Preparing for a vet visit

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Mphair84

Mphair84

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So I have a vet appointment for my cat next week. The vet's not happy that I'm home testing and their concerns about me dispensing insulin doses. I tried explaining that I'm starting small and I'm going to do slow increments of insulin. I told them that I'm not going to blindly give insulin without testing anymore. What information should I be prepared to tell them and have ready on hand? They're concerned that I'm not giving enough insulin and I know that I'm not right now but I plan on slowly increasing with small increments. This is all still new to me I just don't know what I should be expecting.
 
This is more common than you think. We all home test, I was taught how and why it was important two cats and years ago. Testing is just that, a test. It's not a supplement or another medication and I would never go near a cat or human with a syringe of insulin without knowing what I'm doing. Would your vet do that to a child?
You asked what to expect. It's a nasty world out there full of people set in their ways but it's your cat and starting slowly at lower doses is the right thing to do. It's not a race.
 
So my cat had been diabetic for a year. He started on 2 units, then the vet wanted to up it to 3, but after speaking to them about concerns that the test was not accurate they changed it to 2 1/2. I'm ashamed, but I've been blindly giving my cat insulin for a year. Nothing has changed, after doing more researching and talking to other diabetic owners, I'm trying to do what's best for my cat. I'm pretty much starting over. Therefore, my dose is now small and I will increase it slowly. Am I wrong? Should I have just kept my cat on the blind dosing?
 
What is the reason that you are taking Tuffy to the vet? Is this just a regular physical checkup, or is this to specifically address the diabetes? You are not the first to encounter resistance from the vet about home testing. I don't understand either, it's a safety protocol that human diabetics use, and directly applies to our pets also. It doesn't hurt anything, and it can help protect your cat from a hypo, or let you know if a hypo is happening so you can take action. You wouldn't try to build a house without the proper tools or plans, same difference. Testing is a valuable tool to help with the treatment plan.
Don't waste time feeling bad about shooting blind, you are not the first and will not be the last. You have now begun to educate yourself and Tuffy is going to be better for it.
You need the vet to prescribe the insulin, and to care for Tuffy if he gets an infection or gets hurt. The one unit you are shooting now may not be enough, post in the Prozinc forum, get more data for the experienced members to look at (more BG testing at different times of the day and night, when possible). You are right in increasing the dosage in small increments, so that you can see the effects when you test, real time and not overshoot the correct dose. Not via an infrequent test at the vet, which costs you more $$, with added vet stress for Tuffy.
Again, rely on advice from the experienced Prozinc users, they will review the testing data as you go forward, they have been doing this a long time and know what they are talking about. You are new to this new treatment plan, even though you have been giving Tuffy insulin for a year but the results of the last year have not been satisfactory. So, follow the lead of the Prozinc members, become more educated and be Tuffy's advocate and effective caretaker.
If you need to, get another vet that will work with you to get Tuffy regulated and healthier. It's tough to buck the system, but you are Tuffy's protector.
 
It's a routine check-up. my problem is I don't have that much information yet. So I'm hoping before I have the vet visit I will be able to get some more numbers. Should I post this comment on the Prozinc page? I'm scared of what the vet is going to tell me.
 
I would post in the Prozinc forum. The experienced members there are going to be able to advise you better than I ever could.
Yes, get more data, you need it anyway, not just for the vet. If this is not Tuffy's yearly exam, he isn't having other problems, and you don't need vet to get a refill of the insulin, perhaps consider cancelling the appointment just for now.

And why should you be scared of what the vet is going to tell you? If you, a significant other, or your child was diagnosed diabetic and the Dr. told you to shoot insulin, but not to test, what would you do? Take the chance that the dose wasn't too much or too small and hope nothing bad happened? Not likely.
You are a full partner in Tuffy's care. You have power, and getting educated about FD is more power.
Granted, the vet has education you don't have (plus the ability to prescribe medication), but perhaps does not have the expertise that members here have (years of it) with patient, thoughtful, paced treatment that is focused on the safety and health of the cat. Most vets are not as educated in feline diabetes as we would like. They have so many animals to learn about, so many diseases and conditions, and very, very few are able to specialize. It's not that they don't care, they just don't know. Perhaps your vet will be willing to learn from you and pass that along to future patients?
 
When I get back I will post something on the other forum.I did recently just do the spreadsheet it took me a little bit to figure it out. But I'm hoping to take more readings within the next couple of days. I recently just did the spreadsheet.
 
The black PMPS is probably a bounce from being in the yellow numbers that Tuffy Kitty may not be used to. Definitely post in the prozinc page for help. I'll tag @Kris & Teasel as she will be able to make suggestions for you.
One thing I would do is test for ketones in the urine while kitty is still high. Buy a bottle of Ketostix from the pharmacy and test a specimen of urine.. read the result on the test strip exactly 15 seconds after dipping it in the urine. Anything above a trace needs vet attention. It is a good safely measure to take until kitty is regulated..
Try not to be intimidated by the vet. You are doing the right thing by your kitty. Stick to your guns or just nod and then continue as you have been. Some vets are not up to speed when it comes to FD.
 
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I suggest an increase to 1.25 u. Your kitty is definitely responding to the ProZinc with a decent drop to nadir. However her whole curve needs to shift down more. Gradual increases of 0.25 u at a time will get you there. I'd ignore that black. It could be a rebound from the 209 or it could be a wonky test strip. We usually suggest doing a second test right away when you get a reading that seems to be far out of line with previous readings.

I hope you can reach some sort of arrangement with your vet. As @Idjit's mom said, Tuffy is your kitty and you have every right to treat his FD in a way you're comfortable with. :)
 
So I definitely with retest next time I get a high reading like that. I will also raise it to 1.25 units. I will get some test strips, but that horrifies. Do I only test them when his numbers are in the black or yellow?
 
Mphair84 said:
So I definitely with retest next time I get a high reading like that. I will also raise it to 1.25 units. I will get some test strips, but that horrifies. Do I only test them when his numbers are in the black or yellow?
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We test routinely. here. Usually it's a minimum of three times a day. It's seems horrible and dauntingf until you start doing it. Then it quickly becomes very routine. Here are some good tips: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
 
How long should I watch the high numbers before I up the does? So on the weekends or days I have off I'm trying to get more numbers. I have more numbers to add to the spreadsheet, but I am having issues figuring out how to add them.
 
Mphair84 said:
How long should I watch the high numbers before I up the does? So on the weekends or days I have off I'm trying to get more numbers. I have more numbers to add to the spreadsheet, but I am having issues figuring out how to add them.
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I answered on your ProZinc thread. It would be better, I think, to ask your dosing questions over there. :)

Generally we recommend holding a dose no more that 4 cycles (4 twelve hour intervals) if the low numbers are above 200. It's best to post for advice at the start until you become more familiar with Tuffy's patterns.

You should be able to click on your SS in "Google Drive" (not in the link in your signature) to get to the version that allows you to add numbers. The link in your signature takes you to the version we can all see here but it's not possible to add anything to that one.
 
I figured it out and added to the spreadsheet. Yes, I was. So 2 days is 4 cycles? I'm learning so much.
 
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