Ok. So I finally got the report from the 1st visit today, while at the vet. Weird she would email to me instead of just handing it to me. Here is part of it:
Diagnosis:
* Diabetes mellitus, poorly regulated
* Sporadic appetite; r/o primary intestinal disease (food allergies, IBD, etc), dental pain, etc, pancreatitis, etc
From Dentistry/Oral surgery service:
- Generalized stage 1 periodontal disease
- Focal stage 2 periodontal disease (104, 204)
- Tooth resorption (408)
- Historical tooth resorption without any remaining crown and resorbing root structures (307, 407)
- Retained tooth root (401)
Summary:
It was very nice to meet Rufus, he is a handsome big guy! All of his vital parameters were within normal limits and his
current weight is 21.5 pounds. He does have some hairloss on his limbs and belly, but other than being heavy, the
rest of his outward exam was unremarkable.
We talked about a number of potential things that can cause insulin resistance and interfere with diabetic regulation.
His labwork did not identify any other significant disease processes, which is good news. The abdominal ultrasound
that was performed also did not find any significant abnormalities. The pancreas was not sonographically irregular, but
it is possible that there is mild disease present. The difficult thing is that if the disease is so mild as to not show up on
ultrasound, it is hard to think that it would be adversely affecting his appetite. He does have history of suspected food
allergies, so it is not too unexpected that the radiologist felt that his intestinal tract was mildly thickened. There is no
loss of wall layering or indication of other more serious disease, such as intestinal cancer. It may become necessary
to consider performing a more thorough gastrointestinal work-up to definitively diagnose this intestinal thickening,
which could be related to his sporadic appetite.
Gastrointestinal disease can certainly have an impact on diabetic regulation, based on how much eats, what he eats
and how frequently. His dietary intake also impacts the ability to consistently administer insulin, because we don't want
him to drop too low. The good news is that the dose of insulin that Rufus is currently on (5 units twice daily) is by no
means excessively high or suggestive of an insulin resistance. This seems like alot of insulin, but he is a pretty big
guy. Often we will start newly diagnosed diabetic patients on a dose of insulin that is around 0.5 units per kilogram of
body weight twice daily, so he may just need to have a bit more insulin to stabilize his condition.
At this point, you have elected to have the Dentistry/Oral surgery address Rufus' dental disease to see if that helps
with his appetite. He did have some tooth resorption and had a few teeth extracted. We are also going to send him
with a medication called gabapentin that may be helpful if he has any pain/discomfort that is contributing to his
symptoms. Please give as directed below.
We know that it is frustrating to have multiple issues going on, which makes it hard to know what the primary issue is.
If he is still having appetite issues following the dental evaluation, than we may need to more strongly consider
additional evaluation (such endoscopy, gastrointestinal panel, etc) to see if there is anything else that we need to
address. Rufus is really lucky to have someone so committed to his care! Please know that we are here to help with
Rufus's ongoing care in any way that we can. Please continue to monitor him for any excessive lethargy, changes in
appetite/water intake, vomiting/diarrhea or any other symptoms that are worrisome to you. Do not hesitate to contact
us if you have any questions/concerns regarding his ongoing progress.
So, this GI panel she talks about doing, is that what you had suggested before
@Wendy&Neko ?
Oh well. Rufus is a little higher today, so wondering if that .75 is too little? Also, this AM shot was possible fur shot, but I can't smell it. There definitely was a drop left in it that he didn't get. And I have 3 strips to last until Wednesday. 
I do have a new human meter, but no control solution. I can use the new strips in my meter but wanted to do more side by side tests. I feel horrible about this.
And it is only usable for 3 months. I'm wondering if the specialist uses AT2? I brought him to the emergency vet and they used a handheld meter. Maybe they could sell me a couple strips.
