Lantus vs ProZinc

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LamontsMom

LamontsMom

Member Since 2015
Hi All,

I'm a relative newbie here--joined last week. My cat was diagnosed with diabetes 4 days ago. When his numbers were high on Monday, I switched him to Wellness wet food. He's been completely on wet food since Wednesday and the vet wants to start insulin on Tuesday. Vet #1 wants to Lantus.
I'm going to another vet for a second opinion. Vet #2 specializes in cat and diabetes. He uses ProZinc. He's open to Lantus.

Aside from price, are there any compelling reasons in either camp to pick a med? I've read things online that were HEAVILY Prozinc and a lot of people in my original posts on this forum (including someone who's cat went into remission on Lantus!!) are heavily Lantus.

I want to do the best for my kitty. Does it make that much of a difference?
Thanks for any responses.
 
Unfortunately, there's no "one size fits all" answer.....the best insulin is the one that works for your cat!!

I think here, there are more of us using Lantus because it's the only insulin that has a published protocol on it's use and we like to have the "science" behind it
 
I like that too. I do like the flexibility of ProZinc. Mark Peterson, who's an feline endocrinologist wrote in a column that while there are published reports on the efficacy of Lantus, in his experience, the outcome is the same with ProZinc. I like that there are people on this board who are using Lantus with good results.
 
Both ProZinc and Lantus need to be given 12 hours apart, so if you're thinking ProZinc is more flexible (time wise) it's not really true

The main difference is that with ProZinc, when one shot wears off, it's gone---out of the body....with Lantus, there's a "depot" that forms that will "carry over" to the next shot
 
They're both very good insulins. The price really is about the same (I can't explain the math, but I think it's basically that you get the same amount of insulin for roughly the same price, even though Lantus seems more expensive. You get more Lantus in a vial than ProZinc or something like that...).

It really is whatever works best for you. We have folks on this board who use both insulins, so we can help with whichever you end up going with!
 
Actually, Prozinc is not as rigid in regard to a 12/12 schedule as Lantus/Lev. Even their website states duration to range between 10-14 hours. The "flexibility" advantage to Prozinc, should you choose to use it that way, is that the dosage can be adjusted as needed. Some people shoot a consistent dose, while others adjust it depending on the numbers on a "shot by shot" basis.

Lantus (assuming you follow the TR protocol) has a better remission rate. And the majority of cats on the board use an "L" insulin.
 
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Thanks! Earlier I spoke with someone in my building whose cat's been on Lantus (6 units a day) since February. He's doing fine on it. And doesn't self monitor and even says she's not completely strict about the timing of it and he's never become hypoglycemic, which is great.

I guess I'll see what vet #2 says. I wanna give my sugar baby the best possible chance--regardless of what that involves. I guess I'll make up my mind by Monday.

BTW, regarding the dose, vet#1 told me if my cat doesn't eat 70% of his food (or more), give him a 1/2 dose (of Lantus).
 
Sounds like vet #1 is more familiar with the older insulin, like Caninsulin/Vetsulin.....with those insulins, it IS very important that the cat eat enough before you give it because it's so harsh and hits so "hard"

With the newer insulins, like Lantus and ProZinc, it's not as important that there's a certain amount of food on board when you give the insulin...that's one of the reasons they're so much better....they're much more gentle
 
It's funny you say that (about vet #1). That's really what I felt--and what's been frustrating. She feels stuck in a lot of old-school modalities. She actually was resolute about not having 4 meals day saying it's CRUCIAL the cat only eats 2 meals a day--with his insulin.

Chris, btw, thanks again. Your support and guidance through this process has truly been invaluable. :-)
 
We've heard the same stories so many times!!

When you've been here awhile, if you start to help other new sugarcat moms, you'll see it's a very familiar problem!

We can't really blame the vets (much)....trying to stay up to date on the latest treatments for every disease in every type of animal they see is pretty impossible...if they tried they'd never have time to actually see patients!

One of the reasons this message board is so valuable is that the people here might not be vets, but they do nothing but deal with feline diabetes and the diseases that tend to come with it...they've already got the "real life" experience in what works and what doesn't and they try to stay informed on the latest improvements in the treatment of FD

And I'm more than happy to help! When I was new, scared and confused, others helped me...Just "paying it forward"!
 
Thank you! I'm actually getting a little pissed about vet#1. My cat needs insulin and vs. walking out of there with a prescription, I now have to wait til Monday to get one from another vet.

And Lamont is currently lying on the bathroom floor. Yes, it's a little hot in here, but he doesn't feel well. I'm fairly sure he'll be ok til Monday, but still..

Thanks again!mit's great to know you guys are there.
 
Back from vet#2 and I thought he was GREAT! He only sees cats, the office is super chilled out--you feel like you're going into a spa--and the staff is really nice. Vet #1 (par for the course) had *not* sent the bloodwork and he didn't want to make a decision without looking at it but....he took Lamont's glucose twice (and mind you, Lamont goes INSANE at the vet: growling, biting, thrashing, trying to escape, his body tenses when you touch him, hissing--which is why his numbers at the vet are normally in the 300-350 range). Today: one was 376 and the other...300. At vet#1, his number was over 500--like 550. That's a huge reduction. So I told the vet I'd like another fructosamine because the last one was taken based on blood from 10 days ago and Lamont's been on a wet food carb diet this week. So he did and he'll figure out a course of action based on that and the blood work.

He does want to use ProZinc and said that remission doesn't happen for the majority of cats but when it does, it's based on being strict with insulin shots (every 12 hours) and diet. You don't have to monitor the blood with ProZinc as much as you with Lantus so I think it's a better fit for me and Lamont. He's also fine with Lamont grazing (diet-wise) as long as he eats something when he gets his shot. That's a HUGE HUGE relief for me because I never thought I'd get him to eat at certain times. He hasn't done it his whole life and all of this is traumatic enough...

All said, I'm very very happy with vet#2. And relieved Lamont's number are lower already!!

Thank you guys SO much for all the support.
 
LamontsMom said:
Hi All,

I'm a relative newbie here--joined last week. My cat was diagnosed with diabetes 4 days ago. When his numbers were high on Monday, I switched him to Wellness wet food. He's been completely on wet food since Wednesday and the vet wants to start insulin on Tuesday. Vet #1 wants to Lantus.
I'm going to another vet for a second opinion. Vet #2 specializes in cat and diabetes. He uses ProZinc. He's open to Lantus.

Aside from price, are there any compelling reasons in either camp to pick a med? I've read things online that were HEAVILY Prozinc and a lot of people in my original posts on this forum (including someone who's cat went into remission on Lantus!!) are heavily Lantus.

I want to do the best for my kitty. Does it make that much of a difference?
Thanks for any responses.
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Hi--My boy was diagnosed in October-vet #1 gave me vetsulin-the numbers did come down but my baby was sad -lethargic-miserable…
I went to a kitty only vet-she preferred pro zinc and we switched with a sliding scale and dosed more than 2x a day as needed-honestly I think I tested constantly but he was happy again. It did wear off much sooner than lantus for my guy-
Vet #3--a phone consult with a cat only vet for over 20 years in CA ( I am in Chicago) she has a 80% success rate of remission and prefers lantus-(some will relapse)

We switched less than 2 weeks ago and honestly I wish I had started with lantus… he is holding his numbers lower longer which is key to remission. We have a ways to go but with the support of this group (whichever insulin you choose) and knowing your cat and whatever you use you will want to test so you know how your kitty responds to whichever insulin you decide on-
hope this helps some??
Lots of amazing info on this site….
(edit--diagnosed in September tried to control with diet, started insulin Oct)
 
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Thanks, Jayla! Good to know. Chances are, if I start insulin, I will start on ProZinc. My cat was lethargic yesterday and this morning but now, back from the vet, he actually is acting more like his old self. Happy, alert, playing. It's all confusing. At this point, I think it's more important to go with a vet I feel confident in. And this new guy? First time we've been to a vet where he really listening to my cat's heart, looked at his gums, examined his skin, his eyes, everything. I was SUPER impressed. I guess if he puts him on ProZinc and there isn't a great result, we'll switch (some of this vet's patients use Lantus.)

Thanks again!
 
sounds like your in good hands…. :) If you are near Chicago I have almost a full vial of pro zinc exp 10-16 has been properly handled and refrigerated.
 
When you say you don't have to monitor the blood with ProZinc like with Lantus, what do you mean? I ask because for ProZinc, you do need to check blood before EACH shot, and also need to get nadirs (mid cycle tests) when possible. We dose based on both preshot AND nadir. I know nadir isn't as easy if you work, but we ask you to get it as much as possible...especially at the beginning when figuring out a dose.

When you get the insulin, I suggest starting at no more than 1 unit...we can help you figure out a good dose if you'd like!
 
Thanks, Jayla and Rachel. Jayla, I live in NYC but thanks anyway for the offer!

Rachel, this vet mentioned testing before each shot and also getting mid-cycle tests when possible but he said when he's started cats on Lantus, he felt it was important to test more than that. He said if he did start him on ProZinc, he'd start at 1 unit.

That said, the woman who lives in my building and whose cat is on Lantus (diagnosed last Feb on 6 units a day) has NEVER tested and I looked incredulous when she told me that. She said she's lax about stuff like that and her vet never said she had to and her cat has been completely fine . Never been hypoglycemic and is regulated (via the tests her vet gives). She said sometimes she's a few hours late with the shot and it's never affected him. She said she grew up with a diabetic dog and later a diabetic cat so she's pretty relaxed about it all and has never had an issue. I don't think she's hoping for any remission. Just regulation.
 
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Okay, gotcha! I never used Lantus so I just wanted to make sure you knew of the importance of the nadir and preshot tests. :) Sounds like the vet you've got is very experienced...and I don't say that about a lot of vets! :)
 
I have to say, I was SUPER impressed with him. I've never been to a vet I felt this confident in (at least so far). He was very very highly recommended. And I can see why. Most of the vets we've been to have misdiagnosed my cat or tried to get multiple tests. I felt this vet genuinely loves cats (and knows a heck of a lot about them!)
 
So far your neighbor has been one of the most fortunate caregivers in the world. But she's flirting with disaster. I have seen two cats, on Lantus, in the past couple of years that weren't so lucky. Both were on lower doses than 6u. Both caregivers had become complacent, and stopped testing regularly. One came home to a cat in a hypoglycemic coma, and he could not be revived. The other woke up to find her cat had died due to hypoglycemia.
 
Gee, that's terrible! I told her about testing, even recommended this and told her how helpful it is but she wasn't interested. I hope her cat remains in ok health.
 
The other thing is that 6u is a scary high starting dose. The AAHA guidelines for starting dose say the max starting dose should be 2u, with most cats starting at 1u. Definitely don't go to her vet!

I think you're okay starting with Prozinc, and 1u. And home testing. :)
 
Rachel said:
When you say you don't have to monitor the blood with ProZinc like with Lantus, what do you mean? I ask because for ProZinc, you do need to check blood before EACH shot, and also need to get nadirs (mid cycle tests) when possible. We dose based on both preshot AND nadir. I know nadir isn't as easy if you work, but we ask you to get it as much as possible...especially at the beginning when figuring out a dose.

When you get the insulin, I suggest starting at no more than 1 unit...we can help you figure out a good dose if you'd like!
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Is testing before every shot really necessary with prozinc? This isn't what my vets have recommended at all. They want a curve each week, but have not said anything about pre-shot testing, certainly not before every shot. Is that really recommended for prozinc? I just switched J-Roc over to prozinc a month ago (Lantus wasn't working). I test a few times per week and do a curve once per week, but do not test before every shot. I thought that was just if you were dosing based on a sliding scale. His poor ears!
 
It's very important to test before each shot. If you don't, you are shooting an unknown number...which can be very dangerous. We've had several people on the PZI forum who have surprised a low number at preshot test time and, therefore, had to adjust or skip the shot. Not testing before each and every shot can cause a hypo episode since you just don't know what number he is at.

A curve once a week isn't really necessary...though we are mostly data junkies here and love to see test numbers! Generally, you want to get a test before EVERY shot, a nadir (mid cycle) when you can, and a curve every once in awhile. I generally recommend them when we are having trouble figuring out what is going on so we can see if the extra data helps.

Have you checked out the PZI forum? Everyone there has used or currently uses ProZinc or PZI and we'd love to have you join us!
 
LamontsMom said:
That said, the woman who lives in my building and whose cat is on Lantus (diagnosed last Feb on 6 units a day) has NEVER tested and I looked incredulous when she told me that. She said she's lax about stuff like that and her vet never said she had to and her cat has been completely fine . Never been hypoglycemic and is regulated (via the tests her vet gives). She said sometimes she's a few hours late with the shot and it's never affected him. She said she grew up with a diabetic dog and later a diabetic cat so she's pretty relaxed about it all and has never had an issue. I don't think she's hoping for any remission. Just regulation.
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I love your new vet but please don't listen to your neighbor. There is no possible way for her to know her cat has bee ok the whole time because she doesn't test. A cat bouncing between 400 and 40 is going to show the same as a regulated cat on a fructosamine test because it just averages out BGs over the last 2-3 weeks. People don't inject insulin into themselves without checking their BG and they shouldn't be sticking insulin in a cat without knowing if it is safe.
 
J-Roc said:
Is testing before every shot really necessary with prozinc? This isn't what my vets have recommended at all. They want a curve each week, but have not said anything about pre-shot testing, certainly not before every shot. Is that really recommended for prozinc? I just switched J-Roc over to prozinc a month ago (Lantus wasn't working). I test a few times per week and do a curve once per week, but do not test before every shot. I thought that was just if you were dosing based on a sliding scale. His poor ears!
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I've had 5 diabetic cats in my care and none of them had issues with their ears and I test a lot so I know what the heck is going on. All but Deandra came for testing when they heard the canister of strips or the meter beep. And I actually think D didn't get as used to it because we tested her less than the other cats.

This board definitely encourages testing before every shot. Most people who help when dose questions come up can't/won't help if there is a lack of testing. There is just no way to know if its safe to give your cat insulin, or how your cat is reacting to the insulin without it.
 
Melanie and Smokey said:
I've had 5 diabetic cats in my care and none of them had issues with their ears and I test a lot so I know what the heck is going on. All but Deandra came for testing when they heard the canister of strips or the meter beep. And I actually think D didn't get as used to it because we tested her less than the other cats.

This board definitely encourages testing before every shot. Most people who help when dose questions come up can't/won't help if there is a lack of testing. There is just no way to know if its safe to give your cat insulin, or how your cat is reacting to the insulin without it.
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J-Roc doesn't mind the testing at all - seems to like the attention. I'm just noticing his ears bleed more than they used to sometimes.
 
J-Roc said:
J-Roc doesn't mind the testing at all - seems to like the attention. I'm just noticing his ears bleed more than they used to sometimes.
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My guy likes the attention too --sometimes he gets annoyed but usually is cool with it. It seems his ears bleed easier the more I test. I put a salve on each night (I test 2-6X a day) and his ears are perfect in the morning. J-Roc is a cool name!
 
LamontsMom said:
He does want to use ProZinc and said that remission doesn't happen for the majority of cats but when it does, it's based on being strict with insulin shots (every 12 hours) and diet. You don't have to monitor the blood with ProZinc as much as you with Lantus so I think it's a better fit for me and Lamont.
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Unfortunately, your vet is not correct about this. Studies have shown that cats have very high remission rates (81+%--it's in that article I attached for you in your other post under "remission rates comparison") on Lantus or Levemir when home testing at least 3x a day and adjusting the insulin appropriately, and on a low carb, canned diet. Also (Prozinc people, correct me if I'm wrong) I believe people here who use Prozinc also test at least 3x a day, or at very minimally 2x a day, so the amount of testing is not that different.
 
LamontsMom said:
That said, the woman who lives in my building and whose cat is on Lantus (diagnosed last Feb on 6 units a day) has NEVER tested and I looked incredulous when she told me that. She said she's lax about stuff like that and her vet never said she had to and her cat has been completely fine . Never been hypoglycemic and is regulated (via the tests her vet gives). She said sometimes she's a few hours late with the shot and it's never affected him. She said she grew up with a diabetic dog and later a diabetic cat so she's pretty relaxed about it all and has never had an issue. I don't think she's hoping for any remission. Just regulation.
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Oh Dear. Please don't listen to your neighbor. She has no idea if her cat has ever been hypoglycemic or if he's regulated well because she's not home testing. As I mentioned before in a previous post, cats don't show hypoglycemic symptoms unless they are severely (life threatening) hypoglycemic, and you never want to get to that point. When cats have low numbers, or even lower numbers that their bodies aren't used to after having high numbers for a long time, their livers will dump glucose into the bloodstream, which will then in turn raise their BG for up to 72 hours. So unless you're testing at least 3x a day (before each shot and some mid-cycle test), you will never know if your cat has high BG because their dose is too high, or too low.

I kind of see it this way--dosing insulin is like aiming for the bullseye on a dart board. It's hard enough as it is--and without testing, you're doing it blindfolded. When you're testing, each one lets you get more accurate with your dose, so more tests you get, the closer you get to move to the board before throwing your dart.
 
J-Roc said:
J-Roc doesn't mind the testing at all - seems to like the attention. I'm just noticing his ears bleed more than they used to sometimes.
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Are you putting pressure on the poke spot for at least 20 seconds after each test? Bandit was always tested 3-9 times a day when he was on insulin and we never had a problem with bleeding or bruising of his ears (except those occasions when my partner was learning how to do it after several years again and would miss the "sweet spot" and sometimes hit the vein).
 
Julia & Bandit said:
Are you putting pressure on the poke spot for at least 20 seconds after each test? Bandit was always tested 3-9 times a day when he was on insulin and we never had a problem with bleeding or bruising of his ears (except those occasions when my partner was learning how to do it after several years again and would miss the "sweet spot" and sometimes hit the vein).
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Oh yes. I always stem the bleeding.
 
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