5/23 Luci AMPS 256,2+219,6+228, 9+263,PMPS 249, 2+223, 9+214

[Sue and Luci]

Yesterday

Luci growled at me this morning when I gave her the insulin shot - somehow after her vet visit she's been jumpy and doesn't want to relax for her testing - I was surprised that she's reacted so adversely to her brief visit to the vet yesterday - she must not have liked having her blood drawn for her pre-op labs - tomorrow is the dental - cleaning - she sure won't be a happy camper when she goes through that!

It's taken me a long time to gain her trust and get her to relax for the testing/shots - now we're starting over?

 

[Mandy & Rex (GA)]

Luci may be telling you she isn't happy with you bringing her to the vet yesterday.

If you continue to feed her every test, I think she will be quick to forgive and forget... until tomorrow!

 

[Sue and Luci]

@@Wendy&Neko, @Mandy & Rex
Vet's office contacted me this morning and said her blood work came back ok to proceed with dental tomorrow; however now they say no food after 9 p.m. + 1/2 dose (.5 u) at 7:15 a.m.
I asked them to check her BG at 9:15 and to let me know what that number is. The anesthesia procedures don't start until noon. I think that's a long time for Luci to go without food and to have insulin on board. I EMPHASIZED to them that she has a history of going hypo very quickly - and they assured me they'd keep an eye on her...I'm not feeling very confident today. I'm starting to think about calling another vet and pulling the plug on tomorrow. Although this is the same vet who did her dental last year; and extracted two bad teeth at the same time. Although at that time Luci was not on insulin...I know these vets have their ideas but I trust this board more...they're making me a nervous wreck...advice?

 

[Mandy & Rex (GA)]

@Wendy&Neko (your tag didn't work)

I don't know what to say. I don't understand why they keep changing their instructions. You would think they would do one protocol for all cats or two - one for non-diabetics and one for diabetics.

 

[Wendy&Neko]

When the vet's office called this morning, did you remind them she's diabetic and ask why the fasting instructions had changed? Ask them to confirm with the vet? I would suspect the front office staff of the mistake.

 

[LuanneP]

9pm seems early to start the fast even for a non-diabetic. When I go to the board certified vets for procedures, they say no food after midnight. The regular vets usually say no food after 10pm. When Merry had his dental I did give him half his insulin dose in the morning & I think she started the procedure around 10am & I know she checked his BG often while he was there.

 

[Sue and Luci]

When the vet's office called this morning, did you remind them she's diabetic and ask why the fasting instructions had changed? Ask them to confirm with the vet? I would suspect the front office staff of the mistake.

We exchanged texts - multiple times - and I asked her if that was noted in her chart? Is the fact that she's diabetic noted in her chart? I expressed my concerns again - and asked for a test at 9:15 and a text with her BG. It wasn't a phone conversation.

 

[Sue and Luci]

I've cancelled the appointment for tomorrow! Those people had too many conflicting instructions. I've rearranged her for an exam and dental cleaning next Thursday - the instructions from staff there were no food after midnight and NO Insulin in the morning. They also asked me to bring my own glucose testing kit so they could use that and save me a few $$ from using their machine to test her - astonishing!
I can live with that. I hope Luci can too.
Better that she's too high for the day than too low. This first vet was making me very uncomfortable - I had visions of Luci laying in a cage going hypo because she's had nothing to eat for over 12 hours and insulin on board...

So next week I'll spin up again...sheesh.

 

[Sue and Luci]

@Wendy&Neko (your tag didn't work)

I don't know what to say. I don't understand why they keep changing their instructions. You would think they would do one protocol for all cats or two - one for non-diabetics and one for diabetics.

Thanks for that...I'm just too nervous to even function correctly - I see I put two @ symbols...

 

[Stacy & Asia]

Oh Sue! What a mess! I’m glad you listened to your gut though, hopefully the new place has more clear and consistent communication. I really hope you don’t have to start over with testing, I hope Luci was just a little rattled from the vet visit and the vet switch will put her at ease a bit.

 

[Juliet]

I've cancelled the appointment for tomorrow! Those people had too many conflicting instructions. I've rearranged her for an exam and dental cleaning next Thursday - the instructions from staff there were no food after midnight and NO Insulin in the morning. They also asked me to bring my own glucose testing kit so they could use that and save me a few $$ from using their machine to test her - astonishing!
I can live with that. I hope Luci can too.
Better that she's too high for the day than too low. This first vet was making me very uncomfortable - I had visions of Luci laying in a cage going hypo because she's had nothing to eat for over 12 hours and insulin on board...

So next week I'll spin up again...sheesh.

That is exactly the instructions I was given. No food after midnight, no insulin in the morning and Silver was the first appointment at 8am. Ensure you are given antibiotics after the dental. Clavamox is best. I brought my own insulin - prefilled in a syringe so I knew they would give the dose I wanted them to give. He got the dose shortly after eating after the dental.

 

[Sue and Luci]

That is exactly the instructions I was given. No food after midnight, no insulin in the morning and Silver was the first appointment at 8am. Ensure you are given antibiotics after the dental. Clavamox is best. I brought my own insulin - prefilled in a syringe so I knew they would give the dose I wanted them to give. He got the dose shortly after eating after the dental.

So you did take insulin there! They asked me to do that - however the procedure isn't going to start until noon - another one that wants them there early with no food - but at least she goes in at 10 a.m. and it'll be for an exam - and I will be staying for that part - then they'll start the process of prepping her for the procedure itself. I said if they give her insulin after the procedure like at 3 pm (although I have no idea how long the procedure will take)...then I would have to get up at 3 a.m. to give her the next dose.

So please - what time does she get her next dose? Will it depend on what time she gets her dose that day after the procedure? Wouldn't it be better to skip one dose and make sure she gets her PM dose on her usual schedule?

 

[Sue and Luci]

Oh Sue! What a mess! I’m glad you listened to your gut though, hopefully the new place has more clear and consistent communication. I really hope you don’t have to start over with testing, I hope Luci was just a little rattled from the vet visit and the vet switch will put her at ease a bit.

That first vet had me so freaked out...I feel better already - but was practically shaking from their various instructions - the final straw was to give her insulin with no food on board. I think those people have little to no experience dealing with diabetic cats - and they're not going to practice on Luci!

 

[Stacy & Asia]

That first vet had me so freaked out...I feel better already - but was practically shaking from their various instructions - the final straw was to give her insulin with no food on board. I think those people have little to no experience dealing with diabetic cats - and they're not going to practice on Luci!

The most recent protocols for surgery and diabetics suggest keeping some basal insulin on board, so that part isn’t weird to me. However, given Luci’s patterns and how she likes to drop, they did very little to assure you they understood your concern and let you know what they would do to make everything go smoothly there and they could have. If you have the energy to write them an email or something to let them know why you cancelled, it may help them, it could have been some front desk issues that they would like a chance to resolve if they know about it.

 

[Sue and Luci]

The most recent protocols for surgery and diabetics suggest keeping some basal insulin on board, so that part isn’t weird to me. However, given Luci’s patterns and how she likes to drop, they did very little to assure you they understood your concern and let you know what they would do to make everything go smoothly there and they could have. If you have the energy to write them an email or something to let them know why you cancelled, it may help them, it could have been some front desk issues that they would like a chance to resolve if they know about it.

They seemed to be happy to hear I cancelled! Very cheerfully said, ok, no problem. I also told them that another vet's office would be contacting them to request the blood work done yesterday - oh, sure, no problem!

Personally I don't think they 'get it'...and I'm pretty tired of wasting my breath with them. I'm in overload right now - work issues, etc. I may write them a real letter as I don't have an email address for them - when things calm down here.

 

[Mandy & Rex (GA)]

I'm glad you were able to find another vet that could fit Luci in quickly. If you skip that morning, don't bring insulin. You can give it at your normal PM time. It will be okay to skip one dose.

If you are going to stay with the 'new' vet, then have them request Luci's file from the old vet so they are up to date on everything Luci has had done.

Lastly, but not in least importantly...

 

[Wendy&Neko]

By the way, even people who have been told to give half a dose have occasionally given a fur shot. Not always on purpose. No names mentioned, just skip the dose that AM and go back to your regular schedule. My vet even had me skip the PM, turned out to be a mistake. Some anesthesia induction drugs lower the BG so she was just being cautious. Test when you get home and again at normal PS time and see if she's going down.

Take a can of her regular food. They may feed her after the procedure and you'd rather it be LC.

And breathe. Not all injected insulin goes to combat the carbs in cat food. The brain, amongst other cells, also uses it. A half dose is usually safe unless the cat has an overfull depot.