UK new PZ user help please

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Di and Jasper

Di and Jasper

Member Since 2013
Hiya. Im having problems finding any information on the use of Hypurin PZ in the UK. My cat Jasper was diagnosed with FD in feb 2012 and was put on caninsulin. Vet said not to test and he kept going back for fructosamine tests. Shock of all shocks in oct 12 he had a hypo fit. I saw a different vet and after a couple of days In Hospital for Jasper the vet recommended home testing and said she doesn't feel that fructosamine tests are any good as they only give you an average! Since then his pre meals levels all always between 20 and 24 but 4 hrs later he drops right down to between 3 and 5. The vet has now put him on PZ but she had lots of problems getting hold of it. She has told me not to change his diet but everything I read seems to say that the standard whiskers Felix etc are to height in carbs. So am a little confused about food. (Sorry off topic). I have been told to give jasper 1 unit once a day, is this normal ? Again everything I have read says cats do better with twice daily insulin. How long dose a vile of insulin last. It's quite expensive( £58) especially if I have to throw most of it away so dose anyone know if they do small bottles. I don't have an issue with paying for it just hate waste. I'm sure there's loads more questions but I feel like my head is about the explode lol. Any advice would be greatly appreciated, even my vet has admitted that its not often cats are given PZ in the uk so she's had problems trying to get info. Thanks.... Dianne
 
First...WELCOME to the best site on the planet to help you help your kitty.

I must say your second Vet is right and kudos to her for using PZ . We have many UK members that can advise you better than I. (My diabetic kitty passed away many years ago but not from diabetes.)

I just wanted to welcome you and say it is daunting at first but soon you will be giving advice. You will get the hang of all this.

Again, WELCOME,
jeanne
 
Thanks Jeanne I have searched all over the net for info and I have to say this site seems full of knowledgable people. There's so little information in uk on FD it's great that that this is a multinational site.
 
We don't want your head exploding! We have a UK member who has used Hyperin PZI for years successfully. I'll send her a private message and see if she will stop by. It is a different insulin than the PZI or ProZinc we use in the US. I think Elizabeth says her kitty can go longer than the usual 12 hour cycles so she can help with dosing.

Re the food. Yes, we like wet low carb food. (Again Elizabeth can help with UK brands.) But do be careful with changing food and starting insulin. Our Oliver went down 100 points overnight when we switched. If we had given him his usual dose, he would have hypoed. And yes, home testing is the most important thing you can do for your kitty.

Welcome! Take a deep breath. We all are paying it forward for the help we received when we were new and scared. It gets easier, promise!
 
Hello Dianne, and welcome to FDMB!

Yes, it's true that there are not very many people using Hypurin PZI for their cats - but I am one of them. :smile:

The reason there aren't many cats on Hypurin PZI is that, until a year or so ago, there was another PZI insulin that a lot of vets used to use (made for animals), but that was discontinued. Many vets had never heard of Hypurin PZI (made for humans). Further, vets in the UK are obliged, I think, to try animal medicines first and only to prescribe human ones if the animal meds aren't effective. So, mostly they tend to stick with Caninsulin. (I wonder why your vet is having problems obtaining Hypurin....?)

Hypurin PZI has a very long duration in the cat's system. I'm guessing that is why your vet has suggested that you only give one shot a day. S/he wants to be sure that you're not giving insulin when your cat's blood glucose doesn't warrant it. However, because you are able to hometest you can check whether your cat's blood glucose is sufficiently high for you to give a second dose. I find that mostly my cat can have 2 doses a day, but sometimes he goes 24 hours on a single shot.

Because of the long duration of Hypurin PZI any doses that are given 12 hours apart will overlap for a time. So, one dose will be wearing off while another dose starts to become active. When I switched to Hypurin PZI I found that I needed to reduce the insulin dose because of this.

Regarding how long the vial of insulin lasts, well, I keep mine in the salad drawer of my fridge and it has lasted around 5 - 6 months. But batches seem to vary; one vial lasted just 3 months before losing potency.

Given that you can hometest (and it was brilliant of your vet to encourage that) it would be great if you could collect some test data about how your cat is responding to the Hypurin.

And have I understood you correctly that you're feeding canned food in jelly (Whiskas/Felix)? Most foods in jelly are fine, and not too high in carbs. I've got a link somewhere to an online carb calculator and I'll post it here shortly for you.
 
Thanks Sue have to say my head is no longer exploding as I have a glass of wine in my hand.
Elizabeth thats what it is was the insulin had been discontinued and she had to find a alternative. I think I'm so mixed up in the worry that I'm just not think clearly and am looking for things to worry about. I'm very lucky with jasper as he's a big soft mummy's boy so the home testing isn't an issue for me. He even jumps up on my knee before meal time so he can have his blood tested (only because he wants his breakfast/tea). Have you found that Bertie regulated better on PZI? My vet is really good and at the moment I am having once weekly telephone consultations with her to monitor jasper. He has his first dose of PZI tomorrow and she has asked me to do a curve. Am now taking big breaths and big gulps of wine and claming down. Am just really thankful I found this site and that I'm not alone
 
Hi Dianne,

I've got a glass of wine here too! Maybe it's a 'UK thing'! :lol:

Hypurin has been absolutely brilliant for Bertie. Prior to that his BG numbers were pretty dreadful actually, and I had come to believe that it was always going to be like that for him. The fact that he did so much better on Hypurin came as a total shock! :shock:

However, when we started on Hypurin it took a couple of days for the insulin to really have any effect on him. That isn't so unusual when changing insulins. Some cats take a day or so to adjust to the new one. So, don't be disheartened if the blood glucose numbers you see tomorrow don't seem like an improvement.

I first heard about Hypurin PZI from a vet who had previously been a chemist working in animal medicines. He recommended it as as being good for cats: It's a bovine insulin and just one amino acid different to a cat's own insulin. Caninsulin is a porcine insulin and not as close to cat insulin as the bovine is.

If this doesn't work for your cat another insulin to consider it Glargine (the US name here is Lantus). It has a proven track record of being a good insulin for cats, but not many vets in the UK will have experience of using it. But, vets can sometimes be persuaded, so there is another option out there if Hypurin doesn't work for Jasper.

Did you ask your vet for a change of insulin, or did your vet see that the Caninsulin wasn't working well?
 
Dianne,

Here is the link to the online cat food 'carb and calories' calculator. You just add in the % amounts of 'protein', 'moisture' etc from the side of the can, and - hey presto! - it works out the amount of carbs for you. For a diabetic cat you're looking food that has less than 10% of calories from carbs. And in fact an awful lot of foods have far fewer carbs than that.
http://fnae.org/carbcalorie.html

What you choose to feed will depend on your budget and where you choose to buy the food from. Some folks in the UK feed Whiskas and Felix in jelly or Butcher's Classic. If you can shop online then it is certainly worth checking out 'Zooplus' as they sell stuff that supermarkets don't. A good choice there for diabetic cats is Bozita canned food. Grau 'grain-free' is also good, but it's a premium food and the smaller cans are very pricey; however the huge 800 gram cans are a good buy, and you can freeze portions of it to include in a rotation with other foods to reduce wastage.

Some foods include as an ingredient 'vegetable protein extract' (which I suspect is soya, but I'm not sure...). A minority of cats seem to be very sensitive to this and it can elevate their blood glucose enormously (my cat is one of those). Felix 'as good as it looks' is one of those foods, and a few other brands including some supermarket own brands contain it too, I think. Jasper may not be one of those cats that's affected, but it is as well you're aware of this...
 
Oooh! Important thing about Hypurin PZI that I forgot to tell you....

With Caninsulin, the insulin peak (blood glucose nadir/lowest number) usually happens around 5 hours after the insulin shot, give or take half an hour. There's a sort of 'typical Caninsulin pattern'. But Hypurin doesn't seem to be like that...

With Hypuin Bovine PZI the time the insulin takes to start working ('onset') and the insulin peak seem to vary quite a bit from cat to cat. From what I know about Hypurin there doesn't seem to be a 'typical' pattern time-wise. It seems to be a very individual thing...

I'm really interested to see what BG readings you get tomorrow, and SO hope that this works well for Jasper!
 
Elizabeth you are a life saver... Thanks for the advice it's good to finally start to understand the food thing. Jaspers has whiskers in jelly at the moment in tins as he won't eat the stuff in pouches. I don't know why he's just a little strange. :lol: I'm going to take his bloods every 2 hours tomorrow would like to do it every hour but I'm at work in the morning so hubby is taking blood and he's not very confident at it. Not sure if I should do a full hourly curve on Sunday as well? I'll post his levels on here tomorrow. Again I can't thank you enough for helping me with this it so nice to know that there's support out there from people who are actually experienced at it.
 
Oh one more thing. You said you keep you insulin In the salad draw..... I just keep mine on the shelf, is it better in the salad draw?
 
Hi Dianne,

I think for many 'curves' doing tests 2 hours apart is fine. And I'm SO impressed that you're hubby tests too (even though he's not confident about doing it. Bless 'im!). That's something my husband has never wanted to do! ( I think he's done about 2 tests in the 6 years that Bertie has been diabetic..... :roll: )

As to doing 'hourly' curves..... Hmmm.... It could give you some useful info. But it may be more tests than you actually need to do. It is certainly useful to know when the insulin starts working in your cat ('onset'), and then to monitor how fast and how far the glucose drops after that (and this is the period where hourly testing can be really helpful actually); but after the insulin has peaked and the blood glucose starts to rise, I don't think hourly tests are so necessary. I think you can relax a bit then. ;-)

Oh, regarding storing insulin in the fridge; I keep it in the salad drawer just because the temperature is more constant there, that's all. The general advice is not to store insulin in the fridge door because that area is most likely to be exposed to warmer temperatures, and the vial can get rattled around every time the door opens and closes.
 
Hubby has tried to do the test and failed :sad: He said he really tried but Jasper got sick after 5 minutes and their both got upset. He has managed to do the test before a couple of time but I have told him that its not easy to do and ill check him when I finish at 1pm. So I think ill leave the curve until tomorrow.
 
Jasper had 1 unit of insulin this morning at 7:45 his level was 20.4. At 1:10 his level was 2.9 nailbite_smile after food he went up to 4.8 at 1:35 at 1:55 he's now at 5.4. Thanks Elizabeth for the emergency telephone call and all your help and calming me down. Have spoke to the vet and he say half a unit tomorrow and see what happens. Will let you know his numbers tomorrow.
 
Hi Dianne,

I do hope you're feeling a bit better/calmer now. I know what happened this morning really gave you a fright, but you did a brilliant job! Despite how you felt you did exactly what needed to be done. :smile:

I've posted here to try to get advice on measuring small doses (and explaining a bit about what has happened today to see if anyone else can advise on this situation)
http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=86344&p=924546#p924546

Best wishes,

Eliz
 
Hi Eliz
Just checked him again and he's 5.9 so looks like he's still going in the right direction. I know he's feel better because he's just told Herbert off (the ginger cat) for trying to get into his bed with him :shock:
 
Hi Dianne,

Love the cat photo. They're both real cuties! :smile:

I didn't think to ask earlier but what glucose meter are you using? Given that your vet suggested that you hometest are you using an 'Alphatrak'? It reads differently to the meters made for humans (which most people here use - because the test strips for those are so much cheaper!) If folks here know which meter you're using they'll take that into account with any blood glucose numbers that you post tomorrow.

I'm home most of the day tomorrow so do phone too if you want to talk anything through.
 
Hi Elizabeth
I'm using accu-chek Aviva. It was a little confusing picking one but my vet said not to bother with the animal ones as they are expensive and the human ones work just as well.
 
Just thought I'd let you know jasper a numbers today. At 7am he was at 18 and I gave him half a unit, +2hrs 15.8, +4hrs 11.3, +6hrs 8, +8hrs 9.6 and +10 13.3 so a lot better than yesterday :-D
 
Oh, Phew! I've been thinking about you, Dianne, and wondering how things were going with Jasper... nailbite_smile

Well, that is a nice curve! :smile:
I expect you are very relieved! Nice gentle drop, and nice gentle rise... I'm guessing the 'onset' (when the insulin started working) would probably have been about an hour and a half after the shot (+1.5). And it looks like the peak of the cycle is somewhere around +6 or slightly sooner. Well, this is really useful information, because although the numbers themselves can vary a bit from day to day the actual pattern of the cycle (onset and peak) should remain fairly constant.

Well done, Dianne!
 
Hi Dianne, I'm rather late to this particular party but - as another fellow UKer - just wanted to add my support and say well done for doing so well. FD can be a real minefield but you should give yourself a big pat on the back for getting to grips with it as you have. And I'm with you and Elizabeth - a glass of wine is an essential in our armoury so here's to you :-D

Diana (in Surrey)
 
Thanks Elizabeth I was so relieved when I saw the numbers were better than yesterday. I'm not going to give him any more insulin today, although I will continue with the curve. I'll see what the vet says on Wednesday as to wether I give him twice daily shots. I didn't realise that the curve would keep to a similar pattern, I just assumed that if the numbers were different then the curve would be different, so it's quite handy to know.
Hiya Diana thanks for the support, I have to say Im sat here now with a nice glass of red :-D
 
I am very upset that my vet has just refused to give my almost 24 year old cat Hyperin B. She went hypo on Caninsulin when she was first diagnosed 4 years ago and I dislike that insulin!! They say that under Cascade they have to offer Caninsulin as they have had no adverse cases in their surgery that warrents offering another insulin.

Any ideas please? I guess that rules out Lantus, altho at her age I thought it best to stick with a similar insulin. She was also just diagnosed with hyperthyroidism today too :(

Thanks,
Kay
 
Hi,

Jumping onto this thread as its along the same lines as my cat's diabetes situation and also uk based. My cat has been on Caninsulin for 6 months but two glucose curves have shown that he is not getting enough coverage and there are many hours when his levels are too high. My vet has suggested moving to Hypurin bovine PZI, but the price is high via his suppliers (over £70). I am looking at getting it from a regular pharmacy with a private prescription from my vet, and have been quoted much less (around £40) so am likely to go with that option. Is anyone getting their PZI via regular pharmacies or know of other cost-effective suppliers ? I've been told that as the vial is only good for 28 days, I will have to get this monthly, but one of the posts here suggested that it could be used for longer. Is that right ?

Finally, regarding syringes, what size do i need ? U100 ?

Thanks in advance.
 
If supply of the Hypurion is difficult/expensive, and you've already done any mandated trial of Caninsulin, I'd consider Lantus or Levemir. To provide some info on it for your respective vets, the AAHA put out a report on using it here.

I grant you its from those upstart colonies, but perhaps the vet will ignore that! ;-)
 
Berkleyn said:
Hi,

Jumping onto this thread as its along the same lines as my cat's diabetes situation and also uk based. My cat has been on Caninsulin for 6 months but two glucose curves have shown that he is not getting enough coverage and there are many hours when his levels are too high. My vet has suggested moving to Hypurin bovine PZI, but the price is high via his suppliers (over £70). I am looking at getting it from a regular pharmacy with a private prescription from my vet, and have been quoted much less (around £40) so am likely to go with that option. Is anyone getting their PZI via regular pharmacies or know of other cost-effective suppliers ? I've been told that as the vial is only good for 28 days, I will have to get this monthly, but one of the posts here suggested that it could be used for longer. Is that right ?

Finally, regarding syringes, what size do i need ? U100 ?

Thanks in advance.
Click to expand...

Hello from Surrey, and welcome to FDMB! :smile:

I get my Hypurin directly from the vet and it costs about £80, but it can be cheaper to get a prescription from your vet and then get it from a pharmacy. There will be VAT added to the cost but even so it should save you a few quid.

As to how long it lasts, well, the blurb probably says 28 days, but in my experience it can last considerably longer. The vials I've bought have always lasted at least 3 months, and one lasted about 8 or 9 months before it sparked out (ie, lost potency).

I have to say that if your vet is actually suggesting a switch to Hypurin PZI then you are one of the lucky ones! An awful lot of folks in the UK have tried to persuade their vets to prescribe it and the vets have refused to do so.

You will need U100 syringes for Hypurin. These can be bought online much cheaper than from your vet. I get mine - the .3ml ones with the half-unit markings - from vetuk.co.uk: http://www.vetuk.co.uk/veterinary-s...rofine-0-3ml-insulin-syringes-u100-demi-p-296

Are you testing your cat's blood glucose at home. If not we can help you learn to do that. It won't hurt your cat and brings a lot of benefits. It will enable you to know whether the insulin dose you're giving is correct; will enable you to understand how the insulin is working in your cat's body; will give you a sense of control over the situation like nothing else can; and will save you money in vet's bills because you can do the curves at home! If you'd like to try to learn then I'd be happy to send you a kit to get you started.

If you switch to Hypurin hometesting is very important. That's because it has a much longer duration than Caninsulin. With Caninsulin you can be pretty sure (as a general rule) that when you give one shot the earlier shot will have left the cat's system long ago (assuming you're giving shots 12-hourly). But with Hypurin there can be quite a lot of overlap, which means the preshot numbers (the cat's blood glucose level at the time of giving the shot) can get much lower than previously. And there may be times when the cat's blood glucose level is too low for him to receive an insulin shot. Hometesting will let you know that.

Juliet (aka 'Dr Schrodinger') switched from Caninsulin to Hypurin PZI. Do have a look at her cat's spreadsheet (the link is in her 'signature' at the bottom of any of her posts) and you will see how differently Caninsulin and Hypurin PZI can work.

Switching to Hypurin will also mean that you'll have a greater chance of getting your cat into remission because he'll have insulin working in his system for more of the time. There are no guarantees of course; some cats go into remission and some don't...

What are you feeding your cat at the moment?

Oh, and what is your name, and your cat's name?

Eliz
 
Sorry not to have replied before now. My cat Leonardo has adapted well to PZI and is on 2 units 12 hours apart. At our last vet check, we were told to come back in three months. I was happy with that but hearing that people self-check at home, I'm wondering if I should be doing the as well ? Regarding supplies, I now get one one private vet prescription for 3 vials and keep them in the fridge until I need them. I found tesco was the cheapest for private prescriptions and the vials arrive next day. I was told that the insulin lasts only 28 days, so I move into a new vial then, but sounds like I am switching to a new vial before I really need to. Anyway, all seems I be going well since the switch from caninsulin. I actually came on the forum today looking for ideas on new food, and found some good reports on Grau, so might try that.
 
Hey Berkleyn,

Welcome back!

I am very happy that Leonardo is doing so well on his Hypurin. That's great news.

It might be a good idea to create a new thread telling us a little more about him, so we can give you some more helpful info. How old is he? What is he eating at the moment?

Hometesting is a really good idea, fullstop. It lets you know how much insulin your cat needs. But even more so if you are changing his diet. If he starts eating food with a lower % carbohydrate, then he might need his insulin dose reducing in order to avoid a hypo incident. All it takes is a cheap human-type meter, and a tiny drop of blood from Leonardo's ear. We can help you with this, if you want to learn?

You can keep Hypurin PZI in your fridge for quite a few months. The insulin stays active much longer than the stated 28 days & this will save you a lot of money. Some of us keep the same vial for 6 months!

With respect to food, I have put together a list of suitable foods available to us UK people, and where to buy it from. You can access it here: https://docs.google.com/spreadsheet/ccc?key=0Aq4WIfRfL3G1dDd2dkNtMnNoMDZYaDVxTGtSd1dmWmc#gid=1 (the link is also in my signature).

Tell us more about your kitty?

Juliet
 
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