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Protamine zinc insulin, PZI, is long acting insulin
combination. Protamine zinc is added to insulin as a means of slowing
insulin absorption. PZI was once made with beef and pork insulin but the
PZI described in this monograph is made with human recombinant insulin.
Diabetes Mellitus is a relatively common metabolic
disease seen in middle-aged cats and dogs. Most dogs suffer from Type
1 diabetes, while cats usually have Type 2 diabetes. Type 3 diabetes may
occur in either cats or dogs. In addition to insulin, the veterinary management
of diabetes requires owner education, dietary management and regular glucose
testing. With appropriate management, most animals can live a normal duration
life.
Human recombinant insulin found in PZI is acceptable for use in dogs and
most cats. When administered subcutaneously, the onset of action is between
1 and 4 hours; the peak is between 4 and 8 hours; the duration of action
is from 6 to 24 hours in the cat and 6 to 28 hours in the dog. PZI is
generally given once a day. There are oral hypoglycemic drugs that may
be used in addition to or in place of insulin in some cats.
• Hypoglycemia: The initial signs of hypoglycemia
include nervousness, vocalization, anxiety, muscle tremors, ataxia, and
pupillary dilation. The alert owner may be able to offer the patient some
food or oral dextrose to counteract the hypoglycemia. Positive response
should occur within one or two minutes. More severe signs of hypoglycemia
include seizures shock and coma. These animals require prompt veterinary
intervention.
• Urinary tract infections are a common secondary problem in cats with diabetes.
• Intact female cats should be neutered because the increased progesterone with diestrus makes the management of diabetes more difficult.
• Dietary changes can affect insulin requirements.
• Insulin may be used in pregnant animals although breeding animals with diabetes is generally discouraged. Insulin may be used in lactating animals.
• Injection site reactions may occur. It is important
to use multiple sites.
• There are multiple drug interactions with insulin.
• Drugs which may increase the hypoglycemic activity of insulin include: captopril, enalpril, alcohol, anabolic steroids, beta-adrenergic blockers, MAOI's, guanethidine, phenylbutazone, sulfinpyrazone, sulfonamides, tetracycline, and aspirin or other salicylates.
• Drugs which may decrease the hypoglycemic activity of insulin include: dextrothyroxine, dobutamine, epinephrine, estrogen/progesterone combinations, furosemide, glucocorticoids, isoniazide, phenothiazine derivatives, and thiazide diuretics.
• Thyroid hormones may increase blood glucose levels. When thyroid hormone is begun in a diabetic, hypothyroid patient, additional monitoring should be considered.
• Topical glucocorticoids can alter glucose levels in the diabetic patient and should be avoided if possible.
• Insulin can change serum potassium levels. Patients receiving
digoxin and those on diuretics should receive additional monitoring of
serum potassium levels.
• Overdose with insulin will lead to varying degrees of hypoglycemia. Description of mild hypoglycemia is included with the side effects. More severe hypoglycemia can lead to seizures, blindness, cerebral edema, permanent brain damage, coma and death.
Dr.
Barbara Forney is a veterinary practitioner in Chester County, Pennsylvania.
She has a master's degree in animal science from the University of Delaware
and graduated from the University of Pennsylvania School of Veterinary Medicine
in 1982.
She began to develop her interest in client education and medical writing 1997. Recent publications include portions of The Pill Book Guide to Medication for Your Dog and Cat, and most recently Understanding Equine Medications published by the Bloodhorse.
Dr. Forney is an FEI veterinarian and an active member of the AAEP, AVMA, and AMWA.
You can purchase books by Dr. Forney at www.exclusivelyequine.com
The information contained on this site
is general in nature and is intended for use as an informational aid. It does
not cover all possible uses, actions, precautions, side effects, or interactions
of the products shown, nor is the information intended as medical advice or
diagnosis for individual health problems or for making an evaluation as to the
risks and benefits of using a particular product. You should consult your doctor
about diagnosis and treatment of any health problems. Information and statements
have not been evaluated by the Food and Drug Administration ("FDA"),
nor has the FDA approved the products to diagnose, cure or prevent disease.
Wedgewood compounded veterinary preparations are not intended for use in food and food-producing animals.
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