Should I request an insulin other than PZI?

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JaimeAnne

JaimeAnne

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Hello,
I am new to the world of sugar kitties. I am awaiting my vet's return call, but the receptionist said his notes on Sabu's file said 2 units of PZI.

We haven't started insulin yet, so should I request a different one--or might there be a reason he'd chose this one over some of the others? I can't get it online, 800pedmeds stopped carrying it, so I'm stuck with purchasing the vials at the vet for $130 each.

I just want to make the right decision before starting him on treatments. A good insulin that I can get cheaper online than at the vet...

Thanks!!
 
Jaime, with much experience with both levemir and pzi (pro zinc) i would suggest either levemir or lantus.
IMHO.
I think many many board members would agree.
It does require a bit more testing.
 
are you using pzi or prozinc?

Prozinc is a good insulin and one that is more forgiving with schedule issues than lantus or levemir.

From a cost aspect, I think they are all comparable. Prozinc may be a little cheaper. If you go with lantus or levemir ask for pens not the vial - as you will pay more for the pens, but you will get more use out of them before they go bad on you.

you may want to visit the insulin support group pages to read up on each insulin and then decide which you want to try first.
 
Jamie
that price doesn't sound right. Bob is on pzi and i was able to buy it over the phone for 52.00. The vet called in the prescription and all I had to do was call and pay for it. That.price included overnight shipping as well. It was a 10ml bottle of 40iu/ml pzi. I got it frim Veterinary Pharmacies of America. www.vparx.com is their website.
I don't have any experience with the other types but it seems to be "vet's choice" in what type. Pribably whixhever kund they had success and experience with.
Carl in SC
 
Sorry for the typos....I'm using my "smart" phone!!!
Carl
 
Since you have not yet started insulin, I would go with levemir or else lantus. Definitely get the pens or cartridges as they are 3ml each and you have no waste. With a vial and you stay at a low dose, you may have waste. The original cost for 5 pens may be more than a vial, but store the extras in the frig and they will be good till expiry date if not yet used.

I am not familiar with PZI, but do know that levemir is a great insulin and use it for both of my cats.
 
carlinsc said:
Jamie
that price doesn't sound right. Bob is on pzi and i was able to buy it over the phone for 52.00. The vet called in the prescription and all I had to do was call and pay for it. That.price included overnight shipping as well. It was a 10ml bottle of 40iu/ml pzi. I got it frim Veterinary Pharmacies of America. www.vparx.com is their website.
I don't have any experience with the other types but it seems to be "vet's choice" in what type. Pribably whixhever kund they had success and experience with.
Carl in SC
Click to expand...

I think you are referring to the compounded PZI that is available from BCP or Wedgewood now. That is actually a fairly normal price for Prozinc.

The big cost difference between all the insulins is long term, and at that, it isn't much. Most people can use a PZI/prozinc bottle for 3-4 months, some longer. Those that use lantus/levemir get the pens for around $120 shipped from Canada and each 3ml pen will last one to two months, depending on the dosage, so 5-10 months for a pack of 5 pens. If you by the pens here in the states it is around $210 for a pack of 5 pens. So assuming 4 months on a PZI vial - about $32.50 a month; 5 months on Lantus/Levemir from Canada - about $24 a month; 10 months Lantus/Levemir from Canada-$12 a month; 5 months L/L from US- $42; 10 months L/L from US - $21.
 
Thanks,
I spoke with the vet, he stood firmly by PZI without a real convincing reason why. Depending how much a second opinion will cost, I may take him to another vet.

I googled PZI & it seems to be various pro zinc insulin products, but there was one specifically called pzi that was discontinued in 2008 which the vet confirmed that the pzi he's suggesting is not discontinued and still readily available. I just don't want to be stuck buying it from the vet, ya know?

His new diet starts today, with 2 other cats giving him wet food & the others dry will be fun!! ;-)

Thanks for the advice!!
 
Jaime,

ProZinc is probably what the vet is prescribing. It was available last year as a new insulin and mostly available thru vets. Also, it uses the u-40 syringes that are only available thru vets. The u-40 syringes are a 29 gauge (thicker than the 31 gauge I use for me and my 5 diabetic kitties).

ProZinc doesn't have much of a track record. Lantus is my choice for newly diagnosed diabetic cats (have had 15 thru my house over the last 4.5 years). Remission rate is quite high. It has been used for cats for at least 5 years.

As others have told you, get the pens if you get Lantus or Levemir. Up front a little more expensive, but long term cheaper.

Good luck with your sugar dancing!

Claudia
 
Jamie,

I have 12 cats, 2 of which are diabetics, everyone here eats exactly what the 2 diabetics eat. Just good old fashioned Friskies pate-style canned catfood. I have to tell you even my non-diabetics look and act better than they ever did on the dry food. Their coats are so sleek, shiny and soft, those that were over weight lost weight effortlessly, and everyone here is muscular and toned because they are now chasing each other through the house at warp speed. Now the downside to feeding 12 cats a canned food only diet, is that I get very strange looks at the store when picking up the week's worth of catfood. :lol: So if you would like you can just feed everyone the same diet, mine, personally think they hit the jackpot when mom adopted 2 diabetics because they now get what use to be only for treats and special occasions. :-D

Although in the very beginning of their diet change, I honestly didn't think I was going to be able to keep up with the rapid rate of consumption. :roll: But once they realized that there would always be more wet coming, they slowed down to a normal rate and stopped trying to see if they could eat me out of house and home.

Mel, Maxwell, Musette, and The Fur Gang.
 
Another Lantus user here. We used Lantus for a month before going into remission. My vet chose it because of it's track record. Thanks to the folks here, I learned to shoot the insulin in the side belly ish area vs the scruff of the neck as the vet tech demo'd. I also changed his diet & home tested. We also moved into a 2 story home right before his diagnosis, so there are a few reasons for the remission. I have a co-worker who's diabetic cat is also on Lantus. We both use U-100 syringes.

Maybe you can call anothr vet in the area to find out what the would prescribe...good luck & keep us posted!
 
Hi Jaime,
When Gandalf was first diagnosed, we were given PZI insulin, which over the 2 1/2 yrs we used it increased in price at least $20 to about $100. For one bottle which I had to throw away in 3 months.

Once I discovered how poorly it was controlling Gandalf's blood glucose, I switched to Levemir and have never looked back.

I know some people's cats do very well on PZI, but I firmly believe Gandalf is healthier in terms of his diabetes in the years since we have been using Levemir, which is coming up on 4 this September. Yes, he's been diabetic for 6 1/2 years.

And Levemir is more cost effective. 1 pen holds 300 units of insulin. So that's approximately 120+ days on one pen, they come in packs of 5. I usually buy 1 box of pens every 15 months. At even $200 a box, that is a little over $13/month if dose is around 1U. Some cats need more, but some need even less and some go in to remission. Especially on Levemir.

With either Levemir or Lantus you can use any U100 insulin syringes, ones you can get at Wal-Mart for cheaper than the vet will sell you U40 special syringes for PZI.

I don't mean to make any PZI users upset, but yes, you should request either Levemir or Lantus. Lantus is being used by more veterinarians now and is available in similar kind of pens, so maybe ask for Lantus as he may have heard of it. Levemir would probably get a "Huh?" and then they will think you're asking for it because of the new commercials :lol:
 
Ok I'm starting to freak a little, I feel like I'm taking too long to get him on insulin, but I want him on a good one!!

I've been calling around and asking what insulin they would put him on and the receptionists say you'd have to speak to the dr and the office visit is 50-100. I don't want to take him to another vet not knowing what he'd prescribe him, it would be a waste of time & money!!

How did you get your cats on Lantus?? Is ProZinc really that bad, at least until I find someone who will prescribe Lantus?`(I know It wouldn't be as easy as it sounds)

Ahhh!! :?
 
JaimeAnne said:
Ok I'm starting to freak a little, I feel like I'm taking too long to get him on insulin, but I want him on a good one!!

I've been calling around and asking what insulin they would put him on and the receptionists say you'd have to speak to the dr and the office visit is 50-100. I don't want to take him to another vet not knowing what he'd prescribe him, it would be a waste of time & money!!

How did you get your cats on Lantus?? Is ProZinc really that bad, at least until I find someone who will prescribe Lantus?`(I know It wouldn't be as easy as it sounds)

Ahhh!! :?
Click to expand...


Instead of asking what insulin they would put him on, call around, say you're shopping for a vet up to date with feline diabetes treatment and ask what insulins their other diabetic patients are on. If they give you a vague answer, like "Many different kinds," say "can you be a little more specific? for example, are any of your cats on Lantus?"

Once you find a vet that is giving cats Lantus already, it's 99% certain they'll write you a prescription for it if you ask for it specifically at your visit.

Also, did you try asking your own vet if they would write you a script for Lantus instead? Tell them you read this article: http://www.ncbi.nlm.nih.gov/pubmed/19592286, and that you really want to try it because of the 80+% remission rate in newly diagnosed cats.

I've found that if I go to the vet armed with information, they pretty much do what I ask them to do. Sometimes you get a few prickly vets that don't like to be challenged, but in my opinion if a vet refuses to work with you, then you should find a new vet anyway.
 
If your vet is saying PZI, then it is probably a compounded PZI insulin.....maybe from Vet Pharmacies, maybe from the local compounding co. if there is one in your area. Now, if he says Prozinc, PROZINC is a trademark of Boehringer Ingelheim Vetmedica, Inc. and it is called Prozinc. BCP is a compounding pharmacy in TX that does make a good PZI insulin, compounded, but a lot of people use it and have over the years.

As others have stated, you would do so much better to start with either Lantus or Levemir. Saying just PZI doesn't mean much.......you need to find out what and whose PZI he is talking about. Vets really need to be more specific when speaking to clients. I would not use any insulin compounded except from BCP.
 
PZI is fine. I had compounded from Baltimore through my vet for about $98.00. Has one year expiration date. Mine was PZI 100 not 40, but most kitties in the PZI forum I think are on the 40. Of the 5-6 of us that joined/started near the same time (Late Feb early March) - 3 of us have kitties that no longer need insulin. Mine was the shortest time 1 month on insulin.
HUGS, and deep breaths!
 
Thank you so much everyone!! Your advice has been invaluable. :-D

Earlier today I dropped off the info on Lantus that *Julia&Bandit* gave me, he just called back.

He gave me a lecture that when a certain PZI they used was discontinued they started using Lantus but did not recieve the same remission rate as the abstract said (fine, there are a lot of variables-I remember my college chemistry!) and that the danger with Lantus is that cats that do go on remission it's often found out when the cat is hypoglycemic (which is why I will learn how to test him frequently) and he said that most cases the remission is because of a low carb/high protein diet that many cats refuse & that he'd rather have a cat eat than no eat. (Already changed his diet--He LOVES it, so no problems with diet here.) They currently use Vetsilin.

So, after the lecture I said thank you for informing me, will you prescribe him Lantus? He said yet, and they have pens in the office to teach me how-I am going in w/ Sabu in 2 hours for our lesson.

Thanks so much!!!!! I am much more comfortable making informed decisions than just taking someone's word for it--even if they are the professional.
 
Okay, seriously--you guys and the vet is going to hate me by time the night is through!!

I came across this site, and now I'm panicked about giving him insulin!! I started him on 1/2 of 3oz can mixed with dry last night & this morning the same then for lunch gave him a whole can (3oz) of wet....now this link is telling me I could sent him into hypo by giving him insulin!!!

http://www.diabeticcatcare.com/detox.htm

Any advice??
 
Lantus does come in 'pens' a ball-point-pen shaped device that humans use.

However, here, we just use regular insulin syringes. You take off the pen cap and
insert the syringe needle into the little rubber part in the cartridge. DO NOT insert air
into the pen.

The pens with the 'pen needles' are only capable of delivering insulin in 1-unit increments,
and are not as accurate as we would like at small doses.

With syringes instead of the pen-needles, you can adjust doses by 1/2 units and give small doses,
such as 1/2-unit.

Vet's info that Lantus does not have a good remission rate---where does he get that?.
Maybe his experience is tied to his diet recommendations, not the insulin.

I would not use Caninsulin if possible to avoid it. PZI is better than Caninsulin.
 
Jaime you are getting a lot of mixed information.

If in fact the vet is recommending prozinc - I used this insulin - not on Maui, but on a cat that I was pet sitting for named Blue last summer. I changed his diet to an all wet low carb (in fact very low carb - as he was very carb sensitive).

I used the prozinc, and used the regular human insulin syringes U-100 and converted the dose from the U-40 syringe to the U-100. It's an easy conversion and I will look for the conversion chart.

anyway, my point is, with home testing, change of food and prozinc - Mr. Blue quickly reduced his bg levels and I had to micro dose him - thank goodness I had the U-100 syringes, as I could better micro dose with those 1/2 markings on the syringe.

When I returned Blue to his human, it was another two -three months before he was completely off insulin. It's now one year later and he is still in remission.

So, don't write off prozinc as a bad insulin - it's not, and in some ways is more forgiving than lantus. I'm a huge lantus fan - Maui was on it and it worked great for her, but I don't want you to think that the vet is giving you bad information or that you are being misinformed by this board.

I don't know enough about the other PZI products - so I can't comment, but I do know if you use prozinc you aren't making a mistake. I do suggest if you get that, that you get the human U-100 syringes and convert your dose.

I will look for it and post shortly.

here is the conversion info: http://www.felinediabetes.com/insulin-conversions.htm
 
JaimeAnne said:
Okay, seriously--you guys and the vet is going to hate me by time the night is through!!

I came across this site, and now I'm panicked about giving him insulin!! I started him on 1/2 of 3oz can mixed with dry last night & this morning the same then for lunch gave him a whole can (3oz) of wet....now this link is telling me I could sent him into hypo by giving him insulin!!!

http://www.diabeticcatcare.com/detox.htm

Any advice??
Click to expand...

There is some controversial info on that site unfortunately. I would not advocate witholding insulin from any cat that has diabetic glucose numbers. A diet change can cause a hypo if you have worked up to a dose that works with the dry food and then change the diet. (some cats on dry food get more than 5u twice a day because of the carbs) If you start low and switch diet at the same time, you should be fine. Please don't let this vet convince you to start with a dose higher than 1u twice a day. Too many vets start with whopper doses because they think it is dosed by weight or whatnot. There are many cats that only need around 1u and if you start at say 3u, then you have already gone past the optimal dose. If he does prescribe a high dose - express concern that you might be overshooting the optimal dose by starting out high. If he still pushes for it - just smile and say ok. When you get home - you hold the syringe and you can make the decision to start with a lower dose.
 
Thanks so much, once again!

Good news, he's starting Lantus 1u 2x per day starting tonight. The vet tech showed both me & my husband how to do a bg check w/ a human meter & showed us where we could inject insulin. Only bad-ish news is the vet prescribed the pen, but I will just use it & see how it goes. His bg was 580 yesterday so I imagine he'll go up in dosage when I take him back next week. Only time will tell at this point.

I'll keep ya posted! :smile:
 
JaimeAnne said:
Only bad-ish news is the vet prescribed the pen, but I will just use it & see how it goes.
Click to expand...

The pen is good. You don't use it with disposable needles. You will need U100 syringes. You take the cap off and put the syringe needle into the rubber stopper at the end to draw your insulin. If you overdraw the 1U, don't shoot the excess back into the pen. There is a silicone lining in syringes that damages Lantus.

Here's a coupon for Lantus at a US pharmacy from the Supply Closet post. http://www.lantus.com/solostar-insulin-pen/solostar-coupon.aspx
 
JaimeAnne said:
Thanks so much, once again!

Good news, he's starting Lantus 1u 2x per day starting tonight. The vet tech showed both me & my husband how to do a bg check w/ a human meter & showed us where we could inject insulin. Only bad-ish news is the vet prescribed the pen, but I will just use it & see how it goes. His bg was 580 yesterday so I imagine he'll go up in dosage when I take him back next week. Only time will tell at this point.

I'll keep ya posted! :smile:
Click to expand...

That's a good starting dose. Have you started to hometest yet? Remember that the high remission rate with Lantus is only with the combination of home testing and diet.

At least three tests need to be done daily--once before each shot, and one about 6 hours into one of the cycles. This is the minimum number of tests you need to get to keep your cat safe and get his insulin dose adjusted correctly, but if you can get a few more then more data is always better.

Check out the stickies in the Lantus forum. There is very important and useful information there that will help you out: http://www.felinediabetes.com/FDMB/viewforum.php?f=9

As for the pens, it is more economical to have a prescription for those than the vials, because you won't have as much waste. I got a prescription for the pens after I threw most of my first vial away. You do not want to use the needles that are made for the pens, though--you need u100 syringes with half unit markings. Lantus dosing is done in small, .25u increments, and the needles that are made for the pens only allow adjustments in whole units.

Look at this sticky to see how insulin is drawn from the pen with a u100 syringe: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
 
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