Hmmm... Levemir or ProZinc

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my Casey bear

my Casey bear

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I found a new vet for Casey today and I am very pleased with our visit. We desided to run a ...blood panel??...test to make sure there are no underlying illness prior to starting an isulin regiment, and plan to begin treatment on Thurs (after the test results are in). This new vet prescribes ProZinc most often, but would be willing to go with Levemir after she talk with a pet specialist she knows whom has had experience working with it.

From what I have read and learned (thanks to FDMB) there are things I like about both forms of insulin, but I know I have a lot more to learn. I know that they are both great products, butt I am afraid I may miss an important component in making the correct decission for Casey's care. For example: I just found out tonight that there are a number of variations of ProZinc...I think. I brought up questions and opinion re: each product with the vet, but I do not know if I missed any would be vital. I was advised to request a u100 seringe and 30-31G needle with Levemir. Would that hold true if I would go with ProZinc too? I am trying to think if there may be questions or concerns that I may have missed/did not know to ask or bring up with the vet.

I have expressed that my goal/hope is to get Casey OTJ and diet regulated ASAP, and my concerns of having Casey go throught BG "peakes and valleys" and my uncertainness that I would be able to maintain a strict 12/12 schedule. Are there other pertainent questions or concerns I should be discussing with the vet?

Roberta
and Casey
 
ProZinc is usually U40. Mine was U100 and compounded in Baltimore. From what I've seen of others postings, the benefit of the u40 is you start with the normal dose, but when you get down to needing micro doses you switch to u100 needles and a conversion chart. My Maisey was only on insulin for a bit over a month, so I'm no expert. When I was micro dosing Maisey it seemed I was down to a couple of drops.
 
I've used both. I switched because pz was getting too expensive, and doesn't work well for a cat with acromegaly. I like levemir a lot. From what I've seen, pz works best for cats on very small doses. I could be way off, though. You can use u-100 syringes with pz, but you have to use a conversion chart to measure the dose, and dose very carefully. the u-100 syringes are MUCH cheaper! 100 for $10 at walmart. The U-40 syringes cost an arm and a leg at the vet. PZ is probably the most flexible insulin for dosing slightly outside of the 12/12 schedule. But you have a life, we all do, so levemir can fit in, too. Have you read the stickies? Lev builds up a "shed" that the body can draw from if the insulin need arises. That can help get you through the times that a dose may be a little late, but may result in raised bg levels over a couple of days when the shed is refilling. Look at Peggy & Mickey for an example of how flexible the dosing can be. But if you're just worried that you may be late cuz you go to dinner or a movie or work an hour late every so often, don't let that deter you from lev. I don't want to seem like pz isn't a good insulin. It is, and it works GREAT for some kitties, but it doesn't seem to work reliably great for most or all kitties. lev and lantus are probably the best universal insulins--in that they work well for a large number of kitties. I chose lev because it doesn't sting at high doses which is important for a high dose kitty like my Charlie.
 
If I had to use insulin again, I'd use either lantus or levemir and I'd not even consider prozinc. Not because it can't work but it seems more problematic. Lantus would depend on my schedule and levemir just seems to work well.

Please note that while remission is a goal everyone has, it is not always attainable. Your first goal is to get Casey stabilized then regulated, then see about the rest :)
 
I switched to levemir a few months ago and just love it. I find it gives a very good consistancy with numbers. A few bumps along the way but mostly nice steady cycles.
 
I use levemir for both mine.
Prozinc has to be obtained from a vet, doesn't it, as well as the U40 syringes but with levemir, or lantus, you can get them at any pharmacy and the same with the U100syringes..... if you run out or need to get more insulin or syringes and it's a holiday weekend and your vet office is closed for 3 more days, what will you do?
As well, levemir and lantus are longer lasting.
Prozinc may work fine for some, but I think that levemir is the better choice.
 
I can't really help with the insulin choice. We literally just started ProZinc TODAY. Our first injection was this morning. My vet is experienced with ProZinc, so I felt that going with it would be best to start. She wasn't familiar with Lev or Lantus. If I have a question about ProZinc, she will be able to answer it, but if I were to go on Lev or Lantus, she wouldn't be able to help because of her inexperience with those drugs. I just thought going with something that my vet was familiar with was the best route for us. Something for you to think about :)

If you do go with ProZinc and are going to stick with the U40 syringes, DON'T get the syringes from your vet. My vet charged me 44.30 for 100 of them. Order them online at hocks.com They are like 15 bucks for 100 and you get the disposal case as well and shipping is super cheap.
 
I don't know anything about Levemir.

Nanner has been on Pro Zinc and you don't have to get U40 syringes from the vet. You can order them online, we did it thru Amazon. Here lately he's been on such a small dose I've been using U100 syringes so I can be more accurate.

Paula & Nanner
 
Jen & Squeak said:
Please note that while remission is a goal everyone has, it is not always attainable. Your first goal is to get Casey stabilized then regulated, then see about the rest :)
Click to expand...

Jen makes an excellent point. It is very easy to become frustrated over progress when only OTJ is the goal. In order to get to OTJ, there must be regulation first. With regulation comes OTJ, if the cat's pancreas is able to heal.

There is so little clinical research done with Levemir you really only have the experiences of members here to go by. I used the old Idexx PZI for 2 1/2 years for Gandalf and it resulted in declining health because it just would not last long enough each cycle. That is the main advantage to Levemir, it's longer acting, and its ability to stabilize blood glucose is the reason it's a better choice to regulate and maybe achieve OTJ.

Take a look at the graph in the Levemir ISG sticky 101 if you haven't already for a comparison of PZI and Levemir curve numbers.

Your best success will also depend on starting on a low dose. .5U (one half unit) sounds very conservative, but we have cats doing well on even less than that. You need U100 syringes with half unit markings, those help a lot.

Good luck, You're in the right place to use either insulin successfully though, so it may come down to cost for you. That's a consideration for many people and beginners sometimes don't realize that. I cringe when I think how much I spent on PZI compared to what I spend now.
 
Thank you everyone for reading/responding to my post!! Based on the info you all have given me I was planning to stick with my original idea of going w/Levemir, however...things may have changed.

Recap: The vet wanted to use ProZinc and I was requesting Levemir, so she wanted to confer with the specialist she new before prescribing the Lev.

Well, I finally heard back from the vet about a half hour ago. She had talked w/the specialist about Casey and was told she needed to use Lantus. This will be my new thread for the day! Finding out how forgiving Lantus would be if I might not be able to stick exactly to the 12/12 schedule.

Thanks again,

Roberta
and Casey
 
Lantus and Levemir both need the 12/12 schedule.

Some cats are more sensitive than others.

With Tiggy, we can flex about an hour per day and still get good results with no big bouncing. So if we need to shoot up to an hour early or late once in a while -- it is ok with him.
 
Phoebe_Tiggy_NortonGA said:
Lantus and Levemir both need the 12/12 schedule.

Some cats are more sensitive than others.

With Tiggy, we can flex about an hour per day and still get good results with no big bouncing. So if we need to shoot up to an hour early or late once in a while -- it is ok with him.
Click to expand...

Is a 12/12 schedule ideal? Yes it is. But it's not always practical.

Levemir can be used on a split dose basis to move shots later and on a reduced dose basis to move shots earlier. A member of the Lev ISG has an even more erratic schedule than mine and her cat's preshot yesterday morning was 114! We custom designed a shot schedule for them.

If he can do that well, any cat can. I suspect Lantus could be used in this manner as well. It just takes someone willing to work with it and learn what works for their cat and situation.
 
Well if you go lantus you will have no shortage of helpers over in lantus land! Tons of kitties are on lantus with great success.
 
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