1st vet curve on Monday (17th) - questions I should ask on phone tomorrow?

Hi, my name's Candy and my FD kitty is Fena. I've posted in the Introduction section but haven't had time to set up my signature, etc. yet which I'll be hopefully doing this weekend. I wanted to ask this now though since I can't find the sheet where I wrote down all my questions to ask the vet on the phone tomorrow (they're open until 2pm EST but closed Sundays and Fena goes in at 8am first thing Monday morning) so trying to remember them all now and ask if maybe I'm forgetting something?

Fena is approximately 14 years old but I'm not sure, got her from a friend who found her on the streets. Then in Sept. 2009 when he had her at a clinic the vet estimated her age as 5 at the time. I got her (and more) just 2 months later, Nov. 2009.

Diagnosed August 26th, 2018 (BG was 444) and due to constipation issues (clean outs, enemas, etc) her vet curve was pushed back from Sept. 10th to the 17th (this Monday).

She weighed 11.5lbs on the 25th (had lost weight) but on Aug. 31st she was down to 11.

She's on 1 unit ProZinc 2x daily plus finishing an RX of metro (bowel stimulant) which she has 3 doses left of 1/2 tablet 2x daily - she takes her last one Saturday night. She'd previously been on Cerenia (2 refills) and Lactulose (finished bottle no refill).

Fena and Mao (brother but not related) are officially off ALL kibble (was Purina One Indoor + Immune Health) as of last night (13th) and ONLY eating FF or Friskies pates 3-4 times a day plus left overs over night. Treats are Halo freeze dried chicken (they love it!), tuna water, or on rare occasions if she still won't eat or eat enough with that then I'll crush 1-2 Temptations catnip treats or flake a little tuna over her food.

---I am NOT home testing yet sadly but I will be, pronto as soon as I can arrange it, probably this weekend or Monday itself while Fena's at the vet for her curve.

QUESTIONS TO ASK MY VET BEFORE MONDAY (in no particular order):

1.) They want her in at 8am, but that's her established shot/med time AFTER I've gotten her to eat enough - should I feed/shoot before bringing her or just show up even earlier? They start "checking in" patients at 7:30am they told me which MIGHT be enough time to get her fed, etc.

2.) If THEY want to feed her (see #3 below) how much will they offer? Full can all day? 1/2 can to start then 1/2 later? She's used to her mini meals now which is usually either 1/2 Friskies plus 2 cans FF a day, 1 can Friskies and 1 can FF a day or 3 cans FF a day depending on how well she's eating for me. It used to be only 1/2 can a DAY when I got her home on the 27th, still increasing slowly.

3.) Can I bring my own food? The vet fed her Hills i/d canned when they had her (11am Aug. 25th until pick up 11am Aug. 27th) and sent her home with some which I weaned her off of slowly. I want her curve to be as accurate as possible so would hate if they gave her "their" food.

4.) Will they test before they feed/shoot her if they don't want me to do it previously? Then every 2 hours after that until... what, 6pm normal preshot time or will they take her to 8pm?

5.) If they up her dose by more than I feel comfortable with (depending on how my testing her goes the first few days) can I just do the 1 unit I get my own picture of her/consult this website? Example if they want a 1-2 unit increase, etc. Just to note, this is a vet and hospital facility and Fena's vet is the one that told me to go to catinfo.org to get the food list and about the less then 10% carbs but she never mentioned a thing about home testing, this message board, etc. so I'm not sure what her stance on it is so should I bring it up that I wanna do it or let it go for now, or..? When I asked for help sheet printouts on diabetes at the bottom of one of the pages it had a section on home testing - it didn't seem to be for or against.

Can anyone think of anything else I should ask, before Fena goes in? I'll be getting copies of all her blood work so far plus the curve results and asking questions about her pancreatitis/constipation along with asking about what her anemia/potassium/phosphorous levels were. At the time, the vet only mentioned severe constipation, confirmed pancreatitis via "Senior Prof /w spec FPL Feline" and diabetes.

I'll also be mentioning possible neuropathy - when she walks, her front legs "cross" like a NY fashion model, one in front of the other like she's strutting a runway (which she's done for a long time to be honest) plus her back end is a bit weak for having BM's but she IS now able to go upstairs, downstairs, get on the back of the couch, etc. things she hadn't been able to do since she got sick initially - though she COULD still jump on the toilet seat/lid. But for BM's she starts out good then kind of slowly "melts" until she's essentially "sitting" in the box with her tail as high as it can go.

I should also mention, though I refer to Fena as a "she" - it's ACTUALLY a "he" and he's been neutered. I explained more about it in my Introduction post.

Any help is DEEPLY appreciated and I'll answer any and all questions - thank you SO much!! I also apologize if this post is a bit all over the place, it's all in my head what I wanna bring up but typing it out doesn't always come so easily to me, I need more sleep!

 

Welcome once again.

I don't have the answers to most of your questions but maybe someone else here will.

Home testing is the most important thing you can do. Please find a way to start today if possible. Your home test results will be more "true" because your kitty won't be stressed by being at the vet.

Also setting up the spreadsheet to track Fena's BG levels will help you and help us to help you and Fena.

Did you talk to your vet's office today? What did they say to your questions?

 

Hi Jean, and yes I did - well I did yesterday since it's Sunday now.

They said to "do what she feels comfortable with" in regards to feeding/shooting before we go since her apt. is at her shot time so I've opted to feed/shoot before we leave the house. The shot'll be about 15 min. early but I'd rather that than have her schedule pushed back.

They said they can feed her as often as I advise, so she can have her 2 mini meals before I pick her up at either 6pm or 8pm they're not sure, it depends on how she does but usually pick up for curves is at 6pm according to the tech I talked to and I can also bring my own food for her. If it turns out it's an 8pm pickup, I'll question them on the phone again if I don't hear any word by 5:30pm.

They will test her once she gets there, but the tech wasn't sure on how often after that - I suggested every 2 hours but she said they did maybe every 3-4 but didn't sound "sure" and the vet was in surgery when I'd called so she couldn't ask her.

I didn't mention home testing to the tech, but the vet will be there at pick up time so I'll be bringing it up then. I actually DID get to Walmart today and got supplies - they didn't have everything I wanted but I did the best I could for the time being. I also called the number on the box (Relion Micro) to get control solution which should arrive in 7-14 days, per the phone rep.

I'm wrung out today so haven't done anything with the supplies other than checking out the meter, manuals, etc. I tried to study it but after a bit it started going over my head so I knew I was too tired. I'll be back at it tomorrow and testing on myself to get used to it while Fena's at the vet.

 

Candy, you don't have to have permission from the vet to home test. It's one of the best tools you have to keep Fena safe. The blood glucose levels (BG) you are going to get are going to be more accurate that they get at the vet, due to higher stress levels. And the tech not knowing how to do a curve? That doesn't inspire confidence. You can do your own curves at home, saving money, stress and knowing that Fena is eating what and when he should. Idjit won't eat or pee at the vet if he is there for any long period. We did have the first curve done there, and I wish we had just waited until we were more practiced at testing. He was starving, hadn't urinated all day and was scared out of his mind. We didn't do him any favors.
Get your spreadsheet ready, then you can record all your tests, and the time and dose of insulin. Here is a link to the SPREADSHEET
It's mostly a matter of practice, and it becomes part of your daily life. If you were diabetic, or another beloved human in your home, testing wouldn't be an issue, it would be a fact.

 

Hi Lou,

Ooh I know definitely! Fena's pretty mellow actually, when she was diagnosed she'd been at the vets already for 24 hours and her BG was 444 - factoring in stress, she might've been 100-200 points lower. She did eat, drink and pee for the vet - no poop but that's what we'd been there for. Mainly she just laid around in her cage sleeping or lethargic. When I visited her the day she was DX's, she perked right up and ate a TON out of the bowl, then we snuggled. So while I know doing this at home is the best option, I can't help but be curious to see what their results show.

If nothing else it might give me an idea of HOW stressed she is at the vets, in ways that I can't visually see once I can compare theirs to mine done at home. But I agree, her vet works with at least a dozen others at the facility which bills itself as a hospital - so they have a ton of techs, assistants, etc. a lot of them right out of school so I'm not thrilled either.

In the end, I want to be the one taking care of her diabetes - like you all do, and save the vet for when you really need them for everything else. But since I'm like a fish out of water, I think the first curve being the vets might help me..? Hard to explain. Hope I'm not being silly. One of those "multiple pairs of eyes on the issue" kinda things I guess, at first?

But yeah, I'll be taking over her testing daily, her curves, etc. after this first vet one. It's my mission. To phrase it better, I guess I just hope the vet will be on board with me wanting to take control of the testing at home - she's been amazing so far, so I'd like to be able to work with her in case I need her for other things in the future where her diabetes is inevitably tied into it. Having to switch vets, again, ugh.. I don't even want to think about it right now, but I will if I have to. Just not a fun prospect.

Going to head over to that spreadsheet link now actually, thanks so much for posting it! There's a TON of info here - trying to absorb as much as I can, as fast as I can.

 

It will be nice if the vet is on board with you testing at home. But even if she's not, please do it anyway. It is the best and safest thing for Fena BY FAR. And will help you to get her more healthy faster. Test at least twice daily - before AM shot and before PM shot. And it's a good idea to - at least sometimes - also test 2 and/or 4 hours after the shots so you can learn how she reacts to the insulin.

 

I am so glad you are willing to home test. And, I do know that the immense amount of info here is mind boggling. Just break it down into the components you need right now: feeding the right diet, enough calories, the insulin, home testing and yourself staying rested enough and sane to take care of the fur kids, while still working and daily life. It's going to take adjustment, but that's life too. Sounds to me like you are on track, it will come, and there are so many people here to help.

 

Definitely take your own food in. If they feed her high carb food, it'll totally ruin what good a curve might do at the vet. I say might be, cause I learned not to trust numbers at the vet. Neko had her first curve at the vet, then no more there. Apparently she was mad at the vet and hissed everytime she went to take blood. Couldn't have been good for her blood sugar numbers. I had a civie hyper stressed at a vet (due to crystals), bloodwork showed BG over 220. Vet the next day reviewing results with me wanted to double check to see if he was diabetic. I tested at home - 53. Nope, not diabetic!

See if the vet can help you learn how to home test. There are lots of videos out there, but practising with someone who knows how to do it can help your confidence. I regularly showed my spreadsheet with the vet, that helped get her on board with me testing, and changing the dose.

Good luck tomorrow!

 

I remember reading that too! Okay so... if I feed/shoot (well she FINISHES enough food) at 8am, then her AMPS would be... 6am? That's when I've been getting up, but I'm trying to push it ABIT earlier, maybe 5:45am? So I'm awake enough, LOL. Then it would be.. +2 hours (10am) and +4 (12pm)? Same as night, just PM?

Trying to go as much by memory as I can to test it if that makes sense? From everything I've read I mean, to make sure I understand.

 

Right, so.. right diet: FF and Friskies, and I bought some 9Lives and Special Kitty just in case, all pate.

Calories.. here's where I'm struggling abit. When I first brought Fena home on Aug27th, I started her on wet food nonstop plus kibble (just to get her to eat) - she started out for awhile ONLY getting 1/2 Friskies a DAY, plus kibble. But now, kibble stopped Thursday night and she's up to about 8oz (or a bit more) a day - not including additional wet food for overnight. She's 11lbs, or was, on her Aug31st visit so she's lost a good 2lbs. She's been eating better.. the vet said shoot for 2 to 2.5 cans (5.5oz) daily, is that right, or..? So 11 to 11.5oz?

She's a pretty sedentary cat, doesn't get the zoomies like her brother - maybe once a blue moon but she DOES walk/trot follow me around alot so is the 11+ ok or more? To put her weight back on I mean and then watch her. I have a baby scale bookmarked, in case I need to buy it.

Yeah the staying rested/sane enough is... hard. But one day at a time right? I just worry that if I feel like this NOW (exhausted/drained) after a little less than a month, what am I going to feel like once I get the testing started, which'll be full of misses, redo's, etc? I'm trying though and will not stop!! God bless this site!

 

That's what I was thinking, they sent her home with Hills i/d initially and since they'd been feeding it to her nonstop for the 2 days she was in, I slowly weaned her off and DON'T want her back on. The tech (and like an idiot I forgot to ask) said they'd be testing via "blood draw" - which seems stupid to me, so I'll be asking when I take her in if they MEANT that or if they really meant AlphaTrak, etc.

VERY good idea! If they have a tester there, like the Alpha - can we practice on that or should I bring my own meter in, when I pick her up..? I don't think I've read about how testing with the Alpha differs from human meters beyond the number results. Is the practice itself the same, or..? Gosh I need to read more.

And thank you, we'll need it! Her vet is on "school row" - PreK-8th building then 9-12 High school on the SAME ROAD within 3 miles of each other, plus to-work traffic, and it's supposed to rain barnyard animals all day tomorrow too, 100% chance of rain, 1-2" expected day and night. Vet stress, plus driving stress during school/rush hour...

 

The AT operates very similar to a human meter, except you have to set a code to cat. Never done it, but have heard from people who forgot to set the code.

 

When Cameron was diagnosed i agreed to a vet curve (kicked myself for wasting the money afterwards, but that's another story) and they tested with blood draws. I was really annoyed by that, to be honest. Seemed so stressful and unnecessary to do actual draws from his inner thigh instead of an ear poke!