Should I find a new Vet?

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Danielle Hrubiak

Danielle Hrubiak

Member Since 2015
I just dropped Abilene off at the vet for her first curve test. I spoke briefly with the nurse as the Dr is off today.
-First she brought up the fact that it is a huge NO-NO to be using a human meter and ranted about why and how it's basically a joke for people to use them and think they are getting accurate results. She said I can only use an alphatrek and went on to tell me that they had already purchased one for me (implying I HAVE to buy it). She said they ordered it bc I was interested last appt and she said I said I wanted one. Which isn't true at all. I told her I cannot afford to pay $1 per strip for that meter and that a huge majority of people on this forum use human meters with wonderful results. She told me that its not possible to get a comparison between the meters. She also said the strips aren't that much for the AT. (Yeah, maybe not at their cost).
-She then made me feel like an awful person for allowing Abby a snack in between meals as she shook her head in disappointment. She said I am ruining the purpose of the insulin and causing the BG to rise midcycle when it should be continuously decreasing. She is FIRM about twice daily feeding. I wanted to cry.

I have gotten a bit of suggestions and opinions from a few people on here so far (and I am very grateful and appreciative of them)...but I was wondering if there happens to be a Vet on here that could comment and give me a professional opinion about this. I am getting completely conflicting suggestions/advice/instructions from my vet office in comparison to what a lot of people on here do and say. I need to know if my vet is wrong/uninformed etc?

What is the "proper" feeding schedule for a cat on prozinc? So many offer mini meals which makes sense to me.
The vet said if I wanted to stray from twice daily feedings that I would have to consider doing 3x a day insulin injections?

-She also said 1 can of food per meal is way too much. That would be 3 oz of FF classics twice daily. According to the chart they are roughly 90 calories per can-give or take a few. I read 4-6 oz is a rough avg of food per day. Abby is currently about 7-8 lbs and small framed. She lost a lot of muscle mass and a few lbs (which she needed to lose a few anyhow) from this disease. I was trying to plump her back up a bit by allowing her to eat as much as she wanted at meal time--which was about a can, ESP considering she's not regulated yet and not properly utilizing the food she does take in. So I figured she needed a little more. Can someone tell me how much to feed if this is too much?

I'm so confused and I don't know what to do or what is best? I literally just want to cry.
 
Oh and they are pushing another urinalysis test today. They did one last week and she tested +1 for ketones. I purchased the relion testing strips and tested her on Saturday twice and the strips both came back negative. She implied that she doesn't think the strips are accurate. Should I allow them to do another urine test on her today? Or is that not necessary.
 
Hi Danielle,
I'm so sorry for what you are experiencing with your vet. She sounds horrible. Please know that you are absolutely NOT alone in this! Your vet is wrong about many things, plain and simple. Lots of people on this forum struggle with balancing what vets are telling us VS what our own cats' experiences are telling us. If I were you, I would look for a new vet.

You do not need to use the AlphaTrak, and the test strips really are more than $1 each (believe me, I've been buying them for a year!). The vast majority of members here use human meters just fine. I know @BJM's signature links have tons of info on this.

Mitz is on ProZinc too and I feed mini meals thru out the day and I leave her wet food out all night so she can eat when she wants. You are not doing anything wrong! In fact, you are going above and beyond what a lot of people are willing to do to help your kitty get well. I have no experience with ketones so I can't comment on that. Hopefully, others will chime in about that.
Hang in there!

Joan
 
in my opinion - you need a new nurse!! Admittedly I am not a vet but I know that there is a lot of people on this forum who free feed their sugarcats and will just remove the food two hours before testing. I actually do stick to the two feedings a day (a can each time of fancy feast) and my litttle one is maintaining her weight (or gaining a little) - there are times when I do give more - when she is clearly starving - which doesn't happen that often but it happens and when her blood sugar is low.
As far as glucose meters go - there is a difference between human and the alphatrak and there is a way to compare the differences (i took my meter in and compared it with the vets meter - there was a difference - my vet seemed unconcerned as I am home testing and not going to kill my cat by giving insulin when it is unneeded).

Do not be intimidated or forced into anything by this nurse - I am not sure why she is pushing so hard on you but don't buy into her tactics.

You appear to be doing the very best for your baby and home testing is VITAL!! There is a difference between meters but every meter will let you know when or when not to give insulin. So many people on here use Relion and they all have diabetic cats!! I use the One Touch Ultra 2 - and it has saved Scamp!!

We are here supporting you and you are doing great!!!
 
The thousands of posts on this site are proof positive that testing with human meters is just fine. Sometimes these so-called professionals are so closed-minded! I love my vet, but look to this site and the wonderful information, support, and encouragement herein to manage Lulu`s diabetes. Since I`ve found this site, Lulu`s BG numbers are slowly stabilizing. When I first started home testing and having a really tough time, one lovely member was willing to go well and beyond to help me succeed in ear-poking (thanks Alix!!) The other day, I was worried about Lulu`s BG numbers falling too quickly, and another lovely member stayed up half the night with me, coaching me along (thanks Julie!!)
Also, bear in mind that many vets are in business to make money (I don`t blame them for that, we all have to make a living), but I find it appalling that some find it necessary to lay a guilt trip on their clients and imply that if you don`t accept their rhetoric, then you are not a caring cat mama. Please try to just let this go and not take it to heart. If your intuition tells you to find a new vet, then go for it...you are the client, after all, and don`t have to tolerate disrespect. I could go on and on about this (don`t get me started on the arrogance of many medical doctors, lol), but will end my rant here.
 
Danielle I am so sorry you have been faced with dealing with an insensitive uneducated vet tech. This is how my first vet's clinic worked..I never saw the vet...except the first visit...I always dealt with the technician. After Tuxie's blood results came back I went in and got a copy and studied the results. Then I made an appointment to talk to the vet about some questions I had about some levels being low/high. So who do I get when I go for my VET appointment...the tech again. She of course knew nothing about test results and said don't worry about it the vet know what they are doing and is busy with patients. DUH!! I PAID for that visit...with the VET. I dropped off a list of $$ for the vet and again the tech called me.

I too was told only an AT meter..Lantus was the only insulin used for cats...only 2 meals a day no matter what...no home testing....and don't ask questions just do as you are told. The vet may have been a decent vet but since I had to deal with the tech all the time I changed vets..interviewed the new vet and decided to use her. I am SO glad I changed. You need to be able to work WITH your vet and not made to feel any worse than you do after haveing a beloved pet diagnosed with diabetes. Time for a change IMHO.
 
Danielle,
You said the nurse is the one that made all of these comments, does your vet agree with what she said? If so then yes I would look for another vet, if not then I would make a point to let the vet know what she said. Actually either way when you pick up Abilene you need to tell the nurse & the vet that you did not appreciate how she talked to you and how she made you feel when you are doing everything you can for her. I mean honestly it sounds like she was scolding a child.

You are doing everything right you can for your baby and they should be supporting you not making you feel bad. You are not doing anything wrong.

As for the ketones I have not had a issue with that since Frodo was first diagnose. But I am not sure why the test strips would be wrong.

Frodo is on Prozinc also, since I work from 8 to 5 he is fed morning & evening, and at bedtime I put food out to get him and his brothers & sisters through the night. Days I work from home I give them a snack of Tiki Cat as a treat. I also use the Relion meter and my Vet is perfectly fine with it, she wishes she had more clients that would take up home testing. She also has viewed this website and thinks is is amazing, and loves all the information and help that is provided here. We all know the readings are not exact, but they get you in the ballpark for dosage, which is the important thing.

I am curious, how does your cat handle the stress of being at the vet office? I ask because you said they are doing a curve on her, and honestly that is something you could do yourself and the results would be more accurate and it would help you with the cost.

Like Sue stated you are the best advocate for your cat, you know her better than anyone else. And as for doctors, I look at it like this, I am not going to put up with something from a vet that I would not put up with from a human doctor or a nurse for myself.
 
Hi Danielle,

I, too, was told to feed my cat only twice/day. At the time she only weighed 5.3 pounds! She lost over a pound and like your cat, has a wee frame. It broke my heart to feed her only 2x/day and see her looking at her food dish throughout the day. Seeing her bony frame and hearing her little mews at her empty foodbowl made my heart break. I called my vet about this and he immediately said to feed her well prior to each insulin dose and add two smaller snacks throughout the day. He agreed her weight had to be dealt with. Chloe is now up to six pounds and her bones aren't jutting out like they were. I've continued her extra two snacks throughout the day Yes, eating raises blood glucose levels but guess what? The two extra a feedings aren't hurting Chloe as her BGs are actually coming down nicely! You need to have a face-to-face talk with your vet and raise your concerns. This is, afterall, your baby and you are the only advocate for her.

I'm so sorry the vet tech was so difficult. You should never be made to feel guilted into buying the meter she is trying to force on you. (or so it sounds like) I use a human meter and tested it against a friend's meter and guess what? They were only off by two numbers.

I wish you all the best in dealing with all of this. I'm a little over a month in since my cat was diagnosed. Hang in there....

Opus
 
Should you go in search of a new vet, there are Vet Interview Topics in my signature.
Also, international feline diabetes expert Dr Rand of the University of Queensland published feline-specific reference numbers when using a human glucometer. These are incorported in my signature link Glucometer Notes.
 
I agree with everything said above. My vet is an all cat clinic and they do not push the Alphatrac meters. In fact, if anyone wants to hometest, they provide free human meters to them when they have them available. If you do decide you need to change vets, can you tell us where you are located? There may be members near you that can give you some recommendations.
 
Hi guys. So I was just about to post a reply to all of your wonderful comments and tell you about my consult with the dr when I picked up Abby today...but that needs to wait a minute. When I picked her up dr said he had changed her dosage since the 1 unit was not anywhere near sufficient for her numbers. He increased her to 2 units twice daily and had done the honors of feeding her dinner at 7pm and giving her the PM injection of 2 units. Well come to find out the dingbats didn't take a PMPS test so im not sure where she was at then, but the last recorded BG test was 2 hrs prior to that and was 319(my meter) and 364(theirs). Well I just check Abby's BG now (PM+2.5) and she registered at 192. So in 4.5 hrs she went from 319 to 192. Isn't that a huge jump? And it's only +2.5 hrs. I'm so scared she is going to go hypo on me tonight considering dr said her lowest BG is +6. If she's 192 now, I'm scared to know what she'll be by then?! Am I freaking out too soon or should I prepare to stay up all night with her and have some form of sugar at hand?

-Do you think the huge decrease could be due to her not eating from 645pm last night to 645pm today? Vet nurse said she didn't want to eat all day? I call BS on that.
And they shattered my feeding bowl I sent with her today--said they didn't use it but somehow it broke. I smell liars. GRRR...
 
Your vet is crazy....diabetics need to eat so the insulin has something to work on....I've never heard of someone suggesting you don't feed a diabetic for 24 hours!!

That's a pretty good drop, but not a totally out of the expected range, especially if they increased her a whole unit....that's another thing we never do. We do increases in .25unit increments so we don't go past a "best dose" and slowly work up as we see how they respond.

It's always best to keep some high carb food in the house, like Fancy Feast Gravy Lovers in case you need it. The carbs in the gravy work well to bring up the numbers and it doesn't wear off quite as fast as plain sugars like Karo/honey/syrup

She's still fairly high so there's no danger right now, but I'd plan on getting a +4 just to see if she continues to drop so quickly

I'd also go back to 1 unit (or maybe 1.25) tomorrow and work her up slowly
 
Yeah, I think you definitely need to go vet shopping? Strange that the doc would bump the dosage that much, typically, ProZinc gets 1/2 unit bumps. If you're really concerned about kitty going hypo, you could give her a 1/4 tsp of corn syrup, that's not enough to mess with her morning numbers too much.
 
He's not only crazy, he's an ass.
Well the instruction regarding feeding was not to feed after her PM meal last night as they wanted to feed and give the insulin for the curve this morning when I took her in. But apparently "she wouldn't eat"...
There's a feline specialist here but so expensive. I plan to make a consult appt with her to see what it would require for me to transfer Abby to her practice. If she requires all new testing and such, I'm not sure I can afford to do it all over again from scratch. I'm already $800 in, in just a week. I should have went there initially but they didn't have an available appt for a week out and I needed her seen ASAP when she was first diagnosed.

I too thought the increase seemed extreme, but he said at her numbers she clearly needs more? I asked if this increase would possibly put her in a hypo state--he replied..."it shouldn't".

He also has me starting a new schedule--which is insane. He said according to his 1 set of numbers--her lowest BG is at +6. So he told me to follow this schedule... At 7am-feed 1/4 can, shoot 2 units. At AM+6-feed meal- 3/4 can. At 7pm-feed 1/4 can, shoot 2 units. At PM+6 feed meal-3/4 can. That would put me at 7am, 1 PM, 7pm, and 1am. How is this realistic? Thankfully I do have a schedule that would allow for this--but he doesn't know that. So how would this work for someone who works a typical job away from home?! I think this guy is off his rocker...

And that darn nurse asked me again at pick up--"so did you want to get the alphatrek now?" Really??

(Ill be adding more in a minute about what this lovely vet had to say about some other things...I secretly recorded the convo and need to listen to it again...)
 
And how much should I give?! All I have is a can of friskies shredded chicken in gravy. Or I have honey, agave, pure maple syrup, pancake syrup...
 
Try some of the gravy off higher carb food and test again in 20+ minutes. We don't worry till they drop below 50, but this is a big drop and you have a couple hours till nadir
 
Okay. I gave her 2 tbsp of gravy food. She's acting like she's starving. She inhaled the food freezing cold from the fridge. Wouldnt even allow me to heat it. She's only had 1 can of food today where she normally has 2--all bc of the morons at that clinic. According to this drs new schedule for her--she's supposed to get another can at 1 am. Should I feed her now or wait until I retest and feed at 1am like directed?
 
And breathe. You can handle this with food (or honey if absolutely necessary.) Yes, she dropped quite a bit but she is still in safe numbers and you should be able to bring her up with gravy. You can test to keep her safe.

The reason for the gravy is so she doesn't get too full when you want her to eat.
 
Oh and here is the cherry on the sundae from today--after the dr told me about the dosage increase and he scurried off--I asked the vet nurse how often I should be testing her BG for this next week. She said.............. "Oh don't even bother." Seriously?!
 
You definitely need to find a new vet who knows more about feline diabetes. After you get through tonight, maybe start a new thread and ask if anyone is in your area and knows a good vet. Meanwhile, we can help you keep her safe and help you figure out dosing.
 
While you are monitoring for low numbers, and steering them, if she goes below 50 mg/dL on a human meter, feed 1-2 teaspoons of high carb gravy, or low carb food with a few drops of Karo or other syrup on it and re-test at 30 minute intervals.
Repeat until past +7 (nadir period) and glucose is rising at least 2 times in a row and above50 mg/dL.
 
I don't know what id do without this forum. Good golly... You all are life savers. Thank you thank you!

Btw--in response to Lisa and Witn's question about my location--I am in Lexington, KY if anyone can recommend a good vet around here!!?
 
Did you get another test? Is she coming up or holding steady?

She may be lower because she didn't have much to eat today and now that she has had some food, she may come back up.
 
Exactly my thoughts Sue!! And that's exactly what happened. At +2.5 she was 139, at +4 she was 64, I gave 2 tbsp food with gravy and just rechecked about 30 mins after she ate, up to 146 now.
 
Great - good news. I would watch her for a while longer (you want three rising tests before you really relax). Tomorrow, I'd go back to your previous dose, get pre shot numbers (always) and a number in that +5-7 range, whenever you can. It is possible that she will be higher in the am because of the higher carb, and a possible bounce from the lower number that she is used to, but I'd still stay at one unit.

If she is higher in a few cycles than you want, then a safe increase is +.25, not a full unit.
 
BJM said:
Google Maps locations of veterinarians near Lexington, KY.

If you enter your full address in the search box, you see the ones closest to you.
Click to expand...


Thanks for that! There are quite a few options around my area, I just don't know who to trust. I'm on vet #2 already. With my luck, I'll have to keep bouncing around to several more before I find the one. I'm hoping someone on this forum may also live around here and be able to recommend one to me. Unfortunately, I only moved to the area about a year ago and don't know too many people here to ask for recommendations either.
 
To help you weed through candidate vets, see my signature link Vet Interview Topics for some questions to ask (compiled from posts on the message board).
 
Danielle Hrubiak said:
I just dropped Abilene off at the vet for her first curve test. I spoke briefly with the nurse as the Dr is off today.
-First she brought up the fact that it is a huge NO-NO to be using a human meter and ranted about why and how it's basically a joke for people to use them and think they are getting accurate results. She said I can only use an alphatrek and went on to tell me that they had already purchased one for me (implying I HAVE to buy it). She said they ordered it bc I was interested last appt and she said I said I wanted one. Which isn't true at all. I told her I cannot afford to pay $1 per strip for that meter and that a huge majority of people on this forum use human meters with wonderful results. She told me that its not possible to get a comparison between the meters. She also said the strips aren't that much for the AT. (Yeah, maybe not at their cost).
-She then made me feel like an awful person for allowing Abby a snack in between meals as she shook her head in disappointment. She said I am ruining the purpose of the insulin and causing the BG to rise midcycle when it should be continuously decreasing. She is FIRM about twice daily feeding. I wanted to cry.

I have gotten a bit of suggestions and opinions from a few people on here so far (and I am very grateful and appreciative of them)...but I was wondering if there happens to be a Vet on here that could comment and give me a professional opinion about this. I am getting completely conflicting suggestions/advice/instructions from my vet office in comparison to what a lot of people on here do and say. I need to know if my vet is wrong/uninformed etc?

What is the "proper" feeding schedule for a cat on prozinc? So many offer mini meals which makes sense to me.
The vet said if I wanted to stray from twice daily feedings that I would have to consider doing 3x a day insulin injections?

-She also said 1 can of food per meal is way too much. That would be 3 oz of FF classics twice daily. According to the chart they are roughly 90 calories per can-give or take a few. I read 4-6 oz is a rough avg of food per day. Abby is currently about 7-8 lbs and small framed. She lost a lot of muscle mass and a few lbs (which she needed to lose a few anyhow) from this disease. I was trying to plump her back up a bit by allowing her to eat as much as she wanted at meal time--which was about a can, ESP considering she's not regulated yet and not properly utilizing the food she does take in. So I figured she needed a little more. Can someone tell me how much to feed if this is too much?

I'm so confused and I don't know what to do or what is best? I literally just want to cry.
Click to expand...
 
Danielle Hrubiak said:
I just dropped Abilene off at the vet for her first curve test. I spoke briefly with the nurse as the Dr is off today.
-First she brought up the fact that it is a huge NO-NO to be using a human meter and ranted about why and how it's basically a joke for people to use them and think they are getting accurate results. She said I can only use an alphatrek and went on to tell me that they had already purchased one for me (implying I HAVE to buy it). She said they ordered it bc I was interested last appt and she said I said I wanted one. Which isn't true at all. I told her I cannot afford to pay $1 per strip for that meter and that a huge majority of people on this forum use human meters with wonderful results. She told me that its not possible to get a comparison between the meters. She also said the strips aren't that much for the AT. (Yeah, maybe not at their cost).
-She then made me feel like an awful person for allowing Abby a snack in between meals as she shook her head in disappointment. She said I am ruining the purpose of the insulin and causing the BG to rise midcycle when it should be continuously decreasing. She is FIRM about twice daily feeding. I wanted to cry.

I have gotten a bit of suggestions and opinions from a few people on here so far (and I am very grateful and appreciative of them)...but I was wondering if there happens to be a Vet on here that could comment and give me a professional opinion about this. I am getting completely conflicting suggestions/advice/instructions from my vet office in comparison to what a lot of people on here do and say. I need to know if my vet is wrong/uninformed etc?

What is the "proper" feeding schedule for a cat on prozinc? So many offer mini meals which makes sense to me.
The vet said if I wanted to stray from twice daily feedings that I would have to consider doing 3x a day insulin injections?

-She also said 1 can of food per meal is way too much. That would be 3 oz of FF classics twice daily. According to the chart they are roughly 90 calories per can-give or take a few. I read 4-6 oz is a rough avg of food per day. Abby is currently about 7-8 lbs and small framed. She lost a lot of muscle mass and a few lbs (which she needed to lose a few anyhow) from this disease. I was trying to plump her back up a bit by allowing her to eat as much as she wanted at meal time--which was about a can, ESP considering she's not regulated yet and not properly utilizing the food she does take in. So I figured she needed a little more. Can someone tell me how much to feed if this is too much?

I'm so confused and I don't know what to do or what is best? I literally just want to cry.
Click to expand...
 
For now, you feed as much as you need to....diabetics are literally starving to death since the glucose the cells need can't get into the cells without insulin. Think of insulin as the "key" to the lock on the cell's door....to get the glucose out of the bloodstream and into the cell, you need the key!

Once she gets under better control, her appetite and need to eat will naturally come down

Your vet probably isn't necessarily a "bad" vet...the sad facts are they get very little education in school and once in practice, they can't keep up with the latest treatments for every disease in every type of animal they see.

The people here do nothing but deal with the diabetes, so we see a LOT of it and have just learned what works
 
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You really need a new vet, I just managed to get my high dose probable IAA cat OTJ in FEB and I did it free feeding friskies and fancy feast and using a relion confirm, I think when you starve your cat is when you end up with cats going hypo or DKA, if you get really desperate you can drive to the clinic I use here in Glasgow,KY, they have 3 great vets. They did recommend the alpha trak but I told them that I used the Confirm most of the time and just adjusted the numbers for them and they were fine with free feeding and me using Fancy Feast and Friskies, also the vet that was seeing Scotty had never even heard of Levemir but when I asked for it he did some research and wrote me a prescription, they are also fine with me calling and asking questions, as a matter of fact I called them today with a question about one of my civies.
 
True, human glucometers are not clalibrated for animal use. However, I went with the Reli-on from walmart because of the cost. Where I focused my energies was with the consistency of the blood sugar results. I also made sure that I kept her on a schedule...feedings the same portion size, blood sugar testing and insulin delivery at the same times every day. I took her into the vet for annual wellness exam. They did do achemistry panel on her and were impressed with the results. The consistency of her home testing results were great. I feed her wet food only and had the recorded blood sugar results to show what dry food did to her sugars. The vet was most impressed. Stewey receives Lantus insulin twice daily but feedings 5 times daily which helps to keep a more stable blood sugar. Hope this helps. Good luck from jane and stewey
 
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