Twice a day divided..

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Jeanne & Dottie

Jeanne & Dottie

Member Since 2016
:cat:Howdy All..Thanks again for getting us through yesterday's crisis. :bighug:

Ok, today we're starting a new insulin plan. I called my vet around noon...Dottie's sugar was at 336 at 7am, so the vet AGREED with me:woot: , about a divided dose of insulin! He wants to start back at a total days's worth of insulin at 5 units, so I was to give an injection of 2.5 units of PZI at 1:00 AM, and 2.5 units at 1:00PM, and get back to him tomorrow.

I fed Dottie a bit of tuna and water, as she only took two licks of her PurinaOneSmartblend

When I retested after sleeping a bit, at 5:35pm it was at 352! I know I felt Dottie's skin against the barrel of the needle, and I felt her fur afterwards, and didn't find any moisture, nor did her fur smell like insulin. That means that either I was off a bit in trying to guestimate the half unit in the needle, or that 2.5 units doesn't affect her as much as I had hoped. We'll see if anything improves after her next injection at 1:00am, which is five hours from the time I place this post. I should feed her before her insulin, (1:00am is one of her normal feeding times here)

Yes, to most of you my hours don't make much sense, because I sleep during the day. No, I am not a vampire. Shiftwork threw a monkeywrench into my body clock. I've never been able to make the transition back to normal. I sleep during the day from about 5am t0 Noon, and nap here and there to make sure I get at least 7 hours a 'day'.

Hence Dottie's whacko insulin schedule. I may have to try to adapt once again to normal hours, but it'll be hard. Even as a child I would stay up late, hiding under the covers with a flashlight to do homework and read. I am a Child of The Night, no doubt about it.

OK.....:confused:Wow, the needles I have aren't marked for half units...so it's a lick and a promise to get it exact. Dottie's 1:00PM dose z92.5 units PZI) was given, and since I was still super sleepy, I decided to go to nap in the recliner again.

AND...... Woke up, took Dottie's BG at 5:35 , and since last injection, (see above paragraph) her BG went up a tiny bit, to 372!

So her next injection is due at 1:00am, and right now, as I post this, that's still 4 hours away. Until then, I will feed her tiny meals of lean baked chicken if she insistes on eating something, (plain no skin) with a sprinkle of Fortiflora so no carbs there... her blood sugar won't go up and mess with that 372 BG.

Am I doing anything wrong? Dottie's quite perky at the moment, Perky enough to bat at a little mylar krinkle ball I threw her way. I did test her urine to watch for keytones, and she's good to go, right where she should be, protein-wise.:cat: Oh Happy Days. BUT...there is that BG of 372.
 
I think I would give the new divided dose a few cycles, Jeanne. Her levels were low yesterday so she may be reacting to that. Are you feeding and then testing? We suggest no food for 2 hours before the pre shot test. Food can raise levels; you want a "true" number unaffected by food.

What is she eating? It sounds like you are feeding some people food? Lots of us feed Fancy Feast, Friskies, Wellness. There are lots of possibilities on this website by a vet: www,catinfo.org. She has a food chart; we try to stay under 8-10% carbs:

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

If you want to shoot smaller gradients, you can get U100 needles. Because ProZinc is a U40 insulin, you need to use a conversion chart:

http://www.felinediabetes.com/insulin-conversions.htm
 
Deep breath, one cycle, one shot, two cycles two shots is not an indicator of anything, especially at the beginning and the fact that you were giving one massive dose. Give it a few cycles and you will likely see some improvements.

I'm still working on getting things right with Fern. He had a 55 the same day as Dottie. PZI seems to work really well for him and from what I've been reading he might be the perfect "candidate" for having a multitude of doses based on his BG. But I know it is going to take a while for this bean to figure out what those numbers are based on the info I get back from him. What it means for me now is he has massive drops and then bounces because his body isn't use to low BG numbers any more. Which means we take a step back because it takes 3 days for them to "flush" the bounce (according to those here). So I'm going to guess Dottie had a massive bounce when she got 7 units. That was less then 3 days ago, she won't have a "normal" cycle until at least tomorrow. Also you might have gotten Dottie as she was rising when you gave her the shots.
 
The vet did give me U100 needles. The entire syringe holds 30 units. The unit increments are listed as 5, 10, 15, etc. I see no half unit increments.

Usually I feed PurinaOne Smartblend Chicken classic, which has proper balance. Occasionally also I will feed FF, and the carbs are correct in relation to the other ingredients, well balanced. But I noticed in another post, a suggestion that if BG levels are high in between shots, it would be ok to feed lean chicken, to avoid any carbs that would tinker with her high numbers, before the next injection. I do have a cat carb ratio calculator on my smartphone and I'm careful to feed only food that has the right balance of carbs. Except for this time when I want to avoid adding carbs before her next shot.

Right now she seems a bit sluggish, got out of her bed, sat on the floor, then turned around to get back into bed. She's kind of blinky eyed, can't tell it if it's because she's just waking, or a little foggy. Respiration is normal. Her ears prick right up if I toss a toy behind her. Her keytones are normal. Nothing on her breath that might signal trouble, either. In fact, her little toothless pink mouth is kinda endearing :joyful: So far she's managed to keep her tongue in line:pbut it's early and her gums haven't shrunk down yet.

Yes, her body may be feeling around for balance, like a pendulum that swings back and forth. I really would prefer we go slow, to let her stabilize. I don't want to risk a sudden meltdown. It snowed heavy here, and driving is treacherous on the secondary roads. And I can't risk a fall getting to the car. So I want all to be serene, LOL.:smuggrin:

My own feeling was that it had been too soon for my vet to order a one time a day whammy of PZI...it seemed a lot for me to give a cat who was only two days on insulin. He had started her out at 5 units.

OH! Ferndoc..Your avatar. Is your cat in...a bag?
 
Hmmm....if you're shooting 2.5U and using a U100 syringe with PZI (which I believe is a U40 insulin) that means you're REALLY only giving the equivalent of 1U of PZI!!! Am I right @Sue and Oliver (GA) ???

To be giving 2.5U of a U40 insulin, you'd have to give between 6 and 6.5 U in a U100 syringe

The Purina Smartblend is fine ...it's under 10% carbs so it's fine as a regular food

Just to clarify....Although ECID, generally speaking if we can, we'll try to get most of their food into them before nadir (about +6) each day because in some cats, if you feed them after nadir, it's like slamming the brakes on the insulin....it's already starting to wear off and if you add food at that point, it's fighting a losing battle, but IF they really need a snack after nadir, feeding plain protein is the best way to go because it has the least effect on their blood glucose
 
Ok what is nadir? And now I'm confused. PZI goes by two measurements under two separate classifications? All I know is, the vet handed me syringes, said Load It Up To Here...called it 5 UNITS of PZI and sent me home. So I assume that 5 units isn't an arbitrary figure. Why would two different sources use two different meanings for the word Unit?
 
Nadir is the lowest point in the cycle...so if (for example) you had these BG results AMPS 200, +3 133, +6 85, +9 143, PMPS 211.....the "nadir" for the AM cycle would be the 85 at +6

I tagged Sue about my question about your dosage since I don't use PZI or it's related insulins, but if I am thinking right, you may not have been giving 5U of PZI all this time

What color are the caps on your syringes? If they're red, they're U40...if they're orange, they're U100
 
But why would the vet call it five units if it isn't? This all is beginning to sound very scary. How can I trust my vet to give me the correct terminology if he's using one scale while manufacturers might be using a different scale entirely?
 
At any rate I just tested Dottie because she looked a bit sluggish, and her BG is now 179. Am I now wrong to feed her before she gets her shot? I'm beginning to second guess everything:confused:
 
The main time we don't want them to eat is for the 2 hours right before shot times so that when we test, we get a number that's not influenced by food....so if you're normal shot time is 1am, you want to take up all food after 11pm

After you get the Pre-shot test, it's fine to feed....with some cats, we see that if we feed them after nadir (when the insulin is already starting to wear off) since you're adding carbs PLUS the insulin wearing off, it can "slam the brakes" on the insulin.....but some cats you can feed right up until +10 and it really doesn't matter....which is why it's good to keep good notes on your spreadsheet as to when you feed and what
 
What color are the caps on your syringes? If they're red, they're U40....if they're orange, they're U100....let's make sure we know which ones you're using before trying to figure that part out
 
They're orange. And I just read on the PZI forum....there's a conversion chart offered. If this were a U40 syringe, at 2.5 dose, in a U100 syringe that dose would be at 12.0! That's over twice what I'm giving now.

I've got to tell you something, folks. I'm discalculate. I have severe trouble with number conversions. Numbers swim before my eyes like letters do to a dyslexic. It's a brain thing.

This is why your SS terrifies me. It's a jumble I have trouble sorting out. I cannot hold numbers and do calculations in my head. Getting them on paper is a challenge too. So I'm going to have to move very slow with this. It's a lot to take in all at once, and easy to feel like one is drowning.
 
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Don't let our spreadsheet confuse you....all you'd have to do is enter the numbers as you get them....the reason we like to have it available to us is so that WE can see how you're doing.....the people with experience will want to see how he's doing before they give you advice on when it might be time to increase as well as help to see the "patterns" we look for

We can even help set it up for you if you want....then we transfer it to your ownership and all you have to do is enter the numbers....let US worry about what they are telling us:).....just holler if you want help!

Jeanne Skadowski said:
If this were a U40 syringe, at 2.5 dose, in a U100 syringe that dose would be at 12.0! That's over twice what I'm giving now.
Click to expand...

No...if you were giving 5U it would be 12.5U on a U100 syringe....look at the conversion chart again...you thought you were giving 2.5 PZI (a U40)....so if you follow that over, that's between 6 and 6.5U in a U100 syringe

If you've been giving 5U in a U100 syringe, that's the equivalent of only 2U of a U40 insulin....so if you only gave 2.5 tonight, that's only about 1U of a U40 insulin....which all just means you've been giving less than you thought you were

BUT...what's important is that we now know which syringes you're using and that (so far anyway) you haven't been giving 5U of PZI....Give Sue some time to get back with us and in the meantime, just continue measuring the insulin the same way you have been!

Actually, this may be good news....it's better that he's actually been getting less!
 
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Hmmm...I thought that was what I said. Whew..it's good for my kitty, but now I wonder if my vet is wrongfully boosting the price on insulin. Even using the U100 needles and Protamine Zinc Insulin 100UNITS/ml...it is going to cost us over a hundred dollars a month for the insulin she's getting now. He gets it from a private pharmacy who compounds it, and he won't write prescriptions for outside sources so that we can go elsewhere to get it. That means he's getting a share of the profits, and is thinking of his bottom line. Since he's the only game in town unless we want to risk our lives 8 months out of the year on very bad roads....see where I'm going? If he's calling these markings 'units'...perhaps I'm being charged unit prices for fractions of units. Am I making sense here? Not sure...again, numbers are beyond me.

I tried to get the pricing list in the PZI forum, but unfortunately, google wants me to use my gmail address to access or I must 'ask permission' from the owners of any documents that are uploaded to Google. So I need to wait till my email is 'approved'.
 
Jeanne Skadowski said:
That means he's getting a share of the profits, and is thinking of his bottom line. Since he's the only game in town unless we want to risk our lives 8 months out of the year on very bad roads
Click to expand...

I think you may be right....the only other thing I can think of would be to find a different vet who would write the script so you could get it directly from one of the companies that sells it sometime in the months it's safe to travel...at least then you could re-order from them and have it delivered to your door during the months it's not safe to travel
 
Ok I just tested Dottie's blood and it's at 137 before feeding her. I will feed PurinaOneSmartblend now. Even after her eating, hould I wait a bit before giving her shot ? Or what if she doesn't eat. I need to know now.

Getting a better vet would be good, but then it means traveling on horrible roads. Everyone thinks that New York State is all like the Big Apple. It's not. And lake effect snow is dreadful. In winter they close the roads here frequently so that would limit our access to a vet, period. Vets don't 'share' patients very well so if I left this one, I wouldn't ever be welcome except for extreme emergencies.
 
Generally, without knowing how she's going to respond, we say "no shot if under 200" but that doesn't necessarily mean "no shot at all"....When you get a Pre-shot that you're not sure about shooting, it's best to "stall", DON'T feed, and re-test in about 20-30 minutes to see if she's coming up on her own

Once you get more data on how she responds, that "no shot" number can come down some, but for now, I wouldn't shoot anything tonight if she was only at 137...especially if you've already fed her
 
From Private message;

  1. Now that you've fed her, it's too late since she's got carbs on board now.....we don't shoot under 200 unless we have enough data on the cat to know it's safe

    And was it 157 or 137? In your post, you have 137

    China's SS 2015 / China's SS 2016
    China White's Profile--Civies..Cheaser & Cleocatra..Maine coon X's Drooler..Peaches (GA 12/4/14) Location--Mid-Missouri
    Chris & China, 15 minutes agoReport
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  2. Jeanne Skadowski
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    Ok I just read that if the BG is lower than 200+ at preshot, I shouldn't give the shot right away but should wait 20 minutes or so and retest then.

    Jeanne Skadowski, 13 minutes agoReport
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  3. Jeanne Skadowski
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    Shoot, lol. I hit the wrong button, my fingers don't work. it was 157. *looks hard at the screen*:oops:

    Jeanne Skadowski, 12 minutes agoReport
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  4. Chris & China
    Joined:
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    Ok I just read that if the BG is lower than 200+ at preshot, I shouldn't give the shot right away but should wait 20 minutes or so and retest then.
    Yes...except that also says "don't feed"....see now, when you test again in 20 minutes, her number should go up because you fed her

    If you shoot then on that "food influenced" number, she may crash later on....she's still very early in this twice/day dosing...I think it'd be safer for you to skip tonight and start over tomorrow

    China's SS 2015 / China's SS 2016
    China White's Profile--Civies..Cheaser & Cleocatra..Maine coon X's Drooler..Peaches (GA 12/4/14) Location--Mid-Missouri
    Chris & China, 10 minutes agoEditReport
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  5. Jeanne Skadowski
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    Gotcha. Yes I knew they'd go up if I prefed her. She eats like a bird, so I've got to get it in her, when she's willing. I am waiting 20 minutes. She's so mad at me for testing so much. Her poor little ears,...

    Jeanne Skadowski, 8 minutes agoReport
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  6. Chris & China
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    I know a little bit of basics about using ProZinc and PZI, but it is a totally different different type of insulin than the Lantus we use so it makes it hard for me to feel real comfortable advising you on dose other than to just repeat the information available in the Protocol for ProZinc/PZI

    China's SS 2015 / China's SS 2016
    China White's Profile--Civies..Cheaser & Cleocatra..Maine coon X's Drooler..Peaches (GA 12/4/14) Location--Mid-Missouri
    Chris & China, 7 minutes agoEditReport
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  7. Jeanne Skadowski
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    Really? Well I'll still do a test. What should her numbers be that would indicate giving her a shot? I'm getting mixed up again.

    Jeanne Skadowski, 7 minutes agoReport
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  8. Chris & China
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    do you have some Neosporin with pain relief ointment? It can really help heal those ears up quickly

    China's SS 2015 / China's SS 2016
    China White's Profile--Civies..Cheaser & Cleocatra..Maine coon X's Drooler..Peaches (GA 12/4/14) Location--Mid-Missouri
    Chris & China, 5 minutes agoEditReport
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  9. Jeanne Skadowski
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    Ok I understand. At the very least I shouldn't give her insulin unless her numbers are above 200, right? And I'm giving 2.5 units using the U100.

    When she did crash, her BG hit 55 at 19 hours after her first and only does of insulin, when she was only on one shot a day, at 1:00pm. And she had 6 hours to go before her NEXT daily shot. So her curve took a nosedive pretty far past the 'central' point. And yes I am using Neo :) with pain reliever

    Jeanne Skadowski, 3 minutes agoReport
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  10. Chris & China
    Joined:
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    If in 30 minutes, she's above 200, the problem then will be "but that's a food influenced number"...if you shot then, once the food wears off, she could come down fast

    It's probably going to be best (and safest for her) to just skip tonight's shot and get back on track tomorrow at 1pm....the only other choice would be for you to wait 2 more hours, test her again and IF SHE'S ABOVE 200 THEN, give her the shot....but you have to be able to move your next shot back by 12hour....so if you shoot at 3am tonight, you're not going to want to shoot her again until about 3pm tomorrow
 
You know, I think that's how the vets think about it. They ignore the fact that it's a food influenced number, and just treat twice a day figureing that the next shot will keep the cat level. But it doesn't, does it? Why the heck then don't more vets get sued for people losing their cats to improper dosing? The way they want to do it means that the cat ends up on more and more insulin.
 
I am very blessed that when China was first diagnosed, they kept her overnight to get a urine sample from her so I got on the internet and found this wonderful group of people and read, read, read....and learned, learned, learned!!!

By the time I went to pick her up, I knew what insulin I wanted her on, knew that I didn't want to buy any of their "Prescription crap" and once I got my script for my Lantus, all our dosing decisions were made with the help of the great people here

I don't even discuss China's diabetes with her vet anymore past them asking "How's she doing" and me answering "she's on 1.5u and her BG readings run between 50-120 most of the time"......and thats the end of it!
 
So I think you have figured it out. PZI can be formulated in a U40 or a U100 strength. It sounds like you have the U100 insulin so you are using the right syringes and what you see is what you shoot.

If your syringes measure by one unit markings, you can use ones that measure 0.5 units. It is easier to see and dose smaller amounts with those. They should be available in any drugstore as human diabetics use the, too. You want U100 3/10cc syringes with half unit markings, 30 gauge (that's the thinner ones). They can be 1/2 inch long or 5/16 inches long - some people like the longer ones, some the shorter ones.

It sounds like her numbers are coming down which is good. Yes, it is best not to feed 2 hours before you are going to take a test that will help you decide what to shoot, as you want a true number, not one influenced by food. Where are you now in terms of the time for her next shot and when did she eat last? (Not clock time but by hours since the food and hours until shot)
 
All this insulin stuff is loaded with numbers and can be very confusing, so let me help you sort it out. I hope this helps!

Units:
  • This is the measurement of the amount of insulin you give.
  • This is what you measure in the syringe. Example: "Give 1 unit twice a day."
U100/U40 Insulin:
  • This is the concentration or strength of the insulin. All insulins come dissolved or suspended in liquids.
  • U-100: which means it has 100 units of insulin per milliliter of fluid. Human insulins (levemir and lantus) are U100.
  • U40: which means it has 40 units of insulin per milliliter of fluid. Most animal insulin are U40 (like PZI), but can be compounded to other concentrations, like yours.
  • I think all US states require a prescription for the human insulins. I'm not sure about undiluted PZI, but since yours is diluted, you really can't get it anywhere else.
Syringes:
  • They are either U100 or U40, to match your insulin. (You are using U100 syringes because your insulin has been compounded into a U100 insulin.)
  • Syringes come in different gauges, which means thickness of the needles. The higher the gauge, the thinner the needle. For example, a 31 gauge needle is thinner than a 28 gauge needle.
  • Syringes also come with different capacity. 3/10 mL/cc means it holds a maximum of 30 units, which I think is the smallest. Look for this size syringe marked with half-unit markings.
  • Syringes also can have different needle length, but I won't elaborate on this right now.
  • Some US states require a prescription for syringes, some do not.
 
Well I have syringes with an orange cap, and they're very thin, the bag they come in says "30 gauge, 3/10cc x 5/16? needles. They do not have half unit markings, and these are the only needles available. We get them through him, or else, just like the insulin. (Oh, our insulin is compounded by a pharmacy called Wedgewood.) So there you have it:arghh: It's so frustrating.

If I use another vet, 20 miles away, I risk not being able to get Dottie to the her during snowstorms, like the one we had yesterday. White out conditions. Roads closed. We are in serious snow country here. Nobody goes anywhere. Dottie'd be dead before I could get help from the new vet.

That means I would have to slide to the vet I have now, and if I leave his care to go to another vet, I will not be welcome back except in dire emergencies. To have a potentially hostile vet treat my little girl makes me uncomfortable as to her care...so I feel I'm going to end up in a stalemate no matter what I do:banghead:
 
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I know you're in a tough spot with the insulin, but I don't know why you couldn't get a script for syringes so you can buy them elsewhere...just say you need to save money anywhere you can (I'm thinking NY requires a script for syringes?)

You can get them online from ADW then....All these have half unit markings and are the correct syringes for the U100 insulin you use:
UtiCare
Monoject
Carepoint
Sure Comfort

They're also available at WalMart if you have one near you..Their Relion Brand 3/10ml, 3o or 31 gauge, 8mm insulin syringes all come with half unit markings
 
I will see what I can do. Hope he agrees. Trying to see a half unit with the ones he gave me is a nightmare!

Oh, the new scale just came in. She's 9.5 lbs. Hasn't lost weight since before the surgery. That's good.
 
He shouldn't care, Jeanne. You are just wanting a syringe that will let you see the amount you are dosing. They are really no change from what you are using now - just make it easier for you to measure carefully.
 
k I will ask him. HEY:bighug:I solved my furry wicking problem tonight. I let Dottie calm down, washed her ears and feet, cuddled her a bit and then SHAVED the edges of her ears! No more fur there.

Now I can get a drop of blood without that fine fur wicking away the drop. I had to be really careful and put my finger beneath her ear so I could be aware of how much pressure I was putting on it. Whoever suggested that in another thread...thank you! Her ears look funny, darker pink than I would have thought, but I can get a sample now. She didn't even notice me. All is forgiven.

Tonight at 10:00pm her BG is 299
 
Yes I did not give that shot. I will hold off till I get an idea of how she fluctuates naturally. I have got to get some sleep tonight..and it's tough to sleep during my 'waking hours' but I'll do it.

And I lost the link to the SS. Closed it out. I still log my times and BG my own way though, so I won't lose track. I know it's hard for you to understand, but trying to explain how the SS looks to me is like trying to explain color to someone who can't see. Numbers literally jump off the page at me and everything gets all mixed up. Graph lines don't help..they MOVE.
 
299 is definitely high enough for insulin. If you want to reduce, you could just give one unit.

Your SS should be in your Goggle docs. If you go to Goggle docs and check, it should be there. Then save it to your favorites or bookmark it so you have it. If you are having trouble with it, you could give someone else permission to edit it and they could enter your numbers. I have done that for several people and could help you out. It is very hard for us to help you with dosing when you need it if we have no record of doses and levels.
 
Is there a way to present numbers that is easier for you?
Would listing them in a vertical column be better? using words instead of digits?
If you have some tactics which work better for you, maybe I can adapt our grid to work better for you.
 
From private message

  1. Well, I have decided to back off the insulin altogether for a few days. Here is my reasoning"

    Dottie has been under great stress at home, had rotten painful teeth and gums, major surgery using anesthesia that affects her very badly. The vet started her, (my opinion) on 5 units of Prozinc, then upped the dose the very next day to 7. This poor baby hasn't had time to get any equilibrium back whatsoever before we started messing with her hormones. So we don't really know where she stands on an ordinary day.

    She had been at 300 for a bit, before the week she had surgery. When we got at the vet's that reading suddenly became 445. Her stress levels were horrific, because she had a broken tooth, and I couldn't get her an appointment for almost a week.

    I want to see where she's at, once her mouth has healed...it still isn't completely healed, as I can see by the way she picks her food up in her mouth. It's still sore, and before she even moves in response to anything, she has to yawn widely to stretch her mouth open because as she sleeps, it gets frozen.

    A few days without insulin can't be too much of a disaster. I really think that her pancreas is sputtering, trying to kick into gear. If I can give her a couple of days, perhaps it'll start ticking.

    Today she's furious with me. For the first time since I owned her, she bit me. Her ears are really sore, and I can't get a drop of blood from her feet. Not one drop. Her scruff is elastic, so I don't think she's dehydrated. She is drinking, although not a lot. But I have been mixing a bit of water with her meals so she's got enough fluid.

    I found an interesting link that no doubt most of the members here have seen. www.catinfo.org? The vet there claims that some cats actually function very well with BG lower than 55. That since cats are obligate carnivores, their liver doles out the glucose order...cats in the wild consume next to no carbohydrates. So this vet has stated that as long as I'm feeding very low carb food like FF or POSmartblend..that low level that she has reached in her cycle, may actually be her normal BG level.

    She has always been a very sedentary cat. Not a lot of racing around, just mostly sitting in the window watching birds, with a daily rather sedate romp with a Da Bird toy. So it makes sense to me that without the stresses she's previously had, her BG might indeed be very low normal. I'd like a chance to see if the numbers bear me out.

    When she did bottom out at 55 or 67...she was actually quite chipper, looking around, cuddling her toys I put around her, and looking like a normal happy cat.

    So I'm going to allow her that three day window to see if this is a pattern that is normal for her. Cross your fingers for us. I won't let her out of my sight until I can see those low numbers for a length of time that will reassure me. If she does suddenly crash, I will bundle her up and get her to the vet, who is only two miles from us. But I've got to get a base normal for her. Hang the vet, he's throwing darts at a board. His declaration that 'cats never go into remission' shoots down his credibility as far as I'm concerned.

    I hate living in this town, there's no good health care for humans or animals. Consumer Reports did a survey on Human hospitals and gave our hospital one of the lowest ratings on their survey. Sky high infection levels and poor care all around. And apathy like that seems to be projected across the board to animal care here. When I lived in Baltimore, I had at least ten vets within reach, as well as several emergency vets. Moving here was like going to a third world country. If I had my druthers, I would light a fire under hubby and insist we move, but he likes it here...and so far he won't budge, since it's his home town and these people have been his friends since he was born. I should have married a city guy...hindsight is both a wonderful and dreadful observation.



    I may call the vet about 20 miles away, who supposedly only does cats. I guess a second opinion can't hurt, but we're so low on funds that if she charges an arm and leg for the same tests, (I do have the bloodwork printout) I might not be able to afford that opinion. And she'd have to do better by us than just shoving needles and insulin in our hands and threatening to not treat us if we don't get all our supplies from her.

    Jeanne Skadowski, Today at 5:29 PMReport
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  2. Chris & China
    Joined:
    May 10, 2013
    I totally understand the reference to living in a third world country!! I moved from Kansas City, Missouri to a small town in mid-Missouri with a total population of about 1000....the only vets in town do more large animals than small so I have to travel over an hour to see a vet that's a member of the AAFP (American Association of Feline Practitioners) and she's vet #5

    I got "lucky" on vet #3....he didn't know anything about feline diabetes so when I asked for Lantus, he gave me the script....since then, I just call vet 5 when I need refills since she doesn't "manage" China's diabetes other than asking me what dose she's on and what kind of numbers she's getting

    I get all my dose advice (and always have) from the FDMB and we're going on 3 years since diagnosis.

    I understand your reasons for wanting to let Dottie "settle", but I'm going to say I don't agree....the key to gaining remission is getting them into normal numbers as quickly as possible...the longer you wait, the more damage is done to the beta cells in the pancreas that are the ones that are able to "heal" and resume producing insulin. Once they're too far gone, remission is never going to happen

    Also, while the FDMB has a really good record of cats going into remission, the facts are that MOST of them never will and will require insulin the rest of their lives.

    I think you're stuck in a bad situation with a vet that doesn't know the best way to treat FD...PLUS the crazy requirement that you only buy insulin from him!!

    China's SS 2015 / China's SS 2016
    China White's Profile--Civies..Cheaser & Cleocatra..Maine coon X's Drooler..Peaches (GA 12/4/14) Location--Mid-Missouri
    Chris & China, Today at 6:28 PMReport
    Reply


  3. Chris & China
    Joined:
    May 10, 2013
    ↑
    I may call the vet about 20 miles away, who supposedly only does cats. I guess a second opinion can't hurt, but we're so low on funds that if she charges an arm and leg for the same tests, (I do have the bloodwork printout) I might not be able to afford that opinion. And she'd have to do better by us than just shoving needles and insulin in our hands and threatening to not treat us if we don't get all our supplies from her.
    If you have recent bloodwork from your current vet, new bloodwork shouldn't be necessary. What I did to find a new vet was call around and ask for the vet to call me back when they had some time and discuss how they treat their diabetic cats....I already knew what I wanted to hear, so it was just a matter of finding one that was willing to answer my questions the way I wanted them answered!! Like:

    What kind of food do you recommend? What's your preferred insulin and are you willing to use others? How many diabetic cats have you got in your practice and how long do they generally live after diagnosis? Do you support home testing?

    China's SS 2015 / China's SS 2016
    China White's Profile--Civies..Cheaser & Cleocatra..Maine coon X's Drooler..Peaches (GA 12/4/14) Location--Mid-Missouri
    Chris & China, Today at 6:31 PMReport
    Reply


  4. Jeanne Skadowski
    Joined:
    Saturday
    No, Chris..I did not give insulin last night. If I were to ask my vet those questions he would be insulted and tell me to take a hike. Again, the fact that there are so few vets out here, gives them a bit more power.

    What we need are websites that allow clients to review vets, like the ones that review human doctors.

    The one vet I would consider...she supposedly specializes in cats..is the one who is so out of reach for us at least half the year, due to wicked weather. I will call her, to see what's up. Perhaps there's a vet who is willing to do more work by phone, when traveling is out of the question...and I don't mind paying for that. Now that we have computers, and skype, face to face can go a long way for human doctors..and it is reasonable to think that at least some of the time, it might prove beneficial for animals too. But our vets are so booked with patients that long phone consultations would probably be a no-no, not with so many last minute emergencies that come through his door. He does work hard. He doesn't have a partner, so he's only one man with patients in an endless stream.

    Yup, I do realize that waiting too long can be dangerous. But it's also dangerous to force her into insulin when we don't know whether she's actually diabetic or whether her BG fluctuations are due to old fashioned stress. The vet was so insistant, swearing that cats never go into remission. We were put on the spot.

    So we'll have to agree to disagree.

    I wish Dottie could talk. Then perhaps I could explain why I do what I'm doing..and she'd understand why all the ear pokes. I'm going to have to shave the edge of her ear. Even with the larger gauge needles, that fine fur of hers wicks away the droplet of blood before I can get to it with the meter or a fingernail. My hands shake on a good day. One is almost useless except for large motor movements. So I fumble more than most in getting that blood. Hubby isn't home enough to do it, and he's squeamish anyway. He says he loves his cat...but somebody else do the work, please. He's 'busy'.

    Today my baby bit me, hard. Something she has never done before. I was working on getting blood when a snowplow rounded the corner and came into town. She nailed me, and went under the bed, where I couldn't reach her. She has only just come out. I know her BG went through the roof. I hesitate to do anything more than test with urine strips for 24 hours. Sometimes it's better to pick your battles instead of forging on.

    We'll see. Please, everyone keep their fingers crossed that three days won't be a bad decision for us, ok?
 
Chris & China said:
I don't even discuss China's diabetes with her vet anymore past them asking "How's she doing" and me answering "she's on 1.5u and her BG readings run between 50-120 most of the time"......and thats the end of it!
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I've got to that stage, too. After the months of not being able to get an insulin Rx and the resultant exacerbation of Saoirse's pancreatitis I only share the basics now, and I give them a butcher's at her spreadsheet when I go for consults. Our main vet is well aware that I know what I'm at when it comes to adjusting doses.


Mogs
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Critter Mom said:
I've got to that stage, too. After the months of not being able to get an insulin Rx and the resultant exacerbation of Saoirse's pancreatitis I only share the basics now, and I give them a butcher's at her spreadsheet when I go for consults. Our main vet is well aware that I know what I'm at when it comes to adjusting doses.


Mogs
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Same here. I gave my vet the link to my SS, he checks it every once in a while or if I call with a question, but basically leaves me alone when it comes to Squallie's treatment. He does want to do a curve at the clinic, though, (which I think is wholly unnecessary!), if I switch to Lantus.
 
Squalliesmom said:
Same here. I gave my vet the link to my SS, he checks it every once in a while or if I call with a question, but basically leaves me alone when it comes to Squallie's treatment. He does want to do a curve at the clinic, though, (which I think is wholly unnecessary!), if I switch to Lantus.
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Lucy, stick to you guns about them NOT doing the curve for reasons of undue stress on Squallie and you are perfectly capable to do it and also money. That really makes me so angry for you! :mad:
 
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