Possible misdiagnosis?

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sylvie1313

Member Since 2011
Hi,
I have been reading on this site and others for about a week now and I am still at a loss for what to do. I dropped my cat off at Petsmart 7am for a dental last week and got a call mid-afternoon that he was diabetic. During his pre-screen, his blood glucose was 300. The vet insisted upon immediately getting him in for a glucose curve and starting insulin. My head was spinning and I wanted some time to do some research. I just felt that one reading wasn't enough for such a huge diagnosis. I was thinking things like maybe that catnip he ate this morning caused it, or maybe he ate a weird bug. I bought the Precision Xtra meter, some urine strips, and started changing his diet first to Fancy Feast, and since the meat grinder just arrived, he'll be on a raw food diet. Even if he's not sick, it's just better for him. The meter read at 62 and 68 at different times. Those were the only two readings I got before I ran out of the 10 strips. I wasted 2 on myself because I'd rather learn how to use it on myself before terrorizing my poor cat. Getting enough blood was more of a problem than I though too. I called the vet and was COMPLETELY dismissed because I'd used a human meter and "we had this discussion". He had told me NOT to use a human meter, but after reading on here and other sites, I did and still do feel he is wrong. He's been fed that nonsense from Abbott about the meters being statistically different. By the way, I'm a medical researcher and that study was bogus. Why didn't they test against their own Freestyle or Precision? Hmmmm? Maybe because then they couldn't justify selling the Alpha Trak at 4 times the price? Anyway, my vet will not accept my home readings. AND he's too busy to see me again before I go on vacation. I'm leaving my cat with a friend and I need to know if the cat needs insulin! I went into another Petsmart today for an appointment for a glucose test and they knew I wanted it as quick as possible to minimize the stress effect. It was 150. I'm thinking it's stress from the visits that causes it to spike. The vet didn't agree and still thinks it's probably diabetes. She also said the human meter was not accurate or "why would they have made a pet meter?". Great logic. I reminded her that a lot of vets have always used a human meter and still do and she had to agree. Still, this is my baby and I can't be wrong. The test strips are taking forever to get here, they were due in the mail today, but maybe tomorrow, so I can get more readings. Does anyone have any feedback for me? If I get 20 readings in the normal range at home, can I be confident that my cat is not diabetic, or is the vet right and the home testing is pointless? I turn it over now to all of you feline diabetes experts. I have already learned a lot from you and hope you can help me further.
 
You're apparently smarter than the average pet owner so this vet doesn't know how to deal with you!

From the readings you got at home, most likely your cat is not diabetic, but perhaps could be pre-diabetic, so that eating high carb and/or dry food could push him over the edge, so to speak and the vet stress also makes it go higher than usual. I have personally seen a 200 pt difference from the vet reading to my at home reading 2 hours later, so I think there's a lot to be said for vet stress and anyone who dismisses stress just has not tested the BG of enough stressed cats!

I don't know your circumstance and this is just my opinion, but can you find a vet that is in private practice rather than affiliated with a major retail chain? That in itself makes me wonder if there isn't a major profit motive behind some care decisions. There can be in private practice too, but when the stuff is right there in the store, well, you get the idea.

My advice is to make sure the person caring for your cat while you're away feeds ONLY low carb canned food and if you can, teach them how to test maybe once a day after a meal. Some cats BGs can be reduced to normal by diet alone and 62 and 68 are perfectly normal numbers, even 150 under mild stress is OK. Giving the cat insulin could be a disaster waiting to happen. Home testing is absolutely NOT worthless - it has saved the lives of many cats and probably yours as well.

And no, a diagnosis of diabetes should not be done on one blood test! A urinalysis for sugar in the urine or a fructosamine test to show average levels over an extended period of time would have been more revealing and more accurate.
 
what Vicky said.

I don't like the sound of this vet, sounds a lot like my former vet, who actually forbade me from home testing and then said if I had to I was only allowed to use the alpha trak.

I found this board, talked with several people, even called Abbott to talk about the alpha trak and freestyle meters and wanted to know how one was more appropriate than the other. The doctor I spoke with, could only tell me about the difference between human, dog and cat blood and how their meter knows the difference between dog and cat. He sited studies they did on animals, but could not answer why I should use one meter over the other. When I asked about cost - all he could say was that the animal meter and strips were more expensive because they were not as mass produced as the human meter and strips. Of course, that still never answered the question if one was better than the other.

So, I used my human meters and never looked back. There is only one human meter that I would NEVER recommend and that's the true test (generic label for pharmacies). Aside from that using a human meter works just fine for the cat.

Since you will be traveling, keep the cat on a low carb wet diet, see if your friend will test daily and that will tell you whether or not you will need to start insulin, when you get back. And of course, if you do, we are here to help.

If you tell us where you are located, we may be able to give you a vet recommendation AND have members nearby who can provide in-person assistance.
 
I second what the other two ladies have said.

My vet and I have compared the "pet only' and my meter side by side on numerous ocassions and they have always been within just a few points of each other. He also doesn't not rush to treat diabetes in a cat unless the reading is 300+ at the office. What he normally advise, is that his clients get a human meter, or they will send home a human meter with them and ask them to test their for a week, then call him with those numbers. If they are having trouble getting blood to test he calls me, and I set up a time with the client to go to their home and I help them learn. He fully acknowledges that vet stress can elevate a cat's BGs into the 200s without them truly being diabetic.

Now he wasn't always this good at treating FD cats, but he is open minded and knows he doesn't know everything about everything and was willing to learn from me. And as he has told me on several ocassions he can't argue with success. He's seen my Maxwell's bloodwork from when he was first Dxed to today. Since I have been volunteering with them three of the cats that I have taught their owner how to properly care for their diabetic cats have gone into remission. And yesterday while I was in there dropping off copies of the vet records for the FD kitty that I'm about to adopt, the office manager was handling out Binky's list (the food charts we use here) to a young couple with a brand new kitty, and telling them that if they wanted to get their new baby off to a good start in life, feed her only high protein low carb canned food, and asked them if they would like a recipe for making their own raw food for their new baby. Their learning. =) btw the kitty they were talking about was a perfectly healthy little 12 week old seal-point siamese. So some vets are better than others and mine just happens to be one of the good ones,

Mel,Maxwell and The Fur Gang
 
All I can say is Ditto to the other three people. Find a vet (research and make sure the one you choose has experience with diabetes) that isn't affiliated to a large chain (they do share medical records by the way). So your second opinion wasn't a real second opinion since they saw any notes and such from the previous vet. Those notes probably talked about you mentioning doing your own home testing and such. Honestly I don't know why some vets are adverse to home testing it just makes sense. What is in the best interest of the kitty is all that matters. Since you have already started wet food you will see a major change in BG. I also agree that the stress of simply going to the vets will cause the BG to jump (sometimes HUGE amounts). You are doing the right thing by questioning.
 
sylvie1313 said:
He's been fed that nonsense from Abbott about the meters being statistically different. By the way, I'm a medical researcher and that study was bogus.
Click to expand...

This is very interesting, and corresponds to our own 'research' here.

Any proof of that ? That's it was an invalid study ?

We would be very interested in any data on the validity/invalidity of that study.

We get newbies here all the time whose vets are pushing the Alpha Trak, and talking them
out of it is difficult.
 
I've heard that the vet hospial PetSmart has in many of its stores (Banfield) isn't the greatest. Vet seem to be not very knowledgable, seem to be pushy, services are limited. Is there another vet hospital, preferabley an inependant non-chain associated one, in your area that you can take your cat to? What general area do you live in? There may be a member here who can recommend a good vet.

A singe bood glucose reading is useless. All it tells is what the level is right at that momen. Vet stress can skyrocket blood glucose levels in many cats. It is not an accurate way of determining if a cat is diabetic or not. Clinical signs of diabetes plus a fructosamine test is how a diagnosis is made. If you are getting normal blood glucose leevls at home (generally between 60 to 150) and your cat is not showing any sisng of diabetes (flooding the litter box with sticky sugary smelling pee, always hungry and eating all the time but losing weight, camped out by the water bowl drinking like a fish , etc), then it's very unlikely that your cat is diabetic. A diet change to low carb canned or even raw food can help reduce the chances of diabetes.

I suggest cancelling the upcoming appointment. Look for a new vet in the meantime and after your vacation, take your cat to the new vet. Bring all your cat's medical records with you. My two cents :smile:
 
The readings you have been getting are consistant with what a non-diabetic cat would have. There are several reasons why the vet could have got a 300 on their reading. First is vet stress. Cats are normally stressed when going to the vet and it could easily raise a cat's BG levels 100 - 200 points. The second is if you cat was getting a dental and the cat had any pain or infection, that also would raise the BG levels. Unless your vet ran a fructosomine test which gives an average over several 2-3 weeks, I would not trust the vets reading from a simple glucose test.

My suggestions: 1) As long as your tests are consistantly below 100, no insulin. 2) If you start getting consistant results over 150, find a new vet that knows something about feline diabetes and have them confirm the diagnosis with a fructosomine test. Then depending on the results you may need to start giving insulin. For newbies, we recommend that you do not give insulin unless the BG level is over 200.

With your changes in diet, you have greatly reduced the chances of your cat developing diabetes. Great job about being proactive and learning to hometest. :RAHCAT
 
as far as the meters - rest assured that any human meter is fine to test your cat. I have an expensive "cat" meter and a human Reli-On meter and sometimes I test one after the next and they are within 10 to 20 points of each other. Just fine!
 
I agree with Abbott. There are differences between human, feline and canine blood that effect BG measurements. However, The accuracy of human meters is way good enough for our needs. The accuracy of meters is no better than +/-20%.

Karen & Smokey(GA) said:
sylvie1313 said:
He's been fed that nonsense from Abbott about the meters being statistically different. By the way, I'm a medical researcher and that study was bogus.
Click to expand...

This is very interesting, and corresponds to our own 'research' here.

Any proof of that ? That's it was an invalid study ?

We would be very interested in any data on the validity/invalidity of that study.

We get newbies here all the time whose vets are pushing the Alpha Trak, and talking them
out of it is difficult.
Click to expand...
 
Larry and Kitties said:
I agree with Abbott. There are differences between human, feline and canine blood that effect BG measurements. However, The accuracy of human meters is way good enough for our needs. The accuracy of meters is no better than +/-20%.
Click to expand...


Did you really mean to say you agree with Abbott ? Your statement above seems contradictory.
 
I agree that Abbot that the differences in blood between humans, felines and canines result is statistically different measured BG values when using a human meter. However the differences, although statistically different, still result in the human meters being fine for our uses.

Karen & Smokey(GA) said:
Larry and Kitties said:
I agree with Abbott. There are differences between human, feline and canine blood that effect BG measurements. However, The accuracy of human meters is way good enough for our needs. The accuracy of meters is no better than +/-20%.
Click to expand...


Did you really mean to say you agree with Abbott ? Your statement above seems contradictory.
Click to expand...
 
Thanks everyone. I got my test strips in the mail today and measured again. It was 73. I took my cat immediately back to the vet for another reading. I measured at the office too and got 132 and the vet got 142. Close enough for me and it PROVES that his levels go up due to stress. They still wouldn't say that he wasn't diabetic and wouldn't acknowledge my meter. I gave them a print out from the article on home testing from this site with the results of the study. By the way, aren't one of you the creators of that study? I had tried to PM you earlier for those results as I wanted to see them and show them to my vet. The Abbott study wasn't invalid, I do believe they got those numbers, but first of all it wasn't an independent study. They had everything to gain from the results saying what they wanted them to say. They only tested 2 meters, and not even their own prized meters, one of which I am using. I would wager that they tested every meter on the market and published the data for the two with the greatest statistical differences. They aren't "lying", but are they really being truthful? That is why studies have to be independent. They can present the data to say what they want it to say. They didn't even try to say why they chose those two meters, but I think I have just guessed the real reason. I have contacted them about their study and I wonder if they will reply. I am almost tempted to get an Alpha Trak and conduct my own study, but I do not want to put my poor kitty through that.
I ordered a fructosamine test today and once I get the results of that, if they are fine, I am going to start some major complaints against Banfield. WHY didn't the first vet offer fructosamine? Why was he so quick to treat with insulin? Yes, he would have done a glucose curve, but my cat's levels would have been elevated due to stress and I'm positive that the first insulin dose at home would have resulted in a hypo and possibly death. It would have probably been blamed on me.
Well, I'm off to the store to get some whole chickens to make my own catfood! Even though I'm pretty sure my cat isn't diabetic, he could be pre-diabetic, and even if not, this raw food diet sounds like the best plan for both of my aging cats. My meat grinder arrived yesterday and this life-long vegetarian is about to grind up some birds. I must love those cats!
Thanks again, you guys are the greatest for your support in this very confusing time. I should be able to trust my vet, but obviously not. This is not the first time. Last September my older cat had high liver enzymes which turned into kidney failure, which turned into stage 4 cancer. $1000 later I walked out and my cat was better 24 hours after their "medicine" got out of her system. She was perfect at her checkup last week. I thought it was just a bad vet and changed locations, but I was wrong. All of these "diagnoses" are happening at routine visits! No symptoms, just one level off on the bloodwork! I think it's malpractice and I'm going to start complaining.
 
72 is a nice normal number

Bad teeth can make blood sugar high
dry food too

So - it is great that you are testing blood sugar at home. We recommend for newly diagnosed kitties - not injecting insulin if BG is below 200.

So - your kitty may be diet controlled in short order and not need any insulin.

Stick to your guns -- you're right
 
you may also find this discussion on alpha trak helpful: it's from the old board, but the info is still pertinent: http://www.felinediabetes.com/phorum5/r ... ?8,1840808


also this is a good guide regarding BG levels and what is considered normal and diabetic:

http://petdiabetes.wikia.com/wiki/Blood ... guidelines

the numbers you got I would consider normal range, even the numbers at the vet - again elevated due to stress and personally, I'd discount any BG tests (except fructosamine) taken at the vet. As the fructosamine is looking at the average BG over a 2-4 week period and vet stress doesn't really come into play with this test.

Personally, I think the alpha meter could be useful - only if they sold the strips everywhere and at reasonable prices. The fact that there is a premium on this meter and you can only get the strips from a vet is ridiculous. It only serves to line the vet pockets and what happens when you run out of strips and the vet office is closed? Or worse yet, they are out of stock, then what do you do. Yes, this has happened to people who have that meter and off to the drugstore they go to pick up a human meter. which takes a smaller amount of blood and overall costs less to maintain.

I'm thrilled to hear that your may not be diabetic and your instincts are right on target with the diet change. That alone will do wonders to prevent diabetes and it's a great diet for all your cats. Have fun grinding.

One grinding tip - to protect the grinder - chop up the bones and skin before putting through the grinder, I find by chopping them up and making them smaller the grinder doesn't have to work as hard and therefore protects the investment. I did invest in a good small butcher knife and it's a great way to get out frustrations, yes it's labor intensive, but worth it in the end.

Oh second tip - don't put any of the grinder in the dishwasher! I made that mistake and it's supposed to be hand washed.

Third tip - make more than one batch at a time and freeze it all, I use ziplocs to store it in, I can get it to lay flat and easy to thaw out. Then just toss the baggie when done, no washing or anything needed.

Good luck and keep us posted on his BG levels. Also curious what the fructosamine says. Make sure to get a copy of his records and test results from the vet office.

and Yes, Stefanie and Toonces is still an active member here. so you can always pm her and talk about your experience.
 
What kind of grinder would you all recommend? I was thinking about purchasing one. tyty in advance
Mom to Sugar Bean (OTJ), Civvie Slappy girl and crf/hd Gumpy girl
 
Noxin was around 300+ on his first vet visit. When I asked for a copy of all his lab and paper work I noticed a note from the lab next to his Blood Glucose reading noting that the number could be induced by vet stress, but that since he had a history of poly urea/dispia, diabetes should be <i>considered</i>. And then they did further testing.

I would be very suspicious of your cat's diagnosis, and if after further testing he turns out to be non diabetic, I would most definitely lodge a big complaint. Telling you to give insulin to a creature that doesn't need it is a death sentence.
 
That vet scares me. A cat going in for a dental (an infection situation that is known to sometimes elevate BGs) shows a 300 (which isn't monstrously high) and he's throwing insulin at the cat before even watching to see if the BGs come down after the dental, no attempt to change diet or anything else, or even looking for other diabetic signs it appears (any excessive drinking, eating, peeing, innaproppriate going outside the LB, greasy coat, lethargy?). I'd actually go look to see if there are already commplaints against him. With that kind of treatment, I wonder how many pets he's already killed.

Then he treats you with such hostility!?!? That alone would have gotten him an earful and a view of my backside for the last time. Pet meters are calebrated for pets so they do read a little different (pet blood composition is slightly different than humans). But since ALL meters have and error rate of +/-20% like Larry said, the difference isn't going to matter, the readings will be close enough.

My vet didn't recommend, didn't encourage, but didn't discourage home testing - pretty much didn't really talk about it. When I said I had started, she said to bring the meter in, we tested side by side and that was the last time they tested unless they are doing other bloodwork, then they run BGs anyway. My meter read 54, theirs read 61. I'd just drop a copy of the spreadsheet off at the beginning of the week and she'd call me to talk about dose adjustments.
 
Hello, I just wanted to say that I am so glad I came across this site and post. The beginning of the original post is almost a carbon copy as to what happened to my cat Evey. She was dropped off at the Petsmart Banfield in the morning for an annual teeth cleaning. My wife picked her up on her way home from work. She entered the door carrying a bag of perscription Royal Canin cat food. She said the vet said that her blood glucos level measured around 220 mg/dl so she had diabetes. Although, Evey is a little overweight, she is young (5yrs) and we had been feeding her premium (or what we thought was premium) food all her life, and keeping the portion levels as close as possible to the bag recommendations. I immediately came across this post upon educating myself. The vet perscibed her the glipzide pill for the next two weeks, and wanted her back in 2 weeks so that she could test and identify how much insulin Evey would need. I quickly ordered the Alpha Trak because I didn't want to run into the issues noted in the previous posts. The initial levels while on the pill measured below 50 mg/dl, so I quit giving her the glipzide pill. After that and untill the vet appointment the levels stayed between 70 and 90. I called the vet to discuss the levels, until now I had not talked to her. I wasn't in anyway being standoffish to her, but when intruding myself I said that I understood that Evey "may have diabetes" and the vet immediatly cut in to say she in fact did have diabetes. I mentioned my readings and verified that they also use the Alpha Trak. She said that the pill must be working and that we must have caught it in an early stage. She said to continue with the pill and just call in the numbers in stead of coming to the appointment. I forgot to mention that I quit giving her the pill but did give her my spread sheet. I only gave her the pill for 4.5 days and quit because I didn't want her to go into a diabetic coma or become diabetic. Glipezide forces the pancreas to produce more insulin than normal. Whick is another issue, the vet said taking Glipizide wouldn't cause any detrimental effects, but that is not what I read on the medical sites. Its been months now and I was checking her levels once a week. I recently quit checking because they are alway mid 70s (no matter when I check). So I fully believe that cats can be misdiagnosed for diabetes. I worry what might have happened if I had dropped her off that day and let the vet monitor her...
 
Troy - diagnosing diabetes based on only one test taken at the vet office is a bit silly. Unless the test is a fructosamine test, one test alone cannot diagnose diabetes - vet stress has a lot to do with BG levels going up, you also mentioned the cat was getting a dental - so if there was a problem with the teeth, that too can cause the bg to go up.

Regular testing at home, will definitely tell you whether you have a diabetic cat or not. Plus if you see the symptoms - peeing a lot, drinking alot, eating a lot, etc.
 
I agree with everyone's advice and especially Dr. Pierson's website and recipe. My 3 civies look and feel incredible! It's cheaper for me too! I buy flats of thighs when they are on sale, then immediately bag and freeze what I don't use. I heat my oven to 550 degrees to deal with surface bacteria, which gives me more raw in return. I defrost about 2 days worth of food at a time, and my card have gotten to where they prefer it cold! Oh well, easier on me and they're healthier.

I like making my own mind up as well, good on ya! Find a vet that agrees. ;-)

Ohbell, I use the Tasin TS-108 from One Stop Jerky Shop. It does everything I need! I got the sanitizer spray and silicone spray as well. I like them and will reorder them when needed.
 
Troy that is really scary and I hope you file a complaint through the link provided earlier in the thread. A single BG test of 220 at a vet's office is not something to diagnose diabetes on and I think most any reputable vet would say so. Those people are killing cats. Thank heavens you are an observant pet parent, but many out there don't know any better and would have continue to give glip.
 
Wow, that vet is totally incompetent and could have killed your cat by giving insulin. You should definitely lodge a complaint both to the veterinary board and also to the managers at Banfield/Pet Store location and their HQ's. And don't forget to give them a crappy rating on Google reviews etc :-D

GoGo always tests high at the vet but they know stress will increase glucose levels and their general approach is just to check there are no symptoms and tell you to come back if you see increased thirst/peeing. If the values are super high they recommend a fructosamine to confirm. At GoGo's annual physical it was ~260 and I tested her at home to make sure she was ok and she was 60 the next day.
 
Adding my voice to the rest, I agree that starting a cat on insulin based on one reading and then bullying people into not hometesting is a recipe for a dead pet. SHAME on these vets. I personally wouldn't go to Banfield anyway based on what I admit is rather flimsy reasoning (I just think it's sketchy that it's in PetSmart and they make money off you coming and going depending on what the cat is diagnosed with) but now I will definitely steer clear.
 
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