Frustrated with vets

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Mimis mom

Mimis mom

Member Since 2019
I got a call from the original vet that treated Mimi for diabetes- with Vetsulin, and they told me this is the last box of insulin syringes they will approve because Mimi needs to come in for blood work, etc.
My fear of bringing her is this- they don’t agree with me on things and look down to me when I tell them I might know more than them about how to treat diabetes. They told me to dose her with a pen that measures in 1 unit increments-
no need to test, and to only do a curve once every couple of weeks. Also wanting me to put her on the prescription diet which I DO NOT agree with at all.

I know I’ve talked about this before- how should I go in there prepared, armed and ready- know what tests she actually needs, how to politely tell them “I believe you’re ill informed” or the like.
I’m asking not because I think you guys just know more than a vet- I’m asking because it sounds like a lot of you have had GOOD vet experiences and maybe you can tell me whst to do, because I hate bringing her to a vet that is ignorant.

She needs her teeth cleaned- and definitely needs a tooth extracted- my fear is putting her under while she’s sick with diabetes and having it stress her body- is that fear or accuracy to be worried? I would never forgive myself if something happened to her while she got her tooth removed.


@carfurby

@Marje and Gracie

@Wendy&Neko

@Bobbie And Bubba


Or whoever else wants to chime in!

Anxiety has been higher than usual in me lately :(
 
Regarding good experience with vets, shop around if you can. We took our guy in to his regular vet (who he had always went to basically just because of geography) at first, and while she successfully pulled him out of his DKA, she started us on a regime that in retrospect was not the best thing for our guy. When we had issues getting timely follow-up appointments, we asked around and found out that the best feline diabetes specialists in our area were located less than 2 miles from us and were super easy to communicate and schedule with.

TLDR: if you have options in your area, do not hesitate to shop around for a different vet!
 
Not all vets are good vets, just like not all people are good people. A good vet isn’t necessarily one that knows everything there is to know about diabetes, it’s one that’s willing to work with you and objectively look at the evidence you provide to support how you are choosing to treat, as well as all the data you collect for Mimi. If that vet is not willing to do that, they are not a good vet for you. Sophie has seen both good and bad vets, and I simply do not go back to the bad vets (and I’m lucky to have that option).

As for the dental, lots of diabetic cats have dentals, even while they are not regulated. Sophie had one while she was unregulated and it went totally fine. There is always worry, like with any medical procedure, but having a vet you trust perform the dental will help a lot. Sophie had a board certified team do hers and I trusted them 100%.
 
Sarah&Soph said:
Not all vets are good vets, just like not all people are good people. A good vet isn’t necessarily one that knows everything there is to know about diabetes, it’s one that’s willing to work with you and objectively look at the evidence you provide to support how you are choosing to treat, as well as all the data you collect for Mimi. If that vet is not willing to do that, they are not a good vet for you. Sophie has seen both good and bad vets, and I simply do not go back to the bad vets (and I’m lucky to have that option).

As for the dental, lots of diabetic cats have dentals, even while they are not regulated. Sophie had one while she was unregulated and it went totally fine. There is always worry, like with any medical procedure, but having a vet you trust perform the dental will help a lot. Sophie had a board certified team do hers and I trusted them 100%.
Click to expand...
I know I can’t afford someone board certified I’ll have to shop around. Mimi has an 8000$ vet bill from her DKA visit and now that I think more about it I totally think she could have not spent so long in there if they did some things differently...
Anyone ever been to Banfield animal hospital for dental work?
 
Mimis mom said:
I know I can’t afford someone board certified I’ll have to shop around. Mimi has an 8000$ vet bill from her DKA visit and now that I think more about it I totally think she could have not spent so long in there if they did some things differently...
Anyone ever been to Banfield animal hospital for dental work?
Click to expand...

I’m not sure if it varies by state/clinic, but I was not charged more because of the fact that the vet was board certified. That vet is just who the clinic employed to perform their dentals. I do live in an inexpensive state though, so dentals tend to be cheaper here than other places
 
Vets have professional liability if something happens to your cat. Probably why they insist on some bloodwork.

Vet Interview/Screening Topics & Check List

Check with friends, relative, neighbors, co-workers for opinions and recommendations for a vet.
Check yelp, google, Angie's List.

See who your vet uses for emergency 24 hour care. Check how far away that emergency location is from your regular vet.
Get recommendations from the emergency vet clinic.

See if a vet will take walk-ins.
Ask what professional guidelines your vet clinic uses.
(2018) AAHA Diabetes Management Guidelines for Dogs and Cats
(2015) ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats
2018 WhatsNewInCanieAndFelineDM.pdf

Arm yourself with information to present to your vet, including your spreadsheet. Practice what you are going to say.

There should be plenty of vet clinics in the capitol district where you live.
 
I copied off the procedure foy my insulin and e-mailed it to my vet. I also sent her the spreadsheet, which she loved so much that she wants one for all her diabetic patients. She has been open to any information I find. Her vet tech says I know more about diabetic cats than the vet. Vets just don't get that much education in vet school. I agree with trying to find a vet that is as knowledgeable about diabetic cats or is willing to learn.
 
My vet started me on Caninsulin, in spite of me saying Lantus was better for cats. It’s what she knew. I had known her for decades, worked with her as one of the local vets who did free exams for the shelter. I adopted a cat from there she treated and thought wouldn’t survive. She knew I was up for a challenge but also had a record of following up with her suggestions in terms of visits and treatment. She was also just happy I was one of those that wanted to treat. It took a locum vet to get us on Lantus. For dosing I supplied the Roomp and Rand paper and copies of the spreadsheet. I was the first client to home test.

Vets like seeing research papers, so they know there is something to back your claims. Look for papers and AAhA guidelines that back your arguments. Print them off, highlight the bits about diet and testing and dosing. Later with the acromegaly, my vet learned from us, and was willing to do so. Though I admit I did have to use the phrase “humour me” once or twice. :p

If it’s been more than six months since the last vet visit, not a bad idea for new bloodwork, probably a senior panel, sometimes called geri panel, including the T4/test.

I ended up taking Neko to a dental specialist. She was complicated, had some cardiomyopathy. Dental specialists have someone during the operation dedicated to anesthesia and monitoring vitals. I wanted that. Plus the specialists see older more complicated pets. My main vet didn’t have dental X-ray equipment at the time. The specialist knew about acromegaly, saved one of her teeth, and in a subsequent visit had to remove a bony growth from her jaw. He was up for the challenge.
 
Sorry I’m Just seeing this now.

I agree with Wendy about presenting data and research to your vet. But it does seem like you have a lot of obstacles to get through with this practice. Might be easier to start off with a new vet. Call and ask for a consult appointment to talk to the vet. There is a stickie somewhere on the forum for questions to ask the prospective vet. I’ll see if I can find it for you. Take your SS to show him/her. If they are on the same page with you for testing, NOT using the pen with needles attached as 1 unit increments either way up or down are too much

If you feel good going forward I would schedule the cleaning .If a diabetic cat has a bad tooth and or just inflammation from swollen gums due to tartar and pocketing, the diabetes will be harder to control. Pain and inflammation causes the numbers to go up. Once removed often kitties will start requiring less insulin and numbers will start to level out.
 
Noah & me (GA) said:
--Putting any animal or human under general anaesthesia is never risk free. Age and current medical conditions should be carefully considered. Many members have taken their cats to a dental specialist.

I got lucky with two knowledgeable and compassionate vets who knew all about testing, dosing and even bouncing. One is on a first name basis and both make sure their staff are not snot-nosed idiots. Vets are not like a health care plan, if it feels wrong to you then it is wrong. There's the door, you owe them nothing.
Never let someone with a plaque on the wall intimidate you. I can wear a tie with a stethoscope around my neck too but that doesn't mean I'm smarter than you.
When my GA Nigel died the entire staff signed a card and they sent us flowers. When Andrew died at 2:00AM because of a mistake we got a phone call, "You're cat is dead, you can pick him up anytime after you pay the bill".
There is something really wrong with the world when strangers on the internet know more than someone who cannot accept their faults.
Click to expand...


Everything you said is so true, and I wish I could find a vet like the one you have! It’s hard because I don’t always know if they are going to be a good vet and you pay they office visit, leaving feeling like something wasn’t right.
I know Mimi needs her tooth out- I wonder if she’ll feel better afterwards... I have an appointment with Banfield through Petco on Monday for her- let’s see how it goes because they have affordable plans.
 
Bobbie And Bubba said:
Sorry I’m Just seeing this now.

I agree with Wendy about presenting data and research to your vet. But it does seem like you have a lot of obstacles to get through with this practice. Might be easier to start off with a new vet. Call and ask for a consult appointment to talk to the vet. There is a stickie somewhere on the forum for questions to ask the prospective vet. I’ll see if I can find it for you. Take your SS to show him/her. If they are on the same page with you for testing, NOT using the pen with needles attached as 1 unit increments either way up or down are too much

If you feel good going forward I would schedule the cleaning .If a diabetic cat has a bad tooth and or just inflammation from swollen gums due to tartar and pocketing, the diabetes will be harder to control. Pain and inflammation causes the numbers to go up. Once removed often kitties will start requiring less insulin and numbers will start to level out.
Click to expand...


Ya I think her tooth has been bothering her for a long time but the idea of them getting put under for the procedure always made me feel uneasy and nervous.
Will vets actually talk to you without getting “paid”
I feel like they would be like “um you need to come in for a visit”
I’ll check out the interview list though
 
Wendy&Neko said:
My vet started me on Caninsulin, in spite of me saying Lantus was better for cats. It’s what she knew. I had known her for decades, worked with her as one of the local vets who did free exams for the shelter. I adopted a cat from there she treated and thought wouldn’t survive. She knew I was up for a challenge but also had a record of following up with her suggestions in terms of visits and treatment. She was also just happy I was one of those that wanted to treat. It took a locum vet to get us on Lantus. For dosing I supplied the Roomp and Rand paper and copies of the spreadsheet. I was the first client to home test.

Vets like seeing research papers, so they know there is something to back your claims. Look for papers and AAhA guidelines that back your arguments. Print them off, highlight the bits about diet and testing and dosing. Later with the acromegaly, my vet learned from us, and was willing to do so. Though I admit I did have to use the phrase “humour me” once or twice. :p

If it’s been more than six months since the last vet visit, not a bad idea for new bloodwork, probably a senior panel, sometimes called geri panel, including the T4/test.

I ended up taking Neko to a dental specialist. She was complicated, had some cardiomyopathy. Dental specialists have someone during the operation dedicated to anesthesia and monitoring vitals. I wanted that. Plus the specialists see older more complicated pets. My main vet didn’t have dental X-ray equipment at the time. The specialist knew about acromegaly, saved one of her teeth, and in a subsequent visit had to remove a bony growth from her jaw. He was up for the challenge.
Click to expand...
What’s the Roomp and Rand papers?
 
Mimis mom said:
Will vets actually talk to you without getting “paid”
Click to expand...

You can call and ask for the vet to call you back (this will usually happen after business hours)...If they don’t call you back, that’s a telling sign too!! These are where I started....they didn't have to answer all the questions with the "right" answers (that I learned here), but you can learn a lot by how willing they are to listen to other points of view too. They didn't have to agree with me but they also had to be willing to at least discuss it....not slam the door in my face at the mere suggestion that I might know what I was talking about.

Vet Interview Topics

1. Do they support home testing? Are they willing to use a human meter? (if you get an absolute NO or pushback that they will only accept numbers from a pet meter, move on)

2. What type of food do they recommend? Do they support feeding an over the counter low carb canned or raw diet? (again, if they suggest "prescription" food, that's one thing...if they say something like "I only want my diabetic cat patients eating (fill in the blank) prescription food"...move on.

3. What is their "go to" insulin? (Lantus, Basaglar, Levemir or ProZinc are the most recommended) If you start with one insulin, are they willing to switch to another if you're not getting the best results? If so, how long would they expect you to try?

4. How many diabetic cats have they treated? What kind of results have they gotten? Any in remission? How long have the cats they have treated lived?

5. Do they have pricing you can live with? How often would they require you to come in and why?

6. How do they determine their starting dose of insulin?

You're not necessarily looking for one who will agree with everything you want to do, but there's a difference between a vet that's willing to work WITH you instead of dictate TO you.
 
@Mimis mom
I completely botched the Reply feature making my reply almost unreadable. This is what my post, following post #12, should have looked like. Your words are in itallics.

My fear of bringing her is this- they don’t agree with me on things and look down to me when I tell them I might know more than them about how to treat diabetes.
--Looking down on a patient is called the "It's doctor actually" syndrome. I have such a rare condition I'm actually more up to date on current treatments than an ER intern who knows a little bit about everything. It infuriates them. It's also referred to as being a pompous ass and you're in no way obligated to put up with it.
No need to test.
--You already know this is wrong and arguing won't help. Save your energy for yourself and your cat.
Also wanting me to put her on the prescription diet which I DO NOT agree with at all.
--Most vet clinics sell prescription food as part of their business model. It's all about money. All our non diabetic cats eat Royal Canin SO and their constant UTI's are a thing of the past but the food was recommended, not forced upon me.
Should I go in there prepared, armed and ready- know what tests she actually needs?
--The need for some tests are obvious. Anything else and you have the right to ask what the test is and why it's needed. The "Wellness test" is my favorite. Wellness is such a vague statement it could mean almost anything. Ask for details and make sure the test doesn't overlap with tests already done.
She needs her teeth cleaned- and definitely needs a tooth extracted- my fear is putting her under while she’s sick with diabetes and having it stress her body- is that fear or accuracy to be worried?
--Putting any animal or human under general anaesthesia is never risk free. Age and current medical conditions should be carefully considered. Many members have taken their cats to a dental specialist. Teeth are not to be ignored.
I got lucky with two knowledgeable and compassionate clinics who knew all about testing, dosing and even bouncing. One is on a first name basis and both make sure their staff are not snot-nosed idiots. Vets are not like a health care plan, if it feels wrong to you then it is wrong. There's the door, you owe them nothing.
Never let someone with a plaque on the wall intimidate you. I can wear a tie with a stethoscope around my neck too but that doesn't mean I'm smarter than you.
When my GA Nigel died the entire staff signed a card and they sent us flowers. When Andrew died at 2:00AM because of a mistake we got a phone call, "You're cat is dead, you can pick him up anytime after you pay the bill". That was an emergency clinic devoid of compassion but happy to take my money. The other clinic gets baking and I've known most of the staff for almost 20 years.

There is something really wrong with the world when strangers on the internet are more helpful than someone who learned life's lessons from a textbook. Don't get me started on techs.
 
Noah & me (GA) said:
@Mimis mom
I completely botched the Reply feature making my reply almost unreadable. This is what my post, following post #12, should have looked like. Your words are in itallics.

My fear of bringing her is this- they don’t agree with me on things and look down to me when I tell them I might know more than them about how to treat diabetes.
--Looking down on a patient is called the "It's doctor actually" syndrome. I have such a rare condition I'm actually more up to date on current treatments than an ER intern who knows a little bit about everything. It infuriates them. It's also referred to as being a pompous ass and you're in no way obligated to put up with it.
No need to test.
--You already know this is wrong and arguing won't help. Save your energy for yourself and your cat.
Also wanting me to put her on the prescription diet which I DO NOT agree with at all.
--Most vet clinics sell prescription food as part of their business model. It's all about money. All our non diabetic cats eat Royal Canin SO and their constant UTI's are a thing of the past but the food was recommended, not forced upon me.
Should I go in there prepared, armed and ready- know what tests she actually needs?
--The need for some tests are obvious. Anything else and you have the right to ask what the test is and why it's needed. The "Wellness test" is my favorite. Wellness is such a vague statement it could mean almost anything. Ask for details and make sure the test doesn't overlap with tests already done.
She needs her teeth cleaned- and definitely needs a tooth extracted- my fear is putting her under while she’s sick with diabetes and having it stress her body- is that fear or accuracy to be worried?
--Putting any animal or human under general anaesthesia is never risk free. Age and current medical conditions should be carefully considered. Many members have taken their cats to a dental specialist. Teeth are not to be ignored.
I got lucky with two knowledgeable and compassionate clinics who knew all about testing, dosing and even bouncing. One is on a first name basis and both make sure their staff are not snot-nosed idiots. Vets are not like a health care plan, if it feels wrong to you then it is wrong. There's the door, you owe them nothing.
Never let someone with a plaque on the wall intimidate you. I can wear a tie with a stethoscope around my neck too but that doesn't mean I'm smarter than you.
When my GA Nigel died the entire staff signed a card and they sent us flowers. When Andrew died at 2:00AM because of a mistake we got a phone call, "You're cat is dead, you can pick him up anytime after you pay the bill". That was an emergency clinic devoid of compassion but happy to take my money. The other clinic gets baking and I've known most of the staff for almost 20 years.

There is something really wrong with the world when strangers on the internet are more helpful than someone who learned life's lessons from a textbook. Don't get me started on techs.
Click to expand...
Thank you!!
 
When Freckles had her dental work, the protocol was to have blood work and xrays done prior - so they knew if the cat was a good candidate for anesthesia and what the xrays showed. The vet did the blood work/xrays the same day as the dental. I had them phone me after the blood work/xrays and tell me the results BEFORE they started the dental. This way, Freckles was only sedated one day (they have to sedate her in order to get enough blood for tests anyways).

If/when you go have the dental done, post to this forum prior. I received lots of good advice and was prepared for the dental.
 
Judy and Freckles said:
When Freckles had her dental work, the protocol was to have blood work and xrays done prior - so they knew if the cat was a good candidate for anesthesia and what the xrays showed.
Click to expand...
-rays of what part Freckles? Anesthesia is required for dental x-rays while x-rays for other body parts can usually be performed with out anesthesia
 
Some cats require light sedation for x-rays, regardless of what body part is involved. Some places do have a sort of restraining box so the kitty isn't mobile. It depends on the practice. And like Judy and Freckles, all of the vet's I've used have done routine labs to insure my cats were in good health for anesthesia and they did pre-dental x-rays as well as post-procedure x-rays if there were any extractions.

I have always used a cats only practice. The vet that diagnosed Gabby was wonderful. However, she was not familiar with the TR Protocol despite prescribing Lantus. I came in with the protocol in hand and told her, respectfully, this is what I wanted to do. She skimmed over it -- she was also reassured because it had been published in a leading vet journal. This was the same appointment that I came in with cases/bags of the prescription food I'd bought and returned it all. When she challenged me on the food, I simply asked her if she knew the carb count on the food. She didn't. I did. What she wanted to be assured of was that I knew what I was doing. Once she realized I was feeding Gabby a lower carbohydrate food that was of better quality than the Rx stuff, she was fine with my decision. The next time I was there, she had done in service training for all of the other vets in the practice to get them trained up on TR. When I moved to Columbus, I found another vet at a cat only clinic. She took one look at Gabby's spreadsheet, asked me a few questions about diabetes management, and basically said I knew what I was doing and to ask if I had any questions. I adore my vet and she is great with my cats.

I also speak medicalese so my experiences may be different. I also "manage" MDs all the time. What you don't want to do is to get someone defensive or imply that you know more than they do. As much as we know about FD, if it's some other disease or multi-organ issue, we are out of our depth. My conversations with vets have always been respectful and I've always been clear that I deserve the same respect. I think it helps to remember you are paying them and the customer deserves to be treated well.

Even with MDs, they won't prescribe indefinitely even if it's a medication that you need to take for life. They have a liability and if you don't come in yearly and they miss a problem, it's their malpractice. So not renewing your syringe prescription is not abnormal. Of course, there's a work around. I needed an Rx for syringes and I bought my syringes from ADW. They did not ask for yearly prescription renewals. Likewise, nodding your head about the Rx food and acting as if you are feeding what the vet suggests is fine. You can let them know you're able to find it at a cheaper price online when places like Amazon or Chewy's have sales. The vet isn't coming over to your house to see what you're feeding Mimi.
 
Sienne and Gabby (GA) said:
They have a liability
Click to expand...
This is something people seldom think about. Canada's laws are slightly more relaxed than in the US but being allowed "back there" is still a big no-no. There was one occasion when Andrew needed to give a blood sample and four people could not keep him still, I was asked to help. Ordinarily if a cat is that stressed you'd pull the plug but Andrew was in dire straights. He was already wearing the hood and mouth breathing when I came in the room, we did what we had to do and did it quickly.
Human doctors as well as pharmacists face even bigger legal challenges. I've been on strong pain meds for a long time and my doctor trusts me not to be an idiot. If I start drinking heavily (I don't drink) and then need a liver or kidney transplant or if I plow into a school bus people will start asking questions and it will all lead back to my doctor. She could lose her license and her life would be over.
It's more than just basic respect, it's your vet's or doctors livelihood. You might assume your vet knows you're not an idiot but the stories I've heard about what happens when you walk out that door would horrify you.
Not meaning to drag this post on forever but I know of examples where an animal's owner has made a stupid mistake and rather than admit it they get a new vet and just never come back.
 
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