Glargine

Re: Glargine

Martin Atkinson — Tue, 24 Sep 2013 11:05:29 GMT

[quote user="Thomas Johnson"]

[quote user="Martin Atkinson"]

IME there are very few cats which are truly stable on PZI

[/quote]

I had always had doubts about how well you could stabilise a cat on PZI until a recent case. Overweight male neutered 6 year old cat, owned by a recently widowed old lady who was unable to inject him as he is very strong and she couldn't hold him still and inject him at the same time, neighbours offered to inject him for her but could only do it once a day, so started him on PZI due to longer duration of activity, and made sure his caloried intake was reduced! Weight came down to normal over 4-5 months, blood sugar levels and fructosamine results good, another 4 months later started to become aggressive and stealing owner's food, started to gradually reduce insulin as blood sugar a bit low, and now off insulin completely.

[/quote] As cats almost invariably suffer from Type 2 DM I wonder how many are truly insulin dependent and those that seem to do well on PZI may cope because it is at least giving their pancreas some rest/support so it can recover, I suspect your case is probably one of these. In the olden days I always gave cats PZI and they seemed to do OK, including my own (which incidentally to my shame died of the consequences of an unattended hypoglycaemic episode) but since I started doing things properly and measuring curves it hasn't worked and I don't even think about it now.

Re: Glargine

Thomas Johnson — Tue, 24 Sep 2013 09:18:39 GMT

[quote user="Martin Atkinson"]

IME there are very few cats which are truly stable on PZI

[/quote]

Re: Glargine

Andrew Henfrey — Mon, 23 Sep 2013 19:27:31 GMT

I see Boehringer are licensing PZI for cats in Europe, hopefully released here also.

http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/veterinary/medicines/002634/smops/Positive/vet_smop_000107.jsp&mid=WC0b01ac058008d7aa

Re: Glargine

Martin Atkinson — Mon, 23 Sep 2013 18:25:21 GMT

[quote user="Rob Davis"]I have a cat which has been imported from USA, is currently stable on PZI, but obviously we no longer have this available, so are going to need to change. The owner reports the cat was previously stable on glargine in USA, though no notes available at present, [/quote] I would take this with a huge pinch of salt until you have the notes and done a glucose curve yourself. One vet's 'stable' is another's 'hasn't had any crises recently'! IME there are very few cats which are truly stable on PZI you may find that it will be actually fine on Caninsulin and you have got to be able to justify not following the cascade. That all said I am a fan of Glargine and it is true that it is a fiddle getting micro-doses accurately from 100 iu/ml insulin even with 0.3 ml syringes but because there is a much flatter curve you are less likely to get dangerous hypo or hyper glycaemic episodes. If you're not aware you can get 3 ml pen cartridges which are less wasteful than the 10 ml bottle and if you're giving 1 iu increments you could actually use the pen.

Re: Glargine

Rob Davis — Mon, 23 Sep 2013 16:06:29 GMT

[quote user="robloxley"]

[quote user="Rob Davis"] is currently stable on PZI, but obviously we no longer have this available, so are going to need to change[/quote]

Why not put it on Hypurin PZI?

[/quote]

Thanks for that. For some reason I though it wasn't available any more, but I will look into it.

Re: Glargine

Rob Loxley — Sat, 21 Sep 2013 15:15:14 GMT

[quote user="Rob Davis"] is currently stable on PZI, but obviously we no longer have this available, so are going to need to change[/quote]

Why not put it on Hypurin PZI?

Re: Glargine

Andrew Henfrey — Sat, 21 Sep 2013 14:41:34 GMT

Another question about Glargine. How are people dosing as at 100iu/ml and not diluting it gets difficult to dose in anything less than 0.5iu intervals using 0.3ml 100IU syringes?

Re: Glargine

John Flynn — Sat, 21 Sep 2013 13:18:04 GMT

Start here:

http://www.uq.edu.au/ccah/docs/diabetesinfo/link5.pdf

http://www.uq.edu.au/ccah/docs/diabetesinfo/link3.pdf