Horrible Vet Experience - Feeling Hopeless

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DaisyPaws

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Hello,
New here - and apologize in advance for the long post but just need to tell the story to someone who might care...
We live in an area that seems to be a feline veterinary wasteland. The vets around here have a fondness for livestock, and sporting dogs, but seem to think of cats as lesser creatures.

About 10 years ago, we had a beloved senior cat with recurrent skin allergies. One of the two vets in town gave him what we later found out was WAY too high a dosage of corticosteroid. When he began to have problems, same vet ran a blood test and diagnosed him as diabetic. He sent him home with a high dosage of insulin and a return appointment for two weeks later. Within a couple of days, the steroid wore off and his diabetes went into remission, causing a major hypoglycemic incident. He survived, but was never truly "himself" again. It was beyond sad, and we felt so guilty for not being more persistent after we got the brush off from the vet.

Fast forward to today... our little rescue kitty had a dental injury a week ago after a fall from the showerhead in the tub. (She is a climber!) The vet (not same as above) gave her antibiotics and wanted her back in today to extract a couple of teeth if they were still loose. We dropped her off per his instructions and awaited the call back that we could come get her. As time passed and no call, we began to call to check on her. The receptionist insisted each time that they would call if there was a problem, and when she was ready to come home. Finally, at 5 pm (still no call!), we drove over.

The vet informed us that they did a standard workup before the dental work, and revealed at UTI infection and that the cat is diabetic. They not only didn't do the dental work, but left our kitty in a cage all day, without calling us. The vet went on to explain that it was closing time, but we could come back tomorrow to get set up for insulin - no need to bring the cat back in.

When pressed for details about the test, he said Daisy's glucose level was 900. He couldn't say what time the test was done, because "one of the lab kids" did it and didn't record a time - but it was "probably this morning sometime". His plan of action is to start on 1 unit of insulin twice a day, and bring her in for check ups every 2 weeks until everything is normal.

This raises some immediate red flags! First, cat has been on antibiotics (Clindamycin) for a week, and they gave her a shot of Convenia today, for the UTI. Vet does not know if Convenia was given before or after blood test. Plus, Daisy has been in pain (dental) for a week and was under stress at the vet's office. There just seem to be an awful lot of factors that could cause an abnormal test. 900 seems crazy high for a bright-eyed, active cat of average weight; if "lab kid" can't record a time - or his/her name - what makes us think the number is even right?

We asked about getting a curve, and were told we could "if we really wanted, but it will cost you, and won't change the treatment plan". We asked about home monitoring and were told that "it isn't the least bit accurate". As I am reading tonight, it sounds like home blood glucose monitoring has become fairly accepted practice.

When we asked about the pros and cons of waiting and testing again - to see if stress or meds might be impacting numbers, the response was, "You probably don't want to give shots but don't fool yourselves that this will go away. You have two choices - start insulin now or we could just put the cat down. We can do that today."

He never asked about her diet, or about her behaviors (water intake, etc.) at home. We know for a fact that cats can go into remission - diabetes may not "just go away", but the need for insulin may, at least for awhile.

We're feeling pretty shaken by it. Other than problem vet #1, the next closest small animal vet is over an hour's drive away, and quite possibly no better than the first two. We were burned before by blindly following vet's instructions, and even though it scares us to death, the only plan we can figure out is to try to establish a good relationship with a way out of town specialist (kitty cat road trip!) and then try to monitor and adjust as well as we can from home. That seems horribly wrong, but if the only vets around see no point in monitoring and adjusting...

And we're angry and frustrated, too. No one would consider this an acceptable standard of care for a child, or suggest that a child be out down because it is too much work to care for her. We're out $200 for today's visit, with a stressed, depressed cat who still has a sore mouth, and no answers, just questions. Money isn't the problem, but it seems a crime that someone could be paid to be so useless and cruel!

Sorry again for the crazy long post. Thanks for reading - and we're thankful for any suggestions!
 
What a horrible time you and your sweet kitty have had. The good news is that, once you get some insulin, you can treat the diabetes at home. You don't need your vet's permission to test at home. We suggest you feed wet lo carb food to help bring down her bg levels. See this website by a FD vet: www.catinfo.org. We have support groups for insulin so you can get support and dose advice.

Do a lot of reading. Ask a lot of questions. If you don't have any other options for vet care, you can treat diabetes at home. You can do this. We will help you!
 
Did you get insulin? We can teach you how to take care of your kits diabetes at home but we can't do the dental :) now that you are smiling .....

You can do this. We have newbie kits with monitors and other stuff to get you testing at home, then you will REALLY know what his blood glucose is. As far as insulin, you want either one of the L's (Lantus or Levemir) or ProZinc and you should start off slow, usually 1 unit twice a day, there are insulin sites here that will guide you once you know.

You are going to need a vet, this one sounds?? not very caring. Where do you live? just area, we might have someone near who knows a user friendly vet for a diabetic cat in your area. Take a deep breath, you will be fine.
Nancy and Payne
 
Despite your horrible experience with the vet, it is not hopeless. You might want to post your general location (town, state/province) and someone may have vet suggestions for you. It also helps with suggestions of type of glucometer, foods, etc.

There are several key things - diet, hometesting, type of insulin and then post on the support group for that insulin. Wet, lo carb food is the best thing to feed a diabetic one. No dry at all, even for treats. Hometesting will save you money and give much better results. You just need any human glucometer with test strips and lancets. We take a drop of blood from the edge of the ear for a test. It sounds brutal, but most cats don't even notice. If you are in the US, you will need a vet to write a prescription for insulin. In Canada, we can just go to the pharmacy and buy insulin and syringes.

Everyone on this board lives with one or more (it can't be that hard if people knowingly take on another diabetic cat!) diabetic cats, and so the advice and suggestions are all based on direct experience. If one technique doesn't work, there will be many more offers of helpful hints.

Read lots, especially the topics at the top of the pages (called stickies). Read about the different types of insulin and how they are dosed. Post again with questions.
 
Oh Lordy, your vet is completely misinformed. Diabetes is treatable!!!! I will give him points for suggesting a dose of 1 unit 2x per day, though - it's good to start at a low dose. I don't buy his 900 BG reading at all. Can you go to your drugstore tomorrow and buy a human meter and strips? The pharmacist can show you where these are. There are some reliable, cheap options at Walmart - the "Relion" brand. Test kitty at home when he's not stressed out and cages all day. This certainly will cause inaccurate (higher than usual) BG numbers. Drawing blood from kitty's ears may seem impossible at first - but if it's something that we all can now do with one eye closed and one hand tied behind my back (well, almost).

Check the BG levels at home to get a TRUE reading. There are a bunch of links to videos on this site that show you how to do it. This is how I learned: www.youtube.com/watch?v=_zE12-4fVn8

This is good reading too: binkyspage.tripod.com/faq.html

The best insulin to start out on I believe is LANTUS. Please don't let him bully you into vetsulin or catsulin or something like that. Many cats here have gone into remission with Lantus. My cat tilted the meter when he was diagnosed (meaning that he was so high the meter could not read it). He no longer needs insulin and is controlled with a low-carb diet only. Those who do not go into remission live long and healthy lives, just like their human counterparts with diabetes.

It's totally scary now but you'll handle it and it will get easier and easier. Ask lots of questions here, don't be shy.
 
Hi DaisyPaws,

I'm sorry you've had to go through this kind of horrible experience, not once but twice... Heavy sigh...

Please understand that there are a lot of truly wonderful vets out there. Yes, there are sadly some like the two you have mentioned...

I don't know what state you live in; but, depending on your state's health laws, you may need a prescription for insulin and syringes. Therefore, you may need a vet. Chances are, you will need one. Would you consider calling the small animal vet that isn't so close? You know, to kind of do a phone interview... Give this vet the info you have and see what they have to say.

And, Sue is right, once you get the insulin and syringes, we can help you. And, I'm stifling cursing regarding what that vet said about home testing. Then again, I've taught two great vets the value of home testing... Get a meter, test strips, lancets, Vaseline, a handful of uncooked rice put in a sock, and you're good to go.

Ketostix (tests for presence of ketones in urine) or Keto-Diastix (tests for presence of ketones and sugar in urine) would also be good.

If your precious furry girl does need to be seen by either the farther away vet or the local one, I'd humbly ask for a fructosamine test, because of that 900 reading that may or may not be valid. A fructosamine test will "tell" you the kind of average range of your furry girl's BGs for the last three weeks or so, meaning part of the results would include time before the Clindamycin and Convenia. If you go for this test, be firm that you want it read and analyzed by an outside lab like IDEXX, I think (can't remember the name of another big lab)...

I only had one horrific experience with a vet... I left the examining room for a couple of minutes to go pee... Returned to find the ex-boyfriend alone. Asked, where's Gizzie?! He said three vet techs came in and leashed her and took her away for a blood draw... I said, but I said no leash, no restraints. I told the vet I'd hold her. He shrugged... About 30-45 minutes later, three vet techs came in with a collared and leashed Giz wrapped in a towel. They put her on the table and said, there might be some bruising, as I was looking at her shaved legs... Gizzie's lab report (from a big lab) from that visit came back saying her BG was 711...






Welcome to the place you never wanted to be; but, will be blessed for having found.

Love and hopeful, healing hugs for you both, DaisyPaws,
Deb and Nikki -- and, Giz, forever dancing in my heart...

PS: She was on a showerhead? She is a climber!
 
PS - I don't know how those two meds might affect glucose readings. Can anyone chime in on this matter?

Based on whether or not the meds would influence the numbers, it may be wise to wait to start insulin until your cat has the meds out of his system.
I am no expert by any means, but this could be something to consider.

In the meantime, you can get those numbers down a lot by switching to a diet of low-carb wet food. There are a lot of choices that are affordable (including SOME fancy feast flavors, and other brands). I use Merrick "Cowboy Cookout" "Surf and Turf" and "Grammys Pot Pie" which are all 6 carbs or less. Again, there are many brands to choose from who offer low-carb options.
 
I agree with SaraJaye. According to my new vet, urinary tract infections can cause a BG reading to be high and the cat may not be diabetic at all. My cat had a UTI at the time he was diagnosed with diabetes. Now after a diet change and only a few weeks of insulin, he is off the juice. So I wonder if he really was diabetic after all or maybe just prediabetic if there is such a thing. With an additional dental problem with your cat, I would wait until all the infections are cleared up before giving insulin. A change in diet in the meantime would be good but remember a change in diet can drastically reduce the need for insulin and BG will be lower than when on the previous food. So while you are waiting for the infections to clear up, change the diet. Get some probiotics to help with the diet change so that the tummy is settled during the food change. Then test again once the infections are cleared to see what the BG levels are. I would do that at home too since a visit to the vet usually increases the BG level significantly due to the stress. Just my thoughts based on my experience...
 
What a terrible day you had and your kitty had yesterday.

Couple of things.

The need for the dental could be causing the higher BGs. Has your cat been drinking more water recently? Wanting to eat more food, seem really hungry?

A BG of 900 seems awful high to not be showing any signs. That would be a very distressed kitty, judging from my own diabetics when they have high BGs they are cranky as anything and really hungry and they keep their heads in the water bowl from extreme thirst, plus they pee like crazy. Any of that going on?

Stress at the vet would also cause increased blood sugar. The UTI, any infection at all would increase BGs. Infections=stress=higher blood sugar.

If this were my cat, I'd go to the pharmacy today and buy a glucometer, AccuCheck, One Touch Ultra or if you have a WalMart buy the Relion (cheaper but great). Start hometesting and get your own BG readings. At home your cat is calmer and comfortable, even if you mess up the first few readings :) We can point you to the videos and pictures on how to do this.

Also, sorry to say this and I know you may not want to hear this, but the vet from 10 years ago may have changed during this time. I once left my vet only to come back to her because we talked it out and she agreed to listen to me and review my research. Since that time she, well the whole practice, has changed how they handle FDs including prescribing a better insulin and recommending hometesting.

What type of food is your kitty eating now? That could also be a contributor to the FD, like you mentioned.
 
Hometesting is very accurate (after all, human diabetics gamble their lives on it every day!) and will help you figure out what is going on. I do have to say that a bright and active kitty doesn't fit with a BG of 900 ... I think you are quite right to question this!

And your vet may be interested in reading this. The Canadian Veterinary Assoc has a site for information for pet owners. Their official advice for treatment of feline diabetes is to hometest.

Recently, a home blood glucose monitoring initiative was reported in the literature that provided a practical method for owners to check blood sugar at home by doing a small prick in the ear and using a low volume automated glucose meter. This is a big step forward in feline diabetes management because it is well known that while in hospital for monitoring, cats tend to not eat well and are stressed, both of which can interfere with blood sugar assessment. It is important to have a blood glucose curve done after insulin therapy is begun so that the veterinarian can check how quickly a particular cat processes the insulin type prescribed. Cats have a very wide spectrum of time that it takes to metabolize the insulin, and this test is very important for the safety of long-term insulin therapy.

I am so pleased you found us. Let us help.
 
Hello again,
Thank you all for the kind replies.
I am feeling a little better today, as I watch Daisy chasing and wrestling with our other cat, stomping into the kitchen to demand food, and snuggling down in her favorite sunny spot for a s snooze.
Now that she has recovered from the stress of her day yesterday, it gives me the perspective to say that she may be diabetic, but she is not desperately ill at this time. We have time and can take things day by day.

Which is good, because we called today and were told that the vet is out of the office for the rest of the week. (sigh.)

As far a warning signs, Daisy has always been a big drinker. As soon as she discovered faucets (and she was rescued at 4 weeks), she has been the kitten/cat wanting to play in and drink from the faucet. These days, she has a couple of fountains that she loves dearly. As a result, she has always been a big producer in the litter box, too. We have not seen any recent changes there but would say "more than the norm" may be her norm.

For food, we have another kitty who requires a low purine diet and who has to be encouraged to get enough fluids. We've had the cats on Weruva's chicken varieties and on Blue Buffalo dry food. We've also dabbled with the TikiCat chicken and chicken/egg varieties on occassion, when they've been on sale. We're thinking we might put Daisy exclusively on the Weruva "Paw Lickin' Chicken" and the Tiki chicken, since those varieties don't contain sweet potatoes, carrots, or other veggies. Her days of dry food may well be over. Does that sound like a good first shot at a low carb diet, provided that we feed enough that she does not lose weight?

We're also buying a glucometer and planning to give her at least a few days to get over her UTI before beginning home testing, and will then look at insulin when we feel like we have something of a baseline. It sounds like Lantus is the way to go. We also already use the Smart Cat cat box for environmental reasons (love that thing!) and so testing urine will not be too hard if we can make sure that we are testing the correct cat's urine.

Thank you again for the support and words of hope. It really helps me feel like we can handle this, even without a good vet in our corner.
 
Weruva is really good for the low-carb-ness of it, unfortunately it is quite low-calorie so if you are going exclusively that route, hopefully they will eat enough to maintain a healthy weight. You're on the right track though. I am told that Merrick's "Cowboy Cookout" is the same exact makeup as a mouse (a cat's natural prey) insofar as it's protein/fat/carb content. Cats thrive the most when they are given food that most mimics their ancestral diet. In addition to being a food-regulated diabetic, my cat also got a much softer coat, a huge decrease in his dandruff problem, and shed significantly less fur after we began the low-carb diet.
 
I like your plan but do agree with SaraJaye on the food.

I'm glad you're feeling better about things today. Once you start hometesting, post the numbers and we can help you intrepret them, although I get the feeling you'll already know what's what :-D
 
I noticed that a lot of people on here seem to really like the Merrick foods - thanks for suggesting it.

Our other cat is suppossed to avoid organ meat (inc. liver) and fish/seafood if at all possible. The list of foods we've found that work for her has been pretty short!

It would be ideal to feed them both the same thing, since they swap plates two or three times during a typical meal. Unfortunately, it seems that most of the higher calorie/low carb foods have organ meats. Wonder if there is a high calorie/low carb treat or supplement that we could give Daisy?

I did notice that the Merrick foods also contain veggies, so maybe we won't have to completely eliminate the Weruva flavors with those ingredients.
 
Another great option is the Merrick BG line. Is phosphorus an issue for you as well (given the organ meat and fish issues?)? If so, I would look at Merrick BG turkey (lowest in phosphorus, highest in protein) or beef. The chicken isn't bad either, I would just avoid the chicken/quail variety as it is very high in phosphorus.

I'm so sorry about the vet situation, but others are right. Play along, get the insulin, and you can do it on your own from there, with tools and guidance from everyone here that will help you keep Daisy safe and healthy. If Dr. Rottenvet decides to go with Lantus, ask him to prescribe the solostar pens... they will be MUCH more cost-effective for you, and a box of 5 can last you at LEAST 6 months with proper care, so you don't have to keep going back to the vet. I am thankful that I live in a metro area with plenty of vet options and was able to breakup with the vet that diagnosed Willie. But yes, once you have the insulin in hand and you are hometesting, you will have the ability to control Daisy's dose (if one is even needed) and keep her safe. If you start insulin, I would be very vigilant about hometesting, especially about the time the Covenia is wearing off. I would also see about getting the dental done ASAP as dental issues can raise BG#s.

Above all, just know that you are not alone and you have found a place that will equip you to make the absolute best out of a pretty crappy circumstance. You are in great hands!!
 
DaisyPaws said:
I did notice that the Merrick foods also contain veggies, so maybe we won't have to completely eliminate the Weruva flavors with those ingredients.

True, they do - although veggies aren't the worst thing in the world for cats. Many cats eat around the veggies, actually. We keep Merrick and BG varieties rotating, so the cat doesn't get bored with any one flavor.
 
The Merrick Cowboy Cookout is made of beef and I had one who had some allergy or issue with the beef when we tried to move to that. So just be sure that yours are okay with beef. They liked it but someone threw up and had major poop issues. The same happened when I tried Fancy Feast beef. I did not want to change to FF chicken, etc. when i saw that fish was listed as an ingredient on every one of the classic flavors that I was going to use. The Merrick Before Grain looked like an option but we ended up changing to Wellness Chicken and Wellness Turkey in January. So i feel like we are still in the experimental phase with food. If you have a cat who has UTI issues, i read that UTI kitties need low phosphorus, low magnesium, no fish, no gluten, and no soy. Also no dry food at all. Add water to the canned food too to make sure they have adequate water intake. I have one diabetic OTJ and one UTI kitty. Once I started adding water, I hardly ever see anyone go to the water bowl. With a UTI kitty, I need to check the litter box all the time so I don't use an automatic litter box. If I need to see who goes, i set up the camera. If i need a sample, I put small plastic bathroom cups in the litter box in several places.
 
Hey! - the Merrick BG turkey looks like it could be a fit for both kitties!
A few more calories per can than Weruva, and no organ meat.

As for the dental work, the vet said he does not want to sedate her for that until the diabetes is under control, but I wonder why that would be an issue if her bp and other "vitals" are normal. This is the same vet who said she was very healthy for her age (10) the prior week, when he gave the antibiotic.

If the dental problems could be elevating the BG, and are for sure impacting eating habits and drinking habits, it seems like it should be taken care of first. We won't be able to figure out her "normal" until we get her as close to it as possible.
 
I just had a similar experience and this is in a city that prides itself on its love of animals so you are not alone it this. The vet I took Fiend to would not even check his sugar level...fortunately I did find a vet that helped and was supportive of treating him at home. Just stick with the message board...they will help.

Good luck....
michelle and fiend
 
Just wanted to give an update that we tried our first ear stick this morning.
She hated having the warm rice bag on her ear but didn't care about any of the rest of it.

The first reading - 1 1/2 hours after eating breakfast - was 403; still quite high, but lots lower than the 900 that the vet told us.

She is still under the influence of the Convenia for the UTI. (By the way, every time I've ever had a cat on Clindamycin, they've come down with a UTI right after. Anybody else have this experience?)

The vet refuses to do the dental, even though she has a broken tooth that is causing her pain. Guess we'll just have to wait until she is regulated to do that, though it seems counterintuitive to me.

Vet has taken the rest of the week off, so we'll have to wait until Monday for insulin prescription. We'll check her numbers more closely before beginning that.
 
Your cat might not need the rice bag. Although I've heard about the advantages of it, we've never tried it and have been fine when drawing blood.

Is there another vet you can see regarding the dental? After the dental problem is addressed, it is possible that glucose levels could drop across-the-board as a result. Thus, if you are accustomed to using a certain dose of insulin based on today's numbers - and then your cat's numbers drop significantly (and naturally) as a result of the dental, your previously-administered dose could cause a hypo episode unless you test A LOT for (at least) a few days after the dental, and adjust the dose accordingly.

Not saying that is a definite outcome, but certainly a possibility.

I know you're not on insulin yet, so now would be a great time to get that dental done, and then you will be in a position to know your cat's true BG values, and can start with a smart and informed dosage, and not have to worry about levels changing as a result of the dental.

BTW, my vet never even introduced this possibility when my cat got his dental and extraction. Thank goodness I was prepared thanks to all the good info here.

DaisyPaws said:
Just wanted to give an update that we tried our first ear stick this morning.
She hated having the warm rice bag on her ear but didn't care about any of the rest of it.

The first reading - 1 1/2 hours after eating breakfast - was 403; still quite high, but lots lower than the 900 that the vet told us.

She is still under the influence of the Convenia for the UTI. (By the way, every time I've ever had a cat on Clindamycin, they've come down with a UTI right after. Anybody else have this experience?)

The vet refuses to do the dental, even though she has a broken tooth that is causing her pain. Guess we'll just have to wait until she is regulated to do that, though it seems counterintuitive to me.

Vet has taken the rest of the week off, so we'll have to wait until Monday for insulin prescription. We'll check her numbers more closely before beginning that.
 
I don't think you'll get your cat regulated without the dental.

Could you ask the vet for pain meds, Buprenex, not Metacam. If we can do pain meds then maybe we could get that BG lower. But if it were my cat, I know my vet would do the dental and monitor the BGs during the day. We do not give insulin the morning of a dental, I leave the insulin with the vet and if they feel the cat needs it, they give it later.
 
Please consider posting your general location in case one of us lives nearby and can provide local help.

Meanwhile, I'd push for that dental. And I'd be wishing for a new vet :(
 
Hi again, dear DaisyPaws,

DaisyPaws said:
The vet refuses to do the dental, even though she has a broken tooth that is causing her pain. Guess we'll just have to wait until she is regulated to do that, though it seems counterintuitive to me.

Vet has taken the rest of the week off, so we'll have to wait until Monday for insulin prescription. We'll check her numbers more closely before beginning that.

It seems counter intuitive to me too! Listen to your gut and heart. You know your precious climbing furry better than anyone else on the planet! Would it be possible to get her to another vet?

I'm in total agreement with SaraJaye, Jennifer, and Jen. Get her dental done.



DaisyPaws said:
The first reading - 1 1/2 hours after eating breakfast - was 403; still quite high, but lots lower than the 900 that the vet told us.

Welcome to the Vampire Club! We love "lots lower"! Figured you could use a little boost right about now...

Love and continuing encouraging hugs for you both,
Deb and Nikki -- and, Giz...
 
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