Pls help.. Cat on Vetsulin, production suspended, now what?

Hi, I'm new to the forum, but my 11 year old cat has had diabetes for over 2.5 years. At first he was put on PZI and was on it for while, then my vet said that PZI was no longer available (not sure if it discontinued or what) but ever since then he has been on Vetsulin. He has been doing very well on it. Although he is still overwieght, he has great energy and no neuropothy (which he had while on the PZI). Overall he is a very happy kitty, and even will lay perfectly still for his insulin shots. So, you can see my dismay when I found out that Vetsulin production has been suspended (at least in the U.S.).

According to their website, they stopped producing it because "The product has been found to be out of specification in regards to the long term stability of the crystalline, or long acting, component. Specifically, the concentration of the crystalline component is higher than what is outlined in the specifications of the product. Consequently, the amorphous, or short-acting, component may have a lower concentration."

They say that they are trying to resolve the issue, but until then I have to find an alternative insulin.

He has been getting 6 units, every 12 hours with food.

Has anyone else had to switch from Vetsulin because of this? Or have any suggestions for a similar substitute?

My vet only has 1 course of action... switch to Lantus. But she said that that was the only one that they were familiar giving to cats.
She suggested I talk to my local pharmacy to find info on other insulins, and we could try something else.

I have 2 reasons for not wanting to switch to Lantus. First my vet says Lantus has different onset, peak, and duration compared to Vetsulin.
Second, Vetsulin was only $32 per 10ml vial, But Lantus is $100+. I can't afford much, due to the economy.

Thanks for any help/advice you can give.

 

Hi there

Yes, there are issues with vetsulin and so many are switching. THat said, if you are in the USA you can still get PZI, just from BCP instead of IDEXX. Slightly different formulation but good. Lantus though is a great alternative! Yes, it is a bit more expensive BUT if you buy it in pen form it actually works out very well, plus you should need a lower dose.

About that dose...6 units vetsulin twice a day is pretty unusual...what are you feeding and how did you reach it? SOrry to pry, but I wonder...

Jen

 

Hello, I am sorry to not have time at the moment for a more detailed response, but there are more economical ways to make lantus work for you and I would really encourage you to make that switch.

The vials on vetsulin are unstable and vets are being discouraged from prescribing it.
Here is a link that contains a lot of info about lantus and levemir. They are much gentler acting insulins and I suspect your cat will feel really good with a change like this.

LANTUS & LEVEMIR: More Information

Could you edit your title here to add, lantus as option? That will bring more people with experience. You could also go to the lantus insulin support group and ask questions there.

Hang in there.....lots of people here have made the switch and been glad they did

Kimmee

 

totally understand the money situation.

1 thought: if lantus is more likely to get kitty into remission you might not be talking insulin for that long.

2nd thought: BCP PZI is cheaper (BCP Pharmacy in texas). your vet might be able to get you a free half vial sample of it. check the prices, tho. it's been a while since i've checked BCP's price for PZI. here's the link for a free sample for your vet to get you: http://www.bcpvetpharm.com/pdf/sample.pdf

 

Hi,

your information is correct in respect of the vetsulin being outside of specification.

Lantus actually has a longer duration than vetsulin and therefore has significantly more chance of keeping a cat in non-diabetic numbers for a larger part of the day than Vetsulin. This means less damage is being done to the kidneys (they work over time when the level of blood glucose is above about 220.Called renal threshold).

Lantus can actually last longer than vetsulin, so although it is initially more expensive, you may be able to use more before discarding. There is an argument that Lantus should be tossed (like vetsulin) every 28 days. However there are members on the board who have used a cartridge up to 9 weeks.

Levemir is almost identical in action to Lantus, but does have a guaranteed useage of at least 42-44 days (sometimes longer).This is provided they are kept at 2-8 degres centigrade.

The onset with both of these insulins is around 1-2 hours.
Nadir usually 6
Duration, minimum 12, sometimes longer (called carryover)
Both do require as consistent dosing (12 hrs) as possible.

They are both superior insulins in my view to vetsulin. Have a look at Lucky's SS.You can see we couldn't get regulation on Caninsulin (European brand name for vetsulin) but on Levemir she was beutifully regulated.
Caninsulin was just over £20 for one 10ml vial.

Levemir was just under £80 for 5 3ml cartridges, that lasted over 6 months.So you can see, it actually worked out cheaper.

Do you hometest? This is really important. I'm a tad concerned that your cat is on 6u twice a day. It is rare for cats to need more than 5u and here on the board most are between .5u-2.u on an on-going basis. There are high dose cats that have other conditions (insulin resistance/acromegaly)that do require higher amounts, but my limited knowledge of these suggests they are on high differing doses, not consistently on the same (I could be wrong).

I therefore think having some bg readings could go a long way to helping you manage your cats diabetes. On top of that, he was very young when diagnosed.(may have a chance of stil going into remission despite the fact he has been diabetic for so long)
What food do you feed him? How much?
And, do you home test and test for keytones?

I know this is a lot of questions, but for beans (us)to offer advice it's important to have the facts. Food and the %carbs in it can have a significant impact on how much insulin a cat needs (and possibly lessen the cost of buying insulin)

If you look at various threads here you can get a sense of the advice and support offered and if you look on the Lantus ISG right now there are several cats in the past week that have either gone into remission (become diet controlled) or are on the trial to see if they can manage just with diet alone (14 days without insulin and maintaining non-diabetic numbers).
Also lots of stickies explaining how Lantus works. We can talk you through this if you wish to try.

If you do think you ned to change food, please don't do it until you have looked at insulin doseage.High %carb in food could be the only thing stopping a cat from going into hypo when on a large dose of insulin.

Lastly I can't comment on PZI, but Lantus or Levemir are the 2 insulins that appear to be having the highest success rate in terms of remission or micro-dosing and maintaining non-diabetic numbers for a large part of the day (ultimately happier, healthier kitty in my view)

Please keep on asking any questions.

 

Remember that Vetsulin is a U40 insulin while Lantus and other human insulins are U100. For the $32 Vetulsin vial you only get 400 units compared to 1000 units for Lantus. Thus, te cost differential is less than half what you may think.

 

There is a brand new, FDA approved, PZI type insulin that was released around Thanksgiving 2009. It is called ProZinc. We use it, and I am liking it a lot. It is manufactured, very stable (ive dropped it 2x), and is suppose to be ok to use until empty in most cases ( too new for me to tell on that).

My story is similar, Cody was on vetsulin around 2 years, (but I was never really satisfied with his readings which may have been from other undiagnosed -medical problems). In Nov 09 we switched to compounded PZI and then PROZINC on 12-22-09. The transition has been awesome for us. Wish I had known sooner....

Because it is FDA approved, your vet will/should know about it. It is suppose to act similar to other PZI products, with a slow steady long nadir and a 12-24 hr duration. They say most cats need 12 dosing.

I just started posting online BG so you can't see what his curves were like on Vetsulin, but they weren't pretty. Now things are slowly steadily improving, which is much easier on me and he seems much happier. He is on 1/2 the vetsulin dose, and his average numbers have steadily dropped over 80-100 points and are still dropping. Can you see me smiling? :razz:

 

Just a question for verification of your 6 units dose...

Vetsulin is a U40 insulin. Are you using U40 syringes from the vet or U100 syringes from a human pharmacy?

If you are using U100 syringes with U40 insulin, then the dose is really only 2.4 units.

(U 40 is dilute compared to U100 human insulin)