What would you like your vet to know about you & your cat?

Hello FDMB Members,

My name is Dr. Bonnie Bragdon and I work for Abbott Animal Health, the company that manufactures Alpha TRAK, a portable blood glucose monitor. I currently work with veterinarians and veterinary students to provide education in monitoring diabetic dogs and cats. Before Abbott Animal Health, I practiced small animal general medicine for about 10 years.

I will be writing a presentation that discusses prescribing home monitoring for diabetic dogs and cats using a portable blood glucose monitor. The presentation will be delivered to veterinarians and their staff.

I would like to hear your experiences with home monitoring and the assistance your veterinarian did or did not provide. I would like to include your experiences in general, as well as by direct quotation. I do NOT plan to include the website address or member identifiying information. I did request permission from Rebecca Price, the message board webmaster. She granted permission and gave me guidelines.

I am always available to answer questions about Alpha TRAK. I can be reached directly by email at bonnie.bragdon@abbott.com.

Thanks!
Dr. B

If you can get more vets on board with home testing, that would be great!

For me, home testing has been an invaluable tool in getting my cat's diabetes under control. My vet encouraged me to learn to home test because I could not afford to keep bringing my cat in for regular glucose curves, and we had not been able to get his diabetes under control after several months of periodic testing at the vets office. With home testing, a change to low carb canned food (4% carb), and a change to a longer-acting insulin (PZI), I was finally able to get him regulated. I rely on home testing as a daily tool to be sure I am safely giving him the insulin he needs.

On another note, my understanding is that the Alpha TRAK is basically unaffordable for many people. If the price were brought in line with other meters & test strips, I think it would be a more useful product. (My apologies if I've misunderstood the price or confused it with another meter!)

Although my vet encouraged home testing, I was sent home with instructions to shoot an absolute dose at absolute times. Those instructions caused my cat to rollercoaster . Had I not been diligent in checking levels several times a day and had I not sought further help from a specialist vet, I could have easily sent my cat into a scary hypo situation. I don't know about other insulins, but vets ought to advise their patients to drop their lantus doses if they see rollercoaster numbers - ie 350 preshot/40 nadir. My original vet also gave no instruction on how to proceed when PS numbers were low. Obviously if your PS is 100, you don't shoot immediately.

I learned about home testing from FDMB close to 12 years ago. No vet ever told me about it and all I know about FD I learned from this board. The cost of the AT and test strips is way too high and if a vet only promotes that meter, then there are cats that either will not be tested, euthanized, or hopefully find FDMB and learn human meters are just fine. A lot of owners cannot afford that cost. There is also the problem of not keeping an eye on how many test strips you have left. If you run out, you cannot just go to a pharmacy and buy them and not all vets stock them.

Hopefully, while Abbott is busy talking with vets about the AT, they will encourage vets to bring themselves up to date on FD. Too many are woefully lacking in knowledge. Also promote that testing at home basically removes the stress induced numbers and owners can give their vets the curves done at home.

As for me and my three diabetics, we will continue to use the One Touch Ultra. It has never failed me and in comparison with Antech labs it was only 8 points off.

The vet that diagnosed my Charlie, back in 2004, told me the following... give him two units of Humulin L, 12 hours apart. Buy some Karo syrup for when you recognize a hypo occurring, then bring him back in a month.

Had I listed to him, I would never have had my Charlie for five more years. He died at age 18, from a stroke. I monitored his BG levels with a human (OneTouch Ultra) Meter. My son, who helped develop the 'bloodless' testers... told me the meters are looking for glucose... and would test any blood.. and would recognize the glucose in cow's blood.

I switched him to PZI VET when Humulin stopped making L, he adjusted very well and his dosage kept dropping lower and lower, but he was definately insulin dependent from age 12 to age 18.

I addopted another diabetic cat prior to Charlie passing. He had never been treated as his owners refused to treat and returned him to the humane society... The director of the HS changed his diet to low carb Fancy Feast and we picked him up a few days later. (It was in Minnesota, but several hours drive from us.) He tested 587 when we tested him at home later that night. New people, long drive with strangers, and two brothers, one hissing - had him very stressed. Within ten days of testing and reducing his dose, he has remained off insulin for the past three years. Testing and FDMB helped save two wonderful cats!

I hope that the manufacturers of the pet specific BG monitors will consider that pets are these people's 'children', and they are much loved, but many cannot affort the expensive meters they are manufacturing.

Please educate these vets on the home testing of diabetic pets. Simply going to the vet will raise an animals stress level, which of course, raises their BG level.

My vet encouraged me to test at home on the weekends. She told me that if we brought him in to do the testing he would be stressed out and his numbers would be higher and the cost is expensive. I appreciated her honesty.
It was through this board that I learned I should not be shooting blind and spot check.
I started off using the One Touch Ultra, which was very good, but recently switched to the ReliOn Micro because the test strips were less expensive.

My current Vet is a gem and has been learning about Levemir insulin and has entertained my hometesting...respectfully. But she also still doses by weight and does not encourage homestesting. I find this with majority of vets.

Our old vet would have killed my cat if i'd listened to her. She gave us a set dose of vetsulin based on weight and scared-to-death-at-the-vet BG values ( 6u BID ) and said I was abusing my cat by hometesting and that the ears are a very sensitve place and I was hurting him by taking his blood there. Also that feeding canned food was "spoiling him", not helping him nutrionally.

This is WHY they are my old vet and not current one.

I'd like to see ALL vets get a better understanding of current FD practices- hometesting, low carb wet food ( PLEASE stop listeing to Hill's... cardboard with fish flavor!) and dosing based on home tested BG's, NOT WEIGHT!

I'm not sure if Rebecca told you that you couldn't or something, but I personally PREFER that you give out the web sites address so that more vets and FD owners can come here and learn!

Also agree with others about price of AT...cost prohibitive and not functional when it comes to buying strips on weekends or when vet is out of stock.

I use Relion micro- $14 and strips are $20 for 50. They have tested within 10 points of several vet meters....I could never afford the AT at current prices- $180 ish for a kit w/50 strips, right?

Good on you for getting the word out to hometest!

In 2005 when Gandalf was diagnosed diabetic if I had learned from my vet that home testing could have resulted in remission for him, I would have paid whatever and done whatever I needed to learn how to accomplish that. With today's longer lasting insulins, Lantus (glargine) and Levemir (detemir), being used for cats the probability for remission is even higher, however, home testing is the key to achieving remission.

That is the message which needs driven home to veterinarians - learn how to help your clients achieve remission for their cats via home monitoring. If Abbott could be on the forefront of that movement, many many feline diabetic owners would thank you.

In the meantime, thank you for your efforts and willingness to listen to the feline diabetic owner community here.

1. Test, test, test, test, test!!!! Our cats actually look forward to testing/treat time.
2. The Internet is your friend, not your foe.
3. Learn with us...it's okay that you're not an expert in diabetes, but when we find a group of people who are, please support us. If we ask for specific tests, please humor us.

Testing: My cat has acromegaly (I'm sure you know what it is, but just in case you don't, it's a pituitary tumor that causes the need for large amounts of insulin). The growth hormone produced by the tumor can fluctuate, which causes insulin needs to fluctuate. It's very, very, very important that these cats be tested several times a day; it's scary enough shooting your cat with 15 u of Lantus (versus the normal 1-3 that most kitties use), but deadly if the tumor has slowed down and 15 u isn't required any longer. If you peek at our spreadsheets, Gayle & Shadoe clearly illustrate how drastically insulin needs can change in a short time.

Protocol: Many of use follow the German Tight Regulation Protocol. This protocol allows you to increase doses much quicker than the older "curve every 2 weeks" protocols that many vets are following. This brings the BGs under control quicker, brings remission when possible, and allows us to spot the possible acromegliacs quite quickly. It's a very successful protocol and we would like for our vets to recognize this.

Alphatrak vs Human Meters: My former vet was under the impression that human meters were unreliable in pets and that I should only use the AlphaTrak. However, considering that I tested at least 4 times a day, the AlphaTrak was too expensive. Additionally, the AlphaTrak required more blood than the human meters. Our experience here is that the human meters work great.

I am the odd ball here, I have a diabetic ferret.
My vet was told by an exotics specialist and the book info he had that the prognosis was poor, very few ferrets are spontaneous diabetics and most don't see 2 weeks before succumbing.
He offered to get me one of your meters and strips but as they are so very far to travel to I was afraid of needing strips and not being able to get them so I went with a Reli on micro and took it with us and we both tested the same drop of blood, he with his and me with mine, there was only 20 points difference on a high number so we didnt get the Alpha trac.
That was the extent of his assistance to Pippin, the rest I researched and finally I found this place and we got him on Lantus, we test at least 4 times a day, often much more as he is a ferret and must be difficult LOL
This site, lantus and home testing have kept him with us and with good quality of life for over a year and a half now.
Testing at home is so very important and should be encouraged. What is prohibitive for newly diagnosed pets is the cost, they have already been shocked, bombarded with information, and many expensive vet bills, to tell them they now have to spend another $90. for a meter and $50. for strips every week scares most of them from home testing at all, we all love our pets like our children but we can only afford what we can afford. The lantus pens here are $237. a box, you add the cost of many strips for testing and that puts it out of many peoples reach. Its not that it isnt a great product its simple economics.
I do want to thank you for coming here and asking opinions and I do hope what we say will make a difference down the line for others just starting out trying to treat their beloved little sugar pet.

Base dosing on IDEAL WEIGHT, not actual weight.(My cat hypo'd on her first shot as she was given 5u.If it hadn't been for finding this board she would of died that night)

Start low, go slow.Invaluable piece of info, start at no more than 1u.
Remind them, just because they have been to university doesn't mean they always know better than a proactive customer.The internet is not an evil thing, keeps people better informed and it's use will increase so encourage them to work with it.

If vets actually showed people how to hometest (can be quite tricky learning from the written word or watching a video).
Vets could have an info pack, would really give people more faith in their capabilities. I went through 4 vets, 3 of whom didn't support hometesting and stated because my cat was fractious I should euthanise. The 4th was more helpful, but still didn't think I had a brain, but at least I got the insulin script, the rest I did on my own with help from here. Not ideal but you kind of lose faith!

I know vets have literally hundreds of ailments in a multitude of animals they need to know about, but there's nothing wrong in saying 'I don't know, lets find out together'-would get heck of a lot more respect from me.

Marketing wise-look at the price of the Alpha Trak in comparison to human glucometers, it's why it isn't recommended here.Availability of strips is another issue.

You are definitely seeing variations on a theme here. My vet prescribed 4 units twice a day of PZI. She didn't know about hometesting. We got on the internet and found this site and it literally saved my cat's life. We started hometesting that day, changed the diet and rapidly lowered the dose.

Since then, my vet has advocated hometesting for other patients. She has attended several seminars on feline diabetes and is on board with diet, although she still wants the Hills DM fed. (We agree to disagree.)

What we see are too many people come on here with advice from vets that is absolute - no hometesting, starting at too high a dose and no knowledge of diet. I wish there was more education done for vets on fb - and not just by the dry food manufacturers.

in my case, my vet knew about home testing but did not even tell me it was possible.
some vets automatically assume that asking a client to do something means they'll get overwhelmed and elect to put to sleep. not to give the client the option does not give them credit.
i had to google feline diabetes to find this site and learn about home testing. it helped to have an experienced person come to my house and show me how, which another member here kindly did.
home testing is easy, and eventually the cat comes to recognize it and the insulin as helping make her feel better so many cats actually come over to their owners or their normal test spots at shot time. we encourage this by always saying something encouraging when testing, no matter what the BG result is, and by giving a little treat for being a good kitty.
if we lack confidence at first we learn to fake it. the quicker and smoother the testing process, the happier the kitty.
at the beginning ears don't always bleed as well so it helps to nick the capillary or to use a larger lancet. if you're not successful at first, wait 5-10 minutes then try again so cat isn't traumatized by endless tests.
before i home tested i kept a log on my cat's actions/behavior but i just couldn't tell from looking at her whether her glucose was high or low. home testing gave me confidence and insight.

years later a friend of mine whose mom's dog had died of diabetes told me how sad it was that pets couldn't be home tested like humans are. it was devastating to have to tell her that yes it was possible. if she'd only known--if her vet had only told her...

My first diabetic, Norton, was diagnosed in 2006. My vet did not recommend home testing or changing the food. The only insulin she prescribed was Humulin N. She did at least start with a low dose, and had me bring in Norton once per week for a glucose check. She uses a human glucometer in her cats-only practice, and taps blood from a vein for the check.

We gradually got up to a dose of 13u BID (yes, really that high). The only time he hypo'd was at the vet's following a dental procedure in 2007. After coming home, he was different, and I was concerned that he may have suffered brain damage or something. He started walking in circles. I started researching on the internet and found FDMB.

Here we found out about food (low carb canned food), home testing and high dose conditions. Norton seemed to fit the profile documented HERE for acromegaly but my vet insisted that he was not. We started home testing and changed his diet to low carb canned food. We were able to reduce his dose from 13u BID to 8u BID. I insisted on having the IGF-1 blood test done, which confirmed that Norton had acromegaly. A neurologist confirmed that he had a brain tumor. He ended up developing an aggressive inoperable cancer and we helped him cross the bridge.

My vet did not want to make diabetes treatment too complicated, too difficult or too expensive for people to go ahead. She was afraid that more people would PTS their otherwise healthy pet if she demanded that they home test and change to more expensive food and use a more expensive insulin.

Since Norton passed away in 2008, my husband and I have adopted two diabetic cats through this board. They only visit the vet for annual wellness checks and if some health issue crops up. We do not go for weekly blood glucose checks, and I have offered to help any of her clients that would like to learn how to home test. Our cats are well regulated on a tiny dose of Levemir BID.

There is a wealth of information here -- difficult to summarize in a few sentences everything that we would like our vets to know.
Dosing insulin -- Start Low and Go Slow (no dosing by weight)
Regulation cannot be accomplished in a few days at the vet clinic -- due to stress, a cat needs to be tested at home in the normal environment
Food - high protein, low carbohydrate canned or raw food is best -- less than 10% carbs -- NOT prescription
Define Do Not Inject conditions -- vomiting, won't eat, blood sugar below 200 (for new diabetics who have not built up blood sugar data / experience)
Explain Hypoglycemia - what to watch for and how to treat (high carb - gravy food, syrup if extreme)
Testing urine for Ketones if blood sugar is over 300

Please read all the "sticky posts" at the top of the various forums - here are a few of my favorites
How to home test
http://www.catinfo.org about Feline Nutrition (written by Dr. Lisa Pierson, DVM)
PZI - genetically the closest to a cat's own insulin
The N Primer (about using Caninsulin, Vetsulin & Humulin N safely)
Lantus - protocol, storage shed, becoming data-ready to shoot lower numbers (also applies to Levemir)
Acromegaly, IAA, Cushings - High Dose conditions - What we know

P.S. I started out using the True Track meter, and switched to the MAXIMA AST which I found online at www.hocks.com. The test strips cost $16.50 per 50ct and the meter kit was free with purchase of 100 test strips. Now they charge a couple extra $ but still an excellent price.
With two diabetic cats, we test AT LEAST 4 times per day and cost is an important factor in our meter choice. Blood drop size is another important factor. The True Track required a 1 ul drop and the Maxima AST is better - requiring only 0.5 ul.

The best meters out there require only 0.3 ul drop, but the test strips cost about $1 EACH.

Phoebe

Hi Dr. B.
Many people come here with incredibly little information about treating their diabetic cat. And often the information they do have is not the best. Vets sell Diabetic Dry food, it seems to make a profit or do not know any better. They very rarely encourage testing and are offended at times if the newbie who has visited here trys to tell the vet what they've learned. I wish Vet's would put down the power or ego struggle and realize all we want is to save our dearly loved cats. Most vet's it seems do not urge hometesting instead want us to come in quarterely for a curve.
We have learned soooo much here and I'm sorry to say it seems we often are more educated about treating diabetes than our vets. I cannot tell you the wealth of knowledge on this board. And it has lessoned some this past year due to board changes and old timers leaving.
Economically it just makes sense for us to use human glucometers.
I guess the biggest point I would make to vets and students is that we parents of our kitties and dogs CARE! We really really really care! If sending them to this web sight would help why are vets so adverse to doing so. Can't help but feel it interfers with the bottom line dollar.
Please send your diabetic patients to this message board.
Lori and Tom
Newbie Supply Kit Person

Hello,

my experience with vets and home testing has been good.

The vet that diagnosed Luna, did not push me to purchase an animal meter - he said any human meter from my local pharmacy was fine.
Unfortunately, everything else about my cat's treatment and his advice was not-so-good.

I have a new vet now, and she is very supportive of the way I handled Luna's treatment.

However, when it came to home testing and showing her Luna's spreadsheet, she encouraged me to test less.
This too is very common with a lot of members coming thru here.

Vets have told some of us "you don't need to test this much", "pre-shot numbers are good enough"
Well, it's not good enough.

Collecting the data was important to me and has helped me learn how insulin works for each cycle. This is something I learned here on the FDMB.
Along with the assistance of this board and home testing, my cat is now diet controlled on a low carb wet food diet and does not require insulin anymore.

I do agree the AlphaTrak is an expensive meter with expensive strips. I've never used it, but know others here on the board do and trust it.

But with the high cost of initial diagnosis, supplies and insulin, it's quite overwhelming to get by on a limited budget.
Some of the meters are reliable and affordable, some not so much, but all are easily attainable at any pharmacy.

Thank you for taking the time out to post and to ask for feedback.
Good luck with your presentation!

My vet did not mention home testing to me. When I asked about it - after reading about it here - I was told I would have to learn to draw blood from his leg vein and use the Alpha Trak meter and they quoted me the price. (sorry, but "yikes!") I asked about ear pricking and was told , "You'll end up with a very pissed off cat". So that discouraged me from trying to learn. My cat, Beau, was on vetsulin and he was unregulated for over six months while I proceeded to bring him in once a week for a blood sugar test. His BG was high, low, high, higher, etc. During this time I also asked about diet (having read about it here). I was told that we needed to get him regulated first than we could see if his diet needed changing. He was eating about 2/3 dry food (IAMS).

At six months I took him for his test and was told to raise his dose, again, even though he had hypoed at the vet for a curve on a lower dose. I remember being very frustrated and thinking "He needs less insulin, not more." I came back here and started reading. I got a meter and some strips - at Walgreens - and started testing. I also began phasing out the dry food, which I could do safely because I was testing. Beau was regulated within a month, off dry food and on a much lower dose. He went from 5u once a day to 1u bid.

Two years after his diagnosis, I switched him to levemir and he was off insulin in about 3 months. I have another diabetic, that I adopted because he was going to be euthanized because his owner couldn't or wouldn't care for his FD, who is on levemir and tested at home. I felt I could handle another diabetic because of my experience with Beau.

Beau has been off insulin for almost a year and tested 104 yesterday 45 mins after breakfast. He has other health problems: cardiomyopathy (since age 3) and hyperthyroid and is prone to pancreatitis.

You will note that I, and others, say "I changed this" or "I did that". I felt that I had to take over beau's care regarding the FD because he wasn't getting "better" - meaning regulated. I could see that he felt crappy and things needed to change. I can honestly say that FD is a home managed disease. You have to test at least twice a day and do curves where the cat is not stressed (at home versus the vet) in order to make dosing decisions. I think the owners need to have an understanding of dosing protocols so that they can make decisions - just as human diabetics do, or parents do for there diabetic children. But the keys to managing diabetes, in any species, is testing and diet. I still take him to the vet for his other health issues. Make no mistake: I love my vet!

It would be great if vets taught owners to test at home and stressed the importance of that and diet - real low carb foods, not "somewhat' low carb foods. It would also be helpful if the Alpha Trak meter and strips were a lower cost. I have used several types of meters and now use the Contour that I got free from Bayer. I find the strips for it a bit more expensive than the meters I have used, but it is very accurate and I can accept the price.

Thank you, Dr. Bragdon, for gathering this information and presenting it to vets.

PS - about the "pissed off cat"? Beau used to come for his test, get up on the table as I got supplies ready and purr the whole time. Treats (boiled chicken) is the key. It is a bonding time. He was jealous when I got Jeddie and started testing him "instead". Beau was already off insulin and didn't need testing all the time. Jeddie was not happy about being tested (I got bit very hard a few days after I got him), but he puts up with it, hardly struggles, sometimes is waiting for me, and loves his treats.

I adore my vet and use an entirely feline practice. They are committed to continuing education and state of the art technology. That said…

When my cat was diagnosed, she was hospitalized with DKA, pancreatitis, and hepatic lipidosis at a critical care hospital. The IM vet started Gabby on Humulin N, never instructed me how to give a shot nor was home testing ever mentioned. I was to bring my cat back for a curve 2 weeks later.

By the time I brought Gabby back to my own vet for a fructosamine level, I had started doing research and reading. I asked about home testing and my vet suggested we get Gabby under control and then think about my learning to home test. Both the IM vet and my vet had me feeding prescription food.

And then I found FDMB. Someone on the Health board made a comment for which I am forever grateful: “If this were a child, would you for a second even consider giving a shot of insulin without having tested first?” I turned off the computer and went to the nearest pharmacy and purchased a meter.

What I consistently see with people coming here is that it is the rare vet who actively encourages home testing. Rather, vets make statements to the effect that we will stress our cats out by testing, home testing and/or meters other than blood chemistry analyzers are inaccurate, one member was told by a vet that she suffered Munchausen by proxy given that she was testing, we test too much, we won’t know how to interpret the results, the information we get on-line is from a bunch of internet “crazies,” and the list goes on as do the horror stories. Spend some time reading on this Board and you will, most likely be both shocked and heart broken.

What many vets don’t do is give you their home phone number or have an emergency contact number so you have a resource if your cat has low numbers. Instead, the response is to take your cat to the ER. If you have followed any number of posts here or on any of the Insulin Support Group boards, low numbers are rarely allowed to reach the level of a hypoglycemic crisis. Why? Because we home test and have learned to manage those numbers with food. We’ve also seen that our cats need to spend time in lower ranges if their pancreas is to heal and they are not going to experience rebound and if we want to achieve diet control or tight regulation. The majority of vets are happy if cats stay in numbers under renal threshold. We know we can do better.

At the most cynical level, the aggressive endorsement of prescription food, most of which is higher in carbohydrates and lower in quality than commercially available food, the lack of consumer education in the use of home testing, and empowering caregivers by giving them the tools to manage their cats’ dosing, suggests that many veterinarians are only interested in their bottom line. If caregivers do not buy prescription food from their vet, do curves at home, and stop coming in for fructosamine levels, we cut into the profit margin. In a more generous vein, many people are afraid to home test and most vets do little to allay that fear.

I would hope that vets want to partner with us. Most of us read about feline diabetes. We share the research that is available. As a case in point, I e-mailed my vet the Roomp and Rand Lantus protocol. Several weeks later, when I brought Gabby in for an appointment, she told me that she wanted me to use a dosing protocol with Gabby and proceeded to tell me about the Tight Regulation Protocol. I had to remind her that I told her about it. It’s a dialogue. Many vets want to be the authority, yet aren’t there when your cat is running numbers in the 40s at 10:00 PM. The caregivers of diabetic cats need to have the tools to manage their cat’s diabetes and feel supported by their vet to do so.

I can honestly appreciate that vets can't be experts in every disease for every species of animal that they treat. It must be overwhelming. Directing their clients to reputable web resources would be to everyone's advantage.

Wow, Sienne ... I couldn't have said it better myself. You get a standing ovation for that write up!

I was told that I would kill my cat by home testing and taking dosing decisions into my own hands. Flat out - I would kill my cat. What a thing to say! Our specialist said that I was unnecessarily traumatizing my cat by testing and that keeping Oscar at and around 200 was optimal. How in the heck can a cat go into remission while staying around 200 ?!?! I feel that avoiding a potentially deadly hypo episode is extremely important, and cats can be trained to not mind home testing at all, just the same as they learn to take a pill when they are sick. Now that our foster kitty is starting an OTJ trial, my home town vet is singing my praises and telling me what good work I have done with him. Home testing is the absolute key when it comes to successfully getting a kitty into a strong remission. There is no other way to safely do it.

Just to add...
my cats don't get a treat at test time -- and they still come and jump up when it is test time. It is a friendly cuddle & petting time for us with no food until the meal is given a few minutes later after both cats have been tested.

My cat was diagnosed in October 2006. I had been going to the same clinic for 10+ years but that clinic had recently changed hands and the vets there were changing jobs faster than I changed my socks. When Mousie was diagnosed it was bring the cat in, run tests, take cat home while waiting for test results, then get the diagnosis. In the time it took for the test results to come in showing indeed she was diabetic, I spent hours researching and taking notes about feline diabetes.

I had read about home testing and it was one of my questions I asked the diagnosing vet at the time but he said we didn't need to worry about that right now. Mind you, he also started her on Humulin N insulin.

Three weeks later when she was lethargic, inappetant, and vomiting if she did eat, I called the vet. The staff was extremely non-chalant about her condition and did not think I needed to bring her in. Diabetes runs in my family and I knew something was wrong. It was at that time that I found this message board. I also discovered that I had a feline diabetes specialist right here in my town and was encouraged to call her. We decided that at the very least, our diabetic cat was going to see this new vet. She diagnosed Mousie with a urinary tract infection and told me we not only were going to fix that but we were also going to be proactive about Mousie's diabetes treatment. She told me "go get a Freestyle Flash and be here at 5:00 and we'll teach you how to take care of her."

There was no ifs, ands, or buts with this new vet. If your cat is diabetic and you are a client of hers, you home test, plain and simple. If you aren't willing to be completely hands on in the care of your cat's diabetes, find another vet. Fantastic! My kind of person. That vet and what she taught me along with the hundreds of friends I've made here over the years has allowed me to not only have a very healthy diabetic for nearly 4 years now but it has allowed me to help hundreds of others and their diabetic cats.

I ran what we call our Newbie Kit operation for awhile. We collect meters here thru donations & purchases, test strips, lancets, everything that is needed for hometesting and send them out to people who's animals are newly diagnosed. We consider it critical to the safety of our pets to have the ability to test their glucose levels at a moment's notice when needed and to monitor them daily. For me, there's no ifs, ands, or buts about it. Hometesting equals saving your pet's life in my eyes.

Mind you, in the time I ran the Newbie Kit operation, I sent out over 300 test kits and not a one was the Alpha Trak. Why? Because people don't have them to donate. They are expensive and the availability of the test strips make them too difficult to use. Can you imagine being the owner of a diabetic cat in Cincinnati, Ia and the cat starts acting oddly at 11:24 pm on a Saturday night? You test your cat and find that his glucose level is at 32. You realize kitty is going into hypoglycemia. You intervene as you know how to do or are instructed to do by people here because there is no 24 hour ER in Cincinnati, IA. But you only have 4 test strips left for your Alpha Trak meter. Where are you going to send your husband to to get some more test strips so you can monitor and hopefully save your cat's life in the middle of the night? There's nowhere to go.

But if you have a Freestyle Lite or a One Touch Ultra or a Relion or a Contour meter, your husband can run into town to Walmart and get some test strips whenever you want, middle of the day, middle of the night or whenever. Or, for that matter, you could probably call your friend Susan down the road and borrow some from her since she's diabetic and has the Freestyle Lite also.

If your goal is to promote the Alpha Trak in your presentation, Abbott needs to make it marketable. And at the price and availability of it now, it is simply not marketable to alot of pet owners. Hometesting is critical to the care of a diabetic pet but if it is so far out of touch with today's economy, you will have more people putting their pets to sleep than treating them for a disease that can be so simply managed.

Your Freestyle line of meters are virtually the same thing. Why can you make the Freestyle meters affordable but not the Alpha Trak? I am a business owner and understand and appreciate profit and loss and all that gobblygook. But know that selling one Alpha Trak and making $50 profit on it is not the same nor is it better than selling 10 of them and making $5 profit on each one. You can have one person buying strips until they realize they can't afford them or you can have 10 people buying strips regularly because it is all affordable. Big picture.

I recently handed the Newbie Kit operation over to another member here, lori and tom. I'm sure she'd gladly send out Alpha Trak meters in the starter kits if she had some to send out. ;-)

Thank you so very much for asking for our input on this. You will not find another group as dedicated to caring for diabetic pets as you will find here. The experience and knowledge levels here are astounding. Abbott and other diabetic supply companies could and should learn a lot from the men and women here.

Cindy

Hello Dr. Bragdon,

Thank you for coming to us and asking our opinions on these very important matters. Veterinary education on the daily management of diabetic cats is, as you can tell, near and dear to the hearts of many here.

I won't tell you about my personal experiences with my diabetic cats because I can't add to the well-stated comments of those who already have posted. But I do want to bring a different perspective to your thinking.

I coordinate an Internet rescue called Diabetic Cats in Need (DCIN). The mission of this rescue is to support diabetic cats in their original homes, rehome unwanted diabetic cats, and educate caregivers on the appropriate treatment of diabetic cats. I organized DCIN because I perceived a need to coordinate the efforts that many were making on this Board to find an alternative to the euthanasia of individual cats for the sole reason that they had developed diabetes.

I receive on average three or four contacts a week concerning a diabetic cat in need. Sometimes it is a vet's office, shelter, or rescue that has had a diabetic cat surrendered because the owners could not or would not treat the diabetes. Sometimes I am not told the reason for the surrender, and sometimes I am told that the reason given is that treatment would be too complicated or too expensive for the owners.

Sometimes I (and the cat) am fortunate enough to be contacted before the surrender and am able to speak directly with the owners. Too, too many times, no one has explained to the owners the nature of the disease and its appropriate treatment. Much of the lack of information is the same as that cited above. In today's economy, frugality is key. I teach these owners that a low carbohydrate commercial wet food selected with the help of Janet and Binky's food chart is better for their cats' diabetes treatment than the much more expensive wet or dry prescription food available from the vet. I teach them how a long-lasting human insulin like Lantus or Levemir can be an economical and effective choice. (However, I also find BCP's PZI also to be a good choice on a budget.) I teach them that a glucometer is the first best tool that they can have to get their cat healthy again and to keep it healthy. Again, because of frugality, I recommend Walmart's Relion or the Maxima glucometer systems. Too often, these owners had been told that the cat would have to return to the vet's office quite often for spot checks and insulin curves that would cost on average $25/test.

The very real financial burden of the vets' treatment plans, on top of the emotional burden of finding that their sick cats have a disease that they often didn't even know cats could get, often leaves the owners in an unmanageable position. They are distressed at the thought of euthanizing the cat, so they turn to surrender, not fully aware that the end game likely will be euthanasia in the hands of strangers after a period of stress and terror for the cats, perhaps even diminished health due to nontreatment or mistreatment of the diabetes or exposure to communicable diseases.

Perhaps the first best thing vets could tell owners is that diabetes is not a death sentence, that the cats can have a natural lifespan, and that an overwhelming number of cats become diet controlled and do not need insulin for the rest of their lives. I cannot recall a single owner I have spoken to knowing on first contact that remission was a possibility. I am happy to say that DCIN has been successful at helping to keep a number of diabetic cats in their original homes, and some of those cats are now diet controlled. Often, that outcome has required assistance from DCIN in providing insulin and other diabetic supplies, almost all of which were donated by or financed by donations from the big hearted members of this Board.

I am glad that Abbott has taken an interest in the cause of diabetic cats and dogs. However, I have no illusions that that interest is anything other than a business decision with a focus on the bottom line. There may indeed be a precision benefit to an animal calibrated meter; we had an extensive discussion about that here just within the past couple of weeks. Given that cost is a life-deciding factor for many diabetic cats, home monitoring is key to minimizing vet costs but, unfortunately, the AlphaTrak cannot at its present pricing be a part of a plan for "frugal feline diabetes."

I agree w/ Kelley, Sienne laid it all out and then some

My experience? A vet who sold me an insulin that had had a FDA warning out on it for months, and had just been recommended to stop use by the mfg., triple priced syringed, "diabetic" cat food that had triple the carbs any cat should eat and dry is fine! No mention of home testing. From experience w/ a CRF cat I knew there was a lot of good info on the web. This site was at the top of the Google search. By the time I had absorbed a fraction of the information available, the vet was closed for the weekend! Saturday I went out and bought a meter and started testing, by Monday morning I had read a whole lot more, was getting some good tests and fired the vet.

Testing and diet, those are the keys to treating diabetes.

I know that vets have a lot of different animals to learn about, a lot of diseases to study and trauma to learn about. But cats are now the most numerous pets in the country. I'm tired of the attitude that you really have to take care of dogs, but cats will be OK. I want my vet to understand the proper nutrition must be the basis of care for all their patients. If they learn that there will be a lot less disease for them to deal with. Estimates are that 1 in 50 to 1 in 200 cats in the US are diabetic, a disease that was virtually unheard of in cats before it was realized that profit could be made from commercial cat foods.

I too would have much more confidence in a vet who didn't know and admitted it, but was willing to learn, than in someone who tried to act as he knew everything. That is impossible. If we can learn from books the internet and each other, vets can continue to learn too. They have many resources unavailable to us to turn to when a patient presents with a problem they are, as yet, unfamiliar with.

As for the Alpha Track, once again it is just too expensive. The price would prevent many from starting to home test, the price of the strips would limit the amount of testing many could do. My strips are a third the price, that means I can test that many more times and have that much more data to help Tess go into remission. Your company makes a very good human meter that many here use. I know that because of more limited demand the AlphaTrack is more costly to produce, but the difference in results does not make it any more desirable to use from our point of view so why would we suffer the added expense. Moreover, the protocols which we use for tight regulation were developed using human meters and all the ranges need to be altered to be suited to the Alpha Track.

Hello Dr. B,

Glad to hear that you are interested in what the clients and patients are experiencing and needing.

I have a great Vet who encouraged me to home test, recommended a change in diet and gave me his email address as well as cell phone number. However, I really have learned the most about treating diabetes from the board here. Tips, tricks and techniques provided by the folks here have been a godsend. While my Vet can guide me on occasion, I can't expect an immediate return call from him when I have a question that needs to be answered immediately or late at night. I'm also aware that most of his patients/clients don't go to same extremes in the care of their cats as do the folks here on this board. Cat owners are a special group of people. I'm also aware that Vets might be hesitant to endorse and encourage shooting low numbers due to liability issues even if they are aware that we are testing at home. They can't control what we do at home and many I suspect don't want to be held responsible for any mishaps. Vets tend to give general information that most of their clients can handle without consideration for those of us who want to go the extra mile in terms of taking care of their diabetic cats. So I don't think patients and clients are getting enough reliable and detailed information about diabetes management from their Vets. The Vets might need two protocols for dealing w/clients...(1) For the "typical" client who can't home test (2) For clients who want to learn about diabetes, home test, are eager to get their cats well regulated and evidently off the insulin.

I appreciate you taking the time to hear from this special group of cat lovers. Hope we just didn't give you an ear full, but provided you with some insight to our needs, wants and wishes in terms of treating feline diabetes.

Hello, Dr. Bragdon,

My first experiences with a diabetic cat came in January of 2006. My cat, Charcoal, was almost 11 years old at that time. I noticed how much weight he was losing, drinking a lot, etc. and suddenly had hind leg neuropathy. I was very frightened, not knowing that these were signs of a disease like diabetes.

The first vet that saw him, came to my house, as Charcoal was a very scared cat, and we had to practically dig him out from behind my sofa.

The vet tested his blood, and examined him, and called me the next day to let me know his blood glucose was over 400 and that he was diabetic. I was adamant at the time about NOT giving him insulin, nor testing him, etc. Mainly because I knew nothing about cats having diabetes. So, I let my poor boy suffer for 2 months, before I finally realized it was either treat him, or put him down. I chose to try to treat him. My vet and another friend from this site advised me to read all about diabetes on the FDMB site here, which is what I did.

He was on PZI insulin, and I used several different monitors over the years. My vet thought I was goofy though, when I showed her how I was keeping a log on his blood glucose tests (I tested his ear). She said I just needed to test once in a while, and give him a steady dose of one unit twice a day of insulin. Well, I just could not shoot insulin blindly, without testing, so I kept up with my log.

Charcoal started gaining weight again and had less trouble walking. I treated him for 3 years, until he died last March 12, 2009.

In October of 2006, my Rudder, a very large male, 11 years old, started drinking a lot and I started him on PZI after he was examined and tested and found to be diabetic.

My thing that I would like my vets to learn and understand is how terrible it is to think that cats can thrive on Hills' W/D dry food, as this is what my other vet I had was prescribing for my Rudder, due to urinary problems. He ate that like candy, as did Charcoal and my other cats, but so far, they were the only two that developed diabetes.

Rudder died last July 23, 2009 from what most likely was microscopic intestinal cancer, but I treated him for almost 3 years with PZI insulin. He was just a week shy of 14 years old.

The one really important thing I learned through all of this, was that diabetes in cats is treatable, but not only that, this website has taught me so much about diabetes, that I now realize that I have learned to feed my cats better foods, and I also still check my remaining cats' blood glucose every couple of months or so. None of them mind their ears being pricked.

My husband died 5 years ago, from a lot of disease processes, but Diabetes was what I believe killed him in the end. I only wish I had known then what I later learned from treating my cats with diabetes.

Checking my cats' blood, and shooting insulin got to be so easy, that I could test and shoot in a matter of a few minutes. My cats would come to me like little dogs when I called them for their test and shot. SO, I hate when I hear some people say they could never test their cat's ears because it would be horrible and painful.

My other vet I take my cats to, who was the one that euthanized both Charcoal and Rudder, was always amazed at my record keeping, and he remarked that he wished more of his clients would learn and do the same thing that I was doing.

Diabetes is a disease to me that is easier to treat in cats, than another disease that I have dealt with, and that is Interstitial Idiopathic Cystitis. I lost a 5 year old cat last year, and I now have a female I treat that has it. My vet has said that Diabetes is much easier to treat and control than that disease. Just thought I would mention that.

Thank you for doing this study.

Dr. B,

I appreciate your coming to this site to ask real cat lovers taking care of their diabetic kitties through home testing. To me, that shows something many vets seem to lack: respect for the animal's "owner" (my kitty owns me, actually).

Here's my truth:

I too nearly lost my kitty following a vet's poor advice. The directions for administering Lantus were simply wrong. The dosing nearly killed him -- way too high, once daily, no home testing. The feeding advice was wrong, too -- "diabetic" formula kibble. He meant well, but he didn't know enough.

Thanks to the support and knowledge I gained here, my kitty is now in remission, after 15 months on insulin.

So here's what I'd love you to tell vets:

1. Either upgrade your knowledge about feline diabetes, or send the cat to a specialist. There's no excuse for giving bad information based on ignorance. Maybe your company could sponsor continuing education credits on FD!
2. Empower and train your client to home test.
3. Learn something about nutrition! If you're dependent on selling product, then for heaven's sake, sell healthier product.

As for the Alpha Trak, provide a home line with widely available and affordable strips.

Again, I appreciate your reaching out to us. This site is evidence that have the motivation to treat feline diabetes successfully!

Dr. B,
It does'nt appear you will get much support for the alpha track here. The only unfortunate part of this fact is that your product is not the important factor for us, the overall care for out cats is. I wish all vets would have access to our site...as a support to work with the vet not against the vet. All clients of the vet who have a diabetic cat should be sent here. That would be the most humane thing to do since we are a 24/7 operation, world wide and nobody is ever alone with an emergency situation.
You see that we generously help each other, pass around what others may need, and the one thing that every single one of us has in common is a LOVE for our cats and dare I say...it's true, each other's cats.
We are an amazing group. We arrive at a newbie's home at times arms filled with equipement and toys and a food list. We sometimes spread the word if someone lives close to another member. We have babysat for each other's cats. If you watch us in action during an emergency 'near' hypo you will see many of us stay up half the night until the newbie and cat are stable. We have cried at the passing of another's kitty whom we've all grown to know and love. We have sent money to a person in crisis with their cat.
We call it paying it forward, we take no profits, we are tireless in our finer moments.
It's hard for a manufacturing company to compete with this...they can only understand that unless they make an affordable product with available strips we may encourage it's use.
send it to me, heck, send me several. I do the newbie kits. Sent out 33 this summer alone.
If you have a product we can actually promote in good faith you can bet we will promote it.
Lori
Newbie kits.
Given the priviledge when Cindy and Mousie decided to pass it on.

Welcome Dr. Bragdon,

Just to get this common comment first and out of the way and then go from there
-- the Alpha TRAK meter and strips are waaay too expensive for most cat owners. There are much less expensive human meters and strips that work just as well. maybe better. As long as your system costs more to use than human meters and strips, it will never be promoted by experienced (non vet) feline diabetes caregivers for use. (and many savvy vets as well)

From my reading posts on this board, I have sadly read of vets *pushing* this meter on clients and insisting that human meters are not accurate enough.(not true) One even refused to treat the kitty if they used a human meter. This is reprehensible. It seems they are either ignorant or their bottom line is more important than their patients care. I do not grudge a corporation or vet or any business from making a profit.
But the price difference and convenience and availability of buying AT strips as has been noted by others, is way out of line w/ the market for meters and strips in general. In fact w/ Abbott's own Freestyle meters. ;-) Gee I got one free w/ a coupon !

So..... the first thing I would want a vet to know about home testing is that there is a wide variety of products available to test a cat or dog or ferret . A person needs to find a system they can afford. The strips are the pricey part. so that needs to be a very big factor in selecting a meter. ( Optimally, on this board, we like to test before every shot, spot checks, mini curves and the occasional full curve)

I would like vets to make sure the client knows that it can be affordable to treat feline diabetes.
That it is a treatable disease. That it is not a death sentence for their cat. That cats live long normal healthy happy lives with FD. That while it may be overwhelming to clients in the beginning, they will support their client to learn to help their cat.
That it takes less time then you think in the beginning. That once they get it down, it will not take more than a couple minutes to test and shoot. That they will not have to give up their own active lifestyle in order to home test and treat . ( I think that's a biggie for some )
In other words -- to promote treatment and home testing for this disease in a cost effective way.

They might even mention, that @ 2/3 of cats dx'd will go into remission by either diet change alone ( low carb canned) or a combo of diet and a course of insulin. That treatment and close monitoring of their pet may reap great rewards. ( and to note that if changing dieting home testing is most important as insulin needs will change) While we do not stress remission as the goal here, it is something that is hoped for and happens when an owner commits to following set protocols which includes much home testing. (and again cost of meter and strips factors into this.)

I would like vets to promote the idea that they are partners w/ the client for their pets care plan.
That they will listen to them and rely on them to do the testing. That they will go over numbers
( most folks here keep a nice spreadsheet so it is easy for them and their vets to see what is going on w/ their pet)
To express that the best way to keep vet costs down is by home testing.
(my vet has said she doesn't understand why any vet wouldn't want home testing. It just makes more work for her if someone doesn't test ! and of course, is better for the cat)
That cats are less stressed to have testing down at home( and most no stress once they get used to it), so numbers are more accurate.

That testing a cat's ear will not hurt their ears. gee for as many pokes as I gave Winnie her ears were just fine ! and no, testing did not stress her. she got treats and extra TLC. I even had a specialist tell me that frequent testing was too stressful and would her ears. bah! Lucky I knew better. I see too many newbies come on board that have been told that or told that any testing was too painful and stressful for a cat. wrong. I hope that myth can be corrected. Of course I must add that we do have a saying on the board :
ECID ( Every Cat Is Different) so there are exceptions. more likely to the stress part . ( but *most* are still able to be tested)
and some have found that if a particular cat's ear doesn't bleed well or the cat really doesn't like it for whatever reason (rare) that paw testing is a good alternative.

My own experience..... I was lucky. My vet presented me with home testing from day one and presented it as the norm. She told me to go to the drugstore and just pick whatever one took a low blood sample w/ *sipping* strips and was free w/ rebate. She also gave me the link to this site ! I was surprised when I got here 5 years ago, that this was the exception and not the rule. It seems like it still is. :sad:
My vet complains that the biggest hurdle is to get patients to comply. On this board, we tend to sometimes forget that we are not the average pet owner. Some are too afraid to test. I think the suggestion to come here is great. I do think that more clients might comply if my vet had a local diabetes clinic meeting every now and then, say one evening every couple months or so.. to go over the basics for newbies in person. and to let those who have been testing share experience hands on. Really what this gets back to is alleviating fear of not only home testing, but of the fear of someone's life being too disrupted . ( and again, it needs to be presented as affordable, so that caregivers can comply. Your system currently does not fit in that picture )

And as far as my experience with my sugar kitty Winnie. As with many others, it did bring us closer.
She even knew to tell me when she was low and to test her ! She had a special in your face meow for that.
would even wake me up if needed. She had multiple health issues and was on dexamethasone-- all of which effected her BG. We shot around that. The dex effect for her was rather predictable. ( I have pre insulin curves of her on dex)
But her other health issues made her more unpredictable than most kitties. so I tested a lot.
I think that is something else we stress on the board. That health conditions must be prioritized.
If your cat needs a treatment or med that will effect it's BG insulin can be adjusted. Steroids, when necessary can sometimes actually make BG values better --- by resolving/controlling an underlying health condition that was causing BGs to be elevated.
Again. Home testing is the best tool to carefully monitor such situations. ( and again you can see why cost is such an important factor, in order for pet owners to do this)

Thank you for coming to the board and asking our input. I wish we could be more enthusiastic about your product. Perhaps our input will help to change the way the AT system is sold and priced.

Please feel free to hang out and check out what is going on around the board. It's a great place for vets to learn too !


Best,

Where to start?

My former vet actually forbade me from home testing. Then said if I insist on it the only way she would allow it and treat Maui is if I used alphatrak. I contacted abbpott and spoke with one oif the doctors that make alpha to better understand the product and why I should choose it over a human meter.

The reasons he provided while very technical were not practical for my wallet and being forced to work with Mauis vet.

Additionally vet education is critical Maui was a steriod induced diabetic and sadly vets use steroids as a way to treat the sytmptoms and not the problem. All her life Maui had skin issues instead of looking at allergens (in Mauis case it was dry food) this vet gave steroid shots. It wasn't until the fd and my coming here that I learned how bad dry food is for cats.

My catss only eat low carb canned and homemade raw food and Maui hasn't had a skin issue since.

Vets are also sold on prescription food and dry food and many of us have learned how that is not what a cat needs.

My new vet and I don't discuss food as she doesn't understand but she does encourage home testing and will work with the client to make sure they have enough information and can test and shoot.

So in your presentation please address the importance of a species appropriate diet, home testing, proper insulin, dosage and timing and how other factors such as steroids can cause or contribute to diabetes.

I forgot to add that many of us are well educated and have done research on this subject so when we ask the vet questions, please don't treat us with disdain and disrespect. Please be open to our questions and concerns and partner with us in this process.

My former vets got angry when I asked questions and questioned their treatment process.

We need a partner not an adversary in this process and the vet is not always right. As someone else pointed out it is ok to say I dont know. It is not ok to be totally rigoid and the vet's way is the only way.

This former vet insisted on keeping Maui for a week to "regulate" her. Additonally she insisted on shooting insulin in 8 hour increments why? Not beacause it was protocol rather that the office was closing and she wanted to get the shot in before leaving. When I said no, the vet told me it was my fault for bringing her in so late in the morning. That they could not shoot 12/12.

With the support of this board, I took her home and found a new vet.

In addition to the diabetes related information already posted I would like my vet to know the following:

1. It is vital to keep up with new developments in treatment and using VIN ought to be mandatory. Ignorance is the most often seen complaint on this and other cat health fora.

2. Stop pushing annual vaccinations. Aside from the dangers of VAS it has been shown that the vaccine titers last for many years. See Item 1.

3. Use diagnostic tests before prescribing any antibiotics, we and our cats are being overdosed and that is leading to resistant bacteria. And please remind vets that antibiotics don't do a thing against a virus.

4. Listen. Repeat, listen. Pet owners have information that too many vets are in too much of a hurry to hear. This is dangerous for the treatment of the pet and disastrous as far as client trust is concerned, it is deeply disrespectful.

5. Learn about nutrition and stop pushing the inferior quality so-called 'prescription' foods. It's time to realize that the health of your animal patients is more important than your food concession profit center. We call dry food kitty crack and Science Death for a reason.

6. Use specialists more often. Admit you don't know everything.

I think almost everything I would say has been said, but would like to add that anything you learn from us, your clients, doesnt go away when we leave your office. Use what you learned for other clients! I do generally like my vet but the office will not let me post info about the FDMB on the bulletin board, and to my knowledge does not mention it. This despite my success getting my Merlyn off insulin.

Clients need ALL the information to make informed decisions about caring for our pets. No one is saying clients need to be FORCED to hometest, but not mentioning it at all is criminal.

Human diabetes is a self managed disease. No one would tell a human diabetic to drop by the office once a week for a glucose check and not hometest. Feline diabetes can not be managed in an office environment. Regulation/proper dose can not be found at the vet office after a few days. Clients need to be supported and empowered to learn as much as possible so they can handle the BG ups and downs at home.

I feel that by developing the Alpha Trak, at least you have made some vets aware of hometesting. But I think some other vets simply jumped on the hometesting bandwagon when they realized they could make money off it. This may have been an anomaly but we had one board member whose vet was RENTING the Alpha Trak and selling strips at an outrageous price.

I too thank you for asking our opinion!

adding that a favorite saying around here a few years back was:
giving insulin without testing blood glucose is like trying to drive with a paper bag over your head. :mrgreen:

I am so happy that Dr. Bragdon has come to us for opinions! I did warn her, though, that we are a VERY opinionated bunch! LOL!

Of course, Dr. Bragdon has the literary references for veterinary journal articles recommending home testing but isn't it great she is talking to us front line pet owners, too! I really appreciate all the responses you are giving her.

Hugs,
Rebecca
Webmaster

Even though my vet does support hometesting, surprisingly they keep trying to tell me that I do not need to test before every shot. I have even had this response even after I had shown them weeks of data that showed that both of my diabetic cats experience BG readings way too low to shoot (usually in the 50's) at least once a week. If I had given insulin at that time, my cats would have become hypoglycemic and possibly died.

I have had a total of four diabetic cats, two of which I adopted knowing they are diabetic, and have hometested before every shot for all of them. My vets have learned that even though they say I should not test before every shot, I am the one who has final say so in my cats' care and I am going to do what I feel is best for them. That means that I will test before every shot - no exceptions.

My experience was similar to that of many others who have already posted. My vet did not mention hometesting, and had us come in to do "spot checks" of her fasting glucose every couple of weeks. And not once did he ever even attempt to do a BG curve (much less have me do one). I went almost a year "shooting blind" and putting poor Motska through several hypo episodes. Additionally, he had me purchase "prescription" dry food for her. All of these things are VERY wrong and very expensive!!!

Once I found about this message board, learned to hometest, and switched to low-carb canned; I shared (or tried to share) this information with my vet. He looked at me as if I had grown a second head!!! Just because he is a vet and I am not, does not mean that I am completely ignorant of all things medical or veterinary. If I could have afforded the cost of switching to a new vet (new bloodwork, etc.), I would have done it immediately!

I know that all of these problems have already been shared with you, but I would suggest also emphasizing the effect that "white-coat syndrome" can have on a cat's glucose levels -- possibly raising it 100 points or more, depending on the cat. Motska is NEVER over 350 at home -- and even a reading that high is extremely rare. But she can easily get readings over 450 at the vet's, and yet he insists that it is not possible for her fear and stress to raise her BG that much -- that the readings I get from my ReliOn meter must be very wrong. Based solely on the fasting BG numbers he was getting from her in the office, he had her up to 3.5 units BID. If I had blindly followed his advise, Motska would be dead by now. Instead, she is healthy and happy and her dosage is down to .2 to .6 units BID.

Dr. B

I would like to tell you about what happens to a kitty that isn't home tested, or at least one cat that was not. My darling Muse was laid to rest 3 months ago tomorrow, and all for the want of test strips. I have a wonderful vet now but it wasn't that way when Muse first became ill. My old vet tells me that her weight loss was because she was old, and would not even consider testing her for diabetes, then when I finally insisted and it was discovered I was correct, his answer was might as well put her to sleep she is old and not worth the expense to treat! So I packed up my kitty and never darkened his doorstep again. It took awhile but we found a terrific vet that not only encouraged us to change her diet but about home testing, our only problem was that both my husband and I were unemployed so cost was a factor for us. Our lovely vet loaned us her Alpha Trax meter and some test strips to get us by until we could get a home meter for ourselves. The only problem with that was that when we brought Muse home from the Vet's it was over a long holiday weekend and the vet was going to be closed until Wednesday of the following week. Well since Muse was on Humilin N her numbers were all over the place and being a nervous momma I was checking her a lot those first few days, so we ran out of strips on Sunday night. Now had it been a human meter I could have just run out and got some from the local drug store, unfortunately that wasn't the case. So I had to just shoot blind and pray.

This turned out to be deadly for my Muse, she hypo-ed over night and passed away, all because I didn't have a way to access something as simple as a test strip.

Things I want my vet to know:

I'm not a child or stupid please don't talk to me like I am.

You may have gone to school for 8 years to be a vet, I have lived day in and day out with this animal for almost that many years. I KNOW my animal. Regardless of what the books say is normal I know if it is normal or not for my animal.(My Old vet told me when I got worried that Muse wasn't as vocal as before that Himmie's don't talk much, maybe Himmie's as a rule don't but Muse was a talker)

Trust me to do what is best for my baby, I'll tell you if I can't do what you are asking of me. (One of the most endearing features of my new vet is she asks are you comfortable being able to do this or that for my remaining cats.)

Other than that I think everyone else has covered the major points.

Mel

Dr. B,

Can you tell us when/where you will be making your presentation? I (and, I'm sure, many of the other members) would love to be able to inform our vets -- in case one (or hopefully, several) of them is motivated to attend. Or if not, would there would be some way to get transcripts, or other information that you'll be providing?

Again, thank you for taking an interest in our beloved sugarcats!!

Kris

I for one would love to hear what Dr. B. thinks of all this we have thrown out at her.
It must be alot to swallow our not so well hidden resentments, our dissapointments, our lack of faith in our vets at times. Well deserved I might add.
Coming from the perspective of a Veterinarian I would love to hear your feed back. And I hope you won't take our issue's personally. These were our experiences. I almost wish and pray that after hearing us you go back into practice and specialize in feline diabetes :mrgreen: Then we could totally support you and your endeavors. I do realize medicine is a business. But 'do no harm' is the first order of the day.
Lori and tomtom

Lisa and Merlyn (GA) said:

<snip>

I feel that by developing the Alpha Trak, at least you have made some vets aware of hometesting. But I think some other vets simply jumped on the hometesting bandwagon when they realized they could make money off it. This may have been an anomaly but we had one board member whose vet was RENTING the Alpha Trak and selling strips at an outrageous price.

I too thank you for asking our opinion!

Click to expand...

Lisa, you make a good point that I would like to reiterate. although I was very loud in my post about AT meter/strips being out of line in cost for practical use. I do agree with her that it is a BIG deal that your company recognized the importance of home testing pets w/ DM, and by selling the AT, that alone has gone a long way to inform vets about home testing. And it sounds like you want to include education on FD to boot. Thank you . I hope you continue to do so....... and with an affordable system of course ;-)

Grrr.... I forgot about that poor person whose vet had her renting the AT. :-x

welcome to the fdmb, dr. b!

i won't reiterate the afford-ability factor of the alpha trak. the point has been made. a few years ago, i was fortunate to have had an opportunity to compare results (on my kitty, in my own home) between the alpha trak meter and my own freestyle meter. while the difference at higher numbers was greater, the difference at numbers less than 100 was minor... within a few points. frankly, precision accuracy at higher numbers doesn't concern me much. as the one behind the syringe poised to inject, it's those low numbers that concern me the most. i find my freestyle and freestyle flash "human" meters reliable, affordable, and as accurate as i need them to be when practicing tight regulation.

as far as my personal experience with home monitoring and the assistance my vet did or didn't provide...
i must preface my comments by saying i love my vet! during a scheduled appointment, he never acts rushed or appears to be in any hurry to get onto the next appointment. he'll spend as much time with me as it takes for me to ask questions, receive answers, and feel comfortable with decisions made. he listens and he's open to discussion. he respects me and i respect him. he doesn't charge an arm and a leg for every procedure. if he doesn't know something, he admits it... and is willing to research and/or refer me to a specialist. in the case of an emergency, his cell phone number is given if you call his practice after hours. what's not to love about this guy!

when alex was diagnosed with diabetes a little over 4 years ago, i was

• told diabetes is not a death sentence
• given a prescription for a vial of lantus
• told to shoot 1 unit every 12 hours
• shown where to inject and received an injection demo
• instructed to rub karo on her gums if she acted strangely
• sent home with cans and a bag of Hill's Prescription M/D
• told to come back in a week to have a curve done in the vet's office
• told the goal was to keep her blood glucose numbers in the 200 - 300 range

that's it. no mention of hometesting. no mention of signs of a hypoglycemic event. no mention of possible remission.

unfortunately, her blood must not have been checked for ketones because as the day wore on she became extremely lethargic and refused to eat anything. the next morning i had her back at the vet's office. she was diagnosed with diabetic ketoacidosis and spent the next week hospitalized for treatment. much to my surprise, she recovered beautifully. we went home and proceeded to administer 1u of lantus bid for the next week.

it was during this week that i found the fdmb. i couldn't believe all the information available! it was here i learned you could test kitty's blood sugar at home. who knew! well, it was a good thing i learned about hometesting because when i took alex back the following week for a blood glucose curve it was a complete failure. four vets and a couple of vet techs could not test alex. she would not let them get near her despite multiple attempts throughout the day. they called me. the sweet, mild mannered little kitty i knew at home evidently turned into cujo kitty in the vet's office!
right then and there, i KNEW i had to learn to test alex at home.

that evening, on my way back to the vet's office to pick alex up, i stopped at a drugstore and purchased a freestyle meter kit. i walked into my vet's office, meter in hand, and asked them to show me how to use it. i was told i could not use a human meter... was told i had to get a "special" meter designed for use with animals and that they were very expensive. hmmm... okay. i thanked them and left.

i came home. it didn't take long that night to find several hometesting video demonstrations on the internet. read the instruction booklet which came with the meter from cover to cover. practiced testing on my guinea pig husband. took a deep breath and tested the cat! it was a success! i did it... on the first try! yaaay me! i felt empowered. i could manage my cat's diabetes!

learning to test blood sugar levels at home was only the beginning of our journey. knowing the basics of feline nutrition and learning the importance of a high protein - low carb diet in the treatment of feline diabetes came next. learning how to use the "new" long-lasting insulins followed. we now know it's possible for 83% - 84% of cats started on a tight regulation protocol with lantus (glargine) or levemir (detemir) within six months of diagnosis go into remission. imho, not only is hometesting essential for those who wish to pursue remission using tight regulation, but it's the only way to feel like you're keeping your kitty safe when administering insulin no matter what your goal.

after a short stint on insulin and a diet change, alex was in remission for almost 3 years before other health issues put her back on insulin. i continued to test her monthly while in remission. hometesting has not damaged her or her ears in any way, shape, or form. her data is linked below. you can see she's tested a lot! to this day she willingly hops onto her testing spot when called (sans treats) to "test her bg's". my vet is in awe. now he understands the benefits of hometesting and diet in the treatment of feline diabetes.

my vet and i both learned and became partners through this experience. i hope your presentation will convey this possibility to other vets.
thank you for the opportunity to provide some input.
good luck with your endeavor...

I just wish vets would at least send new clients to FDMB. At least here we can promote home testing, answer questions no matter what the hour, help a person going through a hypo with their kitty in the middle of the night with no ER around, and help educate the owners on info their vet has never given them. Not all live in a big city.......many are rural.....and this board is always awake and ready to help.

Hello Dr. B;

I am very fortunately familiar with treating diabetes in humans, dogs, and cats, so that saved me from a lot of "first time diagnoses fear". My Dad is a type II diabetic, my niece a type I diabetic, my Mom was a diabetic educator for many years at Childrens' Medical Center in Dallas, and they also has a diabetic Schnauzer, named Annabelle. I am hypoglycemic.

When my Stormy Blue, (now age 14), became a steroid induced diabetic 20 months ago, I was sent home with a bottle of Vestulin and advised to administer 2 units BID. At the time, Stormy Blue weighed just under 5lbs and was positively skeletal. When I asked if he should be on a special diet, I was steered to Hills W/D, but advised that he could continue to eat his Purina Indoor Cat Food with no problems.

When I opined that Stormy Blue should be placed on an IV of LR as I felt he was dehydrated due to the excessive urination and vomiting, the vet stated, and I quote: "Be prepared to have a crisis with him in the first couple of weeks. All new diabetics have a crisis until they become used to the insulin". I guess I must have had a blank look on my face, because he repeated it - twice over. I asked again about admitting Stormy Blue for fluids and was told to take him to the ER vet if he needed them overnight as this particular office was closing in under an hour. I was given no advice about home monitoring. It was never suggested to me. I was not advised about potential hypos, (fortunately I was aware of the possibility with my experience), nor how to treat one should it occur in a cat. That night, Stormy Blue wound up at the ER vet due to complications from dehydration. He was hospitalized for two days afterward and the bill was over $2,000.00.

While Stormy Blue was in the hospital, I went out and purchased low carb canned food that I felt was suitable for diabetics. And another box of strips that matched my own personal meter - the TrueTrak. Humans I knew how to test - dogs, too, cats? I could learn. I did learn with the help of a youtube video. And no, no vet ever tried to teach me how to do it, nor was I advised to have a "no shoot number" with insulin. I learned by the seat of my pants, it sort of felt like flying blind, most times. I used the Vetsulin for a month, and then switched over to Lantus as my Mother gave me a spare cartridge of it after the Vetsulin crapped out. I made a lot of mistakes at first, but I had Stormy Blue off of insulin and diet controlled within 6 weeks of his diagnoses. He did have some instances of hypoglycemia there toward the end of his being on insulin, but he made it thru and now, has normal numbers so long as he eats nothing over 5% in carb value. His previous vet tried to tell me that Stormy Blue is no longer a diabetic because he is no longer on insulin. I told her that is not true - that he is a diet controlled diabetic, but he will ALWAYS be a diabetic and I will ALWAYS have to keep him on low carb food if there is to be hope of keeping him off of insulin. And yes, Stormy Blue has tested this assertion of mine by stealing a high carb nosh, now and again, (he stole a bagel once, tore into the bread a couple of times, and even stole a few bits of dog kibble - all instances resulted in his BGL shooting over 500 until the carbs cleared his body).

So, I guess what I would want ALL veterinarians to know is the following:

Give the people who come into your office with a diabetic animal an EDUCATION about how to treat this disease. If you do not have that knowledge yourself, then refer them to someone who does. If that referral is to an internet board, so be it. FDMB is a Godsend to so many people. The wealth of knowledge on here in treating diabetes, (and many other illnesses), is staggering. It is not a shame for a vet to say they are not an expert in any area, but that they sure point you in a direction to get you some more help!

DON'T treat people as if they are idiots incapable of dealing with a chronic illness in a beloved pet. People need to feel as if you are their partner in treating their beloved furbaby's illness - not their boss. Telling someone that they have to do it the vet's way, or the highway is a sure fire way of losing a client.

STOP pushing high carb "RX foods" as the appropriate diet for a diabetic. Those foods are, many times, what CAUSED a cat to become a diabetic.
There are many, much better, less expensive alternative foods for diabetics available at the local grocery store.

Be open to learning what your client can teach YOU about dealing with a chronic illness in a pet. They have been, after all, caring for that sick animal day in and day out - sometimes for YEARS - and when you are dealing constantly with an illness like that, you tend to become an expert at it. LISTEN to them and learn from them and pass that knowledge onto the next patient that comes in with the same disease....



Thanks for listening!

~M

I've had two diabetic cats. Peaches was dx'd when she was 8 years old. For four years she was on humulin U insulin. I loved my vet at that time, but now I know he didn't give me good information on feline diabetes. Those four years I was shooting blind and she was eating hill's w/d. I was so very lucky. We moved away about the same time I ran out of U after it was discontinued and my new vet (who was a feline specialist) prescribed lantus 2u BID. Within two days of starting lantus she was having uncontrollable diarrhea all over the house. The vet was no help asking me to bring in stool samples and telling me it couldn't be the insulin causing it.

That's when I found FDMB and saved her life. One of the members came to my house and showed me how to test her and suggested I drop her dose. Peaches was regulated on .5u of lantus for another 2 years until she died of what we believe was cancer.

One of my cats would never stop eating dry food, so last year he was dx'd with FD at 15 years old. This time I knew what to do. I worked really hard to get him to eat wet food, but it never really took, so we settled on a low carb dry food and started him on lantus. When he was beginning to go into remission I would sometimes test him more than 20 times per day. Within 6 weeks he was in remission and stayed that way until he passed in june from something unrelated.

I want more vets to get on board with the low carb diet for felines. If that happens, more people will be able to have their cats healthier for longer. I know they make a lot of money from selling the food, but sometimes people need to stop being so greedy and just do the right thing. Feline diabetes is an epidemic and it can be stopped if more people are educated. It does have to start in the vet's offices, though. Only so many people will pay attention when us crazy cat ladies start talking to them in the pet food aisle about what's good for their cats!

The vets also need to be more supportive with home testing, and not afraid to recommend it. Some here may not agree with me, but IMO if a cat's owner can't or won't do what's needed with disease, euthanasia is kind as opposed to not treating. I think owners have a right to know how to best treat this disease so they can either make a firm commitment to it or doing the right thing for their animal if they can't. I think they also need to know that FD isn't a death sentence, and also that remission is possible. When Peaches was first diagnosed, I had no idea remission was a remote possibility. The vet probably didn't either.

I want to thank you for your interest in this, as it's very close to all of our hearts.

When my cat was dx I was sent home with instructions to feed my cat a prescription dry food, shoot 1 unit of insulin 2x a day, watch for hypo symptoms and come back in a week for our first of many curves. I was 24 at the time- working 2 jobs and driving an 11 year old car. I did not have the money to spend $150 at the vet every 2 weeks, nor did I have the money for the expensive prescription food she pushed on me. I came home devastated and found FDMB...they set me straight and I began hometesting a few weeks later. My vet seemed to have some knowledge of all of the things discussed here on FDMB, but she really agree with a lot of it. I think because that wasn't what she was taught in school- and because she didn't have any other clients to prove her wrong. Over the course of the last several months she seems to be coming around after seeing how much my data has helped in my cat's treatment.

Hometesting has given me more information than a curve every few weeks at the vet ever could have. It has allowed me to tightly regulate Kazi's diabetes safely- I can usually pretty well gauge where she will be at before I do my spot checks. If she throws me a curve ball (and she has) I can counteract it with food BEFORE she ever gets to a dangerous point and is showing signs of a hypo. In the beginning testing was difficult- there IS a learning curve for sure. But once you (and your cat) get the hang of it the whole process is quick and easy. My cat doesn't mind it a bit- and often times half falls asleep (I test via paw pad)...she seems to like the foot massage every day! :lol:

Dr. B.,

When my cat was diagnosed, our veterinarian gave us no information in respect to either food management or insulin management. At the time we were on Vetsulin. Her assistant, however, gave us the URL to a website (not this one) where we could familiarize ourselves on everything. Thanks to her and the website members' assistance helping us with our sliding scale, our kitty was off insulin in six weeks. Our second kitty was taken to another vet (the first one had retired). He didn't know much about FD but was open to learning more. Together, we went through several insulin changes (Vetsulin, PZI and Lantus) until we finally found Levemir. He learned about split dosing from us and has since passed the option on to other FD owners. Every time we go in with any of our cats, he puts his hand out automatically for the spread sheet that he knows I'll have - I bring this every time knowing that he'll ask how he's doing. He goes through it line by line, dose by dose to see what I've done. Every time he says that he can't say anything that he's so well regulated. He's always available via phone or email if something comes up. His knowledge of FD has increased and he's increased mine by passing along articles he's read in veterinarian magazines. He encourages home testing and does everything he can to save kitties whose owners balk at treating by giving them two options: treat or adoption to us. He's a jewel and we make sure that he knows it!

Good luck with your presentation!

Dr. B,
Thank you for coming here to get input!
This forum saved Bailey's life - not my vet.
My vet never let me know about home testing. Once I asked him about it he was willing to support me, but was really concerned I believe the biggest obstacle with home testing is that owners will change the dose based on the readings they are getting. Many vets feel that they will become liable for an owner taking dosing decisions into their own hands.
When I asked my new vet about her thoughts on home testing she stated "most of my clients just don't want to be bothered". I believe if she would just show them how easy it is more would actually home test. A diabetes diagnosis is very overwhelming for a client. Vets need to take the time to step a client through each piece.
1. Vets need to become more educated on diabetes or send their clients to a specialist.
2. It takes a partnership with your client. Don't just hand them a bottle of insulin and have them come back once a month for a curve. It will never work. Diabetes = managed patient care. It takes effort from both sides that includes home testing, appropriate insulin, changing insulin as needed (with clear lines of communication), proper food, testing for ketones, etc. (My vet never mentioned testing for ketones!)
3. Feline and canine diabetes needs to be treated like human diabetes.
4. Vets need to learn more about conditions like acromegaly, cushings, etc. After years of trying to regulate Bailey my vet threw up his hands. If he would have known about this test, I'm 100% positive Bailey would have tested positive and it would have called for a different dosing method.
CJ

unfortunately the Dr. has not been here since Aug. 30th...i had asked here and in a pm if she would'nt mind giving us a little feedback...no word.
just thinking we all gave our side, it would be nice to know what is the feeling on the vet's side about our feelings, abilities, use of the internet etc.
i hope we hear from her.
we are learning about the vets too!

Re: What would you like your vet to know about you & your ca

Hi Everyone,

First, let me profusely apologize for not checking in sooner! I had no idea there would be such an overwhelming response.

Second, thank you all so very much for taking the time to respond.

Third, my goal in the next 30 minutes is to download these responses into a document I can read without having to access the internet. I will review every response. My plan is to find trends and add several slides to my presentation with those trends in your experiences. Your responses may be quoted directly, but there will be no names, no user names and no name of this specific web site. I will also coallate these reponses and send them to our marketing team. The marketing team will not have any identifying information, just responses.

Again and finally, I can not apologize enough and I hope you haven't felt too much like I am just another veterinarian who won't take the time to listen.

Will be back to post again. Hopefully, in the next week. If you should need me sooner, please don't hesitate to email me directly at bonnie.bragdon@abbott.com or call me at 706-224-6377.

Best regards and kindest wishes!
Dr. Bonnie, Abbott Animal Health Veterinary Liaison

Re: What would you like your vet to know about you & your ca

I am sorry, I missed your original post. It is likely too late but if not, here's my experience

My cat was diagnosed after losing weight and acting lethargic. My vet prescribed the old Humulin L at 2 units twice a day and Purina DM canned. I found this website shortly after....people here (in 2002) were already strongly supportive of testing. My vet was against hometesting; she'd just been to a seminar by an 'expert' who said that vets should dose by using the results of fructosamine tests, that cuves didn't work. Well, we tried that route and it failed as we took Squeak off of insulin too quickly. So I learned to test despite the fact she didn't think it would work, and it DID work. We used an old bayer elite xl and he was soon off of insulin, after slowly tapering off.

Hometesting DOES work, it saves lives, it saves time and money and frustration.

And I do not believe that a glucometer for animals is required...no offence