The Trouble with Columbo
So far it’s been a busy and extremely frustrating Saturday all on account of my old moggy, Columbo…
Today I took him to the vets for his six-monthly check-up. All went well, even to the extent that he didn’t try to take the vets arm off when they took a blood sample for the fructosamine test that checks whether his diabetes has been under control since the last visit. He’s even lost a bit of weight, which won’t do him any harm, although at 6.8 kg he’s still not exactly slim. His only indiscretion was to have a wee in his carrying box on the way there, but that’s nothing particularly unusual and was easily dealt with.
However, when I went to pick up his supplies (food, medication, syringes, and insulin) the vet informed me that the manufacturer of the kind of insulin he normally gets is no longer supplying it. This particular type is of a flavour called “Protamine Zinc”, although I don’t know really know what’s so special about that. Anyway, given that I’m running low the vet wrote me out a private prescription for human insulin, which apparently they are allowed to do if the supply of veterinary products runs out.
So I took Columbo home with the other stuff, left him in the house and, prescription in hand, romped off to the nearest pharmacy, which turned out to be the first of many I visited this morning. The problem is that human persons who are diabetic generally don’t use the old-fashioned vial-and-syringes approach to administering insulin, but get their dose from preloaded gadgets that look a bit like pens. These won’t do for cats which have skin that’s too thick. So one after the other various pharmacists explained that they would have to order the stuff I needed, and that it might take a while to arrive since there’s not much demand for it these days. None of them had a supplier that was open on saturdays either..
Eventually I gave up trying to find the insulin today and left the chit with a pharmacist to order on monday when their supplier is open. That is, if they’re able to supply it at all.
I’m not sure what I’m going to do if I can’t get the supply Columbo needs. Probably we’ll have to switch to another type of insulin, but the problem with that is that we’ll have to establish the right dose. He’s been stable on his current dose of his normal insulin for a long time now, but it did take a long time to sort how much he needs. If I have to start again on a different type, it will probably require several tests to see how he responds.
Anyway, having hoped to get the business of his insulin supply sorted out today, I’m now forced to wait until monday to see if I can get the necessary from the pharmacist. If not, I’ll have to talk to the vet when the fructosamine results come back to see what to do about starting on a new type. It’s all a bit of a pain, and I’m knackered after traipsing around half the chemists in Cardiff on a wild goose chase.
Columbo, however, is oblivious to all this and is doing pretty well. While I’ve been running around on his behalf he has been sleeping as is his wont, this time in the bathroom. He’s a picture of him taken after he’d just woken up.
Now it’s time to do a bit of relaxation of my own, in the form of the Guardian Prize crossword.
In the Dark 
November 20, 2010 at 3:05 pm
Aww you’re such a sweetie. I never knew you’re such a cat lover. He’s really cute. I wish I could keep a cat in London. It’ll just get run over like the previous 3.
November 20, 2010 at 7:55 pm
Interesting that human insulin is close enough. You can reconstruct a mammalian family tree from interspecies differences in the insulin molecule, and (of course) it matches the tree inferrred from DNA.
I’d try another vet rather than another pharmacist. I’ll bet someone has a stash that will do the trick until this transition – which must be taking place all over the country, and perhaps the world – has settled down.
November 20, 2010 at 8:00 pm
I think the standard form of insulin actually comes from either pigs or cows, but it’s the same basic stuff. The issue, as far as I understand it, is the concentration and the form of suspension it is delivered in. There are slow-release and quick-release versions, which are presumably different in the way the insulin is contained within other stuff.
It may turn out to be straightforward to switch to another brand of veterinary insulin, but I’m not going to take the chance without talking it over with the vet.
Interestingly, human insulin seems to be cheaper!
November 21, 2010 at 8:55 am
Good luck and what a lovely cat! Our moggy has been on caninsulin for years. I presume it’s not caninsulin that’s not being supplied any more?
November 21, 2010 at 10:29 am
The insulin I’ve been getting up to now is called Insuvet. It still seems possible to order it online, but only the vet can do this as it needs a prescription.
November 21, 2010 at 10:25 am
If you need to use human insulin but can’t get a vial, a pen cartridge is usable with a syringe – you just treat it like a vial and extract through the rubber tip. It’s not as convenient as a vial – it probably holds less, but it’s doable.
In reply to Anton and telescoper above, in the days when we were more commonly using animal insulins, the time delays were done by mixing with other things, but now that insulin is produced by genetically engineered bacteria it’s straightforward to deliberately fiddle with a couple of amino acids here and there to modify how easily it forms dimers and maybe other structures, which affect how long it lasts in the body.
Most insulins work across quite a range of animals though – you can even get away with fish insulins.
Hope you find something suitable soon anyway.
November 21, 2010 at 10:31 am
That’s useful to bear in mind for emergencies. I think the cartridges usually contain about 5ml. I have a 10ml vial, but I don’t use all of it. Once opened it only lasts 4-6 weeks.
November 22, 2010 at 7:11 pm
I’m happy to report that I managed to get the necessary insulin this evening, from a friendly pharmacist who ordered it this morning and got it from the depot this afternoon. Good stuff.
Now I’ve got 4-6 weeks to sort out a more permanent arrangement, so the panic is over.
November 24, 2010 at 8:35 pm
And more good news. Columbo’s fructosamine test result is very good, showing that he’s had good control of the diabetes since his last test. No change in his dose for another 6 months.