Charlie's vet visit & the fight to get him on Lantus!

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Charlies_Mom

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Hi everyone, just giving a quick update on Charlie since his vet visit last week. Good news is, Charlie is as healthy as a horse besides his BG, of course. :RAHCAT They did a CBC and everything was in the "normal" range except his BG level. Since Charlie has not been able to stay regulated on Humulin-N for over a year now, I pressed the vet to immediately switch him to Lantus or Levimir. However, he insisted on ruling out an infection first, because he claims that a UTI or some other infection could cause his BG to be impossible to stabilize. I don't know that I buy this argument, but he wouldn't budge. He insinuated that he doubted that Charlie has a serious infection (his WBC count was normal), but he still insisted on ruling out this possibility before switching his insulin, so I didn't know what else I could do. Therefore, he gave him a Covenia shot and wants to see us back in 2 weeks. If the antibiotic doesn't help regulate his BG (which I know it won't), the vet is then willing to switch him to Lantus.

I must add that I later found out that Convenia shots are not the safest option for antibiotics. Had I known then what I know now, I would not have allowed the vet to ever give Charlie one. The vet just presented it as an "easier" way to give him an antibiotic so I wouldn't have to struggle with pills or liquid, and I trusted him. I'm 99% sure Charlie did not even need an antibiotic, so that's a little frustrating. Charlie seems to be doing okay, but I'm keeping an eye on him for any side effects. His BG is all over the place as usual. Thanks to DCIN for helping me with the vet bill and for some much-needed testing supplies. Hopefully, we're on our way to getting Charlie finally regulated! I just hate that my vet is making it harder than it needs to be!! :-x

- Anna & Charlie
 
I am glad you are aware of the Covenia issues and will be watching him. It is not a common problem to have issues with that antibiotic but it does happen.

IMHO, it was irresponsible of the vet to give a long lasting antibiotic to a kitty without symptoms and no diagnosis of an infection. (Like a doctor saying about a baby, he looks fine but I want to rule out an infection, so here's some antibiotic....)

Have you posted your city and state to see if there is an FD friendly vet near you? Would that be helpful?
 
I agree that it was very irresponsible of your vet to give him an antibiotic shot without an indication of infection--Humulin N is not a good insulin for cats and that is the most likely cause of the high BG. If your vet is being difficult, I would find a vet who is more willing to work with you and is more current with feline diabetes. What's important with vets is not that they are familiar and current with every part of feline diabetes treatment (because those vets are few and far between), but they are willing to learn and are supportive when you bring them information about the right treatment path.
 
If you think your vet is totally unwilling to learn, I would encourage you to find another vet .. even if it means traveling a ways.

If you think there is some chance to educate him, you might print out some of the Lantus info from the forum and the Convert A Vet post - expecially the Roomp & Rand article (attached here) - provide them to the vet. Since the articles are from veterinary journals, they'll carry more weight than citing this message board.

Lantus/Levemir testing & dosing protocol Roomp & Rand

After giving him some time to do the reading, you might tell him that you are considering finding another vet if he is unable to get up to date on contemporary feline diabetes care.
 
I completely agree with all of your responses! It was very irresponsible of the vet to give Charlie the shot, and I wish I had've stopped him from doing it. Luckily, Charlie's doing fine except for the continuing erratic BG levels. The sad thing is, this is the FOURTH vet I have taken Charlie to! The previous three were even more irresponsible than this one and the last one nearly killed Charlie once due to his poor judgment. (Early in treatment, he raised Charlie's insulin dose by TWO units per DAY! We woke up to a comatose kitty and spent $500 saving him via ER vet visit)..the scary thing is, this vet has his own insulin-dependent diabetic cat, so I thought he knew what he was doing! After educating myself more, I now know that you never raise insulin like that.

I'm very fed up with the vets around here and the bad experiences I've had with them. One vet (whom Charlie's also seen) basically suggested that I put my kitty with pancreatitis down just because "she's old". I ended up giving her the needed meds and syringe-feeding her for a couple of weeks and saved her life.

Anyway, yes, I do need a FD-friendly vet. I am in a small town outside of Winston-Salem, NC. If anyone knows of a FD-friendly vet around here, I'd be eternally grateful (and so would Charlie)!!! cat_pet_icon

- Anna & Charlie
 
Plugged "Vet near Winston-Salem, NC and got this map

If you zoom in, you can see more details of the location.
If you zoom out, any red dot is a vet; click on it for contact info.

Think of the interview questions you want answered from a prospective vet:

What insulin do you prescribe for a feline diabetic?
- What is the starting dose you typically use?
- How much do you increase a dose when it seems necessary?

What type of diet do you recommend?

How many feline diabetics are you currently treating?
- how long do your feline diabetic patients typically survive?

Do you ask you clients to home test the blood glucose level?

Are you willing to update your knowledge of contemporary feline diabetes by reading veterinary articles?
- If yes, what glucometer do you have them use?
Do you ask your clients to test the urine for ketones?
Do you have your clients bring in the cat to do a glucose curve?
Do you have 24 hour staffed hospitalization facilities?
 
Hi Anna & Charley -

Don't have any recommendations in W-S, but I've had a dog w/ cancer treated (2nd surgery/chemo) at Veterinary Specialty Hospital - VSH - in Cary (near Raleigh). It is a referral facility, but it's 24-7 and I've been really pleased with the service. Animal Eye Care is located in the same facility and they've treated 5 of my cats and done glaucoma surgery on a dog. They operate independently of one another, and require a referral from your vet, but IMHO the costs were competitive with my local vet. Others have had good experiences at the NC State Vet School.

I'm sure between W-S and Greensboro you'll be able to find a sympathetic/experienced FD vet, but if you want to expand your range, VSH might be an option.

The questions in the last post are right on target. Be sure to "interview" these potential vets to ensure that they have the bedside manner to work WITH you. Good luck!

Lu-Ann
 
I will just echo others' concerns about Charlie's treatments and the need to seek a more "current" vet, meaning somewhere that keeps up with current treatment protocols such as the AAHA's.

It may mean a half hour drive or so to find Charlie a more up-to-date vet. Although I will say regarding the euthanasia incident with your other cat - for a lot of vets they much more often see the type of owners who would euthanize rather than treat that type of illness. So when we are told those things, that's partly why.

Good luck.
 
Thanks for your suggestions! Charlie's current vet is actually 20 miles away. I've been going farther and farther away from my hometown as I've tried to find more competent vets. I know that the NC State Vet Hospital has an excellent reputation, but I could never afford to take him somewhere like that (or to any type of specialist right now). I was recently laid off from my job due to our branch closing, plus our Care Credit card is completely maxed out and it's difficult finding employment when you're pregnant on top of everything else. I've never been unemployed before, so this is all new to me...we've never struggled to get veterinary care for our 2 cats until this happened, but luckily, DCIN has stepped in to help get Charlie on the right path. They actually covered Charlie's last vet visit.

Thanks for the ideas on questions to ask potential vets! Great idea!! :smile: I guess it'll just take time to find one that is suitable for Charlie's needs.
 
You might be surprised about some of the specialty places. I was pleasantly surprised that the veterinary opthamologist could successfully treat the eye ulcer w/ meds that cost less than the eye removal that was recommended locally.
 
Cannot wait until Charlie's vet visit on the 27th, when I can FINALLY get him some Lantus!! 2 nights ago, his BG was 205 so I skipped insulin that night and went to bed. I woke up and tested him as usual to find the meter reading "HI"!!! :o In the 1-2 years I've been treating Charlie's diabetes, the meter has NEVER read "high" before. I freaked and quickly gave him his insulin and it steadily came back down. How in the world does it go from 200 to over 600 overnight when all he eats is FF Classic wet food?!?! I joked that he must've been sneaking the brownies while we slept, lol. I'm ready for him to get off this BG roller coaster! :YMSIGH:
 
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