my big day....gulp.

Status
Not open for further replies.
Charliemeow

Charliemeow

Very Active Member
Today I think I've finally worked up the courage to call Charlie's vet and discuss his crappy numbers, a possible insulin switch, and maybe an acro/iaa test. I'm still debating the bloodwork, but I'll definitely bring it up. I don't know why I'm so afraid of the vet. I have NO problem pestering my dd's pediatrician, or standing up for myself. I'm an alt-vaccinator for her, and I feel fine sharing my opinions on that subject with her pediatrician....yet I can't bring myself to question the vet. Is that kooky or what? I feel a lot more educated about human-y stuff than pet stuff. Mostly because all of my fd info comes from the internet and I can't help but think that getting your info that way looks lazy or is frowned upon. If anyone has links to reputable sites (universities, veterinary journal studies) related to fd and you feel like passing them along, I'd sure appreciate it! My big concern is that the vet feels that Charlie's numbers are good enough. I want some solid, evidence-based info that states otherwise. She always says "it's different with cats than with people" when I point out that no human would accept numbers as high as Charlie's are. Sorry to ramble. I do that when I'm nervous. Wish me luck! nailbite_smile nailbite_smile nailbite_smile
 
The testing is something that your vet cannot deny you. It is YOUR MONEY, so if you want a blood draw done and shipped off to MSU for testing, that is YOUR choice. Tell the vet to give you an estimate of the cost for the blood draw and the packing and shipping via FEDEX to the MSU lab, then arrange for a day to take him for the draw. Tests are done on only a certain day of the week, so your vet has to be aware of that info.
When you go into your vet, take a printout of both test info sheets from MSU, and TELL the vet you want the testing done, even if it's just to rule out the possibilities. You may have to keep pushing your vet to get things going; I had to harrass my vet office because they did not think that Shadoe was acro.
Well, when the test came back positive, they were shocked. When I asked them to do the same tests for Oliver, I did not hear a peep out of them... they arranged it and shipped off the blood draw to the lab at MSU.

It's very important that you know if you are dealing with a functional pancreas or not. If your vet can't appreciate the importance of that one MAJOR item, it's time for a new vet.
 
Update: I left a message for the vet to call me back, and the tech asked what it was regarding. I said his #s aren't showing improvement regardless of dose and that I think it's time to try a different insulin. She said "well there really isn't any other insulin for a cat, but I'll have the dr call you". Does she think I'm stupid? I know that lev isn't technically approved for use in cats yet, but I'm pretty dang certain that lantus is! Ugh. Now I just wait for the vets call back
 
claudia i just wanted to say today is tom's first day on lev. woke up to 600+. shot 1u. i am so freakin nervouse that i am a total newbie today. i have to be gone for 6 hours. i am not so much afraid of a crash as him riding that # as his usual dose is 2.5 pz.
the point is i have a fresh new understanding of newbie nerves. now every dose will be a question mark for me. i almost needed this reality check for what it's like. if i was ever too cavalier with you my humble apologies. i'll still be here and kinda hope you join marcy and me in lev. but will be posting here and in health...less traffic in lev than here.
best of luck sweetie,
lori
 
Thanks Lori! You and Tom Tom have a big day, too. I sure hope this is what he needs! I'm happy for you and marcy!

I just got off the phone with the vet. She was relatively open to switching to an l-insulin. Sounds like they have used lantus in a couple animals, but never lev, so she was pushing me toward lantus. She said they'd need to research it more before I switch though. I asked about the bloodwork and she flat-out refused to do the draws for those tests. First she said "I'm not sure cats can even have acromegaly" I assured her that they could, but she still said no to the blood test because "then I'd have to treat it, and I don't know how". So she said I'd have to see an endocrinologist to get that done. I'm fuming. There is literally smoke coming out my ears, I think. She's not even willing to research and learn?!?! Time to start calling around for a better vet.
 
oh claudia i know how you feel, i have fumed to the point of smoke...and tears and some of my vets
 
Charliemeow said:
I asked about the bloodwork and she flat-out refused to do the draws for those tests. First she said "I'm not sure cats can even have acromegaly" I assured her that they could, but she still said no to the blood test because "then I'd have to treat it, and I don't know how". So she said I'd have to see an endocrinologist to get that done. I'm fuming. There is literally smoke coming out my ears, I think. She's not even willing to research and learn?!?! Time to start calling around for a better vet.
Click to expand...
That is appalling. To completely deny the existence of acromegaly is insane. She must not be keeping herself up-to-date. The vets I use aren't specialists but they are aware of the condition. And just the fact that you're having problems with the insulin you are using would make me think she'd want to help you find solutions.

There is no reason for her to refuse to draw the blood. She isn't doing the diagnosing, the lab is. I can't even image your frustation. I'm angry and she isn't even my vet! If you were in Rhode Island, I have some very good vets I could recommend....in the meantime, hang in there. I know there must be a vet out there that will work with you rather than against you.
 
To not even test is ridiculous. I feel angry for you! But I'm proud of you for asking the necessary questions. Now you know where you stand and what needs to be done. Stay strong. You're doing a great job and we're all behind you.
 
I'm so sorry Claudia. Can you fax them any of the material off of the acro site? That's the first thing I would do and that study?

Perhaps one of the acro folks would be so kind to fax your vet a package on acro?

If you vet will not do the testing then it sounds like new vet time. Or maybe you can just the the script for Lev for now then find another vet to do the testing with?

I think one of the ideas with Lev is that especially at a higher dose it may not sting like Lantus may?? And maybe a little cheaper.

In dealing with people, just remember you are trying to get what you need done for Charlie and try not to surrender to the insanity of other people - letting others' issues effect you is not usually the best way to get results. I know you to be a strong and thoughtful person, I suspect you can bend this vet if you feel you need to stick with them.
 
Thanks for all your kind words! I think the steam has stopped coming out my ears. Time to move on. I'm going to start calling other vets around here tomorrow. I got some ideas from some kind folks in community. There has to be a better one out there who is willing to help my kitty get well...in other words: Do Her Job!! My main reason for preferring lev is that "they" say it doesn't sting like lantus supposedly does. I'm not sure if this is what human diabetics say, or if people notice that their kitties flinch when they inject high doses of lantus. Plus, I fear I'd be a total outcast in lantus-land cuz I have no plan on following the tilly protocol and testing 20-some times a day!

Gator: are you going soft on me? ;-) what you meant to say was stubborn and opinionated, right? :lol:
 
Charliemeow said:
Gator: are you going soft on me? ;-) what you meant to say was stubborn and opinionated, right? :lol:
Click to expand...
Call it whatever you like. ;-) Whatever gets the results for Charlie is what matters. :smile:

I did see you post in Community - that was very good thinking to get that going ahead of the showdown. Very..."thoughtful." :smile:
 
Hi Claudia,

Keep in mind the vet at I believe the Avon Animal Clinic is up on the use of Lantus and probably Levemir too. Sometimes it does pay to go to the bigger clinics?

As far as research there are awesome stickies in the Lantus forum with links to peer reviewed materials. While my current vet doesn't use Lantus, I did provide her with the Roomp Protocol for her own review. 'Course Dr. Price is pretty familiar with my technical skills, although I have been considering that if things go funky...she might not be my best resource. I will most likely pick-up the phone for Avon.
 
The fact about Lantus stinging is TRUE.

the liquid carrier for Lantus is acidic.

the liquid carrier for Levemir is not acidic, but neutral

A human diabetic has told us that indeed, her Lantus shots sting compared to other insulins that she has used.

cost effectiveness:

Lantus is designed to be good for 28 days at room temperature "guaranteed" by the manufacturer. While it will last longer stored carefully in the refrigerator, many people replace the cartridge before finishing the insulin.

Levemir is designed to be good for 42 days at room temperature "guaranteed" by the manufacturer. This means you can use the entire cartridge before it goes bad if you store carefully in the refrigerator.

There are several documented studies in Veterinarian literature / journals about the use of LANTUS in CATS.

Not so with Levemir, but many people are using it for their cats with great results. It is very similar to Lantus is effectiveness, and I personally chose to use Lev over Lantus for the previously stated two reasons (stinging and cost/efficacy)


ALSO -- there is no specific treatment for Acromegaly that can be done by a regular practice vet other than helping with symptoms (pain, etc). There is SRS (stereotactic radiation surgery) done by CSU.

What the Acromegaly (IGF-1) diagnosis gives:
1> proof that your cat has a functioning pancreas -- diabetes is caused by pituitary tumor (this affects HYPO treatment!!!)

2> a reason for needing more insulin, and confidence that you are doing the right thing for your kitty by increasing the dose beyond what seems "reasonable"

3> a network of acromoms that can help advise / watch for related symptoms / recommend treatments that work and document treatments that didn't work

The IAA test is done by the same lab as the IGF-1 and costs $14. It is definitely money well spent to have both tests done from the same shipment of blood since shipping and blood draw are the biggest costs.

Hope this helps!
phoebe

p.s. My vet refused to prescribe Lantus or Levemir in 2008. I eventually ordered Levemir from Canada with no prescription (before the law was changed). Later, I presented the cat (Tiggy), the spreadsheet of data, requested a fructosamine (result = Well Regulated) and requested that she write a prescription for Levemir cartridges (in 2010 after the law changed).
In 2009, my vet got a new client whose kitty was already on Lantus, so she finally did the research and realized what a good insulin it is. So.... when I requested the Levemir script -- she wrote it. The insulin is cheaper in Canada, and I am 35 miles from the border, so..... i make a road trip when I need insulin. It costs $110-120 for a 5-pack of Lev. (not including gas, tolls, etc)
 
Thanks Phoebe, that is helpful. it's good to know that I'm not the only one whose vet refused to do what they requested. If my dd's pediatrician told me that he refuses to test for a certain illness because "then he'd have to treat it", I can guarantee he wouldn't be practicing medicine for much longer. How is this acceptable? I understand if she were to refer me to an endocrinologist IF the results came back positive, but to flat out refuse to test? That's just crazy!! I'm going to call the big expensive animal hospital down the street from mine tomorrow and grill them on their diabetes knowledge. I'll also discuss the acro issue with them. If I don't like their answers, I'll try the Strongsville animal hospital that Blue recommended. I wish you could still get insulin from Canada without a script. That would really make my life easier to not need a middle man.

449 pmps tonight. I think I'll go up to 6u tomorrow.
 
Ugh! Sorry it didn't work out with your Vet. bcatrun_gif bcatrun_gif bcatrun_gif
Best to cut and run now.
So glad you stood up for Charlie and asked the vet about the insulin change and the tests. :YMHUG:
 
wow go away for awhile and see what i missed!

Outstanding summary Phoebe! and she's right about not really much (regular practice vet) "treatment" for acro other than higher dose insulin, pain management as needed, and treatment of other issues such as enlarged heart, or kidney disease if they are found to develop.

Having the diagnosis:
1. made it easier for my vet to prescribe Cody's pain med (gabapentin) because even though it is hard to diagnose pain in cats, its pretty obvious/logical that he could be suffering from headaches from the tumor (light avoidance) and bony/neurological pain from bone growth in adult bones that aren't supposed to be growing.

2. Plus knowing he has an enlarged heart meant that he's been on (inexpensive) meds that have been protecting his kidneys (enelapril).

3. and knowing to watch for, and react to, fluctuating insulin needs; and how to treat an "acro hypo"

and since when is Klinger on Lev???? hows he doing?
 
Thanks for stopping by Nancy! Klinger and Tom Tom both jumped the pzi ship for levemir. I sure hope it helps them both! I hope Charlie doesn't have any pain. We don't have any sunshine this time of year, so I can't tell if he's avoiding bright light. He just goes to wherever the heater blows the strongest. I do too! All my kids are freeze babies like their mama!
 
Status
Not open for further replies.
Back
Top