Levemir required in UK

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marymartin

Member Since 2010
My cat Felix has been well regulated on Insuvet Protamine Zinc Insulin for the past five years. My Vet has now informed me that Insuvet Insulins are no longer available in the UK and the only Insulin licensed for animal use is Caninsulin. I have read all the information on Caninsulin and don't want to use it. I would like to try switching to Levemir having seen good reports from the people using it for their cats. My Vet won't/can't supply me with Levemir or a prescription for it. Does anyone have any Levemir that I could buy from them or could anyone advise me where I could buy it from without a prescription. This is a real problem here in the UK and I would be very grateful for any help or suggestions. Many thanks. Mary
 
Mary, welcome! Where in the UK are you? I'm not sure about the "prohibition" on lev in the UK (or all of the UK) being true. I think there are many members here in the UK using Lev and Lantus. I know in certain parts of Europe vets are required to Rx caninsulin first and then, if regulation hasn't happened in a month or something, they can Rx other insulins like lev and lantus. We had a couple of German members using lev that had to start on caninsulin.

There is a new protamine zinc insulin, ProZinc, made by another company. Link here: http://prozinc.us/ Maybe that is available where you are?

Most of us buy lev from Canadian online pharmacies, but you may need a script. When I was first ordering it from them I did not need a script (I am in the USA), but now we do need one. Not sure what the regulations would be for you and where you are.

For more specific information, I would suggest that you post on the main Health forum and ask ab out lev in the UK - and the ProZinc as well. You will get more eyes on your post over there.

Good luck!

ETA: you might find this thread helpful, especially the last post with some links to UK info:\
http://felinediabetes.com/FDMB/viewtopic.php?p=201707
 
Hi Mary

I know, I am totally at a loss for words as to what I think of these drug companies and what seems a total lack of concern for our cats welfare - sighs

Here's a link to a discussion re: trying to get hold of Levemir

http://felinediabetes.com/FDMB/viewtopi ... 22&t=11312

I too, will be moving over to Lev - but I know it will take some persuasion. There are some good stickies here with information for vets and vets should also be able to read about Levemir on 'VIN" (The Veterinary Information Network). Hometesting would be a must.

When I spoke to Pfizer uk (manufacturers of PZI and Neutral) they said it was not a decision taken likely but they were unable to get hold of beef etc etc etc......but worse of all had no alternative plans at moment for an alternative although vets have been advised that there are "Off label" alternatives to the recommended caninsulin.
And there were also "off label" alternatives for ketones etc.....(they couldn't tell me what though)

Good luck Mary - let us know how you get on.

Steph
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Hi again - I emailed the manufacturers of Prozinc but sadly they have no plans to export to the UK. One other thing worth reading is Kimmee's great sticky on Canninsulin

viewtopic.php?f=19&t=302

It goes through feeding/shot times - to me, that would mean a 4am start......it's not just "here's a new insulin try it and see" its also about whether a certain insulin is "workable" around your schedule.

You know, maybe we should start some kind of petition, I know, there are plenty of very scared diabetic cat owners out there - but who would we approach. The RVC? Our MP's (waste of time IMHO)
 
Hi Sheila and Steph thank you for your replies to my post, I am in Lancashire in the north west of England.
This is a terrible situation which is going to affect a lot of diabetic cats in the UK and I agree some sort of protest should be made but who to and how I don't know.
Thank you for the information about the availability of ProZinc in the UK. I asked my Vet about ProZinc and she hadn't even heard of it, I discovered that there is an equivalent Insulin to Insuvet Protamine Zinc available it is Hypurin Bovine Protamine Zinc.
The Insuvet Insulins were made under contract by Wockhardt UK for both Pfizer and for Schering-Plough Animal Health, who owned the brand name earlier. Wockhardt makes the same insulins under their Hypurin brand name.
I asked my Vet to prescribe Hypurin Protamine Zinc for Felix but she refused, she said she could only prescribe Caninsulin. Mary
 
I don't know what the current status of the caninsulin/vetsulin manufacturing issues are now, but they were bad enough about a year ago for the FDA to issue warnings against them. And, I believe, after that most vets in the US stopped Rx'ing it. See here:

http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=311

This insulin has a proven track record of problems and was designed for dogs to begin with. Not the best product for a vet to get behind and refuse to Rx anything else.

Mary, here is a recent thread about ordering lev online: http://felinediabetes.com/FDMB/viewtopic.php?f=10&t=32416
 
Hi Sheila
I spoke to my Vet about the FDA's warning regarding Vetsulin/Caninsulin and gave it as one of the many reasons why I don't want to use Caninsulin. My Vet had not heard of any warning, said it was probably only certain batches that were affected and it didn't apply to the Caninsulin in use in the UK. From what I have read it applies to all batches and is a worldwide problem.
This is so difficult, you would think the Vet would be working with the owner to do what is best for the cat instead it feels like I am arguing with the Vet all the time to try to get the treatment for Felix. At the moment every road I go down leads to a dead end. I feel that I will have to change my Vet but I don't know if I would have any more success with another Vet. Also Felix is unwell at the moment because he also has congestive cardiac failure and I don't want to cause him further stress by having to take him to appointments at a number of Vets. If anyone knows of any route to take I would be extremely grateful for their help. Love Mary x
 
Mary,

can you call around to the other vets and ask if any of them might be willing to discuss Rxing Levemir to you BEFORE you take your cat in? Explain about his heart condition and that you are trying to minimize stress on him, but that if you knew they'd be willing to Rx Lev, you'd gladly bring him in for an apt and exam, etc.

Also, there is a thread a little further down the Lev page that you might find helpful. You'll need to read through the whole thread.

viewtopic.php?f=10&t=32416

Again, I highly suggest you have a vet on board prescribing the insulin you are using or wanting to use. It really is best to have a medical professional on your side. Insulin is a potent drug that requires caution, not something to play about with- of course, you know this. And we here know you are only looking to do what is best for your sweet prince, Felix. ;-)

(((Hugs)))
 
While everything Melissa says is true (about having the vet on board), I do have to say that I obtained lev without my vets help and switched Beau to it myself. I had discussed lev with her, but she didn't really know anything about it (she knew about lantus, but I didn't want to use it). I even dropped off info on lev to her, but never heard from her about it. At this point, I manage his diabetes and she manages other things. Beau has hyperT and cardiomyopathy. The heart issues were diagnosed when he was 3 (he was a feral, God knows how that happened at such a young age).

Anyway... not sure if you are comfortable with doing that sort of thing, or if that sort of thing is "done" in the UK where you are. While insulin is not something to mess with, you can get a lot of help here with dosing, etc. I guess the big question is what happens if Felix needs other care and the vet asks about what dose of caninsulin he is on, etc.?

Have you posted on the Health forum asking about where to get either ProZinc or Levemir where you are?
 
Hi Mary

I don't know if this will help but I had kept this from a previous discussion (it may even have been the one I gave you a link too) but it names a vet who is well regarded and who supports the use of Levemir in cats

"Can the UK vet access VIN (veterinary information network)? There is an experienced VIN consultant named Alice Wolf DVM that my vet respected, who supports lev in cats, so I eventually got a Rx. maybe this info could be useful."


Also, I agree, rather than take Felix in to see other vets...ring round, email, go and visit by yourself and ask if any would support you. I remember having to do that when Pheobe was first diagnosed and my original vet poo-pooed hometesting. Out of around 30 vets in Norfolk only one supported hometesting. hard to believe but true. It may help - you never know.

I have emailed some professionals to see if they can help shed any light/suggest ways forward - I'll let you know if I hear anything. Don't give up.

Steph
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Hi Sheila, Melissa and Steph, thank you for your replies and suggestions, I do appreciate your help. Steph I know that you are in the UK as well, is your Vet going to prescribe Levemir for you? Mary x
 
Mary, the link Stephanie gave you up above.....

viewtopic.php?f=22&t=11312

...is a really good one. Not sure if you got a chance to read it. The people responding are pretty knowledgeable about this whole topic. You might PM Steve and Jock and see if he has any other suggestions since he wrote that thread back in April. Also, Monique said in that thread that she was able to get her own doctor to write her a prescription, not sure if that would be possible for you or not.

But do PM Steve. He lived in London for a while but it looks like he is living in Edinburgh right now. Anyway, if you don't hear back from him let me know...I think I have his email addy. He also has one listed in his profile, just click on his name.

P.S. Just as an interesting side note. Steve's kitty Jock was the first cat worldwide to use Levemir. That was when Steve was living in Sweden back in 2005.
 
Hi Mary,

Yes, I am hoping to be able to put Murphy onto Levemir. However, I know I will have to prove as much as I can that it would be the right insulin for him. I do have a 'history' of managing diabetes as I also looked after his sister Pheobe who had a condition called Acromegaly. I was able to keep her in reasonable numbers for several years despite her insulin resistance (using PZI). I was only able to do that using tight regulation but I kept my vet informed of her numbers all the way along and diligently home tested. In addition to Murphy's 'reactions' to insulin (very panicky liver at times and easy to rebound even on half a unit) I'm hoping that that experience will help.

Steph
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I have sent emails to all the Vets within travelling distance hoping to find one who is at least willing to discuss prescribing Levemir for Felix. I have also emailed a number of Online Pharmacies in Canada to see if it might be possible to buy Levemir without a prescription, although I am worried about the time it may take for the Levemir to arrive and lack of refrigeration. I have sent an email to the Veterinary Medicines Directorate to see if I can clarify whether it is ultimately the Vets decision based on their clinical judgement which Insulin to prescribe. Will report back when I have any news. Mary x
 
It will be very interesting to hear the results of all your inquiries - especially what the Directorate say about it.

I do hope that one of your lines of inquiry produces an answer that says you can get/give Felix levemir!
 
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