Good News for McGee!

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Anne & McGee

Anne & McGee

Member Since 2020
Good morning, just wanted to give an update on McGee - on Sunday I did his first home test after already giving 2 doses of insulin (thankfully it wasn't more than that!) and I got a 55. You guys helped me understand what this meant and to not give the insulin, and I reached out to his vet (normal vet, not the one who was doing his dental and diagnosed him as diabetic). She advised to take several readings yesterday (a curve, think) and to not give any more insulin. Yesterday his readings were 68 before breakfast, 75 +2, 65 +6, 69 +10, and 72 +12 (which was his 2-hour post dinner reading). This morning he was 66 before breakfast. She told me these were definitely not the numbers of a diabetic cat and that his stress elevated his blood glucose numbers on the pre-anesthetic test and by the time they did a urine test to "confirm" he had been stressed for so long that the sugar had spilled into the urine. Unfortunately, the diagnosing veterinarian did not feel it necessary to do a fructosamine test, which surely would have shown that he was not diabetic (and I didn't know at the time to ask for that!). So, as of this morning, apparently I don't have a diabetic cat after all, which is wonderful!

I cannot thank this group enough because if I had just blindly listened to the instructions of the diagnosing vet I'm sure I would have pushed him into a hypo and killed him. I can't even imagine.
 
Yay! Great news, Anne. As you correctly observe, this situation clearly demonstrates why it's important to evaluate clinical signs and run a fructosamine test to confirm a provisional feline diabetes diagnosis, not just rely on a couple of BG readings and a urine sample collected under stressful conditions.

As a general comment, it may sometimes be appropriate to immediately commence insulin treatment based on a sound preliminary FD diagnosis while waiting for a fructosamine test result. For example, my Saoirse was given her first insulin straight after her provisional diagnosis based on a vet office blood test and urine sample. However, she had pronounced clinical signs (drinking and peeing for Ireland, eating like a thing possessed, lethargic, coat in tatters, losing weight in spite of increased food intake). In addition to the clinical signs, her in-office blood glucose reading was stratospheric (33 mmol/L / 594 mg/dL) and her urine sample (collected at home, so no vet stress influence) was poisonous with sugar. Some cats may also be throwing ketones when presented to the vet for examination and that needs to be addressed straight away.

In McGee's case, there was complete absence of FD clinical signs so perhaps the vet who issued a provisional Dx of diabetes should have been more guarded in approach. To the vet's credit, they did at least pick up a potential issue. Some vets miss FD completely. For example, due to her abnormal clinical signs, I had brought Saoirse in to our then vets over a week before she got her Dx, and the vet who saw her gave her a Dx of an "old lady" who had had "a good innings", refused point blank to run any diagnostics, gave her a steroid jab and packed us out the door. In fairness to the first vet you saw, Anne, I think their heart was probably in the right place even though their initial response was a tad overzealous. :)

Anne & McGee said:
This morning he was 66 before breakfast. She told me these were definitely not the numbers of a diabetic cat and that his stress elevated his blood glucose numbers on the pre-anesthetic test and by the time they did a urine test to "confirm" he had been stressed for so long that the sugar had spilled into the urine.
Click to expand...

Thanks for sharing your regular vet's feedback: it's helpful to get confirmation that it is possible for temporarily elevated BG due to prolonged vet/travel stress to result in a breach of the renal threshold. Very useful to know.

Well, Anne, your little fella may not be diabetic, but he'll always be Sugar McGee to me now. ;)

Delighted for you both. :cool:


Mogs
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Red & Rover (GA) said:
That is awesome. Still, do keep the carbs as low as you can and take the occasional test.

And do inform the dental vet. It might just save another's cat's life. We are strong believers of paying it forward.
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The dental vet is actually at the same clinic and my regular vet is the owner - and I was sure to pass on my experience to her! There is definitely room for improvement with how it was handled.
 
Critter Mom said:
Yay! Great news, Anne. As you correctly observe, this situation clearly demonstrates why it's important to evaluate clinical signs and run a fructosamine test to confirm a provisional feline diabetes diagnosis, not just rely on a couple of BG readings and a urine sample collected under stressful conditions.

As a general comment, it may sometimes be appropriate to immediately commence insulin treatment based on a sound preliminary FD diagnosis while waiting for a fructosamine test result. For example, my Saoirse was given her first insulin straight after her provisional diagnosis based on a vet office blood test and urine sample. However, she had pronounced clinical signs (drinking and peeing for Ireland, eating like a thing possessed, lethargic, coat in tatters, losing weight in spite of increased food intake). In addition to the clinical signs, her in-office blood glucose reading was stratospheric (33 mmol/L / 594 mg/dL) and her urine sample (collected at home, so no vet stress influence) was poisonous with sugar. Some cats may also be throwing ketones when presented to the vet for examination and that needs to be addressed straight away.

In McGee's case, there was complete absence of FD clinical signs so perhaps the vet who issued a provisional Dx of diabetes should have been more guarded in approach. To the vet's credit, they did at least pick up a potential issue. Some vets miss FD completely. For example, due to her abnormal clinical signs, I had brought Saoirse in to our then vets over a week before she got her Dx, and the vet who saw her gave her a Dx of an "old lady" who had had "a good innings", refused point blank to run any diagnostics, gave her a steroid jab and packed us out the door. In fairness to the first vet you saw, Anne, I think their heart was probably in the right place even though their initial response was a tad overzealous. :)



Thanks for sharing your regular vet's feedback: it's helpful to get confirmation that it is possible for temporarily elevated BG due to prolonged vet/travel stress to result in a breach of the renal threshold. Very useful to know.

Well, Anne, your little fella may not be diabetic, but he'll always be Sugar McGee to me now. ;)

Delighted for you both. :cool:


Mogs
.
Click to expand...
Thank you so much for your information and help! I am sorry your baby didn't have a good experience either. It's so sad, and so much of it could be easily different. I do think the diagnosing vet had good intentions and I do understand the reasoning behind it, but I think she definitely jumped the gun, especially if she knew how upset he gets in the car (poops, pees, throws up, huge ropes of drool EVERYWHERE, he's a total basketcase in the car). I would have been totally happy to pay for the fructosamine test had I known about it, to really get a sound diagnosis, and as you said, he didn't have any other signs, which was never even discussed. I'm so very happy at the outcome and I have passed my experience on to my regular vet, who is also the clinic owner, so that hopefully they can make some adjustments as to how these things are handled. At the LEAST I should have been made aware of home testing and the importance of it to make sure of his numbers before a shot, especially, I would think, on a new diagnosis.
 
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