Please help me! my vet won't prescribe insulin, etc.

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Sara and Buttercup

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this is part of thread from right below. i wanted to post my most recent post separatly so people would see it.

i just got back from another incredibly frustrating appt at the vet's office. i showed him the numbers that we climbing into the lower 200 to mid 200 and that she has sugar in her pee and he said do nothing, no insulin, no lowering the dose of the steroid. just leave it there. i asked about the potential for damage to the pancreas and he said there wasn't any. i wasn't even able to get a prescriptoin for glargine.

so i have no insulin and a cat consistently over the renal threshold. we were talking about glargine a little bit and he said that "it's a 24 hour insulin" even though he knew i gave it to her with success as a twice a day against his advice. i brought in my old speadsheet from this site to show him that i had started giving it to her and was giving it to her in the mid to upper 100's and he wouldn't even look at it or glance at it. he is obviously threatened by my and COMPLETELY CLOSED MINED.

could you guys please guide me in what to do????

i will post her numbers here every day and IF THERE IS SOMEONE OUT THERE THAT HAS OR HAS HAD A CAT ON STERIODS AND INSULIN AT THE SAME TIME, COULD YOU PLEASE POST OR WRITE TO ME.... IT LOOKS LIKE I AM GOING TO HAVE TO GO AROUND MY EFFEN VET again AND RELY ON THE INTERNET for medical advice.
THANK YOU ALL VERY MUCH.
and how am i even going to get a prescription for glargine if he won't give it to me?
 
Sara

You need to calm down. If this vet will not treat the diabetes, do you have any others nearby? I know you don't have many options but you need the option to give insulin. And you need to trust yourself. Treating steroid induced diabetes isn't all that much different except that you know it might be transient so testing is especially important as is giving a very low dose.

Jen
 
Hi - where are you located?

we may have members in your area that would share insulin.

I use Levemir for Tiggy, and a 5-pack lasts over a year.

My vet was "old school" and only prescribed Humulin N when Norton was diagnosed back in 2006.

Finally, I was able to get her to write a prescription for PZI in 2008, but she refused to consider the newer human insulins.

Enter a new client transferred in -- already using Lantus with great results. My vet finally did the research and realized it was very effective.

When I adopted Tiggy in 2009, I was able to order Levemir from Canada with no prescription -- so I did. (laws changed in 2010)

Anyway, when i showed my vet several months of great results on Lev, she wrote me a prescription for Tiggy in 2010.
 
I assume you probably live in a rural area and there aren't too many vets. However, you definately need to get rid of this one. This vet is just ignoring a medical problem when there is objective evidence of it. Even if he or she didn't believe you, they could have simply taken BG or a urine sample. This really borders on malpractice and you might want to consider reporting this one to the board in your state or province. Who knows your cat might not even need isteriods if this #*~^ prescribed it. Please forgive my pseudocursing LOL
:-}
 
you're right, janelle. i live in a rural area and there aren't too many vets here and each one seems worse than the last. this is not the first time this has happened. i basically go there for blood work and basic stuff like that but do a huge amount of my own research on the internet and also consult with outside vets but it still is really hard. i wish i could report him. at the last appointment i went to with her a week before this i asked him what the side effects of budesonide were and he said
"has she collapsed yet?"
almost like a joke. and that's all he said. he didn't know apparently. like that was some kind of joke. i didn't think it was funny at all.
he didn't prescribe the budesonide actually. a specialist did (6 hour drive with my cat to see her). and i think she actually did or does need them to control long term hard to control diarrhea.
 
It sounds like you need to find a new vet! And I agree with filing something against this vet too.

I would suggest calling around to any other vets in your area and speaking to someone before you bring your cat in. Tell them the numbers you're getting from home testing, and that glucose has shown up in the urine. Hopefully you can find a vet that's not too far away who's more knowledgeable and open to insulin use. By calling around first it will help you weed out any bad vets so you won't make wasted trips and spend extra money on appointments that get you nowhere. And even if you have to drive a little far to get to a vet who will give you a prescription, you may be able to just call in when the bottle runs out/expires, give them the numbers you're getting from home testing, and they can call-in a refill to your pharmacy (so you don't have to keep going back).

I'm sorry you're having to deal with this, I can imagine how frustrating this must be!
 
Perhaps a consultation with Dr. Lisa Pierson, our resident nutrition and other things cat expert? I don't know whether she is willing to have conversations with local vets with her recommendations, but she might.
 
Humulin N is available with no prescription -- it might be better than no insulin at all.

I did use N for 18 months with Norton. It works - just not long lasting.

Since your kitty is steroid induced and not running in the 500+ blood sugar -- maybe Humulin N would be enough to get Buttercup out of the 200s
 
There's also the sticky post on converting your vet.
It may be time for this yokel to take some continuing education courses on feline diabetes!

A possible finagle - can you get him to consult with an veterinary teaching hospital? He might believe their instructions.

And if you've got the glucometer that can test for ketones, or the test strips that can pick them up in urine, you might want to start using them. It'll give you a heads up if the cat starts into ketosis.

As an absolute last resort, you could confront him with the liability issue he faces if he fails to treat your cat appropriately, ie, you'll sue his a@@ off if you do not get diabetes treatment for your cat.

And a sideways maneuver - if there is a local paper, you might write some short articles on feline diabetes for them to publish and raise the overall knowledge base of the community. That way, if any of them find the problem with a pet, they'll have a clue and may be able to go to a knowledgeable vet for care.
 
I have heard in some states or in Canada you can get certain insulins without a prescription. However in some states like Florida you need a prescription for all insulin.I have also run into a few human MDs who treat patients and other health care workers like dirt. There is more options to pursue for an MD who is indifferent or incompetent.With vets the regulations seem to be a lot looser.

If you complain to a state licensing board, in most states the board is mandated to at least address the complaint.
 
long shot but would it be possible to call the specialist that prescribed the steroid, tell them that it has sent kitty back into diabetic numbers and see if they would call in a script for lantus?
 
Cindy + Mousie said:
long shot but would it be possible to call the specialist that prescribed the steroid, tell them that it has sent kitty back into diabetic numbers and see if they would call in a script for lantus?
Click to expand...
This is a great idea! That vet should be able to give you a rx (they have seen your cat), especially if you can fax them the numbers. They might insist on have an "official" blood test from your vet, but that should be doable. And using "N" might work, too.

There is a problem with reporting a vet you are going to HAVE to use in the future - if he is uncooperative now, just imagine if you report him! I know it's justified, but there just aren't that many choices in some rural areas. I think it could be a case of "burning your bridges" to report him without a backup in place. He really can't complain if you get the insulin from the specialist.

PS: My vet did not worry about Maggie's numbers until they were over 250 even though she knew that was above the renal threshold. Partly this was because Maggie had a habit of dropping by over 200 on just a tiny amount of Lev and we reasoned that going too low (35) was worse than being at 250.
 
Ugh, that vet would be reported if he was mine. I doubt I'd really have anything real to go with, but F in bed side manner and keeping with the times. You might need to deal with a screaming kitty in the car for a little longer of a trip to a new vet. :/

I have to ask, what is this battle with diarrhea? Manny has had diarrhea/soft stool since I got him in '08 and the previous owners also said they had tried to find something for it. He was on W/D for weight and it has kept him from diarrhea but still looser stool. Since he's at a good weight and newly diagnosed, I'd like to switch him but the diarrhea is back full swing. It's very frustrating and messy since he's long hair. :evil: (this really does warrant the face)
 
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