I asked for PZI..Vet has prescribed Lantus!!

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Harrycat

Member Since 2012
ARGH.....

THink we might have got our wires crossed, between me and the vet....

I deliberately asked her to try the Bovine PZI, but I have just had a conversation with the surgery and the script says Lantus.

Should I be pleased or not??? :lol: :lol:

Cat is still showing high numbers (starts at +20 most days - UK figures) and we are currently on Caninsulin which is the reason I asked for the PZI as his numbers were off the scale before I switched his diet.

I am sick of vets :evil: Can anyone explain or show me some links on what the pros and cons of Lantus vs PZI would be? I have been basing all my research on getting the PZI and now she is adamant we try the Lantus.
 
Lantus is a VERY good insulin, and there are a lot of people on this board who use it. There are two insulin users' board here - one for Tight Regulation and another for more Relaxed users. Some cats who are prescribed Lantus can ever go into remission. Lantus is a long-acting fairly gentle insulin that can produce nice, long flat curves when regulated - avoiding a lot of the up and down cycles that shorter, harsher insulins can produce. AFAIK, Lantus is one of the "gold-standard" insulins for treating feline diabetes.

There is a TON of information on the Lantus Tight Regulation Board, and a lot of people who can help you.
 
Thanks :)

I looked at the Lantus board and could only see dates etc as the titles of the posts.... so I ran away again... :oops: :lol: :lol:
 
I have used both insulins and they both work well.

Did your vet write the script for a vial or the pens? If the vial, you may want to ask for the script for pens instead. Even though the initial cost is about twice as much as a vial, you get 5 pens. With the pens you are usually able to use almost every drop of insulin before it becomes ineffective. With the vial, it usually starts to become ineffective around 3 months, long before you will be able to use the vial up. In the long run, it usually costs more over a year's time to use the vial vs the pens. Depending on your dose, a package of pens could be enough insulin for almost 1 year.
 
THanks guys - great answers!!

I have asked for the vial, mainly because I still have a stock of Caninsulin U-40 needles (but now wandering if they will be useless??). I also want to make sure that this is the right insulin for him before I invest?

Given that it's UK, would you still get 5 pens in a pack? My head is :? with the conversions and the lack of info from my vet. She did mention the pens, but we dismissed that as more expensive so it's good to know. I have a pal who is a UK pharmacist so hoping she can shed some light for me!!! :-D
 
Harrycat said:
THanks guys - great answers!!

I have asked for the vial, mainly because I still have a stock of Caninsulin U-40 needles (but now wandering if they will be useless??). I also want to make sure that this is the right insulin for him before I invest?

Given that it's UK, would you still get 5 pens in a pack? My head is :? with the conversions and the lack of info from my vet. She did mention the pens, but we dismissed that as more expensive so it's good to know. I have a pal who is a UK pharmacist so hoping she can shed some light for me!!! :-D
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Lantus is good news! But... Lantus is a human insulin, so it is a U100 insulin, that means you need to get U100 syringes. All veterinary insulins are U40, all human insulins are U100. See if your vet will take the U40 syringes back. or see if someone in the UK needs them to mail to them/sell them.

Yes to my knowledge the pens always come in 5 packs. It is probably a good idea to start with a vial to see how your cat responds. Oh and my Merlyn used ONE Lantus vial for 6 months-and then he went OTJ (off the juice). It didnt develop "floaties" for 2 more months..but that was when it was sitting unused in my fridge.
 
I have asked for the vial, mainly because I still have a stock of Caninsulin U-40 needles (but now wandering if they will be useless??). I also want to make sure that this is the right insulin for him before I invest?
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Whether you get a vial or the pens, you will still use syringes to administer the insulin. We don't shoot straight out of the pens.

BUT, you're going to need U100 syringes in either case with Lantus as it is a U100 insulin.
 
Hooray for Harry! \M/

No, it's no bad thing. It's a good thing!

No, you can't use the same syringes. You can buy a box of 100 U100 syringes (BD) for about 20 quid - either through your vet or over the 'net. (try http://www.viovet.co.uk/Pet_Store_I...in_Syringes/c158_8040_1782_5387/category.html).

Yes, I would get your backside to the Lantus Support Group & start with a loooow dose & watch those numbers come down.

It may take a while for him to get used to his new insulin, so don't panic if the first week is a bit 'all over the place'.

How exciting!! He's going to feel sooo much better soon!

Juliet
 
Juliet,
Just curious as I've never understood the conversion, but what does a quid equal in USD? And is it slang as far as relating to a pound?
 
Carl & Bob said:
Juliet,
Just curious as I've never understood the conversion, but what does a quid equal in USD? And is it slang as far as relating to a pound?
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1 quid = 1 GB Pound Sterling = 1.52 USD with current conversion rate.

Yes, it's slang. Wikipedia (for what it's worth!) tells me it might be derived from 'quid pro quo', or 'something for something'.

(Sorry Jackie! Completely off topic, but it'll give the US folks an idea of how much we pay on this side of the pond...)
 
Thank you, Juliet. I think that's consistent with the cost here.
What is (besides my cat's name:-) ) a "Bob"? As in "a ten bob note"?.
 
Ah, well, 'bob' is predecimilisation. A 'bob' used to refer to a shilling, so a 'ten bob note' was ten shillings, but now it is often used in the same way as 'quid', 'squid', 'nicker' etc.

There are also multiples, like 'fiver' & 'tenner'. A 'score' is £20, a 'pony' equals £25 (don't ask me why!). A 'bullseye' is £50. A 'ton' or 'century' is £100. A 'monkey' is £500. A 'grand' (or 'Bag of Sand') commonly means £1,000. Why a monkey is half a bag of sand, I have no idea. :lol:
 
Deb & Wink said:
...Lantus is the top choice for cats these days and Levimir is a close second. Pzi is in third place and the humulin/caninsulin types are in dead last.
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Hi, re PZI, we get Hypurin Bovine PZI here in the UK and it is the longest lasting of all the insulins. It is an excellent insulin for cats.

Jackie, if you're using Lantus you will need to give shots as close to 12 hours apart as possible. If that isn't going to be possible for you (it isn't for everybody) then you may want to get your vet to amend the prescription to Hypurin PZI.

Eliz
 
I agree that bovine PZI is an excellent insulin for cats. I am just wondering your basis for your statement that " it is the longest lasting of all the insulins".

Elizabeth and Bertie said:
Deb & Wink said:
...Lantus is the top choice for cats these days and Levimir is a close second. Pzi is in third place and the humulin/caninsulin types are in dead last.
Click to expand...

Hi, re PZI, we get Hypurin Bovine PZI here in the UK and it is the longest lasting of all the insulins. It is an excellent insulin for cats.

Jackie, if you're using Lantus you will need to give shots as close to 12 hours apart as possible. If that isn't going to be possible for you (it isn't for everybody) then you may want to get your vet to amend the prescription to Hypurin PZI.

Eliz
Click to expand...
 
Larry and Kitties said:
I agree that bovine PZI is an excellent insulin for cats. I am just wondering your basis for your statement that " it is the longest lasting of all the insulins".

Elizabeth and Bertie said:
Deb & Wink said:
...Lantus is the top choice for cats these days and Levimir is a close second. Pzi is in third place and the humulin/caninsulin types are in dead last.
Click to expand...

Hi, re PZI, we get Hypurin Bovine PZI here in the UK and it is the longest lasting of all the insulins. It is an excellent insulin for cats.

Jackie, if you're using Lantus you will need to give shots as close to 12 hours apart as possible. If that isn't going to be possible for you (it isn't for everybody) then you may want to get your vet to amend the prescription to Hypurin PZI.

Eliz
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Click to expand...

Hi Larry, Hypurin Bovine PZI Insulin produced in the UK has a really long duration. It has a duration - in humans - of up to 36 hours. But in cats it lasts, typically, less than half of that. So, in cats it can often last up to 15/16 hours, so a lot of dosing involves an element of overlap; which can be both a blessing and, sometimes, a challenge...
 
Thanks Eliz, I am already on a 12 hour dosing with the Caninsulin and it works well for us so no worries there ;-) The kids are pretty much on a 12 hour cycle so I am generally home at the right times for that!!

Loving the cash definitions ;-)

x
 
I could not find out where it says PZI is best. The first articl includes:
Remission rates:
 Lente = 2 of 8 (25%)
 PZI = 3 (4) of 8 (37-50%)
 Glargine = 8 of 8 (100%)
Most remissions within 4-6 wks
C

Deb & Wink said:
That ranking of insulins for cats was from the University of Queensland, Centre for Companion Animal Health.

Here are some of their great articles.

http://www.uq.edu.au/vetschool/content/clinic-stlucia/feline-dm.pdf

http://www.uq.edu.au/ccah/docs/diabetesinfo/link5.pdf

http://www.uq.edu.au/ccah/?page=41544

http://www.uq.edu.au/vetschool/content/clinic-stlucia/feeding-remission-uqdiabetes.pdf
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Harrycat said:
Thanks Eliz, I am already on a 12 hour dosing with the Caninsulin and it works well for us so no worries there
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That's great then, Jackie. Fingers crossed that Harry will be seeing better numbers soon! :smile:

I would strongly recommend that you have a good read through of the information stickies on the Lantus forum. Lantus works differently to Caninsulin. I think folks here dose Lantus on the nadir (lowest number of the cycle) and not the preshot number. And Lantus is a 'depot insulin' - something that it is important to understand the concept of. And re usage, I think you have to be careful about not injecting Lantus back into the vial if you've drawn out too much (something you can do with Caninsulin).

It might be worth printing out some of the dosing protocol info (developed by a vet) and sharing that with your vet so that you're 'singing from the same page'....?

Eliz x
 
Brilliant advice again Eliz.

I had a good read through the Lantus board last night and watched the vid on how to handle the vials so happy with that. Also like the 'bath salts' analogy that someone gave me on there in that not all of it dissolves in at once so go steady away!! I will try and follow the 'tight regulation' protocol when I introduce it, but will have to wait until after the bank holiday as I have to go away for one night so have my parents injecting for me and don't want them hassled with the fear of a new brand!!

Thanks again

Jax
 
Larry and Kitties said:
I could not find out where it says PZI is best.
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Longest lasting? :
http://images.wikia.com/diabetesindogs/images/c/c4/Human_Activity_Profiles_Various_Insulins.png

Jackie,
Lantus is also a loooong lasting insulin & delivers a constant ('basal') dose to the bloodstream over ~16hrs in kitties (depending on the cat) as you probably know by now! This means there'll still be insulin in his system after the 12 hours of a standard BG curve.
Good luck with his first curve, when you manage to do it. Keep us posted. I have all my bits crossed. :razz:

Juliet
 
Larry and Kitties said:
I could not find out where it says PZI is best. The first articl includes:
Remission rates:
 Lente = 2 of 8 (25%)
 PZI = 3 (4) of 8 (37-50%)
 Glargine = 8 of 8 (100%)
Most remissions within 4-6 wks
Click to expand...

If I'm not mistaken, the PZI used in that study was the "old" pzi idexx which was discontinued several years ago. If it's the study I recall reading before, there were also "flaws" insofar as they didn't follow some of the methods used "here" either. Dose adjustments, diet, home testing weren't done the "FDMB way", for instance. There wasn't any "tight regulation" going on. But no doubt, Lantus kicked butt with those 24 cats.

I'd never heard about hypurin pzi before reading Juliet's threads since she joined, but it certainly appears that the type of pzi available to her is a much different type than we "across the pond" have access to. And one that could help a cat like mine who rarely got more than 10 hours out of a dose of VPA PZI.

It isn't a formal study or anything, but if you read on the DCH forums, they claim a remission rate of 85% using bovine PZI and Prozinc following a modified version of the Hodgkins TR protocol.

Point is, there isn't a "best insulin". It comes down to ECID and how you use your insulin of choice. The best insulin is the one that works best for YOUR cat. And you can't know that "going in".
 
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