? 8-Aug Maverick AMPS 608 l +6 473 - Concerned after vet input

[Christie & Maverick]

http://www.felinediabetes.com/FDMB/threads/7-aug-maverick-amps-563-5-459.181885/

I sent over Mav's spreadsheet this morning to the vet, and I have some concerns about the comments that I received, I would really appreciate any feedback!

They agreed with me that dose increase is recommended, but they want me to increase to 2u. Then, I was told not to bother with any more testing, I should just run another BG curve in 7-10 days. I politely tried to explain that I am uncomfortable with giving him any shot without at least testing AMPS and PMPS, and an odd one here or there to see how he is doing, and to get a better picture of how his treatment is progressing. I was told the testing is probably just stressing him out and that if I keep testing, he'll become afraid of me and I'll damage my bond with him. WHAT?! I explained that is not an issue at all, Maverick is just fine, and while I won't be testing him 6 times a day, I will be testing him AMPS and PMPS regardless of what they feel is required.

I also asked whether it would make sense to go up in a smaller interval vs. a full 1u, since he might have been bouncing up to the reds following the yellows. The comment I received is that this is what they normally recommend, and based on what they saw on my spreadsheet, the vet is not worried at all that I am risking possible hypo. Telling me not to worry, that it's very unlikely to happen makes no sense to me. I'm very frustrated at their nonchalant attitude in general.

I would prefer to have a good working relationship with my vet, and I don't want to go all "rogue" on them and not follow their instructions, but I think it's time for a second vet opinion.

In the immediate term, is an increase to 1.5u possibly warranted based on his high numbers and not much movement down over the last week, or as per SLGS, I should take a patience pill, bump to 1.25u and see how we do?

 

[apple]

I have no insulin advice.

Keep testing, that is my advice.

More people will come along and post. I doubt you will find any that say don't home test.

 

[Tuxedo Mom]

First suggestion would be to completely get rid of the dry food...it is far too high in carbohydrates and will make it difficult at best to see good results with the insulin. If you can remove the dry food, you certainly do enough testing to follow the TR (tight regulation) protocol whic calls for increases...as needed..every 3 days. Vets often want to do increases in 1 unit increments. However increasing from 1 to 2 units is doubling the insulin dose. The protocols that are followed, and considered safe, call for 1/4 ( 0.25) unit increases. I am hesitating about what to advise because of the continual high numbers. If it were me...and this is only MY opinion, I would be tempted to go to 1.50 units..only because you monitor closely. However others may say to stick with the smaller increase. If at all possible removing the dry food could be a big help towards better numbers.

Hopefully some others will weigh in soon.


ETA As far as not testing...cow patties....the best way to keep your kitty safe IS to test. I have had 2 FD kitties and neither one ended up being afraid of me or "damaging the bond". My Tuxie (GA) would run to the test mat and purr through the ear pokies and the shots. If anything the regular interactions with our kitties STRENGTHENS the bond. I wonder how many vets who suggest not testing would do that if it were themselves or their child???

 

[LizzieInTexas]

I would see if you could find a vet that specializes in cats or even better FD.

If you are comfortable posting where in Canada you are someone might be able to give a suggestion.

I guess you could say I went rouge but my vet was won over when she saw my spreadsheet. She also listens to me and works with me for the good of Gizmo on other issues so it is more of a team effort.

 

[Jill & Alex (GA)]

Your vet's input is a very familiar story... too familiar. If I had a nickel for every time I heard your vet's words over the last 11 years, I'd be rich! Ha, well maybe not rich, but you get the idea.

If one sets aside that you've chosen to follow SLGS and considers that you're trying to reach some middle ground with your vet... based strictly on the data you've accumulated and if you continue testing as much as you have been and are prepared to steer low numbers if necessary... I do think there's room to increase the dose to 1.5 units tomorrow morning "if" you don't see some decent movement between now and tomorrow morning. Increasing in the morning will have given him 6 cycles on 1u since the yellow on 8/5.

As far as your vet is concerned... if he asks, you can just tell him you agree with an increase, but wanted to take it a little slower... you didn't feel comfortable immediately taking the dose up to 2u BID. Taking that approach shouldn't ruffle your vet's feathers. It's a compromise of sorts.You increased as the vet wanted, but are going slower as you wanted.

Just my thoughts...


PS --- Honestly, I think hometesting helped create an incredible bond between me and Alex. It was a time when she received lots of loving and one-on-one time. I tested her for many years. All I had to do was call her and tell her it was time to test her BG. She would come running and then jump on to her "testing place". The other cats were jealous!

 

[Christie & Maverick]

Thanks everyone for offering your thought and opinions, I'd like to see where he is at tomorrow morning after he's 6 cycles past his yellow, just to be sure, but I think I see value in getting him up to 1.5u, even if I'm bending the SLGS methodology just a smidge .

I needed to skip his PMPS reading, I'm down to three strips I need one for +5 or +6 tonight, and for sure one tomorrow AMPS, I had a few error out on me. I guess my vet needed to order them in, so I have to wait until tomorrow. That's just a wee bit annoying .

 

[Sienne and Gabby (GA)]

Are you using an AlphaTrack meter? If so, the strips are available on Amazon.

I also agree with everything Jill posted. As for testing, Gabby was a tortie complete with the attitude that went along with being a tortie. She knew testing meant treats and she didn't give me the least bit of problem when I tested and I tested a lot. Of course, she wouldn't let anyone but me test but that was her tortitude!

 

[Christie & Maverick]

It is the Alpha Trak, I'll definitely check out Amazon...I must admit, that will be a first, I've never bought anything online . I had a long haired Calico, she was full of personality and attitude, but no comparison to the torties .

It's so true, Maverick knows in a short amount of time we've been testing, that he gets treats, lots of kisses and chin scratches and he's just fine. I also kiss his belly and tell Mr. pancreas to behave...it's not worked 100% just yet, but I'm sure Mr. P will get the message soon

 

[Marvin's Mom - Nat]

You are doing the right thing, I think home testing is the most important. I would ask the Vet if he had a child with Diabetes would he shoot without testing his child?

When you do remove the dry food, please monitor very closely, some kitties numbers drop low fast. It really does make a big difference, plus will also help the other two cats stay healthy too. If Mav is getting into the dry it may explain some of those high numbers.