Is a Blood Glucose Test Needed in this Case?

[Casey Warner]

I'd like opinions, in case I'm wrong.

I had my boy Tony in to the vet a while back because he was acting odd. He has never been diagnosed with diabetes and has normal blood glucose. But his urine glucose and urine protein were both 2+.

I've been doing blood glucose and urine testing at home under the vet's guidance. They also had me do a curve and it was normal. I consulted the online feline CRF/CKD group and they think this is a kidney related problem, as do I. Or, I wonder if it could be cancer.

The vet thinks this is diabetes or pancreatitis, even though all those tests came back normal.

The vet wants me to bring in Tony for a checkup and wants to check the blood glucose there. I don't want them to. I want them to run an appropriate blood and urine test checking all the kidney functions. This should give a better idea where the problem is occurring (pre-renal or post-renal). This test should be around $120-$150 if they do as I ask. The blood glucose test is $30.

If I've already done all these blood glucose tests at home and they're all normal, do you think I need to spend $30 getting it done at the vet clinic? It seems like such a waste. I don't think he's diabetic. I'd rather make sure his kidneys are ok. He's losing protein in his urine. He's losing weight. Something needs to be done and I think a complete CBC and Chem panel are the best option.

If I am wrong, please tell me and tell me why I'm wrong.

Thank you.

 

[Sarah&Soph]

I definitely agree with what you have said! Are they just wanting to check his blood glucose in the clinic with a hand held meter? If so, I think it might actually be detrimental even. His blood glucose is almost certainly going to be higher at the vet from stress which may just cause them to be like, “See, diabetes!” when all your tests at home have show that to not be the case. A CBC and chem panel seems much more appropriate to me. If they insist on some test for his blood sugar, ask them to do a fructosamine test. This will give an average of his blood glucose over about two weeks.

 

[Chris & China (GA)]

A senior blood panel should include the glucose level anyway. It sounds like your vet might be wanting to do a fructosamine test which shows the average blood glucose over the past 2-3 weeks.

It would at least give him an answer to his concern about diabetes....but you are the client and he works for you. If you don't want it done, you have the absolute right to say no

 

[Casey Warner]

They didn't say anything about a fructosamine test. But isn't that just as pointless in this case?

It sounds like to me they're looking for one high glucose test just so they can say he has diabetes. Tony's last home test was around 53.

I don't understand what they're looking for, and I don't think they do either. Everything points to kidney related issues. It might not be kidney disease, but there's clearly something going on.

 

[Sienne and Gabby (GA)]

I tend to agree that a blood glucose test may not be informative. A fructosamine may be useful if for nothing else, to appease your vet. If there's something out of the ordinary, like an insulinoma, a fructosamine test may shed some light.

Most complete blood panels, if your vet uses IDEXX as the lab include, an SDMA. This is a test that is predictive of kidney disease. It can be helpful along with all of the other renal function tests that are standard on a panel. IDEXX can also run a Spec fPLI which is a test for pancreatitis.

What are the odd behaviors that you observed?

 

[Casey Warner]

Most complete blood panels, if your vet uses IDEXX as the lab include, an SDMA. This is a test that is predictive of kidney disease. It can be helpful along with all of the other renal function tests that are standard on a panel. IDEXX can also run a Spec fPLI which is a test for pancreatitis.

Already did those. Both were within normal. BUN was just barely high, creatine was normal.

What are the odd behaviors that you observed?

He wasn't acting like himself. He wasn't and still isn't eating normally. He's doing a weird thing with his tongue and he eats weird because of it. The vet didn't see anything abnormal in his mouth. I worry about some type of oral cancer that maybe isn't visible to the naked eye. Maybe it's under the tongue or at the back of the mouth.