New member, ? re: home curve costs

Tl;DR: are you being charged for home glucose curve interpretation? I was charged 70$ for telling the vet my results.

Hello everyone!
This is my very first post, though I have read countless threads since February when my 15 year old senior, Meat, was diagnosed. Oh how I lurked. It seemed like whenever I had concerns and my vet wasn't being helpful, somebody here had already gone through the exact thing we were going through. In the beginning sometimes I read the posts through tears of concern for my little Meat! This site really helped me give her the best care possible and frankly I'm VERY confident that my vet learned multiple new things because of my insistence on home testing and refusal of the prescription food in favor of better options. You guys are really making the world a better place. I can't thank you all enough.


My question is this: are you being charged for "interpretation" of your home curve numbers? I haven't seen a single post mention a cost related to that in the entire forum, and I've been looking very hard.

My vet charged me 70$ after I emailed them the numbers from my home curve (which they explicitly told me not to perform and gave zero instructions on, insisting on either the free libra implant or an in-office curve over the course of the 7 hours they are open as being more accurate).

How it happened: I had told the vet I was uncomfortable administering insulin after an extreme diet change (cutting out kibble) without any testing and thus had been testing at home and that I thought the numbers I was getting were probably pretty reliable. He insisted it was not reliable and asked what numbers I got so I sent them, with the nadir noted, along with the times of any food. He said "looks great, I can tell your numbers are accurate. Keep up the same dose!" and then billed me for interpreting a home curve at 70$. The front desk person called and cheerfully informed me they had needed to make up a new kind of charge for me because none of their patients had ever done a home curve before (No wonder with how vehemently they discouraged it!)

Should I change vets over this? 70$ for answering a question they asked?? I have liked this vet usually when dealing with other cat and dog issues through the years, but with this they seem to mostly stand in my way while I insist on best practices until they "catch up" and finally agree with me after a few back and forths. The desk staff has given me obviously harmful advice a few times (eg."it doesn't matter if her glucose tests at 90, give her the full dose of insulin. That's another reason why you shouldn't test at home, it will just confuse you").


I'm sorry this is SO long!!!

 

Hi Molly and welcome to the FDMB!

Trust me, for a very first ever post, it is not long at all. Meat is beautiful, my wife has a particular soft spot for Calicos.

while $70 is not a lot it is the first time I've ever heard of such a charge. My vet looked at Hendrick's spreadsheets and did not charge us, for what that's worth. It was not a specific request to analyze a curve, however. I don't know if I would find a new vet over such a thing but I definitely wouldn't ask them to do further analysis, especially when you've got all the super-experienced and knowledgeable people here at your disposal! Curve analysis is something folks here do a good bit of.

I must say, your tenacity and dedication to Meat is commendable. So many people just wilt in the face of a vet who disagrees with diet, home testing, or dosing. Which I totally understand after all they are supposed to be the experts that you place all your faith and trust in them, believing that they will know exactly what your cat needs! Our FD journey was an eye-opener, honestly. Soooooooooooo many people come here relaying tales of similar experiences with their vet, almost down to the letter! Crazy.

Let's have more pics of that pretty girl! Upload is broken so just drag and drop or copy/paste pics into a post and hit reply.


Coko says hi Meat!




Bonus pic...Shylo, Hendrick and Roxy. Hendrick is demanding a morsel of the home made cat food I am preparing them for dinner.

 

My Coco was diagnosed last year on June 2nd took him once after that and the Vet was reluctant to care for him, he had been going to this Vet for 11 years along with my 4 year old Coco, Yet he did not wanted anything to do with his diabetes, he was in an emergency hospital for 8 days left with all supplies for the diabetes, but I had no idea how when where to do what was necessary, it cost me close to $2,000. I found this Forum in August, I am yet to take Corky to the Vet. not once, with this Forum and the amazing members I have been able to learn all that is needed to care for him, and there's always a new experience. They guide me on dose increase, decrease, foo, feeding everything as of today my Corky is stable has not had any other illnesses, and when in a case of emergency the member are there thru and thru until he's Glucose is back to normal range. I personally will Not take him to a Vet again, I trust this Forum to the fullest, financially Vet will open a hole in your pocket, will not inform you properly. I wish you the best with Molly, do what your heart tells you to do about a Vet, even when I have totally panicked at times for low glucose, the members have been amazing, if you read other members post you will see you are not alone in your concerns and home testing is the most efficient way for you to take control and see hourly, daily how your Molly is doing Glucose wise to stabilize him, if needed, without taking him to the Vet for testing as they usually suggest on a weekly basis, my Corky from 1 hour to the next, has raised/decreased his glucose, I test him every two hours, but that's me, and if help is needed I have the members from this Forum, that's how my Corky has not had any organ damage ( this one is also long)

 

Oh my goodness, your kitties are beautiful!!! You really have an eye for photography as well, what lovely portraits! How can anyone not fall in love with those faces at first glance?! Im ready to empty out my pockets and give H whatever he wants! I'm a softy for the torties just like your wife, and Coko is an extra marvelous example!

Yes, it seems the charge itself is kind of unheard of, though I agree, 70$ is a drop in the pan on our diabetes journey! We are definitely poor but pet health is one area I dont cut corners. I think I was more upset that it seemed like they fished the already interpreted numbers out of me without informing me there would be a charge because they decided afterwards to charge because they didn't want to miss out on the 200$ from office testing. And of course it feels like I'm teaching THEM and 70$ is the same cost as an office visit to simply look at my records. My records probably seemed obsessively immaculate compared to what they do in office: a test every 3 hours, but they are only open for 7 hours. Thats maximum 3 tests and so much stress for Meat, who was abandoned extremely obese with severe asthma at 13 in a shelter by her lifelong owner. She was shuffled around 3 or 4 shelters for a year. She's a very chill cat but I recoil at the idea of her in a kennel-like environment again, even for a few hours; what if she thinks I abandoned her too? She's my best girl (ok, my only girl lol, but shes great) and I just want her to have the best life now that we are together! I'm not great with photos but here she is:

We don't use her baby sock filled with lentils for testing anymore, but she still really loves for us to heat it up and she plays with it and lays on it. I think she likes how it smells, which admittedly is kinda nice lol

Thank you so much for your kind reply! Sorry it took me so long to reply, I'm on mobile and am having trouble figuring out how to paste pictures!

 

I am so glad to hear that!! It really seems like this forum is better than most peoples vets. I know there are some amazing vets out there but I see so many similar stories to mine where it just seems a better choice to manage feline Diabetes at home, even if cost were not a consideration! I'm so happy Corky doesn't have any organ damage, you guys really bring me so much hope with you successess and healthy kitties, I love seeing and hearing about everybody's cats!! I don't know what I would have done without you guys

 

if iphone, should be long press on a picture to copy, long press then release in the reply box to get the option to paste.

I think. I haven't had an iPhone in a long time, have a Pixel 8 pro.


You are 100% correct that the stress and cost of taking a cat in for a curve is something that the gurus here do NOT recommend. Not only can the stress cause the numbers to spike higher, throwing off the accuracy of the curve, but there is the cost, the time, and the wellbeing of the cat! Doing a home curve was one of the very first things people here recommended to me, for Hendrick, but at the time it sounded insane to me as I had never even done a single ear-poke home test. But of course they were right, in the end.

What a kind thing to do, take in a 13-year-old rescue with health concerns. Wait, are you my wife?

 

Um... nope. My vet doesn't charge for reviewing my Google spreadsheet or even responding to questions and concerns I have. And my cat has a lot more than diabetes going on so there's always something I need the vet's opinion on.

If you don't like the vet for whatever reason, you can switch to a new one. You don't have to tell the old vet why.

 

That's funny, I didn't realize it was you, but I watched the video in your sig with Hendricks when I first learned how to test! YOU specifically have helped me. It really did seem like an insane thing to do. Poke my cat, with a needle? In her EAR?! Against vet orders?!!! But yet, here we are! And Hendrick took it SO WELL. So does Meat, now.

 

Agreed. Meat has many issues as well and this has never been a problem before, they always tell me to ask them ANY questions I have and obviously there was never a cost associated before.

I'm just curious if there is a single other person here that has been charged for this.

 

In this Forum Never a charge for anything, if you are referring to this forum, the best person to direct this question to is a long time member Suzanne & Darcy you can click on search type her name, then PM her your concern

 

awwww that really touched my heart. I actually feel quite guilty that I don't spend more time here helping newbies and giving neglected threads some attention. And yet, here is an example where I helped without even knowing!

 

Sorry for the confusion, I didn't write that clearly at all, my apologies- this amazing forum has definitely not charged me a dime, it has only saved me money!! Its one of the most valuable free things I can imagine! Thank you so much for offering to help though, I will do that if I have any forum type questions.

I was just rewording my original question in a reply to Squeem3 about if any members here had experienced a $charge from their vet for doing their own curve at home.

 

Welcome Holly and Meat, never in my life have a heard a vet charging to review your curve. That's crazy.
If it wasn't for me taking the advice from the experienced members here I know Tyler wouldn't be in remission today. He's been in remission for 3 years already knock on wood ( he is low carb food controlled )
I wouldn't pay it
What is the name of the wet food you are feeding ?
A favor in your signature can you add the year Meat was diagnosed please

We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help

Here is the link to set up your spreadsheet if you want to give it a try, if you have trouble setting it up, just ask ,we have a member here who would be happy to do it for you
@Vasalisa

 

running this forum is not free, but using it is. Maintenance and server fees definitely add up, thank you for reminding me to donate again!


https://www.paypal.com/webapps/shop...1391846070_f9462874ea06a#/checkout/openButton

 

Suzanne! has been my Corky's guardian Angel Corky & Coco

 

Hi Maria her kitty's name is Meat
@CORKY

 

Thanks for adding that information to your signature
If it wasn't for me taking the advice from the experienced members here I know Tyler would not be in remission gpfor 3 years already knock in wood.
He is now low carb food controlled
@Vasalisa

 

Thank you so much for your reply!! It makes me really feel better and have hope to see the remission stories, so glad Tyler is doing so well!! He is so cute, too!

Meat is currently eating the Fancy Feast classics, but will go on a hunger strike without at least some small amounts of dry food. It's been a struggle to get her off the kibble. She was a bargain kibble cat her whole life until I adopted her and transitioned her down to one small meal of what i thought at the time was a healthier dry food (i and heart and you, chicken and duck flavor) along with the fancy feast classics. She has been accepting to the Young Again dry food (with 5 pieces of her old kibble added. Im slowly working it down literally piece by piece but she notices!!), unfortunately she had the loose stools after a few good weeks and now we are going for the Zero Max dry food. Thanks to members here for the advice about these foods and samples of them!!

I added the year to my sig and will definitely get on that spreadsheet, I see how helpful they are and I am definitely going to be using the forum from now on regarding interpretation!! Thank you!!

 

Maybe you can try replacing the kibble with freeze dried treats ,maybe she will like these

Click on this link and look at post #6. Numbers are to the right
You can get any freeze dried treats ,information is there
https://www.felinediabetes.com/FDMB/threads/brand-new-many-questions-3.255627/#post-2878703

Freeze dried treats that only contain one ingredient (the meat or fish) is zero carb and fine to feed to a diabetic
They do notice everything

 

Thank you so much, I have gone through a few of those, I was sure she would love the minnows but she wouldn't touch them! She ate one salmon purebite and never ate one again no matter how i gave them to her. She ate the raw instinct as a treat pretty reliably, but not when I tried to introduce it slowly as kibble replacement. She seems to really like freeze dried chicken hearts, but just chews them up without eating them. I really WANT to do freeze dried, it seems like such a great option in EVERY way, I tried a bunch of other freeze dried options even before her diagnosis just trying to get her off kibble. I haven't given up, though, and I plan on working my way through that list until I find some more options for her. I have lots of neighbors that enjoy our expensive treat cast offs haha!

The young again and dr elseys dry food she is mostly on (except the 5 tiny carby kibbles of I+❤️+U) are supposedly zero carb and she likes them, so if we can just achieve a better poo with them (maybe by mixing?) we would be in good shape! From what I've read here, that can be a challenge because of the non starch binding agents used. It would be so much easier if she would just eat only her regular fancy feast wet food without going on a hunger strike! Oi!

 

They are something else aren't they lol
I have one more suggestion lol

One member posted this
Bonita flakes could be a great idea, we call them Stinky Fish because they absolutely reek. But all our cats and dogs love the stuff.
or sprinkle a little Parmesan cheese on the wet food .
That's all I got
@Vasalisa

 

That's a great idea! I will pick some up tomorrow, I am really hopeful about them!

 

You can even try sprinkling a little Parmesan cheese
Fingers crossed she likes the Bonita flakes
I hope you can find them in a store, I have never really looked for them in a pet store. Probably a Asian store would have them, if you can't fund them just Google them and order them on line

@Vasalisa

 

I've seen bonito flakes at Petco, usually a small container for a really expensive price. An Asian market would have bonito flakes in big bags for way less money, probably a few dollars at the most. Amazon will have a multitude of different brands in the grocery section if you need to order online.

FortiFlora is also great to entice cats to eat. It's a probiotic and not a very good one at that but works great to get even inappetant sick cats to eat. The main ingredient is animal digest, what many dry foods are coated in and super yummy and irresistible. A little sprinkle goes a long way.

 

Hello and welcome - what a great first post!

As you've seen, we have many members who are very welcoming and supportive and great at answering questions. I wouldn't point at any one person as the "go to" person. All of us here are volunteers, just paying it back to those who helped us. If you look at the joined date under our pictures, you see some people have been here a long time, even after the diabetic cats are no longer around.

I echo the others, I've never heard of someone being asked to interpret a curve or blood glucose (BG) numbers. My vet did ask me to use a different format from our spreadsheet to display the numbers. After two times and too much work, I stopped doing it. At that point I wasn't really asking my vet for dose suggestions any more. I liked my vet, had been to her for over 20 years. We just evolved the relationship that the insulin dosing was my domain, and she helped with everything else. My cat got rather "complicated", so I was glad to have her in my corner.

 

The Young Again Zero does have a reputation for causing soft stools in some cats.

As for the vet charge … yes, I’ve heard of vets charging for reviewing curve information (as well as for responding to emails and phone calls), although it is definitely the rare exception and not something I’ve experienced firsthand. (I can count on one hand the number of times I’ve seen it mentioned in my 19 years on FDMB)

I think I’d give the clinic a call and politely ask the vet about the fee, and perhaps request that they provide an adjustment this one time. Sometimes an office manager or someone else enters billing info and the vet doesn’t even know something was charged. Even if they do, it usually doesn’t hurt to nicely ask to “level set” so there are no surprises in the future and everyone is on the same page. It’s worth noting that (1) you believe you’re a good client, (2) you’ve never been charged for phone/email discussions/questions in the past, so you had no reason to believe this time would be different (3) you were providing the info at their request, and (4) you believe that it’s a reasonable expectation that if they were going to charge, they give you a heads up in advance so you could budget for it. And that going forward if it’s their policy to bill for reviewing curve results, that’s fine, you now know and will plan accordingly.

Most vets I’ve dealt with over the years try to be reasonable (there are a few exception I can think of, lol), but they can’t read minds so won’t know you’re unhappy unless you politely speak up.

 

I shop at a lovely international market and got the Bonito flakes cheaply there, as you said! I had considered the FortiFlora but decided against it, after reconsidering though it does sound like a good idea for exactly my situation. Thank you!!

 

Thank you so much Wendy, you're being modest, I have read so many of your posts dating from years back and you are SO HELPFUL!!!! I hope to be as knowledgeable in the future so I can pay the community forward as well, this site is really an inspiration and shows how kind and wonderful that humans can be sometimes when we work together!

I really DO want the vet in my corner, and I can't really afford to be charged for communication with them, Meat is seemingly a bit complicated herself (because of her steriods +), and I am just starting to learn everything I need to know and it's all very complicated! Hopefully our relationship can evolve like yours has with your vet. It doesn't seem like they will be much help with dosing, as right now they just want to keep her at the same dose because she is staying under 300, but because she still has symptoms I feel I must continue to look for the sweet spot where she is actually managed. I just began her spreadsheet moments ago (after much wailing and gnashing of teeth trying to figure my phone out) and am now psyching myself up to post a question about her dosage - it's SO hard to ask for help, even in a wonderful place like this where I haven't seen any nasty interactions at all!

 

That is excellent advice, and I am going to take it.

i really would love to maintain a good relationship with this vet, as their failings seem to be things most vets have/do and they have been willing to learn and update their knowledge when I insisted.
I cant stay with them if they insist on charging me for an office visit every time I try to update my records/email them a question, but what you wrote sounds very reasonable and I think we will probably come to an understanding.

Thank you so much!!

 

The spreadsheet only shows insulin being given in the AM? Are you only shooting once a day? Humans do that, but cats have faster metabolisms so need twice a day.

If you are interested in following one of our dosing methods, we can help you with dosing. My vet was so busy she didn't really have time to help me, or at least when I needed the help, so I started asking the folks here as there is usually someone 24x7. Since there is still some dry food in the picture with Meat, you would be using the Start Low Go Slow dosing methods, or SLGS. A description of the dosing method is in this post.
Sticky Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

 

Hello! Thank you so much for replying.
Thats my mistake, she IS getting dosed twice a day, since I hadn't been previously testing in the PM it slipped my mind to add that to the spreadsheet! I will update that now.

Yes, I definitely want to do SLGS! I've read that page a few times, it seems like the best method for us, even if we can eventually get off all dry food. Sometimes it's a little difficult for me to internalize so much dense medical information but this site is a life saver- the info is very digestible, even if I'm a bit slow at it!

 

Lots of people start with SLGS, and for some people and their schedules, that's all they can do comfortably.

If you are ready to give it a go, I have some suggestions for you. First, do you have a day off when you could do a curve? That would be one of testing every 2 hours for 12 hours, or testing every 3 hours for 18 hours. The idea is to get a better idea of how low she's going. We decide how to change dose based on nadirs, or the low point that Lantus/glargine takes them. Second point related to that, you might want to try getting some spot checks just before you go to bed at night - many cats go lower at night. And it is that low point we are trying to spot.

 

Yay, suggestions! I'm SO ready❤️ Her last curve was march 6, I can do another curve as soon as tomorrow, and my ketone strips arrive today so they will be in action soon as well. I actually just made a post mentioning how I regret not testing PMPS, I hadn't realized that they can dip lower at night sometimes. I will definitely be doing both am and pm now, as well as the nadir when I can. I am learning so many new things!