 
Vyktor was always free fed. When he got diabetes I just started taking the food from him from +10 to preshot. If a cat doesn't over eat it's a good way of doing things.
 
Carl provided great information. There are other differences between the "L" insulins and Prozinc/PZI. If your plan is to use Lantus, you might want to take a look at the starred, sticky notes at the top of the board. There's an overwhelming amount of information in those notes (so don't worry if you feel overwhelmed!) but it truly does become second nature after a month or so.
 
tonimarmalade said:
Since she eats several meals daily because she needs to gain some weight back and Dr. P. Said she prefers several little meals to 2 big ones because the numbers are less apt to spike, I guess I just go forward as I'm doing and let her eat when she is hungry which is frequently.
Thank you for your response.
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I completely agree with Dr. Lisa. Frequent small meals work best.
 
I will study the Lantus info. ASAP. Thanks for understanding the "overwhelming" feeling. Many critical needs need my attention presently both human and feline. But I try to keep myself focused in the moment and it all works out. Deep breaths are great!
Many thanks!:bighug:
 
Lantus is a great insulin. The only protocol for treating diabetic cats that's been published in a professional veterinary journal is the one we follow here by Dr. Rand/Roomp. Lantus & Levemir provide the longest duration in a cat's body, and cats are fast at metabolizing insulin. The longer duration, the better blood sugar control in the cat's body, which is important.

Just wanted to add a welcome. Please feel free to ask questions. Everyone is overwhelmed in the beginning - we absolutely all get it. People here are great at helping to explain things or suggest tricks that work for them. Dr. Pierson is great - she used to post here on FDMB and we refer people to her site about food. It can help if you ask people as you come across something that is confusing.

I took a peek at Marmalade's ss - they are irresistible to me! LOL. You've got some lovely blue cycles going. You're already doing a great job with Marmalade!

There are a couple of things I'd suggest. We know that many, many cats have their lowest blood sugar readings at night because of Dawn Phenomenon, which influences their morning cycle. So we always encourage people to get a before-bed test, just to see what the kitty might have going on in the evening. One test in the evening can be really helpful at filling out the picture.

The other thought is to just ask you to consider what your goal is for Marmalade? Are you aware that diabetic cats have the potential for their pancreas to heal and to begin putting out insulin again? Some cats are able to go off of insulin and become diet-controlled. It doesn't happen to every cat, and we don't know which ones will do so, but it happens often enough that we like to make sure people are aware of the potential. The PDF that Wendy linked you to above, is from the pre-eminent researchers on Lantus and diabetic cats, and Dr. Rand says that the path to remission is to get the cat's blood sugar back into normal range (50-120 on a human glucometer) as quickly as possible. That's the range that pancreatic healing can occur in.

I wanted to pass along this post - i found it hard to find information when I was new. This is just an index of where to find information on the Lantus/Lev forum.
 
I feed remi small meals throughout the day and night. He is now a diet controlled diabetic thanks to the members of this forum but when he was on insulin I would

Test, feed and inject insulin
Test at +2 (food no longer affecting the test) and then feed again
Test at +4 and the feed
Feed at +5 or +6.
Repeat in the evening

Ofcourse the amount I tested changed according to levels I found but in essence unless he was going low I tried to test 2 hours after he ate and always removed food 2 hours prior to his next shot was due.
 
With all my heart and faith I believe that Marmy will get to and stay in remission! The closing on all my email correspondence reads" For those who believe, all things are possible."

I will read up on Rand/Roomp and the other info. Asap. Thank you for your guidance. I just read your ss for Punkin. What a beautiful cat. You certainly did all you could for him. And your other little kitty is also beautiful. Hopefully healthy!
 
phlika29 said:
I feed remi small meals throughout the day and night. He is now a diet controlled diabetic thanks to the members of this forum but when he was on insulin I would

Test, feed and inject insulin
Test at +2 (food no longer affecting the test) and then feed again
Test at +4 and the feed
Feed at +5 or +6.
Repeat in the evening

Ofcourse the amount I tested changed according to levels I found but in essence unless he was going low I tried to test 2 hours after he ate and always removed food 2 hours prior to his next shot was due.[/QUOTE

What a great guideline! I will see how it works with a little tweaking to fit Marmy's schedule. She ( along with our old hyperthyroid and declining Mystic and our Mia "isabelly", MArmy's older sister, who is overweight but losing a little bitsince we have switched to all wet, low carb)also eats little tiny snacks through the night! Thank you. Who's in charge here!:cat: A diet controlled diabetic! Music to my ears and eyes. Good for you and Remi!
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She's parked on my lap right now. Anya is nearly 6 and doing great. After punkin died we got 2 kittens, one orange, Frodo and one tuxedo, McGee. Both boys are great and all of them make me smile.
 
After I answer this heartwarming message from you about your three kitties, I am going to spend about an hour and a half with our deaf, CKD, asthmatic feral lover girl kitty in her heated condo we call the garage and she has called home for 2 years. After she eats she will jump up in my lap and purr the whole while I am with her. What an angel! They three M,s won,t let her in. Love them all!
 
Hope I did the right thing with Marmalade. Those low numbers had me reading all about shooting low. Will test her again before she has her third snack of the mornng.
 
Still low- 81 and Ihave to leave her for about 5 hours. I am going yogi everyone lunch and pray. She seems wonderful! And I prayed forged numbers. I am not sureIam posting the right place either. Please advise this first time inThe green lady and Marmalade? Thanks you all.
 
If you have to leave the house, please out out lots of low carb food fro Marmalade to munch on. Looks like she's surfing, but better to be safe.

For future reference, at this forum we ask that the first times that you shoot below 150, you test, DO NOT feed, and post for help before shooting. There are a few options the experienced members can help you through. And when you shoot your lowest ever, it's always a good idea to get a +1 and a +2 test to see how the cycle is going.

Although the AMPS was a bit of a surprise today, getting at least one test during the night time cycle might have given you a heads up. A lot of cats (like mine) go lower at night. A before bed test is very helpful in figuring out what is happening.

One housekeeping note, due to the number of kitties here, we ask that you start one new post per day and link back to the old post. And change the subject title if you have any questions - that way it'll be spotted easier.
 
Thanks. I am home. She is fine but no more greens:blackeye:.How and where do I start a new post linked to the old post? Thanks for your guidance. I will get a pm test tonight.
 
We just mean to start a new post here (in this forum) each day and put the link to the prior day's post in the new one....that way it's easy for people to go back and see what was said the day before

If you look at some of the other condo's (that's what we call posts) in this forum, you'll see that we each put the link to yesterday's condo in todays. Just copy the address in the address bar and paste it into your new post
 
Just spoke with Dr. Pierson and she said not to test before bed right now but to go back to Fat 2 which I did and to go to1.5 if I get a green PS again. Thanks for all your help.
 
What you're seeing is a "bounce." Your kitty isn't used to those green numbers and her pancreas and liver went into a panic and released a stored form of glucose along with counterregulatory hormones. It can take up to 3 days for a bounce to clear.

Not to take issue with Dr. Pierson, I think it's a very good habit to get into to get a before bed test. Last night, that might have told you a great deal. You have no way of knowing how low Marmalade's numbers went. Tonight, it will be helpful to see if the numbers are staying high or coming down.

If you don't know how to "link" the thread from today to the one you start tomorrow, do the following:
  • in this thread (i.e., the one from the previous day), copy the location from the top of your browser
  • open a new condo
  • in the text box, click on the icon at the top that looks like a paper clip (7th from the left)
  • This will open up a box, paste the link in the box and click "insert"
  • The link will then be in your current day's condo
If you want to name the link (e.g., "Yesterday's Condo"), type what you want to name the link and highlight the name. Then click on the paper clip icon and follow the above steps.
 
Hi Toni - what a nice green streak for Marmalade today! woo-hoo!

I'm somewhat shocked that Dr. Pierson said not to test in the evening cycle. Would you send her that link I gave you above about Dawn Phenomenon, and let her know that those of us here on FDMB really strongly, super encourage everyone to get at least one test in the pm cycle because so many cats go low in the pm cycle. It's a huge safety concern for us. I know she's referred clients to FDMB and she has a link on her website. It's essential information or we wouldn't all harp on the topic to every single new member. There are cats that do all of their low numbers in the pm cycle. The question that pops into an experienced member's head when we see an amps in the 60's, is "how low did kitty go during the night if they have RISEN to the 60's 12 hrs after their last shot?"

It's pretty likely that once you've had a green streak like that, unless you reduce the dose before she goes below 50, you're going to see that again. When a cat gets under 120, that's the range that the pancreas has the opportunity to heal in.

You're doing great - you're getting a lot of experience right off the bat!
 
Hi Toni,
I'm relieved Marmalade is OK. :cat:

I don't use the same insulin as you but I am also a huge fan of the 'before bedtime' test.
In my experience (my cat has been on insulin for 8 years) it is almost the most useful test that you can do (apart from testing before each shot). That test can be a great predictor of what might happen later in the cycle. And it can either settle your mind and let you know that you can sleep, or it can sometimes alert you to the fact that you may need to do some more monitoring during the night.

I also must confess that I'm a tad baffled by the advice to give 1.5 units if you get a green preshot. Whilst this may be correct in the circumstances (some folks here have learned from experience that they can give shots at low numbers) a green preshot number may also indicate that your cat is going into remission and doesn't need that shot. Has your vet suggested a 'no shoot' number to you? (ie, a number below which you don't give the shot?)

The folks on the Lantus forum here aren't vets but they do have loads of combined experience of dealing with their diabetic cats on a daily basis. If you are ever in doubt about whether to give a shot (or about how much to give), do consider posting here to talk things through with someone. There is almost always someone here. Or, if there isn't anyone here, you can post on the main health forum.

It's lovely to see those numbers improving for Marmalade.
You're doing a great job! Well done!:D

Eliz
 
julie & punkin (ga) said:
Hi Toni - what a nice green streak for Marmalade today! woo-hoo!

I'm somewhat shocked that Dr. Pierson said not to test in the evening cycle. Would you send her that link I gave you above about Dawn Phenomenon, and let her know that those of us here on FDMB really strongly, super encourage everyone to get at least one test in the pm cycle because so many cats go low in the pm cycle. It's a huge safety concern for us. I know she's referred clients to FDMB and she has a link on her website. It's essential information or we wouldn't all harp on the topic to every single new member. There are cats that do all of their low numbers in the pm cycle. The question that pops into an experienced member's head when we see an amps in the 60's, is "how low did kitty go during the night if they have RISEN to the 60's 12 hrs after their last shot?"

It's pretty likely that once you've had a green streak like that, unless you reduce the dose before she goes below 50, you're going to see that again. When a cat gets under 120, that's the range that the pancreas has the opportunity to heal in.

You're doing great - you're getting a lot of experience right off the bat!
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Ok. But I don,t know how to
 
I have sent the link to Dawn Phenomenon to Dr. P with your rationale. But my bed time is 8:30 because I am up at 4:30 so with Marmy's pm shot at 6 to 6:15 not sure that will tell me much.
I will say it was a wonderful feeling to see those greens yesterday!
Thank you for all your advice :rolleyes:and support.
 
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