Need advice: PZI or Lantus?

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Martica and Fred

Martica and Fred

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The kitty I just saved from death row at the shelter is coming out soon I think. He was in DKA, but much better now after having been at the vet for 1 week.

The vet said he thought PZI would be the best insulin. I am used to Lantus though because I used that on Fred for 5 years.

What are the pros and cons? Should I just use PZI? I haven't researched it at all yet, have not had time. Is it also long-acting, is it pretty mcuh the same, or should I stick to what I know? The vet said something like because it's from pig rather than human something or other it's more like a cat's own.

any thoughts would be much appreciated. I just got a call from the vet to to drop him off some insulin today. I have some old Lantus in the fridge (not expired yet), but could just have them use the PZI if that's easier.

thanks!
Martica
 
You will be the one doing BG checks and curves. You will have enough of a learning curve just learning how Lantus works for him, why also have to learn the quirks of PZI compared to Lantus?

Is his primary care vet going to be Fred's vet? Then I don't think it should matter to the ER vet and maybe you could explain your reasoning that way.

Hope that helps. Bless you for opening your heart and home to this gentleman.
 
I don't know PZI well either just what I have learned from other posts, but I do know that it doesn't work off a shed like Lantus or Levermir so dosing increases and decreases are based off preshots not the nadir. I do also know that everyone that I have seen that started on PZI and then switched to either Lantus or Lev have to completely change the way they think when it comes to dosing so I'm assuming the same would be true with switching the other way around.

Now since I have one cat that went into remission on Lantus I'm biased...if you know Lantus I think I would be inclined to stick to what you know, if it doesn't work for Shane then you can always switch later...just my 2 cents.

Mel, Maxwell, Musette & The Fur Gang
 
An advantage to PZI is that it's U-40 rather than U-100.

This means it's easier to make small dosage changes (in increments of .2 units), if
you use U-100 syringes with 1/2 unit marks.

Never used Lantus for Smokey.
 
I think another advantage to PZI when cats are getting close to remission is that you can easily microdose or give small multiple doses a day since it does wear off faster, and it is very effective to do this. However, people have great success with Lantus, so if you are used to it, then go for it. Not sure the antibody thing makes much sense.
 
Martica, if you know that Shane will be home with you before Lantus shed builds up, I would go with the Lantus. You know the insulin but it sounds like the vets do not. PZI is in and out, no shed, but if he is going to be at the vet longer maybe it is safer to let them start him on ProZinc and when you get him home you can switch to Lantus.
 
With the right dosing protocol, Lantus has a better remission rate than PZI (80+% vs. about 50%), but PZI is a bit more flexible in terms of schedule. If it were me, I would stick with Lantus unless there was some reason why I couldn't shoot on a 12/ 12 schedule. And even in that case, I still would probably decide to do an altered dosing schedule with Lantus if I was more familiar with how it was dosed and how it worked. The longer duration of action makes it easier to keep BG in normal range longer, in my opinion.

As for cats developing antibodies on Lantus more than PZI, that's *sort of* true but is really not a significant factor in choosing between the two. In theory, feline insulin is more similar to bovine insulin, and therefore cats theoretically should develop more anti-insulin antibodies on a human insulin than on a bovine insulin. However, there have been no studies that have shown greater rates of insulin resistance to Lantus than PZI. In fact, studies have shown a large number of cats successfully regulated on Lantus for long periods of time without any noted insulin resistance, and insulin resistance due to anti-insulin antibodies has been rarely documented in cats regardless of the type of insulin. Most insulin resistance is caused by hormonal issues.

And I've also attached a couple studies to give to the vet if you need to convince them of your position on the Lantus.
 

Attachments

Karen & Smokey(GA) said:
An advantage to PZI is that it's U-40 rather than U-100.

This means it's easier to make small dosage changes (in increments of .2 units), if
you use U-100 syringes with 1/2 unit marks.
Click to expand...

Just wanted to point out that not all PZI is U-40; BCP PZI is available in U-100, U-50 and U-40. We use the U-100 but have also used the U-50 (which is also good for the microdosing).

If you're familiar with Lantus, I'd probably stick with that.
 
For a newly diagnosed cat, my recommendation is Lantus. The remission rate is excellent and there is much more track record on Lantus than the new ProZinc.

I just took a cat that had been diagnosed as DKA in October. I brought him home and switched him from 2 u bid of ProZinc to .05 u bid of Lantus (based on home testing). Within a week, he was testing below 100 for all pre shots. OTJ in two weeks. Because of his DKA, I am monitoring him very closely.

Best of luck with the cat,'''

Claudia
 
Thank you all. I think I'm going to go with Lantus.

now, I just tried to order syringes from Hocks. Haven't placed an order in about 1 1/2 years now. Now, they say they need a prescription and can't deliver I have to go to HealthWarehouse. And I went there and they don't even have the ones I want! Arrgh!

BD Ultrafine II
U-100 Insulin Syringe
31 Gauge
3/10cc
5/16 inch Short Needle--1/2 Unit Markings

I hope I can still get test strips on eBay.
(I sort of forgot all that's involved with supplies and day to day testing! I guess I should open up the spreadsheet docs too.)
 
Gosh and whle I'm at it, since I'm so out of date on everything. What's the situation with those new vet test strips...I remember they came out last year or something but I was already using OTU for so many years that I paid no attention.

As I'm about to hunt for new OTU test strips...is it worth it switching to the new pet glucometer?

Anything I should know about the OTU? And I've seen the ads on TV for the new test strips that suck up the blood--are those all the OTU test strips now, and are those better?

thank you for all your help. Feeling overwhelmed again and this baby isn't even home yet! Maybe he'll go into remission, my, wouldn't that make life easier!
 
Might try American Diabetic Wholesale for syringes. I did a quick search there and didn't see the ones you listed but these are the ones I use for Musette and love themhttp://www.americandiabeteswholesal...t-ultra-comfort-insulin-syringes_2552_178.htm

Can't answer the meter question but personally I think I would stay with the human meter for ease of finding strips in a pinch...Vet meter = strips only available at the Vet's for twice the price.

Mel, Maxwell, Musette & The Fur Gang
 
What state are you in? There are some states in which you need a prescription for syringes, and some you don't. http://www.isletsofhope.com/diabetes/state-law/state-prescription-laws.html

If I get my 31g, .3cc, 5/16 in. syringes at Walmart, and they're about $13. If you're in a state where you don't need a prescription, you can walk right in and order them at the pharmacy. If you do need a prescription, just ask your vet for one when he writes you the prescription for Lantus, and you're all set.
 
fwiw, my $0.02 :-D , in a cat with DKA history, i'd go with lantus too. from what i've seen the prozinc takes a while to start working very well in a lot of the kitties so i wouldn't want to risk dka again while you're trying to figure out the prozinc and if it's going to work or not. you know lantus and how it works and for that matter, R could be used easily along with it in a dka kitty.

as far as the strips go, no big change in strips as far as i know other than there are meters out there specifically marketed for cats & dogs now (alphatrak, ipet, etc....). they cost alot more as well as the strips and there's really no need to spend more for the same end result that you can get with your OTU.

which otu do you have?

as far as i know all or most meters now take strips that "sip" or suck the blood into them easily so if your otu is too old, you may need to get a newer model.
 
Martica, the OTU has sipped for years, over 9 years, so just go buy some of the OTU test strips but read on the box which meters they are used for. I have a feeling you have the regular OTU meter, no bells or whistles, just like I have. I love mine....wouldn't trade them for anything.
 
Julia, thanks so much for those studies. I printed those out, along with some of the other research under FDMB articles and gave them to the vet with a letter I wrote asking him to start with a conservative dose of 0.5U BID.

And thank you for those leads on syringes, etc.

Martica
 
Many of us use Walmart's ReliOn Confirm, a branded version of the Arkray Glucocard 01. The latter may be found online, also at American Diabetes Wholesale.

If you're not adverse to Walmart, this means the test strips are available at most hours of the day.

If you can do it, you can buy them in bulk at ADW and get free shipping.
 
BJM, thanks so much, but believe it or not, I don't have a Walmart anywhere near--I'm in New York City! I'm going to stick to the OTU for now, just ordered some strips off ebay.
 
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