10/25 Zyler AMPS 270 +5 216 Vet ?s PMPS 234 +6 205

kelcie

kelcie

Member Since 2023
Zyler goes to a new vet office today. When we got the diagnosis we did not even get to speak to a vet after, no discussion on food, a plan forward, etc. I hope today goes much differently and the vet is supportive.

Question for you all - how involved is your vet in your management plan? What role do they serve and how often do you typically see or talk to them? Is there any additional testing recommended? Is fructosamine needed if I’ve been checking BG? Thoughts on if a libre would help to increase his dose as I’m at work and unable to test throughout the day?

https://www.felinediabetes.com/FDMB...298-2-275-pmps-268-3-285.282861/#post-3117239
 
Also huge thanks to you all, this group has been my lifeline for helping manage Zyler so far!
 
kelcie said:
Question for you all - how involved is your vet in your management plan? What role do they serve and how often do you typically see or talk to them? Is there any additional testing recommended? Is fructosamine needed if I’ve been checking BG? Thoughts on if a libre would help to increase his dose as I’m at work and unable to test throughout the day?
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My personal experience has been that vets no almost nothing when it comes to feline diabetes. It's usually prescription food (which isn't even low carb), not the best insulin (vetsulin etc) and no advice to home test. I have been managing Bandit's diabetes on my own ever since I found FDMB - which was fortunately, very early into Bandit's diagnosis.

If you are testing at home, you don't need to go to the vet's for periodic curves (they're expensive and can be inaccurate due to stress) and you don't need the expensive fructosamine test either - though many vets insist on it.

The Libre is becoming more and more common and can be a useful tool, but it doesn't take place of testing with a blood glucose meter. It reads much lower in lower/normal numbers and can give some wonky readings. The biggest complaint seems to be the sensor quitting before the 14 days is up (we've had them fail in the first 24 hours) as well as the cat knocking it off through scratching or rubbing against anything it can find. Here's a detailed document on the Libre written by an FDMB member:

https://docs.google.com/document/d/...f13UiOiEM-6MsrFNpR9ztaPawF6dLk2b906QZ6VP6/pub
 
My vet is a gem. He got me to start home testing. The only curve Max ever had was after his first shot. I tested enough at home to not need another curve in the office or at home. Max was very stressed at the vet that increased his BG. My vet managed his other issues and I with the help of the FDMB took care of fd. I did send him a copy of the spreadsheet every once in awhile. I was not sure he saw them but found out otherwise if Max needed to see him and I had not sent one in over a month he mentioned it. He showed the ss to his students when they spending a week with him. I know that because if I was there during an exam he brought it up on his computer.

Unfortunately too many vets don’t have enough knowledge to manage fd. There’s a vet interview list on the board if interested.

A fructosamine is not needed as you have real time testing.

The I’m not a fan of the Libre. It reads in the danger zone at times when an ear prick shows otherwise. At times it just reads lower other human meters and the BG you see is 30 minutes later than real time. When you start comparing the results it becomes a question of which is accurate. They can malfunction and fall off before the two weeks. Others love them though.
 
Thanks for the feedback @tiffmaxee and @Bandit's Mom

I know the vet has to be at least supportive to continue to prescribe the insulin and syringes. The vet I saw initially did not give any refills and only allowed the vial.

I know the new vets office does not record in office curves and recommends libre for dose determination so that’s where I know I’ll have to decide. I just didn’t know with TR if a libre would help get him to appropriate levels quicker as I could potentially increase every 3 days if I have more data? Don’t know that it helps as I’m still not home to respond to hypo but could drop high carb kibble. I’ll read more on the post shared about the quirks
 
kelcie said:
I know the vet has to be at least supportive to continue to prescribe the insulin and syringes.
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Yes, so you just nod and smile and agree so they will give you the script and do what you think is right once you get home :-)

kelcie said:
I just didn’t know with TR if a libre would help get him to appropriate levels quicker as I could potentially increase every 3 days if I have more data?
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With TR, you increase every 3-5 days depending on nadirs. With the low blue nadirs you are seeing on this dose, you would hold it 5 days. If you were seeing nadirs over 200, you'd increase every 3 days. The downside with the Libre is the wonky data that you get at lower numbers. For now, the amount of testing you are doing is good enough :-)
 
Bandit's Mom said:
Yes, so you just nod and smile and agree so they will give you the script and do what you think is right once you get home :)
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Ok great, I haven’t done any urine/ketone testing. Is this something I should consider testing again? At what point do you test for ketones at home?
 
Had a long evening of work preparing a presentation for tomorrow. Will update on the vet appointment and ask follow up questions, but in summary vet pushed to go back down to 1.5U and take curve in 2 weeks via alphatrak to evaluate dose…
 
Why is the vet suggesting you go down to 1.5U? The lowest he has dropped to on this dose is 125 which is above the normal range. In fact, depending on how he does tomorrow, Zyler might actually need to go up to 2U!

It's amazing how vets will insist on pet meters for curves/testing but are okay to use the Libre on cats which is a human CGM system! :mad:
 
Bandit's Mom said:
It's amazing how vets will insist on pet meters for curves/testing but are okay to use the Libre on cats which is a human CGM system! :mad:
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I pushed hard back on this trying to get an explanation and brought up this exact point. I’ve learned the majority of vets practice what they were taught with little question and critical thinking.

The vet says she wants a reading on 1.5U for two weeks since they don’t dose at 0.25U increments since there isn’t a line. I recognized that it is somewhat variable in terms of could be 1.6-1.9U. I did not decrease dose.
 
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