First Glucose Curve at Vets

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Douglas_my ginger cat, Aug 4, 2020.

  1. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    Hi! I have just picked up Douglas from his first glucose curve and as it was late, his vet is going to call me tomorrow to discuss the findings. However the nurse gave me a print out of the fructosamine result taken when he first went in this morning (not having eaten since about 1am and prior to his shot). It shows 595 umol/L, which I guess is high. Can anyone explain or give some pointers or questions that I should ask the vet when he calls tomorrow.

    Also, has anyone on here used or heard of anyone using the 'freestyle libre flash monitoring device' on their cat?
     
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  2. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Hello! :)

    I asked Deb once to explain frustosamine tests to me and here's what she said:

    We don't really use frustosamine tests here since everyone hometests. It's basically just used to determine diagnosis, and nothing more.
    Forgive me if I've already asked but are you hometesting yet? If the numbers are high I wouldn't be surprised, stress raises BG and I don't know any kitties that don't get upset about being in a clinic. If your vet recommends a dose increase larger than 0.25 units I would not increase as quickly as they suggest. Try to remember that your vet's findings are from a single day - your cat was stressed more than likely, and it's possible kitty could have been bouncing (we don't know without testing) so if the findings are high don't be upset. Please share with us the numbers when you get them. :)

    As for the libre, no personal experience, I know a few people around here have tried it - it's supposed to last 14 days but I don't think it usually lasts that long. Some kitties get 10 days, others 3, some don't stick at all. It's cheaper to hometest but nothing wrong with using the libre. I think it'd be a great idea if someone is catsitting for you.
     
  3. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    Hi @Panic,

    Thank you. Thats interesting to know about the fructosamine. I will definitely ask for BG numbers that they took throughout the day. Looks like I paid for 6 alphatrack strips so they should have a record of that.

    I am not hometesting at the moment. I'll be honest, I'm scared to do that. I am not very good with blood (I know that might seem like a cop out) and feel it will stress Douglas out even more, as well as me. I watched a video of a lady wrapping her cat in a towel but even that looked extremely stressful. I am at a bit of loss as I cannot afford glucose curves once a month with the vet but don't want to spend money on a home test if I won't be able to actually do it.

    Sorry if this sounds whiny
     
  4. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Not at all! I'll be honest with you: I bought a home testing kit after everyone here insisted I start. But I was nervous about it and stuck everything in the closet and didn't touch it for over a month. Initially I really didn't understand the value of it (not saying you don't, just saying I didn't). I just told myself "I'll start next week ... next month ... after this or that vet visit". I was $800 in the hole in the first two months doing that. And Panic hated going to the vet all the time. So I gave it a try. Thinking back I'm kicking myself and darn lucky she didn't die, what with how high a dose the vet was sending her and I wasn't testing. I got real lucky.

    Since you're in the UK I don't know what the recommended meter is but know that there are MUCH cheaper options than the Alphatrak. I don't think most people could afford to test if they could only use it.

    As for being scared of blood - it is a VERY teeny drop. A lifesaving drop! But testing shouldn't stress Douglas out - if it does you need to change what you do. It's supposed to be a fun time for you both! I have a video of my Panic getting a test (and now that she's gone I cherish it even more) and I love seeing how bonded we became just taking a test. You don't have to do the towel wrap, some people do because it works for them, but other kitties jump right into their "spot" because they know treat time is coming after the test! They enjoy it! Panic and I would make a cuddle session out of it, she loved test time. I'd plop her down in my lap and she's get into "position" and wait for me to finish. They're not afraid of test time. :)

    Believe me, I understand being nervous about it. It takes time. Focus on both the fact that it's cheaper (because when it comes down to it finances often win) and that it will be less stressful for Douglas, getting to stay home with you instead of having to get stuck in a carrier and left at the vet all day. It's good for both of you. ^-^
     
  5. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    When you get that first successful test you will be so happy just knowing its possible. You can start by going through all the steps get all your supplies together and do several dry runs. You will gain confidence that way. Its daunting but you WILL do it for your baby!
     
  6. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    I must say, the first time I successfully administered his insulin shot without the resistance, I did feel a massive sense of pride. Not just for me but for Douglas too.

    Thinking about it now, when I dropped off Douglas off at the vet yesterday morning and I was talking to the nurse she did make a comment on how I probably knew more about FD then she did. Was a little taken aback at how easily she said that.

    Thanks @Panic and @jt and trouble (GA), you're encouraging words do really go far with me and I have woken up with a more determined mind. I hope it stays determined enough for me to do something about it!

    I did create a thread about UK supplies so gonna hunker down and sort myself out! I need to give myaelf a good talking too in the mirror
     
  7. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Anna, take heart! We really, really do understand the anxiety and nerves that newcomers here feel about the prospect of testing at home. The vast majority of us hadn’t had much hands-on experience of getting involved with medical care for our kitties before we started treating FD and it does feel like a huge learning curve. The last thing we want to do is scare you away but you’ll have got the message now - testing bg at home is very important, it will save you money and give you peace of mind.

    The procedure does look weird when you haven’t seen it done before but honestly, it’s just a knack, it needs a bit of practise that’s all, and after a while you won’t think anything of it. As well as the actual steps involved, the key really is to stay calm - our kitties pick up on our nerves and it makes them skittish. You need a nice relaxed cat and a nice relaxed human! There are lots of tips and tricks you can use - play soothing music or have a tv sitcom on, have a glass of wine beforehand - and before you know it, it will be done. Then the other important thing is a treat - a tasty morsel for your kitty for being a good boy, and something for you (another glass of wine perhaps lol or some chocolate). The point is that you both associate the procedure with nice things - and then as you go on, it gets easier anyway and you don’t have the same amount of nerves.

    So I’d say definitely get a meter and start familiarising yourself with it and practising on yourself maybe. It may take a while to build up to testing Douglas and again, we have nearly all been there so you aren’t alone. But persevere! As I said, this will give you peace of mind - being able to check bg can be a lifesaver.

    You can do it!
     
  8. KyraCat

    KyraCat Member

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    Jul 1, 2020
    Hi - Can I say Douglas is a beauty!

    We're in the UK and use a human Nexus RX Glucose monitor (It was a spare one my dad had - he's diabetic too!) and the strips are about £18 for 50 from a chemist or you can get them for £15 for 50 on Amazon.

    I am still very very new to the group and only 30 days in to home testing and already it feels like we were never not testing, it is just a normal part of the routine now! It feels amazing to say that because the first week was tough - not on Kyra, he was getting tuna treats - but for me because if does take time to get it!

    I know the worry is that you may be upsetting your cat trying to test them at home but it really is no where near the stress they go through going to the vets every fortnight (that's how often our vet wanted Kyra in for). Don't get me wrong Kyra will have a little wriggle or he'll try and bat me away whilst nose deep in tuna sometimes - but that is getting less and less often now.

    It's also about perseverance and not letting yourself get away with not testing. I would try and make excuses before each (usually failed) attempt at doing a test, like 'oh Kyra had a stressful morning I should leave him alone' or 'Oh he's upstairs and we do testing downstairs I shouldn't disturb him' but each time I told myself no, you have to do this and I did and now we test every day a few times a day and especially before his insulin. It is not easy at first and I told myself I couldn't do it and I was even looking in to ridiculously expensive litter that didn't absorb in order to test his urine instead - that would have been fun with 2 other cats in the house....Also the home videos of people testing their cats are done by people and cats who have gotten the knack of it so don't stress that your testings and your cat are not reacting the same way as the model cats in the videos.

    I found that for the first week we maybe got one successful test but we tried every time, you know the old saying practise makes perfect.... I would also talk to Kyra and tell him right last attempt and if it doesn't work I will leave you alone. By the second week we were well away! Still bumpy but we were doing it!

    It is the tiniest drop of blood needed but only you know how badly you react to the sight of it. Someone could tell me it's only a small spider but I'm still up on the chair shouting for some one to get rid of it!!

    Do give the testing a go if you can, honestly, from a newbie to testing, if becomes so normal so quickly but that first week will feel like and eternity of failures. Just know that we (I at least) have been there too!
     
  9. Critter Mom

    Critter Mom Well-Known Member

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    You and me both, Jemma. :nailbiting: Just the mere mention of the word makes me go all cringey.


    Mogs
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  10. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    And this is the problem isnt it? You have a rare opportunity here to, as I use to say "LEARN TOGETHER" as I did with Troubles Vet. This is a good thing as you may, now be saving other clients your vet will encounter.;):coffee:
    j.
     
  11. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    I have just had the call from the vets and I mentioned about home testing as he wanting to bring Douglas in for another curve in 10 days. At £250 a pop, it is unfeasible for me. He advised to buy Alphatrack and was not convinced with human meters as he found these 'unreliable' maybe I will compromise with him on this although he did not seem very impressed that I wanted to home test from the second curve.

    He mentioned that Douglas BG results throughout the day went from 21 to 30 levels. I have asked him to send me a copy so perhaps I can add this as the first entry on the spreadsheet. Following this, he has said to up his caninsulin to 3 IU per shot. @Panic , I know you mentioned to only up by .25 each time, so am a little conflicted with what to do.
     
  12. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    OK Anna it’s up to you if you decide to go with the vet’s suggestion and get the Alphatrak - just bear in mind the ongoing outlay (strips are a lot dearer than those for human meters). Maybe do a bit of research and work out the costs involved and see if you can manage those? Alternatively - just a suggestion - you could get a cheap human meter now as a back-up if nothing else, to practise the testing process...you may waste some strips at first while you’re getting the hang of it, and at 50p or so per strip for the Alphatrak you don’t want to be wasting too many. Also bear in mind that you don’t have to get the meter that the vet wants you to get - a human one is absolutely better than none at all, and I don’t think you should be led to believe that they are unreliable. That sounds a bit of a cop-out to me.

    As for dosage, yes we usually suggest small increments only. A jump from 2u to 3u is a big increase (think of it in percentage terms) and we here would certainly say increase small amounts at a time, the points being that you may be a) overdosing your cat and b) skipping over the ideal dose.

    Things to consider!
     
  13. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Agreed! The vet can't force you to up the dose, buy an Alphatrak, anything at all. If they think they can, well, you're the client, fire him. ;) Not saying it will get to that but remember YOU are the boss, not him!

    Also note that those "unreliable" human meters have been used in cats for many years - Alphatrak is still fairly new in the world of diabetes.

    Plus the nurse did say you know more than them. ;) Remember - that vet doesn't have much experience with feline diabetes. You can tell because of the way he ups doses, prescribes Caninsulin (sounds like he thinks Douglas is no different than a dog!) and doesn't agree with human meters. The people here have decades worth of knowledge and experience and studies and proof to back up what we say. He doesn't. It's easy to be intimidated and not "rock the boat" but don't let someone convince you to do something irresponsible due to their lack of knowledge.

    You've got this!!
     
  14. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    Time to get my big girl pants on!
     
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  15. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Yes and stay cool and calm... there is no need to fall out with the vet even if you do disagree. You can simply say that you can’t afford the Alphatrak costs, or regular curves at the vet’s... there’s no answer to that unless they lend you a meter themselves (unlikely). You definitely know more about FD than the vet now, so the trick is to get him/her to respect you for that and work together for Douglas’s benefit. It’s not a power struggle, it’s about caring for this little boy as best you both can. A good vet will be on the same page as you.
     
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  16. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Totally agree!
     
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  17. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    Hi Anna,

    Another newbie here, but as Kyracat, I can't remeber not testing a few weeks in.

    If you are in the Uk, I feel your pain with the price of supplies. My vet also suggested alphatrak, which I bought it at animed (the cheapests place I could find, have been discovering lots of new websites). However, the strips are really expensive. I saw people here using the strips from frestyle lite (produced bythe same company as alphatrak, but for a human monitor), and decided to try because is half the price. In my hands, it gives very similar results, so I'm keeping my expensive alphatrak strips for "special occasions" (like the two near hypos this week :eek:). I confess though, given the rate I am going through strips, that I have bought the human gluco navii, which i intend to use to make a curve at the same time as the alphatrak sometime next week. Fingers crossed they are equivalent as other people have found (i.e different, but always about the same amount different), those strips are 5X less than alphatraks....
     
  18. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    I am going to do some research about the meters and as @Diana&Tom mentioned I need to relay all the costs and see what I can manage long term. I need to keep remembering that this is not a short term thing.

    I definitely go through waves of feeling overwhelmed and then feeling I can take it on, I just need to take a step back more often and take a deep breath.

    @Panic is right, I am the client. I pay each time to see the vet so if we don't get on, I can take my business elsewhere! :woot:

    Can I ask what tuna treats you are feeding Kyra?
     
  19. KyraCat

    KyraCat Member

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    Jul 1, 2020
    Oh it's literally just tinned tuna in spring water. I put it in a sealed tub and let him have a little as I test him and then after the test, just to let him know what a good boy he is :) He was having chicken or turkey but I found he got bored of it and it went off too quickly... which meant more money spent...

    Completely get the overwhelmed feeling! Some weeks I feel like we're smashing it other weeks I could cry. I was actually having a breakdown just this Friday (negative feed back from our vet - trying a new vets tomorrow) but I posted here and the gang rallied round and picked me straight back up.
     
  20. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    You’re doing really well Anna, it is overwhelming whilst you’re taking it all in so give yourself credit for how much you’ve learnt in a short time, and also do other things so you’re not focusing on this to the exclusion of other things in your life. I know it’s weird atm but watch a movie or cook something really nice in the evenings to give yourself a breather.

    And yes, being practical will help so you start to feel more in control. Work out how much a meter, strips and lancets will cost (did you get some recommendations on another thread, sorry I can’t remember? Or there are I think suggestions in the UK guide that I linked for you in one of your threads). Once you have the meter the main cost is strips - they usually come in tubs of 25 or 50 and can vary a lot in price so shop around online. Many people buy strips on ebay - avoid high street chemists as they will be top prices. As a guide, you’ll need to test bg before every insulin shot, so two strips per day minimum, and when you do a curve you’d be testing every two hours during the 12 hour cycle, so more strips needed. And there may be times when you just want to do random tests for various reasons. So you do need to keep a good supply of strips to make sure you don’t run out at a crucial time.

    And keep posting here for practical and moral support! Everyone understands where you're coming from and we are all rooting for you :)
     
  21. Critter Mom

    Critter Mom Well-Known Member

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    That's what things look like when you're doing it right! ;) :woot:


    Mogs
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  22. Critter Mom

    Critter Mom Well-Known Member

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    Following on from Diane's helpful info on test strips, make sure to use them in order of purchase to avoid ending up with out of date strips. (Buy two pods. Use pod 1 with pod 2 held in reserve. When pod 1 is nearly gone buy pod 3. When pod 1 is finished, start on pod 2 with pod 3 in reserve. Rinse 'n' repeat.)


    Mogs
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  23. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    I didn't realise when I joined here how much I would rely on the moral support!!

    Can I ask, how long before the shot do I do a BG test? For example, currently I feed Douglas at 0700 and administer his shot at 0730. Am I testing before he has food too?

    @KyraCat, Douglas goes crazy for tinned tuna so have associated the shot with the tuna. Positive association
     
  24. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    Thats a good idea! However did not realise they can go out of date!l, thanks for the heads up!
     
  25. Ann & Scatcats

    Ann & Scatcats Well-Known Member

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    Dec 31, 2009
    @Douglas_my ginger cat

    The Fructosamine is a very good check parameter were you stand at start and to were you are going, your regulation aim
    https://www.felinediabetes.com/beyondBGcurve.htm

    You had both a High Fructosamin - 595, which is high

    and very high vet curve bg's 21-30


    Your aim in regulation is to have a Fructosamin of Under 400
    and bg's under 15.


    You do that with proper zero carb meat food and a lower insuline dose,
    and by setting up a Spreadsheet for the bg's
    Here, Choose International Spreadsheet Templet
    https://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

    You will do just fine.
     
  26. Panic

    Panic Well-Known Member

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    Apr 10, 2019
    Oh yes, I had those spontaneous burst of tears in between learning everything during the first few months! It's a lot to learn, a lot that needs to be known early on, and sometimes all the information gets dumped on your at once and causes you to freeze up. If you ever get overwhelmed or confused, don't hesitate to ping us for specifics. :) I had a few go-to people I used all the time (they were probably tired of hearing from me, they say they weren't though :rolleyes:) which helped me get the hang of things.

    AGREED. No need to bring out Mama Bear attitude if it's not necessary ... but don't be afraid to growl if you get cornered. ;)

    That is the worst! I wouldn't call myself un-confrontational, just ... timid. I don't like to challenge people who are supposed to be smarter than me. I don't want to look/sound stupid. Sometimes I would nod and say "okay!" because I was put on the spot and didn't get a moment to step back and think about it, I like to make peoples' jobs easier ... but when my vet sent my low-carb food back out the door and told the tech to tell me "you can't use this, she won't reach regulation on it" I had to square up and (politely) challenge her about it and told her Dr. Lisa Pierson's food chart says otherwise. I was proud of myself but the moment I left kitty at the vet for her curve and for the chart to be reviewed I was terrified. :woot: It's part of being their mommy/daddy though - you are their advocate! A Catvocate! And Jemma BEST of luck finding a vet that works for you and Kyra! Keeps us updated!

    I will admit though there were some days that I wished I could just put one of the senior members on the phone to bark at the vet for me. :oops:



    You would test at 0700. You want to make sure Douglas is high enough for insulin without food in the system. So if Douglas was lower than normal, you might want to stall feeding another 20 minutes to see if his BG rises on his own without food influence. :) And just to throw out there, is Douglas getting a snack around +1? Usually between +1 and +2 is when Caninsulin hits hard.
     
  27. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    The drill is:

    1. No food for 2 hours before preshot test.

    2. Do preshot test and then feed.

    3. With Caninsulin*, wait 20-30 minutes before giving insulin (assuming preshot BG shows it's safe to do so).

    At onset Caninsulin typically lowers BG quite hard and fast. Onset time is typically anywhere from 45-60 minutes after dose admin. Allowing that 20-30 minutes between feeding and dose admin allows time for the cat to get 'locked and loaded' with carbs ready for the insulin to go to work on.


    Mogs


    ETA:

    * When using an insulin with a gentler onset, e.g. Lantus, it's usually OK to give the insulin right at feeding time. One exception to that might be where a cat is experiencing eating difficulties and one might need to hold off on the injection until one is sure the cat has eaten enough to be safely given the insulin.


    .
     
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  28. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    Yes, he eats a little snack usually +1.5, +4.5 & +7.5. I learnt this from the forum as the vet just wanted to give 2 main meals at the beginning. When I asked about cats being grazers, he back tracked and said I could give smaller meals throughout the day. But he never mentioned to eat snacks after shots due to the insulin effects.

    So you guys must've eased mind as I dreamt that I waa successfully hometesting! But also that Douglas slept on my bed again (he did this when i first got him, but stopped around the time he started grtting ill. Thats the dream to get him back for bed cuddles)
     
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  29. Critter Mom

    Critter Mom Well-Known Member

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    Same story here.

    Saoirse had always been a grazer but within about 48 hours of being put on the two meals a day regimen by her diagnosing vet she started getting really painful bouts of vomiting up clear foam. I rang the vets about this to ask for advice and the response I got was literally, "She's had it her own way for long enough, she'll just have to get used to it." No exaggeration whatsoever here. After I picked my jaw up off the floor (again - wasn't the first time they gobsmacked me). I decided to increase her food allocation a little to give her snacks every three hours. No more foamy vomit. I was not going to see my cat endure avoidable discomfort.

    At the next check-up the following week, I informed them of what I was doing, and that it was not negotiable.

    Fired them a few days later. ;)


    Mogs
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  30. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    That’s an appalling response from the vet, Mogs, no wonder you switched away from them.

    Yes, foamy vomit = sure sign of acid tummy caused by not eating. I don’t like to go too long myself without food as I start to feel a little nauseous after 4 hours or so, but a small snack like a biscuit or banana makes me feel better. Why would we want to deliberately cause our kitties discomfort by withholding food - just small low-carb snacks between main meals makes them much happier... and surely that’s what our over-riding goal is. Some vets seem to think our pets are machines :(
     
  31. Critter Mom

    Critter Mom Well-Known Member

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    Quite.

    Luckily our kitties have healthily obstreperous beans to recalibrate any skewed perceptions.

    [​IMG]


    Mogs
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  32. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    This is good to know too as previously Douglas had vomited foam and never really understood why.

    And here I thought all vets cared. Thats appalling!
     
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  33. Critter Mom

    Critter Mom Well-Known Member

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    That was mild by their standards! They lost one cat on me (hepatic lipidosis - they failed to initiate sufficiently aggressive efforts to get food into my Danú in time because they "[didn't] want to stress her out"), and the vet who examined Saoirse when she presented with clinical signs of diabetes initially refused point blank to run any diagnostics when I requested they do so. She gave a diagnosis of "old lady" who'd had a "good innings").

    It's 10 years next month since I lost my Danú, and I'm still angry; she was only seven, and tests showed there were no other underlying issues (eventually - they screwed up getting the test results back too). :mad: :(

    Because they screwed up so badly with Danú I didn't trust them with Saoirse. I became much more assertive about getting her the care she needed. Thankfully I found FDMB and it helped to save her. I also found a wonderful new vet.


    Mogs
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  34. Douglas_my ginger cat

    Douglas_my ginger cat Member

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    Jul 25, 2020
    So the vet sent me the graph of the glucose curve and I'm pretty disappointed. It shows that they fed and administered the insulin shot at the same time in the morning and did not feed him again for the next 9 hours. Even though I spent about 15 mins with the nurse, when I dropped him off, going through his feeding schedule. Surely this curve is not a true representative of Douglas' bg levels.

    I am going to stick these results in a spreadsheet this weekend and finally order that glucose meter. Let's get some real, accurate data!
     
  35. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    I think you will be glad you did. ;):coffee:
     
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  36. Critter Mom

    Critter Mom Well-Known Member

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    Correct. It's generally true because so many cats experience travel/vet stress and that can elevate BG levels above what they would normally be at home.

    You're right, too, that because the vets didn't mimic Douglas' regular feeding schedule you won't have a picture of the effects of feeds at particular times in the cycle and how they will interplay with the action profile of the insulin. That said, maybe being at the vets may have put Douglas off his food a bit even if they had offered it. ;)

    Amen to that! :)


    Mogs
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    Last edited: Aug 7, 2020
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