01/26/18 Texas Gizmo PMPS=170, +2=120, +3.5=64 , +4.5=67, +4.5=56

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LizzieInTexas

LizzieInTexas

Member Since 2016
01/25 +11=146

AMPS=173

Still fighting him on eating. Yesterday AM was no issue at all. Last night was a struggle getting him to eat +2.5 and +4.5. I finally gave up. He ate about 2/3 of each snack.

I got some bad news yesterday - I got a letter from the vet office that his vet (Dr. Pratt) is leaving the practice. She is leaving the field completely. I am so bummed I just don't know what I am going to do but I have to find someone quickly and hopefully someone that specializes in cats and FD particularly. I have absolutely no idea where to start.
 
I hope Gizmo eats better for you today. So sorry to hear about your vet. Is there another vet in the office that is any good? I hope you can find someone good quickly. :bighug::bighug::bighug:
 
They are all good but not "cat" vets. Sure they will see him but they don't have the attitude towards FD and treatments that Dr. P has. And I love the facility - I haven't even been there since they reopened since the Harvey flooding. Oh, and Dr. P was the dental specialist there. :arghh:
 
Bummer about Gizmo's appy still not tip top and bummer about your vet leaving. That has happened to me with two female vets at the practice I go to. It is very frustrating. It's worse than a hair dresser relocating and I thought that was horrible!
 
Bobbie And Bubba said:
Bummer about Gizmo's appy still not tip top and bummer about your vet leaving. That has happened to me with two female vets at the practice I go to. It is very frustrating. It's worse than a hair dresser relocating and I thought that was horrible!
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I am just so sad. I really liked her and she was so good with Gizmo and I could tell she really cared.

Speaking of hair dressers - how is the family of yours doing in Puerto Rico?
 
LizzieInTexas said:
how is the family of yours doing in Puerto Rico
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They are doing well, living with one of their daughters. As per my hairdresser, Margie, they are depressed and want so badly to go back to PR but, Margie of course doesn't want them to as they are too old to be battening down the house with every hurricane. Thanks for asking.

I hope you'll find another vet equal to Dr. Pratt. One of the ones that left my practice was Dr. Platt. LOL She started her own practice and it was just too far. Logistics is important.
 
Bobbie And Bubba said:
Logistics is important
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My biggest concern but at least I have a good vet hospital less that 10 miles from here and they are 24/7. That is where I took him after Thanksgiving with his last panc flare. I will give him nausea meds before I leave.

It is sad about the family not being able to "go home". I can't imagine but it is a valid concern. There is no where to run to when you are on an island.
 
It sucks that your favorite vet is leaving. It will probably take a lot of legwork on your part, but I hope you eventually find a new vet you love. Sorry Gizmo's appy is fluctuating.
 
That is such a bummer about your vet leaving, I hope you have time to proactively vet shop and find one you love before you really need them. Sending find a great vetty vines to you! :bighug:
 
Prayers for a successful hunt for best vet for Gizmo ( and you:bighug:). My vet of 25 years just retired so I feel your pain . We live in a small town and now our vet is 40 minutes away but so worth the effort . I know you will find a wonderful vet ASAP . :bighug::bighug::bighug::bighug:
 
I am trying to locate a check sheet/interview questions on screening a vet for FD (and other conditions). I found this one but it is pretty limited. Does anyone have one? If not, can we work on one here? If we can get a good list maybe we can get the admins to put it on the Health links / FAQ Forum or update the existing link.

Here is what I have so far but know I am missing some stuff:


Do you use IDEXX lab?
Do you have an in-house lab?
Do you do ultrasounds and/or x-rays in house?
Do you support home testing for diabetes?
Do you prescribe controlled substances for pain if needed (Pancreatitis)?
Will you write prescriptions so meds can be obtained from other (vet) pharmacies?
Are you open to meds being compounded for easy of admiration?
Are you familiar with Tight Regulation Protocol (TR)?
Do you do dental procedures in house?
Do you encourage testing for high-dose conditions (Acromegaly, IAA, Cushings)?
 
Beth 73 said:
Lizzie, this is an awesome project and a perfect place to launch it :) I would want to know if they are open to the use of human meters vs alpha trak ?
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Good point. I made it a sub-question (follow-up) on the TR Protocol
Do you support home testing for diabetes?

Are you familiar with Tight Regulation Protocol (TR)?
- Human BG meters ok? TR was developed using human meters.
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I hope that there is a lot more input as this has been an on-going issue here with people trying to find vets or open discussions with their existing vets.
 
To me, the single most important thing is a sense of partnership. My vet has medical skills and training I don't, but I know my cat. We need to partner together to give my cat the best care. I would ask about their experience with FD and have them describe how they have partnered with a client regarding the long term care of a FD cat. I would listen for details regarding how dose decisions are made and also try to understand their level of comfort in partnering with you. It takes time and a certain level of confidence for a vet to have an effective partnership with something complicated like FD.

I love my vet, but he has been up front with me that he learns stuff from me. He diagnosed Rosie, so I didn't select him based on FD experience. He knows medical stuff and favors clinically proven medications. Insulin dose and supplements are left primarily to me. We partner in overall care. Over the last year, Rose has been seen several times for non-FD things (constipation, arthritis, CKD, UTI, skin abscess etc). I need him to partner with me and help treat these other things.

He didn't know anything about TR or home testing with a human meter. I don't consider that a bad thing because he listens to me regarding what I'm doing and why. Once I shared my meter readings with him he wanted to know the math to convert my readings to his. Once I told him it doesn't work this way he settled more on the spreadsheet colors and less on the specific numbers.

I also highly value the fact that he is an excellent teacher. I have been doing SQ fluids since before there were youtube videos, so maybe this isn't such a big deal now, but it was very important for me to be taught how to do whatever I can at home. I consider both the stress on Rose and expense. He is very practical this way and is supportive of me giving injections, SQ fluids and enemas as needed. I'm in a state where I need RX for almost everything, so I need him to support me in providing this level of care.

Hope this helps. I realize these aren't yes/no questions, but I hope there can be some good "listen for" guidance in the questionnaire you put together.
 
Carol in Chicago said:
To me, the single most important thing is a sense of partnership
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Excellent. I would walk out if I didn't get that "feeling" but a lot of newbs might not fully understand how very, very important building a partnership with your vet is.

Another thing I added was - How will you (vet) communicate with me (care-giver) and how can I communicate with you? Phone calls, text, emails?
 
Not all questions for the vet, but some other important info to gather: Do they have a quiet waiting room/area for cats? Do they have a doppler blood pressure machine and a high-end u/s machine? If you'd ever board, do they have separate areas for cats and dogs? Would they allow you to be present for tests (u/s, BP, etc)?
 
Good questions, Lizzi, and good additions, Alicia: we always go straight to the quiet cat area at the vet's. Do they have specialist training in feline medicine? I look for that, as well. I've given up on a vet actually being familiar with micro-dosing for FD: I just listen to them, nod, go home and follow TR here. :-) I'm more interested in what they would do for other conditions (e.g. Pancreatitis, CKD, etc.).

It is so hard when a good vet leaves! I hope you find someone you and Gizmo like...
 
LizzieInTexas said:
Excellent. I would walk out if I didn't get that "feeling" but a lot of newbs might not fully understand how very, very important building a partnership with your vet is.

Another thing I added was - How will you (vet) communicate with me (care-giver) and how can I communicate with you? Phone calls, text, emails?
Click to expand...

I love @Carol in Chicago ‘s post! I really think that’s the biggest thing, if they are willing to listen and partner with you. How a vet handles diabetes or if they know the TR protocol is pretty much of zero concern to me, because it’s like looking for the last unicorn, frankly. The much more important stuff is what Carol highlighted. I’ve also found if you go in and don’t make diabetes a big deal, but talk matter of factly and confidently like “I’ve got this all sorted” it really helps. They will either follow your lead with that, or they will be rigid and uncomfortable and you will know that’s probably not the vet for you.

I also love the communication bit. Can I send weekly or monthly reports by email or how can I get some questions answered without having to make an appointment and bring my cat in? Those are great things too. The pain meds is also a good one, one of my vets didn’t think pancreatitis was painful, Asia changed his mind about that, but still, if you know your cat and you know it’s painful, you don’t want to have to pull teeth to convince a vet of that, many already recognize this to be a fact. I would also make sure they are comfortable with the medications and supplements you are currently using and won’t try to switch you to their favorite things to prescribe since your cat is already tolerating those well. Sounds like a really good list and I agree, it should be preserved for future reference.

Good luck finding a new awesome vet, Gizmo is a lucky guy to have you, Lizzie! :bighug:
 
Sorry about your vet leaving. I know how frustrating and stressful looking for a new vet can be. I think that finding a vet that will work with you in a partnership is probably the most important factor. Someone who will listen and understands that you know your cat the best. Good luck in your search and I hope Gizmo appy returns!:bighug:
 
There are cat friendly vet practices. They have to meet criteria established by the American Assn of Feline Practitioners. The link has information along with a link to finding a practice in your area. Consider speaking with your current vet and ask if there's someone she trusts and would recommend.

I'd make a couple of suggestions to your list. I would not ask if a vet will prescribe a "controlled substance." It could be misconstrued as you are drug seeking under the guise of your cat needing opiates. Rather, I would let a vet know that your cat has been successfully treated with buprenorphine (which would be in your cat's records) for pancreatitis and you know some vets are reticent to prescribe it. What does this vet think?

Rather than asking immediately about whether the vet uses TR, I'd ask a more general question first -- How does the vet approach managing feline diabetes? (Try to be sneaky about finding out is the vet going to insist on doing curves in the office, wanting fructosamine levels, and how the vet will respond to your changing the dose on your own.) Then ask about TR -- and be reasonably specific that you're talking about the Roomp & Rand version of TR (download a copy of the protocol and bring it along). If you then bring up home testing, you may get a better read on whether the vet supports it or thinks you'll terrorize your cat.

Will the vet respect your wishes about not prescribing certain medications (e.g., metacam, Convenia)? Do you get push back about prescribing these meds. (My vet categorically doesn't prescribe either.)

Most vet practices will do dentals. Ask about whether they are equipped to do dental x-rays. Take a look at the post on dental procedures. There are questions included about evaluating a vet practice re. dentals.

Do they do their own ultrasounds or do they have someone who comes into the practice to do ultrasounds?

Don't be too wed to IDEXX. IDEXX does have several tests that are proprietary like fPLI, SDMA, etc. However, there are some tests that are only run at TAMU (Texas A &M), Michigan State or some vets use Antech.

Ask for a tour of the practice. You want to see how the cats are treated. You also want to make sure it's clean -- especially the area where they do surgery -- and doesn't smell like a litter box that's never been changed.

Also, they should not give you a hard time about meeting with a vet to see if you want the vet to care for Gizmo. I interviewed the person I want to cut my hair and that's way less important than the person who will care for my cat. I did offer to pay for the vet's time when I interviewed a new vet when I moved to Columbus but they absolutely refused to take any money.

Talk to people in the waiting room. What do they have to say about the practice.

Read reviews on Yelp. Go to the state licensing board and see if there have been complaints. If it's hard to access information, call the board and ask to find out how you can get information about complaints. The Better Business Bureau may be another resource but it's likely to be related to the practice vs a particular vet (unless it's a solo practice).

If and when it's time, will they do in home euthanasia?

If it's important to you, find out where the vet trained. Given where I've lived, the vets in Chicago trained either at U of Illinois or Ohio State. Ohio State is constantly in the top 5 vet schools. Everyone in Columbus is an OSU grad. That said, keep in mind that someone graduated at the bottom of the class.

Trust your gut. Are you walking away feeling unsettled or do you feel like this is a person that is knowledgeable, will communicate much like Carol described, will be your partner in caring for Gizmo, and is someone you like.

 
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@Sienne and Gabby (GA)

All very good and valid points. When I wrote that about "controlled substances" I thought exactly the same thing. It was more of a brain storming/getting ideas and notes down. That is why I threw it out here - exactly for that type of input. I will wordsmith and tweek my document tomorrow implementing your input.

Would you be willing to review once I have done that and smooth out the rough edges and better organize it? I assume that you would know who could post it (I will and can) and where but I am not sure where it should be posted. Or will someone else be willing to review and help?

Thank you all for the suggestions. If there are any more I will add it to the document.

I think I found a vet office today. They are a cat only practice and I think I will setup an in-person interview if they will do that (I hope so). They are a bit farther than I would like but not un-doable (is that even a word)
 
Thanks for website refer, Lizzie . It looks very promising and look forward to hearing your thoughts after touring it . Must say I am insanely jealous as there are no “ cats only” practices around here ....how fabulous !
 
LizzieInTexas said:
If we can get a good list maybe we can get the admins to put it on the Health links / FAQ Forum or update the existing link.
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LizzieInTexas said:
I assume that you would know who could post it (I will and can) and where but I am not sure where it should be posted. Or will someone else be willing to review and help?
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You've been given some good ideas. Like @Stacy & Asia , I really like @Carol in Chicago 's post. Finding a vet who is willing to be your partner is key. My own vet wasn't the most knowledgeable about feline diabetes, but he was open to learning with me and if he didn't know the answer, he said so. Then he'd refer me to someone who would help. Mutual respect was the foundation. I think he's great and hope he doesn't retire any time soon!

Once your document is complete I'd be more than happy to bring it to the mods and administrator for discussion and approval if you're looking to make it "FDMB official".

Good luck with your vet search. Hope you've found "the one"!
 
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