Pita-Official Vet Call-More Confused Now!

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Caitlin M

Caitlin M

Member Since 2017
Hi again!

Hope everyone had a good weekend. I received my call from the vet about Pita's blood work and she said that it is indeed Diabetes but everything else looks fine- so yay! I am bringing him in on Wednesday and we are starting PZI injections twice a day. She said after 10-14 days I would bring him back and she would then do a Glucose Curve at the office. I have read that G.C. can be affected by stress to the vet and he is a VERY bad traveler. Should I ask/insist on doing it at home or just hope for the best?
The thing I am SO confused about, is the Glucometer and at home testing. I asked about it and said said he did NOT NEED to be tested at home and she thinks it puts a lot of stress on the parent and cat. Ok. From everything I have read on this website as well as dozens of others, this is the first time I had heard of a vet saying NOT to do at home blood testing. Any thoughts or advice would be greatly appreciated so when I go in on Wednesday I can really discuss this. Thank you all.
 
At Teasel's diagnosis my vet said he had to eat low carb wet food, he was started on a low insulin dose and I was told to test BG at home. A vet tech showed me how to inject and how to prick the ear for a BG test. My vet wanted me to do the BG curve at home after a week on insulin and email the results to her for review.
 
I'm honestly not sure what to do. It would be $200 for the day with her doing the curve. I can do this but I'd rather use that money for new food and insulin. Also, ever heard of a vet telling someone there's no need to do ANY at home testing?
 
Caitlin,
here we go again, the vet is saying NO to home testing! It is insane!
Please don't fall for it, it is your cat and you MUST test at home, this is the only way to do it!
You will save yourself a lot of money, agro and save your kitty from unnecessary stress by testing at home and showing your vet the data you've gathered.
Remember, you pay your vet, you are responsible for your kitty's well being and the vet has to respect that and should work with you. If your vet is not willing to do so I would strongly advise you look for a better vet.
You seem to care deeply about Pita and I'm sure you will manage to treat her diabetes very well. You will get as much help and encouragement as you need here, just let us know how we can help.
Please go and purchase all needed supplies (glucometer, test strips, needles), you don't have to buy them from a vet, a regular pharmacy will do.
Good luck.
Sending hugs,
Marlena
 
Caitlin M said:
I'm honestly not sure what to do. It would be $200 for the day with her doing the curve. I can do this but I'd rather use that money for new food and insulin. Also, ever heard of a vet telling someone there's no need to do ANY at home testing?
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I've read a few reports of that here and I really don't know what those vets are thinking. I agree that you can put that $200 to use in a better way. If your cat is very stressed at the vet's then BGs might well be overly elevated and any insulin dose prescribed based on those numbers could be too high.

Many vets have issues with home testing if the owner isn't using a pet meter. Their readings compare favourably to what the vet 's equipment would give but the strips are very expensive. Some people get around the problem by having a pet meter for BG curve use only so the vet understands the numbers and they use a much more economical human meter for day to day monitoring.
 
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That all makes sense. Thank you. I feel like everything needs to be dumbed down for me at this point! Any suggestions for Pet meters as well as a still good/accurate home meter?
 
I use a pet meter, alpha trak 2, for curves done at home to show my vet the BG numbers. I use a human meter, Relion micro for everyday testing. My vet prescribed 2 units of insulin twice a day for Smoky at diagnosis and he almost had a hypo where his blood sugar dropped to a very low number.
I found the FDMB board fortunately and the good folks here saved me a trip to the emergency vet.
I ended up going to a few different vets before finding one that was OK with me home testing. Stick to your guns and insist on home testing.
 
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Please, if you can, test at home. I didn't initially and could have killed Sky through to high a doseage - she was hypo within a week.

More recently if I hadn't tested recently (and I almost didn't as i was so tired in the morning) I would have sent her hypo as she was too low for a safe dose. it can be expensive to do, and can be difficult initially, but it is well worth it for safety.
 
OK, am I correct in assuming that I will start giving him Insulin after my visit on Wednesday and then in 10-14 days will be able to do the Curve?
 
Honestly, I don't know what's wrong with some of these vets, suggesting NOT to test at home! Ask your vet if she had a small child at home who was diabetic, would she not test and just blindly administer insulin? I think not. It's the same situation with our sugar cats. Home testing is crucial to the safety and well-being of your cat! And yes, you can do your own curves at home, where kitty won't be unduly stressed. It's ridiculous to pay the vet $$ to do a curve at the clinic/office when you can save the money and avoid the stress by doing it at home. Yes, it will take a little while to learn to home test and become proficient at it, but it's not as difficult as it may seem initially, and is 100% doable! Before you know it you'll be an old hand at it! :):)
 
You can start testing at any time, and in fact we'd encourage that! You don't need to always do a full curve when you test, the minimum we suggest for safety is to get a pre-shot reading before every shot. Random "mid-cycle" (between shots) tests are excellent data to give you a rough idea of how effective the insulin is-- some of us test about that much, some of us test a lot more than that, it's just a matter of what works for you and your cat.
 
Thanks everyone-I'm sure there will be boatloads of questions soon, but I truly appreciate all the responses. It's amazing and comforting knowing that this is such an active site and dedicated community. It makes me feel less alone and for that I am beyond grateful <3

One more thing- It's normal to begin Insulin (PZI) and then do a curve 10-14 days later? Or is it not okay that my vet is starting Insulin before that? Thanks!
 
That's what I did with Maury because his insulin had to build a depot. 2 weeks of initial dosage and then first curve was scheduled. I spoke with another vet who told me I could do the curve and e-mail them results, be a less expensive for me and less stressful for my boy.:cat:
 
Squalliesmom said:
Yes, that would be fairly standard practice.
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Thank you! That's a relief. I see that you use the ReliOn Confirm- do you like it and think it gives accurate reads? I'm now trying to figure out if I should get both the Alphatrak 2 AND the ReliOn or if I can be okay with the ReliOn only. I'm aware that as time goes on I'll figure things out, but for now I'd love popular opinions from experienced owners!
 
Caitlin M said:
Thank you! That's a relief. I see that you use the ReliOn Confirm- do you like it and think it gives accurate reads? I'm now trying to figure out if I should get both the Alphatrak 2 AND the ReliOn or if I can be okay with the ReliOn only. I'm aware that as time goes on I'll figure things out, but for now I'd love popular opinions from experienced owners!
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My first vet, who I am no longer with, pushed me against my better judgement to buy the Alphatrak meter. It was expensive, and the price of the strips is exorbitant! I went out immediately and bought the Relion Confirm, which I use exclusively. It is affordable and reliable, and the strips are readily available (Alphatrak strips have to be ordered online). My current vet still has a hard time wrapping his head around the different values the human meter gives but is okay with it since he knows I know what I'm doing. Another thing to consider is that almost all of the protocols we follow here are designed for using a human meter.
 
I've never used anything but the Confirm or Micro....and China hasn't been back to see a vet for her diabetes since she was first diagnosed almost 4 years ago

The people here have more real life experience than any vet ever will....we live and breathe this disease.

From day 1, I trusted the people here who'd been through it all before...especially since I was getting such bad advice from my vet....Now IF you can get your vet to work with you, that's great and highly recommended, but it's not absolutely necessary either

The people here know what the human numbers mean and how to interpret them and our protocols were written with human meter numbers in mind.

The only reason you'd really need to get an AlphaTrak is if you absolutely want to stay with your current vet, take their advice on dosage and they refuse to take the results from a human meter...but first I'd try to convince them that human meters work fine.....it's not the exact number that's the most important...it's knowing when your cat is safe and when it's not....and knowing if the trend in the numbers is going down or not
 
Thank you both! I will go out and purchase it tomorrow. Also good to know that I can post the reading and get help understanding what it means.
 
Caitlin M said:
Thank you both! I will go out and purchase it tomorrow. Also good to know that I can post the reading and get help understanding what it means.
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Also a good idea to look for "alternate site" lancets. They're thicker and produce an easier blood drop. And keto-strips for testing urine for ketones. An extra bottle of strips for your "hypo kit" in case you run into low numbers and need extra strips.
It's important to test before meals and pick up any food 2 hours prior to those tests.
It will all be easy soon enough!
 
Hi Caitlin. Not to overwhelm you but you might think about what you are going to feed Pita. A low carb wet diet is best. I was given m/d at my vet which is actually too high carb. The higher the carb is the more insulin it takes to counter it. There is a list of low carb foods here on the site. (Not sure where but someone will post it for you.)
If you post what you are currently feeding there are a lot of knowledgeable people here that can talk you through safely changing to low carb. A switch in diet can dramatically lower BG numbers.

As to home testing, my vet told me to get a meter and home test at the first vet visit. I was a little apprehensive at first because we had just adopted Morris from animal control and he wasn't always agreeable about things. Now he purrs while I test him. There is nothing stressful about it. I think why some vets might possibly say not to test is they probably get clients freaking out over numbers, calling the vet in a panic over a single high number, and changing insulin willy nilly. The forum here has very experienced knowledgeable people that can guide you every step of the way. I have never consulted my vet about dosing as I have great gurus of my type of insulin here on the forum that have guided Morris and I well. I have a super vet that knows I will go educate myself on an issue. Recently when I had Morris in to check his ears he asked me what numbers I was getting. I was able to speak intelligently on preshots and nadirs thanks to this forum. My vet's response "you're doing great".
 
My vet initially never suggested home testing, but one day she mentioned in passing if I wanted to do a curve at home. After the curve, I had to take him in to get her response and I asked about continuing and she said you don't need to but if you would prefer then that's no problem. That was before I found this site and trusted the vets implicitly. But even I realised the importance of home testing once I started and said I wanted to continue. It was only once it slowly dawned on me that they were using me as a cash cow for supplies, check ups and fructosamine tests that I started doing my own research and found this site. I then only bought them to the vets for insulin (a requirement in the UK Cascade system) but now they are on the same insulin and I get my supplies abroad, they will only go if they are unwell with something other than diabetes. I have never asked their advice on a high number or a low number, I always come here for advice.
 
Caitlin M said:
Hi again!

Hope everyone had a good weekend. I received my call from the vet about Pita's blood work and she said that it is indeed Diabetes but everything else looks fine- so yay! I am bringing him in on Wednesday and we are starting PZI injections twice a day. She said after 10-14 days I would bring him back and she would then do a Glucose Curve at the office. I have read that G.C. can be affected by stress to the vet and he is a VERY bad traveler. Should I ask/insist on doing it at home or just hope for the best?
The thing I am SO confused about, is the Glucometer and at home testing. I asked about it and said said he did NOT NEED to be tested at home and she thinks it puts a lot of stress on the parent and cat. Ok. From everything I have read on this website as well as dozens of others, this is the first time I had heard of a vet saying NOT to do at home blood testing. Any thoughts or advice would be greatly appreciated so when I go in on Wednesday I can really discuss this. Thank you all.
Click to expand...
My DVM said check only once a day regardless. WHAT??? I ended up staying up many nights performing hourly BG due to severe BG drops. I reminded DVM of the severity of Ketoacidosis and mainly severe hypoglycemia prognosis in some human diabetics. I am not proud of my thinking but do believe that for some DVM'S, cats are not a big priority since they may be more interested in dog owners who will sell their house to pay for care in this area of the country. My dogs' bill was $17 K ... but he ordered NPH for my cat because it was cheaper than LANTUS...but I got the LANTUS. I do not mean to sound unappreciative of my DVM. He has performed rare excellent surgeries on my dogs that in the past needed to be cared for at Auburn or Cornell for their surgeries. Follow the advice of FDMB..They got Elliott into remission by exhausting me by making me do what I was suppose to do..I no longer contacted the DVM for cat advice after finding the FDMB "cat" people!!!!
 
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Chris & China said:
I've never used anything but the Confirm or Micro....and China hasn't been back to see a vet for her diabetes since she was first diagnosed almost 4 years ago

The people here have more real life experience than any vet ever will....we live and breathe this disease.

From day 1, I trusted the people here who'd been through it all before...especially since I was getting such bad advice from my vet....Now IF you can get your vet to work with you, that's great and highly recommended, but it's not absolutely necessary either

The people here know what the human numbers mean and how to interpret them and our protocols were written with human meter numbers in mind.

The only reason you'd really need to get an AlphaTrak is if you absolutely want to stay with your current vet, take their advice on dosage and they refuse to take the results from a human meter...but first I'd try to convince them that human meters work fine.....it's not the exact number that's the most important...it's knowing when your cat is safe and when it's not....and knowing if the trend in the numbers is going down or not
Click to expand...
Chris and China know it ALLLLL!!!!! Thank God for all of you!!!!
 
Hi All!
So I bought the ReliOn Confirm, a pack of 100 strips,100 lancets (alternate site) at 26g to start out with and the ointment with pain relief. I also got a notebook! My vet uses the Alpha Trak 2, so my plan is to bring mine in tomorrow and ask her to show me how to use mine and possibly test with both to see any difference in reading?
I was speaking about this whole forum yesterday and realized quite quickly that everyone here is amazing. I already appreciate and trust you all greatly. I'm apprehensive about my appointment tomorrow but feel ready to discuss leaving if she will not comply with my wishes. I have a few questions written down but want to know if anyone has suggestions for questions I should ask the vet? Also, as far as food, I went out and bought 3, 24 packs of Fancy Feast Classic. I have 2 boys and am planning to do 1 1/2 cans am & pm (3 cans a day). His brother is bigger than Pita anyway, but could probably lose a little weight to begin with (don't tell him) :)
I would love to know how many times I need to test his blood a day and what exactly should I be recording?
Also, how does she know what amount of PZI to start him off with? Is it based on the blood test from last week? I'm nervous about the dosage being wrong and having something happen before I do the BC 10-14 days after.
::Big sigh:: Ok, I will leave it at that for now and be back tomorrow to post how everything went and get down to the nitty gritty of officially starting everything! Happy Valentine's Day! Hope you all snuggle and smush your kitties with kisses <3
 
You can't really compare readings from the Alpha trak and Relion (or any human) meter. There is no scale of comparison. Your human meter will always read lower than an Alphatrak. The important thing to know with either meter is what different ranges mean in terms of regulation, and what number indicates kitty is dropping too low (hypoglycemia). Our protocols here were designed with a human meter in mind. If kitty tests at 50 or under on a human meter it's time to take quick action to bring blood glucose back up. On an Alphatrak that number is 68. Those are really the only two numbers you can "equate" between meters.

Your vet may be less than thrilled for you to use a human meter because he/she can't interpret the numbers. My vet, who Squallie never sees for his diabetes but who I trust implicitly, has never been able to wrap his head around the human meter numbers (he has a link to Squall's spreadsheet in case I need to discuss it for some reason - also makes the vet feel like he's doing something helpful, lol) as to him, they look dangerously low when using the Alphatrak scale as a reference. They are not too low using a human meter scale, and he has learned to trust my knowledge of what I am doing. My point is that you can quite safely use a human meter, as long as you know and understand the ranges of numbers and, most importantly, what is "TOO LOW", even if your vet tries to tell you that you can't.

You should test before his pre-shot meal both morning and evening, and any other tests you can get in at random points during the day are also a big help, especially when he is new to insulin. You will need to try and find out what his nadir is (the lowest point of his cycle) so you can see how the current dose is working for him and to make sure he isn't dropping too low. Always pick up food at least two hours before you test, so you don't get food-influenced test readings. We suggest a test-feed-shoot routine, and we record our results in a spreadsheet. Here are directions for how to use it. It will fast become your best help in successfully treating your kitty!

I don't use PZI so I can't say for sure but most insulin dosing starts at 0.5U - 1U every 12 hours, and can be adjusted up or down from there. Here is a link to the PZI forum where you van probably find answers to many of your questions. Anything you can't find an answer for, just sing out and someone will lend you a hand!

Good luck with the vet tomorrow, please let us know how it goes! :):):)
 
1. As many members know because they put up with me 24/7, my poor Elliott often got THREE BG tests especially when I was worried..which was always. What I found was 20-30 points difference between Relion with Relion strip and Alpha Trak with AlphaTRAK strip. However, I got a 3- 8 point difference when using freestyle strips on AlphaTRAK meter. As far as frequency of BG testing frequency, I think I wrote somewhere, I was exhausted on many sleepless nights doing BG every hour and sometimes FDMB members made me do it every 30 minutes...and look at the outcome..REMISSION. And so, since Elliott is in remission I only check him once a month unless I see a lot of urine or he looks thinner than his brother. When I do check now, I use Relion/Relion and AlphaTRAK/AT or Freestyle strip just for my own peace of mine. I think normal FDMB cat people have done this long enough to know they don't have to second guess themselves as I still do. If this was a new DVM that you were seeing for the first time, I would ask very assertively, "Are you up on cat diabetes, since many of your colleagues are not or just don't care enough?" However, I have already expressed this to my DVM who I trust with my dogs 100%..but Based on his instructions with the cat, the NPH, and the little need for wanting so few BG results and as a HCP! I had no choice since I was so shocked. I am not familiar with PZI..will look it up...thought that was the animal source one??? I feed FF low carb to TWO cats and once in awhile ...Friskies low carb.. 6-8 cans or 3-4 cans respectively because if ideal weight is 15 lbs, the charts say feed 300 calories per cat.
Squalliesmom said:
You can't really compare readings from the Alpha trak and Relion (or any human) meter. There is no scale of comparison. Your human meter will always read lower than an Alphatrak. The important thing to know with either meter is what different ranges mean in terms of regulation, and what number indicates kitty is dropping too low (hypoglycemia). Our protocols here were designed with a human meter in mind. If kitty tests at 50 or under on a human meter it's time to take quick action to bring blood glucose back up. On an Alphatrak that number is 68. Those are really the only two numbers you can "equate" between meters.

Your vet may be less than thrilled for you to use a human meter because he/she can't interpret the numbers. My vet, who Squallie never sees for his diabetes but who I trust implicitly, has never been able to wrap his head around the human meter numbers (he has a link to Squall's spreadsheet in case I need to discuss it for some reason - also makes the vet feel like he's doing something helpful, lol) as to him, they look dangerously low when using the Alphatrak scale as a reference. They are not too low using a human meter scale, and he has learned to trust my knowledge of what I am doing. My point is that you can quite safely use a human meter, as long as you know and understand the ranges of numbers and, most importantly, what is "TOO LOW", even if your vet tries to tell you that you can't.

You should test before his pre-shot meal both morning and evening, and any other tests you can get in at random points during the day are also a big help, especially when he is new to insulin. You will need to try and find out what his nadir is (the lowest point of his cycle) so you can see how the current dose is working for him and to make sure he isn't dropping too low. Always pick up food at least two hours before you test, so you don't get food-influenced test readings. We suggest a test-feed-shoot routine, and we record our results in a spreadsheet. Here are directions for how to use it. It will fast become your best help in successfully treating your kitty!

I don't use PZI so I can't say for sure but most insulin dosing starts at 0.5U - 1U every 12 hours, and can be adjusted up or down from there. Here is a link to the PZI forum where you van probably find answers to many of your questions. Anything you can't find an answer for, just sing out and someone will lend you a hand!

Good luck with the vet tomorrow, please let us know how it goes! :):):)
Click to expand...
At least your DVM cares enough to consult your spreadsheet..I like him/her!!
 
Caitlin M said:
what exactly should I be recording?
Click to expand...

We have a spreadsheet we use here that is a very valuable tool in your "diabetes toolbox"....we will want to see it before giving much in the way of dosing advice....You'll see under most of our comments that we all have a link to our spreadsheets!

Here are the instructions on getting the FDMB spreadsheet....You'll need an email addy that's associated with a Google account, but that's it....the spreadsheet does most of the work!!

If you have any problems setting it up, I'd be happy to help...Just click on my name and choose "Start Conversation" to send me a private message
 
1. As many members know because they put up with me 24/7, my poor Elliott often got THREE BG tests especially when I was worried..which was always. What I found was 20-30 points difference between Relion with Relion strip and Alpha Trak with AlphaTRAK strip. However, I got a 3- 8 point difference when using freestyle strips on AlphaTRAK meter. As far as frequency of BG testing frequency, I think I wrote somewhere, I was exhausted on many sleepless nights doing BG every hour and sometimes FDMB members made me do it every 30 minutes...and look at the outcome..REMISSION. And so, since Elliott is in remission I only check him once a month unless I see a lot of urine or he looks thinner than his brother. When I do check now, I use Relion/Relion and AlphaTRAK/AT or Freestyle strip just for my own peace of mine. I think normal FDMB cat people have done this long enough to know they don't have to second guess themselves as I still do. If this was a new DVM that you were seeing for the first time, I would ask very assertively, "Are you up on cat diabetes, since many of your colleagues are not or just don't care enough?" However, I have already expressed this to my DVM who I trust with my dogs 100%..but Based on his instructions with the cat, the NPH, and the little need for wanting so few BG results and as a HCP! I had no choice since I was so shocked. I am not familiar with PZI..will look it up...thought that was the animal source one??? I feed FF low carb to TWO cats and once in awhile ...Friskies low carb.. 6-8 cans or 3-4 cans respectively because if ideal weight is 15 lbs, the charts say feed 300 calories per cat.
Squalliesmom said:
You can't really compare readings from the Alpha trak and Relion (or any human) meter. There is no scale of comparison. Your human meter will always read lower than an Alphatrak. The important thing to know with either meter is what different ranges mean in terms of regulation, and what number indicates kitty is dropping too low (hypoglycemia). Our protocols here were designed with a human meter in mind. If kitty tests at 50 or under on a human meter it's time to take quick action to bring blood glucose back up. On an Alphatrak that number is 68. Those are really the only two numbers you can "equate" between meters.

Your vet may be less than thrilled for you to use a human meter because he/she can't interpret the numbers. My vet, who Squallie never sees for his diabetes but who I trust implicitly, has never been able to wrap his head around the human meter numbers (he has a link to Squall's spreadsheet in case I need to discuss it for some reason - also makes the vet feel like he's doing something helpful, lol) as to him, they look dangerously low when using the Alphatrak scale as a reference. They are not too low using a human meter scale, and he has learned to trust my knowledge of what I am doing. My point is that you can quite safely use a human meter, as long as you know and understand the ranges of numbers and, most importantly, what is "TOO LOW", even if your vet tries to tell you that you can't.

You should test before his pre-shot meal both morning and evening, and any other tests you can get in at random points during the day are also a big help, especially when he is new to insulin. You will need to try and find out what his nadir is (the lowest point of his cycle) so you can see how the current dose is working for him and to make sure he isn't dropping too low. Always pick up food at least two hours before you test, so you don't get food-influenced test readings. We suggest a test-feed-shoot routine, and we record our results in a spreadsheet. Here are directions for how to use it. It will fast become your best help in successfully treating your kitty!

I don't use PZI so I can't say for sure but most insulin dosing starts at 0.5U - 1U every 12 hours, and can be adjusted up or down from there. Here is a link to the PZI forum where you van probably find answers to many of your questions. Anything you can't find an answer for, just sing out and someone will lend you a hand!

Good luck with the vet tomorrow, please let us know how it goes! :):):)
Click to expand...
At least your DVM cares enough to consult your spreadsheet..I like him/her!!
Chris & China said:
We have a spreadsheet we use here that is a very valuable tool in your "diabetes toolbox"....we will want to see it before giving much in the way of dosing advice....You'll see under most of our comments that we all have a link to our spreadsheets!

Here are the instructions on getting the FDMB spreadsheet....You'll need an email addy that's associated with a Google account, but that's it....the spreadsheet does most of the work!!

If you have any problems setting it up, I'd be happy to help...Just click on my name and choose "Start Conversation" to send me a private message
Click to expand...
Chris and China.., You set up my spreadsheet even though I really TRIED..!!!! Thanks again!!!!
 
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