So fustrated with my vet. (A Rant & some ?s)

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Danica20

Member Since 2014
First I apologize for the upcoming rant. I need to unload on some people who will understand and I feel this is the right place to do it.

First off Pinky has been going through a diet change (which was not recommended by my vet) and her progress has been great! Her numbers are steadily decreasing and today was her first day on all wet food. Her number at her AM nadir today was 299. A week ago she was testing at well over 400.

Today she had a vet appointment. I brought her spreadsheet and I had some questions about her insulin. First we waited over a half and hour in the waiting room. Pinky gets stressed by dogs so I'm sure that did not help her glucose numbers. So finally we get to see someone. First it was a vet tech who asked about her diet. We said we were switching her to an all wet food diet. The vet tech said "that's good." This is the same practice that said over a week ago that a diet change "wasn't necessary" and could change her diet "if we wanted to." Frustration level rising.

The the vet comes it. She tested 329 there. Which makes sense. It was 6 hours after her shot and she's on novlin, which from everything I read only lasts around 8 hours in cats. She would be on the upswing of her curve at that time. Is this right or am I mistaken? So the vet tells us to increase her dosage by a 1/2 unit. It was there I brought out the spreadsheet and explained we were doing a diet change. I also inquired about other insulin's because I had researched online that novlin only works for 8 hours in cats, so there is 4 hours where she is unregulated. It was there we got the smirk. The vet claimed that "all of there animals here are on novlin" and that he's never heard that it only lasts 8 hours it cats. I asked about Lantus, PZI, and Levemir by name. He said he's never heard of Levemir, Lantus is no longer available and PZI is expensive. I told them cost is not an issue, I want what is best for Pinky. So at this point my frustration level in through the roof. I tried to explain to him my spreadsheet but I don't think he quite understood. It was the end of the day, we were the last appointment and I felt we were being rushed out. He then said he'd discuss this with the other vet we saw and have us call the other vet on Monday. He reiterated to up her insulin a 1/2 dose. Not one time did he ask what time I gave Pink her am dosage. Shouldn't that been his first question?

Today is Pinky's first day on an all wet diet. From what I understand I should wait to see what her levels look like before I raise her dosage. Is this correct? If I'm to follow the vet's advice Pink would be up to 2 1/2 units. Today was the first day she reached the 200s. Am I right to believe that if anything I should lower her dosage if she remains in the 200s? If someone could look at her spreadsheet and give me guidance. I'm so upset with my vet right now, it's beyond frustrating. If I hadn't found this place and done my own research, Pink would still be on a high carb diet and her numbers would be going up. The only reason her numbers are going down is because I took the bull by the horns and made the decision on my own to get her off the kibble. It doesn't seem wise to me to tell us to increase her insulin dosage when today is the first day she's gone to all wet. Am I mistaken? I also feel that my questions about Novolin were brushed off. I feel like today's vet trip was a colossal waste of time that only stressed out Pinky and myself. I felt like I was looked down upon as one of those people who do their research online and that they think they know better that the vet. Well Pinky's numbers speak for themselves. She's still has a ways to go but she's closer now that she was before. I am seriously thinking of pulling Pinky and her sister Harley from that vet. Am I overreacting? Deep breath. Thanks for reading.
 
Re: Sooo fustrated with my vet. (A Rant & some ?s)

Wow, reminds me of my vet visits lol. I had to DEMAND Hidey to be put on prozinc with my vet which is really funny because when he was diagnosed they said they were going to put him on prozinc, charged me prozinc and gave me vetsulin which is basically the same thing your using. Me not thinking gave him insulin for about a month looking at his wonky numbers wondering why until I looked at the flipping package to see vetsulin listed.....I lit my vet up!!!!! Of course when he was diagnosed she said I didn't have to change his diet and if I wanted to she'd recommend science diet......of course she would!!! Not to mention she told me I didn't have to home test, I would have killed him if I didn't take it upon myself. After a little over a month on prozinc, switched to only low carb canned, and mini meals Hidey is now diet controlled. I loved when I had to take Hidey in for a dental and I got to tell them he was in remission. I got a "that's great" but didn't feel they meant it at all lol, then they hit me with he is showing signs of beginning stage kidney disease so I got a print out of his labs. I did my research just like I did with the diabetes and I don't see it in his labs, although I am watching a few things just in case. I figure it can't be a bad thing to watch his food since he is getting older. IMO vets are just like drs. They don't like natural cures or patients taking it upon themselves to do what they feel is right. The funny thing is, I have so many problems with my vet and she's still the best I found in my area.

As to upping the dose, I wouldn't. Today is the first day with all wet, AND it was a stressful day. I'd wait and see :-D
 
Re: Sooo fustrated with my vet. (A Rant & some ?s)

Danica - Man, I felt my blood pressure rising just reading your post! I think I'd be looking for a new vet ASAP. Lantus isn't available? He's never heard of Levemir? What the ever-lovin' heck?!?

I really admire you for taking that bull by the horns and doing your own research, just like so many others here have done successfully. You probably already have, but have you read Dr. Lisa Pierson's site, http://www.catinfo.org? Sure wish we could all find a Dr. Pierson in real life! I know she would say to NOT increase Pinky's dose.

Good luck, Danica. You are Pinky's hero and I know he's in good hands! :thumbup
 
No apologies needed.

First off, no I would not be increasing the insulin just yet, especially since you are doing that diet change. Yes, there are better insulins available and Lantus (glargine), levimir and Prozinc are all used by many users here.

Danica, you are Pinky's advocate. Vent away, sweetie, we understand completely. I was fighting the shelter staff and 3 different vets when I was fostering Wink. Got him OTJ following the recommendations from this message board. If I had continued to follow the "professional advice" from those vets, Wink would either be dead from a hypo or still getting insulin instead of being OTJ for the last 16 months.

You need to push back at your vet and get them to read any sort of current research on the different insulins. Heck, even the Merck veterinary manual does not recommend using Humulin/Novolin N in cats if your goal is remission and it should be. "In newly diagnosed cats, insulin glargine is the insulin of choice."

Your vet sounds like they are not current with any of the diabetes research from the last 5-10 years. Time to get them updated and educated so the next diabetic patient they get can get better treatment.

How about sharing this link with your vet? AAHA Diabetes Management Guidelines for Dogs and Cats, vet journal published back in 2010.

Or how about this research, put together in a slideshow format, on the various insulins and success rates in cats. It's from the folks at the University of Queensland, down under you know. ;-) I think this slideshow should be simple enough for your vet to understand. I believe it's from 2005-2006.

Can provide other vet journal published research if you are interested, but thought that was enough for now.

Honey, we are behind you 100%. We will not laugh at you, or sneer at you, or make you fell bad. We are here for you and will support you in anyway we can. Hang in there. Sending you hugs for the horrible condescending treatment you encountered at your vet practice.

If it were me, I would call them back and demand a prescription for a better insulin. Get a prescription for the pens if you get Lantus or Levimir. There are plenty of users of Lantus, Prozinc and levimir here to help you out.
 
Fist I just want to give a big THANK YOU to everyone who replied. Thank you for your kind words and reminding me that in the end I'm doing this for my Pinky. All I want is to get her healthy. She is newly diagnosed so this is her best shot at possible remission. It is just so disheartening to go to a vet, who is suppose to help Pinky get better, only to meet a brick wall. I plan to call on Monday. If they still refuse to put her on a better insulin, I'm pulling her and her sister out of there. I need to get her off of novolin. It's not working for her. If you look at her spreadsheet it works in her for about 8 hrs, then she'll go unregulated and her numbers go up before it's time for her next shot.

Geneva- Dr.Pierson's site was one of the first things I found when starting to do research on feline diabetes. It was her site that made me think, "hey my vet may be wrong about a diet change." In fact I even looked up where her practice was located in the hopes she might be anywhere near me. Sadly she's clear across the country.

dirtybirdsoaps - I feel a little bit better knowing that I'm not the only one dealing with a misinformed vet. Sadly It seems a lot of folks on here are dealing with the same issues. I feel If I only listened to my vet, Pink would be just pumped up on inferior insulin and would have no hope of remission.

Deb & Wink - Thank you very much for those links. I especially found the research from Queensland interesting. Not to mention the graphs made everything click for me. Their graph on vetsulin/catsulin shows exactly what pinky's cycle is right now on Novolin. It's not the best treatment and my Pinky deserves the best! Not to mention their study makes me feel so hopeful that if I can get Pinky on Lantus of Levemir she has a good shot at remission! Also I had previously read the AAHAD's Diabetes Management Guidelines. I wondered why my vet did not provide me with these guidelines, so I checked what my vet had given me when Pinky was first diagnosed. Surprise, surprise my info packet is "Diabetes Mellitus: A Owners Guide to pet care, provided as a courtesy by HILL'S PRESCRIPTION DIET and your vet." :roll:
 
hi Danica,

you have my sympathies, I went through a similar thing when I thought Angel was having a hypo (am pretty sure now he wasn't, just his bg was very low and he was hungry and I panicked). One of the lovely people on this board pointed out that with being on here and having access to the latest research, we are probably more up to date with the best treatments for diabetes than many vets. Stick up for yourself, after all, YOU are paying THEM. Don't let them try that 'I'm the vet, I know best' becaue they don't ALWAYS. Even my own vet, who is lovely, put Angel on Caninsulin and recommended Hills dry md!! (hopefully will be on Lantus or PZI very soon)

I'm in UK but noticed a lot of people in US weren't happy with their vets and a while ago I found and posted this list, it's vets who only see and specialise in cats. I don't know if any are near you.

http://www.zzcat.com/CRF/supplies/catsonly.htm

And in case you're interested, this is what happened to Angel at the emergency vets...thought you might feel better knowing you're not alone. I felt so guilty for taking him, feeling I'd let him down. viewtopic.php?f=28&t=120699&p=1259314#p1259314

x
 
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