08/06: Squallie Hypo Watch - AMPS 419, +3.5 86 - BG Rising OK

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I don't think my vet is taking into account how much impact Squallie's new diet is having on him. He went from very high carb canned food and at least 31% carb dry food to zero carb canned food and 8% carb dry. That's got to be having an effect on his BG, too.
 
Back again.

Did the vet look at both of your spreadsheets or just the Alphatrak numbers, Lucy?
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She didn't look at either of them. I just told her where his numbers had been going the past few days. His scheduled "appointment" yesterday was not really so much an appointment but a quick test and check of his numbers by her. Also, we were there over an hour early because I got panicky when his numbers started to drop again, figured if things went crazy I wanted it to happen there rather than here! So we were only there maybe ten minutes, she didn't even charge for the visit, it was so brief. I'm really not kidding when I say that, at this point, I think I know more about feline diabetes than she does. When I first asked her, several months ago, if he might have diabetes (based on my observation of his behavior and symptoms) she ruled it out without even testing him, and if he's not hte first diabetic cat she's treated, I don't think there have been many before him!
 
Lucy, with a diet change my Radar went from 7 units 2x a day to none required in basically one week!! My former vet had no real idea of how the diet change was impacting what was happening and she did look at my spreadsheets. For us it was a nail biting plummet that we only survived because I used the data I collected and made the appropriate adjustments to the dose.
Needless to say I fired that vet and have decided that driving 40 minutes across the city to my original vet is a better option. For sure you know your cat and his numbers better than anyone because you test him regularly.
 
Lucy, with a diet change my Radar went from 7 units 2x a day to none required in basically one week!! My former vet had no real idea of how the diet change was impacting what was happening and she did look at my spreadsheets. For us it was a nail biting plummet that we only survived because I used the data I collected and made the appropriate adjustments to the dose.
Needless to say I fired that vet and have decided that driving 40 minutes across the city to my original vet is a better option. For sure you know your cat and his numbers better than anyone because you test him regularly.
That's awesome! I really think his diet is having a huge impact on his numbers; all of this craziness started shortly after we weaned him over to the new low/no carb foods. She wants me to try him on 4 units 3x daily at eight hr intervals but I just tested him at +7 and he's only at 95. There's no way I'm giving him insulin with numbers that low!
 
I think you're on the right track. I also would not give any insulin at that BG level. Keep up the monitoring and let us know how Squallie does.
 
She didn't look at either of them. I just told her where his numbers had been going the past few days. His scheduled "appointment" yesterday was not really so much an appointment but a quick test and check of his numbers by her. Also, we were there over an hour early because I got panicky when his numbers started to drop again, figured if things went crazy I wanted it to happen there rather than here! So we were only there maybe ten minutes, she didn't even charge for the visit, it was so brief. I'm really not kidding when I say that, at this point, I think I know more about feline diabetes than she does. When I first asked her, several months ago, if he might have diabetes (based on my observation of his behavior and symptoms) she ruled it out without even testing him, and if he's not hte first diabetic cat she's treated, I don't think there have been many before him!

Your experience of trying to get Squallie diagnosed is pretty much identical to what I went through last year. The vet in question gave a diagnosis of "old lady" and dismissed me as a hysterical pet parent, and point blank refused my direct request to have diagnostic tests run on Saoirse who, incidentally, was clinically a poster kitty for diabetes at the time.

I've said it once. I've said it twice. Now I'll say it a third time: Your vet made a HOWLING ERROR yesterday and unnecessarily put your cat in harm's way. That 22 should have scared the living carp out of her. It did out of me.

You need a vet who is there should there be an emergency (e.g. hypo, ketones), and for day-to-day management of Squallie's diabetes and all his other health concerns you need a vet you can trust. You need one who: will listen to you; who will look at your cat's data; one who acknowledges any gaps in their diabetes knowledge and who is willing to learn more. Most of all you need a vet who will work in partnership with you in caring for Squallie and keeping him safe on the insulin he needs.

I don't have the communication skills to couch this in softer terms. I would rather risk being a bit (a bit?!) blunt and give you my honest opinion (and it's only my opinion; other members' opinions may differ):

I would not take any dosing advice from your current vet for my cat.*

If I was in the same situation with Saoirse and there was a choice locally I would look to move to a practice that was more diabetes-literate, who would listen to me, and whose vets paid much greater attention to their patients. The door wouldn't hit me on the way out.



Mogs


ETA:

* I'm not saying this based on the knowledge and experience I've gained through studying FD and managing Saoirse's diabetes over the last year. Even if it was this time last year when I knew hardly anything about diabetes I still wouldn't have taken any advice from your vet for my cat. I would have listened to my cat's body screaming at me that the doses were too high. I am so thankful you are home testing. :bighug:
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Your experience of trying to get Squallie diagnosed is pretty much identical to what I went through last year. The vet in question gave a diagnosis of "old lady" and dismissed me as a hysterical pet parent, and point blank refused my direct request to have diagnostic tests run on Saoirse who, incidentally, was clinically a poster kitty for diabetes at the time.

I've said it once. I've said it twice. Now I'll say it a third time: Your vet made a HOWLING ERROR yesterday and unnecessarily put your cat in harm's way. That 22 should have scared the living carp out of her. It did out of me.

You need a vet who is there should there be an emergency (e.g. hypo, ketones), and for day-to-day management of Squallie's diabetes and all his other health concerns you need a vet you can trust. You need one who: will listen to you; who will look at your cat's data; one who acknowledges any gaps in their diabetes knowledge and who is willing to learn more. Most of all you need a vet who will work in partnership with you in caring for Squallie and keeping him safe on the insulin he needs.

I don't have the communication skills to couch this in softer terms. I would rather risk being a bit (a bit?!) blunt and give you my honest opinion (and it's only my opinion; other members' opinions may differ):

I would not take any dosing advice from your current vet for my cat.

If I was in the same situation with Saoirse and there was a choice locally I would look to move to a practice that was more diabetes-literate, who would listen to me, and whose vets paid much greater attention to their patients. The door wouldn't hit me on the way out.



Mogs
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Believe me, I don't disagree with you! Squallie had all, and I mean ALL, the classic signs of diabetes when I first asked her to test him. And I think that 22 alarmed her tech more than it did her! Sadly she really is the only one close to me and, at least until I get my car repaired, I'm pretty much stuck with her. Also, because I'm disabled, I usually need someone to go with me to help and I have to work around their schedules. I can get him there myself in an emergency, if I have my car, but it is extremely hard on me. I will say she was a little more receptive to my input this last trip; maybe next time I go in I should just have all my data (my tablet) with me and give her no choice but to look at it. I mean, what's the worst that can happen, she'll fire me as a patient, lol? Don't think so.
 
Oh golly gosh - that diet change likely did have a huge impact on his need for insulin! You did good managing all this.

WOOHOO on baby finally showing up!! BIG YARD DANCE!
Thanks! Hopefully we can get to a point where he needs very little insulin, with this diet.
Woohoo, indeed, lol! Little bugger's spent all day sleeping off the effects of his adventure, too, after eating everything in sight first!
 
Okay, need a little advice again. We've reached the 8 hr mark where the vet told me to give him another 4 units; I just tested him and his BG is 135 with the Relion (175 with the Alphatrak). I guarantee if I give him insulin at this point that he will have another hypo episode. I called my vet and, of course, she is now closed for the day. So I have made the decision NOT to give him any insulin at this point, rather, to check him again at the 12 hr mark and give 4 units then, if necessary. I hope I'm doing the right thing! If anyone has any other ideas please let me know!
 
Sadly she really is the only one close to me and, at least until I get my car repaired, I'm pretty much stuck with her. Also, because I'm disabled, I usually need someone to go with me to help and I have to work around their schedules. I can get him there myself in an emergency, if I have my car, but it is extremely hard on me.
Ok, you have to work with what you have. You are the one testing and seeing the trends. Diabetes is a disease that needs to be managed at home, anyway.

So work with your vet as much as you can. But trust yourself and your numbers. You are the one staying up all night if there is another hypo. Set yourself a no shot number and try to keep to it until you understand better how your insulin works with Squallie.
 
because I'm disabled, I usually need someone to go with me to help and I have to work around their schedules

Same scenario here. (((Lucy)))

Well, I guess you're gonna have to call the shots on the diabetes side of things from here on in then, Lucy. (Sorry: couldn't resist the pun! :oops:) You need to let her know about the diet change if she doesn't already, including the change in the % carbs between the foods. BTW, how far along are you with the transition (i.e. what percentage of daily food allowance is wet, and how much the high carb dry food)? Also, do you have a target date for completion of the transition?

You've got data to work with now to show how Squallie's responding to the insulin. Maybe you could email the link to the spreadsheet to your vet and ask her to take a proper look at it and say that you're very concerned about Squallie's safety and that you need to agree a plan of treatment that you feel comfortable with and consider safe for your kitty. (You, after all, are the one holding the syringe.)

Let's say, for illustrative purposes only, that you'd feel safer dropping the dose down to 0.5IU BID and your vet insists that the dose should be higher because of blah, blah, blah reason you could present the case to try the ½ unit dose for, say, 10 cycles (safety permitting) with an agreement that you both review the data together and decide on any necessary dose adjustments. Stress that if the dose were to be too low it can always be increased again.

Hopefully you and your vet will be able to find a mutually agreeable way forward. :)


Mogs
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Okay, need a little advice again. We've reached the 8 hr mark where the vet told me to give him another 4 units; I just tested him and his BG is 135 with the Relion (175 with the Alphatrak). I guarantee if I give him insulin at this point that he will have another hypo episode. I called my vet and, of course, she is now closed for the day. So I have made the decision NOT to give him any insulin at this point, rather, to check him again at the 12 hr mark and give 4 units then, if necessary. I hope I'm doing the right thing! If anyone has any other ideas please let me know!
I think you did exactly the right thing. When I look at his spreadsheet, I do NOT see a kitty who needs insulin every 8 hours at all. Today it looked like 4 units was plenty, and it looks like he might need that much, or less, every 12 hours, not every 8.
Great job!
 
Okay, need a little advice again. We've reached the 8 hr mark where the vet told me to give him another 4 units; I just tested him and his BG is 135 with the Relion (175 with the Alphatrak). I guarantee if I give him insulin at this point that he will have another hypo episode. I called my vet and, of course, she is now closed for the day. So I have made the decision NOT to give him any insulin at this point, rather, to check him again at the 12 hr mark and give 4 units then, if necessary. I hope I'm doing the right thing! If anyone has any other ideas please let me know!

Absolutely the right thing. High # will beat low hypo # any day. You're still buckling down on finding a dose and don't need to be up 72 hours testing every 15 minutes because this vet keeps giving you silly advice.
 
If I listened to my vets Luna would be OTJ still :facepalm:

I think you meant to say Luna would not be OTJ still.
Because being OTJ is a good thing!

If I listened to my vet, CJ would still bouncing around on Novolin and very miserable. I shudder to even think of the ER visits that could have happened without guidance from wonderful members here when CJ went hypo.
 
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I think you meant to say Luna would not be OTJ still.
Because being OTJ is a good thing!

If I listened to my vet, CJ would still bouncing around on Novolin and very miserable. I shudder to even think of the ER visits that could have happened without guidance from wonderful members here when CJ went hypo.

I meant they literally said to make her go "OTJ".. she was over 300 each time they said that. She's definitely not OTJ lol at 12 units/day.
 
I was being very literal, lol. Two vets told us she was in remission, and I did a home test and... 380. One said we don't need insulin - that's stupid and dangerous - just switch to her vet practice brand of RAW food, it'll fix her right up.
 
@Squalliesmom - Lucy, I'd suggest you start a new thread before your next cycle and ask for Vetsulin dosing advice. You got a massive drop from AMPS to nadir on the 4 units (after no insulin last night). The duration you're getting is longer than typical on Vetsulin too, plus there's a real sense of dose carryover from one cycle into the next in your data (the previous dose continues to influence BG into the next cycle).
 
@Squalliesmom - Lucy, I'd suggest you start a new thread before your next cycle and ask for Vetsulin dosing advice. You got a massive drop from AMPS to nadir on the 4 units (after no insulin last night). The duration you're getting is longer than typical on Vetsulin too, plus there's a real sense of dose carryover from one cycle into the next in your data (the previous dose continues to influence BG into the next cycle).
Thank you, will do that right now!
 
I started a new thread but nobody has seen it, I guess. I don't know whether or not to give him another dose, his numbers are still kind of low, and he's not much interested in eating tonight. I don't want another hypo episode, and I'd like to avoid another all-nighter, if possible!
 
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