? Oreo Joe's vet visit brings major crack down

Bonnie & Oreo Joe

Bonnie & Oreo Joe

Member
Hello,

I have been sick and I have really not wanted to try and explain what happened and not sure I can explain it all.

We saw the Vet, Ellen on Tuesday afternoon. She spent 1½ hours with us. There is a vetenary board like there is for physicians that over see what doctors or vets are doing. Well they can come in and look at journals in the different offices. Well I have been caught being American. I had to agree to the terms laid out or there would be no vet treatment anywhere.

Ok 1st - Everytime Oreo Joe's blood work was done he was really sick. Thus they feel that the blood tests were not accurate. They said that there is no way he would be the 1 in a Million cats to be hypothyroid. Ellen explained that by starting him on the medication for his thyroid it made his body think it was diabetic. That is how he showed up with being diagnosed as diabetic.

In thinking he was just not reacting to his insulin and I finally began adding ½ U every 5th cycle. Well the vets darn near died. How could this be allowed. They never ever give 12 U where we are at until or ( actually not sure if ever) he is proven to be a high dose diabetic and they don't feel he ever was diabetic, although after this mess he may be when this is over.

His thyroid meds were stopped on Tuesday and his insulin down to 8U and on Monday goes down to 5U and a week later 3 Units. It will take a couple of weeks or more for his body to regulate to not having the thyroid meds that caused him to think he was daibetic.

The thyroid tests were done and to show that they were not being mean we had a free abdominal xray to check if there was still a lump that was found last year. There was nothing.

I will get the thyroid blood tests and a call from Ellen as soon as they come in. She said if I was welcome to return - no charge - if she was wrong about all of this, that she would eat her words which she would print out from my journal and eat that.

So I saw a 23.3 blood sugar this AM. They are all high now and we have to wait.
I will let everyone know what happens along the line here. She had such detailed explanation that I had no way to refute anything she said. I understood what she said but can't explain it all now.
Hugs, Bonnie and Oreo Joe
 
hi Bonnie! I hope they're right about the thyroid and that stopping those meds will bring some better health to Oreo Joe! Are you able to share your spreadsheet with Ellen so she can keep an eye on how his BG changes with stopping the thyroid meds and lowering the dose? It will be important for her to know how that is changing throughout this transition.

I love that you said you were "caught being American" That cracked me up!!! Having lived overseas for many many years, I completely understand that!

I'll keep my fingers crossed that they are right about all of this and that getting OJ off of the wrong thyroid med will help make everything better!

One note for you: as you know from being on here, there is a risk in letting his numbers run higher that he could develop ketones. Can you get ketone test strips at a pharmacy there and be checking at home? Also, if he stops eating and seems lethargic, get him to the vet ASAP. Hopefully everything will be just fine, but it will be important for you to be watching him carefully during this time. :bighug:
 
Djamila said:
hi Bonnie! I hope they're right about the thyroid and that stopping those meds will bring some better health to Oreo Joe! Are you able to share your spreadsheet with Ellen so she can keep an eye on how his BG changes with stopping the thyroid meds and lowering the dose? It will be important for her to know how that is changing throughout this transition.

I love that you said you were "caught being American" That cracked me up!!! Having lived overseas for many many years, I completely understand that!

I'll keep my fingers crossed that they are right about all of this and that getting OJ off of the wrong thyroid med will help make everything better!

One note for you: as you know from being on here, there is a risk in letting his numbers run higher that he could develop ketones. Can you get ketone test strips at a pharmacy there and be checking at home? Also, if he stops eating and seems lethargic, get him to the vet ASAP. Hopefully everything will be just fine, but it will be important for you to be watching him carefully during this time. :bighug:
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Hi! I copied his spread sheet and emailed it to her. How do I share it so she can look at the one I have for the vet clinic? The link to it or what?
I have the ketone sticks but I will have to shove it in a clump of litter when I hear him jump out. He is potty shy and no one can look. I tried with dried peas in a litter box and he stood and cried with his legs crossed. He is very special. lol
I will try the stick in the clump but last time it made it so discolored that I couldn't really tell. He is drinking tons of course and still eating as much and as fast as I can put the food down. He has been to me every 15 minutes since I removed his food dish almost 2 hours ago. He stares at me using the Vulcan mind meld trying to get me to get his food dish.
Guess being American kept him alive when I was syringe feeding him for 3 months. But now I was between a rock and a hard place. Praying Ellen was correct.
He has dropped to 17.1 at +6 so hoping it is still down in 10 minutes.
Thanks, Bonnie
 
Well, son of a gun! This sure puts a different spin on things! I agree with Djamila -your comment about getting "caught being American" was very funny. I echo her concern about ketones: do whatever you have to do to get urine tests done.

Keep us in the loop! :)
 
If you really can't get the urine test, consider getting a blood ketone meter. My cat is not easy to catch in the box. And with six cats it would be hard to catch the right one. Lol. I bought a blood meter and glad I did because she's been showing some trace Ketones lately.
 
JanetNJ said:
If you really can't get the urine test, consider getting a blood ketone meter. My cat is not easy to catch in the box. And with six cats it would be hard to catch the right one. Lol. I bought a blood meter and glad I did because she's been showing some trace Ketones lately.
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Well outside of no place to buy one - weekend you know we close down - there is no $ for one and ordering from Amazon can take 2 or 3 weeks. I stuck it in the wet litter and wiped off the litter. In the green line - green on left he is in the brownish color next to last on the right. I looked on line and it says 1 on the top of the square and 1000 on the bottom. What does that mean and what do I do? Thanks for the help!!
 

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Bonnie & Oreo Joe said:
Well outside of no place to buy one - weekend you know we close down - there is no $ for one and ordering from Amazon can take 2 or 3 weeks. I stuck it in the wet litter and wiped off the litter. In the green line - green on left he is in the brownish color next to last on the right. I looked on line and it says 1 on the top of the square and 1000 on the bottom. What does that mean and what do I do? Thanks for the help!!
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I just read If the GLUCOSE is consistently >1000 mg/dl, then the insulin dose may need to be increased (it is best to call the clinic before increasing the insulin dose on your own). Note that if the dose was recently changed, it may take up to 5-7 days to see the effect of that change on the urine. His dose was changed Tuesday pm so it hasn't been 5 to 7 days.
 
These strips test both urine glucose and urine ketones. Ignore the upper green line - that's for glucose. You're already testing his blood for glucose with your meter and that's much more accurate. You use these strips for the bottom row KETONE reading. What square did the test strip match? You want it to look like the beige one on the left hand side of that bottom row. Make sure you time the reading properly because the colours continue to change. If you look at the colour guide it says to read the ketones "at exactly 15 seconds". You also need to judge the colour in really good light.
 
The glucose isn't the line you want to read. Since you're testing with a meter, the glucose in the urine test doesn't really matter (it's not as accurate as blood since glucose will show in the blood sooner than in the urine). You want to check the bottom line that says Ketone. You need to check it at EXACTLY 15 seconds...the longer you wait, the darker it gets, but it's accurate at 15 seconds.
 
Rachel said:
Whoops! Cross posted. :)
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SO the green row is the glucose? I can't see a think on the bottle. He isn't going to pee for me. Of course he just went a gallon of urine and is sleeping. I was going to do it again as I think it was a longer wait. So it wasn't accurate. It is 1 AM and I will see what I can get in the AM. If it isn't light tan - negative then I can call the emergency vet and ask what he/she wants me to do. His blood sugar was 16.8 at PMPS.
If that vet kills my cat with this I will not be happy!
 
One trick you can try is to put a few pieces of wrinkled up plastic wrap (like saran wrap or cling wrap) in the litter box in the direction he usually pees. You just need it to catch a little pee in one of the wrinkles. Then when you hear him pee, head in there before he starts kicking litter over it so he'll jump out and let you get the test out of the plastic instead of out of the litter itself.
 
Djamila said:
One trick you can try is to put a few pieces of wrinkled up plastic wrap (like saran wrap or cling wrap) in the litter box in the direction he usually pees. You just need it to catch a little pee in one of the wrinkles. Then when you hear him pee, head in there before he starts kicking litter over it so he'll jump out and let you get the test out of the plastic instead of out of the litter itself.
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Ellen just called, on her Sunday off and did change some things. He was supposed to drop to 5 U Monday but will stay on 8U another week. This is all so stressful. She said while one of the Thyroid tests was a bit low that would be expected as the medication was taken so long.
 
You asked about sharing the spreadsheet with Ellen. You should be able to click on "share" in the top right corner of your spreadsheet, and then click on "copy link". Then open an email to Ellen and hit ctrl - V to paste the link into the email. Then whenever she clicks on it she'll see the updated spreadsheet.

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I'm glad she's going to give him more time with a larger dose. Hopefully getting off the meds will also lower his blood glucose, but until that happens, it's good that she's going to keep him on a larger dose. (although I still wish it was closer to 12u)
 
I have to ask, did anyone check into ingredients of the thyroid meds? Make sure there was no sugars or sweeteners in there? Oreo does seem to be a puzzle.
 
Bonnie & Oreo Joe said:
They said that there is no way he would be the 1 in a million cats to be hypothyroid.
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Well someone always wins the lottery right? This is why I drag a file folder to every doctor I see because the odds of having A, B and C are so remote that, "Oh look, you really do have this rare condition".
I hope the Swedish government is kind to you both. My parents came from good old liberal Holland which is now in danger of becoming a far-right wasteland. Pasty white people who used tulips as currency don't like being outnumbered by "those people".
If Ellen has to "eat her words" make sure you soak the paper in some bitter lemon juice first. I can't imagine a vet EVER being wrong about anything.
Above all I hope Oreo Joe lives a long and happy life.
 
PussCatPrince - GA said:
Y'know. I have no idea what this means. None at all.
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I am an American through and through although I live in Sweden now for 30 years. Vet care here is not at all the same as in the USA. I insist that I am my cats Mom and everything goes through me. Not normal. I syringe fed Oreo Joe for 3 months when the norm here is 2 weeks, no eat go to sleep. I begged and insisted and my vet gave meds for nausea and appetite and after 3 months said There will be no more syringe feeding, it is inhumane and I am no longer going to be an American Vet for you. Call Monday and make an appointment to have him put to sleep. ½ hour later he began to eat. I keep being told, "you are not in America and that is not how we do things in Sweden" So while I have pushed the envelope pretty well I am no longer American and now either do what the Swedish Vets do or I have no vet anywhere in Sweden to care for him. Thus I an no longer American.
 
Djamila said:
I'm glad she's going to give him more time with a larger dose. Hopefully getting off the meds will also lower his blood glucose, but until that happens, it's good that she's going to keep him on a larger dose. (although I still wish it was closer to 12u)
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Looking at his spread sheet he was in the yellow areas when on 6 to 8 U now he is purple and red all the time. I keep praying the board is right.
 
Olive & Paula said:
I have to ask, did anyone check into ingredients of the thyroid meds? Make sure there was no sugars or sweeteners in there? Oreo does seem to be a puzzle.
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He is on the same med as used for people, dogs and cats all over America. levothyroxine
On the thyroid board they said they had cats that were diabetic and on it.
 
Noah & me (GA) said:
Inte jag heller!
Olga och Sven går in i en bar med en pingvin, en anka och en katt.....
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Hej, jag bor i Dalskog mellan Mellerud och Vänersborg var bor ni? Klinikerna jag har hittat i en 2 ½ till 3 timmars bilfärd från oss har aldrig behandlat en diabetiker katt annat än sätta dem att sova. I read Swedish, speak it with a very midwestern accent but have had problems writing it. When I arrived my class was on lesson 38 and when I graduated onto the higher Swedish class they were on lesson 76- I missed out on so much spelling, placement of verbs etc.
 
Noah & me (GA) said:
Well someone always wins the lottery right? This is why I drag a file folder to every doctor I see because the odds of having A, B and C are so remote that, "Oh look, you really do have this rare condition".
I hope the Swedish government is kind to you both. My parents came from good old liberal Holland which is now in danger of becoming a far-right wasteland. Pasty white people who used tulips as currency don't like being outnumbered by "those people".
If Ellen has to "eat her words" make sure you soak the paper in some bitter lemon juice first. I can't imagine a vet EVER being wrong about anything.
Above all I hope Oreo Joe lives a long and happy life.
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Lemon juice and hot chili peppers with the seeds rolled up like a burrito in the paper. Yeah imagine a vet being wrong. My first cat here was diabetic but right after the vet we drove 2½ hours to get to who told me he knew all about diabetic cats - ordered 6½ U canine insulin saying it was way way weaker than human insulin and it was like giving a U of human insulin, almost killed her I found this board and she went off insulin and onto the proper diet with the only food good for diabetic cats available and never had insulin again. She never saw that vet again. Then found the clinic we go to now. She became a kidney failure patient and we went in and met a new vet who refused to let me give her fluids as he had to order the syringes. He said if I was going to insist he would take her out and put her down immediately. Never saw him again. Now he is finally gone. It is difficult since it seems that people don't want to take the time to test at home, say it is to hard to give insulin etc. maybe some areas have vets that know about diabetic cats and I believe they do but not here. We went to 5 different vet clinics and absolutely none treated diabetics and said take her home give her all the goodies and treats she wants and bring her back when it is time to put her down. I believe most of them have been kind and caring but just haven't had any practice in treating them.
 
Djamila said:
You asked about sharing the spreadsheet with Ellen. You should be able to click on "share" in the top right corner of your spreadsheet, and then click on "copy link". Then open an email to Ellen and hit ctrl - V to paste the link into the email. Then whenever she clicks on it she'll see the updated spreadsheet.

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Thank you! Once you showed me I remembered it. Hard being old. In my dreams I am 35, reasonably healthy, thin, and happy with my friends, son and work. I wake up and find me. Yikes.
 
Djamila said:
One trick you can try is to put a few pieces of wrinkled up plastic wrap (like saran wrap or cling wrap) in the litter box in the direction he usually pees. You just need it to catch a little pee in one of the wrinkles. Then when you hear him pee, head in there before he starts kicking litter over it so he'll jump out and let you get the test out of the plastic instead of out of the litter itself.
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Thanks!
 
Those numbers certainly look like the 11u was doing more than the 8u, which means 11u is not too much insulin. But it doesn't matter at this point what we think. Ellen needs to be convinced.

Here is a link to some information about testing for high dose conditions. You have to have the blood drawn at your vet and sent to the UK (unless they can do the test in Sweden?) http://www.felinediabetes.com/FDMB/...-other-high-dose-conditions-what-we-know.375/

Anyway, it might be worth reading for yourself at first. Inside that link are explanations of different conditions, as well as the links for where to go for testing. The Royal Veterinary College in the UK might be a compelling connection to make for Ellen since their information would be coming from other vets, and not just from a cat mama ;)

I know you need to tread softly right now, so it may not be the best time to give this to Ellen, but I wanted you to have it for when the time is right.
 
Bonnie & Oreo Joe said:
Hej, jag bor i Dalskog mellan Mellerud och Vänersborg var bor ni?
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I live in Canada, a land of vast cornfields, multiculturalism and I'm not far from Alliston Ontario where Insulin was developed. This is also where meatballs were first discovered in an abandoned IKEA store.
I get it that different cultures see some animals with a different value system. Whatever value someone places on an animal veterinarians everywhere take some kind of oath and then seemingly alter that as they see fit. When you said "He said if I was going to insist he would take her out and put her down immediately" that is NOT his choice to make. You weren't doing anything unethical or prolonging an animals suffering. I have no time for pompous self important people. You sound like me, just not going to put up with this crap. Doctors are the only profession who say "It's doctor actually". What? Is Actually your first or last name? When a plumber saves your day on a Sunday morning does he insist on being call Your Highness?
I haven't been keeping up with the medical side of this story but everything else, I don't know whether to laugh or cry. It doesn't sound like you need reassurance but it never hurts. You are my kind of human being.
This is for you :) :banghead: :coffee:
This is for Oreo Joe :bighug: :bighug: :bighug:
Say hi to King Carl XVI Gustaf and ask if he can do anything about the way IKEA stores are laid out. That damn "International Marketplace" is not the least bit international. I won't make any ABBA jokes.
If you want to come back home Canada would be glad to have you. I could use a neighbor with a sense of humor and I have two great vets.
And our glorious leader is handsome!
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I'm pretty sure when I typed in "world leaders" the NSA zoomed in on me, and us. What must they think? High dose bouncer/syringe feed/litter sticking to paws/meters and blood. I've got one for them, why don't you call 867-5309 and ask for Jenny. I feel a body cavity search coming on.
Bonnie, do "some of you" or do YOU want Donald?
Let us proceed as if this was the shelter for the world's most unwanted cats. I've taken in a few oddballs and melon-heads in my time so I've done my share.

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Does not get along with children, problems with gas. May not be neutered, constantly humping Putin's leg.
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Apparently had some kind of "bomb". Refuses all attempts at grooming.
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Remember Rob Ford? Crack addict, thought it was PC to say "pussy" on national TV. This is his brother who is now the leader of Ontario where more than a few of us poor schmucks live. Thinks he is Trump Lite.

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Cannot be adopted, lives behind the shelter eating scraps.

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Idi Amin, a strange name for a cat. Generally miserable, urinates constantly.

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Likes long walks on the beach, mushroom clouds.

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94 years old! Please, no life saving measures. Just let me go.

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These last three, not world leaders but I want you all to ponder this. These three are all married so somewhere in the world someone will be sharing a basket with them tonight. There is not a wicker basket big enough for me to even think about this.
I'm going to set up a GoFundMe page to have them all spayed.
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How did this one slip in? Looks like an old shoe I used to wear. Sorry everyone.
Okay, that's it for me today. I'm only doing this for the "likes" because it's still raining and I had to pick up dog poop in the wet grass this morning.
Since we're (me) so far off topic anyways I'll toss this in. I've never gone off topic before. It's a strange feeling.:rolleyes: :smuggrin: ;)
 
Your honor, I object!
Look everyone, I found my other old shoe! Wait, there's something stuck to it.
Is this why Justice is blind because if the bathroom door was unlocked and....
Hey, I was going to put the seat back down but it was already down! Why are you so crabby in the morning? :oops: :(
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Bonnie & Oreo Joe said:
Hi! I copied his spread sheet and emailed it to her. How do I share it so she can look at the one I have for the vet clinic? The link to it or what?
I have the ketone sticks but I will have to shove it in a clump of litter when I hear him jump out. He is potty shy and no one can look. I tried with dried peas in a litter box and he stood and cried with his legs crossed. He is very special. lol
I will try the stick in the clump but last time it made it so discolored that I couldn't really tell. He is drinking tons of course and still eating as much and as fast as I can put the food down. He has been to me every 15 minutes since I removed his food dish almost 2 hours ago. He stares at me using the Vulcan mind meld trying to get me to get his food dish.
Guess being American kept him alive when I was syringe feeding him for 3 months. But now I was between a rock and a hard place. Praying Ellen was correct.
He has dropped to 17.1 at +6 so hoping it is still down in 10 minutes.
Thanks, Bonnie
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Someone recommended using aquarium gravel instead of litter. It should feel like litter to the kitty but isn't absorbent.
 
Be careful what gravel you get. I have live plants in my aquarium so the gravel has a clay composite. When I vacuum the tank (it's a siphon thing) it can kick up enough silt to kill the fish. One of our Tetras is about to pop out some more babies, very tiny and way cool. I also have some "monsters of the deep" that live in caves and are bottom feeders. This is all in a 10 gallon tank, a great hobby.
 
My "conservative cat" wants a big laundry size solid basket filled ½ with litter. If it goes down to much he complains. He hates the litter box Flies out of it as if he is shot from a cannon spreading litter from his box at least 5 yards away.
These posts are like FB lately!
 
Ack! Litter everywhere...yeah mine refused the box with gravel in it. They looked at me like I’d lost my mind when I tried that! The plastic wrap trick works for a lot of people. Others use a long handled spoon (clearly labeled!) to catch urine while kitty is in the box. I was lucky the Gypsy just let me pop up behind her and stick the strip under her...she did look at me funny but that was it.
 
Euthyroid Sick Syndrome - Endocrine and Metabolic Disorders - MSD ...
https://www.msdmanuals.com/...disorders/thyroid-disorders/euthyroid-sick-syndrome


By receiving thyroid medication when he was not hypo thyroid or hyper. He was sick with other illnesses and his T4 showed low and was put on medication he did not need. This put T4 in his body and it made him become Hyperthyroid and with continuing the medication and getting insulin the thyroid worked against the insulin and now he is insulin resistant.

I hope this makes sense as this is what Ellen explained to me 2 times. He will stay on 8 U insulin until after his Monday shot and we will decide if he drops to 5 U when she calls me in the afternoon on Monday.

His spread sheet shows he was in the yellow on lower doses but the higher the dose and I was getting more purple When we changed to 8U and started to raise every 5th cycle. By the time I went to 11½ we stopped getting yellows.
Then Ellen changed to 8 U on the 15th of August he became purple and red.
Last pm and this AM were the first yellows we have seen since the 15th.
Part of me says it makes sense, the pancreas is getting use the the change and it will take time and since he was better on lower doses he should be going lower. The other part of me throws up my hands and yells, "How do I know?"
Hugs, Bonnie and Purrs from Oreo Joe
 
Hi Bonnie - I don't think any of us can predict what will happen next since his meds have changed along with his dose. Time will tell, and it sounds like Ellen really wants to learn about this and do her best for him. Do keep us posted on how he's doing and what Ellen says. At this point it doesn't sound like you have much choice but to follow her lead, so we'll all just keep our fingers crossed the changing his meds will help!
 
@Bonnie & Oreo Joe - in the case of euthyroid sick syndrome, the cat has an underlying condition that suppresses the T4 reading on blood work. That doesn't mean, however, that the levothyroxine caused either his diabetes or his possible acromegaly - more so that he likely had existing diabetes and/or acro and that suppressed his T4 readings. Often, when a cat becomes regulated on insulin, the T4 reading will return to the normal range and even if it doesn't, it isn't usually a cause for concern and requires no treatment in itself. No, he shouldn't have been treated for hypothyroid - in cases where a cat appears to be hypothyroid, underlying causes should ALWAYS be ruled out first. I see here an initial failure to diagnose, or even attempt to diagnose correctly by assuming the T4 reading was accurate and treating for hypothyroid (which hardly ever occurs in cats) in a cat that was euthyroid sick. And that is a problem - most likely that is the problem the board picked up on rather than it being a case of them not being happy with you trying to secure treatment for him. That doesn't mean that diabetes/acro treatment won't be successful - not at all. It does, however, raise the question of whether or not this vet knows what she's doing - euthyroid sick syndrome is a very well known phenomenon in cats.
 
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