Lori&Scout
Member Since 2012
Before I say this, I want to make sure that you guys know I have the greatest respect for vets in general, and I recognize that not knowing a lot about diabetes and the latest advances in that very specific thing doesn't make them bad vets. I respect the amount of school they've had to go through and their compassionate care for animals. I'll also say that I know a fair amount about diabetes, and that I trust the advice I've received here over the years on dosing and testing and looking after my diabetics.
So here in the UK, vets have to start cats on Caninsulin and only switch to human insulin if the Caninsulin isn't working. Well it's been a month and Nip's numbers are still way high even on 3.4U (see spreadsheet) and she is still feeling very poorly, having accidents, drinking and peeing rivers, not grooming. Two weeks ago I told my vet that I want to switch her to Glargine (Lantus) and asked her to help me get to the point where she was comfortable prescribing it. She said that her "hands were tied" until another month had passed with no result. I'm at wit's end with the accidents and trying to arrange cat care while I'm out of town, so I wound up in tears. But I agreed to increase the dose once a week and do a glucose curve and report the results to her once a week.
I made an appointment for yesterday to get Nip reweighed and check for UTI. My regular vet was out so I got one of the senior practice members, a man who had seen Nip only once (before her dx). I was hopeful he'd be more receptive to switching her to Glargine.
I walked into the exam room and he immediately started telling me all the things I'm doing wrong. He first said I was "micromanaging" the insulin dose because he saw in the notes that I was giving her 2.4 U last week. Then he said that glucose curves, whether done at home or at the vet, were a "waste of time" because the cat is stressed and BG goes up. He said even fructosamine readings weren't that great, it was better to just weigh the cat every couple of weeks and go by how much they were peeing. He then said I had increased the dose too fast and was probably getting high numbers due to Somogyi effect. He also said that I should not be "distraught" that she was taking more than a month to regulate as it could take many months. This is all before I had a chance to say A SINGLE WORD or he'd even SEEN Nip. :evil: :evil: :evil:
I tried to explain what was happening but he cut me off. Then I picked up the carrier and said that if he didn't start listening to me, I was walking out and never coming back to his practice. I briefly explained what was going on and also that I was doing what my normal vet (at his practice!) had told me to do, including glucose curves at home, except that I'd increased the dose from 2 to 2.4 to 3 units each week rather than going straight from 2 to 3, so I was going really slow and doubted her high numbers were all from Somogyi. (As for the 2.4U thing, long story short I'm using U100 syringes and the conversion chart. I didn't want to even GO there.) He wasn't really receptive and was very condescending and almost mocking in his tone. Needless to say, I didn't bother to show him my spreadsheet which I'd printed off and brought with me.
I tried to explain why I wanted her on Glargine. His first response was "Isn't that experimental?" I explained the benefits as best I could. He said he'd speak to my normal vet about it because going up to 4U of caninsulin did seem like a lot for a 4.6 kg cat. I did stay calm and respectful, although I was absolutely fuming and I'm sure that was plain to see.
Today, normal vet rang to say that from now on she doesn't want me to do glucose curves or home test but instead to bring Nip in every 2 weeks for a fructosamine test (which requires a blood draw from her jugular!) I said I didn't see the point of putting her through the stress of frequent fructosamine tests when I could (and do) test her at home. She also said she was not going to give her Glargine and told me to give 4U of caninsulin.
I plan to go to 4U Caninsulin, continue home testing, and find another vet. If anyone has a vet anywhere near the midlands in England who might be helpful or if you have had success convincing a UK vet to switch to Glargine, I could really really use your help. :sad: :sad: I'm really upset about all of this.
Lori
PS Last week I asked Ruth from the Royal Veterinary Clinic to give my vet a call and tell her how well Glargine is doing in the remission trials. I don't know if she ever called, vet never mentioned it. Nip is not a good candidate for the trial because she is a Demon Hell Beast at the vet, so I've pretty much exhausted that avenue. :sad:
So here in the UK, vets have to start cats on Caninsulin and only switch to human insulin if the Caninsulin isn't working. Well it's been a month and Nip's numbers are still way high even on 3.4U (see spreadsheet) and she is still feeling very poorly, having accidents, drinking and peeing rivers, not grooming. Two weeks ago I told my vet that I want to switch her to Glargine (Lantus) and asked her to help me get to the point where she was comfortable prescribing it. She said that her "hands were tied" until another month had passed with no result. I'm at wit's end with the accidents and trying to arrange cat care while I'm out of town, so I wound up in tears. But I agreed to increase the dose once a week and do a glucose curve and report the results to her once a week.
I made an appointment for yesterday to get Nip reweighed and check for UTI. My regular vet was out so I got one of the senior practice members, a man who had seen Nip only once (before her dx). I was hopeful he'd be more receptive to switching her to Glargine.
I walked into the exam room and he immediately started telling me all the things I'm doing wrong. He first said I was "micromanaging" the insulin dose because he saw in the notes that I was giving her 2.4 U last week. Then he said that glucose curves, whether done at home or at the vet, were a "waste of time" because the cat is stressed and BG goes up. He said even fructosamine readings weren't that great, it was better to just weigh the cat every couple of weeks and go by how much they were peeing. He then said I had increased the dose too fast and was probably getting high numbers due to Somogyi effect. He also said that I should not be "distraught" that she was taking more than a month to regulate as it could take many months. This is all before I had a chance to say A SINGLE WORD or he'd even SEEN Nip. :evil: :evil: :evil:
I tried to explain what was happening but he cut me off. Then I picked up the carrier and said that if he didn't start listening to me, I was walking out and never coming back to his practice. I briefly explained what was going on and also that I was doing what my normal vet (at his practice!) had told me to do, including glucose curves at home, except that I'd increased the dose from 2 to 2.4 to 3 units each week rather than going straight from 2 to 3, so I was going really slow and doubted her high numbers were all from Somogyi. (As for the 2.4U thing, long story short I'm using U100 syringes and the conversion chart. I didn't want to even GO there.) He wasn't really receptive and was very condescending and almost mocking in his tone. Needless to say, I didn't bother to show him my spreadsheet which I'd printed off and brought with me.
I tried to explain why I wanted her on Glargine. His first response was "Isn't that experimental?" I explained the benefits as best I could. He said he'd speak to my normal vet about it because going up to 4U of caninsulin did seem like a lot for a 4.6 kg cat. I did stay calm and respectful, although I was absolutely fuming and I'm sure that was plain to see.Today, normal vet rang to say that from now on she doesn't want me to do glucose curves or home test but instead to bring Nip in every 2 weeks for a fructosamine test (which requires a blood draw from her jugular!) I said I didn't see the point of putting her through the stress of frequent fructosamine tests when I could (and do) test her at home. She also said she was not going to give her Glargine and told me to give 4U of caninsulin.
I plan to go to 4U Caninsulin, continue home testing, and find another vet. If anyone has a vet anywhere near the midlands in England who might be helpful or if you have had success convincing a UK vet to switch to Glargine, I could really really use your help. :sad: :sad: I'm really upset about all of this.
Lori
PS Last week I asked Ruth from the Royal Veterinary Clinic to give my vet a call and tell her how well Glargine is doing in the remission trials. I don't know if she ever called, vet never mentioned it. Nip is not a good candidate for the trial because she is a Demon Hell Beast at the vet, so I've pretty much exhausted that avenue. :sad:
