12/23 OJ. Getting annoyed with vets

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Luxe

Luxe

Member Since 2020
https://www.felinediabetes.com/FDMB/threads/oj-vet-update.240303/

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soooo im at the vet with him now for his convenia injection and gabapentin refill. I wanted them to reapply the libre so i can get a better read on him because they're still refusing to do the tooth. Now they wont give him a new libre either OR write me a script for one so i could just try to apply it myself. Its not like its medication so im really not understanding why they wont reapply one. And she's still insisting that i reduce the dose further than 2 which she thinks we're already at but im not. He had not great numbers at 2units. Even worse less than that. She feels like cats should never be on more than 2units if lantus but hello, he still has dental issues, he needs more now because he cant regulate. And he's been giving me such a hard time for ear pricks now. Hissing, growling, clawed me, flipping all over. Im sitting in my car waiting for him to come out and trying not to rage cry. I dont know what to do anymore
 
I am very sorry to hear you are feeling so frustrated :( & in a parking lot stressed out.

Based on your previous thread, maybe it is time to take the leap and try another vet? Many vets, due to the pandemic, are willing to speak with you by phone before bringing the cat to them to see if it will be a good fit. This is an opportunity to ask about their philosophy of care for diabetes, meds etc.. Most will not be willing to have a detailed or specific conversation about your pet during the call, but they are open to discussing the more general aspects of how they manage care for certain disease states.

In the end, just as with human medicine, we need to find the right fit with a provider. Sometimes it is trial and error, but hopefully by doing a short phone interview, it will shorten or even eliminate much trial and error :). Illnesses and disease states are challenging enough without feeling like you don’t have a partner in the process of decision making and care. Sometimes these moments are good because the energy behind the frustration pushes us to make a necessary change.

Hang in there :bighug:......& let the vet search begin!
 
Luxe said:
I wanted them to reapply the libre so i can get a better read on him because they're still refusing to do the tooth. Now they wont give him a new libre either OR write me a script for one so i could just try to apply it myself. Its not like its medication so im really not understanding why they wont reapply one.
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I would try to find a vet you can work with. An infection like a bad tooth can cause inconsistant BGs. When I adopted Badger he had inconsistent BGs. Sometimes there wouod be little drop in BGs and other times I wouod get a PS well below 100. This was on three units. Problem was traced to an ear infection cause by polyps in the L ears. Antibiotics would only temporarily resolve the problem. Once the polyps were surgically removed Badger got consistant BG and now is on 1/2 unit Levemir.
 
I think so too. When i asked why they wouldnt give me another libre she said because she was changing his dose and it takes a couple weeks to take effect so she would give me a libre in two weeks to see how the dose change was working. But correct me if im wrong, dont you see changes in a dose within days?? Thats why you would change every 6cycles with TR??

i just hope he stays ketone free. Thats why i pushed for him to get the additional convenia shot today since it had been two weeks and maybe thats whats been helping keep the ketones at bay. Im giving her the the 2weeks. If i dont have a date for a dental by then we'll hopefully find elsewhere.
On the plus side though, he put on another half lb. in the last 2weeks so he's put on a total of 2lbs since his whole ordeal started on 11/9. On the down side he's now obsessed with the more expensive tikicat and turning his nose at the more budget friendly for mommy fancy feast :p but hey, as long as he's eating it works for me
 
tiffmaxee said:
I know how hard it is to find a new vet, especially during Covid, but I would be running from this one. Maybe post a thread asking for vets in the general location near you. :bighug:
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Thanks. And yes its so hard. I always feel rushed on the phone, i would much prefer being in a room where the doctor can't escape my many questions or concerns.
 
Luxe said:
I think so too. When i asked why they wouldnt give me another libre she said because she was changing his dose and it takes a couple weeks to take effect so she would give me a libre in two weeks to see how the dose change was working. But correct me if im wrong, dont you see changes in a dose within days?? Thats why you would change every 6cycles with TR??

i just hope he stays ketone free. Thats why i pushed for him to get the additional convenia shot today since it had been two weeks and maybe thats whats been helping keep the ketones at bay. Im giving her the the 2weeks. If i dont have a date for a dental by then we'll hopefully find elsewhere.
On the plus side though, he put on another half lb. in the last 2weeks so he's put on a total of 2lbs since his whole ordeal started on 11/9. On the down side he's now obsessed with the more expensive tikicat and turning his nose at the more budget friendly for mommy fancy feast :p but hey, as long as he's eating it works for me
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It makes no sense for the vet to refuse to give you another libre. You are totally correct that a dose change can lead to changes in as little as one or two cycles. Now the initial dose might take several days for the depot to build but only then. This is malpractice in my opinion. I’m s sorry this vet is clueless. :bighug:
 
tiffmaxee said:
It makes no sense for the vet to refuse to give you another libre. You are totally correct that a dose change can lead to changes in as little as one or two cycles. Now the initial dose might take several days for the depot to build but only then. This is malpractice in my opinion. I’m s sorry this vet is clueless. :bighug:
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I could totally see if i was asking for all sorts of meds her saying no. But a libre isnt a form of treatment at all so im really not sure if im willing to pay for it why i would be denied. It was great when it was working. Last week when i had a crazy schedule i just left my phone with my mom and she could easily scan him for me. And i could keep better track of his overnight numbers. I am going to try and do an overnight curve on him tomorrow because im off on christmas so i dont mind getting up every 2hrs to check him if i can sleep all day. At least the holidays are ending and things will be a little less hectic soon. I think maybe he's been worse for the pricks because he can sense im super stressed out. Even though i give him lots of pets and tell him he's a good boy and try my best to make it seem like im not going crazy inside working retail during the worst holiday season i've ever had to deal with
 
I agree that it makes absolutely no sense that they wouldn’t put another Libre on or allow you to do it. I have refills on sensors so I am able to fill them whenever I want to use it. I helped another person get started with it & she will have refills as well.

I know it doesn’t help but I am really sorry for your situation with this vet :(.
 
Did an overnight curve last night. Didnt get lower than 300. He's being really unlike himself today of course since its a holiday. Hes not taking his gabapentin in his food so i'm having to shove it down his throat which we both love *sarcasm*. He's hungry but just smooshing the food all over the bowl. Took 20mins to eat a 3oz can of food. Even with the gabapentin his tooth is really killing him. He's also spent the whole morning at the water bowl and in the litter box. I havent seen him drink this much in awhile. I've checked his ketones twice so far. Once at 7am, once at around 1130am. Both negative. The first strip stayed more the beige color, the second strip looked off grey but no pinks or purple so im assuming also negative. I'll keep checking them today and reach out to his vet tomorrow
 
I'm so sorry that tooth is causing so much pain, why can't they just take the dam tooth out.
It makes me so mad that they will let him suffer with this tooth!
Can you ask for anything stronger for pain

Maybe post a thread asking for vets in the general location near you like Elise
suggested.
 
Your vet is also wrong about how long it takes for a new dose of Lantus to stabilize. It takes roughly 3 days. It you look at the information or print out any of the papers on the Tight Regulation Protocol (see the dosing sticky on the Lantus board), you may be able to educate your vet.
 
I knowww. We're going on 2months almost now. He's definitely perked up now that christmas dinner is cooking. He does well we call it shark finning. He walks around between everyones legs purring with his tail straight up hoping for snacks. We gave him half a chicken breast and he ate that no problem so i think tonight instead of tiki cat pate im going to go for the shreds in broth and maybe he'll have a better time eating that
 
Sienne and Gabby (GA) said:
Your vet is also wrong about how long it takes for a new dose of Lantus to stabilize. It takes roughly 3 days. It you look at the information or print out any of the papers on the Tight Regulation Protocol (see the dosing sticky on the Lantus board), you may be able to educate your vet.
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Thanks! Yeah when she said i could get the libre again after two weeks because of the dose change i was just like so confused. I would have thought you're changing the dose i should have it now to monitor better. Im doing a 24hr curve today to show her his numbers for a whole day. when i talk to her this weekend about getting a dental on the calendar im going to definitely demand a libre then because his numbers might drastically reduce once the problem is solved. Inwish i could show her everyones spreadsheets here. She said i shouldnt be hoping for him consistently under 200 because that doesnt happen often but then i come here and i look at a lot of ss to try and compare and i see so many blues and greens im jealous! Im not even shooting for remission anymore though that would be great. I just want him to stay under the renal threshold.
 
Sienne and Gabby (GA) said:
Your vet is also wrong about how long it takes for a new dose of Lantus to stabilize. It takes roughly 3 days. It you look at the information or print out any of the papers on the Tight Regulation Protocol (see the dosing sticky on the Lantus board), you may be able to educate your vet.
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Thanks! Yeah when she said i could get the libre again after two weeks because of the dose change i was just like so confused. I would have thought you're changing the dose i should have it now to monitor better. Im doing a 24hr curve today to show her his numbers for a whole day. when i talk to her this weekend about getting a dental on the calendar im going to definitely demand a libre then because his numbers might drastically reduce once the problem is solved. Inwish i could show her everyones spreadsheets here. She said i shouldnt be hoping for him consistently under 200 because that doesnt happen often but then i come here and i look at a lot of ss to try and compare and i see so many blues and greens im jealous! Im not even shooting for remission anymore though that would be great. I just want him to stay under the renal threshold.
 
Luxe said:
Inwish i could show her everyones spreadsheets here. She said i shouldnt be hoping for him consistently under 200 because that doesnt happen often but then i come here and i look at a lot of ss to try and compare and i see so many blues and greens im jealous!
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Maybe ask the spreadsheet owners in question (via private message) if they'd be OK with your vet having a look at their kitties' data? If they say yes then all you'd have to do would be email the URL(s) for the spreadsheet(s) to your vet to have a look at.


Mogs
.
 
It says a lot about this vets treatment of diabetes that she thinks keeping a cat under 200 is rare :rolleyes:

Feline diabetes is such an emotional roller coaster when you start out :bighug: I wouldn’t be giving up on the idea of remission just yet though, you’ll likely see some big changes when the dental gets done so be prepared for that.

I notice on oj’s spreadsheet that your dosing is not consistent though. Lantus is a depot insulin so it likes consistency with the same dose morning and night so the changing doses aren’t going to be helping any on your road to regulation. Following TR and based on recent history he should be getting 2.75U morning and night.
 
Vyktors Mum said:
It says a lot about this vets treatment of diabetes that she thinks keeping a cat under 200 is rare :rolleyes:

Feline diabetes is such an emotional roller coaster when you start out :bighug: I wouldn’t be giving up on the idea of remission just yet though, you’ll likely see some big changes when the dental gets done so be prepared for that.

I notice on oj’s spreadsheet that your dosing is not consistent though. Lantus is a depot insulin so it likes consistency with the same dose morning and night so the changing doses aren’t going to be helping any on your road to regulation. Following TR and based on recent history he should be getting 2.75U morning and night.
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We were up to 3.25 but she wanted me to go down to 2. She said cats shouldnt be on more than 2u twice a day. I went back down to 2.5 to make her happy but i felt the 2 was way too low. He had some scary drops on the higher doses though overnight so i was like maybe a little less? I just upped his dose last night .25 but he didnt drop below 300. Over the 2.5 units he was going low i was afraid he'd go hypo while i was sleeping. But at 2.5 during the day its doing nothing for him. So im like one dose is too high overnight and not during the day so i really dont know what to do. His shot times are really late with my work scheule so when he was dipping was around 4am when im sleeping and not around to check up on him. I only know he went that low because of the libre
 
Unlike the in and out insulins like vetsulin and prozinc, when you’re giving lantus the cycle you get isn’t just based on what you shot that cycle, it is affected by up to the last 6 shots - this is the depot action. To understand what a particular dose can do you need to have shot that same dose at the same time for the past 3 days (6 cycles). If you’re giving different doses morning and night you’re just confusing the depot and not getting accurate information about the effects of either dose. Check out the sticky on the depot in the top of the lantus forum to help you understand more.

The 2U comment from your vet is patently ridiculous and doesn’t bare much further comment, a cat needs as much insulin as it needs.

I’m seeing a couple of night drops that might seem scary to you because they were so fast but really nothing to be overly concerned about, it’s pretty normal for cats new to lantus to start off that way. For example look at Vyktor’s original spreadsheet (the SS link next to the OTJ party link) lots of bouncing around to start off with and then, by following the tried and tested protocol, all greens and blues. Lantus actually isn’t so good for dragging a kitty down from high numbers, the reason lantus is so wonderful is that once you’ve gone through the bouncy phase and you’re shooting low numbers consistently the cycles end up getting pretty flat and your cat can stay in normal healing numbers most of the time.
 
@Luxe I don't have medical advice but I have been through the 'get another vet' scenario. In my case I still use both clinics and this is as short as I can make the story. Old Vet diagnosed our first sugar cat Nigel, wouldn't let me leave without proving I could do tests and shots, called us twice a day for 14 days to make sure things were fine. That clinic sent us flowers when Nigel passed and the vet is a close personal friend. We came to know New Vet because at March break our second sugar cat Noah needed emergency dental work that old vet couldn't handle. Both vets knew we sometimes went somewhere else and were fine with that but it's the staff that sometimes gets into a twist about it.
Recently Marco was diagnosed with kidney issues by New vet and when his files got transferred in error Old vet explained why that theory was all wrong. She's never condescending, doesn't need to be called Doctor and takes the time to explain what each marker in a blood panel means. Now we've paid for a blood panel, urinalysis and a urine culture ($180) based on what was a hunch. It annoys me when I'm shown results and then rushed out the door without copies and another bill I didn't need to pay.
Covid or not cats cannot be diagnosed over the phone and neither should the amount of insulin if you're testing at home. I know it's easier said than done but it's your cat and your money. If you know something isn't right don't be intimidated because someone has a diploma on the wall. Best of luck.
 
Forgot to add, if you read Vyktor’s spreadsheet you’ll also notice that it wasn’t long after his dental on 24/2 (we do the dates the other way in Australia) that he started screaming down the dosing ladder and then went OTJ ;)
 
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