Does insulin dosing require rigid 12-hr scheduling?

[ja9390]

My Diego went to the doctor today. I showed her my notebook with the data I collected and she graduated him from 1u once a day to 1u twice a day. He gets Novolin and so far we like it, what we didn't like was not being yet authorized to give a second shot, so his sugars were going high and he would drink wildly in the middle of the night and keep me awake with anxiety. Handled it though. Tonight is the first time I gave him a night shot. He tested in the 430s pre-shot and I plan to do one more test two hours later to make sure he'll be safe if I go to bed.

My question: What about people who cannot adhere to a strict 12-hour insulin dosing schedule?? Between my class schedule, my work schedule, and my other work schedule...and my other work schedule...he will have to get varying nighttime dosages. I am able to of course set an alarm to wake up, feed, go back to sleep and wake up an hour later to give his morning insulin however depending on when I get home this may not be followed up with a shot exactly 12 hours from that time. Say he got his breakfast at 6, meds at 7am. Two days a week I work until 8:30 or 9pm so I can't give him his next dose until I get home. To compensate I could give him his morning insulin at 9am that day, but again, depending on whether it's a school or a work day, I may be long gone out the door by 9. So I'm in a pickle. What do I do? I would usually always be able to swing back home to give him some food and his next shot a few hours early before I head out again, but that would really depend on what his pre-test numbers say.

 

[jayla-n-Drevon]

My Diego went to the doctor today. I showed her my notebook with the data I collected and she graduated him from 1u once a day to 1u twice a day. He gets Novolin and so far we like it, what we didn't like was not being yet authorized to give a second shot, so his sugars were going high and he would drink wildly in the middle of the night and keep me awake with anxiety. Handled it though. Tonight is the first time I gave him a night shot. He tested in the 430s pre-shot and I plan to do one more test two hours later to make sure he'll be safe if I go to bed.

My question: What about people who cannot adhere to a strict 12-hour insulin dosing schedule?? Between my class schedule, my work schedule, and my other work schedule...and my other work schedule...he will have to get varying nighttime dosages. I am able to of course set an alarm to wake up, feed, go back to sleep and wake up an hour later to give his morning insulin however depending on when I get home this may not be followed up with a shot exactly 12 hours from that time. Say he got his breakfast at 6, meds at 7am. Two days a week I work until 8:30 or 9pm so I can't give him his next dose until I get home. To compensate I could give him his morning insulin at 9am that day, but again, depending on whether it's a school or a work day, I may be long gone out the door by 9. So I'm in a pickle. What do I do? I would usually always be able to swing back home to give him some food and his next shot a few hours early before I head out again, but that would really depend on what his pre-test numbers say.

Hi --I am not familiar with novolin but I can bump this for you....

 

[ja9390]

Thanks. I also have questions about alternating the blood testing between the ear and the paw pad. I feel terrible that I've stuck his ear so many times and I tried taking from the large paw pad on his back foot to allow his ears time to heal. I warmed his foot up and everything but it was more difficult getting a good stick vs the ear. I had to push harder. Tried three times and he was pissed but I got it. Think next time I will try the lancet pen on the most shallow setting as this time I had just free-handed it the way I do his ears. Anyone have any experience doing good paw sticks? Also, I hear that Pure Bites or something along those lines is a good low carb treat for them to eat right after and I plan on getting him some as a reward for being a superhero and my very first patient...but what about other foods? He has always absolutely loved raw green beans for some reason but I haven't given him any since his dx. Loved when I'd buy him a couple raw shrimp from Winn-Dixie too. Are these OK? I'm thinking of low carb treats that I eat personally but cheese is hard on their stomachs and tree nuts won't even be recognized as food, lol. This baby has been through so much the past few weeks and I'm just ready to see positive results. In the meantime I want to make his life a little happier with some nice treats. I wish I could stick my own fingers 4 times a day instead of going after him.

 

[jayla-n-Drevon]

Thanks. I also have questions about alternating the blood testing between the ear and the paw pad. I feel terrible that I've stuck his ear so many times and I tried taking from the large paw pad on his back foot to allow his ears time to heal. I warmed his foot up and everything but it was more difficult getting a good stick vs the ear. I had to push harder. Tried three times and he was pissed but I got it. Think next time I will try the lancet pen on the most shallow setting as this time I had just free-handed it the way I do his ears. Anyone have any experience doing good paw sticks? Also, I hear that Pure Bites or something along those lines is a good low carb treat for them to eat right after and I plan on getting him some as a reward for being a superhero and my very first patient...but what about other foods? He has always absolutely loved raw green beans for some reason but I haven't given him any since his dx. Loved when I'd buy him a couple raw shrimp from Winn-Dixie too. Are these OK? I'm thinking of low carb treats that I eat personally but cheese is hard on their stomachs and tree nuts won't even be recognized as food, lol. This baby has been through so much the past few weeks and I'm just ready to see positive results. In the meantime I want to make his life a little happier with some nice treats. I wish I could stick my own fingers 4 times a day instead of going after him.

pricking the ear takes time to get it so it works for both of you... many people think they want to hit the vein and what you really want is the "sweet spot"

Dre lays on my leg (I sit on the floor with him) he has his front paws on my thigh and I rub his ear and put a little pressure (like if plucking eyebrows) and gently prick down at a 45 degree angle ... I get as close to the edge of the ear as I can without actually hitting the edge of the ear (he isn't a fan of the very edge)---it took us a while to get it but try to be patient as it is new for both of you-

 

[jayla-n-Drevon]

Thanks. I also have questions about alternating the blood testing between the ear and the paw pad. I feel terrible that I've stuck his ear so many times and I tried taking from the large paw pad on his back foot to allow his ears time to heal. I warmed his foot up and everything but it was more difficult getting a good stick vs the ear. I had to push harder. Tried three times and he was pissed but I got it. Think next time I will try the lancet pen on the most shallow setting as this time I had just free-handed it the way I do his ears. Anyone have any experience doing good paw sticks? Also, I hear that Pure Bites or something along those lines is a good low carb treat for them to eat right after and I plan on getting him some as a reward for being a superhero and my very first patient...but what about other foods? He has always absolutely loved raw green beans for some reason but I haven't given him any since his dx. Loved when I'd buy him a couple raw shrimp from Winn-Dixie too. Are these OK? I'm thinking of low carb treats that I eat personally but cheese is hard on their stomachs and tree nuts won't even be recognized as food, lol. This baby has been through so much the past few weeks and I'm just ready to see positive results. In the meantime I want to make his life a little happier with some nice treats. I wish I could stick my own fingers 4 times a day instead of going after him.

I have never pricked the pad so I have no idea about that--
are you using 29 gauge? 30?
I personally use free hand-mine doesn't like noise.
Yes pure bites is very good-there are many freeze dried treats that are good-as long as it is 1 ingredient and not too rich (like lamb liver)
I put the pure bites or the freeze dried cat man do treats in the vita mix and turn them into fairy dust so no pukis-
green beans do have carbs but depending how carb sensitive he is maybe he can have 1 or 2-
schimp is fine-
some people use a little parmesan cheese to entice them to eat but yes too much cheese might cause tummy upset---a nibble I would think is ok now and them,
Actually if he likes raw -it is the most species appropriate food for him.... are you feeding a low carb can food?
many people here use fancy feast classic variety only-
are you doing tight regulation or so slow? or either?
I am glad you are getting a bed time test-
pretty much everyone here tests before injecting and before bed at a minimum --
I am doing tight regulation (hoping for remission) so I test pretty often.... it helps that he is a really good boy
I am going to tag @MrWorfMen's Mom
Maybe she can help with your Novolin dosing....
your doing fantastic!

 

[manxcat419]

For paw pad testing, use the alternate site lancing cap (if you're using a ReliOn lancing device, it's the clear cap) - it goes deeper, which you need with a paw. Use a 26 or 28 gauge lancet - anything smaller isn't going to work. Hold the paw firmly so you're using the paw itself to put pressure on the lancet and once you prick the paw pad, don't move the lancing device away for about a slow count of 10 - that way the pressure from the device cap will help the blood to well up a little around the hole you just made. I alternated between ears and paws for Rosa, especially when I was testing a lot as I didn't want her to get too sore in any one place...she'll only let me use her right ear or back left paw, and I didn't want to use her right ear ALL of the time on the days I was testing every 30 minutes.

 

[Chris & China (GA)]

Loved when I'd buy him a couple raw shrimp from Winn-Dixie too. Are these OK?

These are fine for "pokey treats"...you can also bake chicken a piece of chicken (if he likes it) and cut into cubes...put a couple of days worth in the refrigerator and freeze the rest

Any "pure protein" source can be used for "pokey treats"

 

[ja9390]

I got great at testing his ear, I just don't want to stick his poor ears over and over day in and day out. I wish they were bigger and I had more surface area to work with. I am not too concerned with him being strictly monitored for right now since he was recently just diagnosed and the goal for now is just to get him regulated and feeling a lot less miserable. I plan to test three times a day, pre-shots and +2 after his night shot. I will locate the Pure Bites and get him some, and he'll be delighted when I bring him some fresh shrimp home tomorrow!! I'm buying him a little harness as well because I plan on daily outings to get him walking around a little more. I don't know what gauge the lancets are--when I get more I'll pick the larger ones for his toes.

 

[manxcat419]

I got great at testing his ear, I just don't want to stick his poor ears over and over day in and day out.

I know exactly what you mean - that was how I felt about it too, especially on the days there was a lot of testing. Even now, Rosa will let me know whether I get to test her paw or her ear when she gets tested each week. I figure it's her getting poked, she should at least get a say in where!

I'm buying him a little harness as well because I plan on daily outings to get him walking around a little more.

Rosa LOVES her harness and her walks. It took her no time at all to settle with the harness because she realized she could get to go out that way. And the exercise definitely helps to keep them healthy.

 

[jayla-n-Drevon]

These kittys!!
Dre has a "NO POKING ZONE" on his right ear

 

[manxcat419]

Dre has a "NO POKING ZONE" on his right ear

Rosa's entire left ear is a "no poking zone". If I even try her left ear, I get growled at! They might have to put up with being poked, but they're going to make sure that even that is on their own terms!

 

[Tuxedo Mom]

My question: What about people who cannot adhere to a strict 12-hour insulin dosing schedule?? Between my class schedule, my work schedule, and my other work schedule...and my other work schedule...he will have to get varying nighttime dosages.

Novalin is an "in and out" insulin so the strict 12 hour schedule is not as important. It tends to have a shorter duration than the longer acting insulins, so by doing a longer cycle the only thing that could happen is Diego's numbers could be higher on the long cycles. But if this is what fits into your schedule then you do what you can. It is better to have time to do a test after shooting, than to shoot and leave right away.

I am not sure whether Novalin can be done on a sliding scale..shooting different doses according to the pre-shot numbers. You could post a question inquiring about this and see what experienced Novalin uers say.

 

[Larry and Kitties]

N/NPH insulin can successfully be used with the type of schedule you have. With N/NPH y can adjust the does as necessary. However, since a high BG is expects after a long period one should be hesitent to increade the does the the next period will be short. Since N/NPH only last 8-10 hours a short period not shorter than that should not cause a does reduction.

 

[Mogmom and Goofus]

To make poking the paw pad easier, when you first pick kitty up, on the leg of the paw you plan to test, grasp the leg toward the top and pull/rub down a few times. Go all the way to the toes, this helps move the blood into pad. I keep the lancing device set at 4. The pads have very little feeling in them so going deeper doesn't hurt them.

When I test Goof, I lay him on his side on the kitchen counter and use my forearm to hold him in place. This gives me both hands free so I can use the thumb and forefinger to make a pumping motion, the blood comes really easily then.

 

[ja9390]

Rosa's entire left ear is a "no poking zone". If I even try her left ear, I get growled at! They might have to put up with being poked, but they're going to make sure that even that is on their own terms!

Laughing hard. They're such humans!!

 

[ja9390]

Novalin is an "in and out" insulin so the strict 12 hour schedule is not as important. It tends to have a shorter duration than the longer acting insulins, so by doing a longer cycle the only thing that could happen is Diego's numbers could be higher on the long cycles. But if this is what fits into your schedule then you do what you can. It is better to have time to do a test after shooting, than to shoot and leave right away.

I am not sure whether Novalin can be done on a sliding scale..shooting different doses according to the pre-shot numbers. You could post a question inquiring about this and see what experienced Novalin uers say.

Thanks, I didn't think so because it's such a quick-to-wear-off insulin but you can never be too sure. It could be a sliding scale insulin...that's a question for my vet and of course anyone who wants to chime in. I brought up my concerns of Novolin and whether or not it will work personally for Diego's diabetes. She said that all of her diabetic cat patients are on Novolin, are well regulated, and only a few have made a switch to a different insulin, but that she'll switch his insulin if we ever think he needs it. So that was encouraging...she also told me this is something his body will have to learn how to use and the lower numbers we want to see may take a good few weeks to appear. I told her not to be concerned with offending me if she ever truly thought he needs a more feline-specific insulin like Lantus and that I would find a way of affording it.

 

[ja9390]

To make poking the paw pad easier, when you first pick kitty up, on the leg of the paw you plan to test, grasp the leg toward the top and pull/rub down a few times. Go all the way to the toes, this helps move the blood into pad. I keep the lancing device set at 4. The pads have very little feeling in them so going deeper doesn't hurt them.

When I test Goof, I lay him on his side on the kitchen counter and use my forearm to hold him in place. This gives me both hands free so I can use the thumb and forefinger to make a pumping motion, the blood comes really easily then.

He doesn't mind it? When I poked Diego's foot last night, he squeaked and tried to get away when I finally made a deeper poke and got the blood I needed Then this morning I switched to taking from the ear, warmed it up really well and the slightest of pokes drew blood. If that cat felt it I would be shocked because he didn't even flinch.

 

[Tuxedo Mom]

Thanks, I didn't think so because it's such a quick-to-wear-off insulin but you can never be too sure. It could be a sliding scale insulin...that's a question for my vet and of course anyone who wants to chime in. I brought up my concerns of Novolin and whether or not it will work personally for Diego's diabetes. She said that all of her diabetic cat patients are on Novolin, are well regulated, and only a few have made a switch to a different insulin, but that she'll switch his insulin if we ever think he needs it. So that was encouraging...she also told me this is something his body will have to learn how to use and the lower numbers we want to see may take a good few weeks to appear. I told her not to be concerned with offending me if she ever truly thought he needs a more feline-specific insulin like Lantus and that I would find a way of affording it.

It is good your vet seems to be willing to work with you. It does take time for the body to get used to insulin so you can give it some time before you think about switching. Some kitties will do wonderful on one type of insulin and for another it may not work well at all. ECID (Every Cat is Different) Same with people...they use different type of insulin depending on how their bodies respond. Thee is no one size fits all insulin.

You can ask for users and people familiar with Novalin what sort of sliding scale might work with your schedule. But as Larry and Kitties said in his post:

N/NPH insulin can successfully be used with the type of schedule you have. With N/NPH y can adjust the does as necessary. However, since a high BG is expects after a long period one should be hesitent to increade the does the the next period will be short. Since N/NPH only last 8-10 hours a short period not shorter than that should not cause a does reduction.

So you have to have a good understanding of when to do different doses and when to keep the same. Hope someone here can give you better/more information.

 

[MrWorfMen's Mom]

I see Larry and Mary Ann have already addressed your question about adhering to a strict 12 hour schedule. I have never used Novolin but I know that keeping to a tight 12 hour schedule is not necessary as it is with the depot insulins. I think the key is to figure out how long the Novolin is working for Diego because every cat is different. Testing is key. While Novolin generally lasts 8-10 hours in most cats, some cats will get less or more "mileage". I suggest when you need help with dosing or timing of your insulin, include the name of the insulin you are using in the title of your thread. That way you'll get more of a response from folks like Larry who have experience with your type of insulin.

Hopefully Novolin will work for Diego but if you should decide to consider another insulin in the future, you might want to look at ProZinc rather than Lantus because it is an in and out insulin like Novolin but last longer, allows for some schedule flexibility and sliding scale dosing. It might be a better solution to your erratic schedule than Lantus. There are folks here very experienced with ProZinc who can help set up sliding scale dosing for Diego.

 

[Melanie and Smokey]

At a recent FD conference that my vet attended, the new info on Lantus is that is should NOT be used on cats.

With a better than 80% remission rate in cats in scientific studies and less instance of hypoglycemia, I'd like to see the justification in that. Other than making more money by selling veterinary approved insulin for the life of the cat. There are a couple of very vocal veterinarians out there that do not believe in Lantus. Their belief is not based on any scientific studies, simply on their own practice research - which since they do not encourage diet change, home testing, or BGs lower than 100 it would lend to supporting their own hypotheses. I'd be curious to know if one of these vets were the presenter of this information.

I got great at testing his ear, I just don't want to stick his poor ears over and over day in and day out.

The more you poke, the more their ears get used to it. The first week or two can be a little sore, but after that their ears "learn to be poked". Our current foster is our 6th diabetic. I haven't had a single one have any long term effects or sustain any damage to their ears and we test a lot. Most have learned to come running when they hear the meter beep or the sound of the strips canister. Cecil was so jealous of Chris getting tested that he'd lay across the top of him when we'd try to test Chris so he got tested a lot more than he needed to for a while Lincoln, our current foster, has been our WORST for testing and really didn't let the previous foster test much. We had to burrito him in a blanket quite a bit a first. Now he just lays across my lap purring most of the time. Its usually harder on the caregiver than the cats because cats really are drama queens when they are being told what to do and not getting their way.

 

[manxcat419]

At a recent FD conference that my vet attended, the new info on Lantus is that is should NOT be used on cats.

I have an appointment at the vet on Monday for some repeat blood work for Regan. I'll ask them if they know about this and the reasons behind it while I'm there. I can't understand why they would recommend not using it as it's the only insulin that seems to have a high proven remission rate for cats.

 

[manxcat419]

Awww (((Tammy))) I'm so sorry to hear about Mouse. I really hope your vet can help her. And I hope you can find a solution for Goof's sore on his shoulder too.

I forgot to add - Lantus has never been the top insulin for use in dogs because, in dogs, they found that they require a bolus insulin at meal times in addition to the Lantus (which of course is the same way that most humans on Lantus use it) so it increases the cost and the number of shots required each day.

 

[manxcat419]

I ran some fairly extensive searches and can't find any published research supporting the idea that Lantus isn't recommended any more. The only thing I do wonder is if it's related to this information about Tresiba which is a new insulin http://www.firstwordpharma.com/node/1355858#axzz40fgMsOMd Maybe this is going to be a new option for diabetic cats as well as humans.

 

[Andy & Pimp]

Could it have been that Lantus isn't FDA approved for cats?

 

[manxcat419]

That's certainly a possibility Andy. Depending on the vet, they might not want to prescribe something that isn't FDA approved for cats, though so many of the common medications aren't marketed for (or even often approved for) cats that you'd wonder at any vet not feeling comfortable using something off-label these days.

 

[Critter Mom]

@Mogmom and Goofus -

Sending prayers that your vet will be able to help Mouse.




Mogs
.

 

[manxcat419]

I did ask about the Lantus, this was what he said: "This info comes from Feline Specialists, not
just a regular vet, Lantus is a human insulin made using human DNA, not cat DNA. The reason
ProZinc, which was developed using cat DNA, was developed was because there were too many
problems with the other available insulins. Because the dosing can be so difficult with the other
insulins, there's too much bouncing, too many hypo events and too many cases of kidney failure
and other kidney problems. If a cat is going to go into remission, it has nothing to do with what
insulin you use, it has to do with the individual cat." Because I only have experience with ProZinc,
I can't say which I think is better, but I can say that in the almost 5 years that we've been using
Dr James as our vet, he's never steered me wrong, or made me feel like he was racking up extra
charges to pad his pockets. He's always been honest with us about everything, good or bad. The
new vet in the office, Dr Britt, has had a lot of additional education in cats and FD, so I trust
their opinions.

Well, there's certainly nothing wrong with ProZinc and if you get good results with it, there's no reason at all to change - it's one of the insulins we know works well for cats. The bouncing and hypo events - I'm not so convinced on those. I don't see from looking at people's spreadsheets that ProZinc causes less bouncing or fewer low numbers than Lantus except that more caution tends to be used over shooting an already low number with ProZinc than it is with Lantus. The packaging I see online states that it's recombinant human insulin. While it is made specifically FOR cats, it is still a human-based insulin. I do wonder if he's confusing with PZI which is similar, but not the same - it's made from bovine insulin which is closer to a cat's natural insulin than human insulin is. The kidney problems - I don't know...as far as we can tell Rosa's kidney issues far predated our use of Lantus for her as there was evidence of very old damage by kidney stones that had passed on her ultrasound. But I wouldn't stop using Lantus on that basis alone.

 

[Tuxedo Mom]

Tammy

for you and a boatload of healing energy being sent for Mouse. Prayers that the baytril will be the turning point!!

 

[manxcat419]

We're
going to try one more thing, Baytril, given sub-q as she threw up after giving her the first dose,
apparently it doesn't taste very good.

Baytril, according to my 2 cats, does indeed taste awful...so bad they have to spit it out and hide the pills! And it has been known to make them vomit too - I think both have had it twice in their lives. Paws crossed that the injected Baytril is the answer for Mouse.

 

[Critter Mom]

Sending prayers that the Baytril will help Mouse.




Mogs
.

 

[jayla-n-Drevon]

Well, here's the skinny:

The last antibiotic didn't help, the congestion in Mouse's lungs has gone deeper down. We're
going to try one more thing, Baytril, given sub-q as she threw up after giving her the first dose,
apparently it doesn't taste very good. I called the vet and explained what happened, he said Icould also give it by injection. Thank God I know how to give those shots. But if this doesn't help,we'll have to let her go.

The sore on Goof's shoulder was larger than I thought, vet shaved the area as the hair was stuck
in it and preventing it from draining. Upon shaving, we discovered that he had an area a little
larger than a golf ball of red, raised and somewhat scaley skin around it, STAPH INFECTION.
I'm so glad I took him in, as this could certainly be the cause of the rising bg. So now I'll use
this spray (can't remember the name) 2-3 times a day, and he DOES NOT LIKE IT. I'd been
using Bactoderm on it, but it wouldn't heal, yesterday I discovered that the ointment's
expiration date was June of 2010. My bad.

I did ask about the Lantus, this was what he said: "This info comes from Feline Specialists, not
just a regular vet, Lantus is a human insulin made using human DNA, not cat DNA. The reason
ProZinc, which was developed using cat DNA, was developed was because there were too many
problems with the other available insulins. Because the dosing can be so difficult with the other insulins there's too much bouncing, too many hypo events and too many cases of kidney failure and other kidney problems. If a cat is going to go into remission, it has nothing to do with what insulin you use, it has to do with the individual cat." Because I only have experience with ProZinc, I can't say which I think is better, but I can say that in the almost 5 years that we've been using Dr James as our vet, he's never steered me wrong, or made me feel like he was racking up extra charges to pad his pockets. He's always been honest with us about everything, good or bad. The new vet in the office, Dr Britt, has had a lot of additional education in cats and FD, so I trust their opinions.

Now I'm not saying AT ALL that I think all of you using Lantus should stop, but I think that
for those who are using the older/harsher insulins and considering switching, I think they
should really consider using an insulin made for cats. The dosing is easier and more flexible so maybe a little less scarey for a newbie who's terrified that they're going to do something wrong and hurt their baby. I wish that Prozinc came in a smaller vial, but if it's properly stored, it doesn't "spoil" 30 days after tapping the bottle. The bottle I'm using now was tapped on October 27, 2015, it's still working just fine.

We used Pro zinc before lantus--I did like that he was himself on it--I just didnt see remission in our future ( I was dosing 6-8 hours apart) although many on pro zinc have had remission. I consulted with the vet who took over Dr Hodgkins practice (who was a avid user of pro zinc) and she firmly believes lantus has better remission/regulation. Who knows..... I think if you ask 10 vets you will get 10 answers
I personally think whatever works is the best insulin for your cat
I have used baytril injection and it has worked well-- if I remember right is is administered IM-1x a day
Hope your baby is all better soon!

 

[jayla-n-Drevon]

I think you're right about that, 10 vets, 10 answers. And yeah, not every insulin will work for every cat. Goof was in remission for almost 6 months, then a bad tooth which needed to be removed and a UTI at the same time, brought him back out. I'm still hoping it'll happen again, though I know the longer it takes, the less likely it is occur. I'm wondering tho why you were dosing 6-8 hours apart when ProZinc is 10 to 14 hour insulin.

Thank you for all the well wishes for my Mouse.

I was trying Dr Hodkins protocol and my guy seems to nadir at +3 and head for the clouds steadily after... we had a few days a week or so ago with lantus where he was low and flat--I was so happy! Then I had a back to back reduction and bak to square 1-
Pro zinc did not last more than 8 hours for us and usually 6. I hope you have better luck--like I said I did like that his personality was happy on it (he was sad on vetsulin)
best wishes

 

[Larry and Kitties]

The reason
ProZinc, which was developed using cat DNA, was developed was because there were too many
problems with the other available insulins.

This is wrong.The proZinc lable says:
Description: ProZinc® insulin is a sterile aqueous protamine zinc suspension of recombinant human insulin.
https://www.prozinc.us/content/dam/internet/ah/prozinc/us_EN/documents/ProZinc_Product_Info.pdf

The predecessor of ProZinc was PZIVet which is:
Description PZI VET® insulin is composed of a mixture of 90% beef and 10% pork insulin. Species differences in insulin structure occur due to amino acid substitutions. Feline insulin differs from bovine insulin by one amino acid and from porcine insulin by four amino acids.1,2
The insulin is complexed with protamine zinc to form a microcrystalline suspension that results in prolonged dissolution, delivery and an extended duration of effect.3,4

http://www.drugs.com/vet/pzi-vet.html

PZIVet was previously a formulaio used for humans.

 

[jayla-n-Drevon]

I just have to say that 80% of what you said flew over my head like a Lear jet.

The vet that gave us pro zinc said she preferred it as it was closer to Drevons biology..... that makes sense to me and I think is why he was so "normal" on it as far as personality. I also (in my opinion no proof) this lantus and lev were not as well known at the time that many vets used pro zinc/pzi or vetsulin.
If it had lasted longer in his body I probably would have stayed with it longer but the dosing was crazy. Hope it works better for you

 

[Larry and Kitties]

ProZinc is not closer than other modern human insulins since all modern insuls are made with recombinant human insulin. That means that bacteria are used to produce the insulin.
https://www.nlm.nih.gov/exhibition/...A/recombinant-dna-technology-alternative.html

ProZinc uses the same insulin(recombinant human insulin) as N/NPH but the additive in ProZinc (protomine zinc) is different that in N/NPH (protamine sulfate) and that results in a longer duration of the ProZinc.
The predecessor of ProZinc, PZI Vet uses a compbinatin of porcien (pig) and bovine (cow) insulin which is closer to cat insulin that human insulin.

 

[ELLIOTT & Fran Munschauer]

Well, here's the skinny:

The last antibiotic didn't help, the congestion in Mouse's lungs has gone deeper down. We're
going to try one more thing, Baytril, given sub-q as she threw up after giving her the first dose,
apparently it doesn't taste very good. I called the vet and explained what happened, he said Icould also give it by injection. Thank God I know how to give those shots. But if this doesn't help,we'll have to let her go.

The sore on Goof's shoulder was larger than I thought, vet shaved the area as the hair was stuck
in it and preventing it from draining. Upon shaving, we discovered that he had an area a little
larger than a golf ball of red, raised and somewhat scaley skin around it, STAPH INFECTION.
I'm so glad I took him in, as this could certainly be the cause of the rising bg. So now I'll use
this spray (can't remember the name) 2-3 times a day, and he DOES NOT LIKE IT. I'd been
using Bactoderm on it, but it wouldn't heal, yesterday I discovered that the ointment's
expiration date was June of 2010. My bad.

I did ask about the Lantus, this was what he said: "This info comes from Feline Specialists, not
just a regular vet, Lantus is a human insulin made using human DNA, not cat DNA. The reason
ProZinc, which was developed using cat DNA, was developed was because there were too many
problems with the other available insulins. Because the dosing can be so difficult with the other insulins there's too much bouncing, too many hypo events and too many cases of kidney failure and other kidney problems. If a cat is going to go into remission, it has nothing to do with what insulin you use, it has to do with the individual cat." Because I only have experience with ProZinc, I can't say which I think is better, but I can say that in the almost 5 years that we've been using Dr James as our vet, he's never steered me wrong, or made me feel like he was racking up extra charges to pad his pockets. He's always been honest with us about everything, good or bad. The new vet in the office, Dr Britt, has had a lot of additional education in cats and FD, so I trust their opinions.

Now I'm not saying AT ALL that I think all of you using Lantus should stop, but I think that
for those who are using the older/harsher insulins and considering switching, I think they
should really consider using an insulin made for cats. The dosing is easier and more flexible so maybe a little less scarey for a newbie who's terrified that they're going to do something wrong and hurt their baby. I wish that Prozinc came in a smaller vial, but if it's properly stored, it doesn't "spoil" 30 days after tapping the bottle. The bottle I'm using now was tapped on October 27, 2015, it's still working just fine.

Nope, he doesn't mind at all, he doesn't even blink. The pads don't have much feeling, thats why they can jump down from high places with out hurting their feet.

Also, Lantus is a human insulin that works in some cats, but ProZinc is an animal specific insulin. It's also an "in and out" insulin, but does allow for a more flexible dosing schedule. At a recent FD conference that my vet attended, the new info on Lantus is that is should NOT be used on cats. I didn't ask why not because I was there with another of my kitties in an emergency situation, my mind was elsewhere. But I needed to get some juice for Goof and asked him about using it for him to maybe save some money. I don't think the money is part of it as he sells me ProZinc at cost.

Disturbing info....Elliott was switched to Lantus from NPH...Does anyone have further documentation on this? THIS IS...disturbing information.

 

[manxcat419]

Disturbing info....Elliott was switched to Lantus from NPH...Does anyone have further documentation on this? THIS IS...disturbing information.

I'm registered with various sites that provide me with news about this sort of thing (courtesy of my college course). I've done extensive searches for new research, new information...you name it, I've searched for it. It seems to me like it's a personal preference thing for the vets involved - I can find nothing that even close to says 'Lantus shouldn't be used for cats any more'. ProZinc is designed for cats, but is still a human-based insulin, not a cat-based insulin at all. Different insulins work best for different cats - Lantus did just fine for us and for a huge number of other cats on the board. The only question you need to ask yourself is "Is Lantus working for my cat?" If the answer is yes, then don't switch. If you find it isn't working after a few months, try something else. Insulin response is a personal in cats as it is in humans - what works for one does nothing for another. Lantus is still a perfectly good choice with a proven track record in cats - yes, it's used off-label but then so are many other medications for cats. I would stop worrying and just see how Elliott does on Lantus.

 

[ELLIOTT & Fran Munschauer]

I am extremely upset...The Lantus cat people are great..and have tried to help me every minute of the day in the past, reminding me that this is a marathon...not a sprint...Patience is the key...I never looked up info on PZI because it was never an option. I am told everyone gets a little crazy after just being diagnosed with DM..This info has just really knocked me off course. Thanks for your response.

 

[manxcat419]

Let me put it to you this way. Unless (and I think it's very unlikely) some information shows up that proves that Lantus is actively dangerous in cats, I would have no hesitation in requesting (otherwise known as demanding) Lantus from my vet should Rosa ever need insulin again. PZI and ProZinc are not the same thing - PZI is based on bovine insulin (which IS closer to a cat's natural insulin). ProZinc is a human-based insulin. Elliott was only switched to Lantus a month ago and already he's getting a lot less pink numbers and more of the better readings - I'd stick with Lantus and see what he can do with it over a longer time before you even think about researching other options. Try not to let it make you too crazy - all the longer-acting insulins are good, personal preferences aside.

 

[CarolandTigger]

Our Tigger just made the switch from Vetsulin to Lantus after a DKA episode. He's doing great on Lantus, and his numbers are MUCH better He's been completely in the blues and yellows for the last week. We switched vets...actually the old vet recommended Lantus too, as the new one does. I'll ask her about the other insulins when we go for a curve soon.

 

[manxcat419]

Our vet likes Lantus - I wasn't even offered anything else as a choice when Rosa was diagnosed. I'm not sure they ever use anything else except if they get a case where the cat doesn't respond to Lantus.

 

[Julia & Bandit (GA)]

I am extremely upset...The Lantus cat people are great..and have tried to help me every minute of the day in the past, reminding me that this is a marathon...not a sprint...Patience is the key...I never looked up info on PZI because it was never an option. I am told everyone gets a little crazy after just being diagnosed with DM..This info has just really knocked me off course. Thanks for your response.

I'm sorry Fran, but there was a lot of incorrect information that was given to you up above. Please stick with the Lantus--and give it some time and patience. It can take a little while for things to level out with it, especially if the cat's BG has been out of control for some time before the Lantus was started.

Years ago, some vets and researchers theorized that the old PZI (made from beef and pork insulin), was better for cats because it was closer to (not made from) their own DNA. I think this is where that line of thinking came from. However, there have been no studies that have proven this theory. Dr. Elizabeth Hodgkins was one of the most vocal proponents of that theory, and if I remember correctly a few years ago she retracted her recommendation of PZI over Lantus for that reason.

Studies have since shown that what matters more to successful treatment than the source animal is the duration of action of the insulin . Lantus and Levemir have the longest duration of action in cats, which is why they have higher remission rates in cats than other insulins. The current Prozinc that is prescribed (which is a human recombinant insulin, not a cat insulin) has an OK duration of action (better than NPH or Vetsulin, which have a very poor duration of action) so there is some success with it in cats, but Lantus and Levemir are still the most successful. (See p. 264 of the attached article, where it states "Overall, glycemic control using glargine/detemir is superior to PZI because of the long duration of action these insulin analogues, which reduces periods of hyperglycemia.")

@Mogmom and Goofus I'm sorry, but your vet is not giving you correct nor current information. There are absolutely no new studies out there that point to PZI or Prozinc working better in cats, or Lantus or Levemir not working as well as they previously have been proven to (see attached). Bandit currently sees an internal medicine specialist at Cornell, and his vet recommends Lantus or Levemir to all his feline patients, along with the same tight regulation protocols that you find here on FDMB (or as close to it as he can get the owners to safely commit with their testing frequency). I also happen to have access to all the current veterinary databases and journals that Cornell has access to, and I did a search just to make sure no new significant studies have popped up since I last checked, and there are none.

 

[ELLIOTT & Fran Munschauer]

Thank you Max..Julia and all!!

 

[Julia & Bandit (GA)]

Oh, and I'd like to add--the assertion that Lantus or Levemir can cause kidney problems is absolutely made up from thin air. There is no evidence of this in veterinary literature, anywhere. The largest culprit of kidney disease in cats is dry food, due to chronic dehydration caused by the lack of moisture in dry diets. In diabetic cats, prolonged high blood sugar can also strain the kidneys.

 

[ELLIOTT & Fran Munschauer]

I'm sorry Fran, but there was a lot of incorrect information that was given to you up above. Please stick with the Lantus--and give it some time and patience. It can take a little while for things to level out with it, especially if the cat's BG has been out of control for some time before the Lantus was started.

Years ago, some vets and researchers theorized that the old PZI (made from beef and pork insulin), was better for cats because it was closer to (not made from) their own DNA. I think this is where that line of thinking came from. However, there have been no studies that have proven this theory. Dr. Elizabeth Hodgkins was one of the most vocal proponents of that theory, and if I remember correctly a few years ago she retracted her recommendation of PZI over Lantus for that reason.

Studies have since shown that what matters more to successful treatment than the source animal is the duration of action of the insulin . Lantus and Levemir have the longest duration of action in cats, which is why they have higher remission rates in cats than other insulins. The current Prozinc that is prescribed (which is a human recombinant insulin, not a cat insulin) has an OK duration of action (better than NPH or Vetsulin, which have a very poor duration of action) so there is some success with it in cats, but Lantus and Levemir are still the most successful. (See p. 264 of the attached article, where it states "Overall, glycemic control using glargine/detemir is superior to PZI because of the long duration of action these insulin analogues, which reduces periods of hyperglycemia.")

@Mogmom and Goofus I'm sorry, but your vet is not giving you correct nor current information. There are absolutely no new studies out there that point to PZI or Prozinc working better in cats, or Lantus or Levemir not working as well as they previously have been proven to (see attached). Bandit currently sees an internal medicine specialist at Cornell, and his vet recommends Lantus or Levemir to all his feline patients, along with the same tight regulation protocols that you find here on FDMB (or as close to it as he can get the owners to safely commit with their testing frequency). I also happen to have access to all the current veterinary databases and journals that Cornell has access to, and I did a search just to make sure no new significant studies have popped up since I last checked, and there are none.

I LOVE CORNELL!!!!!!!!!!!!!!

 

[ELLIOTT & Fran Munschauer]

I'm sorry Fran, but there was a lot of incorrect information that was given to you up above. Please stick with the Lantus--and give it some time and patience. It can take a little while for things to level out with it, especially if the cat's BG has been out of control for some time before the Lantus was started.

Years ago, some vets and researchers theorized that the old PZI (made from beef and pork insulin), was better for cats because it was closer to (not made from) their own DNA. I think this is where that line of thinking came from. However, there have been no studies that have proven this theory. Dr. Elizabeth Hodgkins was one of the most vocal proponents of that theory, and if I remember correctly a few years ago she retracted her recommendation of PZI over Lantus for that reason.

Studies have since shown that what matters more to successful treatment than the source animal is the duration of action of the insulin . Lantus and Levemir have the longest duration of action in cats, which is why they have higher remission rates in cats than other insulins. The current Prozinc that is prescribed (which is a human recombinant insulin, not a cat insulin) has an OK duration of action (better than NPH or Vetsulin, which have a very poor duration of action) so there is some success with it in cats, but Lantus and Levemir are still the most successful. (See p. 264 of the attached article, where it states "Overall, glycemic control using glargine/detemir is superior to PZI because of the long duration of action these insulin analogues, which reduces periods of hyperglycemia.")

@Mogmom and Goofus I'm sorry, but your vet is not giving you correct nor current information. There are absolutely no new studies out there that point to PZI or Prozinc working better in cats, or Lantus or Levemir not working as well as they previously have been proven to (see attached). Bandit currently sees an internal medicine specialist at Cornell, and his vet recommends Lantus or Levemir to all his feline patients, along with the same tight regulation protocols that you find here on FDMB (or as close to it as he can get the owners to safely commit with their testing frequency). I also happen to have access to all the current veterinary databases and journals that Cornell has access to, and I did a search just to make sure no new significant studies have popped up since I last checked, and there are none.

What A BEAUTIFUL SPREADSHEET for Bandit..!!!

 

[Critter Mom]

I did like that his personality was happy on it (he was sad on vetsulin)

Saoirse was the same way. The roller coaster BG levels she had on Vetsulin absolutely hammered her system. She was much happier on Lantus.


Mogs
.

 

[ELLIOTT & Fran Munschauer]

Saoirse was the same way. The roller coaster BG levels she had on Vetsulin absolutely hammered her system. She was much happier on Lantus.


Mogs
.

And Saoirse's SS..GREAT and off the insulin??? I hope someday for results like Saoirese and Bandit!!