What to look for in a vet to manage cat's diabetes

Hi all,

We are looking for a new vet to help us manage Leo's diabetes. Leo was treated for DKA at an urgent care specialty hospital, and while they did a great job and saved his life, the bills for follow-up appointments are excessive for the type of care we need for our cat now.

What do you recommend we look for in a new vet to help Leo with this diabetes? Another clinic we contacted in the Bay Area (where we live), was not familiar with the Freestyle Libre (at least on the phone), so that sounded like a red flag.

We are also looking to have Leo get dental work to remove two rotten teeth that could be contributing to this diabetes. Any advice on what to look for in a vet for such procedure is welcome.

Thank you!

 

Here is a link for you to look at re looking for a new vet
https://www.felinediabetes.com/FDMB/threads/vet-interview-screening-topics-check-list.156663/

 

Are you still testing for ketones in the urine?
And how is his appetite?

 

Yes, we tested ketones the last two nights with the strips, negative both times.

His appetite is good, but he drinks more than usual. When his glucose is high he's hungry. He's loving his new low carb food (Ziwi Peak).

Thanks for the link!

 

I feel like it's harder than ever to find a good vet because they don't let anyone in these days with covid protocols. It's all done through the phone while you wait in the car

 

Yes it’s tough at the best of times and now COVID has made it worse.
You should be able to talk to the vet on the phone before committing to them.

great you are testing for ketones..well done.

He will eat more when his BG is high because he can’t absorb all the nutrients in the food and he will be hungry. If he isn’t overweight, let him eat more. And he will drink more and he will be peeing more with higher BGs.

 

Just a little input from a cat mom who's done ear pricks and the Freestyle Libre. Luckily George was able to get regulated and OTJ in two weeks first go around, and I do credit having that plethora of data from Freestyle libre to help us do that.

11 months later and he's no longer in remission and we need to start testing again. He was very insulin sensitive so testing is so important. Initially we were going to put another Freestyle on him but our vet wasn't comfortable as his coverage vet affixed it last time. We ended up deciding on ear pricks this time for a couple reasons. First, it's likely you'll need to become adept at both methods. Secondly, the monitor last 2 weeks but with the surgical glue it took 6+ weeks to come off. There's only a few spots a cat can wear them. The first libre didn't work, I guess that happens. Now normally Abbott or whoever will just give you a replacement, except using it on a cat is off label so they wouldn't warranty it. Fine, buy another Freestyle and put it on him. Attached is a pic of him with the monitors attached, that only last two weeks for monitoring but the poor guy wore them for awhile. Then it took 7 months for his fur to grow back.

I was afraid of doing the ear pricks but it really is so easy & he doesn't mind at all. I pricked my finger with the lancet and giggled, it was lovely to know it really doesn't hurt. There's a learning curve but you'll be a pro in no time.

I don't see it as a long term solution for cats with diabetes, that need long-term testing. But that was just my experience, I wouldn't be surprised if the brilliant folks have figured out how to use them better. This forum will literally save your cat's life, they 10000000% saved George.

I'm very frustrated with my current vet, I just don't know if he really knows enough about feline diabetes. I had to explain the SS to him last year. He doesn't tell clients to test, just to shoot blind. I feel there's a disconnect. I wish I had more advice on that one.

Best of luck!

 

Also ask what insulins they prescribe. Lantus is very good for cats. It they try to push Vetsulin or Canisulin, or any other short acting insulin, I would be leary. Most likely they have not kept up with feline diabetes treatments. Also ask if they support home testing. It will not stop you from testing, but it is better if you have a vet that supports it and works with you to manage his care.