Lantus versus PZI

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Julie and Alice

Julie and Alice

Member Since 2014
Hi all,

I am struggling to control Alice's BG with Lantus because of the tiny doses & her unpredictable response. She is predictable in that at night she needs much less insulin, even if same amount of low carb food eaten. I quite often have to take the food to her - day & night to control her BGs. I need to give her next to nothing at night but have failed in that the last 2 nights I must have given her nothing judging by her BGs.

Can anyone explain the difference between Lantus and a PZI insulin. Lantus does seem to last a good 14 hours in Alice even if she appears to have run out as I've had to shoot late to allow her BG to rise. Also when she appears to have had none over night the AM shot of only a fat 0.25 has still dropped her BG down from 522 to 214 13 hours later.

Would it be better with a PZI, if so which one?

My vet is ringing today so I will try and discuss it with her but would like to have been forearmed. :smile:

Thanks
Juliex
 
Either ProZinc, a U40 Insulin, or BCP PZI in U40 strength might be better since you can measure smaller doses if you use U100 syringes. If yo draw a U40 insulin in a u100 syringe up top the 1/2 unit mark that is only 0.2 units of insulin.
 
I don't know a lot about Lantus but I believe the difference is that Kanyus us mostly dosed based on nadir whereas PZI is more on preshot numbers (though we look at nadir to check for bounces of course). I think Lantus often provides a flatter cycle while PZI is a smile curve...higher numbers AM and PM with much lower nadir. I could be wrong as to how Lantus works (but you already know about it) but that's definitely PZI.

A PZI might help if you're getting crazy different preshots...we can shoot different amounts based on preshot because PZI is an in and out insulin. We also can shoot early or late depending on numbers if need be. My SS is older (Gypsy left for the bridge in January) but you can see how I dosed from there. Or check out some of the people in the PZI forum...I believe Jen and Eddie are chasing the numbers now so you can see how it works.

I only used ProZinc but I believe PZIs are very similar. Let's us know what you decide! Good luck!
 
Hi Julie,

I've no experience of using Lantus. I've only ever used 3 insulins; Caninsulin, Insuvet PZI (a veterinary insulin, now discontinued) and Hypurin PZI (made for humans).

It seems to be the consensus here that Lantus works best where it can be given every 12 hours (and a dose is held for a given length of time to establish the dose's effectiveness (because of the depot filling or draining).
PZI tends to be more flexible in that doses can be changed as necessary. And the timing of the shots isn't so critical. It can also lend itself well to 'sliding scale' dosing for those cats that benefit from that approach.

I've often seen folks say on this forum that cats on Lantus have a better chance of remission. I don't know enough to comment on the truth or otherwise of that. (But over the years I've seen cats on all kinds of insulins go into remission.)

The only PZI we currently have in the UK is Hypurin bovine PZI.
When the veterinary PZI was discontinued in the UK some years back I trawled the internet looking for an alternative, and got some advice from a vet who had previously been a chemist working in animal medicines. He recommended Hypurin PZI, and said he had seen cats do very well on it. It's a bovine insulin and only one amino acid away from a cat's own insulin.
Hypurin bovine PZI is unusual in that it has very long duration (and some depot properties).
However, although Hypurin has a long duration it still seems to retain that PZI flexibility (regarding dose changes and timing of shots): If you change the dose you will see the main effect of that dose change in that cycle. But because the doses will probably overlap (one shot becoming effective as the previous one wears off) that does sometimes need to be taken into account.

People switching from Caninsulin or from veterinary PZI insulins to Hypurin have found that they needed to reduce the amount of insulin given. (I'm guessing this is because of the increased duration and overlap.)

My cat has BG numbers that vary a lot through the course of the year (and that can suddenly rise or fall depending on his pancreas activity). Using Hypurin has meant that we can respond to those changing numbers quickly. For us, that is the main benefit of PZI.

Eliz
 
Thanks all, that is helpful.

I will give it a little longer with lower consistent doses if I can. I have also spoken to the vet today & had advice from Mel too. If I can I will reduce dose again but theres a good chance I may need to change to the UK PZI it does sound easier to use. Tonight she is going high again which is so discouraging and worrying. I only gave her 0.1 units but that is 'something' and in the past she has even gone too low on it & needed glucose. I did leave her 14 hours as she was too low to shoot at the usual 12 hour PMPS. It now appears that she received 'nothing' but I know thats not so confused_cat Maybe I left it that little bit too long.

Its so tempting to give her 'a bit more' but its over 3 hours now since her jab.

Bye for now & thanks again,

Juliex
 
I have used Lantus and ProZinc when I had Spitzer. I also had problems with his erratic appetite, vomiting, or inappetance making it difficult to control his glucose levels using a stable Lantus dose, so I gave the ProZinc a trial. My current diabetic Gracie is on Prozinc.

The doses are adjusted by nadir also, and once you know your cat - ie have test data - you can 'shoot what you see' because you know about how much a dose will drop the cat. That is very flexible for those with erratic schedules, cats that haven't read the manual on how to be a feline diabetic, cats with other medical conditions impacting the glucose levels, appetite, etc.
 
Thanks BJM,

Its sounding more attractive! I will have to continue a little while to test new regime of shooting PMPS later and reducing AM insulin & hopefully increasing PM. Vet said she was going to get a Lantus pen for me to look at but I don't have to buy it apparently unless it seems ok (for the small dosing). I'm sure someone told me that it only works on increments of 1 unit though. I can see the PZI appearing over the horizon though. ;-)

I have bought the caliper but not got around to finding out how to use it. I think you mentioned something about instructions somewhere?

Well, happy Saturday to you - as for me, I'm back to bed to catch an hour as firing on only one cylinder again! @-)

All the best to you & Gracie
Julie & Alice x
 
treat the pen as a mini vial of 3 mL.
Remove the cap and draw out the desired dose with a syringe.

To measure doses smaller than 0.5 units, practice the drop method as follows:
Take a syringe and fill with a colored liquid.
Gradually squeeze out 1 drop at a time of equal sized drops.
It helps to carefully twist the plunger as you press.
Repeat until you can consistently squeeze out the same number of equal sized drops.
Use that info to adjust very small doses.
 
Thank you BMJ & Carl & Polly,

Helpful - thank you.

Both good advice. The Utube link worked fine. Also although I have used turmeric to practise landing on the right line on syringe, (still with difficulty!) I hadn't thought of trying the droplet idea, it sounds good. Think I need to get some proper food dye though.

Have delayed shot tonight by 2 hours again as BG still falling despite lower dose! Maybe reduce again, although didn't find a low nadir, infact no nadir at all!

All the best & thankyou - just got to practice now!

Julie :smile:
 
Never thought of that but did find some Cranberry juice!! I found about 3 largish blobs or 4 small blobs to 0.5 units! Very good idea indeed!! It does give some idea of how much you are given eg about 1 & half blobs at zero!

Can you believe that a skinny 0.5 worked for 15 hours today! No nadir until possibly 14 hours :? confused_cat !!!

I figured out the calipers & with great intent, 2 pairs of glasses & a magnifying glass I could see them (& hubby holding torch)! :lol: Not sure it will help as yet but will have another look when not as tired!

Time for another ear prick :!:

Best wishes

Juliex
 
You may be able to find some clip on magnifiers which can attach to your glasses, perhaps on the UK Amazon shopping link from our shopping section.

If available, Carson Clip and Flip are stellar at the job.
 
Julie and Alice said:
...Can you believe that a skinny 0.5 worked for 15 hours today! No nadir until possibly 14 hours :? confused_cat !!!
Click to expand...

Hi Julie,

If it's the case that Alice's pancreas is producing more insulin (and possibly intermittently) then you may not always see a 'nadir' in the conventional sense. Her body would have two sources of insulin; her own, and the Lantus. One source of insulin would be boosting the effect of the other source.
Depending on the timing of Alice's own insulin output this might sometimes mean that the blood glucose drops more than is typical for a given Lantus dose; or it may mean that the duration is extended. (It could be that the Lantus is dropping the blood glucose sufficiently that Alice's pancreas is able to 'pick up the ball and run with it' for a while until it gets tired...?)
Bertie does this a lot. He often goes 18 - 24 hours on a single shot at this time of year, and has gone as long as 3 days in normal numbers before his pancreas needs a rest.... :roll:

(Oh, re the Carson Clip and Flips that BJ mentioned above, I just checked on Amazon UK and they are indeed available...)

Eliz
 
Ok thanks - have ordered the glasses! So mad with myself though as forgot to do it via shop, sorry. I order so much from Amazon it was automatic but now I know perhaps I can order future stuff via FDMB.

Interesting Eliz re Bertie. Must have been disappointing after 3 days, it must have looked like a pending remission. I do hope Bertie manages to go the 'whole 9 yards' one day soon. Think I may have under dosed this morning but got a good flatish line during the night last night. She tried to walk away this morning as it was a 'one man job' I had been managing without hubby. There was a spot of blood on needle tip so now I'm hoping I didn't inject into a blood vessel nailbite_smile

Its back to beddy byes again for me after another night up! I do begrudge these day time naps but necessary!

Truly grateful for all the great advice and getting me thus far. Got over a couple of mountains thankfully (ear pricks & actual giving of the insulin) + been educated - a steep curve for me :smile:

All the best to a good day for you
Juliex
 
The Carson Clip and Flip come in 4 different strengths. You may need to experiment to find which works best for you.
 
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