Should I switch vets?

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Haley&Diane

Haley&Diane

Member Since 2015
Hi Everyone,

Well, today was Diane's two week checkup at the vet's office. She was diagnosed 2 weeks ago with a glucose level of 478 mg/dL!

Since then, I've been feeding her Purina DM wet with a tiny amount of DM dry (she prefers dry so I'm slowly transitioning her off of it). I did a curve Sunday and her level started at 370 before breakfast, then went down to 330, and then stuck around 259-270 until dinner time. Today her levels were at 251 mg/dL before going to the vet's office.

I gave the vet the curve I did, along with other readings I've done the past 2 weeks. He said that she could probably go on 1 unit twice a day, but that he would prefer not to start her on insulin and wants to re-check in 3 weeks. Does this sound okay? I feel like with levels in the mid 200's for most of the day she should be on insulin....especially since during the curve she was at 370 before breakfast.

Anyway, I also asked if he recommended any low carb high protein wet foods that are not prescription and he said absolutely not. He told me to not switch her off the DM because it's the best out there. He wasn't even willing to look into it for me.

I like the idea of switching vets, but I don't have the money to hop around to new vets to find the perfect one (this is the 3rd vet I've been to since moving to the area a year ago).

So, I guess my questions to everyone here are: Does it sound like it would be worth looking into a new vet? Does anyone here think it's okay for her not to be on insulin....could her levels go down more over the next 3 weeks just from the food? Also, what are your guys' opinions on her levels? I'm not really sure what the levels generally look like for a cat who is regulated...

I'd appreciate any help! I know it's silly to be asking this since it's more of a personal preference, but I know I can't be the only one who has had concerns about sticking with a particular vet. My biggest fear is that since she's newly diagnosed, if we don't start insulin soon then it will be harder for her to go into remission at some point.

Thanks everyone!
 
I'd say the most troubling thing is waiting on insulin. Her numbers are diabetic - we consider a cat in remission if, off insulin, they range from 40-120. She is a lot higher than that. The sooner she starts insulin, the better her chances for remission. The food is less troubling. The vet isn't around when you feed her and can't control her diet.

I guess I'd ask for insulin now and if he won't give you the prescription, start calling around and interview some vets?
 
That's what my concern was...If her levels were even in the high 100s i would understand waiting, but at the lowest she's been 250 mg/dL. He said that the reasoning is because her levels could continue to decrease since they have so much in the past two weeks, but I don't know.

Thank you for your input!
 
See my signature link Vet Interview Topics if you decide to do some checking around.

See Cat Info for another veterinarian's perspective on feline nutrition. The food chart there shows the percent of calories from carbohydrates for the prescription diets. Then compare that to Fancy Feast Classic pates. We've observed drops in glucose from 100-200 mg/dL and drops in insulin needed from 1-2 units lower.
 
Thanks for the info! I will definitely check out the Vet Interview topics. It's so difficult to find a good vet, especially since I'm fairly new to the area i am at. I checked out the cat food charts and I think I'm gonna start giving her some of the fancy feast classics. She's not eating as much of the purina dm and it's much cheaper! If the quality is about the same then I'm definitely going to give it a shot.
 
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback without having to go look in all your past posts.

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Add any other text, such as
your name,
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date of Dx (diagnosis)
insulin
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I agree that she needs to be on insulin sooner rather than later, and if your vet won't budge on it, it's time to look for a new vet. You can find a lot out by just calling around and asking the vet to call you back when they have time and ask how they deal with their diabetic cat patients
 
That's good advice! I didn't think of just calling to see if they will call me back when they get the chance and ask them how they deal with diabetic patients on the phone. I'm just worried because of money and also I know it's important to regulate sooner rather than later. Hopefully there are some vets around here that will take the time to talk to me via phone before making me come in for an actual exam/visit.
 
If you find one you seem to like, just call your current vet and tell them you're going to start a file of her blood test results so you can keep tract of how she's doing..You paid for them, they DO belong to you (I'm just not looking for a big confrontation, so found a way to get the things I wanted without explaining that I was never coming back again)

A new vet should accept the test results you've already paid for (if they're not too old) so you don't have to start all over again
 
Thanks for all of the help everyone! I ended up emailing around to get the opinions of other vets. Most were helpful...but they were all differing in opinions. One didn't approve of at home testing, another wanted to make me do more blood work (even though she just got some a month ago) and another told me that she thinks i should give my kitty more time on the food to see how it goes.

The vet who suggested to just wait another week or so on the food is the one I've decided to go with. I have an appt. next Saturday. She specializes in felines specifically and was extremely friendly and helpful.

As for my kitty, I took her off of the DM and put her on fancy feast. 2 days after switching her levels went from an average of 260 to an average of 220-230! The boyfriend gave her DM yesterday though and this morning her levels got up to 307 before breakfast and were 275 after dinner. I'm getting kind of worried too because she's lost even more weight even though she's been eating almost two whole cans of fancy feast a day! She went from 15.6 lbs 1 1/2-2 months ago, to 12.4 tonight. I did have her on a low calorie diet for a while though so I'm thinking that also contributed.

Hopefully this new vet we will see next week will be the one for us!
 
Spread the feeding out into mini-meals to reduce food spikes and the workload on the pancreas. Add a tablespoon or so of water to the food to help offset dehydration. Feed kitten food (extra protein and fat) to help with the weight loss - ex Fancy Feast Kitten Turkey and Giblet.
 
As long as she's not getting insulin (from her pancreas or from a vial/pen) she's going to keep losing weight. When our cats are diabetic, they're literally starving to death because without insulin, the glucose that every cell in the body needs can't get into the cell.

Think of insulin as a key that opens the door to the cells and lets the glucose in. I think the sooner you can get her onto a good insulin for cats, the better. Did this vet tell you what her preference was for insulin?

Once you have the script, the people here can help you with decisions on dose and when to change it. The sad fact is that no vet will ever see the number of diabetic cats the people here do. Most will only see a handful in their entire career, where the people here have been dealing with this disease every day ...some for many years and have just learned what works and what doesn't.
 
Thank you guys so much for the responses! She's gone back up to 12.8 lbs! She LOVES her Fancy feast! I'm done with the DM altogether because while the vets insist that it's better for her, if she doesn't eat it I don't see the point in feeding it and spending the money. She eats almost 2 cans of fancy feast a day and i can change up the flavor so she doesn't get tired of it.

Her vet appointment is Saturday morning so I'm ready to get her started on some insulin to get the numbers in a more normal range....then hopefully she will start feeling better. Though surprisingly she's been more active and social with the other animals since she was diagnosed...she's like a kitten sometimes! lol. The vet did not tell me what her preference is for insulin....but I'm going to insist on Lantus. I've read that is the best and while it is expensive I am planning to order from Canada to save some money. I also read that her chances of remission are greatest when using Lantus...

I will definitely be one here when she starts the insulin...you all have been so helpful and have made me feel much more calm about all of this!!
 
That's one of the biggest problems we hear about DM...that the cat might eat it for a little while, but they get sick of it quickly....well that and the price!!

If you have any left, take it back to wherever you bought it. It has a money back guarantee so you just tell them your cat refuses to eat it....use that money for something useful like a good insulin or more test strips!!
 
We just got back from the new vet! I LOVED her! She sat on the floor with Diane, let her run around the room, and was very informative. She did a blood glucose sample when they took her to the back and Diane's glucose was at 223 mg/dL! She said she was very happy about that because in a stressful environment such as a vet's office, cats are typically much higher. She didn't even charge me for the test which was nice. This morning when I tested before I fed Diane, her levels were at 245 mg/dL....so I'm thinking my glucometer may be slightly off. But the vet said that a difference of 20 isn't really a big deal at all unless we were looking at lower numbers like 70 vs. 50.

She wants me to keep Diane on diet regulation for a while longer. She said that while getting her into remission would be great, most diabetics are considered to be at good levels if they are in the mid 100s to low 200s. Since Diane is more active and doesn't show any clinical signs of diabetes, she feels safe in her not starting insulin yet. She completely agreed with me feeding Fancy Feast and even recommended that I reference the food chart that everyone on here uses to get other ideas if she starts getting sick of the Fancy Feast.

If her levels do not keep improving then she said that we can put her on insulin and that she would like to use Lantus. She wants me to bring her back next month and to email her in between visits so that we can study her levels and how they have changed.

So, here's to hoping that her levels continue to decrease! They've gone down from 478 mg/dL on the day she was diagnosed to 220 mg/dL today (exactly one month later).

I will definitely look into returning the leftover cans of DM. I just hate it because I'd have to go back to our previous vet and they are not the nicest/friendliest people to deal with.

Thank you guys so much for the help though!!
 
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That's a GREAT report!!! It's so nice to have a vet that works with you instead of against you!!

Just take the DM back and tell your old nasty vet that your cat won't eat it anymore. Since it's guaranteed, that's all they need to know.
 
Haley&Diane said:
We just got back from the new vet! I LOVED her! She sat on the floor with Diane, let her run around the room, and was very informative. She did a blood glucose sample when they took her to the back and Diane's glucose was at 223 mg/dL! She said she was very happy about that because in a stressful environment such as a vet's office, cats are typically much higher. She didn't even charge me for the test which was nice. This morning when I tested before I fed Diane, her levels were at 245 mg/dL....so I'm thinking my glucometer may be slightly off. But the vet said that a difference of 20 isn't really a big deal at all unless we were looking at lower numbers like 70 vs. 50.

She wants me to keep Diane on diet regulation for a while longer. She said that while getting her into remission would be great, most diabetics are considered to be at good levels if they are in the mid 100s to low 200s. Since Diane is more active and doesn't show any clinical signs of diabetes, she feels safe in her not starting insulin yet. She completely agreed with me feeding Fancy Feast and even recommended that I reference the food chart that everyone on here uses to get other ideas if she starts getting sick of the Fancy Feast.

If her levels do not keep improving then she said that we can put her on insulin and that she would like to use Lantus. She wants me to bring her back next month and to email her in between visits so that we can study her levels and how they have changed.

So, here's to hoping that her levels continue to decrease! They've gone down from 478 mg/dL on the day she was diagnosed to 220 mg/dL today (exactly one month later).

I will definitely look into returning the leftover cans of DM. I just hate it because I'd have to go back to our previous vet and they are not the nicest/friendliest people to deal with.

Thank you guys so much for the help though!!
Click to expand...
Better yet, DONATE your d/m (if the package is open and/or the vet doesn’t take returns). Local rescues, humane societies, etc. would gladly take the extra d/m. While I’m certainly not a fan for a number of reasons, someone can use it.
 
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