? Sorry to be a pain, Vet not helping

Status
Not open for further replies.
Mary O

Mary O

Member Since 2016
Looking for advice. I am sorry to vent, but my Vet has pretty much left me high and dry this all started on Wednesday. Yesterday Toes got down so low I had to take her to the vet to get Karo syrup. They told me not to give any insulin this morning unless she was between 4 and 500. She was over 400 this morning and I gave her 1/2 U. She continued to climb and vet told me to give her 1/2 unit 4 hours later when she was at 447. I tested her again this evening 2 hours after her pm meal and she was 384 and after 5 hours she was up to 424. I gave her a unit after calling my vet and them never calling me back. Do you think a unit was okay or was it too much?
 
Whoa! So the vet said to not give insulin unless she was over 400?? I realize she wanted to make sure that you didn't have another low number episode but that's pretty extreme.

What insulin are you using?
 
Rachel said:
Whoa! So the vet said to not give insulin unless she was over 400?? I realize she wanted to make sure that you didn't have another low number episode but that's pretty extreme.

What insulin are you using?
Click to expand...
Prozinc
 
You gave 1/2 unit this AM, then another 1/2 unit 4 hours later, then 1 unit tonight, is that correct?
 
Okay! I asked because the insulins are dosed differently..

Sharon, you asked the exact question I was just typing! :)
 
Hmmm...well I'm not sure why your vet suggested that. ProZinc really should be dosed 12 hours apart. Even if the kitty is climbing, we never recommend giving another shot partway through the 12 hour cycle. How many hours after your second half unit this morning did you give the 1 unit tonight?
 
Ahhh okay. 1 unit was probably okay then. Might grab a test a few hours after the shot to just be sure Toes isn't headed down. But I wouldn't give another dose until tomorrow around 12 hours after this shot.

As a matter of curiosity, how low did Toes go yesterday? And what was the preshot number?
 
Yesterday is a long story, I will try to condense. Wednesday night I picked up from spending the night at the vet. Tuesday when she was diagnosed she had ketones in her urine so they wanted to keep an eye on that for 24 hours. Wednesday night at 8:30 they showed me how to test her. She was at 330 and they gave her 1 unit. They told me to give her 1 unit in the morning. They knew I my Alpha Trak would not be arriving in the mail until early afternoon. When I first started testing her around 1 p.m. after I got the Alpha Trak she was at 112. She continued to go down every hour and once she was at 50 they told me to bring her in. They gave her the syrup and then tested her and she was at 41. They tested urine for ketones and there were not any. This morning when I tested her before her morning meal at 6:30 a.m. she was at 439 so I gave 1/2 unit. 4 hours later (10:30) when she was at 447 the vet told me to give her 1/2 unit more. I gave the 1 unit at approximately 9:30 pm, which was 11 hours after the second dose.
 
Gotcha! That helps to know. Sounds like it's been quite a whirlwind for you!

It's interesting that she kept going down yesterday. I will say this. The BG can be elevated at the vet due to stress. So if she had been home, you might have gotten a lower number, which may have been part of the reason. Probably part of the reason you saw those higher numbers today is due to the karo they had to give her last night...and low numbers can sometimes cause a bounce. Basically, the cat hits a low number and then their body releases extra glucose to try to bring it up...which causes the number to go high.

Tomorrow, before your shot, post and let us know her number. You can post here or the prozinc forum...we have a few folks who hang out there. If you post here in Health, I'd put Prozinc in the subject line. I know @Sue and Oliver (GA) and a few others are on here keeping an eye out, but it's easy for us to miss Prozinc posts on Health since there aren't many of them! We can help you figure out a good, safe dose for Toes.

I know it's frustrated that your vet isn't much help. Heck, I'm frustrated just hearing about it! We're more than happy to help out here. We've all been where you are, and we can help!
 
Rachel said:
Gotcha! That helps to know. Sounds like it's been quite a whirlwind for you!

It's interesting that she kept going down yesterday. I will say this. The BG can be elevated at the vet due to stress. So if she had been home, you might have gotten a lower number, which may have been part of the reason. Probably part of the reason you saw those higher numbers today is due to the karo they had to give her last night...and low numbers can sometimes cause a bounce. Basically, the cat hits a low number and then their body releases extra glucose to try to bring it up...which causes the number to go high.

Tomorrow, before your shot, post and let us know her number. You can post here or the prozinc forum...we have a few folks who hang out there. If you post here in Health, I'd put Prozinc in the subject line. I know @Sue and Oliver (GA) and a few others are on here keeping an eye out, but it's easy for us to miss Prozinc posts on Health since there aren't many of them! We can help you figure out a good, safe dose for Toes.

I know it's frustrated that your vet isn't much help. Heck, I'm frustrated just hearing about it! We're more than happy to help out here. We've all been where you are, and we can help!
Click to expand...

I really, really appreciate your helping me. My vet has never discussed a plan of action and since I saw her when I took Toes in initially for the exam where she diagnosed her, I have only spoken on the phone with her once when she told me she wanted to keep Toes overnight for observation. Every other time I have called I have only spoken with a vet technician who then talks to the doctor and calls me back. Many times when I have called the receptionist says someone will call me back to answer my questions and they never call back. I have never been told about what numbers are safe, what numbers are too high, what numbers are too low, how much insulin I should give, etc. If I hadn't found this forum I would not have known that she was going way too low yesterday. It is very scary for me. I am very devoted to this cat and it frustrates me that I might jeopardize her health because I am not receiving proper instruction from the vet.
 
We totally get that. My vet didn't give me a whole lot of info either. A bit more than yours did, but not much. I found this forum first thing (luckily) and got my info from here!

To give you some basics: I see you are use the AlphaTrak. Most folks here us a human meter (the strips are way cheaper) but the AT is fine too. Basically, on that meter, below about 68 is where we consider the cat to be going hypo. So I would probably set about 90 or so as the point to start watching very carefully. Basically that just means if you get a 90, keep an eye on things to see if she is going to continue down.

In the morning and evening, we test, feed, and shoot all in about 15 minutes. We do it like that so there is some food onboard to help when the insulin goes in. If you get a test that is below...I believe 220 for an AT meter, you want to stall WITHOUT FEEDING for 15 minutes or so. Then retest to see if he's come up to a safe shot. We consider 220 to be the cutoff point for shots for new folks. Some of us shoot under that number, but we have data for how our cat reacts. If you get that number and he doesn't come up preshot, it's best to skip. That way, you don't worry about a hypo.

Generally, we consider a cat well regulated if they have yellow preshots and double digit midcycle points (what we call the nadir) that is lower than 68. Since you have just gotten this diagnosis, though, it might be a bit before you reach that point. Don't get frustrated if you have higher numbers at first. that's pretty normal at first.

Do you have a hypo kit at home? Karo syrup or high carb food? If you get a low number (or are approaching one) post here. There's usually someone around on Health even at night and we've walked plenty of people through hypos. They can often be handled at home...and people aren't afraid to tell you if they feel you need to head to a vet. :)

Okay that's a lot of info all at once. I don't want to overwhelm you more than you already are I imagine. The last piece of info for tonight. We have a protocol for ProZinc we put together. It's here: http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/ . I'd read it when you have a chance. It can help explain how we dose.

I'm about to sign off and get some sleep. But if you get a low number, do post here as someone will likely be around. Tomorrow, before the shot, let us know and we can help you figure out a good dose. And I'm with Sharon...might be time to go vet shopping!

Overall, relax and breathe. You're not alone in this. :)
 
Mary O said:
She continued to go down every hour and once she was at 50 they told me to bring her in. They gave her the syrup and then tested her and she was at 41.
Click to expand...

You really, really need a new vet. Your vet should have advised you to give glucose/karo AT HOME!!!! This was an appalling - and very dangerous - error on their part (and not the only one they've made according to the information you've provided here, e.g. not leaving long enough between doses).

Your instincts are leaving you feeling worried about Toes' safety while under the care of these vets; trust your instincts. If Toes were mine I would be looking to move to a new practice immediately - one where the vets know how to safely treat feline diabetes and all associated complications (e.g. DKA). In the meantime please post here and FDMB members will be able to help you.


Mogs
.
 
This is a useful guide: How to Handle A Hypo

See also my signature link on Secondary Monitoring Tools for other assessments which may be helpful in evaluating your cat (ex urine ketone testing tips), plus the link on Human Glucometer and Lab Reference Numbers and Notes for glucose.
 
I love my vet and totally appreciate that he said flat out "I don't know much about FD" so we have another Dr for my sugar cat and I use him for my other kitty and my sugar cats blood work etc...
 
Status
Not open for further replies.
Back
Top