Worst vet visit ever!

[Sarah and Buzz]

Fortunately I haven't really had bad vet visits, so that subject line might be misleading.

Buzz was her usual self at the vet's, at least at first. She doesn't get too stressed (that I can tell) and is always friendly and never combative or sullen or mean. The vet flipped her over for the cystocentesis, got the urine, and let Buzz get back up. Buzz jumped down from the exam table, walked a couple of feet, froze in place, and just stood there, half-crouched. She stayed that way for about 30 seconds, walked a bit, then began to pee heavily. The vet picked her up, put her back on the table, was looking at her eyes (one of which was non-responsive), when Buzz started puking all over the place and making noises I have never heard before. The vet then said she was worried about ketones and DKA because of these symptoms. While I tried not to hyperventilate, she went to go check the urine.

No infection, no ketones, nothing but urine glucose (which was 1000, but I don't know what that means, I'm assuming high). The bloodwork will tell us if there's some other kind of infection (teeth) and we will get those results in 24 hours. Buzz puked about 5 more times and wouldn't come out from her corner. What scared me about all of this is how unusual all of this behavior is for her. She's not a puker, or a hider, or a random pee-er. The vet did a BG reading, which pissed me right off because it costs $19, and it was 500. Of course it was! It was 350 at home this morning, I could have told you it would be at least 450 after all that rigamarole. ARGH. I like my vet but this kind of stuff is so frustrating.

I told the vet that I was second-guessing the Lantus now because I am scared to use it because it's so different from PZI. She said that if it were her kitty she would go ahead and try it. So she looked up Lantus in her medical book (she doesn't prescribe it and has no clue about it) and said I should start at 2-2.5u BID. I said, as politely as possible, that I would be starting at 1u BID. She told me that it also said to recheck in a week. I told her that wouldn't be necessary as I would be testing at least 4 times a day at home. I mean, where does this woman live? Does she not know that it's not necessary for me to bring Buzz in to do BG checks?!

So I will be starting Lantus on Buzz this evening. I don't really know how to use the pens so I am going to go on over to LL and see what they can tell me. I am so nervous!

I just want you guys to know, in all seriousness, that just because I am going to Lantus doesn't mean anything will be different. You guys are still my FDMB family, and the people who I trust here. I will still be posting over here just like always and keeping up with everyone. I'll always be a PZI-er at heart, I think, and I don't mean that to take away from anyone over in LL, who have all been as nice as can be. Maybe I will be able to get some good experience with Lantus and if any of you guys ever switch, I'll have already been down that road.

 

[Ele & Blackie (GA)]

WOW! How scary and frustrating. Will you get the blood work back tomorrow? I'm so sorry for that traumatic experience. I have never had that happen.

I will be looking for all of your feedback on Lantus. I also have pens in the fridge and I have printouts of how to start. I was waiting until Blackie got back to normal, but I don't know what normal is anymore. Please let us know how it goes with the Lantus and the bloodwork. I'm sending all of the OTJ fairy dust your way - Blackie won't use it anyway.

 

[Sarah and Buzz]

Yep, bloodwork results back tomorrow. Buzz is currently curled up on the upstairs bed (unusual for her, but not unheard of) acting like she feels awful. Not purring when I lay with her and pet her, not really looking at me or paying attention to much around her.

I don't want to try to make her eat if she doesn't want to, but I certainly can't start insulin until she eats and I've made sure she can keep it down. I'll let her be another hour or two and then really try to get her to eat.

I am glad you got the pens; it's nice to know you have back up/options. Ill give you the lowdown on the good, the bad, and the ugly as it transpires.

 

[LynnLee + Mousie]

fwiw, i picked up the 5 free pens too just in case and out of curiosity i took one apart to see what it's all about. you just take off one end of it and there's a rubber stopper just like on a vial. you insert your syringe in there and draw out your dose just like you would if it were a vial. it's just longer and skinnier :smile:

 

[Terri and Lucy]

Poor Buzz--and poor you. Are they going to run a T4 to check for hyperthyroidism? Did they check her blood pressure?

 

[Sarah and Buzz]

Poor Buzz--and poor you. Are they going to run a T4 to check for hyperthyroidism? Did they check her blood pressure?

They did not (nor have they ever) checked her blood pressure. Is blood pressure something they should check at every visit?

I am not sure if the T4 will be included in the panel, but for $98 they better bring me a gold-plated Klondike bar with the results. Buzz had full bloodwork at the time of dx, and I do believe the T4 was in that panel, so I imagine it would be in this one as well. At the time, her T4 was perfect, but that was 5 months ago, and things change. Thanks for the reminder.

 

[Sarah and Buzz]

fwiw, i picked up the 5 free pens too just in case and out of curiosity i took one apart to see what it's all about. you just take off one end of it and there's a rubber stopper just like on a vial. you insert your syringe in there and draw out your dose just like you would if it were a vial. it's just longer and skinnier :smile:

Thanks! That's good to know. I did find the photo in the Lantus stickies, which was also helpful. I haven't even opened the Lantus box and looked at the pens. I'm in denial, I guess.

 

[Terri and Lucy]

They did not (nor have they ever) checked her blood pressure. Is blood pressure something they should check at every visit?

Lucy has hers checked twice a year. Older cats, like older people, need to have regular checkups, including blood pressure.

Lucy's vet thought she was hyper-T for a year before it showed up on the tests. It was the first thing she thought when Lucy stopped responding to the PZI.

 

[Sarah and Buzz]

Lucy has hers checked twice a year. Older cats, like older people, need to have regular checkups, including blood pressure.

Lucy's vet thought she was hyper-T for a year before it showed up on the tests. It was the first thing she thought when Lucy stopped responding to the PZI.

Interesting about the hyper-T. And the blood pressure. I've never seen, nor heard about, an animal getting his/her BP taken, although it certainly makes sense. I learn something new every day around here, which is a very good thing.

 

[judy and squamee(GA)]

So sorry to hear of that bad visit. Could it have had anything to do with taking her urine? Or was it just coincidence that it happened right afterward?

 

[Sarah and Buzz]

So sorry to hear of that bad visit. Could it have had anything to do with taking her urine? Or was it just coincidence that it happened right afterward?

I am not really sure. It seems a little suspicious that it just so happened to be right after the urine draw. Buzz has had a cystocentesis done once before (at the time of dx) and she did not react this way. She has also been to the vet's often when she has NOT had a cystocentesis done and has never reacted this way, either.

She is still not acting normally and has not eaten more than a few bites since this morning (she ate a full meal before the vet as normal). Usually by now she would have had 2 additional meals, so I am worried about her. I also saw her drink water tonight for the first time in MONTHS.

I'm worried about her not eating, I'm worried about not being able to give her insulin because she's not eating, I'm worried about her developing ketones (negative today, though), and I'm worried that somehow something went wrong during the cysto and now there's really something wrong with her. Yes, I worry by nature.

 

[judy and squamee(GA)]

So sorry to hear of that bad visit. Could it have had anything to do with taking her urine? Or was it just coincidence that it happened right afterward?

I'm worried about her not eating, I'm worried about not being able to give her insulin because she's not eating, I'm worried about her developing ketones (negative today, though), and I'm worried that somehow something went wrong during the cysto and now there's really something wrong with her. Yes, I worry by nature.

Well, that stuff is worrisome. (is that a word?). Hope it all works out soon.

 

[Joanna & Bix (GA)]

Awwww, poor kitty & poor bean!!!! :sad:

Did you verify over in LL that you can't give Lantus w/o food? I don't know if the same rules apply....? Since she has had ketones in the past, I would think that getting her BG down some is important, especially since she isn't acting right. Since you've been through low #s before and are a PRO at all this, if it were me I would probably be tempted to go ahead and shoot, and just do a lot of testing to be sure she doesn't go low. Said with 0 Lantus experience, but knowing that you know how to balance lower #s with syrup if needed. I wouldn't suggest it to a newbie, but you already have been through that and know what to do if necessary. PZI might be nice, darn those floaties!!!

Pepcid AC can help a lot with upset tummies if that's what you think is part of what's still bothering her (1/4 of a 10mg (?) tab BID, but I don't know about interactions with other meds, so just mention it in case you want to make further inquiries into it).

Please keep us posted. Sending healing vibes to our little miss Buzz.

 

[Joanna & Bix (GA)]

Just my 2c, but I would also be sure to mention if you head over to LL that she has a ketone history. I wouldn't count on people reading her profile. Whether or not it ends up making any difference in people's advice, it seems like something anyone giving you suggestions should be aware of.

Also I wondered on the 1u you mentioned, if that should be adjusted based on her dosing from PZI? I really don't know, but I know when I switched from Vetsulin to PZI (a time of disaster best forgotten!), the idea was to carry the dose over more or less as a starting point, rather than using the same starting point you would if you had never used insulin. But I don't know if that applies to the Ls. Wacko that your vet said 2-2.5u. Wonder what hat she picked that out of? ohmygod_smile

And to mention on the blood pressure thing as I did a little research on that at one point months ago, the sense I got was that most vets don't check it unless they have a specific reason to suspect a problem. Weird once you think about it, I mean that''s always the 1st thing the human docs get out when you visit, right, the squeezy cuff, they love that! I don't recall though why it isn't more routinely done with cats.

Hang in there, and I hope things improve soon!!!! nailbite_smile Buzz is lucky to have you worrying over her, even if she doesn't appreciate it right this minute! cat_pet_icon

 

[Victoria & Sundance]

Sarah... I'm sorry that you had such a bad experience.

I'm only dipping in here because I know about the blood pressure issues. You said Buzz' eye was unresponsive... Is it dilated?

My former vet diagnosed Sundance's eye problem as an infection and gave me drops. They did not help. Three weeks later, she ended up bumping into something and I took her back... more drops and an appointment to see a specialist the next week.

I came to this forum and posted. I was told to get her blood pressure checked immediately. High blood pressure can cause retinas to detach. If they are caught early they can re-attach. I took her in the next day and sure enough she had hypertension BP at 220 - should be 140. We were given meds and a week later she was nearing normal BP. The vet said she would have had a killer headache.

Because of the mis diagnosis and the fact that the former vet office did not then and still does not have a BP monitor, Sundance's hypertension was not caught early enough and she remained blind until she died. But you'd have not known it after a few weeks. Gosh, she was just as active as ever.


So, yea... we can't say that is what is going on... but it's an easy test and it's only $20 or so. A vet tech can do it and you only have to see the vet if there is a problem so that they can prescribe the medicine. I would really recommend having the BP checked. Your vet may not have the equipment. If that's the case call around to find someone who does. I did that and ended up staying with them... what a blessing that was. Truly.

Good luck and let me know what happens.

 

[Sarah and Buzz]

Thanks, Joanna and Vic, for weighing in.

Joanna, good thought to mention ketones over in LL. I do not have anything in my profile right now, so even if they did check there, it wouldn't tell them anything. I need to make a new one or make a link or something. Also, on the dosing, the Tilly Protocol does say that you should take into consideration the dose from another insulin, but it doesn't say HOW to do that, unless I'm just not understanding it. The vet got out of her book, the one she always seems to have to bring in when I'm in her office (don't know if that says more about her or about me ), was that you should use 0.5u per kg of body weight, whereas Tilly says to use 0.25u per kg of ideal body weight. It just so happens that Buzz is at her ideal body weight or there would have been even more of a difference between the two numbers.

I don't know if you need to have food to give Lantus, but I will definitely look for it and ask if I don't see anything about it. My feeling was that if she wasn't eating when she should, I couldn't count on her eating when I might need her to. Yes, I could give syrup if I had to and she wouldn't eat, but I felt like that would just be making the entire thing much worse than it should be. Of course if she were still not eating tomorrow, I would have to revise that as she can't stay off insulin forever, nor can she continue to go without food. I say "if she were still not eating" because she did eat a little bit, and then I gave her some chicken water (the water from a can of chicken), and then she ate some more. It is far too late to give her a shot tonight, though, so I will make sure she eats a good meal in the morning and shoot her then. She also cuddled with me on the couch for quite awhile, so I think she is on the road to recovery.

Vic, thanks for the info about the BP. I had no idea that Sundance went through all that, but it sounds like her blindness didn't affect her much in the long term. Animals are so adaptable, aren't they? It amazes me what they can go through and still have their lovely personalities intact.

When the vet calls tomorrow with the BW results, I will ask her about the BP equipment. Buzz's eye seems to be normal now; I've repeated the same thing that the vet did several times, and each time it is fine. Perhaps she was just so afraid/stressed that she had a momentary blip in her vision? I don't know if that's possible or not, but it was indeed a bit scary.

Thank you both (and all of you who have responded) for your support. This community is absolutely invaluable and unparalleled for the human connection aspect, let alone the knowledge.