Sticky PZI STICKY: Please read--Newbies and Oldies! Links/info

Discussion in 'Prozinc / PZI' started by Gator & H (GA), Dec 23, 2010.

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  1. Gator & H (GA)

    Gator & H (GA) Well-Known Member

    Jan 3, 2010
    Last edited by a moderator: Sep 15, 2016
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  2. Gator & H (GA)

    Gator & H (GA) Well-Known Member

    Jan 3, 2010
    Newbie Checklist

    Newbie checklist:

    Posting in the FELINE HEALTH forum is the preferred beginning route for newly registered members. The insulin support groups, such as this one for PZI, are recommended for more experienced caretakers. Your level of experience or your level of time & education commitment can only be determined by YOU and the decision on which forum to post in is also YOUR decision. If you are a newbie, please do not let the extreme detail here overwhelm you. PLEASE BEGIN IN THE FELINE HEALTH forum. You can always cross-post here, too. Thank you, Rebecca, Founder, and FDMB

    For the newly diagnosed, feline diabetes can be overwhelming - it's normal and the learning curve is sharp. But stick with it - it does get better and easier. If needed, consume this list as you are able to. Treating the diabetes can also be very rewarding when you see their improvement.

    Even if you haven't mastered a specific item, tackle those items that you can. Post in the PZI or Health Forums with any difficulties you are having. Someone here has almost certainly been through the same struggle, and can offer tips & support. You can always try PMing ["Private Message"] others who have posted in the past too for ideas, clarification or to point to your topic. If you have an emergency you may want to post in the Health Forum in addition to PZI as Health can often be more frequently traveled/viewed. PLEASE USE THE 911 icon for posts regarding emergency situations.

    1) Get your home testing on! This can be challenging to learn. Newbie Kits with meters and testing supplies are available here. And here are links that detail how to achieve home testing - including videos and detailed how-to. It is recommended that you test at least before every shot. The more you test likely the faster you can adjust dosing to hopefully more quickly regulate your kitty. With PZI we also tend to like to concentrate on the "mid-cycle" hours of +3 and +6 and then hours adjoining those hours. Complete curves [testing every 2 hours for 12 hours] should be achieved as frequently as you have time to do so. Reading about curves can be found here. For those with busy schedules, hopefully perhaps take one weekend day a week in the beginning to achieve this. Even if you are still mastering home testing, read on! You can tackle other items on the checklist while you are still learning to test.

    2) Get the diet right! Diet and insulin work hand in hand to treat diabetes. Food contains carbohydrates (sugar) so if you feed a high carbohydrate diet you have to give a lot more insulin. Your first goal in mastering the treatment of diabetes is to switch your cat to a low carbohydrate ["LC"] diet, preferably canned or raw foods. There is no such thing as low-carb dry food. There is low-er carb dry food, but if your cat will eat canned (or raw) that's the best. Please see Janet & Binky's list and look for foods under 10% calories from carbs [not the "Guaranteed Analysis" printed on the can] that are available in your community and are priced for your budget. Low carb treats are imperative too. Dr. Pierson's page has many useful suggestions on how to transition cats who don't take to wet food, so if your cat is holding out, don't give up hope! If your cat does not have a history of ketones, and you are giving more than 1u twice per day, you may want to drop back to 1u twice per day when you make the switch to LC - the resulting lowering of blood glucose ["BG"] values are sometimes dramatic. PLEASE NOTE: You must test before every shot if you are switching from dry to wet food. The diet change alone can radically lower glucose levels.

    3) Pick your “no-shoot” number. This is the Pre-Shot [“PS”] number at which you will not give insulin. For beginners this is usually 200. You can reduce this number as you gain experience. There are other options than just not shooting and you should be aware of your options which you can read about here.

    4) Watch for a Blood Glucose ["BG"] drop from the Low-Carb ["LC"]. After the switch to LC food one should start to see the effect of that anywhere from immediately to seven days. Be prepared to lower the insulin dose as necessary and/or have your no shoot number decided upon.

    5) Dosing. Generally [but not always] PZI , including ProZinc, is suggested to start at 1 unit ["1u"] twice per day.

    6) Print hypo instructions. Make sure you have printed out and read the “how to treat a hypo instructions” and have them stashed somewhere in case you need them.

    7) Read the PZI basics Please read the info in the Basic PZI Reading & Links here. Learning about onset, duration & nadir - or how PZI typically works - is important too. There are also many other helpful topics for newbies and the advanced covered in the remaining reading & links in the PZI Sticky.

    8) Get your spreadsheet going! Once you are home testing, you will hopefully be recording your results in a spreadsheet that we can all view. It is ideal if you link to that spreadsheet [“SS”] in your signature. Instructions for this are in the Tech Support Forum Stickies here at the top of that forum. Keeping detailed notes in your SS will help you later when the reasons why you made decisions are not so clear.

    9) Get that profile up! Creating a profile of your kitty and linking to it in your signature will help us help you better. It's a good place to put the answers to questions you frequently receive or anything unique about your kitty. Instructions for this can be found in the Tech Support Form Stickies here at the top of the forum.

    10) Things not going right? See an incomplete list of things that may cause wonky numbers for ideas. If you are not seeing 'results' in 6-8 weeks after switch to LC and start of insulin then you should re-evaluate. Try posting in PZI or Health asking for feedback on what to try next. There are alternate strategies for using PZI, as well as other insulins, that others may be able to help you evaluate.

    11) Communicate! Remember, the squeaky wheel gets the grease in our PZI group. Some people post daily topics of their progress and we like following kitties and their progress. So do not hesitate to post questions or just how things are going. Ask for help or input if you would like some.

    12) Give back. Lastly, giving back here in PZI the great advice, patience and help that was given to you as a newbie is a great way to help other PZI users. Please share your experience and knowledge with others here in PZI about how to use this insulin. It is only through you that the next newbie can learn the insulin and the cycle can be continued.

    If you wish to see how sausage is made, you can visit this topic to see how the ideas for this guide were conceived. Please also use that draft topic to comment on the list or add your suggestions. Thank you. The bbCode version of this post is available here.
  3. Gator & H (GA)

    Gator & H (GA) Well-Known Member

    Jan 3, 2010
    PZI Links and Reading - start with the basic reading




    To comment or suggest links visit this topic. bbCode version available here
  4. Gator & H (GA)

    Gator & H (GA) Well-Known Member

    Jan 3, 2010
    Using U100 Syringes and doing the conversion

    Using U100 Syringes and doing the conversion:

    The below are ONLY for if you are currently using U-100 syringes or if you intend to use U-100 syringes with a U-40 strength insulin. U-100 syringes are not required for the use of PZI. However, if you feel up to getting the conversion correct 100% of the time, the use of U-100 syringes with U-40 insulin can allow for smaller, more consistent dosing gradients. If you are unsure which syringes you are currently using, U-100 syringes have an ORANGE cap - U-40 syringes have a RED cap. Make sure you know which type of syringe and what strength insulin you are using before you start dosing. Without the proper conversion, use of the wrong syringe with the wrong strength insulin can potentially result in putting your kitty into hypoglycemia or potentially even death. You have been warned: that said, many use U-100 syringes with U-40 PZI insulin successfully.

    bbCode version available here.
  5. Joanna & Bix (GA)

    Joanna & Bix (GA) Well-Known Member

    Dec 28, 2009
    Re: New PZI Sticky

    Onset, Nadir, and Duration with PZI
    ... and some other tidbits!

    Micro Dosing headed to remission
    (courtesy of Sue & Oliver)

    When your cat is consistently in numbers too low to shoot at shot time and in numbers in the 100 range and below during the cycle, you can consider micro dosing. This process should be guided on the forum by experienced members and will require more frequent testing.

    You may be shooting at times other than the 12/12 schedule, when the blood glucose levels rise enough to require a small dose of insulin. You will need to pick a number somewhere near the 150 range at which you will plan to shoot, being sure that the number is indeed rising. The dose at these low numbers will vary with each cat and its patterns, so advice should be solicited. But you may be considering doses below .25 and even considering a “drop” of insulin. At this point, U100 needles and the conversion chart will be necessary.

    It is important during this period to offer small frequent meals. You may want to experiment with the lowest carb foods to help bring down the numbers, staying away from seafood more than once or twice a week.

    Consistent High AMPS numbers and PMPS numbers under 200
    (courtesy of Sue & Oliver)

    If you find your cat with consistent high numbers before the morning dose and numbers too low to shoot a full dose in the evening, you can consider giving shots at a schedule other than 12/12. You can wait in the evening until your cat is either above 200 or in a range you will safe shooting a normal (or lowered) dose. This could be at +13 or +14. Then in the morning, test early enough to be sure your cat is rising, and if he/she is above 200, you can shoot your morning dose early. The hope with this technique is to smooth out the cycle and avoid the sharp dips after the am shot and the high amps numbers.

    It would, as always, be wise to seek advice on the forum about this technique.

    Onset/Nadir/Duration Overview

    Onset, when the insulin starts taking effect, is typically around 2 hours after injection. The numbers will continue to rise until the point of onset, when they start to go down again.

    Nadir, when the insulin is at its peak and BG values are lowest, is generally between 5 and 7 hours after injection. With ProZinc, the nadir can move around in the first 45 days of usage, as their body adjusts to the insulin.

    Duration, the time until the insulin loses most of its effectiveness and BG values start to rise again, is often between 8 and 10 hours after injection. Read more about Duration on the Pet Diabetes Wiki.

    Overlap is when one shot is starting to have an effect (Onset) around the same time the previous shot is wearing off (Duration). This prevents the numbers from rising as much between shots, and thus can be an aid in keeping BG values in a more steady range. For some cats, it may be helpful to use an alternate shooting strategy such as TID to achieve overlap between shots. Often this will assist in improving duration and will allow a return to BID with better results. Read more about Overlap on the Pet Diabetes Wiki.

    Idexx PZI Vet Typical Onset, Nadir, and Duration

    Onset: 1-4 hours following injection
    Nadir: 4-7 hours following injection (within 9 hours for 80%)
    Duration: 9-10 hours following injection

    source for PZI Vet specifications: Pet Diabetes Wiki PZI Vet page

    NOTE: We do not have official data on other insulins in the PZI family, including ProZinc, so we offer the PZI Vet data as a PZI example even though this particular insulin is no longer being manufactured. If you locate data on other PZI insulins that you think we should include in the sticky, send me a note and I will add it!

  6. Gator & H (GA)

    Gator & H (GA) Well-Known Member

    Jan 3, 2010
    ProZinc Sources & Prices

    ProZinc™ Insulin Sources List

    ProZinc comes in 10ml bottles in U-40 concentration ONLY. For more information about this insulin please visit Boehringer Ingelheim Vetmedica's ProZinc™ website.

    Local Pharmacies:
    Costco $77-$82 + local tax Oct, 2010 - non-Costco members can use the pharmacy, tell greeter you are "going to the pharmacy."
    Valley Drug and Compounding $90 + 9.x% tax in Encino CA. Nov, 2009

    Internet Pharmacies:
    Drs. Foster and Smith $114.99 + $19.99 shipping. Choose "ProZinc" from the drop-down menu in the box to the right of the photo. Jan, 2010
    1800PetMeds ProZinc $129.99 + $19.99 shipping Jan, 2010 $80 + $34.65 shipping Jan, 2010
    Allivet $89.99 + $30 shipping Jan, 2010
    Discount Pet Drugs for $99.99 + shipping Jan, 2010

    Coupon Sites:
    FatWallet Pet Forums
    Coupon Cabin

    Try to place any Internet orders on Saturday through Tuesday or Wednesday so your order will be packed and to your door within 24 hours. Or speak with your Internet pharmacy to ensure that your order will be packed and shipped all within a 24 hour time period.

    Most internet pharmacies will PRICE MATCH. And some local pharmacies and vets [like VCA] will PRICE MATCH. It is possible to have your vet call in a prescription to another vet. The bigger online retailers have coupon codes at one of the Coupon Sites above that can soften the shipping blow. For instance 800 pet meds will PRICE MATCH and have $5 off coupons [I've seen up to $20 coupons] that would basically take the shipping down to $15 [at least]. If you rather not go the 800 pet meds route, you might be able to get the $80 AtoZ place to match the total price that 800 pet meds would come out to. Or you may be able to find a better combo of price matching and coupons with another online pharmacy listed in one of the Coupon Sites above. Also since ProZinc has a 2 year shelf life, some may wish to buy a couple bottles at a time to reduce the shipping cost per each bottle. If you get from a pharmacy not listed here, make sure you are getting the real ProZinc in the green, blue and white bottle pictured here and not a compounded insulin like Wedgewood or others. Since shipping must be overnight and on a frozen gel pack, if you can find it locally for a good price that is usually going to save you money. Any other comments PM me and I'll try to incorporate. Also if you find ProZinc at your local pharmacy [or good deals anywhere else], PM me and I'll add it to the list.
  7. Gator & H (GA)

    Gator & H (GA) Well-Known Member

    Jan 3, 2010
    BCP Sourcing & Pricing

    BCP PZI Insulin Sourcing

    BCP Insulin is only available from one place-
    BCP Veterinary Pharmacy
    1614 Webster Street • Houston, Texas 77003
    713-771-1144 • 713-771-1131 fax

    BCP allows veterinarians the option to charge a markup on their insulin. BCP will not discuss price with the consumer until they get the prescription, with an OK from the vet to bill directly. So HINT: ask your vet to fax a prescription and OK BCP to bill you directly. Since BCP is less than transparent about pricing, your pricing may differ from the reports listed below.

    Below are some price reports:
    • U100 - 5ml - $52 + shipping - April, 2010
    • U40 - 10ml - $44.00 + shipping - January, 2010 - via "Kathy and Mickey" (she says PM her with any questions)
    [more pricing reports are needed! Please PM me if you have recently purchased]

    Unless you are local to Houston, overnight shipping on a frozen gel pack is the only way to get BCP insulin. As of April 2010, BCP charges $13.50 for overnight FedEx shipping. BCP wisely only ships insulin Monday through Thursday.

    Visit the BCP Bovine Insulin page or the petdiabetes BCP page for more details about this insulin.

    BCP comes in U-40, U-50, and U-100 strength. Most will probably want to order BCP insulin in U-40 strength. U-40 is the lowest concentration making smaller doses easier to measure especially in conjunction with U-100 syringes. If you do plan on using a U-40 insulin with U-100 syringes make sure to read the info above. On request, BCP will send a free 5ml sample of the U-100 strength insulin but free samples of the U-40 strength insulin are unavailable.

    *please PM me if you have more input/hints/info/pricing reports on BCP and I'll try to incorporate it*
  8. DebH

    DebH Member

    Dec 1, 2012
    I just did a search on internet pharmacies for ProZinc. I think most of the 2010 prices are out of date, but I did find two that are still under $100, I don't know what the shipping costs.

    Both of these are vet only pharmacies, your vet has to order. ... -3252.aspx $82/10 ml 40U $80.00/10 40U.

    BCP is apparently still willing to provide a free sample to your vet, for PZI, so that's the first thing I'm going to try.
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