1/7 Fitzel - Updating the Update and a Question

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Pirate Fitzel's Condo Cove

First - Thank you Marje for stopping in on our previous condo. This is the first chance I've had to get back online and I was so happy to see a post from you with your well wishes for Fitz and me. It's a bit stop, go, stop, go, over here with both my health and the Pirate's. Right now I'm in a quandry re:this new vet and wondering if I'm becoming a hindrance rather than an advocate for my baby girl. (more further down the post)

Ann - Thank you so much for your info on Orbax and relating your experiences with it with Tess. It's hard to tell if the Orbax is helping with the teeth because Fitzel just seems so listless and uninterested in life. I'm hopeful that the issue with her teeth will get resolved soon.

However, and here's my question - how far is too far to push a vet and their staff to get information re:your cat's treatment? I seem to be going through Vet's like a river at it's rapids and I'm beginning to think this is my issue and not the Vet's or staff. The Cliff Note version of our trials has been:

Diagnosing Vet - This vet first dx Fitzel with diabetes and is dead set against home testing. When I found this site and let him know I was home testing he got very upset and told me to stop testing immediately. To just shoot what he prescribed (1u at that time) and to just do that for the next two weeks twice a day and then bring Fitzel in for a fructosamine test. Though I was having trouble learning how to home test, I did feel it was the way to go. I knew if I went on that path, however, I would need to find another vet.

Vet #2 - all was fine here for a few months. The Vet was glad I was home testing and seemed genuinely interested in the TRP. She looked over my hand written log for Fitzel and was impressed and supportive. All was great until Fitzel was dx with pancreatitis and went on bupe. The office techs were responsible for pre-filling the syringes (oral not injectable) with .17u of bupe which I would give to Fitzel every 8-12hours if needed that often. (which she did and still does). On the bottle it stated to call 24 hours in advance to get refills - which I did. But, after 48 hours the bupe was still not filled. After 72 hours the bupe was still not filled. I went down to the vet and demanded to know what was going on. I had a cat in pain and needed to have that prescription refilled. I was told that they have been short handed and the staff is behind in filling prescriptions. I tried to understand this, but was not leaving until Fitzel's bupe was filled. The staff became very upset - saying I was putting undo pressure on them. I was upset because I had a cat in pain and was just following what was on the medication bottle re: refills. Well, I finally got a refill and asked the staff just how much time should I give for them to be able to refill the prescription next time? They said 72 hours.

The next time came around and it took 6 DAYS to get the meds refilled this time. I was furious. I tried to speak to the vet after day 4 of no refill and she did finally call me back saying she would now personally fill all of Fitzel's meds and not to go through her staff. That I should come down now and pick up the bupe. I did - the vet had left when I got there. I paid for the bottles and took them home. (each bottle had 5 prefilled syringes - I had two bottles) However, when I got home I saw that each of the syringes had a different amount of bupe in them. Some had almost .30u - (they should have had .17u) some had 2u, one had almost 5u!!!! Thank god I checked instead of just giving Fitzel the bupe. I called and asked to speak to the Vet - she called me back that afternoon and said to bring the syringes down. I did. When I arrived the Vet took me into one of the exam rooms and I laid out the incorrectly filled syringes. The Vet brought her senior tech into the room with her and proceeded to tell me that no drugs leave the hospital without being signed off as correct by this senior tech. I was astonished as laying out on the exam table was 10 syringes with incorrectly prefilled amounts. The Vet wouldn't even look at the syringes. She just said that I needed to take them home and administer them to my cat as she prescribed. I was stunned. I held up a couple of syringes and said - 'Look at these. They don't have the .17u in them. They have way more than that.' She didn't want to look. She became very defensive and the tech was very defensive and I was standing there with the over-filled syringes which they were telling me were not overfilled. But they didn't look instead walking out of the room. Before I knew it one of the staff asked me to vacate the exam room and leave. I asked for somebody, anybody to take a look at the syringes I was holding. No one would and finally the Vet came out front and asked me to leave the hospital and to take my cat somewhere else to be treated. I couldn't believe what was happening, but I left with the syringes - at least I would have some pain killer for Fitzel even if I had to adjust the dose in each syringe myself.

Vet #3 is the Vet we went to today. This one also is a fan of home testing. She opened her offices to me on Christmas Eve Day to see Fitzel and get her started on Orbax for her teeth issue - also giving me B12 to give to her once a week. I got the bupe refilled - at the proper dosage. On Christmas Eve Day the Vet schedule Fitzel for a fasting blood/urine and gastric panel. I asked how long she wanted Fitzel to fast. She said 8 to 10 hours should be fine. I was told not to give her insulin or any pain or AB meds - that she'd take blood and urine and then I could get Fitzel home and address food, insulin and other meds. This is what I had thought was going to happen this morning. Not so. I came in for the appointment with a hungry Cat who had no morning insulin. The main receptionist was working with another client and then looked over at me and said, 'Okay, just leave the cat with me and you can pick her up tonight.' WHAT???? I said I wasn't leaving my cat all day. That she'd had no food, no insulin, no meds of any kind. I had been told the Vet was going to do a blood/urine test and I'd take her home. (The Vet was in the back with another pet) The receptionist said 'What do you mean you're not leaving your cat. We have other patients and you have to leave her. We'll get to her this afternoon.' I asked to speak to the Vet there and then, but was told that wasn't possible as she was with another client. I said I'd wait for a bit and was told that wouldn't do unless I left my cat. I then demanded to see the Vet (who works by herself as the only Vet there) and find out what was going on. Why was I not told I'd be leaving my cat? What about her insulin? What about food? I wasn't going to just leave her carrier and walk out the door. The Receptionist was very stressed and told me to wait while she went into the back to talk with the vet - the receptionist came out a minute or so later and said - 'If you're going to be this way, give me the cat and the doctor will deal with her now.' I gave Fitzel to the receptionist who took her into the back for what I thought was going to be a blood draw and acquiring a urine sample. A half an hour later I asked what was going on. Was the Vet dealing with Fitzel now? Was she still with another client? I asked the receptionist to please find out. At first she wouldn't, but when I kept insisting (now it had been 45 minutes and no Fitzel) she went back and came out saying the vet was and had been working with Fitz and would be out shortly. That shortly was another 15 minutes. It took an hour to get blood and when the Vet came out she said she couldn't get any urine so I'd need to bring Fitz back for that another day.

I asked her why things were so different than what I had been told was going to happen at this visit. She said she was sorry and I do believe she was but then she told me that most owners don't have any problems leaving their pets to be picked up later. If I had been told Fitzel would need to be left, I would have addressed my concerns about her insulin, what she'd be fed, who'd be testing her while she was there - etc. This isn't something I felt comfortable doing on the fly. The receptionist then told the vet, in front of me, that she'd never known any owner to be so upset over having their cat looked at by a vet when they (meaning me) had made an appointment to do just that. Well, by now, I was exhausted. Fitzel was hungry and I just wanted to go home. I paid up - was told the results would be in maybe tomorrow- maybe Wednesday.

When I got Fitzel home my poor Pirate had blood smears running down her throat and chest and more blood on her right thigh. She had been shaved a bit in both places. No one even cleaned her up. I got a soft clean cloth, cleaned up my kitty. Got her tested, fed, insulin and medicated and was crying the entire time. I still am. I'm at a total loss. The only common denominator on all this is me. I'm jumping back and forth in my head saying I need to advocate for my baby and yet, I'm alienating the very people I need to help her.

I'm so confused. I don't really want to go out and find yet another vet. I'm exhausted and frustrated. I feel like Shirley MaClaine in Terms of Endearment, when she's running about the nurses station yelling that her daughter, who's dying of breast cancer, needed her pain shot now. Not later. Now. I know I'm Fitzel's advocate, but am I expecting too much from these people who are there to help her and me? Is it that I'll trust no one to take care of my baby the way I do? If that's it, then the fault is with me. Vets and staff aren't Fitzel's mommy.

The Vet (#3) is the one who would be doing dental surgery. She also said she wants to put Fitzel on something for her IBD. I'm trying to weigh do I move forward with the Vet given the experiences I've had. Do I look for someone else and in the mean time risk running out of AB and bupe? I'm not even sure who to take her to. It would be off recommendations from Yelp I guess. That's how I found this vet.

Right now my Pirate is sleeping curled up next to Mommy. She's been very needy all day and wouldn't even eat (after her fast) unless I sat next to her and stroked her and told her all was okay now. But is it? I have no idea and that's so hard.

Shai and The Pirate Fitz
 
(((Shai))))
what a pain in the arse...
you've got three crappy vets....
i hate to say it but I think you will have to continue vet shopping...

it's like my own situation in NM.... there are no good rheumatologists....

You should have more options than the three... aren't you in a large population in southern ca....?

I have stayed with my cat for all of her vet visits.... and when she's having surgery...
I'm the last one she sees as they put her out.... tube down her throat...
( and that's a hard one to stay for)

I always speak up and say ... "I don't want to leave her...."
I'll stay... how can I help? "
I've even asked if I could bring in a cot .... can I help with the other animals?
they decline that offer.

I don't think you've done anything wrong. And I'd go write a blog on that 2nd vet... beware... can't even get the syringes right....
You are justified to be so dismayed at the crappy crappy service these vets areoffering...
 
(((Shai)))

FWIW, I'd have gone ballistic. Given that I can speak medicalese, I would have gone over the top with respect to a vet abandoning care over a procedure that is endorsed by the AAHA (vet #1), making a medication error that would get the vet and tech sued (I can't tell you what a flap this would be at a hospital or pharmacy that treated humans -- call the state agency and the place would be investigated especially because it was an error with a controlled substance), and the lack of communication that could have put your cat at risk. (I've been known to terrorize medical residents.) The lack of communication and lack of apology is what gets MDs sued for malpractice.

My first thought is to suggest you call Lisa Pierson, DVM and ask for a referral in your area. Have you posted on Health to ask about vets in your area?

Personally, I'd be reporting vet #2 to the State Licensing Board. You are expecting care for your companion that is consistent with state-of-the-art veterinary knowledge. You are expecting accuracy with regard to medications. You are expecting to be given complete information so you can make informed choices. Those are reasonable expectations. It this was a child, would you expect anything different? If this were a child, could you imagine a pediatrician telling you to not get BG tests or dispensing inconsistent/incorrect amounts of a controlled substance, or a pediatrician that, oops! forgot to tell you your kid had to spend the day at the doctors office? I think you know the answer here and your gut is giving you very good information.
 
I agree. I don't think it is you as I would be doing the same thing. Vet #1.... No brainer. Vet #2...if they couldn't refill in 24 hours, she should have written you a script with numerous refills and you could have it compounded. That's what my vet does. Vet #3....I never ever leave my cats either. That might have been something I would have specifically addressed from the get go although my clinic makes appts for blood draws. I take the kitty in, they take them back on time, the vet draws the blood/urine, we're done. There is no excuse for them bringing Fitz to you with blood all over her...my clinic even dries them where they put alcohol and I've never had any clinic shave them for a blood draw.

I have another friend in S. CA who said she could not find a decent vet. That's unreal...you aren't in some way back town.

I'm sorry your baby and you had a traumatic day. I hope you can find someone you trust.
 
((((Rhiannon/Sienne/Marge))))

Thank you so much for your thoughts on this. It's like some surreal vet horror movie. I'm amazed that in a place like the San Fernando Valley (a HUGE suburb of Los Angeles) that finding a vet, who supports home testing, has an adequate number of techs and staff and that they are well-trained, not only in their tech duties, but in their compassionate people/pet skills is so hard.

I'll look up the info on Dr. Lisa and get in touch with her. I really feel the need for a referral more than just the social media type. That's what I'm going off of in their reviews - and the two subsequent vets after Vet #1 were off of great reviews. Re: Vet #2 - I have written to the state licensing board about what happened, but the whole thing deteriorated into a she said - she said event and while my letter remains on file, I doubt anything will come of it.

With Vet #3 I'm still stunned. Who on earth would leave their kitty and just walk out the door with the thin assurance of -'We'll get to her this afternoon'. Especially a kitty who's insulin dependent, on a special diet and multiple meds - let alone who on earth would do that to their baby no matter what other issues they might be dealing with. We're not talking about a car I'm leaving for a lube and oil change.

I have asked for references re: Vets from the Board - but I'm not sure if it was on Health or here. I didn't get any answers so I went to Yelp and Angie's List. Vet #2 and 3 are listed on both and have very good reviews. This is why I began wondering if I was asking for the impossible, or just being impossible and becoming a hindrance to my kitty rather than an advocate.

For those who don't live around Los Angeles, The San Fernando Valley is quite large with a population of around 3 or 4 million - and growing. It's kind of unofficially divided into East Valley/West Valley/North Mid Valley and South along the main drag called Ventura - near a Freeway of the same name. I live in the East Valley and am trying to keep my driving distance to no more than 10 miles away in any direction - though Vet #3 is a bit more than that.

I'm glad to know I'm not the only one who finds all of these situations untenable and unacceptable. I am anxious to see what the blood/gastic panels have to say about the status of my Pirate - her numbers have been steady in the 300's - mid to high - both AMPS and PMPS - her nadir has been both below 50 and way above 100 - sometimes in the 200's. I'm thinking I'll have to raise her dose to get her out of those high numbers. Right now she's ketone free, but I haven't been able to find the ketodiastix and will have to get them online.

Thank you for your support. My sleepy Pirate thanks you too.

Shai
 
Keep in mind that a reference is subjective, right? The people who liked those vets might have a much lower standard of care. I know lot or people who have no issue leaving their pet at the vet for the day. I can't stand the thought that my babies would be scared to death.
 
Marge - I so agree.

Fitzel would be terrified if I left her and I would be a basket case. It's one thing if I know ahead of time that whatever is going on will require my kitty to be left at the vet. But, there are so many things I would have wanted to be nailed down - in writing. Who'd be giving her insulin? Who'd be testing and how often? What type of food would be offered - if any. What type of cage would she be kept in? Could I bring her own blankie - could I bring a toy? This list just goes on and on and even then I'd probably stay the day just to be there.

I guess my standards are high - I never really thought about it like that, but it's true. I just can't see why anyone would or could be comfortable doing less or being all right with any of the three situations I've encountered.

Sienne is right - these are our children no less than any two legged one. We are all they have between a world they have no control over and a healthy, happy, safe life.

Shai
 
Hey guys sorry to hear all of your troubles. I am in So Cal too pm me and we can exchange info. I like my vet a lot. We are in San Fernando Valley too. I went through a bad vet before I found the one I have now. Take care and please pm me.
 
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