Might switch to PZI BCP from Lantus - questions

Is there a "primer" on PZI I can read? I don't have experience with anything but Lantus, but it's just not working for Janie now.

Any cautionary tales? Advice? Words of wisdom?

Are there folks among you considered to be the PZI experts? PM me if you don't want to mark them in public!

Jane's 20 and has been diabetic for five years, but was on insulin for only the first couple months. Out of remission a month ago due to thyroid problems.

Eager to hear what you all have to say about PZI. nailbite_smile

 

Hi Chris, well this is a switch! The norm is for peeps to leave here to go to Lantus.
I am by no means an expert but pretty darn familiar.
have you been on lantus since the beginning? I know enough to tell you that it's a whole different dance with the pzi and I will be more than happy to walk with you.
Lori
and tomtom too!

 

just checked out your SS, don't understand. looks like you were doing well and then stopped dosing? what was the ndoz? have you thoroughly discussed your dosing with the lantus peeps? not that I don't want you here, would love you here, but you sheet looks fairly decent aside from lack of dosing.

 

NDUZ is "no daylight under zero." I pull insulin in, then push out till the black plunger covers the last hairline of daylight between 0 and 1/2 u. Today, I gave her a dose with the plunger exactlly at the zero line.

Janie's just not reacting well to the lantus. it's what she was on at DX years ago, but went OTJ after a couple months and a diet change. SHe's unpredictable with these wild numbers - a small amount sometimes has no effect (like today) and sometimes too much - with a 100 drop in the first hour and a snowball effect.

Don't know anything about PZi except that a number of Lantus folks had said "Maybe you better try PZI." Unfortunately, we on the board know more about diabetes than my vet. Those days of no dosing were an OTJ trial that failed.

 

Hi Kris! I just lost my post, so I'm going to say this quicker than I did the first time (which you never had a chance to read!)

1) PZI is flexible in terms of times of injections. Big plus for some. Though many do keep to a fairly strict 12/12 schedule.

2) PZI (my impression anyway, I've never used Lantus and only read that part of the board occassionally) is more forgiving than Lantus in terms of being left out accidentally or dropped.

3) Very small dose changes can mean very big differences in blood glucose levels, ECID. For that reason, I'd recommend U40 PZI instead of U100 PZI, in order to make fine tuning of doses easier.

All this from me is hearsay, more or less. We use ProZinc which is supposed to be very similar to PZI, but is not in fact, PZI.

There are fewer of us here on the PZI forum than over there on Lantus. We're more than happy to help when we are around, but some questions can go unanswered for a while, just because no PZI'er happens to be on fdmb for a while.

Oh, and read the sticky! It isn't as comprehensive as the Lantus sticky, but has a lot of info relevant to using PZI.

20 is an amazing age for a cat! Good luck with your choice!

 

OK then Kris, Welcome Janie to pzi island. starting dose 1u depending on your amps or pmps of course. you know the drill, too low don't go. pzi does not have a shed, dosing is based entirely on #'s for the most part....you would NEVER for example shoot a 78 like they do in lantus. your nadir will be between 4-7 or so. starting out i don't know if you need to empty your shed, did they tell you?
set your low shoot at about 140 to start. and if your at that # maybe start at .5
how's that for starters?

 

extremely helpful, donna and lori -- see, with Jane, i would never shoot at 78 on lantus, because sometimes, she nosedives, then we have a huge bungee bounce. SHe just likes a little drama. I can't give her much less than zero!

I'm going to read the sticky tonight at home (gasp- on FDMB on company time), try to do a little research and then sleep on it. Unless, of course, Jane's numbers go kerblooey and I'm up most of the night. She loves a good pajama party. :roll:

 

First, welcome !

Second - random thoughts:

Since you have been giving such tiny doses, a U40 insulin will give you a better ability to accurately give a .2u dose for example (by using your u100 syringes and a conversion chart). 1 u of u40 is more volume (therefore easier to subdivide), but it has the same amount of insulin as 1 unit of u100 insulin, such as lantus. This might be why folks are suggesting it. Assuming ketones are not an issue, I definitely would start extremely low, like .2u just to be on the safe side.

Lantus has a shed and you need to empty this before switching, otherwise you will have 2 units working on a cat who already needs barely any insulin. = disaster. Don't know how long it takes to empty. ask some of the lantus wise ones


In Nov 2009 a new, FDA approved, manufactured insulin, for cats only, was released (http://www.Prozinc.us) This website has a fair amount of owner info and vet info & studies, so its worth reading. Prozinc would be worth considering, is very stable and should stay good after opened for you for a really long time which is important considering your tiny doses.

In my cat, its onset is about 2 hours, nadir somewhere between 4-9 hrs and duration about 11 hrs. For us, the nadir did seem to move around, and the longer were on it and the higher the dose, the later it moved. It has the flexibility that you can shoot early ( if you have rising numbers) or late without it being the end of the world, and you can make tiny adjustments based on other factors like preshot numbers, or getting into the cheezitz, OR you can keep the dose exactly the same. It has taken cats a month or more to get settled into a good dose, and several have experienced frustration, and others have quickly gone otj. It is supplied through your vet. cost range around $84 to $130/10 ml vial (I think wholesale is around $65) It does wear off around 11-12 hours, so unless you shoot early you will get higher preshots, but in my experience, Cody has a long slow hang-time nadir (which might be why it so hard to pinpoint)

Good luck with your decision

 

nancy on 2nd look at jane's SS i see where you suggest a mini dose. jane has several self come downs it appears....or is that the shed working? well we shall find out kris and preciouse of all preciounessess will receive our full loving attention. ok. i remember you from community back last year, do you remember me and tomtom?

 

1) I am worried about the shed so I asked someone with more experience in both insulins to take a look.

2) BTW I noticed today in the title you you are considering BCP PZI. This insulin is compounded in a variety of strengths, so if you go this route, be very sure that you get the u40 strength made up, not the u100. You definitely need the ability to fine tune precise doses by using u100 syringes with U40 insulin. I don't have the link to the conversion chart, but I know it pops up if you search something like "u40 conversion chart" Almost all the PZI moms use the u100 syringes with u40 insulin, so almost everybody (except me) can help with this (Cody's acro doses makes this unnecessary- so we use u40 syringes)

3) BCP is compounded and therefore has a limited shelf life ( I forget what they suggest- maybe a couple months?), and will possibly/probably need to be tossed before you use it up. Be sure to ask for 5ml vial so you waste less.

4) conversely, Prozinc is always u40 and should last until empty, if you need it that long.

 

Hi Kris

That somebody Nancy is talking about is me, and I agree with what she's posted. If Lantus is giving you a migraine, BCP might be a good route for you - or Levemir. BCP will be more cost effective IMO on her microdoses, just remember to roll the insulin, unlike Lantus/Levemir which cannot be rolled, since they are solutions rather than suspensions. If you're finding you are not getting enough duration with BCP, you might consider Levemir, which often helps some of our more spring-board-prone cats If you go the PZI route, definitely second the recommendation that you get the u40 insulin and use u100 syringes to save your eyeballs!

Scritches to Janie for me!

 

Here is the link to the conversion chart that Nancy was talking about: http://www.felinediabetes.com/insulin-conversions.htm

I haven't used ProZinc so I can't really advise too much about that. Buzz was on PZI Idexx until she went OTJ and is now on Lantus. It was very, very difficult for me to get used to the way that Lantus works because it is SO different from PZI, as Lori mentioned. I had a hard adjustment period. I thought that Lantus would help even out Buzz's wild swings that she had on PZI but that hasn't really been the case, so I am curious to see the opposite (from Lantus to PZI) and see what happens for Jane.

This board definitely does not get as much traffic as LL, so don't be frustrated if you don't get as many answers as quickly as you would over there. Some of the regulars here are away for various reasons currently, but ProZinc is gaining in popularity and we're getting more members all the time. Your questions will certainly get answered, so just keep checking back.

Welcome to PZI Land.

 

you guys are great -- thank you so much.

of course, now that i've troubled you all, Janie delivered a picture-perfect curve today on a slightly fat zero dose, or what I call NDUZ (no daylight under zero). We'll see what tomorrow brings!!

 

Kris--I think you might want to consider Levemir instead of PZI. Lucy is 21 and has high blood pressure and hyperthyroidism on top of the diabetes. Like Janie, her response to insulin is totally unpredictable since she went on the other meds. I use the Levemir very much like I did the PZI. I have a very narrow sliding scale (.1 unit higher than regular can knock out a 300 pretty quickly and .1 unit less allows me to shoot when she is under 100. In other words, I'm getting the flexibility of PZI along with the longer duration.

Vicki and Gandalf can give you a lot of good information too. Gandalf is also "mature" with other health problems so Vicki has also had to become creative.

 

Kris I saw you SS today...keep it up precious!