Elmos first curve on compounded PZI

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Kays8cats

Kays8cats

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Hi,

Elmo has been on compounded PZI from pharmacy, U100, yes U100 this is the way the pharmacy makes it.

Does anyone else use U100 compounded PZI???

Anway he was on 1 unit and changed diet to all canned. Not much change in BG after a week or so so switched to 1 and 1/2 units and only very slight decrease in BGs.

Increased to 2 units and he has been on 2 units for about 8 days now.

pre shot bg 360
gave 2 units
+4 326
+6 312
+8 240
+10 220
pre shot +12 -317, gave 2 units

he eats in am after shot and pm after shot ( usually 6am and 6pm) and then again at 10 or 11pm.

Thanks so much input is much appreciated.
 
Kays8cats said:
Does anyone else use U100 compounded PZI???

Anyway he was on 1 unit and changed diet to all canned.
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I do not know any that CURRENTLY uses U100. It can be compounded in U40 strength - it is how your vet wrote the prescription. You may be able to get your pharmacy to dilute it to U40 strength - but now that you have used some I'm not sure how they would do it. But honestly the locally compounded route would be my least preferred option for PZI. I will confess that the exact same thing happened to me - and I took the $50 or so that I spent on it as a loss and got my vet to make the prescription for a manufactured PZI [ProZinc would be the current one]. I still have the full bottle of the compounded in my fridge.

BCP is another good option for PZI and it can be ordered in U40 strength.

What kind of canned food exactly [brand and flavor]?

If you can get a spreadsheet going and profile and link in your signature it will very much help others here help you better.

I'd also be clear in your signature that you are using U100 so folks can make sure to not get things confused. Instructions for that can be found in the stickies in the Tech Support forum.
viewforum.php?f=6

The good news is that if you do change to a U40 insulin, you can still use those U100 syringes, with the appropriate conversion, to give very fine tuned doses. So hang on to those U100 syringes.

Do make sure to read the infos in the sticky at the top of this forum. :smile:
 
I think there may be a couple people around, but I don't recall who. There is one PZI that we've had some debate about where they mix in something else like N maybe, but still call it PZI or maybe Prozinc, but it's a compounded one. Really, it makes my head spin :) but I think that one might be U100.

The curve is interesting with the nadir on the late side. Sometimes that can be a sign the dose is too high (or I'm not sure what variation there might be with the particular type of PZI you use), but I don't see anything else in the #s to suggest that. To me it looks like a nice U-curve with good duration, and #s overall are too high suggesting the dose is too low. If it's 8 days you probably have pretty good overlap going, at least it looks like some overlap to me from the PM PS.

Have the PS been coming down over time? I can't recall if you just recently started testing, or have more data. If the PSs have been coming down I would probably continue with this dose and see if that continues - the PM one is so much better than the AM one it seems like they might continue to improve. If not though, or if tonight's was just an odd-ball cycle with unusually good duration, I'd consider raising it to 2.2u.

I'd like to hear what others think too. I am definitely not a dosing expert by any means, though I like to chime in. :mrgreen: How is he feeling/acting by the way?
 
Thanks,

He eats only friskies canned food, no gravy or shredded or chunks 3 times a day. At am and pm shot and again at 10-11pm.


His pre shots had been going up the past few days. They are usually about 320-360 and the past 2 days they were 400 and 415.

I am now questioning this wacky PZI I got from the compounding pharmacy.

When I was a vet tech I used PZI IDexx on my other 2 diabetic cats but since that is no longer, I just got what my vet has which is the compounded PZI, and yes it is U100 that is the way the pharmacy makes it, I called and talked to the pharmacist.

I must agree from the info that I know that I would rather have a largely manufactured insulin then a compounded one that may not alway be consistant.

I am very low on $$, I have 7 other rescues cats and each has their own issues so I may just use this compounded insulin then switch to BCP PZI, does this sound reasonable??

I have all of his numbers recorded and am going to transfer them to a spreadsheet. Do you know where on here I can find a template to use??

I am also going to adjust my profile like you said, I do have a profile and all that just have to figure out what I am doing LOL, I have been visiting this site on and off for years but I am not too computer Savvy lol.

Elmo looks great and seems to be feeling fine, he is definately feeling better than he did when i fisrt noticed a problem. He is back to chasing the other cats, he eats well, etc. He was 16 pounds and now weighs 13 and is maintaining that weight so far.
 
You are getting very good,maybe to good duration with the one unit. I would continue wit one unit and see what happens after a little more time.
Regarding different insulins:
PZI insulin is made by compounding regular (R insulin if human insulin is uses) with a protamine and zinc additives. The additive extents the duration of the insulin.

Per the package insert for Lilly's N insulin, that insulin is:

"Humulin N [Human insulin (rDNA origin) isophane suspension] is a crystalline suspension of human insulin with protamine and zinc providing an intermediate-acting insulin with a slower onset of action and a longer duration of activity (up to 24 hours) than that of Regular human insulin."

Package insert for LIlly's L insulin (not longer made):
"Humulin L is an amorphous and crystalline suspension of human insulin with zinc providing an intermediate-acting insulin with a slower onset and a longer duration of activity (up to 24 hours) than regular insulin."

The package insert for ProZinc lists the ingredients as: is human recombinant insulin, protamine sulfat, zinc oxide, glycerin, dibasic sodium phosphate heptahydrate, phenol (preservative), water and hydrochloric acid/sodium hydroxide for pH adjustment.
 
Larry,

Elmo has been on 2 units, not 1 unit.

I am in the process of making spreadsheet and will post soon.

Thanks
 
Yep Wedgewood, that's the one I have seen mentioned before. I am almost certain someone around here uses it too. You might search the PZI forum for "Wedgewood" and see what comes up, that might give you the names of others who are using it.

Larry, do you know if all of that means that the compounded one she uses would behave differently than other PZIs, or should it basically follow the same action profile?

SS looks great! You got that one nice nadir on 2u on 4/15, not sure what to make of that, since the other spots tests are ho-hum, and no improved PSs. It looks like he may be a bit stuck in higher #s and need the dose increase you just made to get a breakthrough, and then perhaps it will be a fairly quick dose reduction after that? i.e. looks like he should do ok with a lower dose, only insulin resistance (? right term?) or something like that is keeping it from working right now. Not really sure, hopefully others will chime in!
 
Hello all!
Just returned from vaca last night, lots to do at work, but wanted to let you know about the pzi we used.

Joanna-yes we did use the compounded pzi from Wedgewood. It was compounded with Humulin N and came in u100 strength. Charlie did go otj on it. I think his fd was a result of diet, and since he was otherwise healthy and young, just about any help to his p was all he needed to go into remission (of course, coupled with a diet change to lc).

He was on it for just under 6mos, but we weren't hometesting until the very end (after his hypo).

It wouldn't be my first choice if C came out of remission, but I think it can work for some. Two things concern me about this particular brand--the fact that they use N in it, and the consistency. I think the mass-produced ones like prozinc might be more consistent, but that's just my 2 cents.
 
FurballLover said:
It was compounded with Humulin N and came in u100 strength.
Click to expand...
N huh? I've been castigated before by Larry [maybe even on multiple occasions - oops] for saying the compounded stuff was N instead of R. Maybe it is just Wedgewood that is N - you are positive it is N? Maybe I'm not so crazy after all??
 
Gator-
I called wedgewood in feb to find out exactly what their prozinc is made with and they said it is compounded with N. Unless they have other varieties, that's what they use. My vet called in the rx, and I would simply fill it; so I suppose its possible they have others--but I kind of doubt it.
 
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