Newbie seeking a vet in Augusta GA

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evakot

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Hi All,

I am VERY new to this, my 8 year old male cat was diagnosed with diabetes YESTERDAY (his blood sugar was 400). As you may imagine I feel overwhelmed and lost. I've been reading different websites for hours, as I knew very little about the illness. I could not sleep most of the night, and when I did I had a nightmare about Big Kitty having a diabetic seizure. Awful.

Anyway, onto my question. Through reading the info I became aware that my vet is NOT UP TO DATE with the most effective protocols. She prescribed the Humulin N insulin at 4 units, twice daily, and the W/D diet. When asked about the insulin type she stated that there are NO OTHER OPTIONS available. Clearly, this is not accurate.

Questions:
1. Does anyone know a vet in the Augusta, Georgia area (Atlanta is too far- 2.5 hours away) who is knowledgable about feline diabetes?
2. If not, how do I go about finding another vet? I am guessing that the vets will not be willing to discuss their treatment protocols over the phone...

I appreciate any suggestions.

All the Best to all who are going through this,

Eva
 
Your gut is right, Eva. The dosage your vet prescribed is too high to start with, and of course, Humulin is not the only insulin. My thought is that most vets are like GP's; they know a little bit about a lot of things. But they should be open to learning and first, do no harm. Hopefully we have someone in Georgia with a good vet.

If not, you can interview vets ahead of time. You might call around with general questions: How many diabetic cats have you treated? What types of insulin do you like to prescribe? Do you recommend hometesting? Or you can make an appointment for you (without your cat) and ask these questions. Even if a vet isn't on board with everything you would like, they should be willing to work with you. My vet didn't know anything about hometesting, but she couldn't argue with our good results. Now she reccomends it to others.

You are doing the most important thing you can for Big Kitty - reading and learning and questioning. It is a steep learning curve at first, but we are here to help.

One of the first things we would like you to do is to learn to hometest. We figure we wouldn't give insulin to our children without testing so we do the same for our cats. Here is a video: http://www.youtube.com/watch?v=_zE12-4fVn8 and a website with tips: http://www.sugarcats.net/sites/harry/bgtest.htm I know, more research.
 
evakot said:
Hi All,

I am VERY new to this, my 8 year old male cat was diagnosed with diabetes YESTERDAY (his blood sugar was 400). As you may imagine I feel overwhelmed and lost. I've been reading different websites for hours, as I knew very little about the illness. I could not sleep most of the night, and when I did I had a nightmare about Big Kitty having a diabetic seizure. Awful.

Anyway, onto my question. Through reading the info I became aware that my vet is NOT UP TO DATE with the most effective protocols. She prescribed the Humulin N insulin at 4 units, twice daily, and the W/D diet. When asked about the insulin type she stated that there are NO OTHER OPTIONS available. Clearly, this is not accurate.

Questions:
1. Does anyone know a vet in the Augusta, Georgia area (Atlanta is too far- 2.5 hours away) who is knowledgable about feline diabetes?
2. If not, how do I go about finding another vet? I am guessing that the vets will not be willing to discuss their treatment protocols over the phone...

I appreciate any suggestions.

All the Best to all who are going through this,

Eva
Click to expand...

Hi Eva,
Wow. I'm trying to be politically correct here and failing miserably. You are very right to be questioning this, and I shudder to think of the other diabetics under this vet's care. grr_red

N is an insulin that *can* be used, but there are other options available right now that offer a good bit of piece of mind. Lantus and Levemir are two of the better available options. If you really want to start using the N this weekend, I'd heavily advise you to read the Insulin Support Group for Caninsulin Vetsulin and N before starting. http://felinediabetes.com/FDMB/viewforum.php?f=19

I hope we can find you a vet close by and that even if not, you are able to find a vet who is knowledgeable about all the treatment options for FD including using a high protein, low carbohydrate diet (raw or canned) and a working knowledge of all the insulin options available. Sue gave you a good way to check around without making the commitment of actually showing up.

For now, I'd skip the insulin, learn to hometest, and switch your cat to a wet diet right now. On Monday you can find a new vet and maybe a new insulin.. and like I said, I hope we've got someone close to you to make that task even easier.
 
Sue and Carolyn,

Thank you so much for your responses. We have given Big Kitty (BK) 3 doses of insulin so far (the vet gave him 1 at the office, and then I gave him one last night, one this morning). Is it OK to discontinue, until I find a different vet? Or does it have to be tapered off first? Also- someone wrote that insulin dose is NOT dependent on the cat's weight- I wasn't sure why that is? BK is a large cat (looks like a Norwegian Forest Cat but is not pure breed)- he is currently 18 pounds which I thought was the reason for such a high dose...

Thank you again,

Eva & BK
 
Eva,

I am with Carolyn. Learn how to hometest this weekend and don't give the insulin. Buy some ketone strips so you can test Big Kitty's urine. If you stop the insulin, you can do as Carolyn suggested and start a wet lo carb diet. See this website by a vet: http://www.catinfo.org DO NOT start the lo carb diet if you continue to give the insulin. It can dramatically change Big Kitty's insulin needs.

Someone will know exactly why cats aren't diagnosed by weight. I don't know the reason, just know they aren't. In general, we urge newbies to start low and go slow. Start at .5 or 1 unit and increase by .5 units after letting the insulin settle. If you read the web page Carolyn gave you, you will see that Humulin is a fast acting, short duration insulin. Lantus/Levemir/PZI are less harsh and slower acting and last longer.

You could read the stickies on the Insulin Support group pages so you learn about different insulins. Print off some of the info and take to the vet visit so you can get a better insulin.
 
Thank you, Sue. I'm going to discontinue the insulin, switch to a low carb diet (bought the food today) and try my first attempt at BG testing tonight (going to Walmart now to hunt for a meter). On Monday, I will start calling vets to ask if they use Lantus/ Levimir or PZI. Hopefully, they will be willing to answer over the phone.

But if ANYONE KNOWS A VET near Augusta, GA, please help me out with recommendations.

Thanks again,

Distressed Mommy of Big Kitty.
 
Sounds like you are moving along for Big Kitty. Fantastic! Try the meter out on yourself first so you know how it works. If you put a flashlight behind Big Kitty's ear, you will see the vein that runs down the ear. You are aiming for the little capillaries that come off that vein toward the edge of the ear. If you put a dab of vaseline on the spot after you find it, it will help you aim, and will help the blood bead up.

The other thing that really helps at first is to warm the ear. Fill a thinnish sock with raw rice and heat in the microwave until very warm but not hot. Use it for several seconds to warm up Big Kitty's ear before poking. You can keep it behind his ear to have something to poke against.

Very few of us got blood on the first try; it took us a weekend of poking until we got a drop. So don't be discouraged if it doesn't work the first time. Come back on and tell us what happened. We all have tips and ideas to help.
 
We did it!!!

Hi,

I'm so happy- I got a drop of blood on the first try with Big Kitty!!! He was not a model patient, but we got it done. The reading was 269, which is not great, I suppose, but MUCH better than his reading of 400 at the vet on Friday. I have to figure out a way to keep his attention on something else, he was really, really squirmy and I basically had to put him in a headlock, poor guy. He doesn't seem too mad at me anymore though (he usually holds grudges :-D ).

Thanks for your advise about the rice in the sock- I think that helped tremendously.

Eva
 
Fantastic! Welcome to the Vampire club! That's not a bad number - diabetic but not sky high. Hopefully the diet change will begin to lower the number further and then you may just need a little insulin. Looking good.

I forgot to mention the treat. Give him a treat every time, successful or not. He will begin to associate the treat with the poke.
 
Hi Sue,

In contrast to last night, this morning's attempt at testing was a total failure. I poked him twice but did not get enough blood. He was moving the whole time and kept folding his ear back making it really difficult to see the spot I poked. Then he got so fed up with me that he just ran. So- 2 pokes for nothing...I guess that comes with the territory and not every try will be successful. :sad:

You mentioned treats- what kind do you use...? I know they need to be low-carby.

Also- is there any other spot on a cat (other than the ears and paws) that the blood can be drawn from? I was thinking about maybe shaving just a tiny spot of fur and poking the skin, but I'm not sure if that would be more painful to Big Kitty and maybe not as effective..?

Eva
 
At first, it isn't easy every time. It has as much to do with getting down a routine for both of you as anything. You will get it working your way.

There are a number of lo carb treats. We use Bonito flakes (sometimes called Kitty Kaviar) and freezed dried salmon. Some kitties love pieces of boiled chicken.

No, the ear or paw is best. Oliver moved around at first also. We found the kitty burrito very helpful. We put a towel down next to the couch arm. We set him on the towel and wrapped him up so only his head was showing. I could lean him into the couch arm and he couldn't get away. We only had to do this for the first few weeks. Once he realized a treat was coming after each poke, he stayed put.

We usually say try 3 times at one sitting , and then a treat for both Mommy and kitty.
 
Hi, Eva and Big Kitty!

Eva, what I would suggest is that you drop his dose to 1u bid. That is the starting dose for cats on most insulins. That way he will be getting some help for the high BGs while you are learning to hometest and changing his diet. It doesn't have to be "all or nothing". 4u is too much. FYI, cats have a very fast metabolism so that is why they are not dosed by weight and also why they need insulin every 12 hrs, in general (there are exceptions).

Also, you should know that most cats read about 100 points higher at the vet from stress, so the 296 you got at home may be showing where he is at in his home environment. That test was right around shot time, right? That is not a bad number. On N and other shorter acting insulins you can expect 250-350 for preshot BG and low-mid 100s for nadir (lowest point about 4-6 hours after the shot). N comes on strong and wears off fast, so you may see a drop at 3 hours and he may be back to upper 200s by about 8 hours after the shot.

Other insulins are longer duration: levemir and lantus. They will last the 12 hours and keep him in lower numbers for longer, which may allow his pancreas to heal enough to come off insulin - with a diet change to low carb wet food.

Has someone pointed you in the direction of the Janet and Binky food lists? They will show you which commercially available foods are lowest in carbs. I feed all my cats Friskies and Fancy Feast low carb varieties. They are better quality, lower carb and cheaper than the WD.

You might try browsing the info in the "links" post up top on Health and/or check out petdiabeteswiki: http://petdiabetes.wikia.com/wiki/Main_Page there is great info there also.
 
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