Update for Priss & change of vet

[Priss]

Hi everyone,

I followed your advise and took Priss to a new vet, we had run out of the Lantus from the last vet and needed a new prescription. This one we had the vet visit, a rabies shot (they insisted since I couldn't find the record) and a BG test plus urinalysis again. This time no ketones! However I brought a copy of the prior vet's bloodwork and they want to do another blood panel. The vet said he wanted to redo it because of how high her liver enzymes were. Any thoughts on this? It is $160 plus another visit fee. She is licking her lips pretty often, I don't know if this is hairballs or nausea. Sometimes she sneezes, mostly in a certain room, the vet didn't seem concerned about these but I worry she may have a secondary infection.

He wrote out a prescription for a vial of Lantus and told me to ask for one with a long expiration. I'm a little confused by this because on the forums and from the pharmacists I spoke to, the clock starts ticking once opened and it only lasts a few months at most. Luckily I found a pharmacist who filled the prescription with a 3ml pen for $40. The vet wouldn't write out more than one month. Is this usual? It seems like I'll be paying $100 every month or so just to get the prescription. Also, the vet said he wants me to use the alphatrack and not a human glucometer.

Right now Priss is eating the Merrick before grain chicken, we have a case but I'm going to change over to Fancy Feast once that's gone.

Thanks!

 

[Hillary & Maui (GA)]

I have to wonder, how much this vet really knows about diabetes. I would ask the vet their experience with this.

There is no reason why the vet won't write a script for insulin for more than 30 days. That's just silly in my opinion.

I can understand wanting to do another blood test, but if you just had one done, then wouldn't it make more sense to wait a few weeks to allow for changes? Also, how high were the items he was concerned with? Is it too high that something needs to be done now, rather than later?

There is no need to spend the $$ for an alpha trak, when so many of us use the human meters without issue. The only purpose I can see, is that you have to purchase the meter and strips from the vet and they are very expensive. Also, what happens, when you are low or run out of strips and the vet is closed?

My former vet at first forbade me from home testing, then told me that if I insisted on it, I had to buy the alphatrak from her and could only test when she said so. It was a huge contradiction and thanks to the people here, they assured me that a human meter would work just as well.

The only human meters to stay away from are the ones with TRU in the name - these are the "store" brand versions for several pharmacies.

A good inexpensive human meter can be purchased at Walmart - it's the Relion brand. The meter and strips are reasonably priced. Other good meters are Bayer Contour (really easy to use and takes a tiny amount of blood) and One Touch Ultra (also easy to use, but have to code the meter and requires a larger blood sample).

But back to your concerns, I would question the vet and if necessary, maybe find another new one.

 

[hmjohnston]

This vet seems more interested in the money that a diabetic cat patient would bring with the things they are insisting on than the welfare of a cat.

If they are insisting on a new blood panel so close to the old one- did they say which enzyme (and what it did)? Why, exactly they wanted one done so close to the last test (my new vet waited 6-8 weeks to do another blood panel from the previous because the BUN was elevated for the kidneys)? Get the panel and type it in to run it through the board for suggestions- Mommaofmuse did that with Musettes and she got lots of replies.

Relion micro or confirm, Bayer, all of these are good human meter brands with cheaper strips. Why are they insisting on Alphatrack? If it is because they read "truer" you can reply that you understand the point difference between a pet and human meter and have taken that into consideration. Alpha is expensive with expensive and hard to get strips- vet office only with mark-up. Stay away from anything with True in the name or the Freestyle that take has the butterfly on the strip.

As for the prescription... My vet wrote me a prescription for levemir pens with 3 refills. So doing it in 30 day increments only means they could want office visits to charge for each month unless they won't charge you to come pick it up.

Are there any other vets in the area? I know it is expensive to keep visiting- recently I had to make a switch and called around first to see about FD patients that they had, then I just go and don't bring my cat so I can have the time to talk. Still $49 for a visit but I got to talk to the vet, found out how much he knew about FD and how many patients he has with FD and they feeling bad. Calling around really weeds them out as I had one who said it was mandatory that I feed their science diet dry to my cat, no canned allowed, and another that insisted I do in-house curves every month. I said no over the phone and called the next vet in line. I like my new vet and he trusts me when I come in and say I want something- a change of insulin, testing for acro or IAA- he knows I do my research and that I'm not taking his word as law and the absolute for my cats well-being. He knows I know more about FD than he does and he doesn't mind it at all.

Good luck. First find out the reasoning for why they want to do the things they do, if it doesn't make any sense and feels like they are just going for the money say no and find a new vet- you already have a one month prescription so that gives you some time.

 

[BJM]

...Luckily I found a pharmacist who filled the prescription with a 3ml pen for $40. The vet wouldn't write out more than one month. ...

3 mL * 100 units per mL = 300 units of insulin

at 2 units twice a day, that is 75 days worth, or 2 1/2 months
at 1 unit twice a day, that is 150 days worth, or 5 months

... so he wrote you a 2.5 - 5 month supply, because properly stored, you'll be able to use most of that pen. (the ecseption being a high dose cat with a complicating medical problem such as acromegaly)

 

[Priss]

How long exactly does it last? the pharmacist says 30 days, but I read on here a few months, and recommendations for the pen refills over the vial. The prescription was for 10ML but I asked the pharmacist for 3ml because I thought I wouldn't be able to use the 10ml any longer than the 3ml. The vet told me he couldn't write it for more because it has a habit of disappearing, and they had to do the tests to make sure my cat still had diabetes.

The vet didn't try to sell me the alphatrack and said I could get one on ebay, but that it was calibrated for animals. I did mention I was hometesting with the human one. I'll check the paperwork for the last bloodtest and post the liver results here, that panel from the last vet was done on 4/20, they said it was their senior wellness panel. The other vet never even brought up the liver results to me.

 

[BJM]

How long exactly does it last? the pharmacist says 30 days, but I read on here a few months, and recommendations for the pen refills over the vial. The prescription was for 10ML but I asked the pharmacist for 3ml because I thought I wouldn't be able to use the 10ml any longer than the 3ml. The vet told me he couldn't write it for more because it has a habit of disappearing, and they had to do the tests to make sure my cat still had diabetes.

The vet didn't try to sell me the alphatrack and said I could get one on ebay, but that it was calibrated for animals. I did mention I was hometesting with the human one. I'll check the paperwork for the last bloodtest and post the liver results here, that panel from the last vet was done on 4/20, they said it was their senior wellness panel. The other vet never even brought up the liver results to me.

What has a habit of disapearing? Diabetes? By doing the home testing, the data you collect can show if the cat still has diabetes and how well it is being controlled - the vet doesn't need to do more test$ if you are collecting data.

And a 3 mL pen, stored in the frig after opening, on a shelf, NOT the door (don't roll or jiggle it as that causes it to deteriorate faster, and nothing needs to be mixed) will last that long. If it starts to become less effective, it will happen gradually, not suddenly - you will see this in your test values.