Pharmacist Helps Fill Bovine Insulin Void
Jennifer Gimon’s love of animals led her to adopt many felines through the years. Though the cats have escaped the diagnosis of diabetes, she has seen the effects of the disease and heard many stories of struggle. Thanks to her skills as a compounding pharmacist, she can offer more than just sympathy.
“I’ve dedicated my life to (compounding) this insulin for cats,” said Gimon, a registered pharmacist who is founder and president of BCP Veterinary Pharmacy in Houston.
The story of how Gimon came to re-create a formula that she and others say is the closest match to feline insulin available says a lot about the ways pharmaceutical industry dynamics can affect the delivery of veterinary care these days.
It’s a story with a happy ending, her clients say, because BCP bovine-derived PZI (protamine zinc insulin) gives them an important option in the treatment of feline diabetes.
The bovine insulin Gimon compounds is a replication of Eli Lilly’s Iletin pure-beef PZI product discontinued in the 1990s as the company transitioned to synthetic human insulin. Animal-source insulin has been deemed impractical to produce by pharmaceutical companies in part because of the difficulty in getting the pancreatic crystals needed to make them.
Veterinary use of a pharmaceutical product developed for the human market typically isn’t enough reason to continue production when a preferable human product emerges, industry insiders say. This leaves a gap in treatment options that affects the lives of animals and those who care for them.
Shortly after Gimon was licensed as a pharmacist in 1995 and launched BCP Veterinary Pharmacy, a feline-only practitioner told her how disappointed he was that he no longer could get the Eli Lilly bovine PZI insulin, which he considered the gold standard for treating diabetic cats.
Lilly had provided him the list of ingredients but not the how-to. He went to Gimon.
So she began the laborious process of re-creating the insulin, spending hundreds of hours researching the protamine, how the chemicals bond, what kinds of preservatives could be used and much more.
“I read patent after patent to understand how the insulin was made—all the chemistry behind it, from the very beginning to the end product,” Gimon said.
After two years of trial and error, she finally got the formula right and in 1996 began making BCP bovine PZI for veterinary use.
“At that time, bovine insulin was still very well known,” Gimon said, and she learned the value of producing a high-quality product that would benefit from word-of-mouth marketing.
“Everything we do is per prescription, for the patient,” she said. “We don’t sell to distributors.”
Different Amino Acids
Many feline veterinarians prize bovine PZI insulin because it is only one amino acid removed from that of cats’ natural hormone, practitioners say. Recombinant human insulin is farthest removed from feline insulin, Gimon said, with four amino acid differences.
Porcine-derived insulin is three amino acids different from feline insulin and is closest to canine insulin, she noted.
PZI Vet, a protamine zinc insulin that was a combination of beef and pork, was made by Idexx Pharmaceuticals and widely used to treat diabetic cats. It was discontinued in 2008.
That only added to the importance of BCP’s bovine PZI insulin, practitioners say.
The veterinarian who encouraged Gimon to re-create the product in the first place still considers it the gold standard.
“BCP’s pure beef PZI gives me safe, predictable results in a once-daily dose,” said board-certified feline practitioner Steven K. Wilson, DVM, MS, of Dallas. “I wouldn’t use anything else.
“It IS the gold standard for cats. Why use something else when you have this compounded product which is medically and clinically identical to the former Lilly insulin? Jennifer’s production process is perfect. The product is safe and reliable.
“I have treated thousands of diabetic cats, and I can only think of two cats I could not regulate with bovine PZI. My success rate is more than
99 percent,” Dr. Wilson said.
“How do I define success? My success rate is animals I can regulate. I avoid euthanasia.
“Euthanasia. Owner despair. Feline diabetes becomes a nightmare and many cannot deal with it. I will not accept that that has to be.”
Regulation Takes Time
The challenge with a diabetic cat is getting it regulated on insulin. It can take time to determine the proper dose and a cat may need to be hospitalized while the right dosage is determined. That can be expensive for the client and can lead to euthanasia.
“From a practitioner’s standpoint, almost any other condition would be preferred,” Wilson said. “Diabetes is labor intensive and time consuming for both the practitioners and the clients. Educating the client is very time consuming. But when you can manage feline diabetes, it’s enormously successful. It doesn’t get any better than that.”
“Bovine PZI is sort of a dinosaur—it’s an old, old, old formulation, but it works,” said Glenda Wilson, a certified veterinary assistant who works beside her husband, Dr. Wilson. “Our practice has had as many as 60 to 70 diabetics at a time. It’s so easy to regulate cats on this insulin. The difference is like night and day.”
Richard Henderson, DVM, said his Galveston Veterinary Clinic in Galveston, Texas, regularly uses the BCP bovine insulin and other products from the compounding pharmacy “because we’ve had a lot of good luck with them and trust their quality.”
He said he is seeing growing numbers of diabetic cats—enough to call it an epidemic.
“When I was in vet school in the early ’80s, clinicians told us to expect to see two diabetic dogs for every diabetic cat,” Henderson noted. “In the past few years we’ve been seeing about four cats for every dog.”
Bovine PZI also has been integral to success with Tight Regulation Protocol, the strategy pioneered by Elizabeth Hodgkins, DVM, Esq., for curing feline diabetes.
“I have not found any insulin equal to or superior to bovine-source PZI insulin for managing cats that require insulin for any period of time,” Hodgkins explained in her book, “Your Cat: Simple New Secrets to a Longer, Stronger Life” (Thomas Dunne Books, 2007).
Research Isn’t Over
Gimon said she’s always working to earn her clients’ trust. BCP Veterinary Pharmacy has grown to include 30 employees, but “I’m still the only one who does the insulin,” she stressed.
Gimon is big on testing products and processes both internally and externally. Southern Illinois University is performing research to help ensure the quality, stability and consistency of BCP’s bovine PZI insulin, she said.
Still, the biggest measure of success is performance in veterinary clinics and clients’ homes.
“Providing vets and their clients with options like bovine PZI and then hearing that it has improved the quality of so many cats’ lives are the most rewarding aspects of my job,” Gimon said.
This Education Series article is underwritten by BCP Veterinary Pharmacy of Houston.
This article first appeared in the January 2010 issue of Veterinary Practice News