Concerns about starting insulin tomorrow after seeing vet

[kayteacat]

I came back from the vet with Karo around an hour ago. The people were nice enough, but what bothered me were a few things. First thing is she tried to get a blood draw with a syringe from Karo's arm to use on both my Alphatrak2 and theirs to make sure mine is giving similar numbers. He would have none of it and after her 3rd try and him yelping I said "Let's try his ear, he had no problem with that when I did it." She agreed and he calmed down. The two meters read 140's and 160's. This is half the numbers he had shown when i tested him a couple of days ago, he was in the 300's (297 and 313) mind you this is two hours after he has had his breakfast and he ate a whole can of FF versus his usual half a can.

I'm wondering if this is normal, the fluctuation in numbers going down so much when you first change diet to strictly wet food, or is he on track to remission, or at least improving?
What really bothered me is that she said keep him on 2 units on Lantus (he starts tomorrow morning) and to not change it until I hear from the doctor, that she would relay the info. and what really bothered me is that she told me I don't have to check his blood glucose everyday. I said "really?? even know I'm just starting him on insulin, and his BG #'s are half of what they were when he was diagnosed?" and she said yes, that's right.

I'm remembering questions I wanted to ask but blanked on because I was rushed, like how to know how much insulin depending on his BG #, etc..

I made her assistant go tell the doctor what his BG # was after the visit done, and doctor said no, change it to 1 unit now... like I thought.

I'm really bothered by this veterinary clinic and how they've treated us. I was rushed with his diagnose and I was very rushed today.. she asked "any questions? I gotta run" and before that people were checking on her to see when she would be done. Why am I being treated like this and Karo, when we've paid just like everyone else to be there? I will be emailing them with complaints after posting here, I'm pretty pissed how they handled the situation. She barely showed me how to draw from a vial and then was off somewhere else.

 

[Yong & Maury GA]

Kay, I'm sorry to hear how you both were treated . I have been through at least 3 Vet clinics myself and from being on this forum I've seen more unpleasant Vet experiences. I can finally vouch for those rare good one's out there though! I wonder if you are close to @Djamila as she has a good Vet . Now for more specifics of your post!

The two meters read 140's and 160's. This is half the numbers he had shown when i tested him a couple of days ago, he was in the 300's (297 and 313) mind you this is two hours after he has had his breakfast and he ate a whole can of FF versus his usual half a can.
I'm wondering if this is normal, the fluctuation in numbers going down so much when you first change diet to strictly wet food, or is he on track to remission, or at least improving?

Yes this is not unheard of when doing complete diet change to strictly wet food. How many days has he been on new diet of wet food?

I don't have to check his blood glucose everyday. I said "really?? even know I'm just starting him on insulin, and his BG #'s are half of what they were when he was diagnosed?" and she said yes, that's right.

Definitely no, listen to your gut. Home testing is the best tool in the FD kitty tool belt and especially with such great results from diet change, you'll want to keep home testing. Mandatory testing AMPS and PMPS (morning and evening pre-shot tests). Also, those slightly higher end of normal numbers may be a little stress influenced since they tried to draw blood from his arm 3 times. I'd be a little frustrated too

change it to 1 unit now... like I thought.

Not sure if you've had a chance to read the Lantus protocols but I think even starting on 1.0U is too high for Karo. At least for reading SLGS protocol, since he's been switched to all wet food diet, recommended starting dose is 0.5U BID (twice a day).

If Karo were mine, I would hold off starting insulin, be inclined to get some AMPS / PMPS readings and some mid cycle tests over next couple of days to see how he's doing without stress from Vet and full effect of new diet. You may be one of the lucky few to have a diet controlled diabetic .
And find a new Vet

 

[Kris & Teasel]

Yong has given you excellent info and I agree that you should wait a few days to start insulin. The food change seems to be having a significant effect - in a really good way. If you do start, 0.5 units twice a day is the way to go. Post here for advice.

The shabby treatment you got at the clinic is inexcusable. When I went in for instruction on testing, injecting, etc. after my guy's diagnosis, there was an hour long time slot booked so I didn't feel rushed. The vet answered all insulin related questions. The vet tech took over only to show me the mechanics of injecting and poking the ear to test. That's the way it should be.

 

[Tanya and Ducia]

If Karo were mine, I would hold off starting insulin, be inclined to get some AMPS / PMPS readings and some mid cycle tests over next couple of days to see how he's doing without stress from Vet and full effect of new diet. You may be one of the lucky few to have a diet controlled diabetic

I wholeheartedly second what Young posted. The switch to low carbs brings significant BG improvement in some cats. Until you collected enough BG tests to analyze there is no point guessing hhow much insulin is needed.

What really bothered me is that she said keep him on 2 units on Lantus (he starts tomorrow morning) and to not change it until I hear from the doctor, that she would relay the info. and what really bothered me is that she told me I don't have to check his blood glucose everyday. I said "really?? even know I'm just starting him on insulin, and his BG #'s are half of what they were when he was diagnosed?" and she said yes, that's right.

It used to hurt my eyes to read about such things. Not any longer so I say SACK her. But before you do DEMAND all of the Karo's papers from that clinic - blood works, exams, all of it, and make sure every each one is accounted for. You paid for it - it's yours and Karo's. And then invest some time in ruining this clinic with nasty review on Yelp and Google - not her med approach, sure, but how little time she gives patients and what general level of service is to be expected @that clinic.

 

[kayteacat]

Kay, I'm sorry to hear how you both were treated . I have been through at least 3 Vet clinics myself and from being on this forum I've seen more unpleasant Vet experiences. I can finally vouch for those rare good one's out there though! I wonder if you are close to @Djamila as she has a good Vet . Now for more specifics of your post!

Yes this is not unheard of when doing complete diet change to strictly wet food. How many days has he been on new diet of wet food?


Definitely no, listen to your gut. Home testing is the best tool in the FD kitty tool belt and especially with such great results from diet change, you'll want to keep home testing. Mandatory testing AMPS and PMPS (morning and evening pre-shot tests). Also, those slightly higher end of normal numbers may be a little stress influenced since they tried to draw blood from his arm 3 times. I'd be a little frustrated too


Not sure if you've had a chance to read the Lantus protocols but I think even starting on 1.0U is too high for Karo. At least for reading SLGS protocol, since he's been switched to all wet food diet, recommended starting dose is 0.5U BID (twice a day).

If Karo were mine, I would hold off starting insulin, be inclined to get some AMPS / PMPS readings and some mid cycle tests over next couple of days to see how he's doing without stress from Vet and full effect of new diet. You may be one of the lucky few to have a diet controlled diabetic .
And find a new Vet

Karo has been on strictly wet food for 8 days as of today.
Okay, I'll continue the BG tests then. I should be recieving my Relion Prime strips tomorrow so I'll have to figure that meter out. Alphatrak2 is way too expensive for me to use it as often as I will be needing to.

I haven't read about Lantus protocols but I'll be sure to give it a read. I'm disturbed that my vet tech didn't explain how much to give Karo based on his BG.
I have U100 with my U100 Lantus. The unit markings on the U100 syringes looks like I'd barely give him anything.. assuming the U100 is higher concentrated than U40. They gave me a couple U40 syringes to practice with on paper towels (because they were cheap and didn't need them she said)

I'll plan to watch is BG the next couple of days then and I'll post back here with results. Thank you everyone! <3

 

[Kris & Teasel]

Karo has been on strictly wet food for 8 days as of today.
Okay, I'll continue the BG tests then. I should be recieving my Relion Prime strips tomorrow so I'll have to figure that meter out. Alphatrak2 is way too expensive for me to use it as often as I will be needing to.

I haven't read about Lantus protocols but I'll be sure to give it a read. I'm disturbed that my vet tech didn't explain how much to give Karo based on his BG.
I have U100 with my U100 Lantus. The unit markings on the U100 syringes looks like I'd barely give him anything.. assuming the U100 is higher concentrated than U40. They gave me a couple U40 syringes to practice with on paper towels (because they were cheap and didn't need them she said)

I'll plan to watch is BG the next couple of days then and I'll post back here with results. Thank you everyone! <3

Please HIDE those U40 syringes after you've practiced. If you accidentally used one of those to draw up Lantus you could overdose your kitty in a major way.

 

[kayteacat]

Please HIDE those U40 syringes after you've practiced. If you accidentally used one of those to draw up Lantus you could overdose your kitty in a major way.

I plan to dispose of them in my sharps container after practice, and the u100's aren't open yet. Thank you though, that could be very scary.
Not really sure if each line on the u100 means a unit, or if it's a .25unit? all the lines are the same length, not indicating 1unit. I'll google it, too.

 

[Yong & Maury GA]

First marked line on U-100 syringe should be 5 which means 5.0U. So first long line is 1.0U. If yours have half unit markings they will have half lines in between the fuller lines.

 

[Nan & Amber (GA)]

From the Lantus sticky on drawing and handling fine doses:

1U really is a tiny amount, although if you read through that sticky, you'll see that a lot of times we have to go even tinier when dosing cats!

 

[Djamila]

Yeah! Another person from Washington! That's the second one this week after like two years all alone on here!

I do have a good vet, but I'm in Seattle, and it's a big state, so don't know if that helps at all?

I agree that it would be good to be a little data at home when Karo is relaxed and then post in the Lantus forum to get some advice about a starting dose if that is still needed. I'm so glad you know enough to ignore that awful advice from the vet!!!

 

[kayteacat]

From the Lantus sticky on drawing and handling fine doses:

View attachment 29248

1U really is a tiny amount, although if you read through that sticky, you'll see that a lot of times we have to go even tinier when dosing cats!

Wow, yeah that is a small amount. I had looked through that sticky before but it didn't make much sense until I had my own syringes. If he does end up needing any insulin I'm sure it's going to be a very small amount. He was at 172 BG this morning.

 

[kayteacat]

Yeah! Another person from Washington! That's the second one this week after like two years all alone on here!

I do have a good vet, but I'm in Seattle, and it's a big state, so don't know if that helps at all?

I agree that it would be good to be a little data at home when Karo is relaxed and then post in the Lantus forum to get some advice about a starting dose if that is still needed. I'm so glad you know enough to ignore that awful advice from the vet!!!

Awe, well hello there from not too far away! Karo and I are in Olympia.
Yeah, right?? I'm happy that my gut instinct was to not listen to them, and you guys were awesome confirming my suspicions. Karo (hence the name) was brought back to the living with Karo syrup when he was a kitten, so I'm really scared of his BG dipping too low. I still can't believe they were suggesting that much insulin with his BG being so much better in only a week!

And I'm very displeased that his vet nor anyone from the clinic responded to my email I sent shortly after we got back (around 1030am)
I asked very specific and important things about the dosing with u100 syringes (how to read them), based on BGPS how to know how much up or down depending on his BG, recommended safe diet in conjunction with starting insulin, etc. I have a feeling I wont hear from them now that they're "done" with me.

 

[Lillie]

My cat's BG had a drastic drop when I took him off the dry food. He was diagnosed with diabetes while he was eating mostly dry food. I took him off the dry completely and did one curve at the vet's over a 4 day period then started to home test. Towards the middle of the third week his BG went too low every day to administer any insulin. He also lost two pounds from not eating dry food anymore which really helped his BG too. His readings at the vet were always higher so they started him on a higher than should have been dose. Before I home tested I was blindly shooting and following the vets' recommendation which led to a mild hypo since his BG was becoming way too low to shoot anymore. I could have lost him had I not started to home test. No one told me remission can sometimes happen quickly and if I had continued to inject him daily without ever testing him I could have killed him. He's been OTJ for a good while now but I still need to monitor for a return of diabetes and weight gain.

 

[Yong & Maury GA]

Karo (hence the name) was brought back to the living with Karo syrup

I was wondering

 

[kayteacat]

My cat's BG had a drastic drop when I took him off the dry food. He was diagnosed with diabetes while he was eating mostly dry food. I took him off the dry completely and did one curve at the vet's over a 4 day period then started to home test. Towards the middle of the third week his BG went too low every day to administer any insulin. He also lost two pounds from not eating dry food anymore which really helped his BG too. His readings at the vet were always higher so they started him on a higher than should have been dose. Before I home tested I was blindly shooting and following the vets' recommendation which led to a mild hypo since his BG was becoming way too low to shoot anymore. I could have lost him had I not started to home test. No one told me remission can sometimes happen quickly and if I had continued to inject him daily without ever testing him I could have killed him. He's been OTJ for a good while now but I still need to monitor for a return of diabetes and weight gain.

Wow, that's incredible that he had such a drastic reaction to change of food. And thank goodness you were home testing him. I cannot believe that vet's are not telling people these things. I know that every kitty is different depending on what's going on with them individually, but for those kitties like ours, they could've had a real hard time if we were giving them what was prescribed. How scary, but that is so great that your little guy is OTJ. <3

Thank goodness for this community. I didn't want to "Google doctor" feline diabetes, talking with people who have gone through all this has been so helpful.
It's really sad that my vet did nothing but tell me what I already knew.. but it did lead me to reach out and figure out how to handle it, so no regrets.

 

[Lillie]

He's happy too about being OTJ right now. He hated having his ears pricked, but then again I didn't do it long enough on a daily basis to get really good at. Several times he got his ears pierced. No earrings though. Ha

 

[kayteacat]

He's happy too about being OTJ right now. He hated having his ears pricked, but then again I didn't do it long enough on a daily basis to get really good at. Several times he got his ears pierced. No earrings though. Ha

Awe! Poor little buddy. I'm sure he's still very thankful for you being a great parent.
Luckily Karo doesn't seem to care about being pricked. He really hates staying still though which makes it a bit tricky.

 

[Lillie]

I was always jealous of the people who had no problem with ear pricks and their cats just sat there and let them do whatever they needed to do. Leo is a big strong boy and he doesn't want you to touch his ears so it was always a struggle. We would both end up sometimes with pricks- his on his ear and mine on my finger. You're lucky you have one of the ones who are ok with it. Thank goodness he was good with the injections.