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Insulin for cats - can't afford PZI?


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Initial post: Nov 30, 2010 12:25:20 PM PST
This is a cross post from another community in which a woman expressed concern about being able to deal with an insulin dependent diabetic cat. My comments are not intended to promote one insulin version over another, but rather to help those who have been using PZI (perhaps for years) - or it is recommended by their vet - but who can no longer afford it ... and may even be considering euthanasia because of this.

For cats, the only form of insulin that many veterinarians have considered to be truly effective is PZI (Protamine Zinc Insulin) made primarily from pork. After a few years of successful use, this outstanding drug was apparently seen by most manufacturers as an "orphan drug" which was not cost effective to manufacture. So they stopped making it (maybe 3 years ago?) - and many vets tried to stockpile the drug, so that their customers with insulin dependent diabetic cats could continue to buy it. The price skyrocketed to over $100 per bottle - out of reach of most owners.

The foreign pharma companies and a couple others jumped in and started making it - primarily using beef which apparently is not effective as the pork source - but even then, the price was (and is) prohibitive via that route - typically around $90-$100 per bottle.

BUT - the good news - there are some Compounding Pharmacies in the US which DO compound this insulin with the order of a veterinarian - and some use the original time tested formula. Even better news is that some sell this injectable drug for around $50 a bottle and will ship it to you in a dry ice pack for about $15. My cat (who passed on at age 17) was on PZI insulin for 8 years. He was on a sizable injected dose twice daily, but one bottle lasted him several weeks.

There is a compounding pharmacy in Little Rock, AR that we used for 3 years to obtain PZI after it became so expensive. I can't find a website for them, but the name is Custom Compounding Pharmacy, and the address is 904 Autumn Rd Ste 275, Little Rock, AR 72211 - (501) 217-0000. God bless these people - they are so reliable, and the cost is less than 50% of what most vets and most of the Big Pharma companies charge. All they need is a faxed vet's order. They accept credit or debit cards over the phone, ship it in a "cold pack" to you overnight, directly to your home or business by Fed Ex. They gave my cat 3 extra years after the affordable stock of PZI dried up. He died at age 17 - and not from diabetes. Affordable access to this drug is a lifesaver, if your cat is one who needs the original version of PZI to do well.

In reply to an earlier post on Aug 4, 2011 4:57:25 PM PDT
Missy Miller says:
There is one in Arizona called Diamond Back Drugs. http://www.diamondbackdrugs.com/ My vet referred me to them because the office price was so expensive. Diamond Back only costs $39 for 5ml of insulin. My vet will subscribe me several bottles at a time (my cat gets 4 units twice a day, so it goes quick!) through them to save on shipping.

In reply to an earlier post on Jan 4, 2012 1:40:40 PM PST
PedsRN says:
Thanks so much for this post! It has saved me nearly half of what I was paying.

In reply to an earlier post on Jan 4, 2012 1:45:08 PM PST
PedsRN says:
I came across your post while searching for a less expensive source of PZI. While I'd never euthanize my cat for increased costs, I'd still like to save some money, of course. Although I went with Diamondback Drugs, I still wanted to reply and say how much I appreciated your info. I also had no idea why the price had skyrocketed so much (I was paying around $90 when she was first diagnosed 3 years ago, and it's $120 now!). THanks again!

In reply to an earlier post on Jan 6, 2012 3:17:22 PM PST
Missy Miller says:
I'm happy that I could help! :-)

Posted on Jan 16, 2012 11:56:49 AM PST
Missy Miller says:
I just got a call from Diamondback--beef insulin has been discontinued, so they're transferring over to human insulin! LoL It seems to be a little cheaper too. I get a few bottles at a time, and 20ml of the human insulin is running a bit cheaper (90ish) than what I was paying for 15ml of beef (closer to 100).

In reply to an earlier post on Mar 6, 2012 10:42:25 AM PST
We were just told last night by our Vet that our Tigger will need two shots a day for the rest of his life, he is 15. And our Sophie who is the same age has mammory cancer. I'm an emotional mess to say the least. Nothing we can do for Sohie but to watch for decline in her health and behavoir which will tell us when its time to let her go.
Our Vet will teach us tonight how to do Tigger's injections and has recommended human insulin. Has anyone used this type and what are your feelings on it. Our Vet is wonderful and a cat man himself so I do feel comfortable with his choice.
Thanks,
Roni

In reply to an earlier post on Mar 6, 2012 2:00:45 PM PST
Missy Miller says:
After I made this post, my vet recommended that I not get the human insulin that was being offered by Diamondback. While it has proven effective for dogs, it has been inconsistent with cats. I now use ProZinc, which unfortunately I have not found at a place cheaper than my vet (about 107 for 10 ml). Your vet will have you come in every few weeks to do an ear tip blood test until Tigger's levels are regulated, so as long as you're doing that and adjusting as needed, I think you are good to go.

In reply to an earlier post on Mar 6, 2012 3:45:19 PM PST
PedsRN says:
Thanks for the update. My kittie's needs have def gone up, and I'm unsure if it's the PZI or just the PZI from Diamondback. She is now up to 5U twice a day, from 2-3U twice a day, but it IS working for her. You should check with Walgreens, though. They have a pharmacy program you can join for $20/year. You get a free meter and strips are $15 (normally twice that much), so you can check your cat's CBGs yourself at home. Not everyone is comfortable with that, but it saves you money and them the trauma of going to the vet's. (I'm a nurse so this was not all that new to me). Good luck!

In reply to an earlier post on Mar 7, 2012 2:37:24 PM PST
Missy Miller says:
I'm very lucky--Storm has stabilized so I don't have to do frequent trips to the vet for that anymore. Only a few times a year! I think I reached my limit with giving him shots! :-D Thanks for the info, though.

Did Diamondback switch you over to their new version a few months back? That was the one my vet recommended that I not use in favor of using ProZinc, and I was able to drop him down to 3U instead of 4U to see how it goes. I'll find out this weekend if I'm able to keep him at 3. *crosses fingers*

Posted on Mar 15, 2012 5:19:18 PM PDT
Last edited by the author on Mar 15, 2012 5:26:34 PM PDT
My cat has been diabetic for 5 years, now in remission using bovine pzi. I belong to a wonderful group that uses the Tight Regulation protocol for treating FD cats. diabeticcathelp.com. Bovine pzi is closest in amino acid structure to a cat's natural insulin and is gentlest on the cat's system, and more readily accepted. BCP Pharmacy in Houston, Tx., and Stokes Pharmacy in New Jersey both compound a bovine pzi at very reasonable prices. Please consider one of those pharmacies, they are both very reliable.

Hometesting is very important to stay on top of this disease, as is a low carb (under 10% carbs) wet food diet.

In reply to an earlier post on Mar 15, 2012 8:20:24 PM PDT
PedsRN says:
Thanks! I'll definitely check out those pharmacies. Stella's requirements have gone from 1-2U BID to 5U BID. She's on a very low-carb diet, and we no longer leave food in her bowl at all times as we used to for fear of her crashing while we are gone (sometimes up to 12 hours/day). I spot-check her at home whenever I suspect any major drops or if I've recently increased her dose (it took over a month to get her to 5U because I was worried I'd crash her). Unfortunately I just ordered a new vial of human PZI, so I'll wait until that is gone before ordering another vial. She just passed her glucose curve last week, so for now we'll stick with the current plan. Thanks again for the update.

In reply to an earlier post on Mar 16, 2012 6:59:35 AM PDT
Last edited by the author on Mar 16, 2012 7:07:13 AM PDT
You're most welcome. Check out our forum too, being an RN you would understand the protocol very well. We treat our FD babies just like a human would treat their diabetes. We use a sliding scale to coordinate with the bg, so no static doses. Much less chance of a hypo event that way, and we have a very high rate of remission. Good luck and Best wishes!

And thanks for the tip about Walgreen's. Unfortunately I can't get my strips for less than 44.00/100 there. But my dog's tramadol is a good deal.

In reply to an earlier post on Mar 24, 2012 9:53:31 AM PDT
B. Starling says:
Hello,
I just found this discussion and I'm making the heartbreaking decision about what to do for my cat. We have an autistic little boy who we feel we need to take care of over our kitty and funds are TIGHT, as autism is VERY expensive to treat.
I just tried calling both of the pharmacies above and they will not give me an idea on pricing with a prescription. Can you give me an idea?
Also I love the info and the hope on the website you mentioned and I'm interested in testing at home to keep track of things, but how much does a home testing kit cost?
One more thing....our dr has us on Hill's prescription diet w/d wet food. Is that the best and most budget friendly choice? We are already seeing improvements on this diet but just wanted to see if there were any less expensive options?
Thanks so much!

In reply to an earlier post on Mar 25, 2012 4:34:17 AM PDT
Last edited by the author on Mar 25, 2012 4:45:45 AM PDT
Hi B., first, you don't need the prescription diet. Fancy Feast classic varieties are low carb, so actually are better. No fish please, it's hard on the kidneys. Amazon has their subscribe and save, and for me it's cheaper than any other place I've found. Petsmart has their house brand Great Choice, and their kitten Tender turkey, and mixed grill is very good and very low in carbs. And less expensive than FF. Walmart has a meter and strips, reliOn brand that's affordable and very reliable. Probably around 50.00 for meter and 100 strips. Their syringes are also very reasonable.

This is the price for Stokes, and BCP is about the same, give or take. The 2 5ml vials is a better deal. This is also for u100 insulin, but they do make a u40 also. It has a 6 month expiration.

1-5ml vial is $49
2-5ml vials is $69
Shipping is $13 via UPS in cold packs.

Is your kitty on insulin now?

B., please understand, it's possible for diabetic cats to go into remission, or off the juice, we like to say, with the proper diet and treatment. And if not, they will be so much healthier. There really is hope for your cat. Come join us if you like. We'll help you. Best Wishes.

Posted on Mar 25, 2012 8:32:37 AM PDT
Missy Miller says:
I am very grateful. I have been feeding my cat Blue Buffalo. He may be going into remission. He has been on 4 units 2x day for a long time. 2 months ago we dropped him to 3u, and this weekend we were able to drop him to 2u 2x/day. Blue Buffalo just released a line called "Blue Freedom" two weeks ago that I am going to look into--it is grain and gluten free!

Posted on Apr 21, 2012 7:28:36 PM PDT
If your cat is diabetic (or you think he might be), check out FelineDiabetes.com . There is a wealth of info there, such as how to increase odds of remission by getting the cat on low carb wet food like Fancy Feast or Friskies. Also check out catinfo.org for great info about cat nutrition and why dry food is so awful for cats (especially diabetics). If you are in crisis over affording care for your diabetic cat, contact Diabetic Cats in Need (DCIN).

In reply to an earlier post on Apr 22, 2012 4:58:45 AM PDT
Yes the folks at DCIN are wonderful. We work with them and some of their diabetic foster cats too at diabeticcathelp.com.

In reply to an earlier post on Jun 12, 2012 2:08:20 PM PDT
Wanted to know how the new Blue Buffalo is working. I saw something very interesting about Soy and how it effects the Human body. Thyroid was a big issue as soy keeps iodine absorption to 0. The effect on the Human body is massive in many areas. I have a rescue and have noticed such an increase of so many problems with cats, on the rise. The biggest being Hyperthyroid and Diabetic issues. I thought it may be the flea drops but thinking back these issues came to light as soy became more popular and soy lecithin as an additive in foods. Human foods are full of it everywhere, just read a label. Blue is one that does not use it. I use to use Royal Canin and had so much problem with throwing up. Since I have my guys on Blue Buffalo there has only been a hair ball now and then and no carpet stains. With the Blue I have seen such a change in their coats, waist line and playfulness. So let me know how your doing with it as our diabetic has been doing so well on Blue.

Posted on Jun 12, 2012 2:29:58 PM PDT
Here's a very informative discussion on dry food that I found.
http://www.catforum.com/forum/38-health-nutrition/88053-soy-good-bad.html

Also catinfo.org can answer alot of your questions about cat nutrition.

I personally only feed wet canned food or a raw diet for my diabetic cat. She's been in remission now since February.

Posted on Jun 12, 2012 3:34:21 PM PDT
Missy Miller says:
Following my last post, Storm did up being categorized as in remission while on his current diet of Blue Buffalo Indoor Formula with no insulin injections at three separate checkups. I ended up not switching to the grain-free formula since he has been doing fine on Indoor (and that is what I feed all of the other kitties, too).

Posted on Jun 14, 2012 9:09:52 AM PDT
Thanks for letting me know about the food. I have been using the mature formula as most of the guys are over 7 now. Everyone in the main house eats just that plus canned diet. Sweeny is to be going for a hair cut and ck up soon. I don't think anything has changed with him other then they all seem to be doing so much better with activity level and weight. thanks for letting me know think I will do the same and stay with what I know as long as it works.

Posted on Jul 16, 2012 9:53:37 AM PDT
K. Delahay says:
Hi everybody this is to all who are looking into changin food for their cats. I have three cats and when one of them started peeing in is sleep I took him to the vet hoping it was just a urinary tract infection. All my cats were three years old at the time so I really hoped that it was not something serious. So when I took Odie to a vet he was diagnosed with diabetes. With him being so young I think he was actually born diabetic which seems to be very uncommon. I am disabled on a fixed income and explained to my vet that I could not afford to get two different kinds of food. He sent me a chart which had nutritional values of a lot of different food( I think it was done by Bucky... you can find it online). After reshearching a lot of different foods I ended up changing all of the cats to Taste of the Wild Rocky Mountain for cats which is grain free and I buy it from a local feed store here in Tucson Ok Feed Store. It sells for about $30 for a 15 lb bag. It has helped with my diabetic cat in combination with PZI Insulin and my other two cats are healthier also. For anybody in the Tucson area OK Feed has a great program where whether buy 8 lbs of cat or dog food or 15 lbs of cat or dog food after buying twelve bags and get a free bag (just ask for a punch card). Hope this helps out. Taste of the Wild is lower priced than Blue Buffalo and my vet said that it was a good choice.

In reply to an earlier post on Aug 31, 2012 2:49:58 PM PDT
Last edited by the author on Aug 31, 2012 3:11:24 PM PDT
swusagi says:
I would urge you all to please come to the feline diabetes message board and get some advice! http://felinediabetes.com/FDMB/index.php. We can provide veterinary articles and documents to give to your vet that contain the current treatment recommendations for diabetic cats! The American Animal Association guidelines can be found here: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf

First, there is no dry food that is appropriate for a diabetic cat. Diabetic cats need less than 10% carbs in their diet, and no dry food (even the grain-free ones) are low enough in carbs. This includes prescription diets. If you're feeding a prescription diet, the only prescription food low enough in carbs for a diabetic is canned Purina DM (ALL of the Hill's diets, prescription or Science diet are too high in carbs). However, this is overpriced and nearly identical to Purina's Fancy Feast Classic flavors (which are all low carb), so all you're paying for is the label.

If you're paying for testing to be done at your vet's office, this is expensive and unreliable because stress elevates cats' BG, and the testing is too infrequent to tell you how the insulin is working. Testing your cat's blood glucose daily at home is the only way to obtain accurate numbers and safely give insulin, just like human diabetics do. Here's a great resource that shows you how: http://www.felinediabetes.com/bg-test.htm You can use any human meter--the Relion meters at Walmart are good quality and have inexpensive strips. Even difficult cats tolerate testing after a week or so if you give them a low carb treat after each test. It doesn't hurt them at all--cats have less nerve endings in their ears than people do in their fingertips--they just don't like being restrained and sensing that their human is nervous.

Insulin choice is very important, as there are some insulins which are better than others. PZI is NO LONGER the top recommended insulin for cats, but rather 3rd choice (1. Lantus or Levemir, 2. ProZinc (human recombinant), 3. PZI). Cats do best on the slow acting human insulins Lantus or Levemir because they have metabolisms that are twice as fast as people or dogs. When those insulins are used in combination with a low carb, canned only diet, and dose adjustments via home testing, the large majority of cats (86%) go into remission and no longer need shots. My cat was on Lantus for a little less than a year in 2009; he's been in remission since 2010 and he's doing fantastic! He's healthier now than most cats his age because of the changes I made to his diet (feeding a low carb, canned only food).

So while these insulins are more expensive up front, they will save you a ton of money long term in vet bills and testing strips. And you get a healthy cat in the process, and no longer have to give shots. But there is a window on remission--the longer you wait to start the recommended treatment, the less likely it is your cat will reach remission.

Posted on Sep 7, 2012 4:16:30 AM PDT
Last edited by the author on Sep 7, 2012 4:16:51 AM PDT
Swusagi: I have a recently dignosed cat with diabetes and am having some difficulty getting him smoothed out with his meds (ProZinc). Your comments are helpful. Thanks.
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