We’re here to help you care for your diabetic cat easily and effectively. You can find everything from a handy, downloadable Home Care Diary to treatment tips, answers to common questions and more.
Learn to give PROZINC with ease in these step-by-step video demos.
Preparing and filling the syringe.
We'll show you what type of syringe you need as well as how to fill it and prepare your PROZINC. Plus, we offer some helpful safety tips.
Caring for a diabetic cat can raise many questions. Get fast, easy-to-understand answers now.
Diabetes mellitus is a condition in which the body either cannot produce insulin or cannot effectively use the insulin it produces and therefore cannot regulate glucose in the body. Type I diabetes occurs when the body cannot produce enough insulin to keep blood glucose levels regulated and is most commonly seen in dogs. When the body cannot respond to the insulin in the bloodstream, this is considered a relative insulin deficiency. This is called Type II diabetes and is the most common form in cats. Initially, the most common symptoms or signs of diabetes mellitus are increased thirst, urination and appetite.
Unfortunately, no. Once diagnosed with diabetes mellitus, a cat will always be considered diabetic. However, most cats’ symptoms or signs can be well controlled with insulin injections, diet and, in some cases, weight loss. In fact, a small percentage of cats’ diabetes may go into remission, which means they no longer exhibit the clinical symptoms or signs (increased thirst, urination and appetite), and they no longer require insulin injections. However, these patients should still be considered diabetic because remission is not always permanent and the symptoms or signs of diabetes may return in the future.
Often if a cat’s blood glucose is persistently elevated, the symptoms or signs associated with hyperglycemia will return (increased thirst, urination and appetite). If your cat’s glucose level drops too low, your cat may exhibit symptoms or signs of hypoglycemia (low blood glucose) such as lethargy, sluggishness, trembling and seizures. This is an emergency situation and requires immediate veterinary intervention. Learn more about hypoglycemia and hyperglycemia.
The clinical symptoms or signs most often seen with diabetes mellitus result from persistently high levels of glucose in the bloodstream. Most often owners will notice increased thirst, urination and appetite.
PROZINC is a sterile aqueous protamine zinc suspension of recombinant human insulin indicated for the reduction of hyperglycemia and associated clinical symptoms or signs in cats with diabetes mellitus.1 It is the first FDA-approved protamine zinc insulin for cats.
PROZINC, like other insulin, controls blood glucose by stimulating carbohydrate metabolism in heart, bone and fat tissue, helping these cells to use glucose for energy.2
PROZINC is the first and only FDA-approved protamine zinc insulin for cats that contains human recombinant insulin. The effect of protamine zinc insulin formulations lasts 10-14 hours.3
PROZINC should be mixed by gently rolling the vial before withdrawing each dose from the vial. Using a U-40 syringe, administer the injection under the skin along the back of the neck or on the side of the cat.1 NOTE: It is important that you roll the vial and not shake it. Shaking the vial may reduce the effect of the insulin by breaking the insulin molecules apart. Watch the instructional videos above for more details.
PROZINC is supplied as a sterile injectable suspension in 10-mL multidose vials. Each mL of PROZINC product contains 40 IU (international units) of recombinant human insulin.
Store in an upright position in the refrigerator at 36-46 degrees F (2-8 degrees C). Do not freeze it and protect it from light.1
Although product literature or labels for other insulin products advocate replacing insulin vials every month, there are no special requirements to periodically replace PROZINC once the bottle has been punctured under normal use conditions. PROZINC is a suspension and once mixed has a whitish cloudy appearance. Of course, if discoloration or other abnormal appearances are observed, indicating contamination within the vial, it should be discarded. Loss of insulin activity in the bottle should always be considered whenever clinical symptoms or signs recur, regardless of the amount of insulin in the bottle.4
PROZINC carries a two-year shelf life from the date of manufacture.5
Use of a syringe other than a U-40 syringe may result in incorrect dosing.
Cat owners should contact their regular veterinarian. Veterinarians and veterinary professionals are encouraged to call Boehringer Ingelheim Veterinary Technical Support Team (VeTS) at 1-866-638-2226 for product inquiries.
To report a suspected adverse reaction to PROZINC, please call 1-866-638-2226.
The most common side effect associated with the use of PROZINC observed during the field study was hypoglycemia (defined as a blood glucose value of < 50 mg/dL). Most of these cases were not reported as adverse reactions because there were no clinical signs of hypoglycemia.6 The clinical signs observed were typically mild in nature and were described as lethargy, sluggishness, weakness, trembling, lack of coordination, grogginess and a glassy-eyed or dazed appearance. Most cases were not associated with clinical signs and received no treatment.6
Veterinarians and staff members should educate their clients about the clinical signs above while a cat is undergoing insulin therapy. Reacting to early signs of clinical symptoms will decrease the risk of a more serious side effect. The cat owner should be given an information sheet with each prescription.
Hypoglycemia is the most common side effect with almost any insulin. In the PROZINC field studies, 71 of 176 cats experienced hypoglycemia.6
The following additional clinical observations were reported in the PROZINC field study: vomiting, lethargy, diarrhea or loose stool, cystitis/hematuria, dry coat, hair loss, upper respiratory infection, ocular discharge, abnormal vocalization, black stools and rapid breathing.1
Historically, protamine zinc insulin was administered once daily to diabetic cats, a protocol based more on clinical perceptions of response to treatment than on results of absorption shown in kinetic studies. Studies show that absorption of protamine zinc insulin can be quite variable.
In the field studies, mean time of the blood glucose nadir was between five and seven hours, and subsequent blood glucose concentrations were increasing in most cats by nine hours after administration of PROZINC. These results suggest that PROZINC should be administered twice daily in most diabetic cats to maintain glycemic control.7
Each cat will respond differently, but based on the results of an effectiveness field study, 76% of the cats enrolled in the study were considered a treatment success by 45 days.1,6
The injection should be administered under the skin on the back of the neck or on the side of the cat using a U-40 insulin syringe.1 Watch the instructional videos above for more detailed instructions.
Your veterinarian should determine the treatment protocol for your diabetic cat. Obesity is common in diabetic cats and results from excessive caloric intake. It causes reversible insulin resistance, which resolves as weight is lost. Glycemic control often improves, and some diabetic cats may revert to a subclinical diabetic state (remission) after weight reduction.
Research also suggests that diabetic cats may be predisposed to developing higher postprandial (after a meal) blood glucose concentrations after eating a high-carbohydrate meal. Feeding diets lower in carbohydrates and higher in protein and fiber is currently recommended in the literature4 and may have an underestimated role in the development of diabetic remission.8
If you suspect your cat has low blood glucose (sugar), don’t panic. You can help your cat by following these steps:
It is important that you use a U-40 syringe with PROZINC. If the proper mathematical conversion is made, U-100 syringes may be used, but the risk of administering the wrong dose increases dramatically. We recommend consulting with your attending veterinarian before attempting to dose PROZINC with any syringe other than a U-40.
Please discuss this with your veterinarian.
No. To date, PROZINC has not been studied in depth in dogs.
The cat should be closely monitored for symptoms or signs of hypoglycemia. If symptoms or signs are present, your cat should be administered oral glucose and taken to a veterinarian immediately for continued care. Advice on when to restart insulin injections can only be given by the attending veterinarian.
Syringes should be used once and then disposed of in a puncture-resistant, leak-proof container. Special containers, often called "sharps" containers, can be purchased at human pharmacies specifically for this purpose. Boehringer Ingelheim has a PROZINC Diabetes Care Kit that includes a supply of U-40 insulin syringes and a sharps container. Please consult your attending veterinarian with any questions.
Detailed instructions are available in the video above.
PROZINC is contraindicated in cats sensitive to protamine zinc recombinant human insulin or any other ingredients in the PROZINC product. PROZINC is contraindicated during episodes of hypoglycemia.1
Please contact your physician/health care provider immediately.
1PROZINC product insert.
2Plumb DC. Plumb’s Veterinary Drug Handbook. 5th ed. Hoboken, NJ: Wiley-Blackwell; 2005:412-418.
3Nelson RW. Disorders of the Endocrine Pancreas. In: Nelson RW, Couto CG, eds. Small Animal Internal Medicine. 4th ed. St. Louis, MO: Mosby Elsevier; 2008:764-802.
4Ettinger SJ, Feldman EC. Textbook of Veterinary Internal Medicine. 6th ed. Vol 2. Philadelphia, PA: WB Saunders; 2004:1576-1577.
5Data on file. St. Joseph, MO: Boehringer Ingelheim Vetmedica, Inc.
6FOI for NADA 141-297. (PROZINC)
7Nelson RW, Henley K, Cole C, et al. Field safety and efficacy of protamine zinc recombinant human insulin for treatment of diabetes mellitus in cats. J Vet Intern Med. 2009; 23:787-793.
8Feldman EC. Diabetes remission in cats: which insulin is best? Compendium: Continuing Education for Veterinarians. 2009;31(7A). Supplement.