7/6 Ozzy PMPS 24.3 7 UNITS

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Hi! I just had a quick peek at Ozzy's spreadsheet and am wondering how long the pancreatitis has been an issue. That info may be available elsewhere so forgive me if I am asking again about something you have already made folks aware of.

With my Menace, she was pretty much flat all the time. Sometimes with a dose increase, I would see an initial minor drop in her numbers, get my hopes up and then the numbers would go right back to where they were. I think Wendy & Neko coined it as the "Dose going stale". Lower carb food vs. higher carb food made no difference whatsoever with Menace. Chronic pancreatitis was initially suggested to me as a possible cause but with no symptoms/flareups of pancreatitis ever apparent it seemed likely to me there was something else going on and that's when I pushed for high dose testing to be done.

The test for the high dose condition IAA (Insulin Auto Antibodies) is called "Insulin Antibodies". It falls under Endocrinology, Pancreatic Function on the lab form. I'm sure the RVC would be able to direct you to where/how to get the test done in the UK if your vet is not familiar or co-operating. I would also get the IGF-1 (Insulin Like Growth Factor), done to see if perhaps you are dealing with acromegaly. IAA is somewhat rarer than acromegaly which is thought to occur in up to 25% of cats with diabetes. Some cats just need higher doses of insulin and certainly the pancreatitis and respiratory infection may be influencing that right now, but I noted Ozzy was on a high dose of Caninsulin before the ProZinc, so getting the high dose testing done may shed some light on why he needs more insulin than what is considered average. Just let me know if you have any other questions.
 
The gravy is High Carb and these numbers don't need High carb. Or maybe I am missing something?

Yes, I bought some new wet foods earlier and in a bid to get him off the dry and lower his numbers I gave him this one, earlier. I then remembered that gravy raises numbers. I'm making mistakes, I'm that tired now... I haven't had an uninterrupted night since about a month and a half ago, when the pancreatitis started. I am going to stay up at least until 2 am, where the +6 is, to see where he's at.
 
Mogs isn't on the board often lately but she's in the UK and purchased a ketone testing monitor for her girl, Saoirse, earlier this year. She would be able to direct you. I'm going to tag her for you hoping she will see this.

@ Critter Mom, can you provide some info about the ketone testing glucometer you purchased for Saoirse? Thanks!:)
 
Hi! I just had a quick peek at Ozzy's spreadsheet and am wondering how long the pancreatitis has been an issue. That info may be available elsewhere so forgive me if I am asking again about something you have already made folks aware of.

With my Menace, she was pretty much flat all the time. Sometimes with a dose increase, I would see an initial minor drop in her numbers, get my hopes up and then the numbers would go right back to where they were. I think Wendy & Neko coined it as the "Dose going stale". Lower carb food vs. higher carb food made no difference whatsoever with Menace. Chronic pancreatitis was initially suggested to me as a possible cause but with no symptoms/flareups of pancreatitis ever apparent it seemed likely to me there was something else going on and that's when I pushed for high dose testing to be done.

The test for the high dose condition IAA (Insulin Auto Antibodies) is called "Insulin Antibodies". It falls under Endocrinology, Pancreatic Function on the lab form. I'm sure the RVC would be able to direct you to where/how to get the test done in the UK if your vet is not familiar or co-operating. I would also get the IGF-1 (Insulin Like Growth Factor), done to see if perhaps you are dealing with acromegaly. IAA is somewhat rarer than acromegaly which is thought to occur in up to 25% of cats with diabetes. Some cats just need higher doses of insulin and certainly the pancreatitis and respiratory infection may be influencing that right now, but I noted Ozzy was on a high dose of Caninsulin before the ProZinc, so getting the high dose testing done may shed some light on why he needs more insulin than what is considered average. Just let me know if you have any other questions.
Thank you very much, that was really helpful. I'm getting the acromegaly and the IAA tests done tomorrow. Not sure how long it takes for results to come back. I asked my vet today after a couple of people suggested it on here last night, and he said that he'd been wanting to talk to me about that, too. So...we are testing for both tomorrow. How are they treated, do you know?

No problem at all about asking for details! That's how you can help, I'm more than happy to repeat information, I know that the content in previous threads can be overwhelming, especially if one is trying to keep oneself alive in the process. :) The pancreatitis has been an issue for around 6-7 weeks now, at least diagnosed. He was never diagnosed with pancreatitis before, although he's been diabetic since 2010 and IBD for many more years than that (diagnosed around 2004, I think). He settled on the 8 units of Caninsulin for a long time- 6 years. At that point, and since he's become diabetic up until just recently, Caninsulin was the only animal use licensed insulin in the UK.

How is Menace doing now? Was she diagnosed with IAA and/or acromegaly? Did you go to the RVC? That's where I've been referred to...
How many units is Menace on now and what did she get up to?

Was pancreatitis ever confirmed, did you figure out why the flat curve?
 
Yes, I bought some new wet foods earlier and in a bid to get him off the dry and lower his numbers I gave him this one, earlier. I then remembered that gravy raises numbers. I'm making mistakes, I'm that tired now... I haven't had an uninterrupted night since about a month and a half ago, when the pancreatitis started. I am going to stay up at least until 2 am, where the +6 is, to see where he's at.
That's okay, I wanted to point it out or I would be remiss. You are doing great and I so understand those nninterrupted nights. We will help each other. ;):bighug:
 
Glad to hear you are getting the testing done. It really does make us Beans feel so much better when we understand what's behind the frustration, causing us to feel we are somehow doing something wrong or not enough. Menace has IAA only and that explains her flat curves. Pancreatitis was never confirmed and has never been an issue since her diagnosis. Her acromegaly test came back negative. Acromegaly is however a pulsative condition so while the tests can come back negative, it's not 100% conclusive because the test may be done on a day when less of the growth factor is being produced. Acromegaly can be treated with radiation to the pituitary tumour that causes it but the treatment is very expensive. The alternative is to just try to keep ahead of the problem with high doses of insulin and deal with any other symptoms of the acromegaly as they occur.

IAA tends to burn itself out usually after a year or so. With Menace, I got up to 16u of insulin BID and at just about the 1 year mark, I started seeing a few cycles with some movement in the right direction. I have gradually been reducing her dose in line with her test results and I just reduced her to 10.5u last night so we are still heading in the right direction! It can be a bit of a roller coaster ride while they start coming down but it's all worth the sleepless nights to see the progress and those of dealing with it have all learned to do BCS (BIG CHICKEN SHOTS) when the sleep deprivation starts to get the better of us while the numbers are dropping. I am finding Menace's drops happen in spurts so I get breaks and then back into the fray we go!

Some cats with Acromegaly have needed as little as 4unit or as much as 100+ units of insulin twice daily and many folks dealing with the high dose conditions use regular insulin as well as one of the long acting insulins to keep their kitties in reasonable numbers. I was about to embark on that route myself when Menace's resistance started to break. Some of the more experienced folks with acromegaly and IAA cats have suggested that the ideal long acting insulins for these conditions are Lantus or Levemir because of their long action and predictability so if Ozzy's tests were to come back positive for one of these conditions that is something else you could consider. I'm in Canada so no RVC for me. I wish I'd had benefit of that expertise. Thankfully though, I have a wonderful vet who is super supportive and works with me, as well as the expertise of the folks here who have walked this path before me! They have been immensely helpful!!

Here is a great thread (at least in my opinion:D) with a discussion about the different high dose conditions with several of the "experts" on this board. Hopefully Ozzy is just a high dose kitty with none of these high dose conditions but it helps to be informed so we can help our furry kids in the best way possible. :bighug:
 
Glad to hear you are getting the testing done. It really does make us Beans feel so much better when we understand what's behind the frustration, causing us to feel we are somehow doing something wrong or not enough. Menace has IAA only and that explains her flat curves. Pancreatitis was never confirmed and has never been an issue since her diagnosis. Her acromegaly test came back negative. Acromegaly is however a pulsative condition so while the tests can come back negative, it's not 100% conclusive because the test may be done on a day when less of the growth factor is being produced. Acromegaly can be treated with radiation to the pituitary tumour that causes it but the treatment is very expensive. The alternative is to just try to keep ahead of the problem with high doses of insulin and deal with any other symptoms of the acromegaly as they occur.

IAA tends to burn itself out usually after a year or so. With Menace, I got up to 16u of insulin BID and at just about the 1 year mark, I started seeing a few cycles with some movement in the right direction. I have gradually been reducing her dose in line with her test results and I just reduced her to 10.5u last night so we are still heading in the right direction! It can be a bit of a roller coaster ride while they start coming down but it's all worth the sleepless nights to see the progress and those of dealing with it have all learned to do BCS (BIG CHICKEN SHOTS) when the sleep deprivation starts to get the better of us while the numbers are dropping. I am finding Menace's drops happen in spurts so I get breaks and then back into the fray we go!

Some cats with Acromegaly have needed as little as 4unit or as much as 100+ units of insulin twice daily and many folks dealing with the high dose conditions use regular insulin as well as one of the long acting insulins to keep their kitties in reasonable numbers. I was about to embark on that route myself when Menace's resistance started to break. Some of the more experienced folks with acromegaly and IAA cats have suggested that the ideal long acting insulins for these conditions are Lantus or Levemir because of their long action and predictability so if Ozzy's tests were to come back positive for one of these conditions that is something else you could consider. I'm in Canada so no RVC for me. I wish I'd had benefit of that expertise. Thankfully though, I have a wonderful vet who is super supportive and works with me, as well as the expertise of the folks here who have walked this path before me! They have been immensely helpful!!

Here is a great thread (at least in my opinion:D) with a discussion about the different high dose conditions with several of the "experts" on this board. Hopefully Ozzy is just a high dose kitty with none of these high dose conditions but it helps to be informed so we can help our furry kids in the best way possible. :bighug:
Thank you so much for this, it helps to learn as much as I can about this and to talk to people like you and the other wonderful people on this board, who've been so helpful. The anxiety and constant self-criticism with this stuff really does get to you, to the point where you make mistakes and destroy your health in the process. Thank you for linking to the thread, too, I'll have a read tomorrow. I'm so glad that Menace's numbers have started to come down. Were you/ are you testing for ketones? How did you keep that at bay for so long (the toxicity)?

Ozzy's long-term vet thinks that Lantus or Levemir would be more risky for Ozzy, since the deposit will mean that if he drops, he'll stay there for longer. His BGs vary quite a bit, depending on how much he's eating, and, since I haven't yet been able to break his dry food addiction and that's high carb, a day of being home alone and sleeping and not eating might be dangerous (still amazes me that a diabetic food is high carb; how the pet food industry get away with that, I don't know).
Regardless, I think that if any of these come back positive- I am so, so hoping they don't- we'll look at these alternatives.

If needed, I will also be asking for help with these shorter-acting insulins.

What is BID, by the way? I know there's a glossary, but I haven't been able to go through much of it yet, with everything else I've been reading about.

Hugs!
 
That's okay, I wanted to point it out or I would be remiss. You are doing great and I so understand those nninterrupted nights. We will help each other. ;):bighug:
Thank you! I know what you meant, and you're right, it needs pointing out. I have been kicking myself all evening for that mistake. Although, by the looks of the cycle so far, he wouldn't have come down much anyway. But it certainly didn't need raising. By the way, when you add a note on the S/S, how can you signal that one should scroll further for the note, from the numbers (left to right)? Or do people scroll anyway, as default?
 
hmmmm, there is a way you can put in a comment that will show up as a little triangle in the upper right hand corner of the cell but, I am not sure if other can see it. Go to the upper right hand corner of your SS and click on Comment. There will be a drop down window to guide you and can add a comment and it will show up as a triangle in the upper right hand corner of the cell. I am really not sure if it is visible to others but try it and we can check it out.
 
hmmmm, there is a way you can put in a comment that will show up as a little triangle in the upper right hand corner of the cell but, I am not sure if other can see it. Go to the upper right hand corner of your SS and click on Comment. There will be a drop down window to guide you and can add a comment and it will show up as a triangle in the upper right hand corner of the cell. I am really not sure if it is visible to others but try it and we can check it out.
Thank you. I think I will attempt this tomorrow, my brain is fried. I have just taken his +6 hrs reading and it seems to be going up, not down. I know that the gravy will have played a part, but not even a dent in the numbers? What dose would you start on in the morning, given these numbers? I know that caution is advised, but at this point i am really worried about toxicity building up... :(
 
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Sorry about the "BID". My nursing days haven't quite totally left me even after all these year.:woot: It means twice daily.

Menace has never been prone to ketones and I could never catch her in the litter box or she would just stop and leave. Also with 2 other four footers and with 6 litter boxes in the house, it's hard to keep track of who is going where & when. In the early days, I had the vet check periodically, but Menace, living up to her name, has recently decided that providing urine samples for ANYONE is beneath her dignity so I was contemplating a glucometer that measured ketones until her numbers started coming down. I suppose I am being a bit cavalier here but I am home all day and pretty much pick up on any sign that things are off, so I have procrastinated. Going forward, I would definitely go the glucometer route.

I so understand the kibble issue. My Menace is a kibble addict of the worst kind. I have been trying to get this girl to eat wet food since I got her at 10 weeks old and all she does is try to bury it as if it were her own waste. She won't even eat her kibble if it is in the vicinity of wet food. Those mournful looks of disgust at her brother's food dishes say it all! The only soft thing to enter Menace's mouth has been a few bits off a peanut butter sandwich she decided to sample when Mom wasn't looking! What possessed her that day I have no idea! So I am feeding her kibble as low in carbs as I can get and that she will eat, but still less than optimal for a diabetic cat. She has to eat! Every day for more than 5 years, I offer her wet food and let her contemplate how hungry she is. Never does her hunger outdo her commitment to crunchy food. I have tried every trick in the book and more along with every variety of wet food I could find but to no avail. To my credit, I managed to transition my 17 year old cat to an all wet diet in the process and he won't even touch kibble now so I think I have just been outsmarted by an extremely willful feline named Menace. :rolleyes:

Not being totally familiar with Ozzy's history, I can't argue with your vet's assumption about the long acting insulins but most of your experience has been with Caninsulin. The curve with Lantus or Levemir is much slower and smoother so from my novice viewpoint and what I see on Ozzy's spreadsheet now, I'm not sure how he/she came to that conclusion.
 
Andra, with all the factors that can be in play, it's hard to tell you for sure. I have suspicions about what is going on, but there are so many options...and I'm afraid I just don't know wha tto tell you on dose. When are you getting the high dose conditions checked?
 
Andra, with all the factors that can be in play, it's hard to tell you for sure. I have suspicions about what is going on, but there are so many options...and I'm afraid I just don't know wha tto tell you on dose. When are you getting the high dose conditions checked?
Hi Rachel. I know you can't know for sure, of course. What are you thinking, in terms of what may be going on, the high dose conditions? I'm asking because it might be a lead into investigating other possible causes.

We went to the vet today and they took blood. They are sending it off to check for acromegaly and ketones. They took enough blood to check for insulin resistance too, but then the vet called and said that actually, there's nowhere in England that does this, they send it over to the US! And so...he wants to hold off on that for now, since he said the only identified high dose condition that would change treatment for us in the short term is the acromegaly. He said that there's nothing one actually does about insulin resistance (this is what I've read, as well) other than putting the dose up until it 'breaks' the resistance and things return to normal. Obviously, I'll be checking his BGs consistently, especially if everything else comes back negative, he ends up on a really high dose and that's the most likely explanation.

In other news, as soon as I brought him back from the vet's, his eyes started producing yellowish stuff again and his breathing got a bit raspier. He's been off the antibiotics for the upper respiratory infection for two days now, and I was hoping it had gone away... :(
 
Sorry about the "BID". My nursing days haven't quite totally left me even after all these year.:woot: It means twice daily.

Menace has never been prone to ketones and I could never catch her in the litter box or she would just stop and leave. Also with 2 other four footers and with 6 litter boxes in the house, it's hard to keep track of who is going where & when. In the early days, I had the vet check periodically, but Menace, living up to her name, has recently decided that providing urine samples for ANYONE is beneath her dignity so I was contemplating a glucometer that measured ketones until her numbers started coming down. I suppose I am being a bit cavalier here but I am home all day and pretty much pick up on any sign that things are off, so I have procrastinated. Going forward, I would definitely go the glucometer route.

I so understand the kibble issue. My Menace is a kibble addict of the worst kind. I have been trying to get this girl to eat wet food since I got her at 10 weeks old and all she does is try to bury it as if it were her own waste. She won't even eat her kibble if it is in the vicinity of wet food. Those mournful looks of disgust at her brother's food dishes say it all! The only soft thing to enter Menace's mouth has been a few bits off a peanut butter sandwich she decided to sample when Mom wasn't looking! What possessed her that day I have no idea! So I am feeding her kibble as low in carbs as I can get and that she will eat, but still less than optimal for a diabetic cat. She has to eat! Every day for more than 5 years, I offer her wet food and let her contemplate how hungry she is. Never does her hunger outdo her commitment to crunchy food. I have tried every trick in the book and more along with every variety of wet food I could find but to no avail. To my credit, I managed to transition my 17 year old cat to an all wet diet in the process and he won't even touch kibble now so I think I have just been outsmarted by an extremely willful feline named Menace. :rolleyes:

Not being totally familiar with Ozzy's history, I can't argue with your vet's assumption about the long acting insulins but most of your experience has been with Caninsulin. The curve with Lantus or Levemir is much slower and smoother so from my novice viewpoint and what I see on Ozzy's spreadsheet now, I'm not sure how he/she came to that conclusion.
Your Menace sounds like such a character! Much like my Oz. He's very particular about a lot of things. Hasn't made caring for his IBD and diabetes any easier, but he's such a total sweetheart about all the poking, stinging, and the various other undignified things we've done to him, that I really can't complain! Besides, like your Menace, he's both very intelligent and wilful and quite the character, in many ways.

I'm glad you can be home to care for her, that makes a lot of difference to the anxiety. That sounds like a really full house, and a happy one too, with all those little furry legs running around! :)

What dry kibble did you end up feeding Menace after all? Does she even lick at any wet food? I am still ordering lots of things to try to get him onto a better diet (wet and the low carb dry that @Elizabeth and Bertie suggested). My next plan of attack is to order the EZ complete supplement and try and coax him into the homemade again. I think I have my work cut out!

That's amazing about the 17- year old cat, by the way! Congratulations! It is so much to do with their characters (and other conditions, too).
 
Menace is indeed a character and lives up to her name quite frequently but that's just one of her many endearing qualities. She too is a real "pussycat" when it comes to testing and shots. Thankfully Menace has been very healthy except for the diabetes with IAA. She had a dental done in January and I thought it would be impossible to give her antibiotics by mouth, but she ended up being pretty good about it. I really think they know when we are trying to help them and as long as we have a "can do" attitude, they have confidence in us.

As for kibble, right now I have Menace eating Nature Valley Instinct Ultimate Protein. Not sure if that is available in the UK or not. Sounds great but is about 15% carbs so still too high. Our selection of low carb kibble here in Canada is dismal. I used to feed her EVO but they left the Canadian market leaving me high and dry for anything under 10%. She will not even lick wet food. In fact she won't eat her kibble if it is near one of her brother's canned food meals. One day when her numbers were low, I tried to get her to take some gravy from some higher carb wet food. I had to try to get it in her mouth and let's just say, I got more on me than she got in her mouth! You would have thought I was trying to poison her!:rolleyes:

If you can get TiKi cat food, they now have a kibble available called Born Carnivore which I am going to look into. It appears it will likely be about 15% carbs too but I haven't done the math yet. I tried home cooked, dehydrating, adding kibble to wet, etc. etc. but to no avail. My only regret now is that I wasn't more assertive about the wet diet when Menace was a kitten, but hindsight is 20/20 and there is no point crying over spilled milk.

They are sending it off to check for acromegaly and ketones. They took enough blood to check for insulin resistance too, but then the vet called and said that actually, there's nowhere in England that does this, they send it over to the US! And so...he wants to hold off on that for now, since he said the only identified high dose condition that would change treatment for us in the short term is the acromegaly. He said that there's nothing one actually does about insulin resistance (this is what I've read, as well) other than putting the dose up until it 'breaks' the resistance and things return to normal

Interesting that they do the IGF-1 but not the IAA testing in the UK. The cost of those tests is very reasonable here but then the shipping gets added on, plus money exchange rates and the cost went up considerably so I can only imagine what the costs would be from the UK to the US. Your vet is correct in that all you can do with the IAA is keep dosing until the antibodies cry UNCLE so his decision was a reasonable one. I just hope he didn't get duped by some lab that doesn't know the test can be done locally. The lab my vet uses told her there was no IAA test. I insisted and provided the Univ. of Michigan test code # and then they were fine with sending it off. Such fun when you have to "manage" those who should be the experts for this stuff. :banghead:
 
Menace is indeed a character and lives up to her name quite frequently but that's just one of her many endearing qualities. She too is a real "pussycat" when it comes to testing and shots. Thankfully Menace has been very healthy except for the diabetes with IAA. She had a dental done in January and I thought it would be impossible to give her antibiotics by mouth, but she ended up being pretty good about it. I really think they know when we are trying to help them and as long as we have a "can do" attitude, they have confidence in us.

As for kibble, right now I have Menace eating Nature Valley Instinct Ultimate Protein. Not sure if that is available in the UK or not. Sounds great but is about 15% carbs so still too high. Our selection of low carb kibble here in Canada is dismal. I used to feed her EVO but they left the Canadian market leaving me high and dry for anything under 10%. She will not even lick wet food. In fact she won't eat her kibble if it is near one of her brother's canned food meals. One day when her numbers were low, I tried to get her to take some gravy from some higher carb wet food. I had to try to get it in her mouth and let's just say, I got more on me than she got in her mouth! You would have thought I was trying to poison her!:rolleyes:

If you can get TiKi cat food, they now have a kibble available called Born Carnivore which I am going to look into. It appears it will likely be about 15% carbs too but I haven't done the math yet. I tried home cooked, dehydrating, adding kibble to wet, etc. etc. but to no avail. My only regret now is that I wasn't more assertive about the wet diet when Menace was a kitten, but hindsight is 20/20 and there is no point crying over spilled milk.



Interesting that they do the IGF-1 but not the IAA testing in the UK. The cost of those tests is very reasonable here but then the shipping gets added on, plus money exchange rates and the cost went up considerably so I can only imagine what the costs would be from the UK to the US. Your vet is correct in that all you can do with the IAA is keep dosing until the antibodies cry UNCLE so his decision was a reasonable one. I just hope he didn't get duped by some lab that doesn't know the test can be done locally. The lab my vet uses told her there was no IAA test. I insisted and provided the Univ. of Michigan test code # and then they were fine with sending it off. Such fun when you have to "manage" those who should be the experts for this stuff. :banghead:
I think you're right about them knowing we are trying to help them. And they do trust us. It's such an honour, isn't it? This animal that could shred you lets you shove things in its mouth, poke its ear, its skin and occasionally its bum.

Wow, Menace really hates wet! That's funny, that she won't go near her kibble if it's even in the vecinity of her brother's bowl. I also have regrets about letting him eat dry when he was diagnosed with IBD and the vet prescribed it (he was on wet prior to that, but in fairness, he'd stopped eating the meat, would only have the jelly). But, like you say, hindsight is 20/20. I will look into Tikicat. I doubt we have it here, in the UK. But I might find some place that imports it.

That's interesting that the vet got duped... I wonder why. Surely, the lab has an interest in doing the tests and getting people's money? I'll double check. It's tricky though, raising the question, which is often heard as (and sometimes means) I don't trust your expertise and judgement. Even if we're right, as you were, it's tricky. How did the vet react to that? What does the code mean, by the way? I didn't even know testing places had a code!
 
How did the vet react to that? What does the code mean, by the way? I didn't even know testing places had a code
My vet is so cool and doesn't view herself as the consummate expert in everything as so many medical professionals unfortunately do. She admits her shortcomings and diabetes is not something vets treat on a daily basis. Most practises have very few diabetic patients. I think we have developed a relationship where she knows I will do anything for my kitties and I research until I'm ready to drop. She too is willing to research so we work as a team. The tests I wanted done were so unusual for the average practice that she never blinked an eye. I quite frankly think she is viewing our journey as a learning experience for her as she has never had a patient with IAA before.

Labs often (if not always) have code numbers for the tests they do probably for billing purposes more than anything else. The Univ. of Michigan happens to have that information on their website so it was very easy for me to access it and straighten out the lab personnel who apparently had not run into anyone wanting the test done before either.

I wouldn't shy away from asking again just to be sure. You are Ozzy's advocate and entitled to ask all the questions you want. It doesn't mean you are questioning your vet's expertise....it means you are making sure all the info you have is correct. Any vet/human doctor who takes offense to any questions, in my opinion, is too full of themselves to be worthy of my trust.
 
My vet is so cool and doesn't view herself as the consummate expert in everything as so many medical professionals unfortunately do. She admits her shortcomings and diabetes is not something vets treat on a daily basis. Most practises have very few diabetic patients. I think we have developed a relationship where she knows I will do anything for my kitties and I research until I'm ready to drop. She too is willing to research so we work as a team. The tests I wanted done were so unusual for the average practice that she never blinked an eye. I quite frankly think she is viewing our journey as a learning experience for her as she has never had a patient with IAA before.

Labs often (if not always) have code numbers for the tests they do probably for billing purposes more than anything else. The Univ. of Michigan happens to have that information on their website so it was very easy for me to access it and straighten out the lab personnel who apparently had not run into anyone wanting the test done before either.

I wouldn't shy away from asking again just to be sure. You are Ozzy's advocate and entitled to ask all the questions you want. It doesn't mean you are questioning your vet's expertise....it means you are making sure all the info you have is correct. Any vet/human doctor who takes offense to any questions, in my opinion, is too full of themselves to be worthy of my trust.
Thank you, and sorry for the belated reply. I will try again on the antibody resistance test. There are a number of tests that vet practices do routinely send to the US, apparently, so this may just be one of them. We'll send it if we have to. Your vet sounds like they have the right attitude to this.
 
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