Josie - 03/05 - vet disagrees with hometesting

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Holly and Josie

Holly and Josie

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So today we took a urine sample into the vet to make sure she is over her UTI. She is not. So she is going to get another antibiotic. While we were on the phone my vet told me that Josie still has a lot of sugar in her urine. He thinks I am not giving her enough insulin. He thinks she should get 1.5 units BID. When I explained that I felt that was too much based on my readings at home, he went over his opinion which he shared with me last Friday. His opinion: hometesting is pointless.

He says my meter could be completely off and that unless it were calibrated, there is no way to know how accurate it is. He said it could be off 50-70 points. He also says some of the higher readings could be stress related. Basically, he thinks it's all worthless.

I, of course, disagree with him that hometesting is worthless. But what if my meter IS drastically off? And if she has a lot of sugar in her urine, that means she is not regulated at all. I am just so frustrated and confused.

I DO think the board is more up to date on the latest FD info, moreso than my vet, but clearly Josie isn't getting better. So I'm doing something wrong.

His plan for me is to give 1.5 units BID, stop hometesting because he feels I am driving myself crazy, and get a fructosamine test in 3 weeks. I think that plan is crazy.

But I do want her to get better. And my plan isn't working. So maybe his plan would. Maybe Josie would improve. Or maybe it would just kill her.

Thoughts? Ideas?
 
You know where we will come down on this, Holly. :-D If you hadn't been testing on 2/16, when she was at 96 in the am and you had given her usual 2 units, she would have probably ended up in the ER fighting for her life. Ditto on 2/22, if you hadn't caught the 29 at +4 and just assumed she was fine until you saw the symptoms of hypo, she could have died.

If your vet is worried about your meter, take her in with your meter and compare it to his. Blood from the ear with both meters. Sometimes they are a ways apart (info to keep in the back of your mind), some are within 10 points. Or ask to borrow his pet calibrated meter for a few days and see what kind of readings you get.

Josie is a volatile diabetic. She responds to insulin in different ways daily. Yes, it is stressful for you. But just watching her and guessing what might be happening would, IMHO, be even more stressful. She isn't regulated. Regulated cats are in the 200s at preshot and 100s or lower at nadir. consistently. She is there some days, lower some days, higher others. It has been especially hard because she is giving you numbers that require adjustments in dose often. But if you look back at her numbers, she is safe numbers a lot of the time. She is making strides. I think your plan is working.

This just isn't a disease that you can go home, shoot the same amount each 12 hours and expect results in 3 weeks. It doesn't work that way for humans or cats. (I wonder how many diabetic cats have gone into remission or been regulated in his practice and how many have ended up in the ER) It isn't easy - it's hard! But over 1000 cats have used the protocol on FDMB and the vast majority of those who stayed with it are regulated or in remission.

If you want to continue to hometest, then do. Tell him you just can't shoot insulin blind into your beloved cat.

See if Robin's scale helps to even out her numbers. And Holly, breathe. :mrgreen: You are doing amazingly well.
 
Holly and Josie said:
So today we took a urine sample into the vet to make sure she is over her UTI. She is not. So she is going to get another antibiotic. While we were on the phone my vet told me that Josie still has a lot of sugar in her urine. He thinks I am not giving her enough insulin. He thinks she should get 1.5 units BID. When I explained that I felt that was too much based on my readings at home, he went over his opinion which he shared with me last Friday. His opinion: hometesting is pointless.

He says my meter could be completely off and that unless it were calibrated, there is no way to know how accurate it is. He said it could be off 50-70 points. He also says some of the higher readings could be stress related. Basically, he thinks it's all worthless.

I, of course, disagree with him that hometesting is worthless. But what if my meter IS drastically off? And if she has a lot of sugar in her urine, that means she is not regulated at all. I am just so frustrated and confused.

I DO think the board is more up to date on the latest FD info, moreso than my vet, but clearly Josie isn't getting better. So I'm doing something wrong.

His plan for me is to give 1.5 units BID, stop hometesting because he feels I am driving myself crazy, and get a fructosamine test in 3 weeks. I think that plan is crazy.

But I do want her to get better. And my plan isn't working. So maybe his plan would. Maybe Josie would improve. Or maybe it would just kill her.

Thoughts? Ideas?
Click to expand...

His opinion: hometesting is pointless.
Click to expand...

Perhaps your vet should say those words to ALL the human diabetics in the world... tell them that their hometesting is pointless because their meters are no good.

The dose of 1.5u is too much for Josie at the moment, from looking at the ss, but that's just my opin as I don't use this insulin and not sure how you go about dosing.

I don't know what the others using PZI say; I am sure they will soon enough.
Just keep on with your testing because you are keeping Josie safe... and about the fructosamine test, once you are hometesting, the fructosamine testing is useless ... not to mention an expense that is good for only your vet's pocketbook. You can get the average from your meter! So why pay the vet to draw blood and upset your cat with a vet visit, all to get a number that is on your own meter at home.

Now, how is Josie acting? Does she seem better, less urine, how's her coat, what about her appetite and her weight. All of these signs are very important and it's not all about the numbers.

So long as you follow the guidelines that is needed for adjusting dose for PZI, based on your test numbers, you will do just fine.

What meter are you using? There are known problems with the freestyle meters; I have not used them, but others have. Otherwise, there are no meter issues with the majority of types used.
I have to laugh at the vet saying the higher readings are stress related. I think your cat is just fine at home, and my cats often sleep through having their ears poked .... yeah, it's real stressful.

Josie is YOUR cat and you are doing just fine by her. Your vet disagrees with dosing and testing? Too bad; it's all YOUR choice.
 
Josie,
I just looked at your SS and the last 24 hours are starting to look really good on the 1.25
I would hold the 1.25 for awhile to see where that goes
 
Hey everyone. Thanks for your replies. I knew how you all would feel about the vet's comments. And I feel the same way. There is NO way I would stop hometesting Josie all together. That's crazy. But I just got finished with a very frustrating conversation with him and I was feeling like what if I am doing her more harm than good, what if? But I just can't imagine blindly jumping off a cliff and hoping for the best. And to me that is what he is suggesting.

I would like to find a happy medium between what I'm doing, which is driving myself crazy and what he is saying, which seems insanely risky to me. I truly believe his heart is in the right place. I know he cares about Josie and he has been a wonderful vet to my asthmatic kitty, Simba. I also think he is genuinely concerned that I am driving myself crazy. But following his advice is way to scary.

Mostly I needed the reassurance that what I am doing is not crazy. And that's where you guys come in... Lord knows I have no one else to say I'm doing the right thing. My husband and mother completely agree with the vet.

I'm sure I'll post more later!
 
Aren't you the same Holly that just yesterday tested and caught that steep drop and averted a hypo because you tested?

Yes you are, you chose to be proactive and test to keep Josie safe instead of having to be reactive by waiting and rushing a seizing cat to and ER Vet.

He wants you to give 1.5u even though 1.25u was too much yesterday?

I'm really sorry your vet is reluctant to be a partner with you in Josie's treatment. Josie is your cat not his, if you want to test her then that is what you should do, he doesn't get a vote on that. You wouldn't drive your car around with a bag on your head, so why would you blindly shoot insulin without knowing what the bg is before doing it?

Don't let him freak you out. Your meter might be off by 20%, that's called varience. We are looking for the trends and how the insulin is working during the cycle. Even his meter has a varience.

She will get better because you are taking excellent care of her and will continue to make the best choices for her.

Hang in there.

Robin
 
You don't need a vet for the diabetic stuff, except the rx for the insulin, and in Canada, we don't even need the vet for that. I just go to the pharmacy, buy meters, strips, lancets, insulins, and syringes.

The vet is for tests, blood and urine, for mending broken bones, for Xrays and ultrasounds, and for dentals.
That's the stuff you can't do yourself at home.

If your vet cannot agree to disagree, start looking for a vet that cares more about and animal than the almighty dollar.
 
Comparing your meter with his will give you both a frame of reference. Keep in mind ever meter (even the pet calibrated ones) has 20% variance; we look at trends, not specific numbers.
 
I have experienced this same thing first hand. It took writing my vet a letter to better the situation. If he wasn't willing to support my efforts I was willing to take my business elsewhere. Good luck friend. I'm just so glad I found this board.
 
Thanks you guys. I agree with absolutely everything you all are saying. And when the vet told me his opinions on Friday, I just kind of thought, OK, whatever dude. I like you, but you are WRONG on this one. But today, when he told me Josie had "a lot of sugar in her urine", it gave me pause. I would NEVER stop testing all together, but I thought, maybe I am feeding when I shouldn't? Maybe I am making adjustments that I shouldn't be making? Maybe if I did give one specific dose and didn't vary, Josie would be much better or in remission by now.

It's good to read all of your comments and see that you guys don't see it that way at all. Having you all specifically point out times where you feel that I maybe prevented a crisis reassured me that I'm not completely crazy.

I like my vet, but Josie may have to go elsewhere. Even if the others stay with the current vet. I think at the very least, you need a vet who shares your philosophy. (Hometesting, low carb wet food, etc.) Anyone know any awesome vets in Indiana? :-)
 
We went thru this too Holly. Our first vet we insisted we shoot a large amount of insulin no matter what, and home testing was “only if the cat throws up at 8pm or something”. She also insisted we feed the 14% carbs prescription food. She made me cry from yelling at me 3 times and I had enough and left. I now drive 45 mins to a wonderful and caring vet who is a partner in the care of Asher. There are good vets out there. Don’t put yourself thru hell. Know that you ARE doing the right thing by home testing.

Also fyi, I took all 3 of our meters into my vet two visits ago to check them against his bench top blood test machine. The Relion Micro was closest to his number (this is our everyday meter now), then the Alpha Trak pet meter and lastly the crappy Freestyle we used to use. So the vet was very impressed we are getting close numbers to what he would see. On a human meter too.

Hugs to you. :YMHUG: I know this is freakin hard to deal with. You think they should know their stuff but sadly it isn’t always the case with FD.
 
Holly -

You know we're all behind you. And I understand completely about the way you're feeling. I have good friends who've said I need to not put Grayson through this torture - or let him tear me apart (I was pretty much a basket case after the Moderate Ketone incident). They think it's cruel to test him so frequently. I know I'm OCD when it comes to that, but he truly doesn't seem to mind the tests, as he comes to me when I sit at that table! He's not too fond of the shots or fluids, but with those, he tolerates them. His quality of life is not diminished at all, from what I can tell - other than the deprivation of Kitt-N-Kaboodle! So who are they to judge the choices I've made?

You've done an outstanding job - especially yesterday! Remember, the vet works for you. It's not wrong to question them or their advice. Bottom line is YOU make the choices for Josie. And you're making good choices for her. Don't let him make you question yourself.

Stay strong!

Lu-Ann
 
A couple of people have asked which meter I use - I use the Relion Confirm. I had read that it's pretty accurate. Apparently at my vets office they use human meters, too. The vet said he knows for a fact that their meters are 30 points off. He had them compared at a lab, or something. I wish he would just let me compare mine to his. If he knows his is 30 points off, then we could figure out how accurate mine is. But heaven forbid I ask that, since he doesn't agree with me testing very much in the first place. (He said, at max, test preshot and that's it.)

I do feel bad about testing Josie so much. She does NOT like it and days like yesterday, she was tested a LOT. I really do need to get treats. But as much as I test her I feel like that wouldn't help her weight much. (She is not one who lost weight with the onset of diabetes. She still needs to lose a few pounds.)

It's just hard when you feel like you're doing the right thing, and your vet is telling you that you're basically doing everything wrong! It sounds like a lot of you have been through that struggle!

I really do appreciate everyone's thoughts and reassurance!
 
Holly, bless your heart. :YMHUG: Having a vet disagree with what you know is right is down right hard to deal with. I know. My old vet had me in tears, saying I was being cruel to Poopy by home testing.

Here's something that may help (other than the great advice you've already received from the others)....when you get a chance, pop over to the pharmacy and ask the pharmacist for glucose testing strips. They usually come with the Ketone testing strips but include a glucose test area. I had to ask a couple of pharmacists, all asking me "You mean ketone, right? Not glucose?" before one understood I really did mean glucose. Now, when I test Poopy's ketones, I also get a glucose reading. It tells me how much glucose is in Poopy's urine.

Keep in mind, any (and I do mean ANY) time a BG is above 250 or so, there will be glucose in the urine. It's the cats' natural way of dealing with too much glucose at any given time, to spill it over into the urine to get rid of it. Our task, as momma beans, is to lower those occasions. Will it go away once and for all? Highly doubtful as we are talking about kitties - even regulated they can go up on occasion (I think they plan it on purpose).

Do you need the glucose testing strips? Not at all. Glucose in the urine will happen. It's not the end of the world. As I said before, it's our job to lesson the occasions it does happen. And you're doing just fine! :-D
 
Holly - do you have any chicken in the freezer? Poopy adores his raw chicken chunk treats! I cut up the raw meat into small cubes, about 1/2 inch square. (I only put 6 or so in each baggie, refreezing the bags, putting one bag at a time in the fridge to thaw for treats.) He purrs through his tests, knowing he gets his favorite treat afterwards. :-D
 
Was it mentioned already to be testing urine for ketones? That's one test you should do often; some cats are ketone prone and they can come on fast and you can end up with a sick Josie. And it's not just at high BG numbers either.
KETOSTIX from the pharmacy are inexpensive but they may save you from a rush to the ER one day.
 
Teresa and Poopy said:
Holly, bless your heart. :YMHUG: Having a vet disagree with what you know is right is down right hard to deal with. I know. My old vet had me in tears, saying I was being cruel to Poopy by home testing.

Here's something that may help (other than the great advice you've already received from the others)....when you get a chance, pop over to the pharmacy and ask the pharmacist for glucose testing strips. They usually come with the Ketone testing strips but include a glucose test area. I had to ask a couple of pharmacists, all asking me "You mean ketone, right? Not glucose?" before one understood I really did mean glucose. Now, when I test Poopy's ketones, I also get a glucose reading. It tells me how much glucose is in Poopy's urine.

Keep in mind, any (and I do mean ANY) time a BG is above 250 or so, there will be glucose in the urine. It's the cats' natural way of dealing with too much glucose at any given time, to spill it over into the urine to get rid of it. Our task, as momma beans, is to lower those occasions. Will it go away once and for all? Highly doubtful as we are talking about kitties - even regulated they can go up on occasion (I think they plan it on purpose).

Do you need the glucose testing strips? Not at all. Glucose in the urine will happen. It's not the end of the world. As I said before, it's our job to lesson the occasions it does happen. And you're doing just fine! :-D
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That's crazy that your vet was so harsh about the testing. As if it isn't hard enough for us to test to make you feel so bad that you cry? That's awful. My vet doesn't agree with it, but mostly he just rolls his eyes and tells me it's pointless.

Thanks for the suggestion about the glucose strips! I thought ketone strips were supposed to have a place for glucose, also, but mine don't. I didn't realize they were different strips!
 
Teresa and Poopy said:
Holly - do you have any chicken in the freezer? Poopy adores his raw chicken chunk treats! I cut up the raw meat into small cubes, about 1/2 inch square. (I only put 6 or so in each baggie, refreezing the bags, putting one bag at a time in the fridge to thaw for treats.) He purrs through his tests, knowing he gets his favorite treat afterwards. :-D
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I could definitely get some chicken! I wonder if deli meat would work also? We always have that.
 
Gayle Shadoe & Oliver said:
Was it mentioned already to be testing urine for ketones? That's one test you should do often; some cats are ketone prone and they can come on fast and you can end up with a sick Josie. And it's not just at high BG numbers either.
KETOSTIX from the pharmacy are inexpensive but they may save you from a rush to the ER one day.
Click to expand...

I just started testing for that! That's another thing my vet told me "not to worry about". He said that doesn't happen unless you have chronically high numbers. But I guess I feel like Josie has had high numbers on and off for awhile. So I worry she's at risk. I have tested every day for a few days. And the urine test she had today came back negative for that. Although, the vet thought I was insane for even worrying about that. It seems like a valid concern to me!
 
Tonight Grayson expressed his dislike - one of the few times he ever does. We had to do Sub-Q fluids, as his ketones went from "Trace" this morning to "Small", and we're not letting it go any further - the fluids are my pre-emptive strike. Anyways, he didn't run, he just grumbled for a while. I do them by myself, which means I'm missing that extra arm that pets him while one is keeping the needle still and the other - God forbid - had to scruff him to keep him still. My guys aren't used to the scruffing thing - at all- so I feel bad doing it. Fluids took all of four minutes to do. Four! I told him that we have to "suck it up" and put up with it for a short while. It's no fun for either of us, but it was only four minutes. We can tolerate a lot of stuff for only four minutes! When the fluid was complete, I removed the needle and held him a little bit longer. Then he got a bunch of freeze-dried chicken crumbs. He was like, "Can we do that again? I LOVE fluids!" Silly me, I should've had the treats WHILE he was getting them!

If this is the worst torture I'm putting him through, I think he'll be just fine. Poking his ear for blood seems to not be any kind of problem for Grayson - and I'm sure it's not with Josie either. No, they wouldn't choose to have you do it, but seeing how much better he feels, and seeing his response clearly showing that he realizes he feels better because of what we're doing, there's no doubt in my mind that it's the right thing for him.

You clearly have Josie's best interest in mind. This is just a bump in the road with your vet. Try not to let him upset you!

FWIW: You may want to check back w/ catannc about her vet telling her much of the same as yours has done. She wrote her concerns out and sent it to him. He did some homework, and realized she was right and he was wrong. Changed his whole attitude! That may be a means to get through to your vet.

Lu-Ann
 
I just want to say a couple of things.
My vet said something similar. Wanted me to purchase the pet meter for $200 which my husband told NO. After reading & reading, not doing home testing in the beginning. Within almost 2 weeks of shooting blind Baxter started to walk drunk after a shot. His eyes were huge, he was stumbling. I couldn't get ahold of my vet & I was freaked the heck out. It was so late at night. I slept by Baxter all night long. The next day DH & I went to Walmart & purchased Confirm. You are doing the right thing by testing.
Recently, I had Baxter in the vet. I was told what I committed owner I was by keeping a record & all the testing, but I really didn't need to test so much. You know what...went in one hear & out the other. :roll:

There have been times I have struggled with what my vet has told about FD & what I read here by tons of FD owners. It plays with my mind sometimes. I look at all the things my vet has told me about dosing, the food etc....then I question who is really right. I don't think it's a matter of who is right, its a matter of what works & finding it.

I wrote a post about a week ago. I summed up FD in one word...FRUSTRATING. I know this isn't easy. Hang in there you are going to find what works with the help of your friends here.

:YMHUG:
Jenn & Baxter
 
Grayson & Lu said:
Tonight Grayson expressed his dislike - one of the few times he ever does. We had to do Sub-Q fluids, as his ketones went from "Trace" this morning to "Small", and we're not letting it go any further - the fluids are my pre-emptive strike. Anyways, he didn't run, he just grumbled for a while. I do them by myself, which means I'm missing that extra arm that pets him while one is keeping the needle still and the other - God forbid - had to scruff him to keep him still. My guys aren't used to the scruffing thing - at all- so I feel bad doing it. Fluids took all of four minutes to do. Four! I told him that we have to "suck it up" and put up with it for a short while. It's no fun for either of us, but it was only four minutes. We can tolerate a lot of stuff for only four minutes! When the fluid was complete, I removed the needle and held him a little bit longer. Then he got a bunch of freeze-dried chicken crumbs. He was like, "Can we do that again? I LOVE fluids!" Silly me, I should've had the treats WHILE he was getting them!

If this is the worst torture I'm putting him through, I think he'll be just fine. Poking his ear for blood seems to not be any kind of problem for Grayson - and I'm sure it's not with Josie either. No, they wouldn't choose to have you do it, but seeing how much better he feels, and seeing his response clearly showing that he realizes he feels better because of what we're doing, there's no doubt in my mind that it's the right thing for him.

You clearly have Josie's best interest in mind. This is just a bump in the road with your vet. Try not to let him upset you!

FWIW: You may want to check back w/ catannc about her vet telling her much of the same as yours has done. She wrote her concerns out and sent it to him. He did some homework, and realized she was right and he was wrong. Changed his whole attitude! That may be a means to get through to your vet.

Lu-Ann
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So I am very interested in how you treat for ketones. You give Sub-Q fluids? Does that normally get rid of them? I have had a cat receive Sub-Q fluids before, but only at the vet. Did your vet have to show you how to do it? It's great that you are able to do so much for your cat at home!

This is definitely a concern for me because if my vet doesn't think I need to be worried about ketones, what would he say if I told him I'd been testing for them? If she ever had a problem, I don't know if he would even believe me/take me seriously. And I know my husband would be furious if the vet said not to worry about and I insisted on rushing Josie to the ER. So I am very interested in how you handle this. I figure the more prepared and self-sufficient I can be the better!
 
Jenn & Baxter said:
I just want to say a couple of things.
My vet said something similar. Wanted me to purchase the pet meter for $200 which my husband told NO. After reading & reading, not doing home testing in the beginning. Within almost 2 weeks of shooting blind Baxter started to walk drunk after a shot. His eyes were huge, he was stumbling. I couldn't get ahold of my vet & I was freaked the heck out. It was so late at night. I slept by Baxter all night long. The next day DH & I went to Walmart & purchased Confirm. You are doing the right thing by testing.
Recently, I had Baxter in the vet. I was told what I committed owner I was by keeping a record & all the testing, but I really didn't need to test so much. You know what...went in one hear & out the other. :roll:

There have been times I have struggled with what my vet has told about FD & what I read here by tons of FD owners. It plays with my mind sometimes. I look at all the things my vet has told me about dosing, the food etc....then I question who is really right. I don't think it's a matter of who is right, its a matter of what works & finding it.

I wrote a post about a week ago. I summed up FD in one word...FRUSTRATING. I know this isn't easy. Hang in there you are going to find what works with the help of your friends here.

:YMHUG:
Jenn & Baxter
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OMG, that sounds so scary. Did you ever figure out what was wrong with Baxter that night? Ya know, I just don't understand. Vets go to school for years. I just don't understand how they can appear to know so much less than your average person with a diabetic cat. But I feel like you all are so much more knowledgeable about everything. Which is why I tend to trust a lot of what I read on this board over what my vet says.
 
Holly and Josie said:
So I am very interested in how you treat for ketones. You give Sub-Q fluids? Does that normally get rid of them? I have had a cat receive Sub-Q fluids before, but only at the vet. Did your vet have to show you how to do it? It's great that you are able to do so much for your cat at home!

This is definitely a concern for me because if my vet doesn't think I need to be worried about ketones, what would he say if I told him I'd been testing for them? If she ever had a problem, I don't know if he would even believe me/take me seriously. And I know my husband would be furious if the vet said not to worry about and I insisted on rushing Josie to the ER. So I am very interested in how you handle this. I figure the more prepared and self-sufficient I can be the better!
Click to expand...

I went to the vet following the Moderate ketone test result... after spending the night on the phone 4x w/ ER and Vet School ER vets. The test was moderate, but could've gone up fast, his breath smelled like acetone (nail polish remover), but he was still eating. That was my saving grace. We called and were in the vets office first thing in the am. She checked blood and urine and found no infection (although he had a snotty nose). Gave him a few days worth of Clavamox, and gave him the SubQ fluids. I asked to get some in case I needed them. I went through the bag in 3 days, as his ketones kept hovering around trace/small mostly. Not taking any chances - a $6 bottle of strips or $2-4000 ER stint... it's a no-brainer. She showed me how to do the fluids, although I'd done them about 15 years ago, I didn't remember.

If your vet is upset that you stuck the equivalent of a litmus test in his urine, um.... he's got the problem! When I called my vet to say Grayson had "Moderate" ketones, my vet saw me immediately - AND spent an hour with us testing, consulting, reviewing his spreadsheet, discussing the dose changes, etc. It IS a serious thing. And something you don't want to let get out of control - or you could lose your kitty. It's THAT critical. And a simple test can keep it in check. No reason NOT to do it! If the vet discourages you from doing it, tell him you're being proactive and don't want to risk DKA and the associated expenses. If he knows how to treat diabetic cats, he knows what that means!

I'm pretty hard-headed, so if I choose to spend my money on my pets, I do so. And I know who my supportive friends are - I've stopped sharing too much info with the ones who aren't. It's just easier that way.

Hope this helps. I'm testing shortly and heading to bed, but since Grayson had such good numbers today, I'm not sure I'll be able to sleep, so feel free to respond - I'll check if I get up w/ him.
 
When we take our kitties, and droolers and any other "pet", to the vet, we know they are knowledgeable about issues with animals. One thing to remember, they have to know so much about so many different animals (even if it's just cats and dogs), how can they know everything about one ailment? We, diabetic cat owners, focus on one disease - feline diabetes. (For the most part. Other kitties here have more than one issue so those momma beans have more than one issue to focus on.)

Vets don't specialize like human doctors. So it's sort of like taking our kitties to the general practitioner and expecting them to know everything about endocrinology. Make sense? :smile:
 
Grayson & Lu said:
Holly and Josie said:
So I am very interested in how you treat for ketones. You give Sub-Q fluids? Does that normally get rid of them? I have had a cat receive Sub-Q fluids before, but only at the vet. Did your vet have to show you how to do it? It's great that you are able to do so much for your cat at home!

This is definitely a concern for me because if my vet doesn't think I need to be worried about ketones, what would he say if I told him I'd been testing for them? If she ever had a problem, I don't know if he would even believe me/take me seriously. And I know my husband would be furious if the vet said not to worry about and I insisted on rushing Josie to the ER. So I am very interested in how you handle this. I figure the more prepared and self-sufficient I can be the better!
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I went to the vet following the Moderate ketone test result... after spending the night on the phone 4x w/ ER and Vet School ER vets. The test was moderate, but could've gone up fast, his breath smelled like acetone (nail polish remover), but he was still eating. That was my saving grace. We called and were in the vets office first thing in the am. She checked blood and urine and found no infection (although he had a snotty nose). Gave him a few days worth of Clavamox, and gave him the SubQ fluids. I asked to get some in case I needed them. I went through the bag in 3 days, as his ketones kept hovering around trace/small mostly. Not taking any chances - a $6 bottle of strips or $2-4000 ER stint... it's a no-brainer. She showed me how to do the fluids, although I'd done them about 15 years ago, I didn't remember.

If your vet is upset that you stuck the equivalent of a litmus test in his urine, um.... he's got the problem! When I called my vet to say Grayson had "Moderate" ketones, my vet saw me immediately - AND spent an hour with us testing, consulting, reviewing his spreadsheet, discussing the dose changes, etc. It IS a serious thing. And something you don't want to let get out of control - or you could lose your kitty. It's THAT critical. And a simple test can keep it in check. No reason NOT to do it! If the vet discourages you from doing it, tell him you're being proactive and don't want to risk DKA and the associated expenses. If he knows how to treat diabetic cats, he knows what that means!

I'm pretty hard-headed, so if I choose to spend my money on my pets, I do so. And I know who my supportive friends are - I've stopped sharing too much info with the ones who aren't. It's just easier that way.

Hope this helps. I'm testing shortly and heading to bed, but since Grayson had such good numbers today, I'm not sure I'll be able to sleep, so feel free to respond - I'll check if I get up w/ him.
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Thanks for sharing that info! That's so great that your vet was willing to show you how to work with your kitty at home. I'm sure that has saved you money and stress, being able to treat him at home. My vet doesn't actually know that I have been testing for ketones at home, but I'm pretty sure he would say it's no necessary. When I asked if there were ketones in the urine sample I provided he said no, but you don't have to worry about that. I wish that were true, but I don't think it is. My understanding is that anytime a cat is unregulated, it's a risk.

I think it's time for me to find a new vet.
 
Teresa and Poopy said:
When we take our kitties, and droolers and any other "pet", to the vet, we know they are knowledgeable about issues with animals. One thing to remember, they have to know so much about so many different animals (even if it's just cats and dogs), how can they know everything about one ailment? We, diabetic cat owners, focus on one disease - feline diabetes. (For the most part. Other kitties here have more than one issue so those momma beans have more than one issue to focus on.)

Vets don't specialize like human doctors. So it's sort of like taking our kitties to the general practitioner and expecting them to know everything about endocrinology. Make sense? :smile:
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That does make sense. I guess I just my vet weren't so insistent that his way is the right way. If he doesn't know, that's OK, but just say you don't know, or you'll look into, etc. I think it's when they act like they're experts but they know they're not (because, as you said, they can't always be experts on every issue!) that drives me crazy!
 
Some vets have 'God Complexes' too. I have reminded mine more than once that he puts his pants on one leg at a time just like I do and have also dared him to identify a gemstone with a refractometer. I can see two choices 1) Get him off his high horse (not easy) OR 2) find a new vet... :-D

I took the first path - it worked....he listens to other people more now also so it was truly a blessing for many more than just me.

BIG HUG,
 
Whether you take on your vet or find a new one, either is your choice. Both work well for different people. My old vet office had been sold and the old vet was no longer there when Poopy was diagnosed. I didn't feel too bad about changing vets. I had to shop around but did find a vet I am very happy with.
 
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