New Dx! Some advice re: problematic vet and new course of action?

[Lauren & Eliot]

Hello! This is super long, I'm sorry! D: I had to cut it down because it was pretty much a novel before, so let me know if you need clarification.

Eliot was diagnosed last week and we got off to a really rocky start. Eliot is my (totally worth it) "problem child" who has had most of his teeth removed, a cancer scare, and now this, all in the last 3 years, and this vet has been with me the whole time and until now pretty much amazing. However, after the last couple days I'm at the point where I'm considering taking him to another vet who specializes in FD and can give me a good outline on how to give him the best fighting chance of going into remission, but I thought I'd start here first. <3

I took him in when I noticed he was peeing more often than usual and they did blood tests, called me the next day, I brought him in the day after that. Very normal, but it's at his visit yesterday where it goes downhill.

My overall feeling is they just do not have proper systemization for dealing with FD and are kind of seat of their pants-ing it with no kind of consistency. I feel like they told their vet techs what to do, but there was no list to check off to make sure everything was handled and for some reason they never thought that thorough documentation for their patients was necessary. Like it's not stressful enough, now here memorize all these facts and numbers that we throw at you while teaching you how to inject your cat!

I was initially told that he had lost 3.5lbs, ends up he didn't, they made a mistake, which is fine but. There was no apology or recognition that they basically had me thinking for a good week that we needed to get this fixed ASAP or I was at risk of my cat dying from starvation etc. Then when I went in later to learn how to track glucose I was not only told that the information I was given when I called in a couple days prior to get him to eat at the right times was wrong, I was blamed and scolded for it. Seriously, straight up told, "What were you thinking? We're going to retrain your thought process". Um, excuse you?

The initial booklet they gave me had contrasting information to the training they gave me the same day. I was never asked about his eating habits to help me transition to meal feelings; he's a grazer. They gave him canned food (3% carbs) but also a dry food with 13% carbs which doesn't bode well for them trying to get him to remission with me. They have never made a mention of his weight - I know, I should have educated myself, but this is also their job - until he had FD and then suddenly it was this huge issue but at the same time the recommended calories per day they've given me are huge.

My appointment to learn how to use a glucometer was laughable, with again, no documentation or systemization. The initial booklet mentions their glucometer rental program, vaguely, and says they would make me chart, but that didn't happen, nor did they even teach me how to chart at all. I wasn't even told when I was supposed to be charting, and, again, there was no documentation of what I should be looking for in terms of readings, just a brief mention of "around 8, go to emergency if he hits 5".

It sort of feels like they're not trying to get him to remission and more just, "Hey, don't let him go blind and die, kay?".

This is all so disappointing as, as I mentioned, they've been an amazing clinic up until now. I'm in Canada, so at least the insulin is expensive but not horrific - and it was actually my pharmacist who knew enough to give me cartridges and not 10ml vials like I was prescribed - like in the US, but I need a solid plan, as cost efficient as possible without all the clinic padding, of how to give my fluffy baby the best chance possible to get into remission.

Right now I'm thinking I'm going to use up the wet food I already bought, but I'm going to try to phase out the dry food, bit by bit. I'll buy a different canned food when it's gone; PurinaPro DM (which is what he's on) is fine for carbs but not high enough in protein to justify the cost. I was looking at Weruva Paw Lickin' Chicken but the calories are super low on it; I'd have to be feeding him two cans a day plus some kind of extra calorie topper to get him at 260 calories which is where I want to start him and then gently reduce from there once his glucose levels even out to get him to 14lbs (he's 15.5 now). I'm going through the CatInfo list, but do you have any suggestions? Even better if it's chunky/bits kind as he does not seem thrilled with pate textures.

I'm renting a AlphaTrak2 at the moment, but while they only want $85 to buy the machine, they want $77 for 50 strips! I'll be doing a lot of reading up on glucometers in the next little while, but am happy for suggestions of alternatives.

AND FINALLY! I put out a specific amount of canned food twice a day and leave a very specific amount of dry food out at all times that I'm, as I mentioned, going to try to wean out. As long as I see he's finishing all his food in his 24 hour period, and I'm testing before I put out wet food, is it safe to be giving him his insulin? This is what they've told me to do now, he's on 1U of Lantus twice a day, which is slow acting, but it seems to go against everything I've been reading and after the "What were you thinking" scolding I'm feeling a little paranoid. D:

Thank you so much if you made it this far; this seems like such an amazing community and while I'm sad to have to be here I'm so glad I found all of you. <3

 

[Alexi]

Welcome! Good that you are learning to home test but you don't need to buy a specific pet meter - and the strips are expensive. Many people on the board use a cheap human meter that takes a small amount of blood and takes inexpensive strips. We have Canadians on the board who can advise on the best to get and on the food as well. A low carb commercial canned cat food is what is recommended but you don't need the expensive 'vet diets'. We use a google drive spreadsheet to record blood sugar readings and we have a forum for Lantus users so if you need specific advice on your inulin there are plenty of experienced users that can help. It is a good idea to periodically check the urine for ketones using strips that should be available at pharmacies or anywhere that sell diabetic supplies, I use keto-diastix. Lantus is a slow acting insulin and has a good remission rate so is suitable for your handsome Eliot. Have a read around the sticky threads on the fora which have a wealth of information to help get you started. If you have specific questions then post on the health forum. There is plenty of help and advice available so just ask away with any questions. Feeling stressed and worried is very normal at this stage and we can talk you through everything you need to know.

 

[Chris & China (GA)]

Welcome to the FDMB Lauren and extra sweet Eliot!

You might want to seriously consider a human meter....The Bravo Meter is available in Canada and the strips are a lot more affordable!! All our protocols are developed for use with human meters anyway

Sorry you've had such a hard time with your vet, but it's a story we hear all the time here. Vets only get 5 hours of formal education on diabetes in school (and that covers all species!) so unless they have a particular interest in feline diabetes, they tend to treat their cats like they'd treat small dogs.....at least your vet has you on a good insulin for cats!!

The people here have many years of real life experience dealing with this disease, so they can teach you all the steps of the sugardance that you need to learn

 

[Lauren & Eliot]

Thank you so much for your replies! I audibly made a sigh of relief. (Also, Eli must have sensed the compliments, he finally left his afternoon nap to come see me, ha!)

Alexi: Ketones are probably going to be week three - week one, injections; week two, glucose reads; week three, ketones? - thank you for the brand recommendation. And I'll go pester the Lantus board for their feelings on the best way to administer doses for "free-ish" feeding hopefully meals eventually kitties, thank you. <3

Chris: YOU'RE MY HERO! I'd been making a list of places to get Freestyle Lite strips, since I heard those fit the AT2 - I got it down to $.77/per! XD - but $.40/per plus a free meter? Uh, sold. That's worth having to plan ahead, at least for me. I'm trying to get costs per day (minus food, so insulin, lancets, strips, syringe) to under $2.50 and Bravo would be under $2!

(I'm also looking at MediSure Canada; you get 100 Test Strips, 100 lancets, the MediSure meter, lancing device, carrying case, free shipping and no tax for $70, which sounds great. 100 test strips + 100 lancets are $70 and you can get them in a small pharmacy down the street from me, if there's an emergency. But they're more pricy than $.40 plus I can only find two reviews on them; one negative, the other pretty fishy. Hmm. More research needed.)

And I had no idea they received that little training on diabetes! That makes suddenly so much more sense and makes me feel so much better. I mean, I'm probably going to still mention it to them - and maybe give some suggestions on how to improve their "intro packet" in a couple months once I'm better at this - but I'm not searching quite so hard for another vet. I really appreciate it.

 

[Chris & China (GA)]

Yeah, you guys in Canada get cheaper insulin than we do, but you pay for it in the cost of your strips, so I'm glad I could help save you a little money!!

I was lucky....When China was first diagnosed, it was a Friday afternoon and the next day I had to go back to the vet anyway for a shot clinic for my drooler, so since they couldn't get any urine from her, I had them keep her overnight.....that night I hit Google and pretty much everything I searched for that had to do with feline diabetes led me to the FDMB so I read a lot that night and when I went back to pick her up, I already had a good idea of how I wanted to proceed....Unfortunately my vet was an a** and wouldn't even discuss anything I'd learned, so we left and she's never been back. I found another vet willing to write me the script for Lantus and she hasn't seen a vet for her diabetes since. I've listened to the people here who have the real life experience instead. When she does have to go for other reasons, her current vet asks me how she's doing and I just say "she's on X units of insulin and her numbers usually run from 50-120"....and that's the end of the conversation usually....when she does feel like she has to give me something in the way of advice, I just nod my head and smile and say "I'll have to think about that".....and then we go home and I continue doing what I know works!!

 

[Photorecon]

Hello! This is super long, I'm sorry! D: I had to cut it down because it was pretty much a novel before, so let me know if you need clarification.

Eliot was diagnosed last week and we got off to a really rocky start. Eliot is my (totally worth it) "problem child" who has had most of his teeth removed, a cancer scare, and now this, all in the last 3 years, and this vet has been with me the whole time and until now pretty much amazing. However, after the last couple days I'm at the point where I'm considering taking him to another vet who specializes in FD and can give me a good outline on how to give him the best fighting chance of going into remission, but I thought I'd start here first. <3

I took him in when I noticed he was peeing more often than usual and they did blood tests, called me the next day, I brought him in the day after that. Very normal, but it's at his visit yesterday where it goes downhill.

My overall feeling is they just do not have proper systemization for dealing with FD and are kind of seat of their pants-ing it with no kind of consistency. I feel like they told their vet techs what to do, but there was no list to check off to make sure everything was handled and for some reason they never thought that thorough documentation for their patients was necessary. Like it's not stressful enough, now here memorize all these facts and numbers that we throw at you while teaching you how to inject your cat!

I was initially told that he had lost 3.5lbs, ends up he didn't, they made a mistake, which is fine but. There was no apology or recognition that they basically had me thinking for a good week that we needed to get this fixed ASAP or I was at risk of my cat dying from starvation etc. Then when I went in later to learn how to track glucose I was not only told that the information I was given when I called in a couple days prior to get him to eat at the right times was wrong, I was blamed and scolded for it. Seriously, straight up told, "What were you thinking? We're going to retrain your thought process". Um, excuse you?

The initial booklet they gave me had contrasting information to the training they gave me the same day. I was never asked about his eating habits to help me transition to meal feelings; he's a grazer. They gave him canned food (3% carbs) but also a dry food with 13% carbs which doesn't bode well for them trying to get him to remission with me. They have never made a mention of his weight - I know, I should have educated myself, but this is also their job - until he had FD and then suddenly it was this huge issue but at the same time the recommended calories per day they've given me are huge.

My appointment to learn how to use a glucometer was laughable, with again, no documentation or systemization. The initial booklet mentions their glucometer rental program, vaguely, and says they would make me chart, but that didn't happen, nor did they even teach me how to chart at all. I wasn't even told when I was supposed to be charting, and, again, there was no documentation of what I should be looking for in terms of readings, just a brief mention of "around 8, go to emergency if he hits 5".

It sort of feels like they're not trying to get him to remission and more just, "Hey, don't let him go blind and die, kay?".

This is all so disappointing as, as I mentioned, they've been an amazing clinic up until now. I'm in Canada, so at least the insulin is expensive but not horrific - and it was actually my pharmacist who knew enough to give me cartridges and not 10ml vials like I was prescribed - like in the US, but I need a solid plan, as cost efficient as possible without all the clinic padding, of how to give my fluffy baby the best chance possible to get into remission.

Right now I'm thinking I'm going to use up the wet food I already bought, but I'm going to try to phase out the dry food, bit by bit. I'll buy a different canned food when it's gone; PurinaPro DM (which is what he's on) is fine for carbs but not high enough in protein to justify the cost. I was looking at Weruva Paw Lickin' Chicken but the calories are super low on it; I'd have to be feeding him two cans a day plus some kind of extra calorie topper to get him at 260 calories which is where I want to start him and then gently reduce from there once his glucose levels even out to get him to 14lbs (he's 15.5 now). I'm going through the CatInfo list, but do you have any suggestions? Even better if it's chunky/bits kind as he does not seem thrilled with pate textures.

I'm renting a AlphaTrak2 at the moment, but while they only want $85 to buy the machine, they want $77 for 50 strips! I'll be doing a lot of reading up on glucometers in the next little while, but am happy for suggestions of alternatives.

AND FINALLY! I put out a specific amount of canned food twice a day and leave a very specific amount of dry food out at all times that I'm, as I mentioned, going to try to wean out. As long as I see he's finishing all his food in his 24 hour period, and I'm testing before I put out wet food, is it safe to be giving him his insulin? This is what they've told me to do now, he's on 1U of Lantus twice a day, which is slow acting, but it seems to go against everything I've been reading and after the "What were you thinking" scolding I'm feeling a little paranoid. D:

Thank you so much if you made it this far; this seems like such an amazing community and while I'm sad to have to be here I'm so glad I found all of you. <3

Thanks to google you ended up here, best place for real life informatoin about FD.

I understand how you feel regarding your vet visit. I tough my vet clinic were savers to my kitty when
he started feeling bad. After the salty bill there was the kind of training you received. There was something like 6 steps
for test and shoot, they showed and made me practice all of them, went very well. It's only after more then 3 months
that I realized that all their instructions were what you shouldn't do. Of all the basic steps you have to do only filling
the syringe was explained properly, even then. How to shoot, test and everything else was wrong. They made them very
nice when telling me they would analyze the curves for free. The results ? My cat went through a life threatening situation
where I was left alone to deal with if not able to finance 24h more of close monitoring bet vet and tech.

This was the beginning of a love story with fmdb, they where there during the 24h course of action to save my cat witch
WE DID, not the vet. The vet was just the author of a desaster that could have been prevented knowing diabetes is not
as simple as sterilization.

Last visit to a vet office since then and Small Kitty is progressing.

If you have questions or need opinions don't hesitate to post, can help you here.

Welcome to the club

 

[Photorecon]

r. They gave him canned food (3% carbs) but also a dry food with 13% carbs

I would be tempted to tell you to trash this out but these are so expensive. The same food recommendation was given
to me by the vet, actually 2 vets. There is a lot of reading available on the internet, but many food brands and flavor are
of cat food from the US. You might want to take a look at this :

https://docs.google.com/spreadsheet...NVRaoG_3Dfy64/edit?pref=2&pli=1#gid=964479244

Tell me if the link doesn't work, I'll send you the document. It's from a FMDB Canadian member.

It works for my kitties, Small Kitty doesn't have any significant food spike with this food.

 

[Lisa and Witn (GA)]

If the food they sold you is prescription food, you should be able to take it back to the vet for a refund, even if it is open. Just say your cat does not like it. Many of us feed our cats store brands like Fancy Feast and Friskies. Pate flavors are generally lower in carbs. Anything with gravy is going to be higher.

Unfortunately it is not uncommon to find that the vets we trust have very little training in feline diabetes. Hopefully though, your vet is willing to work and learn from you as you begin this journey. I know there are some vets that think anything we find on the internet could never be true and we should only listen to them. However, all of the members of FDMB have been where you are now and learned how to successfully learn how to manage our cat's diabetes. I have had 4 diabetic cats, 2 of which were rescued sugar kitties, and I have been through a similar experience as you with a new vet at the clinic I have been going to for years. She kept trying to tell me that I did not need to hometest. Which is very ironic since it was the same clinic that taught me how to test with my first diabetic kitty. We agreed to disagree, however after providing her with several weeks of test readings, she finally admitted that I knew what I was doing.

It should be a partnership between you and your vet for Eliot's care. If your vet is willing to be open to new things, they will be able to offer better care for their patients. Because of the information I have learned while being a member here and treating my cats, my vets have started using longer acting insulins, encourage hometesting and recommend this site for patients that are newly diagnosed. They have also learned when prescribing Lantus or Levemir to write scripts for the pens instead of the vials, since it will in the long run save the owners money.

Hopefully your vets will be open to learning new things. If not, just remember that you are responsible for your cat's health and you have the final say in how he shall be treated.

 

[Lauren & Eliot]

I would be tempted to tell you to trash this out but these are so expensive. The same food recommendation was given
to me by the vet, actually 2 vets. There is a lot of reading available on the internet, but many food brands and flavor are
of cat food from the US. You might want to take a look at this :

https://docs.google.com/spreadsheet...NVRaoG_3Dfy64/edit?pref=2&pli=1#gid=964479244

Tell me if the link doesn't work, I'll send you the document. It's from a FMDB Canadian member.

It works for my kitties, Small Kitty doesn't have any significant food spike with this food.

Thank you!! Great link, def works; is Small Kitty on PC or one of the others on the list? I totally know what you mean. I'm cutting my losses and getting rid of the dry food; I got a lower carb dry food to wean him off of, and when the wet food is done we'll get a cheaper, better canned food but yeah, it was stupid expensive. Better of two evils, I guess? Sigh. My partner is already making hinting noises that he wants to make Eli's food, since Eli doesn't seem to like pate texture but loved the shredded chicken topper we put on to tempt him to eat it tonight. Guess we'll see? It's a long road ahead.

If the food they sold you is prescription food, you should be able to take it back to the vet for a refund, even if it is open. Just say your cat does not like it. Many of us feed our cats store brands like Fancy Feast and Friskies. Pate flavors are generally lower in carbs. Anything with gravy is going to be higher.

Unfortunately it is not uncommon to find that the vets we trust have very little training in feline diabetes. Hopefully though, your vet is willing to work and learn from you as you begin this journey. I know there are some vets that think anything we find on the internet could never be true and we should only listen to them. However, all of the members of FDMB have been where you are now and learned how to successfully learn how to manage our cat's diabetes. I have had 4 diabetic cats, 2 of which were rescued sugar kitties, and I have been through a similar experience as you with a new vet at the clinic I have been going to for years. She kept trying to tell me that I did not need to hometest. Which is very ironic since it was the same clinic that taught me how to test with my first diabetic kitty. We agreed to disagree, however after providing her with several weeks of test readings, she finally admitted that I knew what I was doing.

It should be a partnership between you and your vet for Eliot's care. If your vet is willing to be open to new things, they will be able to offer better care for their patients. Because of the information I have learned while being a member here and treating my cats, my vets have started using longer acting insulins, encourage hometesting and recommend this site for patients that are newly diagnosed. They have also learned when prescribing Lantus or Levemir to write scripts for the pens instead of the vials, since it will in the long run save the owners money.

Hopefully your vets will be open to learning new things. If not, just remember that you are responsible for your cat's health and you have the final say in how he shall be treated.

I'm going to see if I can get a refund on the dry food, good idea. If I can't, there's at least a shelter nearby that can use it. I really appreciate your story; it's nice to know I'm not the only one. I read these before bed last night and managed to sleep a little, which has been rare the last week. Thank you so much.

I really hope I can turn my vet around. They've been so great before this, the best would be if I could do the same as you did - which is so great, btw, I'm pretty meek at vets because it's so outside my knowledge range - and convince them to update their "intro packet". At least they had the right insulin, if in the wrong format?