I feel like Growling at the vet!!!

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Joy.T

Member Since 2010
:evil: I just had a conversation with Pumpkins Vet Office. They inform me that I can ONLY use a cat monitor and NOT they human meters. They insist that the meter must be calibrated for cats and not humans. They meter they want me to buy from Abbott is a $244.00 kit!!!! :o :shock: I insist that the human meters are in use everywhere and that is what I will use for Pumpkin Pie. The response was that I'll then have to agree and sign a form that says I will bring him in every month for a curve ($150.00). Reason being that since I insist on using a human meter the results will be incorrect. INCORRECT!!! How about INCORRECT results from a cat that has to be pulled along in his cat carrier for a mile to get to the vets office for a curve !!! ( I was begining to lose my temper at this point) They then said well if you sign a consent we can pick him up and bring him back to you at the end of the the day. OK that seems good but... then Pie will still be freaked out because he will be in a car with out his human mom handle by other people to get in and out of his carrier,put in a cage( which was only one other time for and over night absess tooth) all day,being poked and handle by strange people during the day ,only to have a stranger put him back in his carrier to go in a car again with out his human mom. I know my cat,he will try to escape out of the carrier either in mid transit to the car or while in the car and fly out as soon as the door opens. The vet know they are the closest vet. OMG MY NERVES ARE RACKED.
 
You have GOT to be sh!tting me.
Aren't there several scientific publications indicating that human meters are acceptable for feline monitoring?

Growl indeed. And take a big stinky dump on their desk too.

MJ&Donovan
 
Hi MJ and Donovan. I kid U not. I am not signing that paper!!! The thing is they know they have me over a barrel because the other nearest vet is in NJ a good 15 miles from me. Since I'm disable they know I can't get that far.
 
Hi Gayle and shadoe, at this point I really want to.I am without transportation due to my disability. The town I live in is very small plus where I live is more the outer limits of town. I'm closer to the next town(sneeze while driving and you would miss it).
 
OH wow.. That's crazy! My vet wasn't very happy about me using a human meter either but she got over it! She wanted me to purchase the animal one too for about 185 bucks! And that sucks really bad you can't get another Vet.. but either way they can't force you to sign any papers..That's insane! Some Vets have egos so big it's nuts!! Good Luck!!
 
they sound dirty and underhanded and not the least bit interested in what is best for Pumpkin!! Continue to fight Pumpkins fight!!!
I hope you are able to work something out, and I am dumbfounded how some of these vets run their practice...Talk about being bullies!!
Keep standing up for your and Pumpkins rights!!!!
Look at all the kitties on here, having gone OTJ, while using human glucometers! My vet didn't even bat an eye, was just happy to hear that I do home testing!
 
Hi Mowgli and Keri, I feel that way to. Instead of being support of the effort I am taking to keep pumPumpkin healthy.It seems their more into they $$
 
Will the vet not accept your cat as a patient and/or refuse to give you the insulin if you do not sign these papers?!? You are already using the insulin, correct? Then you'd only need to see the vet for yearly checks/shots or if (heaven forbid) some other ailment shows up.

MJ&Donovan
 
Hi MJ and Donovan, They haven't said that yet. Yes Pumpkin started insulin on 12-8-2010.Plus they started him and 3 units 2 times a day which I've been educated is very high for first doses. So I cut it back to two units 2 times a day. The needles I have 3/10 don't have 1/2 marks on them. He seems to be fine He stop drinking so much and so far he has only urinated twice today.and still has about 3 mouth fulls left on his plate since 7:30 this morning .
 
don't growl. prepare for a discussion. if your vet will listen to reason, i would suggest printing out the following material for his/her review. the Tight Regulation Protocol with lantus or Levemir for Diabetic Cats has been published in the Journal of Feline Medicine and Surgery. this published study addresses the meter issue your vet is referring to. it also cites the use of human meters.

Dosing protocol for cats on glargine or detemir using daily home monitoring of blood glucose concentrations to adjust insulin dose

NB. The blood glucose values were based on using portable glucose meters (Ascensia Contour, Bayer,
Leverkusen, Germany; Accu-Chek Aviva, Roche Diagnostics, Basel, Switzerland) which use ≤0.6 μL of
blood per test. These meters measure blood glucose concentration in whole blood and are calibrated for
use with human blood. Measurements from meters calibrated for human blood which provide plasmaequivalent
values are approximately 10% higher.

NB. It is very important to note that blood glucose concentrations measured using a whole blood
glucose meter calibrated for human blood may measure 30-40% lower in the low end of the range than
glucose concentrations measured using a serum chemistry analyser or a plasma-equivalent meter calibrated
for feline use. Therefore, if using a meter calibrated for feline use (eg. AlphaTRAK, Abbott
Laboratories, CA, USA), or a serum chemistry analyzer, add approximately 30 mg/dL (1.7 mmol/L)
to the target glucose concentrations (see Table 3B). For example, a target > 50 mg/dL (2.8
mmol/L) becomes > 80 mg/dL (4.4 mmo/L) when using a meter calibrated for feline use. Instead of
aiming for 50-100mg/dL (2.8-5.6 mmol/L) , aim for 80-130 mg/dL (4.4-7.2 mmol/L [round numbers
4.5-7.0 mmol/L). Meters calibrated for feline use may read higher or lower than the actual value, in
contrast to consistently lower readings for meters validated for human blood.

ADJUSTMENTS FOR THE USE OF METERS CALIBRATED FOR ANIMALS VERSUS HUMANS IS NOTED IN THE PUBLISHED PROTOCOL FOR LANTUS AND LEVEMIR USERS.


there is definitely a difference between meters calibrated for feline versus human use. what your vet may not know is that the top researchers in the field also know this and have adjusted a tight regulation protocol to accommodate the difference. you might be able to salvage this situation by showing your vet the information posted above. vets and caregivers don't always see eye-to-eye, but it sure is nice to have a working relationship with your vet if at all possible.
 
Thank You. Jill and Alex for that info. I will certainly bring this to the vet. I just pray the vet doesn't deny Pumpkin Pie his insulin he will need more befor this month is over.
 
Hey Joy,
You really should ditch this vet. I understand that the other vet is 15 miles away and that you have a disability and don't drive, but believe me, you can deal with Feline Diabetes without a vet (many of us have done just that with the help of this wonderful board). And when you need a vet for other issues, you can arrange for a car service to take you and Pumpkin Pie there (or maybe lean on a friend). Most likely these "other" vet visits would be few and far between. You would save lots of money, even with the transportation.
Don't sign any papers in any event. And forget about $150. curves! You can do curves at home much better than they can do them in the stressful atmosphere of the vet's office. And your "human" meter is just as good as a meter "designed" for cats. All meters are useful in that they measure "relative values"; these relative values are all you need to know to keep your kitty safe. If you look at the scientific paper dealing with the "Tilly Protocol" that we use here (see the "Sticky" that describes the protocol; sorry, I don't have the citation offhand), you will see that the guidelines for increasing or decreasing dose are given for both the "animal" meter (Alpha Trak) and "human" meters.
Don't let that vet push you around. Do try to find another vet (or a way to get to another vet; maybe with the help of a friend). But most important, don't throw away your money on stuff you don't need.

Hang in there!

Ella & Rusty

P.S. I just see that Jill has given you all the ammunition you need. Follow her advice. She is one of the most knowledgeable people here!
 
Thank You for your encouragement Ella and Rusty.I do plan on taking this in whichfo to the vet. I don't want to discredit the vets but I have lived with Pumpkin for nearly all of this 14 going on 15 years he was 6 mons old when he came to me. So I know him!!! Which this vet doesn't seem to realize the value of
 
here's another link which might be of help:

Information for Veterinarians.
this is info from the University of Queensland. they've been the leading researchers in the use of lantus and levemir in diabetic cats.

my vet has openly acknowledged the fact that he and i have learned together on this journey. however, when i first told him about testing at home he gave me the same song and dance about human meters not being accurate enough. it took him awhile to realize that using a human meter worked out just fine for making dosing decisions. now he promotes hometesting!

i hope you're able to work something out with your vet...
 
Thanks Jill & Alex,I'll give the vet this one also. I'm worried they may say they won't give him a script for his insulin which will run out by the end of the month.
 
Joy.T said:
Thanks Jill & Alex,I'll give the vet this one also. I'm worried they may say they won't give him a script for his insulin which will run out by the end of the month.
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If they try that on I should suggest you report them to the AVMA or whatever organization your vet is (or claims to be) accredited with that is not ethical behavior and demonstrates nothing but crass ignorance.
 
Joy.T said:
Thanks Jill & Alex,I'll give the vet this one also. I'm worried they may say they won't give him a script for his insulin which will run out by the end of the month.
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that's just one of the reasons i've mentioned arming yourself with facts so that you can have an intelligent and civil conversation with your vet.

from what you've said, it sounds to me like going to another vet will be a hardship for you. there's nothing wrong with having a polite conversation with your vet outlining the facts... not only on this meter issue, but your financial facts also. i'd let him know upfront that you want to do the very best for your cat, but you have to work within your means. using a human meter will be costly enough. strips cost $$$. the strips for a meter calibrated for animal use are even more expensive. curves done at home are more accurate than curves done in a vet's office because of the stress factor. heck, insulin isn't cheap either!

i hope the two of you are able to sit down and talk candidly without it turning into a confrontation.
if your vet will not work with you, you may be forced to (and want to) look for another vet.
 
well goshdarnit, I recently checked on the insulin I used on Donovan, and it expires in March 2011. I have one unused Levemir cartridge, plus one barely used (don't see any floaties in it). I've been contemplating what I should do with it. I'll send it to you if your vet turns into a jackass about giving you insulin for Pumpkin.

MJ&Donovan
 
WOW. I had a miserable experience with Maverick's vet too. I felt like crying when I got off the phone and felt so small and cowardly. I have nicknamed her Mrs. Snarky McHissyPants. I think your vet takes the cake though. I'm blown away. You are your cats mom and advocate and have to do whats right for Pumpkin.

I'm saving a fortune not doing curves at the vets office and buying their expensive food. Maverick is thriving. Check out his spreadsheet. This is all due to the advice of this amazing forum. My vet gets ZERO credit. Maverick will most likely be off insulin in the near future (antijinx - people seem to say this a lot so it must help right?).

I have gained an enormous amount of confidence in my ability to deal with his diabetes knowing this group is behind us. I know how to handle a low even though he hasn't had one yet. I know (for the most part ohmygod_smile ) how lantus works (most vets don't), and the food he needs to be controlled.

I commend you for sticking up for Pumpkin. I've read a few condo's lately where people have found amazing and supportive vets. I know they are out there and I will keep trying to find that vet for Maverick.

I am so glad you found FDMB and that we did too. I still shudder to think what managing diabetes would have been like without everyone here.
 
I Re: I feel like Growling at the vet!!!

I will certainly try. Jill and Alex.I even told them that the neighbor that would take me won't be back til jan 2011 and would be able to take me on the 1-6-2011 but they insist on the 22nd of this month. I know the vet bill is $370.oo plus the vist on the 22nd,not to mention the insulin and box of needles $118.00 at wal-mart and the can food,now the insulin will be anthor $90.00 by the end of the month.So... given all this I can't seem to tolerate their attitude and demanding. They know I'm on disability which is why they are being cooperate while I apply for funds.So why burden me with additioal cost of $244.oo for a meter kit UGGG
 
Thank you MJ and Donovan!!! I'm praying that doesn't happen for Pumpkins sake.He shouldn't suffer for a ?@!!*! Vet person
 
Oh the alarm just went off I'm going to heat up some of Pumpkins turkey bits and open up his can food then his injection will be around 6:20 pm.I'll log on after that
 
Joy how much insulin do you have? The vial or the cartridge. From what I have read on hear if you keep it in the fridge it can last many many months not just 28 days if you leave it out.

I was going to ask about the cartridges too. We have five of the 3ml cartridges. We are only half way through one. If you were in Canada I'd send you one too. It would take too long to get it to the US and too much bouncing.
 
Joy, I am so sorry you are having to deal with that vet. If I hadn't listened to the advice on FDMB, I think my cat, Simon, would have had some major problems due to my vet trying to give him too much insulin. The curve done at his vet's office showed that his bg was very high so they put him on 4 units. After discovering FDMB, I got a human glucometer and tested him after a few days of him being on the 4 units. When I tested him, his bg was down to 40 and this was after 12 hours from his first shot of insulin. I withheld his insulin that night and reduced it to 1 unit and tested him frequently after that. Simon has been doing terrific ever since. Simon gets extremely scared at the vet so no wonder his bg was so high. It is just not accurate to base an insulin dose on a bg curve done at a vet. Needless to say, I switched vets and the vet I went to last week (a feline specialist) was so impressed with the spreadsheet and home testing that I was doing. he was fine with the human glucometer even though they use the cat one in their office. I know that you do not have another vet close by, but like everyone else says, you can do almost everything yourself at home. Alot of vets are not used to people testing at home and might not be as informed as they could be. This site is such a lifesaver and all the advice I have been given has really helped me understand everything better and be better informed when I go to the vet. I wish I had a great solution for you, but at least you know you have lots of support and caring people on FDMB.
 
Jill's advice is good. The materials that she linked provide dosing parameter for both human and animal meters/serum chemistry analyzers.

My strategy in dealing with vets and physicians has been to politely ask if they can provide me with the citations and/or journal articles to support their point. If they provide you with information that's more than 5 - 10 years old, I generally ask for something current, after all, science changes rapidly (and I say that with a very sweet smile on my face). BTW, were you speaking directly to the vet or one of the vet techs?

In addition to a burdensome expense for the AlphaTrack, you can only purchase strips from a vet. You can't purchase these on-line. What are you supposed to do if you need to get more strips if the vet's office is closed?

As far as a curve, I use a vet from an all feline specialty practice. She has a link to Gabby's SS. She can look at it any time she wants. She know that I test and that I can manage Gabby's dosing -- I gave her the Queensland/Rand protocol. She does not ask me to bring my cat in for a curve or a fructosamine level. It's unnecessary. She knows it and I would politely ask her what information would be gained from having either of these tests run? Gabby gets highly stressed traveling to the vet. The curve would be way off and I'd end up overdosing my cat.

Most vets do not deal with involved or informed consumers. You are an exception. You now need to let your vet in on the fact that you're doing your homework.
 
Hi Karrie and Maverick. If I keep him on 2 units twice a day,I'll have enough through the end of the month. He was on 3 units 2 times a day by the vet. Tonight is a full 24 hours on the 2units twice a day. He urinated three times but stayed in his bed on the pillow and well was a bit hissy tonight. He barely ate dinner.So now I don't know if its just him or the change to a lower dose.I'll see if he eats later. Generally he is a night time fello. He really hasn't been drinking from the bowl.I am hope-ing its because he is now getting moistture from the wet turkey mixed into his 2 tablespoons of can cat food.
 
Hi Georgia and Simon,yes I am glad I'm here too. I be pulling out my hair inbetween tears. There is so muh to learn about feline diabeties. I am frequently reading the sticky notes.
 
There is a lot to learn Joy. I admit I was overwhelmed. But when I had questions, I asked them. There is still stuff I don't understand.

I understand the basics now. Once I got my spreadsheet up and running, and started my daily condo's with our blood glucose readings it made a lot more sense. You are kind of going blind right now. I hope you get a newbie kit and get started. The money you will save on the vet can go to test strips and insulin.

It takes about two weeks it seems to ship to the US which I think might be risky for insulin. If people think otherwise I'll send one off also. Maybe you won't even need it if Pumpkin is like Bid. He went of Lantus after six days HAHA. Thankfully Bid's mom did home testing.

How was Pumpkin diagnosed - just blood glucose at the vets office or did they also do a fructosamine test.

In the meantime you could get started setting up a spreadsheet and profile and hit the ground running when you start to test. Once you start testing everything will be a bit clearer.
 
Take a deep breath. (We give that suggestion a lot.) The front end of the learning curve is HUGE. Almost everyone who gets here is overwhelmed -- first by finding out their cat has diabetes and then by the amount of information that's available. You don't have to know everything all at once. We're here to help. Ask questions. Read other people's condos -- especially the ones where someone's asking a question. It's a great way to learn. People are very generous with their time and their information. It gets easier -- it really does. Promise.
 
Hi Sienne & your crew. I am going to bring the info to the vet.I was talking to the Vet. Tomorrow I am going to the office. I am applying for funds and I need a written estimate from them.I just worried for pumpkin. They know they will get there money from me even it takes a while. This vet even has a $10.00 fee for medical waste disposal on the bill. I have enough insulin through the end of this month,but I am anxious about the vet will not give him the insulin at the endof the month
 
Hi Karrie and Maverick, actually Pumpkin was drinking far to much water and urinating too much and he stopped grooming himself. That how he was diagnoised. I am praying that its just the food thing. He was a dry food only guy since kittenhood. Actually I'm on a cell phone so a spreadsheet can be done on a cell or probably better from a desktop. I do have a trip schedule for the library Saturday to use the computer there. Oh what hopeful news about Bid. I not sure with Pumpkin he's been in bed most of today :(
 
Ahhh. I think it would depend on what phone you are using whether you could use a google spreadsheet. Maybe you will have to do things a bit differently.
 
Oh I just went to the site. Pumpkin has a vile of lantus which we actually pick up in Pa. Walmart for $89.70. Which was the least expensive. We actually live in NY. So according to that site both states don't require a script. That's a releif just hope pharmacy is cooperative. I will do his spreadsheet on saturday from the library they give one hour per day on computer. I'll post tomorrow and let you know what happen at the vet office.
 
Cool. That vial should keep you going for a really long time even at 2 units a day I expect. Are you keeping it stored in the fridge? Also you aren't supposed to shake or roll lantus if you were instructed to do this.
 
Joy.T said:
He really hasn't been drinking from the bowl.I am hope-ing its because he is now getting moistture from the wet turkey mixed into his 2 tablespoons of can cat food.
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Neither one of my cats hardly drink any water from the bowls since I've switched them to an all wet diet.
I still leave fresh water out, but it is barely touched.
 
Hi Noreen and crew, whew!! What a relief!! I was wondering if was just Pumpkin. That's how it is for me I change the water bowl and very little is out. I do add water to the turkey bits so that they are moist and then add that to his can food.
 
Karrie and Maverick said:
This site says you don't need a prescription for insulin:
http://www.isletsofhope.com/diabetes/state-law/state-prescription-laws.html

I think in NY you can only buy syringes 10 at a time without a script but you could find another vet in the meantim.

I can just walk into a pharmacy here and buy insulin. I wonder if Lantus is a ton cheaper at a pharmacy vs what your vet is charging.
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please note: the new insulin analogs (Lantus is one of them) DO require a prescription in ALL states... as noted towards the top of the given link.
 
OH Thanks for pointing that out!! Jill and Alex. Well Pumpkin has enough lantus til 12-31. I just hope this vet will give him anthor script. I told them I can't do the curve on the 12-22 that I have to wait til 1-6-2011. They just didn't want to hear it.
 
I used the AlphaTrak for about 2 months. I ran out of strips and test solution and the vet was out also. I ordered more and then went and purchased a ReliOn. I never had a 30% variance between the 2. There was more of a variance in the higher numbers than the lower ones. I just could not afford the test strips and lack of availability.

As for vet doing curves, I never did that. In fact, right before Tuffy went OTJ I took her for her physical and he checked her BG and was very upset that I was shooting an 80. Go figure. It works. She is fine.

States that require script for syringes are: AL, DE, CT, Fl (Broward Co only), IL, ME, MA, NH, NJ, NY, PA, RI.
 
And while you may need a prescription for syringes in those states, chances are you do not need a prescription if you buy the syringes via the internet. I live in Illinois. If I walk into a pharmacy for syringes, I need an Rx. If I buy them via Hocks (see the button at the top of the board) over the internet, I don't need a prescription.
 
Hi Barbara and Tuffy, Thanks for your reply. I can't wait to see for myself what pumpkin BG will be when I test him here at home. I plan to start the spreadsheet on Saturday. He does hang out in his bed a lot today so I'm not sure what's up. His eating is normal and so is his urinating. I just worried because this Vet was so demanding and HMM.... what the right word..... well it was you do as I say ONLY like its the vets way or else. So I just have to see what will happen at the end of the month when Pumpkin needs more insulin.
 
Hi Sienne and Gabby, I may just start using Hocks,since transportation is an issue.I Plan to go there tonight if the cell phone battery hold up.
 
Get a human glucometer and do your own curves. With the $150 dollars you will save on the curves (an insane price by the way), you will be able to afford a cab to the vet 15 miles away. You DO need a vet, but your vet should be your partner in caring for your cat, not a dictator. They assist in the wellness of your pet, provide medical care, blood work, etc. But as with human diabetes, YOU are the main caregiver. It is a home treated disease.

My vet uses a "human" glucometer in her practice, and it runs very close to the lab run BGs. Trust us - they are quite accurate enough for good regulation of the diabetes.
 
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