Vet's advice

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Mphair84

Mphair84

Member Since 2018
I got off the phone with my vet today and I'm confused in the information that my vet is telling me. My vet told me that I've been taking my pre-shot test at the wrong time and I should be dosing based on bg levels a half an hour after he eats to get better accuracy. They said that number after he eats should be what I go by the to base my insulin on because after the cat eats his BG levels Spike. The doses need to be factored towards that. I shouldn't be adjusting his dose at all. They like that I test him but they don't want me to actually adjust his dose they want me to keep 1.5 every time.

I asked what I should do when he's too low to give a full dose and they told me just to keep on giving him the same dose. " We're not treating the numbers, we treat the cat".

Can someone please explain this to me because maybe I am not understanding what they're actually saying. I thought that you're supposed to get the levels with no food 2 hours before to get accurate readings and I think they are saying otherwise.

So honestly now I'm feeling a little bit insecure. I thought I was doing a good job but am I doing this wrong?Should I not be adjusting his dose at all and just keep it flat because I thought that I should be adjusting his dose so he's in healthier number rangers but maybe I am changing it too often? I plan on keeping this dose for a little bit and see how that works out but I may have to adjust depending on my cat.

Am I doing this wrong, am I missing something?

Sorry for being redundant it annoying.
 
Wow. I don't even know what the heck your vet is thinking. I can't even begin to interpret it...I can only tell you what we advocate (which I know you already know, but humor me) and do my best to explain why.
  • We advocate no feeding for 2 hours before the preshot test. This is to ensure that your BG reading at preshot is a 'true' number and not influenced by food.
  • We advocate preshot testing BEFORE feeding...again, so it's not influenced by food.
  • You want to dose off the 'true' numbers and not food influenced numbers because the food influence won't be on board throughout the cycle. It's usually hitting around +1 and wears off starting around +2...so that gives you another 10 hours of the cycle where food influence WON'T be a factor and the insulin you gave based on that inflated number might be way too much and cause a serious situation.
  • We advocate changing the dose as needed...while we do agree consistency is best, that doesn't mean you don't change the dose. We change it based off both preshot AND nadir readings. You have to know both where the dose is at the beginning of a cycle AND how low it takes you to determine what to give. You can't give it based off just one or the other. And giving a FULL dose on a low number like a 110 or something? Nope. That could cause a serious hypo situation.
As for your vets comments on we treat the cat not the numbers...sure, you want to treat the cat not just the numbers. That's why we sometimes remind people when their cat is stuck in high numbers to tell us how the cat IS. Is she acting happy, playing, etc. Because your cat is more than just a number. But PART of your cat is a number...and you can't treat the cat by acting as though the tests don't matter. If that was true, what would the point of testing even be?
 
Okay, so I'm right to be concerned with what I was told. I was thinking I wasn't understanding of what she was getting at. I know they have been not impressed that I don't stick with a flat dose. Trust me, it would be nice, but until I change his insulin and see whete that takes us I'm not sure if it will happen the way they want.

I'm actually feeling more confident now to because everything you pretty much said was my concern in why I shouldn't listen. I suppose something of what she said she be lost in translation when the tech told me, but she was talking to the vet, then had me on hold and then kept going back and forth.

They also said I need the fructosamine test and I need to keep the same dose for 2 weeks. Unless I misunderstood, they told me not to change dose even if it's too low.

So I think I should either blow them off, get my cat's teeth cleaned and use them strictly for routine visits and emergency visits or find a cat clinic. I can get my diabetic needs on line anyways so as long as they sign off on it it should be okay?
 
You could also just not show them the spreadsheet anymore. I've been at this so long now that my vet just asks me what numbers I'm seeing at PS and nadir, and what dose he's on, so I give a general answer like, "He's usually around 200 at PS and around 100 at nadir, and he's getting 2u." Now from day to day, of course that changes, and his dose floats a little up and down from 2u, but it gives the vet enough information to know his diabetes is under control and to keep giving me insulin. The vet doesn't need all the little details as long as I'm giving an accurate summary. :)
 
Now that the smart and experienced people have answered... lol...

This is how I (a neurotic lol) interpreted it when trying to understand it for my guy...

His numbers without food are going to be lower... with food will be higher and those higher numbers might give a false sense of security because they're not his *real* numbers...

So for me.. I am terrified of giving too much insulin and having a hypo situation... so... I want to know what his lowest numbers are... his real numbers... I get that the vet assumes "it'll be fine" because the food will be onboard to deal with it but in my mind, as I understand it... food levels are fleeting, and the insulin sticks around for a while.

(I'm brand new to this so this is just moral support and not advice! lol)
 
Good points. I'm just going to back off with the vet . At first I was excited because it felt like the vet actually wanted to be involved but now I realize they just want me to let them take over. Every chance they get it's the same thing, "keep the same dose no matter what, come in for the expensive tests". She's not listening to my concerns. :( BUT they have 24/7 emergency visits and are 15 minutes away..... The next closest place for emergencies is an hour away from me.
 
Good advice from these members. What we recommend here works. See that vet for other issues if you like her but take care of the FD treatment yourself with help from this forum.
 
As far as the fructosamine test I don't see why they need it anyways. She said it'd let them get average of TK's BG levels, but I'd have to stay consistent on a dose for 2 weeks. What's the point?

I already know he's diabetic and is getting insulin, what will the average tell me?
 
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