How much should I listen to my vet?

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h3ll000kitt3h

h3ll000kitt3h

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Okay so got my testing meter last night and tested Butter once I got it. In the AM yesterday I gave a fur shot, not quite sure how much went in. Once I got the meter and tested him it was at like +8 and he was 316. I felt comfortable giving him his shot of 1u after that. Ended up getting up late this morning so testing for his AMBG was at +13 and his BG was 196. I called the vet and she told me to give him his full 1u shot. I felt really really iffy about this and did it anyway. She also keeps telling me that I only have to test once a day (which I know is wrong, from what you guys said). So given my apprehensive feeling about the vet telling me what to do. How much should I listen to them? If I start posting everyday on here (pzi forum), do u think you guys can give me better advice then my vet can? I'm just so nervous and don't want to screw it up. I can't afford an emergency trip to the vet if they keep telling me things that don't make sense. Help!
 
I don't understand the logic of them telling you to only test once per day. If your vet had an infant that needed insulin, would they give a shot before testing?
Maybe some vets don't push home testing just because they think that some people would feel it's hard to do and might choose to put their pet down rather than treat it. But I've never understood a vet telling people they don't have to test when the caregivers don't see it as a problem.

Couple that with them telling you to go ahead and shoot with a 196 preshot. I might have also said "I think that would be okay". But I would have followed that advice with "but only if you are able to test during the day to see how far the BG drops". Your vet might believe that 1u is perfectly safe with a preshot of 196. And he may be right. But he doesn't KNOW. And the only way to KNOW is to test during the middle of the cycle.

If you only test once per day, when exactly does he think that should happen? Let's say you test at AMPS and get a 196. Twelve hours later you have the syringe loaded. What if the BG is 95? I sure wouldn't give a shot of 1u on a 95. Would he?

Edit - sorry, I kept referring to your vet as "he".
 
Heck, I was wondering the same thing with my vet. She told me to just test every so often, as in like once a week. UMMMMM NO!!!! If humans check theirs at least twice a day, why would it be any different? She even told me I could bring him in and have him tested, that's how often she meant. I hate it because shes been a GREAT vet up to this point, I just wonder how much training/education she has on diabetes.
 
I agree with Carl. I don't understand why a vet would say this at all. I know that some vets feel that testing all of the time is a big time waster and makes the cats upset and you only need to "spot test" or test when you think the cat looks or acts off(I actually read this on a newsletter from the vet on American Diabetes Wholesale) but I disagree. As Carl said, you can't know what your cat's BG is at your PM shot time if you don't test and it could be low and shooting could mean trouble.

It is up to you who to trust but if you know how to test and don't mind doing it, I would test at LEAST 3 times a day, maybe even 4 (both pre shots and both +6 or a pre bedtime check if you can't stay up that late) times in the beginning to see how your cat handles the dose. It gives you so much more information with which to base dosing on if you can test a little more often.

Best of luck to you and Butter! (love the name!!)
 
Carl & Bob (GA) said:
I don't understand the logic of them telling you to only test once per day. If your vet had an infant that needed insulin, would they give a shot before testing?
Maybe some vets don't push home testing just because they think that some people would feel it's hard to do and might choose to put their pet down rather than treat it. But I've never understood a vet telling people they don't have to test when the caregivers don't see it as a problem.

Couple that with them telling you to go ahead and shoot with a 196 preshot. I might have also said "I think that would be okay". But I would have followed that advice with "but only if you are able to test during the day to see how far the BG drops". Your vet might believe that 1u is perfectly safe with a preshot of 196. And he may be right. But he doesn't KNOW. And the only way to KNOW is to test during the middle of the cycle.

If you only test once per day, when exactly does he think that should happen? Let's say you test at AMPS and get a 196. Twelve hours later you have the syringe loaded. What if the BG is 95? I sure wouldn't give a shot of 1u on a 95. Would he?

Edit - sorry, I kept referring to your vet as "he".
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Exactly my sentiments. I don't mind testing, I think I've gotten it down to a science. I've been testing him him while giving him some canned food. Not nearly enough for a meal, it takes me like 1-2 minutes to test and he eats slow so he doesn't get enough in to significantly change the immediate results. So considering that I gave him a full 1u this morning. When should I test him next? And how do I know how much to give him for his PM shot? I know I need more data but can someone look at numbers later when I post his this afternoon and help me when its time for his PM shot?
 
If I start posting everyday on here (pzi forum), do u think you guys can give me better advice then my vet can?
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None of us are vets. We're just a bunch of people with experience treating our kitties with diabetes. I don't have any idea how much experience your vet has, or if she has ever had a cat of her own that was diabetic. I don't think any of us would say our advice is "better". And I don't consider myself to be an "expert". I was just very fortunate that my cat went into remission after only ten weeks of insulin.

And I really don't think that would have happened if I had listened only to my vet's advice. I learned a great deal here and on other websites, and stopped following the dose advice of my vet. She was very supportive of home testing and insisted I test before every shot, unlike your vet. She was just a little more generic and heavy-handed with dosage for my comfort. When she said "you might want to try upping it to 5u", I quit listening.

Instead I started making my own dose decisions based on reading a lot of what other caregivers had experienced. I never asked anyone on FDMB what I should shoot. I didn't have to because the information was already there in daily threads and on their spreadsheets. When I chose to increase or decrease, I tested to see what the dose did, and that data enabled me to make intelligent decisions, based on how MY cat responded to the insulin.

I won't claim that "our advice is better". But I will say that if you ask for advice on the board, what you will get is multiple opinions that may or may not agree with each other, but they will be explained so that you understand them. If nothing else, we're a patient group of people. We've all been in your shoes. And our top priority is the safety of your kitty.
 
Hon, mine didn't tell me anything, except to give 3 units twice a day, sent him home with a pen, a box of sharps and him over 700 BG, that THEY could not get down in a WEEK! That was the day I found FDMB and I haven't looked back.

I took 10 months for me to contact his vet again, I took care of him with the help of everyone here and then emailed her his SS and my question. She was amazed and has become our biggest ally now and any time I need something, she's there. She also doesn't tell me what to do, but goes by what I think best, because she says I know my cat better than she does. BAM! She has also asked questions of me about things that she doesn't know. She knew nothing about Levemir, but now has a couple of, hard to regulate, patients on it.

I'm lucky, this not the kind of story that most people have. For the few months, I cussed my vet both under my breath and here! :lol: But I gave her a chance and she's willing to learn from Lucian and she's been very good to us.

Mel has a similar story, her vets have her come teach new patients how to test, etc. :thumbup

Bottom line, you have to decide, thru research and learning, what is best for your cat and stand up for yourself. Had I done what I was told, my Lucian would probably be dead, no doubt in my mind.
 
I agree with Joyce - three or four tests a day is a good starting place. Some days more if the numbers tell youit is necessary.

PZI can reach "onset" about 2-3 hours after the shot. That's when you might typically start to see the numbers come down. You would expect the nadir, or "lowest point" between 5-7 hours after the shot.

I personally feel that +3 and +6 are useful numbers to know.
 
Yeah, I wasn't really asking anyone to be my vet lol. I just don't fully trust them and trust you guys (who probably have more knowledge than the vet). You don't need to give me exact dosages and stuff I just have no idea when to give more or when to give less.

Edit: I put down I was asking people to be my vet but I didn't mean that I meant WASN'T . lmao oops
 
h3ll000kitt3h said:
Yeah, I wasn't really asking anyone to be my vet lol. I just don't fully trust them and trust you guys (who probably have more knowledge than the vet). You don't need to give me exact dosages and stuff I just have no idea when to give more or when to give less.

Edit: I put down I was asking people to be my vet but I didn't mean that I meant WASN'T . lmao oops
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Well, like I said, we'll tell you what we think, but more importantly why we think that way. I might say "more" and Sue might say "less". Others might say "stick with this dose for a couple of cycles". Each of us will explain why and suggest what you might do after the shot. It always comes down to you being able to make an informed decision.

What we really try to keep in mind is that every cat really is different, and so is each caregiver.
 
h3ll000kitt3h said:
You don't need to give me exact dosages and stuff I just have no idea when to give more or when to give less.
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I felt totally clueless in terms of making dosing decisions when we first started the sugar dance with Eddie a few weeks ago. Even after a few weeks of studying the protocol, asking questions, studying the SS's of other cats, and pulling my hair out occasionally, I feel much more confident in dosing based on what I'm seeing on Eddie's numbers. Although, I will say that with the caveat that Eddie definitely dances to his own drumbeat. ;-) You'll get the hang of it! Once you feel comfortable in doing so, post Butter's "condo" with his BG readings, and you'll be able to get several sets of eyes to look at it and evaluate it. If you have a dosing question, put the question mark designation on your topic, and you can get input. Never worry about asking too many questions! The people in PZI are patient, kind, and very knowledgeable.

With regards to the vet, I was apprehensive at first too about doing something different than what I was told to do. At the end of the day, however, Butter is your cat. You're the one on the ground observing him and caring for him. Your vet probably isn't going to be there at 2:00 am if Butters is having scary low numbers, but you can be pretty certain that someone on this board will be able to help you if you find yourself in that situation. That's what helped me decide that if I wasn't comfortable with my vet's advice, I wasn't going to follow it. I think sometimes vets are not necessarily sold on home testing and adjusting insulin dose as appropriate on your own because they don't necessarily know how you're going to be making your decisions. I think they sometimes come around like Debbie's vet did, when you can demonstrate that you are testing, and getting good results with following a protocol that works for Butters.
 
You have gotten some great input. One thing I remember reading is that the average vet gets one workshop on feline diabetes in vet school and that the FD nutrition classes are given by Purina. And then vets go into practice seeing a couple diabetic cats a year. It's understandable that they might not be completely up to date. And remember, they are busy treating other animals, from hamsters to snakes.

My vet didn't disagree with my testing. (i didn't really ask for permission). And I changed food on my own. Then six months later, we went back for a check up, with our spreadsheet, and she was amazed that he was clearly headed OTJ. After that, she started to tout the value of wet low carb and to ask patients if they wanted to hometest.

Your 197 was a lovely preshot. It will be interesting to see how low he goes. I would definitely try to test between +5-7. For reference, we generally said a cat is regulated if they are in the mid 200s at preshots and double digits at nadir (but not below 50 which is approaching hypo territory). We suggest that new diabetics not shoot under 200, but wait 20 minutes and retest, without feeding. If the number is rising and 200+, then you might shoot the same dose as the shot before - if you can monitor- or a smidge less. A cat in remission (OTJ off the juice) runs from 40-120 without insulin.
 
This board is a great resource. Like everyone said, you make your own decisions. I listened to the board, got advice, and learned. In the end, I was making my own choices on dose and getting input just for confirmation. My vet saw my SS and she was amazed!! Said I was doing everything right and that I knew more than she. Mostly, I think you have to decide what you do. I would home test , get advice here, and share results with your vet. You'll do great!
 
I agree with everyone here. Once a vet sees a spreadsheet and how well you know your cat, they come around to home testing and to custom dosing. At least mine did! He was amazed that I got my kitty OTJ with the help of this board and asked for the link to give to newly diagnosed cat families. He was totally blown away with all of the work I did (with the help of this board and mainly Sue my guru..lol) and how we got Simon where he is now. My cat runs a little higher on the AM blood glucose reading (often a little over 120) but once he eats, now that his pancreas is working, it brings him down nicely without insulin.

Follow your gut. Test as much as you can and get data. Then you have a fighting chance of getting Butter regulated at minimum and maybe even remission (the goal of all of us here!!) if you get lucky like we did.

Wishing you many "green numbers" for Butter! :mrgreen:
 
My vet encouraged me to home test but then made a comment that I didn't need to test so much. Once she realized I was going to be testing and changing the dosage, she gave me guidelines. Some I stuck with and some I did not. The thing that bothered me was being told that he would have to be on prescription cat food forever. When he was still in ICU I made a few comments about how high the carb % was in the Hills that they were feeding him. They never brought up the food again. They also were never able to bring his BG down. The day he came home hisAMPS was 548.


I used advice from here and articles I read plus trust your gut. You will get to know your cat. Post everyday; everyone is here for you!

Rae Ann
 
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