Prozinc Not Currently Available in UK - UPDATE 8/7/20

Discussion in 'Prozinc / PZI' started by Elizabeth and Bertie, Apr 9, 2020.

  1. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    It seems that Prozinc has now become unavailable in the UK...

    It has become harder for UK folks to source Prozinc online for a few months now, but many vets seem now to have run out of their own supplies. Larger vet groups may still have some in their other practices.
    Information from people's vets seems to be mixed, with some vets thinking this is something that will last a matter of weeks, some thinking it will be longer, and yet others seeming to know nothing about the shortage... A caregiver who tried to buy from an online pharmacy, Animed, said today; "...Spoke to Animed and they have said it’s definitely a manufacturer issue and they have been told it is unavailable for the foreseeable future, and to contact vets for an alternative."
    ...I also noticed that the Prozinc UK website is down, which may or may not be of any relevance.

    The Prozinc manufacturer, Boehringer, is sending a message (copy below) to those who contact them for further info:
    "Thank you for contacting the Technical Services Team at Boehringer Ingelheim Animal Health UK Ltd regarding the supply of Prozinc®, our protamine zinc insulin product for cats and dogs.
    Unfortunately, we are currently experiencing a temporary supply disruption with ProZinc®.We understand how critical ProZinc is to your pet and we apologise for any inconvenience this may cause.We assure you that we are doing everything we can to restore supply as soon as possible."


    Vets are switching kitties to alternative insulins. And in most cases vets are switching to Caninsulin, by default, since this is the only other insulin in the UK that is licensed for use in cats.

    Caninsulin 'typically' has a faster action and a shorter duration than Prozinc. Some cats have done fine on it, or even gone into remission. But, because it is harder to get good glycemic control with it, it is no longer one of the 'recommended' insulins for cats. The international guidelines recommend the use of longer-acting insulins for cats; those are Prozinc, and the human insulins, Lantus and Levemir. If Prozinc becomes unavailable then the options for longer-lasting insulin are Lantus and Levemir.
    Lantus and Levemir are not licensed for use in cats. But your vet can prescribe these under the 'cascade system'. Some vets do not know this. And some vets will not have experience of these insulins which may mean they are less likely to prescribe them.

    This is not the first time that Caninsulin suddenly became the only licensed insulin for kitties in the UK. A similar thing happened some years ago when a PZI insulin 'similar' to Prozinc was discontinued. At that point many kitties were switched to Caninsulin, or, less often, to alternative human insulins.
    If your vet suggests Caninsulin - and you decide that you do not want that - then you may need to do your homework and find ways to persuade your vet why a human insulin would be a better option for your kitty. It will help a lot if your are regularly hometesting blood glucose, and can show that you have a good understanding of your kitty's diabetes. If the vet is confident that you know what you are doing, they are much more likely to prescribe a human insulin for you.

    Eliz
     
    Last edited: Apr 9, 2020
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  2. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Those hoping to switch to Lantus or Levemir, and wanting trustworthy info to persuade their vet, may be interested to see the international ISFM veterinary guidelines below.
    Longer-lasting insulins are recommended:
    "Although good control of DM can be achieved in cats with both intermediate and longer acting insulin preparations, and definitive comparative studies in diabetic cats are lacking, given current knowledge of the pharmacodynamics of insulin preparations in cats, the Panel recommends, whenever possible, the use of longer acting insulin preparations (eg, glargine [Lantus], detemir [Levemir], or PZi [Prozinc]), injected twice daily, for optimal diabetic control."

    Link to ISFM guidelines: https://journals.sagepub.com/doi/pd...atyGdGaZAO1YOyqdVFwlRvKIDgsFJUh0cov81YaxtUYz8
     
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  3. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Or the (2018) AAHA Diabetes Management Guidelines for Dogs and Cats
    Yes, I know this is information from a USA source, the American Animal Hospital Association. But a good resource none the less.

    What about this one also, to share with vets? https://www.rvc.ac.uk/Media/Default/small-animal/documents/feline-diabetes-guide.pdf

    And (2018) Whats New In Canine And Feline Diabetes Mellitus .pdf

    @Elizabeth and Bertie
    We're running into Lantus (glargine) shortages here, and people are trying Basaglar, a biosimilar to the lantus insulin.
     
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  4. Deb & Wink

    Deb & Wink Well-Known Member

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    Hellokrystie had problems getting a new bottle of prozinc, back around the end of January, middle of February 2020.
     
  5. Schmill

    Schmill Member

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    Sep 28, 2018
    Sadly it seems the "few weeks" was not the case; unfortunately I was completely unaware of this, and just went to order Dusty's replacement Prozinc from our usual supplier to be told they have nothing and don't know when they'll get it again.

    Now to desperately try and source an alternative before the bottle runs out...
     
  6. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Do consider giving Petdrugsonline a call... Someone found recently that they have some Prozinc available but that they are not listing it on their website because it is fairly close to its expiry date (but that date is still some time away)... A couple of people have managed to get Prozinc from them this way...
    https://www.petdrugsonline.co.uk/?g...zrjuPZrHbC6NLOz8r1hjX8dcs2sS4CeRoCHm8QAvD_BwE
     
  7. Schmill

    Schmill Member

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    Sep 28, 2018
    Many thanks @Elizabeth and Bertie I just rang them on the off-chance, but unfortunately they too are now also saying "sorry, no stock, manufacturer problem, no eta".
    To make things worse it seems as if many online retailers are also not shipping insulin at the moment due to the hot weather... :(:banghead:

    I'll be going back to the vet to see what they can recommend. I'm not really wanting to go to Caninsulin since Dusty is a 'grazer' so "fast acting, short lasting" insulin doesn't seem the best for her.
    Will see what human insulins I'd be able to get hold of before I go back to the vet and ask for it though!
     
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  8. Schmill

    Schmill Member

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    Sep 28, 2018
    Out of interest, where do you get your human insulins for feline use? A quick search only seems to return cartridges for use in pens etc?
     
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  9. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Most people use the cartridges like mini vials. This is the cheapest way of buying/using insulins such as Lantus and Levemir. These can be bought from any human pharmacy with a prescription from the vet.
     
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  10. Schmill

    Schmill Member

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    Sep 28, 2018
    So do the cartridges have a similar rubber membrane then, so you just draw out what you need with a syringe as usual? (Allowing for the concentration difference of course!)
     
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  11. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, same rubber membrane. Yes, you use the lantus and levemir cartridges just like you would a larger vial of insulin. Think of the cartridges as being miniature vials of insulin.
    You would need different syringes too. U100 syringes needed for a U100 concentration insulin like Lantus or Levemir.

    You can NOT use U40 syringes with a U100 concentration insulin. The other way around, using a U100 syringe with a U40 concentration insulin is possible, with a conversion chart (2.5 times the U40 dose is what you would draw up in a U100 syringe for a U40 concentration insulin.)
     
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  12. Schmill

    Schmill Member

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    Sep 28, 2018
    Many thanks for the confirmation Deb.
    I'll look at getting some U100 syringes (if the vet is happy to prescribe the U100 insulin) - I'm not sure why I can't use the U40's though, if I run the conversion the other way?
    Dusty gets between 1 and 1.5U of U40 insulin (which on our 0.5U marked syringes is 2 to 3 lines). If I drew instead just under 1 line (~0.4U) of U100 into the syringe that surely would be equivalent? (0.4 x 2.5 = 1.0) ?
     
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  13. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    No, the barrel on the U40 syringe is fatter. So although it looks like you could run the conversion the other way, it would end up overdosing your cat.
     
  14. JL and Chip

    JL and Chip Member

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    Dec 28, 2009
    Technically you can run the conversion the other way BUT is is exceedingly hard to draw up an accurate and consistent dose when doing that and really, really not practical (or recommenced) due to those factors and the risk of error.

    For example, yes, at a dose of 1u of Lantus, you could draw to the 0.4 line on a u-40 syringe. But what if your cat needs a dose of 0.5 units? Are you really going to be able to eyeball draw to the 0.2 line? Or at 0.25u, drawing to the 0.1 line? It’s not very realistic. It’s relatively common to have to fight air bubbles when drawing insulin and that just compounds the difficulty even more.

    I’ve had the insulin/syringe conversion discussion with multiple specialty vets and it really does tend to confound them. And when going the “reverse conversion” direction, it’s pretty easy to accidentally overdose your cat.

    Just my two cents, from someone who has used both u-100 and u-40 insulins, both types of syringes, and is pretty good at math. If you go with Lantus, I strongly encourage you to label those u-40 syringes with a black sharpie and bury them in the back of a high cupboard where they won’t accidentally get used, then get yourself some u-100 syringes. :)
     
  15. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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  16. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Prozinc IS now available again in some places in the UK. Woohoo!
    Viovet have it in stock. And a few vets seem now to have a supply of it (maybe check with your own vet to see if they can now source it..?)
    Here's the link to the Viovet website:
    https://www.viovet.co.uk/ProZinc-Insulin/c35418/
     
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  17. SashaV

    SashaV Member

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    Apr 25, 2020
    What about vetuk? Not that I need it but maybe someone didn't know the site
     
  18. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Currently only Viovet seems to be stocking it. ....Hopefully other sites will be stocking it soon... Fingers crossed...
     
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  19. C1gar

    C1gar Member

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    Jun 17, 2019
    Thank god this is finally coming back in - my cat isnt doing to well on Caninsulin

    Does anyone know if I can just swap straight back over to prozinc?

    Thanks
     
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  20. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, Caninsulin and Prozinc are both in-and-out type insulins, so no carry over from an insulin depot like there would be with the longer acting human type insulins (lantus, levemir).

    You can switch from Caninsulin to Prozinc on the next cycle. No waiting needed.
     
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  21. C1gar

    C1gar Member

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    Thank you!
     
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  22. C1gar

    C1gar Member

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    Jun 17, 2019
    out of stock again :-( unsure if i should swap now if the stock is unsteady
     
  23. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Gah! It does seem to be very erratic at the moment, unfortunately... Some folks have managed to get it from Viovet, others have ordered and then subsequently been told that it's out of stock.

    A couple of days ago I found the info below from the BSAVA site. And someone's vet has just used this info to order Prozinc....from Canada! Apparently it's going to cost her an additional £30-ish for an import certificate, but in her case she thinks it's worth that. ( @Schmill - I don't know if this is of use to you too...? )
    "There is currently a temporary supply interruption for ProZinc® 40 IU/ml suspension and as a result Boehringer Ingelheim Animal Health are currently asking that vet practices do not start any new patients on ProZinc® until supply is re-established.
    For any existing patients already receiving ProZinc®, practices are recommended to contact their Technical Services Team on 01344 746957 (UK) or via email (vetenquiries@boehringer-ingelheim.com) for assistance.
    Boehringer Ingelheim Animal Health are currently doing all they can to keep as many existing patients in an uninterrupted supply of ProZinc® as is possible. There is no directly equivalent licensed veterinary or generic insulin product available in the UK. The only other licensed veterinary insulin in the UK is Caninsulin, an intermediate, or medium acting, lente insulin containing 40 IU/ml porcine insulin. This alternative may not be suitable for some patients and other solutions may be required."


    @C1gar - how is your kitty currently doing on the Caninsulin?

    Eliz
     
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  24. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    I've just been on call with our vet and there's no Prozinc to be had :banghead::banghead::banghead:

    They've been sourcing it from Canada for us during lockdown but now they're apparently out of stock there too... Our vet has a call scheduled this afternoon with Boehringer to discuss options. I'm not hopeful though as the girl from vets office said their manufacturing plant has been closed the last few months and will continue to remain shut due to the current situation.

    If anyone has any ideas where to get some, please let me know!
     
  25. Schmill

    Schmill Member

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    Sep 28, 2018
    Just as an update we too struggled (failed!) to get Prozinc, and our vet was not will to prescribe any human insulins saying that the cascade system meant that the next available was the canine insulin "Caninsulin", and since that is available they cannot cascade further to human ones.
    Thankfully Dusty seems to be doing comparably ok on the Caninsulin, and we've just ordered our second batch as well as having her into the vet for a fructosamine test (having been on the Caninsulin for 3 weeks); hopefully the results from that will be as promising as a curve data implies it should be.
     
  26. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    I expect to have the same chat with our vet! He doesn't want to prescribe human insulin, I've tried before.

    You are lucky Dusty does well on Caninsulin. Perlutz was put on it at the beginning and he didn't do well at all. I'm trying to source Prozinc from another country. Despite the worldwide disruption, some vets in Germany seem to still have little stock. Just hoping the vet will give me a prescription and the vets there to accept it..
     
  27. Georgiana & Perlutz

    Georgiana & Perlutz Member

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    Jan 24, 2019
    Update - I've contacted Boehringer UK and they've said best case scenario it will be back in stock mid August. A friend contacted Boehringer Germany where they've said no chance of it being back earlier than late September.

    Really disappointed that they couldn't find a way to have such a vital product available. I know we're in a pandemic, but it's been 4 months and most businesses, even for hardly essential products, have found a way to keep production going.
     
  28. C1gar

    C1gar Member

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    Jun 17, 2019
    I was also unable to source prozinc - and my cat is stuggling still on Caninsulin - not responing very well
     
  29. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    Can anyone find prozinc at the moment?
     
  30. C1gar

    C1gar Member

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    Jun 17, 2019
    It’s sold out every where I’m afraid till mid September they say
     
  31. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    Thank you C1gar. I am assuming you are in the UK? I am new to this, and struggling with sourcing everything.... Where would you usually buy it from (if it was available)?
    Also do you have a reccomendation for a glucometer that is cheap and reliable for cats in the UK? alphatrak2 strips will bankrupt me soon....
     
  32. C1gar

    C1gar Member

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    Jun 17, 2019
  33. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    thanks! I'll keep an eye on these links. Hopefully it will be available again soon!
     
  34. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Sorry, have just seen this... This simply isn't the case, I think your vet has misunderstood the cascade system completely.... Is there not another vet you can see...?

    Also, see what I posted above from BSAVA (have put some text in bold and underlined some):
    "There is currently a temporary supply interruption for ProZinc® 40 IU/ml suspension and as a result Boehringer Ingelheim Animal Health are currently asking that vet practices do not start any new patients on ProZinc® until supply is re-established.
    For any existing patients already receiving ProZinc®, practices are recommended to contact their Technical Services Team on 01344 746957 (UK) or via email (vetenquiries@boehringer-ingelheim.com) for assistance.
    Boehringer Ingelheim Animal Health are currently doing all they can to keep as many existing patients in an uninterrupted supply of ProZinc® as is possible. There is no directly equivalent licensed veterinary or generic insulin product available in the UK. The only other licensed veterinary insulin in the UK is Caninsulin, an intermediate, or medium acting, lente insulin containing 40 IU/ml porcine insulin. This alternative may not be suitable for some patients and other solutions may be required."
     
  35. Tania c

    Tania c Member

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    Sep 9, 2019
    Hi there sorry a bit late to this thread but I got a few from amazon and by far the best was the cheapest one ‘code free’ I’ll post you a long the test strips are really cheap and the lances, I can’t believe how much I saved when I switched from the alphatrax wish I never brought one! It’s also very accurate I’ve checked with the alphatrax and there really wasn’t much difference!hope that helps x
     
  36. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Prozinc is back in the UK! @Schmill

    This is from the Boehringer UK website:
    "ProZinc 40 IU/ml suspension for injection for cats and dogs
    Normal supply has been restored – vets can place orders via their usual process (updated 11 August 2020)"
     
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  37. C1gar

    C1gar Member

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    Jun 17, 2019
    thank god!
     
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