Lantus or PZI

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Kitty mom

Member Since 2014
I will post this in both forums.
My vet is letting me decide on what medication I want to use PZI or Lantus. I've researched both and just when I think one is better another vet site says the other is the better choice of the two.
I'm going to stay hopeful that we can get Dasher into remission and on one site a vet believes cats have a better result with PZI. We should get his meds tomorrow and I'm so torn as to what's the best choice. I'm a believer its the people who are living this are the best to ask about this. Please let me know as I just don't know, I just want to get him started on one.








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There has been some research done on remission rates of different insulins for cats. If you take a look at our TIght Regulation Protocol Sticky, 5 paragraphs down there is a PDF copy of a research paper that talks about the use of Lantus, Levemir and PZI. There is a table towards the end of the document showing the results of the research.

Ultimately, the insulin that works best for you cat is the one you should use. Lantus does require the ability to give shots close to 12 hours apart each day. For some people, that does not work with their schedule in which case PZI may be a better choice.
 
I do not know PZI, I do not know of studies out there that support a good remission rate for PZI. I am a firm believer in Lantus and its high success rate of remission for newly diagnosed cats. The Roomp/Rand study showed around 84% remission rate in the newly diagnosed cats in the study and 35% in the longer-term diabetics in the study. I like those odds. IMO vets that prefer PZI do so because PZI is a veterinary insulin where Lantus is a human insulin. PZI is one of the better insulin available for cats, but faced with a diabetic cat I will chose Lantus first every time myself.
 
I would agree with both Melanie and Wendy. The PDF that they are referring to specifically compared success rates between Lantus & PZI - and Lantus had a better remission rate. The main thing you should know is that just using the insulin isn't going to get your cat into remission. The key step that helps towards that goal is to get a cat's blood sugar tightly controlled, ie, kept between 50-120 on a human glucometer, as quickly as is safely possible.

The protocol that they both referred to gives dosing guidelines using Lantus or Levemir (which is an equally good insulin). The likely reason that these two are so good is that they last 12 hrs or so in most cats' bodies. The longer the insulin lasts in a cat's body the more even the cat's blood sugar can be - which helps the cat feel better and if the blood sugar is kept in that 50-120 range, the pancreas can heal and begin putting out its own insulin again.

We probably have about 1 cat per week or so go off of insulin. The sooner after diagnosis that the cat gets their blood sugar controlled, the better.

My cat, punkin, was on Lantus for 2.5 years. He passed away in 2013 (not from diabetes) but if i had another diabetic cat now, I'd probably choose Levemir first and Lantus as my close second choice. Those are both excellent insulins. Levemir is a little bit cheaper and cats sometimes end up on smaller doses - not always, but sometimes. that can save you a little bit of $$.

Lots of people have great experience with PZI insulins too - again, the main thing is to get your cat's blood sugar back into normal ranges as soon as is safely possible.

Take a look at this post What is the Insulin Depot? to get an idea of how depot insulins (Lantus & Levemir) work. Near the top of that page is a link to "Lantus and Levemir, what's the difference?" that is really helpful in explaining how it's going to work in your kitty's body.

And as an aside, have you already switched your kitty to completely canned low carb food? no dry food in the picture?
 
Wendy&Neko said:
There has been some research done on remission rates of different insulins for cats. If you take a look at our TIght Regulation Protocol Sticky, 5 paragraphs down there is a PDF copy of a research paper that talks about the use of Lantus, Levemir and PZI. There is a table towards the end of the document showing the results of the research.
Click to expand...
julie & punkin (ga) said:
I would agree with both Melanie and Wendy. The PDF that they are referring to specifically compared success rates between Lantus & PZI - and Lantus had a better remission rate.
Click to expand...
The pdf referred to above is more of a published summary than "new" research.
Here's the link:
Sorry. For various reasons, the study Wendy and Julie have referred to was noteworthy when performed, but it is virtually irrelevant today when extolling the virtues of using Lantus/Levemir over Prozinc or BCP PZI (the "P" insulins currently in use). One might even say the study was irrelevant before it was published (a few years later) because the insulins used in the comparison were discontinued before the research was published in 2009. Lente was discontinued in or before July 2005 and Indexx stopped making PZI Vet on or before April of 2008.

I haven't seen or heard about any research, published or otherwise, which has compared the success or remission rate of Lantus/Levemir with Prozinc or BCP PZI. Has anyone else?

IMHO, the "best" insulin is the one that works for YOUR cat! :mrgreen:
 

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Got to agree with Jill on this...

The linked PDF study might have been relevant at one time, but doesn't compare Lantus/Lev to current "P" products. IMO, there's all sorts of examples and data and spreadsheets that you can point to that show that the "L's" are great choices and people have had great success when using them (especially if you follow TR from the get-go). Just that study isn't a really good example to point to anymore. It had all sorts of "problems" (again, just my opinion). Very small sample size, not a great diet for diabetic cats, curves were run at clinics rather than at home, adjustments were based on those curves, etc). No doubt the conclusions are based on the results of the study. But the study wasn't the greatest...

Absolutely agree with "the "best" insulin is the one that works for YOUR cat!"

For Bob, that was compounded PZI from VPA (which is no longer produced either). It got him off the juice in just 10 weeks. Would he have gone OTJ on Lantus or Lev? Maybe, but the world will never know. ;-)

@ Robin-S:
If memory serves, you have chosen Lantus, right? I wish you great success, and I hope that you will continue to post here in TR, no matter which protocol you decide to go with. There is a great deal of knowledge, experience, and help to be found in LL.

Carl

@ Jill - as far as new research, not that I have been able to find. I know that the makers of Prozinc ran a study that compared Prozinc to PZI Vet in order to show that Prozinc would work as well, or better. That study did achieve that result. Just a note to "P" users who might see this. While Prozinc and compounded PZI do both start with the letter "P", they are NOT one and the same. Both types are still available for use. And compounded PZI is about half as pricey as Prozinc. The two work "sort of the same way", but not exactly in terms of duration and timing of nadir. Many people on the board lump them together as the same thing, but they aren't.
 
Sienne and Gabby said:
FWIW, the American Animal Hospital Assn recommends either Lantus or Prozinc for treating feline diabetes.
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thanks, sienne! unfortunately, levemir hasn't yet earned widespread acceptance in the veterinary community. someday...
 
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