So, so, sooooo confused. This is what the "new" vet says: (Zoey)

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Rose

Rose

Member Since 2015
Hi, everyone. My confusion is based upon my trust in these message boards and what I feel is conflicting information I'm getting from vets. Maybe someone here can help me to reconcile the information.

I've been faithfully monitoring Zoey's glucose and dosing her according to the guidelines set forth under the sticky for Vetsulin. The "old" vet gave his blessing. The curve was indicating the insulin was leaving by the 8 hour mark so I've been dosing every 8 hours, 3 times a day -- and I dosed the amount recommended on the chart for her glucose reading. To me, her numbers were/are improving but evidently I am wrong.

I took Zoey back to the old vet yesterday but did not get any face time with him. His tech said he was far too busy and Zoey's appointment was just for a glucose check and that the doctor wanted me to up her dose to 2.5 units each time. Well ... this is not at all what we had all discussed last week and really rubbed me wrong when they refused to let us see him, especially when we had been there the day before and they had us come back since he was not in the office that day (got called out). So, I made an appointment with a new vet today and they got Zoey right in.

The "new" vet (University of Florida Veterinary School of Medicine graduate -- he told me) said he doesn't listen to "Dr. Google." That all of that may be fine and good and work for some cats, but that in his years of experience, and according to his professor who is some sort of guru for cats evidently, that most cats do NOT come off from insulin and that I should only be dosing Zoey twice a day. Of course, he said a lot of extra words in there and it was all said very nicely, but that was the take-away. He said that while I could continue to dose 3 times a day and tie my life up with having to monitor the cat and stress her out with the extra blood draws, he suggests that I just give her 2 units of insulin twice a day and don't worry about the high numbers and/or the food. He said the changes in dose confuses the liver and is causing the swings. He wants me to test, at most, twice a day. He says to put enough food out that if she does get low blood sugar, she will self regulate and eat food to raise it -- but only feed twice a day. (???) I asked him point blank about her glucose reading being in the 200s or even 100s (like it sometimes is at test time) and he said to still give 2 units and that it will not drop hundreds of points (even though sometimes it does when I give 2 units and the test is in the 400s). He said over time, it will stop the upswings and start leveling out and if we see that it is consistently staying low in the 100s he will want to drop it. He did give me permission (after my apprehension became totally transparent) to reduce the dose to 1 unit if I felt too uncomfortable but that I should not go up unless he recommends it, which he will not do until he sees that it's consistently up for several days. He tells me: don't worry about the high numbers, that the insulin will keep her from going in to ketoacidosis (sp?); and that in his training, any diabetic cat under 350 is considered well managed and that very few cats come off from insulin and it's mostly the ones on Lantus (sp?). He said a "hi" reading was not to concern me because she was doing fine and eating and if it remains "hi" he will adjust the dose.

Then we talked about food and how all of my research/reading has shown me that I don't need to buy their high priced food and that Friskie's Special Diet (whitefish) is just as good. He said he's not concerned about the food and has no problem with the food I'm feeding her but that my research is not true, that DM and such is structured so that carbs and whatnot in it carry the sugar breakdown further than regular food. He went on about how a diabetic person wants to eat things like potatoes and pasta because the body breaks them down slower and the glucose is released slower and easier to regulate; and that the prescription cat foods are designed the same way. Well ... I want to scream. I thought that carbs are bad for felines and that their natural diet is raw proteins. When I suggested making my own raw food (Dr. Piersen) he said if I wanted to go that route that there was a special nutritionist that could formulate a diet recipe specific to Zoey's needs so that the sugars would break down slower. (Are there sugars in a raw diet to break down?)


As far as her being stressed about drawing blood (which he said probably taints my numbers and makes them read higher), I can tell you she definitely is NOT stressed. She sees me pick up her black glucometer bag and she gets on the bed and waits for me to get everything ready. I put her on her back, I alternate the paw that I'm drawing from, she's purring the whole time, she hears it do its "final" beep (she must count them and know) and she flips over and waits for her tuna treat. If she even sees me pick the bag up to move it she will run and get on the bed -- so absolutely no stress. If it's the middle of the night, she nudges me at the four-hour mark to wake me up. I don't know that the "new" vet accepts this scenario as gospel, but I swear it's the truth. We actually are amused and amazed by the whole thing.

So ... I'm conflicted. I guess I'm going to try it his way for the weekend and send in the numbers on Monday and see what he says. I really would like to get where Zoey is not being dosed 3 times a day and tested six (hard on the work / personal time schedule). If anyone can read through this and share with me how to reconcile my conflicts, I would greatly appreciate it. I really want to put my trust and faith in my vets but at this point, I don't know what to do.

I've attached Zoey's timeline for dosing. I tried to use the spreadsheet on the site, but I spent hours trying to reformulate it for the 3 times a day and I thought I had it until I saved it, opened it, and it was gone. I will use it going forward for the 2 times a day, but most everything in my records is 3 times (the first day or two of these records we were still 2 times but then it went to 3). Zoey is no longer on any medicine whatsoever.

All thoughts and opinions are greatly appreciated. Your time is truly valued.
 

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My mother always told me if I don't have anything nice to say I shouldn't say anything at all! But I guess I'm going to anyway - sorry Mom :P

I'm seeing, immediately, a number of (at best) half-facts in what you've been told. Yes, human diabetics should be careful of the type of carbs they're eating. But also of the amount. They don't want to eat a ton of potatoes, pasta or any other type of carb (though whole-grain carbs are the better ones to use their carb allowance on) because - guess what - it raises BG. I've seen it first-hand with my step-son who's diabetic. In fact, we calculate his dose of R insulin based on the carbs in the meal he's about to eat! And humans are omnivores and are meant to have a certain amount of carbs in their diet. Cats are not designed to eat much in the way of carbs, apart from the carbs that their prey has eaten. They're obligate carnivores and do not need potatoes, pasta, sugar, grain or any other kind of carb in any quantity at all. My Rosa is a straight-up example of that...she was on Royal Canin SO dry food (I'm not sure of the exact carb value, but there's certainly a fair amount of carbs in it) on diagnosis. I transitioned her to low carb wet food and, well, look at her spreadsheet - she's on a lower dose of insulin and her numbers are currently good.

It is simply not true that a cat can't hypo from too much insulin on a fairly low pre-shot reading. And not necessarily true that they'll self-regulate either. To an extent a lot can and will, and they'll eat whatever you've left out for them if they feel like they need it. But if the cat drops too low to the point of needing lots of carbs or sugar immediately then the amount of low carb food you've left out isn't going to matter much as it may simply not work fast enough to manage those low numbers. There's a reason why we keep high carb food and syrup or honey to hand for cats on insulin - a low number is potentially dangerous and needs to be dealt with immediately - it's not a case of just waiting for it to self-limit and go away as that doesn't always happen. Again, the same as in humans - a diabetic who's low enough to be hypo will have to use some sort of fast acting carb (glucose or similar) to bring their numbers back up fast.

A cat on insulin that is unregulated can still go into ketoacidosis - in the same way that a human with unregulated BG can, regardless of whether or not insulin has been given. And 350 is above what's generally considered to be the renal threshold for most cats. I thought the number of 180 I was given as a target reading for Rosa was bad enough for being too high, but 350 puts her firmly in the poorly regulated zone. And if he thinks Lantus is so superior as an insulin (and it should certainly get you down to 2 doses a day not 3 - and without a gap where she has no real active insulin in her system) then why doesn't he prescribe it for you at least for a trial?

Unless he's seen you take tests from Zoey, then he cannot possibly know whether she's stressed or not about it. From the way you describe it, she enjoys test time. Whether that's because she gets a treat, or some special time with you, or whatever her reason a stressed cat wouldn't willingly run up to be tested. And if he thinks she's stressed when you draw blood, just how much more stressed is he allowing for her to be when he does it - an unfamiliar person in unfamiliar surroundings?
 
April -- I understand and appreciate everything you just said. I have a very firm understanding (years of Atkins) on how carbs turn to glucose and in my "logic" that would mean to stay away from them if you're diabetic. All of what you said is why I am so conflicted. I mean, this is now two vets who have essentially told me not to worry with the testing and to just dose. What the heck?! And then, like I've just been reading on other threads, they imply who am I going to depend on when I need something and that there is no one in the field that they know of who would tell me to dose the way I've been dosing. They make me feel like I'm making this way harder than it has to be and that I could kill her because I'm making her liver work too hard with the different insulin doses.

The vet did say he would change Zoey to Lantus (did not want to do PZI -- or whatever the one that has the free sample is) but that it was very expensive and may not even work any better than the Vetsulin. The language is very discouraging as if it's a crap-shoot. And that's the "new" vet. The "old" vet kept reiterating how his "experience" with Vetsulin is why he chooses that one and it will last 12 hours, not just the eight that I feel my meticulously kept notes on Zoey prove beyond a doubt is the extent. It's like they look at my notes and all they see is poor dosing and foolishness on my part. I go in thinking I've got the tiger by the tail and am making wonderful progress and they knock me down and step on my throat for good measure.

How do I get things like Vitamin B supplements and nausea meds and whatever else may be needed if I'm not following their protocols? I mean, we've spent over a thousand dollars in the last two weeks and I just found out that I'm without a job at the end of the month. How do I find a willing vet to get the support, or at the very least the indulgence, to help my Zo-Zo? I am so willing to do the work necessary to help her with the goal of getting her off the juice ... but don't I at least have to have a vet to get the basics from? Is there a way to go off the reservation and do this totally without them? Of course, I'm not even sure if Zoey's improvements are as good as I feel they are; and I'm not sure if I indulge the new vet over the weekend and dose every 12 hours if it will at least prove to him that the way you all do thins is better ... or if I'm going to hurt or set Zoey back by all the changes.

It's truly damned if you do, damned if you don't.

When I first started this with you guys a few weeks ago I thought my biggest problem would be learning to test her sugar. If only that were the case....
 
It seems as though a lot of vets don't expect any of us to be prepared to put much time and effort into controlling our cats' diabetes. I was also sent home with a prescription for Lantus and syringes and told that home-testing wasn't necessary, though I could maybe learn it later if I really wanted to. If I'd blindly dosed Rosa on the 2 units per shot (twice daily) that the vet originally prescribed, I'd have been lucky if she'd survived the week until they wanted to see her again for a curve. It's likely that a lot of vets wouldn't suggest dosing and monitoring the way you are because it's a lot of work - more work than a lot of people are prepared to take on I'd imagine. If they told everyone to do things the way we prefer to do them, there's a good chance that a lot of people would say they couldn't cope with that. It's fine for them to know that other vets wouldn't ASK you to do what you're doing, but for them to say it won't work and isn't worth bothering is a hugely generalized statement that clearly doesn't hold true from the results that people on here get with their cats.

My vet doesn't really like what I'm doing, but has had to admit that Rosa's numbers are looking good. I do play the whole 'smile and nod' game with them on some things, but at the same time I was 100% clear with them that Rosa is my cat and there will be instances where I will do what I think is the best for her whether they approve or not. If they don't like it - there are a number of vets in our area and I'm quite sure I can find one that will let me keep doing what I'm doing without too much interference as I'm obviously getting decent results. I don't know the science behind how the liver compensates too well, but I'd have thought that varying the dose depending on the individual cat's response to it is going to cause less work for the liver than having a dose that consistently drops her too low and forces the liver into panic mode - with glycogen being released and sending her levels back up.

I've got no experience with Vetsulin as my vet only really prescribes Lantus for cats unless there's a good reason not to. However, I'm sure I've seen other posts on here stating that it often doesn't last a full 12 hours in cats. That might not have been obvious to either your old vet or the new one if other people weren't home-testing. With no numbers to work from, if all they do is a nadir test now and then, they'll never find out it doesn't last long enough until someone shows them proof that it wears off early in their cat. As you say, your numbers show that Zoey is better regulated with a shot every 8 hours not every 12.

I do appreciate the high cost of all this - Rosa cost me around $1500 in the week leading up to and following her diagnosis. I'm not working at the moment either, and those costs plus the ongoing testing supplies certainly put a dent in my savings. But the per-unit cost of Lantus is actually not all that bad once the initial cost is out of the way. I believe you can also buy it cheaper from Canada - that wasn't an option for me for the first prescription as Rosa's numbers were so high I didn't want to delay starting her on treatment. It's something I'll definitely be doing for future prescriptions though.

I think it really might be a case of calling round a few vet offices to find one who will be prepared to work with you, or at least let you work in the way you can see works for Zoey whether they completely approve of it or not. You do, I believe, need a prescription for insulin so there does have to be some involvement from a vet at least for that. And any improvement in Zoey's condition is a good improvement - these things take time and all you can do is take steps in the right direction with her. And that's exactly what you're doing by asking questions and keeping records rather than just accepting that everything the vet says is going to be right for your individual cat.
 
manxcat419 said:
It seems as though a lot of vets don't expect any of us to be prepared to put much time and effort into controlling our cats' diabetes. I was also sent home with a prescription for Lantus and syringes and told that home-testing wasn't necessary, though I could maybe learn it later if I really wanted to. If I'd blindly dosed Rosa on the 2 units per shot (twice daily) that the vet originally prescribed, I'd have been lucky if she'd survived the week until they wanted to see her again for a curve. It's likely that a lot of vets wouldn't suggest dosing and monitoring the way you are because it's a lot of work - more work than a lot of people are prepared to take on I'd imagine. If they told everyone to do things the way we prefer to do them, there's a good chance that a lot of people would say they couldn't cope with that. It's fine for them to know that other vets wouldn't ASK you to do what you're doing, but for them to say it won't work and isn't worth bothering is a hugely generalized statement that clearly doesn't hold true from the results that people on here get with their cats.

My vet doesn't really like what I'm doing, but has had to admit that Rosa's numbers are looking good. I do play the whole 'smile and nod' game with them on some things, but at the same time I was 100% clear with them that Rosa is my cat and there will be instances where I will do what I think is the best for her whether they approve or not. If they don't like it - there are a number of vets in our area and I'm quite sure I can find one that will let me keep doing what I'm doing without too much interference as I'm obviously getting decent results. I don't know the science behind how the liver compensates too well, but I'd have thought that varying the dose depending on the individual cat's response to it is going to cause less work for the liver than having a dose that consistently drops her too low and forces the liver into panic mode - with glycogen being released and sending her levels back up.

I've got no experience with Vetsulin as my vet only really prescribes Lantus for cats unless there's a good reason not to. However, I'm sure I've seen other posts on here stating that it often doesn't last a full 12 hours in cats. That might not have been obvious to either your old vet or the new one if other people weren't home-testing. With no numbers to work from, if all they do is a nadir test now and then, they'll never find out it doesn't last long enough until someone shows them proof that it wears off early in their cat. As you say, your numbers show that Zoey is better regulated with a shot every 8 hours not every 12.

I do appreciate the high cost of all this - Rosa cost me around $1500 in the week leading up to and following her diagnosis. I'm not working at the moment either, and those costs plus the ongoing testing supplies certainly put a dent in my savings. But the per-unit cost of Lantus is actually not all that bad once the initial cost is out of the way. I believe you can also buy it cheaper from Canada - that wasn't an option for me for the first prescription as Rosa's numbers were so high I didn't want to delay starting her on treatment. It's something I'll definitely be doing for future prescriptions though.

I think it really might be a case of calling round a few vet offices to find one who will be prepared to work with you, or at least let you work in the way you can see works for Zoey whether they completely approve of it or not. You do, I believe, need a prescription for insulin so there does have to be some involvement from a vet at least for that. And any improvement in Zoey's condition is a good improvement - these things take time and all you can do is take steps in the right direction with her. And that's exactly what you're doing by asking questions and keeping records rather than just accepting that everything the vet says is going to be right for your individual cat.
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I hit reply and it reposted. I'm sorry

April, are you happy with your results on Lantus? I don't want to imply that I would not want to spend the money on a new insulin. I have no problem spending the money if there is a plan of action. I'm just not getting anything from anyone who has the means to make it happen that makes me feel like going on Lantus is a good move. Both vets are suggesting I stick with Vetsulin and that I'm misusing it. Am I? I just really thought the log would speak for itself and there would not be this much resistance from the vets. I have an issue with searching out vets that cost a minimum of $100.00 to see you and review your files and then give me nothing but aggravation, frustration and discouragement.

I told the man flat out that I would never dose Zoey without checking her blood sugar and that's why I pinned him down about lowering the dose if the numbers were not high. He strongly suggested that I rely on his years of expertise and made me feel as if I was doing more harm than good with the way I was doing it. I truly feel a lot better about doing what I'm doing but it's all just subjective since the numbers are still going up and down without rhyme or reason and I can't get the professionals to look past the fact that I'm not doing it their way. :/
 
I am very, very happy with the results I've got with Lantus for Rosa. She's come down from a reading of 680 at the vet mid-January, to readings mostly between 60 and 150 (on a ReliOn Confirm monitor). It can take a few dose adjustments to get to a point where the numbers are good - Rosa went up gradually from 1 unit at each shot to 2, and is now back down to 0.75 units twice daily. Every cat is different (you'll see that a lot on here) and there's always the chance that it may not work as well for Zoey as it has for Rosa. But as you're not getting the results you'd like from Vetsulin it would definitely be worth considering switching. Even going from an 8 hour dosing schedule to a 12 hour one gets you a lot of hours back in your day! I fully understand that, just as I did, you'd be prepared to pay for the best treatment for Zoey. But as you say, when each vet visit costs a minimum of $100 it's not easy to search out the best people to work with you. The other good thing with Lantus is that you don't have to change the dose at every shot - instead, you change it when the numbers indicate over a few days that an increase is required, or when the numbers drop low enough to earn a reduction. For me, that meant I could work out approximately when Rosa would need testing more often, especially when she's getting ready for a reduction, as I was giving the same amount of insulin each time.

I have no doubt that when Vetsulin works for an animal it works well. But I cannot understand why, when you can demonstrate that it doesn't last 12 hours for Zoey and isn't giving the regulation you'd like her to have, the vets you've seen are so resistant to letting you try a different insulin. And the up and down numbers, while it does take a while for them to settle, don't seem to indicate that the regulation is there for her at the moment. If it was a doctor dealing with a child, there's no way they'd tell you to give insulin without testing. In fact they'd insist that you didn't dose without knowing the number you were dosing! Nor would they settle for an insulin that isn't giving good control. But for some reason, some vets seem to think that poorly regulated is good enough as long as some form of treatment is being given. Some professionals just don't like to be questioned - the old 'doctor knows best' still holds true for some of them. If only they could see people like us who do question and who are interested in doing everything to make our cats' lives the best they can be as an opportunity to collect data and further their own learning we'd all be much happier!
 
I'm going to make it through this weekend and I will try my best to follow his advice. But I already know that I'm going to be testing often so I have a good set of numbers to show come Monday; and I really don't know that if those numbers stay consistently high that I'm going to let her stay there and not revert back to "my way" of doing things. I do believe that I will call my "old" vet tomorrow (out of the two, he seems most onboard) and ask him to order the Lantus.

If anyone has a chance to look at Zoey's numbers that are attached to the original post, I would be interested to know your thoughts on how she has been doing. I don't know if my interpretation of her progress as being good is a reality or a delusion....especially since my vet visits.

I really do have more faith in this board and the help/advice/literature I've received here than I do the vets we've seen. I'm not sure exactly what that means though since I have to make the vets happy.

April, thank you for your time and reassurances. I'm really glad Rosa is doing so well. You are both an inspiration. :)
 
I think she's making progress - a lot of her numbers are lower than they were the first day or two. It looks as though she might still be bouncing after she gets into the low 200's or lower, but that's normal for cats when they first start seeing lower numbers. It does look as though you've done the very best you can - and with having to dose every 8 hours as well that must make it an exhausting schedule for you. It would be great if others can take a look too for anything I'm missing or any patterns that other people who use Vetinsulin might know to look for that I'm not aware of.

It does sound as though your old vet might be more prepared to work with you than the new one you just saw. As long as he'll prescribe the Lantus (probably a little cheaper to get a prescription from him and buy it from Costco than to have him order and dispense it), then you should be able to get her switched over fairly quickly.

Thank you for the kind words. :) I went through all the concerns and not being sure I could get this right very recently too so I do know how you're feeling. I'm so glad the small amount of experience I have so far and Rosa's progress have been able to help you. :) And the feeling of relief when finally you get a few days where you don't have to worry every minute about whether what you're doing is ever going to work for Zoey or not will make all of this worthwhile!
 
If that vet had a diabetic child I wonder whether he would be hunky dory with his child's BG reading "Hi"? Pound to a penny he wouldn't then think that blind dosing with the odd test here and there was such a good idea either.

You set the treatment goals for Zoey, not any vet. I'm very tired so can't write much this evening (Saoirse's intended dental today went pear-shaped because she was too stressed for it to go ahead). I suggest that maybe having a look at Saoirse's spreadsheet might be of help to you. She was treated with both Caninsulin (same as Vetsulin, different brand name) AND Lantus. It would give you a real-world example of how differently one cat may respond to both insulins.

Like Zoey, Saoirse also has pancreatitis and she officially became diet-controlled six months to the day since she was diagnosed. I was given similar advice when Saoirse was first diagnosed (including attempts to dissuade me from home testing) but when I learned about tight regulation and the possibility of her becoming diet-controlled possibly being better on a longer-acting insulin so I worked to get her onto a protocol that helped her, not one that the diagnosing vet decided unilaterally that we had to follow. (We've moved practices since and things are better there - much more FD-aware).
 
@Rose, your situation sounds scarily close to mine! The vets I have come in contact with said very similar things; almost verbatim!!!

"Don't test at home very much because it's stressful"
Moby is EXACTLY like your kitty when it comes to testing. By the end, he's a purring limp blob in my lap. He doesn't run away when we're done, he's in no distress whatsoever. My initial vet poo-pooed the idea, but had I tested from the get-go, I would have avoided a two day hypo/ER incident. After the hypo incident, she now ASKS to see my spreadsheet because a) she sees I mean business when it comes to his health, and b) it actually gives her important information on his course of action.

"Home tests aren't valid"
I don't want to use my indoor voice for this, but I will. I have proof that Moby's levels go up during stressful vet visits. (it was boosted nearly 100 points before his curve) And if it wasn't for the data from the home testing, I wouldn't have been able to make my case, but I could because I had the data to back it up.

The whole prescription diet thing
I don't have a huge aversion to this, I just want Moby to eat higher quality, less processed foods because that is what I believe in for myself and my family, including my pets. I talked to a lot of specialty stores who knew their stuff about cat diets (and the Dr Pierson article was very helpful to start out my own research) and found a good mix if low carb, less processed, high quality foods I felt were both healthy and in my budget. I did have a vet push the dry diabetic food on me for the reason that, "you don't want to be tied down to being there for your cat all the time, do you?" to which I responded with a silent, mental middle finger...

I totally feel the pressure between what you know to be true of your kitty, what you find here and what the vets recommend. Throughout this last month and a half, I have learned a few things:

1. My kitty's health care decisions are ultimately my responsibility. And if I feel something is not right, I have every right to speak up, ask questions and demand to speak to a professional that I am paying good money to see.
2. I know my kitty better than anyone. No one can read him like I can or understand his actions like I do. If something seems off, it's ok to seek help and ask for assistance in #1.
3. Testing at home helps me manage his health. Period. I have data I can fall back to, I can find trends, I can see what his body is doing and how he is reacting to food and medication. DATA IS GOOD.

I totally hear you on all accounts and you are definitely not alone in how you feel, Rose!
 
(sigh ) ... so, I waited to dose at 7:00 last night to get on a 12-hour schedule. Mind you, when I took my cat in to the vet yesterday, her 4.5 hour post shot BG was 93. I skipped that mid-morning dose, waited until 7:00 and her BG was "hi". I followed the instructions and only gave 2.0 units, fed her a little extra food since we're trying to go twice a day now and she was curled up and sleeping happily. 7.5 hours goes by and she's nudging me to wake me up. I know she's wanting food but everything in me cries to test BG before food so I do; afterall, it's been 8 hours since the last test. Her BG is 483, she's purring wanting food and I'm expected to just give her the food without a second thought and still not give her insulin for 5 more hours at a dose that is already less than what is called for.

That ain't happening.

I've dosed my kitty 2.5 units. The time is going to be thrown off on the next dose because I won't be able to be here; however I expect I will be able to make it back about an hour-and-a-half after the dose time. I will have to leave again right after that but should be home before NADIR so I feel this will be the best option so I won't be worried about going too low without me having a heads up with a 4 - 5 hour out blood test. (I'm putting my thoughts out there so someone can jump in my head and help me out if my thinking is whacked.)

I'm going to make a request from the old vet today and ask him to order/prescribe a longer lasting insulin. Should I request the PZI or Lantus? Is there one that is easier to work with than others? The only reason I lean towards the PZI at this point is because it "seems" to be the preferred method on the "sticky." Everything is open to interpretation so maybe that's not really the case. It amazes me how much I question myself these days....

And I have to tell you, during my appointment I made a reference to how is "my method" any different than a diabetic who monitors his blood and doses according to what/when he eats and his glucose readings. He told me that, "he's not for sure, but he thinks human diabetics are on a constant drip that keeps them level; and we can do that with my cat but it requires hospitalization and is very costly." That all keeps playing over and over in my head and I've come to realize that he just doesn't know how diabetes works. Period. Not that I do, mind you, but I'm willing to open my mind to something different than an accepted "protocol" that was learned in school from an instructor who learned it years before him and is passing it along.

I guess I am committed to keep my journals to myself, do what needs to be done, and when MY cat is OTJ, I will give them all a copy of my records and they can stick them or smoke them. I really don't care.
 
Hi

I don't have time to reply properly now but agree with everything people have been saying. The people on this board live and breath feline diabetes and you will get no greater help then here.

Look at my spreadsheet and you will the difference I got with remi when I switched from vetsulin to lantus. Night and day. He was OTJ within three months. Not saying every cat will but hopefully you will better and longer control of his blood glucose and at least give them the best shot at it happening or a good healthy life.

I don't know prozinc and so I would recommend lantus purely because of my own experience and the fact that there are so many very experienced lantus users that can help with your dosing.
 
I think you've done the right thing. You can't justify to yourself going along with something that you know isn't working for Zoey and you're perfectly within your rights to change back to a method that works better for her. I'm sorry your dosing schedule has been thrown off by a vet who appears not to understand. I can't advise you on the best way to dose with Vetsulin as I have no experience with it at all - I'd hope that someone who does can tell you what's going to be the best way forward with her next dose.

I don't know whether PZI or Lantus is the better option - it may be as simple as it depends on how the cat reacts to each. I've been very happy with the Lantus so would tend to recommend it based on my experience with it, but there are lots of people who use PZI and I'm sure that works just as well for them.

I'm actually really shocked by the vet's lack of knowledge about diabetes in general. Yes, some people do use an insulin pump but most are still controlled with insulin injections, just like our cats are. It does sound as though he has a lot of things that he 'thinks' he knows which isn't the same as actually knowing. If it's entirely possible for many, many people to control their diabetes with home testing and insulin shots, then there's no reason to treat our beloved cats any differently.

I would agree - share only the information that you need to with the vets and use the rest as data to help you take the best care you can of Zoey. You're the person who's with her every day, who knows her and can tell how she's feeling and how the insulin is working for her.

I'm sorry I don't have much advice for you on which insulin to choose or on the dosing question - I just wanted to stop by with some moral support for the decision you've had to make tonight to go against what the new vet asked you to do.
 
Critter Mom -- congratulations on Saoirse's progress! That's been quite a journey the two of you have been on and she stayed stable even through a move. If we could give out gold stars for a job well done, you'd have a slew of 'em!! :)

Marciegee -- the "silent middle finger" made me laugh out loud. That is exactly what goes on in my head.

Thank you both for sharing. The support is like a back brace and keeps me from curling up in the fetal position. lol.
 
Phlika 29 ... wow. seeing all of those blue/green numbers on Remi's sheet is wonderful. I read the comments and there have been so many other issues you've dealt with and still Remi is OTJ. That's pretty amazing. I will expect and work for nothing less for Zoey.

April - girl, you've responded to every post no matter what time I've posted. Do you ever sleep? Your support is wonderful and I feel fortunate to have it. :D

Thank you all. (I really can't say that enough, sorry.)
 
I do sleep - now and then for a couple of hours at a time ;) Rosa's had us on a bit of a roller-coaster ride with coming down the dosing scale fairly fast for a bit and I still don't quite trust her numbers not to drop so I tend to be awake early and late and all the hours in between monitoring her at the moment. :)

And you're very welcome with the support - everyone here helps when and where they can. I got, and am still getting, loads of support from people too - I like to pay it forward when I can. :D It's not long ago I was as confused as you are by the conflicting information and wondering what I could or should do to help Rosa get well - I understand the feelings only too well!
 
@Rose Anytime you need a silent, mental middle finger pointed at someone who confuses you, or gives you the run around, you just let me know!

I wish I had some knowledge about different insulin types, but all I know is Lantus. I found that it can roll differently than other types of insulin, due to the "insulin depot." I wish I found this post before I started it!

And I agree, @manxcat419, you have also responded to many of my own rants, vents and questions. Thank you for being there for me, too. :)
 
Again, you're very welcome Marciegee. We all have to vent and we all have questions. The great thing with this board is that there's always someone listening. :)

I completely agree with you both on the mental middle finger - it happens around here a lot when I'm on the phone to my vet too!
 
Hi,
I've been reading this thread the last couple of days and nodding in agreement all along. I'm in the process of searching out a holistic vet for similar reasons. I'll probably keep going to my current vet too but I want to find someone with a different perspective. I think my biggest frustrations with my current vet are the over-reliance (or so it appears to me) on antibiotics and prescription foods, and the nagging feeling that I'm never being told the full story. It feels like I really only get information if I push for it. Maybe the 'ignorance -is-bliss' approach is fine with a lot of people but it drives me crazy! Like home-testing for example - it was never even mentioned as an option. They just had me coming in every couple of weeks for blood checks and you know how quickly that adds up, not to mention the stress on the kitty. I had to ask about it repeatedly and once I made it clear that I really, truly wanted to try it, they of course said I needed to get an Alpha-Trak. The vet techs were very glad to show me how to use it but no one in the practice gave me any useful guidance about when or how often to test or how to interpret the numbers. I had to seek that out on my own and thankfully found it information here! This forum has been a god-send.

I'm afraid I can't offer any real help regarding insulin. Mitz has been on Prozinc for almost a year but I still feel like newbie because I've only been home-testing in earnest for a couple of months (and kicking myself for not doing it sooner!). I still don't feel like I've got a great understanding of the whole process. We'll get good numbers for a week or so and then she turns into a yo-yo again and I have no idea why. That said, I do believe the more data I can gather, the better I'll be able to help eventually.

I wish you and Zoey all the best on this crazy journey. It really sounds like you're doing everything right. Hang in there!

Joan
 
Joan - no kicking yourself - OK? You're doing the very best you can and you can only work with the information you have. Once you had more information, you used it and changed what you're doing - that's the best anyone can do. :bighug:

I was lucky enough to find this board the day Rosa was diagnosed - I'm an information freak and went looking for everything I could find as soon as the vet told me her BG was raised. I agree that staying with a vet who knows your cat can be a good thing - provided they're prepared to at least work with you not against you. I think all vets now rely on antibiotics and prescription foods too much and only give as much information as they think the average person is capable of taking on board. What they forget is that the average person is now much more informed than they would have been even 10 or 15 years ago because of the vast amount of information that is available with a few searches on the internet!
 
I'm gonna take a leap here and say that Vetsulin is a very poor choice of insulin for a cat--very "old school"; please don't feel offended--its your vet who has a problem if that's what he/she prescribed for your cat. A much better insulin is Lantus, Levemir (only 2 shots per day). PZI is also a good insulin, but I don't know enough about it to comment on it. There are tons of studies and recommendations in that matter; and not from FDMB members--from bonafide vets. I'm sure there are hundreds of people on this board that would agree with me that Vetsulin should not even be prescribed for cats. Also, why the constant changing of injection sites? Just curious. I looked at Zoey's "SS" and it seems the numbers are all over the place. I do hope things improve for your kitty, but if it were my cat, I would absolutely get his insulin changed--I would ask the vet to prescribe one of the better insulins; if he/she refused, I would get out the yellow pages and find a vet who prescribes Lantus, Levimir or PZI and make an appointment, making sure I went with SS in hand. If prescribed Lantus, you can get a Lantus pen for $25 or less with the Lantus Saving Card (go to lantus.com and follow instructions) and use a syringe to draw out whatever unit you are using -- the tips they may try to sell you are not precise enough to measure cat dosing.
 
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The Merck Veterinary Manual lists Lantus as the recommended choice for diabetic cats.
"It is usually preferable to have blood glucose testing performed at home to avoid changes in the pet's routine and the stress of in-hospital testing. Studies in both dogs and cats have shown that at-home monitoring improves glycemic control and increases the likelihood of obtaining remission in diabetic cats. In cats, high-protein diets along with insulin therapy are initiated, with reevaluation in 5–7 days. In newly diagnosed cats, insulin glargine is the insulin of choice. Glargine is a long-acting basal insulin. Used in conjunction with high-protein, low-carbohydrate diets, it is associated with remission of diabetes and discontinuation of insulin therapy in 80%–90% of cases within the first 3–4 mo of treatment."
 
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Okay. Reading that Merck Veterinary Manual just has me fuming ... I'm going to have to wrap my head in duct tape just to keep it from exploding!! It's all a racket. That's the only explanation I have for it. (smh) 30 bucks ... that how much it costs (not including gas and time) to have the glucose checked at the vet's. Even though I have all of the testing results in hand, they still insist on testing. Seems to me the incentive is there to put/keep cats on short-lived Vetsulin/Caninsulin and continue this ride on their gravy train. AAAAAAAAuuuuuuuuuuuuuuuuuuughhhhhhhhhh!

I've called my vet and they're writing the Lantus prescription. Of course, they want to fill it there but I told them no. So now they're charging me 10 bucks for the prescription. Money well spent. I have the Savings Card printed and ready to go. Does the prescription only need to be for Lantus or does it have to be specific to the pen? I just want to make sure that once I have this I don't have to contact them for a long while -- it's going to be me and y'all now.

I should have Zoey's Lantus before nightfall. How do I go about changing? Ideally, I would like to set her up for a 6:00 a.m. injection if it's going to be just once a day.
 
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Hi Zoey,
Rose said:
And syringes ... do I need a different type? I have the ones for the 40 ml.
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Lantus is a U100 insulin, so you will need U100 syringes, preferably with half-unit markings.

Rose said:
Ideally, I would like to set her up for a 6:00 a.m. injection if it's going to be just once a day.
Click to expand...
Lantus is usually given twice a day, and folks find here find that it works best if given (as close as possible to) 12 hours apart.

Eliz
 
Hi Rose,

Fingers and paws crossed for Zoey to do much better on the Lantus. I suggest that you start a new thread with a title along the lines of "Help Needed with Switching from Vetsulin to Lantus".

One thing I observed with Saoirse was that in her case Caninsulin had a bit of carryover from one dose to the next. Her numbers dropped a bit more than I expected on the first few days after the insulin switch. I'd suggest getting in regular tests during the first few days as an extra precaution.
 
I am ABSOLUTELY THRILLED you got a Lantus prescription. Good Luck!!! I, too, suggest you start that thread Aine referenced above as dosing unit(s) may be different (how much to shoot)....
 
Marciegee said:
I did have a vet push the dry diabetic food on me for the reason that, "you don't want to be tied down to being there for your cat all the time, do you?" to which I responded with a silent, mental middle finger...
Click to expand...

Atta girl! ;)

(Been there myself in the past. Thankfully our current vets are really collaborative in their style.)

DATA IS GOOD.
Click to expand...

Absotively!
.
 
Is there every anything easy? Ever?!

I picked up the script and went to Walgreen's with script and Lantus Savings Card in hand. Prepared (and excited) to pay 25.00 for a pen (even if I had to buy five at a time, that's $125.00). Walgreen's tells me that the prescription is regularly $400.00 and that the Savings Card allows me to save up to 100.00 and the cost will be $300.00. Does that even sound correct? If that's what we have to pay, so be it; but I need to research that cost before I just shell it over. If anyone is using the Lantus Savings Card, or any other coupons/discounts, I am interested in knowing the how-to's.

I'm continuing on the Vetsulin until I have three days I can put aside to make the switch and follow the tight schedule protocol for Lantus. I have commitments on Monday and Tuesday that will prevent me from doing the recommended testing so it will be Wednesday before I can make the switch. I'm going to use these upcoming days to try and find the best price and read up on the new information being sent to me.

I'm going to post this on the other thread I have going.

Thanks for the help and encouragement you guys! :)
 
I found Moby's Lantus a tad bit cheaper at Costco. If you have a membership there, I highly recommend! I think it came to about $264 thereabouts. But yes, that sounds right from my own research.
 
My vet prescribed the 10ml vial of Lantus - that came in at about $290 at Costco including tax. But of course with the vial I might not get to use all of it while it's still good - I'd actually have preferred to get the pens and pay a little more. I didn't use the savings card - Rosa's readings were so horribly high that I didn't wait at all. I went pretty much straight from the vet to Costco to fill the prescription.
 
You definitely don't - I'm not a member. You just have to tell them at the door that you're only going in to use the pharmacy. You can't buy anything from the rest of the store, but they will let you in without a card.
 
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