11/09 Butters AMPS 401/PMPS 104/+1 61/+2 54/+2.5 76/+3.25 76/+4.5 77/- Update from IM Vet Visit

Hope everything goes well at the vet :bighug::bighug::bighug: Hope her numbers come down :cat: You're doing all you can, Lyla :bighug::bighug::bighug:Butters is so lucky to have you looking after her.
 
Good luck with the vet visit today!! At least Butters is getting lower numbers here and there. That's always a start!! Wishing you all the best. You're doing so well, Lyla :bighug:
 
Heard from the IM. Poor Butters is still there. She agreed that Butters is still having pain. Apparently she hissed at the IM as soon as she started to palpate her tummy. IM Dismissed all of my other concerns. She said she will give me one week's worth of bupe, same dose as previous, but q12 (no longer q8). Hopefully it does the trick.

She still hears the gallop rhythm.

Other than that, got a 15 minute lecture from her on all the things I am doing wrong with managing Butters' diabetes.o_O I didn't even put it down as a concern.:confused: She mentioned somogyi effect an awful lot. Said I should still be giving her .5u of insulin q12, and any more than that is putting her in danger. Basically, it is my fault Butters' numbers are high because I am giving too much insulin.:banghead::blackeye:

Also, the food I am giving her is terrible for diabetic cats and too high in fat for cats with pancreatitis. She is demanding I send her two blood glucose curves and switch her to a Purina prescription food. OM I think she called it. Anyhow, I felt like there was a thinly veiled threat that she was going to call the SPCA on me or some such thing.:blackeye:o_O She had zero interest in looking at my spreadsheet or listening to anything I had to say, so no point in arguing. :cool:

I'm not particularly stressed or annoyed by it, tbh. Of course it was enough to conjure a voice in the back of my head wondering if I'm doing the right things for her. But I've only been at this for just shy of six months and it has been a roller coaster ride (I hate roller coasters), so yeah, my confidence is constantly being shaken. Shrug.

I will be going to pick her up soon.
 
Sorry to hear poor Butters is still in some pain. I hope the bupe does the trick.

Next time you see that vet (if you do), take along the paper that disproves Symogyi as a thing for a cats on long lasting insulin and following TR. Paper linked here.

For your amusement, the ingredient list of Purina OM:confused: (for overweight cats): Water, meat by-products, liver, ocean whitefish, chicken, rice, powdered cellulose, potato protein, soy protein isolate, artificial and natural flavors, calcium sulfate, guar gum, potassium chloride, salt, choline chloride, Vitamin E supplement, mono and dicalcium phosphate, magnesium sulfate, carrageenan, taurine, thiamine mononitrate (Vitamin B-1), L-Carnitine, zinc sulfate, ferrous sulfate, niacin (Vitamin B-3), calcium pantothenate (Vitamin B-5), Vitamin A supplement, menadione sodium bisulfite complex (Vitamin K), copper sulfate, manganese sulfate, pyridoxine hydrochloride (Vitamin B-6), riboflavin supplement (Vitamin B-2), Vitamin B-12 supplement, biotin (Vitamin B-7), folic acid (Vitamin B-9), Vitamin D-3 supplement, potassium iodide.
 
Sorry to hear it wasn't the best visit. Just what you need - a lecture from someone who think they know it all and doesn't want to listen. :mad:

I hope the meds help Butters and she gets home soon and you both can relax. I think you are managing all of this and the stress amazingly well fwiw :bighug:
 
And even more amusing, that powdered cellulose -- it's what amounts to sawdust.

In addition to the paper that Wendy linked, perhaps you could ask the IM vet if she knows how Somogyi was researched. (Sorry -- this is a favorite soapbox issue for me.) The original research was done in 1938 on a very small sample of humans. The only paper dealing with cats is the one Wendy linked. Dr. Michael Somogyi published this paper is the not so highly esteemed medical journal, The Weekly Bulletin of the St. Louis Medical Society. Since the original paper, the research has never been replicated making the original finding highly suspect. In addition, given that date of publication, long acting insulin, like Lantus and Levemir, didn't exist. Trying to generalize from a shorter acting insulin to depot insulins is not possible. If it were me, and given that I can have a smart mouth especially when it comes to research, I'd suggest the vet do her homework before tossing around a poorly researched term that is questionable in humans and has nothing to support it in cats and is the equivalent of an urban legend.
 
Oh Lyla, I'm so sorry she made you feel less than confident in your abilities to manage Butters' diabetes! You have been doing a stellar job...and once again, you're hearing from the wise ones how vets know and understand so little about feline diabetes - and the unmitigated gall of her to implore that you should feed her that junk.

Get your facts lined you - you're armed now - go and show her the papers - tell her she's uninformed - and march out. She obviously doesn't understand the first thing about FD... grrrrr.... where is the angry faced emoji here? :(

I'm so sorry you have to deal with her alone - I'd like to come up there and tell her a thing or two...and I'll be the others here would as well...

I hope Butters starts to feel better soon! Take care Lyla!:bighug:
 
You are a GREAT MAMA BEAN I had the last VET do the same thing to me 2 years ago GOOD BYE FELICIA!!!! That is when GOD sent us Dr. Pickering who we love Lots of love and healing:bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug:
 
I'm sorry that you had to go through that with the IM, please don't let it shake you. Be confident in your abilities and you know better than anyone that you're giving the best care to Butters.

Stay strong and know that we're all here for you! Praying for Butters to feel better soon! :bighug:
 
Thank you :bighug::bighug::bighug:

What the heck happened today? :confused: When I picked her up I brought a meal for her, along with her insulin and BG meter so I could stay on schedule. I did "test-feed-shoot" in my car. She was 104 @PMPS. I decided to shoot. I figured she would bounce. Joke's on me. We just got home and she is 61 @+1. Someone is getting gravy now and a reduction tomorrow morning no matter what happens.:rolleyes: As I stated previously, I want Butters in healthy numbers, but not where she is earning reductions.

Wendy&Neko said:
Sorry to hear poor Butters is still in some pain. I hope the bupe does the trick.

Next time you see that vet (if you do), take along the paper that disproves Symogyi as a thing for a cats on long lasting insulin and following TR. Paper linked here.

For your amusement, the ingredient list of Purina OM:confused: (for overweight cats): Water, meat by-products, liver, ocean whitefish, chicken, rice, powdered cellulose, potato protein, soy protein isolate, artificial and natural flavors, calcium sulfate, guar gum, potassium chloride, salt, choline chloride, Vitamin E supplement, mono and dicalcium phosphate, magnesium sulfate, carrageenan, taurine, thiamine mononitrate (Vitamin B-1), L-Carnitine, zinc sulfate, ferrous sulfate, niacin (Vitamin B-3), calcium pantothenate (Vitamin B-5), Vitamin A supplement, menadione sodium bisulfite complex (Vitamin K), copper sulfate, manganese sulfate, pyridoxine hydrochloride (Vitamin B-6), riboflavin supplement (Vitamin B-2), Vitamin B-12 supplement, biotin (Vitamin B-7), folic acid (Vitamin B-9), Vitamin D-3 supplement, potassium iodide.
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This ingredient list gets a big "nope" from me.:eek: The vet, though, says it is the best food for cats with pancreatitis and diabetes.:confused: o_O:facepalm:
Thanks, I hope it does the trick, too. I will be giving it a thorough read. I believe you linked it to a condo of mine many, many months ago. A previous vet of Butters' also claimed Somogyi.:( I didn't feel confident enough to really argue with the IM. Plus I had already argued over pain meds and the food I am feeding and the fact that I have managed her diabetes just fine for six months without the IM's opinion, TYVM. A lot of arguing for one phone conversation.
I may email her the article, though. :p

Sienne and Gabby (GA) said:
If it were me, and given that I can have a smart mouth especially when it comes to research, I'd suggest the vet do her homework before tossing around a poorly researched term that is questionable in humans and has nothing to support it in cats and is the equivalent of an urban legend.
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I am not exactly a wallflower myself. :) If I do see her again, and I am really hoping I do not, I will absolutely have no qualms about saying something to this effect. I expect so much better from a vet. Especially when she was so dismissive of absolutely everything I said. At least know that of which you speak.
 
Pamela & Amethyst said:
You are a GREAT MAMA BEAN I had the last VET do the same thing to me 2 years ago GOOD BYE FELICIA!!!! That is when GOD sent us Dr. Pickering who we love Lots of love and healing:bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug::bighug:
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I'm so happy you have an amazing vet!!! It gives me hope that someday I might actually find a good one for Butters, too. :bighug:

JaxBenji said:
:bighug::bighug::bighug:((Lyla)) :bighug::bighug::bighug:
Glad you at least are getting some bupe. Hang in there. Scratch Butters in her fav spot for us :cat:
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Thanks:bighug: I know all was not lost.:joyful: I have some pain meds for her. Butters is enjoying some head scratches while she eats her gravy. :smuggrin:

carfurby said:
I hope the bupe will help get her pain under control. I'm sure she'll be very happy to be home. I'm sorry the vet went off about FD. You're doing a great job taking care of her. She is lucky to have you. :bighug::bighug::bighug:
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Thank you, Carla. I'm lucky to have everyone here to help me take care of Butters. What would I do if I didn't?? I can't even imagine.

Abdullah said:
I'm sorry that you had to go through that with the IM, please don't let it shake you. Be confident in your abilities and you know better than anyone that you're giving the best care to Butters. Stay strong and know that we're all here for you! Praying for Butters to feel better soon! :bighug:
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Thank you, Abdullah! I know you have been having your own challenges lately. I hope the new vet is working out for you and Billo. :bighug:
 
Colio said:
Sorry to hear it wasn't the best visit. Just what you need - a lecture from someone who think they know it all and doesn't want to listen. :mad:I hope the meds help Butters and she gets home soon and you both can relax. I think you are managing all of this and the stress amazingly well fwiw :bighug:
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I honestly felt like a child the way she was talking to me. Except, I don't think I'd talk to a child that way. We are home now but looks like she has decided to join Cole on this fine dropsie Monday. :rolleyes: :bighug:

Sue and Luci said:
Oh Lyla, I'm so sorry she made you feel less than confident in your abilities to manage Butters' diabetes! You have been doing a stellar job...and once again, you're hearing from the wise ones how vets know and understand so little about feline diabetes - and the unmitigated gall of her to implore that you should feed her that junk.
Get your facts lined you - you're armed now - go and show her the papers - tell her she's uninformed - and march out. She obviously doesn't understand the first thing about FD... grrrrr.... where is the angry faced emoji here? :(
I'm so sorry you have to deal with her alone - I'd like to come up there and tell her a thing or two...and I'll be the others here would as well...
I hope Butters starts to feel better soon! Take care Lyla!:bighug:
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The angry faced emoji = :mad:
Thanks Sue. :bighug:You are one of the people here who has taught me so much. All about the liver and the pancreas...I still have your posts bookmarked.:) Part of the problem is I don't get to go in anymore. So I'd have to tell her on the phone. LOL. She wanted me to drop her back down to .5u immediately. Even after I read off days' worth of BG numbers for her from my SS. Can you imagine? :mad:
 
My vet dismisses me too re: FD. I just nod and smile and do my own thing. Thank goodness you got the pain meds, hopefully you will have her pain free and healthy (good numbers) in no time. :bighug:
 
Pull up Butters!

I was so lucky with Neko's IM vet. He was trained in Europe, knew a thing or two about acromegaly, approved of the raw food diet. Of course, we still had "discussions". :p He thought Neko's appy issues might be due to insulin overdose, so I "allowed" (ie paid for) them to BG test her during the first day there. I told them it would be in the blue range (Neko was having a flat blue day) - it was about 6 hours later when they tested - end of discussion on dosing. That plus he found a bunch of other issues causing appy problems. Best of all, he was willing to read articles I sent him and search for some on his own.
 
Wendy&Neko said:
Pull up Butters!

I was so lucky with Neko's IM vet. He was trained in Europe, knew a thing or two about acromegaly, approved of the raw food diet. Of course, we still had "discussions". :p He thought Neko's appy issues might be due to insulin overdose, so I "allowed" (ie paid for) them to BG test her during the first day there. I told them it would be in the blue range (Neko was having a flat blue day) - it was about 6 hours later when they tested - end of discussion on dosing. That plus he found a bunch of other issues causing appy problems. Best of all, he was willing to read articles I sent him and search for some on his own.
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lol. Oh yes, "discussions". There are a handful of IMs where I am, so maybe I will have better luck with a different one. If I get a good primary care vet who can give me a referral.

It reminds me, though, she was in that hospital for five days. I had her dose at 1u. The IM was giving her between zero and .5u, depending on I'm not sure what. I had to pay an extra daily fee for them to check her BG numbers (every four to six hours), and they got progressively higher with each passing day. How on earth does that translate into a cat who needs less insulin, not more?:confused:
 
I am wondering whether she went so low because of the vet visit. And now I'm actually not sure what to do with respect to reducing or holding this dose.

I know some cats go low because of vet visits. I have never had evidence that Butters is one of those cats, but is it possible the vet visit is the cause of her drop? In which case, maybe I should keep holding this dose?
 
Too early to tell, let's see what the rest of the night tells you. Did they do anything at the vet besides the exam? Fluids? Meds? She could also just be rather dramatically breaking a bounce.

How is her appy holding out?

The previous dose wasn't doing much and you held it long enough. Another option is to reduce but just part way? See if you have to battle her numbers or not tonight.
 
Wendy&Neko said:
Too early to tell, let's see what the rest of the night tells you. Did they do anything at the vet besides the exam? Fluids? Meds? She could also just be rather dramatically breaking a bounce.

How is her appy holding out?

The previous dose wasn't doing much and you held it long enough. Another option is to reduce but just part way? See if you have to battle her numbers or not tonight.
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She does like to be dramatic when she decides to break a bounce.
She was there all day in a kennel until the IM could squeeze her in, but she only had a manual exam. I brought a can of food for her, which they fed twice. No meds, no fluids, no lab work. Her appy is very good so far, and I believe it will continue to be good.
Makes sense. I'll see what tonight brings. I'm now thinking that if she doesn't go any lower, I'll continue to hold the dose where it is. If I have to fight her overnight, I will do a partial reduction. Thank you:bighug:
 
Wow. I can't understand why the vet would be so pushy and dismissive at the same time regarding Butters' diabetes. Why not look at your Spreadsheet at least, and show some interest in learning. Someone needs to do some continuing education courses. I'm sure vets have to do them, she needs to choose FD as something to study. I'm not fond of being talked down to no matter who I'm talking to, so I know that conversation would've gone differently for me. You sound like you have a bit more grace than I do. Lol.
I'm glad you were able to get Butters some more pain meds and I hope they are effective for her.
Butters decided to shake things up a little for you this evening. :D. Silly girl. Hope she keeps these numbers steady for you and doesn't bounce high. Have a good night and get lots of cuddles in :bighug:
 
I find it's a lot more difficult to say exactly what is on my mind when I'm not in the room with Butters. I'm thinking about how they still have to take care of her while I drive through traffic to retrieve her, and this and that, and I don't wanna tick anyone off when they are with my cat. lol.

77 @+4.5. Staying pretty flat. She hasn't had food since +2. Glad I remember how to handle the dropsies. :smuggrin: Setting up the autofeeder and setting an alarm, but going to try to get some sleep now.
 
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