Curve?

[Julie Berber]

My vet will not let me do Nippets' Curve at home. They stated they need to do it so they can do any adjusting to her insulin... What's the difference in them doing it or me doing it at home? They were the ones who moved her up to 4U twice a day only to find out the dang vets office is what's causing her to stress out and raise. With me doing her BG myself at home, I have her down to 1.50U Twice a day and still don't have it right but at least its not in the 500s anymore. Today I did move it to 1.25U. Wish I could test her throughout today to see what it's doing but unfortunately I am at work until 5PM. I just don't know what to do about the Vet? Do I just find a new vet who will listen to me?

 

[Larry and Kitties]

Vet stress can artificially raise BG by 100 or more points (USA). Thus, curve performed at the vets can results in too high a dose.
See page 242 of the following:
http://journals.sagepub.com/doi/pdf/10.1177/1098612X15571880
This
https://www.aaha.org/professional/resources/diabetes_management.aspx
also includes

"Precautions and details
"Home monitoring of BG is ideal and strongly encouraged to obtain the most accurate interpretation of glucose relative to clinical signs.34 Most owners are able to learn to do this with a little encouragement, and interpretation of glucose results is much easier for the clinician. See Table 2 for web links to client educational materials."

 

[FurBabiesMama]

First of all, the vet cannot make you do anything.. nor does he/she have to 'let' you do anything. Ultimately, it is your cat. You decide. If you want to try to continue to work with this vet, I would direct them to the American Association of Animal Hospitals (AAHA) guidelines. Larry gave you one excerpt from them above regarding home monitoring being "ideal". Here is another excerpt on the flip side of that:
"In-clinic blood glucose curves (BGCs) are more likely to be affected by stress hyperglycemia than BGCs generated at home. Veterinarians should be cautious of high glucose results and subsequent overzealous increases in dose."

If you are willing to do the curve (normally that means a test every two hours for 12 to 24 hours) and provide him/her with the data, there is NO reason they should have an issue with that. If they continue to be unreasonable about it, if it was me, I would find another vet.

 

[Kris & Teasel]

Completely agree! Your cat - your right to do a curve. They obviously don't have a handle on proper dosing protocol so I'd either be very firm with them about managing the FD on your own or I'd be looking for another vet.

 

[Julie Berber]

I talked to my boss here at work and she has recommended I call her Vet. There should be no reason in this world that I can't do it myself. Especially if I already know the test are going to be reading high due to stress... They had her for only 3 days and already upped her WAY pass the safe zone and she wasn't dropping in the 400s even. It's why the whole Insulin Resistance came into play from them. She's doing so good right now I don't want a set back. It's no where near perfect but I am making some kind of lead way with her. She looks and feels 100% better then she did a week ago. Shes put on over a half a pound of weight and shes actually jumping and climbing the cat tree again. Her Gait is still off a little but no where close to what it was. I think it's time to just find a new Vet....

 

[Julie Berber]

I have a consultation with another Vet this coming up Monday. I've been told she's supposed to be really good with Dogs and Cat Diabetes. I do have a question about dropping her insulin though. From the 1.5 to 1.25, I don't really see much difference in numbers yet. She's still bouncing from 300s to double digits. Should I go ahead and drop her to 1U twice a day and see how she does or give it another day or so on the 1.25?

 

[vbc2000]

Glad to see you have another vet lined up. Both Tigger and I have been much happier since starting home curves. I have spoken to the vet frequently but he has not had to go in for quite some time. Again, we both like that alot!

I just don't understand vets who do not appreciate our willingness to take on the responsibility of home testing/curving. You would think they would be appreciative that we are willing to take such an active role in managing our cats' diabetes. Let us know how the new vet goes.