Scared to go against vet's advice

F

Fuzzbunny

Member Since 2018
My cat has been diabetic for only about a month, but we've made great strides. Since I have been reading here, I realized that my vet did start us out wrong on 5 units of Lantus twice a day. I quickly bought a blood glucose meter (freestyle) and we compared it to her Alpha Trak, and mine was only 15 points below, so that was good.

We had brought the dose down to .75 with a nadir at 60 on my meter. So, then she said to go to 0.5 twice a day and retest at noon (I give insulin at 7am and 7pm, and his nadir was at 11am at 60. After 5 days, I tested and his nadir was around 100 on my meter, and it was probably at bit less than 0.5 as it's hard to see on the syringe. So, she then said to drop the morning dose (though in the office the week before she said to drop the evening dose if his numbers were good, but I didn't get to talk with her, just a message). But, because of this board, I started trying to give more like 0.25 which is very hard to see, and his am and pm preshot numbers average around 140 to 150 and his noontime glucose today was 150.

So, my question is, it seems like his blood sugar has gone up a bit since lowering, and should I just try to do her 0.5 once a day and monitor, or keep on with the 0.25, and if the numbers stay the same as they are, does that mean I should go up to 0.5. Of course, I'd like him OTJ, and he gets Instinct Frozen Raw twice a day as his food.

My concern is that we leave town in mid-October, and if he is not OTJ, I will have to board him with her, and she will expect his dose to be whatever she recommends, so if that's once a day, then that is what she will give him when he's there.

Thanks so much!
 
You are in a bit of a pickle. If I were you, I would have a discussion now about that you have been doing some research and it seems that the same twice a day is better for cats then one dose a day. Now I know there is some peeps that give links to such information so hopefully they come along soon with that so you can have some back up information.

Are you testing noon time every day? Have you ever ran a curve?
 
Thanks for responding. I did do a curve when he was on the 0.75 amount and his numbers were low at +2, 4 and 6, in the 60-90 range. That's why she allowed the decrease to 0.5 and to check at a +5 timeframe which is when I got the 100's. I do not test at noon everyday, but did today to see where he was at.
 
Ok, I think the decrease was warranted with the 60-90 range. I think the next step would of been to go to .5 twice a day vs once a day. It is hard to say though because I can't see all your test data in one place to make sure your kitty is safe.

Do you have a spreadsheet like the one we use here up and running?

Have you made any food changes since dx?
 
Fuzzbunny said:
My concern is that we leave town in mid-October, and if he is not OTJ, I will have to board him with her, and she will expect his dose to be whatever she recommends, so if that's once a day, then that is what she will give him when he's there.
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Another suggestion would be to find a cat-sitter that will either come to your home or just "live there" while you're gone and take care of your kitty at home where he'll be most comfortable.

There are many companies that offer this service!! Do a Google search for "Petsitters near (where you live)"

Or do what I've done.....pack him up and take him with you!! China's been to Branson several years to see the Christmas lights!!
 
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Chris & China said:
Another suggestion would be to find a cat-sitter that will either come to your home or just "live there" while you're gone and take care of your kitty at home where he'll be most comfortable.

There are many companies that offer this service!! Do a Google search for "Petsitters near (where you live)"
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Yes, what @Chris & China said. Sometimes vet techs will do pet sitting on the side and that may be another option.
 
It's unlikely he will be OTJ that quickly. One less thing to hope/worry about. Many vets are inflexible and maybe a bit arrogant towards internet educated patients. She should appreciate the research you've done, not be condescending towards you.
 
It's tough to go against a vet's advice when you looked to them so many times before to help your baby. My vet laughed when I said we were doing 0.25 increases/decreases. And I swear to god if she says "in animals we treat the symptoms not the numbers" in one more email I will lose my mind. I get it. You were not taught in vet school to think outside the box. You do not have extensive knowledge in Feline Diabetes because you literally can't unless you study nothing else and that's not how it works. These people here basically have PhD's in Feline diabetes. Keep your vet involved by all means, but go with your gut and ask questions here DAILY. Last week Tigger plunged from 300+ to 70 by +4 (he's not normally an early nadir either). 1. I would have never caught it without spot testing - which my doctor doesn't recommend because it "upsets everyone." (NOT TRUE). And 2. The only reason I decided to test when I did was because he woke up from post dinner nap kinda wobbly and couldn't resettle. YOU know YOUR cat, and you will get to know them even better watching them like a hawk thru this lol.
 
Fuzzbunny said:
Since I have been reading here, I realized that my vet did start us out wrong on 5 units of Lantus twice a day.
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5u is a lot of juice to start out on.

Tell us about how you discovered your kitty was diabetic and what was BG at the time of diagnosis. How old is your kitty? Anything other health issues?

My recommendation is that you read up on, and choose one of, the 2 methods we use here - SLGS and TR

Get a spreadsheet set up with whatever historical data you have.

Fuzzbunny said:
We had brought the dose down to .75 with a nadir at 60 on my meter. So, then she said to go to 0.5 twice a day and retest at noon (I give insulin at 7am and 7pm, and his nadir was at 11am at 60
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Funny thing about nadir is that it can and will move around. Every cat is different (ECID). Best to shift your mid cycle testing times from day to day. You would be surprised what can happen during the course of a 12 hour cycle.

Fuzzbunny said:
My concern is that we leave town in mid-October, and if he is not OTJ, I will have to board him with her, and she will expect his dose to be whatever she recommends, so if that's once a day, then that is what she will give him when he's there.
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You have some time to get your kitty in the Lantus groove by finding a dose you can safely shoot every 12 hours. Collect as much data as you can and show her the spreadsheet. It's pretty hard to argue with good solid data.

How long will you be gone?


 
Moms2Tigger&Blu said:
These people here basically have PhD's in Feline diabetes. Keep your vet involved by all means, but go with your gut and ask questions here DAILY.
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Yes, what @Moms2Tigger&Blu said! Trust your gut and ask questions. It was only when I started trusting my gut - and sometimes going against what my vet said - that I started to make progress with Pretty Girl. Sadly, it took me too long to figure that out. But everyone here is right. YOU know YOUR cat better than anyone.

Best of luck to you and your kitty. Keep us posted.
 
Fuzzbunny, just to help out a little, here is a link so you can create a signture. This will display Sylvester's pertinent information with each of your posts, and is very helpful when you are needing advice and answers to questions: SIGNATURE
Then a link to making the spreadsheet so that you can record the BG data, shooting times and doses, and this is linked to your signature. It's really important to have that information available to the members that are advising you. SPREADSHEET
If you have any problems with getting the spreadsheet going, there are members who can help.
Wishing you the best!
 
Hi Fuzzbunny, and welcome to Lantus & Levemir Land - the nicest place you never wanted to be.

I think most of us have felt as you do - how do I go against what my vet said? Maybe it will help if you think about all that a vet has to know - they have to learn about tons of different diseases and conditions in multiple species. Unless they are a specialist, it's impossible to know a lot about any one disease. I have the good fortune to live near UC Davis, which boasts the #1 rated veterinary teaching hospital in the US. I was told by a third year vet student there that they get exactly 5 hours of study on diabetes, and that includes both cats and dogs (which respond to the disease very differently). So unless your vet does a lot of study post-vet school, or has a ton of experience with diabetic cats, it's unlikely that she knows a great deal beyond the basics. For instance, Lantus dosing is based on how low a dose take the BG, not how high. I don't know what your cat's numbers looked like at diagnosis, but if I had to guess, I'd say the vet set the dose in reaction to the high numbers. Here, the initial dose is weight based if following Tight Regulation - .25 units per kg of the cat's ideal weight. If following Start Low Go Slow, you start with .5 units.

The fact that you've joined FDMB shows that you want what's best for your cat and are willing to do whatever you need to do for him. We know how you feel.

We are not vets here (although we have some members in the field), but we have a lot of members with years of 24/7 experience with FD. You have to do what you are most comfortable with, but try to keep your kitty's safety as your foremost concern and remember that too much insulin can be very dangerous. Testing is your friend. There is no such thing as too much data.

It would help us (and you) a lot if you could set up a spreadsheet and record all the numbers you have so far. Here are the instructions. Ask if you need help. Read as much as you have time for - the stickies at the top of the L&L page are overflowing with information. Ask questions - we were all new to this once, and we love to help.

Here is a post we put together for new members to help them get comfortable with this site.

We're glad you found us.
 
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