4/23 Jack: 208@amps, 200@+2- testing and IM Specialist update

Last post: https://www.felinediabetes.com/FDMB/threads/4-18-jack-299-amps.288944/
Sorry no post for a while, life is kicking my

Day 5 on 11 units- nothing to say really; could be better, could be worse.

You wouldn't believe the ridiculously stupid and downright IGNORANT email from the vet tech on the insulin resistance testing prices. I seriously already knew all of what she sent. I found my old email [argument] chain from the first time I had Jack tested and in 2022 they charged $166 for the insulin like growth factor -1: the test was $68.00 their cost, plus their office fees were $151.00 + an estimated $15.00 shipping = $166.00 total. The new email is below. I did see a post on how I can ship the IGF-1 to MU myself, but with the Cushing's test, I'm not sure it's worth it. I think I'm just going to let the IM specialist do it all. I can't deal with these morons anymore.
"Hi Christine,
I received a message to work on some prices for you. I think I have everything covered below:
Insulin Growth Factor Test at Michigan State: $72.00 plus shipping. I do not know how much the shipping will be yet. The $72.00 is what MSU charges for the test. I don't know if you pay them directly or pay us. I am trying to find this out. Our cost to draw the blood: Tech appointment= $20.00. Cortisol Dex Test $327.76 in house with us. Will spend the day with us due to the multiple blood draws through out the day. Fructosamine (recommended by Dr. per her notes) =$119.50"

Regarding the search for the IM specialist: I have ruled out going to Penn State in Philly- it's 2.5 hours one way, Jack hates to travel, and the 2 vets that were recommended don't seem to be there anymore. There isn't another vet school near me unfortunately. Crown Veterinary Specialist in NJ is 1.5 hours away but I don't have a recommendation from anyone who has personally been there. That leaves 2: Eastern PA Emergency in Allentown, about an hour and 20 mins and NE Veterinary Referral which is also about 1 hr 20 mins. I have taken one cat to the ophthalmology dept of the place in Allentown, with not great results (poor Rosco died...long story) so winner -winner- chicken- dinner prize goes to NE Vet Referral. I'll call them later today for an estimate on an appointment, the IGF-1, Cushing's, and a senior blood panel. Pray I don't fall over from a heart attack when I get the estimate.

Hope all are well, I think about and pray for all the kitties and human parents every day, I just don't get any time to check in with anyone in depth anymore. Sending hugs and love to all

EDITED TO ADD:
I just got off the phone with the place I had decided on (where I was on hold for 28 minutes) and get this:
consult =$229
ultrasound (must have)=$492-$734
IGF-1= $200-$250
cushings=rare in cats, but if I insist on the test= $400
I just can't anymore. Who has this kind of money? Maybe I'll get the testing done with the fools at the regular vet clinic and see if I can get an IM phone consult through the Cornell Vet link that @Mikanmama suggested.

 

I had been watching for an update from you. It looks like you're making some headway and narrowing the field of vets, so that's a good thing.

Just a thought, but using "pennsylvania internal medicine veterinarian" in a search might get you another choice or two. Smaller clinics with internal med docs would show in this search.

I hope you get some positive information!

 

I tried that, the problem is I am in a rural area, so everything is at least an hour, most times 1.5 hrs away. It's just the direction you drive that is the difference. And the prices are all ridiculous. I just got off the phone with the place I had decided on (where I was on hold for 28 minutes) - get this:
consult =$229
ultrasound=$492-$734
IGF-1= $200-$250
cushings=rare in cats, but if I insist on the test= $400
I just can't anymore. Who has this kind of money? Just wanted to say thanks for your support and suggestions- I really appreciate them

 

I'm so sorry you have to go through all that.
I think I would start with the test with your vet, and go from there. He might not need the whole panel after all? Just my 2 cents.

 

I certainly understand how disheartening it is. Sometimes a day or so to mull things over provides some guidance and clarity. Jack is lucky he's got you in his corner.

 

I don’t know about the other tests but the ultrasound price seems ridiculously high. Even our emergency room here which is state of the art only charged about $200 and sometimes they just do it routinely when he’s checked in and don’t even charge for it! I know different parts of the country have higher rates but wow. After we had a cat with cancer, hubby bought pet insurance and it really pays for itself . Maybe something to consider, but I don’t know the waiting periods after getting it.
I’m so sorry you’re going through this….

 

HI (((Christine))), Jeez, your head must be exploding. It's so damned expensive and crazy. (looks like the bills and estimates I see in my area, too. This market is sooo expensive for vet care)

Just a thought, I have often thought about this program/consultation
below link with Univ of Pennsylvania:

https://www.vet.upenn.edu/veterinar...-medicine/endocrine-telemedicine-consultation

It seems they will do a consultation with your vet and maybe that's an option to look at??

I suggested to one vet I worked with when Ivy was first diagnosed and she never answered me (guess she wasn't interested).

And also...sending you so many hugs of support. I know you are doing everything possible to help Jack

 

Woooh. I'm so sorry Christine, that you have to deal with all those!
This is just all so hard - you are trying your very best and yet, one thing after another!
I wish things were easier and those vet office people would be more courteous!
Telemedicine that Staci has suggested may be an option. Driving for 3 hours altogether would be so stressful!
I wonder if there are home-visit vets near by at all?
I am sending you and hope you can come up with a plan you are comfortable with!

 

What can I say, not winner chicken dinner for sure!

I coached my then regular vet through the tests. My current vet (different one that I love) already had experience with a Cushing's kitty, but not an acro. Tells you how "rare" Cushings is. Does Jack have a pot belly? Any balding/hair loss? Just wondering if you think you are seeing some physical signs making it worth testing him.

 

So the telemedicine thing is great- I am seriously considering having the tests done at the regular vet and then getting a consult- either through these guys you recommend or the Cornell one- I'm not sure how my vet would feel about doing this, but it doesn't hurt to ask. THANK YOU!

 

Jack is overweight, so his belly is big, not sure if it would qualify as a pot belly- not like when my Mom's dog had Cushing's. He does get an occasional hump in between his shoulders, where I give him the insulin, even though I try to move the spot a bit every night. It seems to grow and shrink with his depot, but maybe this is another problem. He actually has thick hair, but extremely poor coat condition- lots of dandruff and what I call 'tribbles' (like from Star Trek)- clumps that he won't let me comb out. There really aren't many classic Cushing's symptoms, but other than the IGF-1 I don't know what else to test him for that may give an answer on his high insulin dose. Thanks for your input and advice- it is very much appreicated

 

I think your are right that those are the two tests to get. I was just wondering if there were any possible Cushing's clues - poor coat and belly are enough reasons to keep it on the list. Just wish it wasn't so darn expensive!

 

I’m glad you like the idea. I think it’s a great option, too. (Especially to avoid the distance you’d need to travel anywhere for a consult).
I’m very intrigued by the program they describe. Please let me know what you find out about both programs and what you decide. Big hugs, Christine