INSULIN CARE AND SYRINGE INFO Proper Handling and Drawing ProZinc (PZ) insulin is an aqueous protamine zinc suspension of recombinant human insulin that is used to reduce hyperglycemia (high blood glucose or high blood sugar) in cats with diabetes mellitus. A licensed veterinarian must prescribe PZ insulin for your cat. PZ insulin should be given to cats only. PZ is available in a 10 mL vial Vials should come packaged in a sealed box from the manufacturer (like the picture above). PZ should NOT be repackaged and sold by the vet. If you are buying repackaged insulin from your vet, even if it was transferred into a sterile container, its efficacy and longevity may be questionable. Proper Handling and Storage of PZ While PZ is a “hardy” and stable insulin, proper handling and storage should be used. PZ should be visually inspected prior to administration. Once mixed, ProZinc suspension has a white, cloudy appearance. Clumps or visible white particles can form in insulin suspensions: do not use the product if clumps or visible white particles persist after gently rolling the vial. PZ should be stored in an upright position under refrigeration at 36-46°F (2-8°C) and protected from light. PZ remains stable even if left at room temperature for short periods of time such as may occur during normal use. Do not freeze or use if it has been frozen. PZ should be mixed by gently rolling the vial prior to withdrawing each dose from the vial. Do not shake the vial. If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon. Do not prefill syringes as the coating in the syringes can contaminate the insulin and make it less effective. PZ should not be diluted or mixed with any other insulins or liquids. PZ has a 2-year shelf life from date of manufacture. Do not use any PZ insulin past the expiration date on the vial. How do you know when your insulin is no longer good? When you lose regulation for no reason. Note that a new vial of PZ can seem to be a little more potent at first so be sure to test frequently for the first couple of cycles after starting a new vial. If you see any hint of "floaties"/"tiny particles"... discard the insulin. If insulin changes color or if rubber stopper is cracked... replace insulin immediately. If the insulin has frozen, it's no longer good. How long will my insulin last? As long as properly cared for, a vial of PZ can potentially last up to six months. If regulation is lost before then or the insulin changes color or develops particles, a new vial should be started. Unopened PZ is good until the expiration date stamped on the box if refrigerated and handled properly. Using Syringes with a Vial U-40 insulin syringes should ideally be used with PZ. A note on U-40 syringes: If you are using U-40 PZ, you must be sure you are using the correct U-40 syringes. In the United States, these syringes usually have a RED cap, but the cap color may vary, depending on the manufacturer or where you live in the world. U-40 syringes are also available that show half-unit markings, making dosing easier as you are fine-tuning the dose. A note on using U-100 syringes with the Conversion Chart: Many people find that using U-100 syringes with half-unit markings makes it easier to fine-tune a dose, in 0.2 unit increments. (You MUST use the Conversion Chart; the link appears both above and below.) In the United States, the U-100 syringes (designed for use with the more concentrated U-100 insulins) usually have ORANGE caps - but again, the cap color may vary with the manufacturer or where you live in the world. PLEASE make sure you are using the correct syringes for dosing PZ: Either the U-40 or the U-100 (again, the conversion chart is required when dosing PZ with U-100s.) We are not advocating use of U-100 syringes with PZ but it is important if you decide to use them for fine dosing, that you correctly convert the dose and have information regarding U-100 syringes. Most caregivers will do best using U-40 syringes with PZ. Don't reuse syringes. You'll not only run the risk of contaminating the vial/cartridge/pen, but re-using a syringe may be very uncomfortable for your cat: Syringe Accuracy Assessment Summary & Data Microdosing If your cat requires a dose below 1u with PZ, you will want to read this discussion on Microdosing. The following information will also assist you with microdosing. IF you have properly converted the PZ dose from a U-40 syringe to U-100 syringe using the conversion chart, then the following information on fine dosing can be used: Below is a pictorial showing insulin syringe scales. The left shows half-unit scale which would be found with a U-100 syringe but if you choose to use a U-100 syringe for micro-dosing, please note the cautions above and use the conversion chart linked above to determine the correct dosing of PZ with U-100 syringes. The right shows a typical syringes scale for whole units as you would find with a U-40 syringe. Fine dose gradations: 0.5U = exactly half a unit 0.4U = skinny 0.5 touching the line 0.3U = skinny 0.5 with daylight under the line 0.2U = fat zero with daylight over the line 0.1U = fat zero barely touching the line If you are using a U100 syringe and have done the proper conversions, the below photos will help you with fine dosing. Shot Placement & Overlap: Flank vs Scruff This document was written by FDMB members jojo and bunny and Jill & Alex (GA) with contributions from Amanda and a Loudogg, Ann & Tess (GA), CD and BigMac, Chris & China, D and Shadow, Greg and Carmelita, and Steve & Jock with edits by Marje and Gracie. Updated Feb, 2020.