Curious...what did you tell your vet and how did they take it?

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Stacym20

Stacym20

Member Since 2014
Bud is going for a check up Saturday morning and I want to show the vet my spreadsheet, I just don't think she'll like that I've been trying to fine tune the dose myself without her guidance. Oh well, isn't going to stop me from doing it. I was just wondering how everyone else handled telling the vet what they were doing and how the vet took it.
 
With my vet, before I even started testing, I mentioned to him that I kept seeing Mikey acting weird at certain times of the day and I was sure it was the insulin. When I started home-testing, I quickly discovered I was absolutely right: Mikey was going borderline hypo and, if I hadn't kept skipping doses every few days out of nervousness, I'm sure he would have hypoed.

I had told my vet over the phone before I brought Mikey in again that I had lowered his dose and my vet said, "well, if you're going to do whatever you want, I don't know why you're bothering to bring him in." I was so terrified that my vet was going to fire me! I brought Mikey in anyway and I took my spreadsheet to show him what I had been seeing and to justify why I decreased Mikey's dose. My vet ended up surprising me by telling me how impressed he was. He saw the wealth of information it was giving me and that it was helping me keep Mikey safe. We ended the vet appointment with him still telling me to do what I want anyway, but this time it was because he trusted that I knew what I was doing.
 
My vet was adamant that I should stick to a fixed dose. My hometesting made it apparent that a fixed dose didn't work for Bert, and that he was better with a sliding scale dosage. What did I do? I gave sliding scale dosage and lied to my vet.... :oops:
It was difficult. I like and respect my vet and still wanted to work with him. But I had evidence to show me that the vet's recommendations weren't working for Bert.... I wasn't comfortable with the fact I'd lied. Lying doesn't come naturally to me. But when I weighed everything up I did what was in the best interests of my cat.

Fast forward to a good few years down the line and my vet is really impressed with Bert's health.
At the outset he said that cats typically lived about two years post diagnosis (two years :nailbiting:!!!!) And as of this month Bertie has lived eight years since diagnosis. :)
Do I have regrets about what I did? Well, yes; because ideally I really like to be open and transparent about things. But I absolutely believe that Bertie wouldn't be alive today if I hadn't been proactive and treated him as I felt was best for him.

Bert recently had a bunch of blood tests done. Those included a fructosamine test which showed that he had 'excellent control' of his diabetes. The vet was extremely pleased. And I felt vindicated! :smuggrin:

Eliz
 
That's a great ending @KPassa! I hope mine goes that well. She asked how he was doing on the diabetic dry junk last time I was there, which was to pick up the insulin and learn about injections. I was honest about what he was really eating and I could see a look on her face as to say "I don't agree but I'm not going to argue." She was supportive of home testing, although again, I don't think she liked the idea that I was using a human glucometer. I'm going to bring it with me Saturday in case they want to test Buds BG; they can check him with mine at the same time to see the difference. So, I haven't seen her since Bud started insulin.
 
Yeah, my vet still buys into the prescription crap, too. We just agree to disagree about diet and I hold out hope that one of these days, he's going to realize how bad the prescription diets are for cats. Luckily, Mikey is allergic to red meats so he can't eat it anyway (the Hill's m/d is pork based). :smuggrin:
 
@Elizabeth and Bertie LOL I was totally of thinking about printing out the spreadsheet after hiding the unit columns... Which I'm still thinking about doing actually... I had said something about the flexibility of ProZinc last time I was there and she was very adamant that it was the same dose, every 12 hours. Bottom line is I wouldn't be lying about the fact that one unit was working at one point, and now it's not.

2 years?? I wasn't given a prognosis, pretty much I was just given a diagnosis, a handout to read, and a prescription for expensive dry junk. Thank goodness for this forum!!
 
The vet I first saw told me not to change Squiggles diet. Now the vet I trust is back from maternity leave , I've told her Squiggs is mostly on low carb wet cat food & she's fine about it.

As the result of todays blood curve she's told me to put the morning dose up to 3 & keep the evening dose at 2 .5 . She's a very caring & conscientious vet , & I don't want to fall out with her by altering Squiggles doses by myself, but when I get more confident, & Squiggles is more or less stable , I will have a discussion with her !
 
If you're going to take your meter in, abstract or print out my signature link Glucometer Notes OR the 2013 Rand article (posted in Lantus/Levemir somewhere) which lists glucometer ranges for various meter types.
 
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I am very lucky in that my vet is happy for me to research my cats illnesses and will often send him research papers that I find, he is happy to read and discuss. However he was hesitant to change remi from caninsulin to lantus. I sent him the current american treatment guidelines and got the a royal veterinary college vet is part of a Lantus trial in the uk to speak to him. Then I showed him my spreadsheet showing the results of the caninsulin and explained that I was worried about the sharp drops and rebounds. He was happy for me to change after that and happy for members of the forum to help me alter the dosage. I would keep him up to date by sending him my spreadsheet every week or so and he would offer feedback.
 
WHAT!? The average life expectancy after diagnosis is only TWO YEARS!?!? Why!? Dweezil is only six years old!!! Why is it only two years??
 
Because most people don't home test, they continue feeding high carb food, and often they don't give shots on time or even twice daily. All of that significantly increases risks of hypo and DKA and even hepatic lipidosis and CKD.

Mikey is going on 2.5 years diagnosed and most likely diabetic for all three years of his life. He's already beaten the odds, as most all the cats here have, because we reduce risk through home-testing. It's like a car accident; who is most likely to walk away unscathed: The guy wearing his seatbelt or the guy without one?
 
monty_dweezil said:
WHAT!? The average life expectancy after diagnosis is only TWO YEARS!?!? Why!? Dweezil is only six years old!!! Why is it only two years??
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Some people only use urine glucose monitoring (if they monitor at all) as a means of checking glucose regulation. Say for the sake of argument that the renal threshold is 13.8/250. The recommendation to avoid organ damage due to glucose toxicity is to keep levels at or below 7.8/140 as much as possible (Alphatrak values). Think of the amount of physiological damage their cats may sustain before glucose actually spills over into their urine? Some other people only monitor water consumption as an indicator of degree of regulation (possibly better than urinalysis). Some give insulin 'blind'. To their credit:

1. They actually treat their diabetic cats. (Not all cats who receive a diabetes diagnosis are that fortunate. :()

2. They may have a vet who does not support - or even actively discourages - home BG monitoring and species-appropriate feeding. (That was the case at the practice where Saoirse was first diagnosed.)

Without independent research maybe some people never find out there is a better way to help their beloved companions.

BTW, one of our vets has a diabetic kitty - diagnosed over a decade ago! :)
.
 
monty_dweezil said:
WHAT!? The average life expectancy after diagnosis is only TWO YEARS!?!? Why!? Dweezil is only six years old!!! Why is it only two years??
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Both my Mitten and Patches were diabetic and on insulin for over 10 years. Mitten passed away because of heart problems. Patched due to stroke or neurological proboem
 
Scout has been diabetic for 3 years, and because of diet change she is 5 lbs lighter !!! and much more active, better coat, etc. than the years before her diagnosis.

As for the vet question, my former vets were so impossible to talk to that I didn't dare show my spreadsheet. Whenever I mentioned the American diabetic protocol, my previous experience with insulin, advice I received from other diabetic cat owners, etc., I was interrupted, my concerns dismissed, and told "Well this is my CLINICAL OPINION and I've been a vet for so many years and I've recently attended a lecture on diabetic care..." I tried to just hold my tongue for my cats' sakes, but eventually I just found a new vet.

When I went to my new vet I was freaking out about bringing my spreadsheet, but she actually sat down and studied it, plotted the glucose curve on paper and compared it with the insulin manufacturer's sample curves, admitted she was not a diabetes expert, did some research on her own, spoke to a specialist, etc. etc. Night and day!

Lori
 
My vet's office taught me how to hometest with my first diabetic cat in 2003 and even gave me the meter. However, I lost Rascal to CRF a few months later. When Witn was diagnosed several years later and I also adopted Spot another diabetic, the new doctor in my vet's office kept trying to "discourage" me from hometesting. I told her no that I was going to test before every shot and we could agree to disagree. I would also be willing to share my test results with her on a regular basis. It took a few months, but she finally agreed that I knew what I was doing.
 
I don't understand why any vets would discourage home testing. Any extra information is good!

I MUST try harder to get dweezil more used to home testing. His life depends on it.
 
It sure is. :)

Why don't more vets come on here? To learn? ;) Seriously though...if they all had the correct knowledge, it'd be SO much easier for all of us.
 
monty_dweezil said:
It sure is. :)

Why don't more vets come on here? To learn? ;) Seriously though...if they all had the correct knowledge, it'd be SO much easier for all of us.
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When I asked her, my vet taught me how to home test. I suspect some vets don't approve of us taking our cats' diabetes management into their own hands, they think they know best !
 
When I said I wanted to home test Maggie, my vet gave me her MIL's old meter, so she was ok with the testing. I also printed out information from this site about insulins when we were deciding what one to give Maggie that my vet read and researched before deciding on Levemir. She was impressed and recommended the site to other cat owners. But most owners don't take the time or effort to managed their cat's diabetes as we do.

There were times she suggested increases that I didn't agree with. Like giving a full dose of insulin when she wasn't eating or too large increases. My standard line was "I am not comfortable doing that. How about "x" units instead?" My vet might not have liked it, but she understood I was the one dealing with feline diabetes daily and the one giving the insulin.

If you don't want to use the prescription food, just explain that your cat will NOT eat it. It is guaranteed by the manufacturer and the vet should take back any unused food.
 
monty_dweezil said:
I MUST try harder to get dweezil more used to home testing. His life depends on it.
Click to expand...

It will happen. Sometimes it just takes a little longer to get the testing down. It took me an entire week before I got one successful test in with Mikey and then another month until I could start regularly getting tests without having a battle of wills every time.
 
I had to get a new vet! My previous vet went ballistic that I sought advice else where. Like that was just what I needed added to my stress level on top of a diabetic cat!!
It's a blessing really. The new vet doesn't know much about diabetes either but she is very willing to learn!
 
My vet was more than happy and actually encouraged me to do home testing. I use a human blood glucose app to keep track of results with the added advantage of being able to email the results straight from the app.
I didn't tell my vet I use a commercial wet food that is all meat with no fillers mixed with the hill's prescription dry. His blood sugar didn't start going down till then. It was then i realised that those special vet foods might not be all they're cracked up to be.
 
I'm having 'communication' issues with my vet too; early days yet, he didn't actively discourage home testing, but neither did he enthusiastically endorse it. He sent me home w/ the Purina DM dry after first visit, but I came home and read Dr. Lisa Pierson's site and freaked; from that afternoon on, Oren's been on Fancy feast (admittedly w/ a little of that DM kibble as snacks occasionally). Such early days yet that i don't have a spreadsheet; only got first test this am, and i freaked about the pre-shot number; 565. Test was fairly stressful mostly because he was hungry and impatient I hope.. I'm hoping to get some more numbers before I'm scheduled to take him back to vet on 6th Feb for his first possible dose adjustment. I'm not sure how my vet will react if i bring him some numbers..
(using a Relion Confirm). I suppose I should bring that with me?
 
If you take in your glucometer, take in a copy of my signature link Glucometer Notes, so you have the feline reference values.
If the vet comprehends it is like reading temperature in Celsius vs Fahrenheit, you may not have much problem with the meter issue.
 
well that makes me a bit more nervous; are you saying my reading of 565 this morning was 30-40% low on the Relion?? wow...
 
Well my vet visit went well. I think she was impressed with all the numbers I had, she even asked if she could keep my spreadsheet! And @BJM I brought your glucometer notes and she read them over and didn't say a word to me about using a human glucometer. :) I did wind up hiding the dose column. She asked if I was keeping him on one unit and I said yes... Hey, 1.2 is close enough right? ;) she was very adamant that he should be kept on one unit while we are ruling out other factors. His thyroid test came back at the higher end of normal so that's something to keep an eye on. He goes in for a dental cleaning in 3 weeks and she said she was looking forward to seeing more numbers from me!
 
Megan & Oren said:
well that makes me a bit more nervous; are you saying my reading of 565 this morning was 30-40% low on the Relion?? wow...
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Regardless of the glucometer, the higher the numbers, the bigger the range, so pretty much anything over 250-300 is still "too high," whether it's an AlphaTrak or a human meter. It doesn't change what you're doing (holding the dose or increasing the dose), so it doesn't make too much a difference if the number is 305 or 605.

We have a saying around here: "It's better to be too high for a day than too low for a minute." So, don't stress out too much about the higher readings as you're working on fine-tuning the dose. Just make sure you're testing for ketones and you're increasing the dose as necessary to get Oren into better numbers.

And congratulations on your first home test! :woot:
 
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