I don't know. My vet is usually pretty reasonable with costs ... so fingers crossed it won't be that much. I just made the appointment and figured I would go from there. The lady I talked to seemed more interested in making an appointment to check his BG. I told her I wanted all his bloodwork checked again so we shall see. I am hoping the vet isn't to upset that Gizmo is now getting 6.5 units of insulin. (He told me to increase to 5 units and I started TR and have just kept going.). Needless to say, I'm a little nervous about this appointment, but I have to do what I believe is best for Gizmo.
Sometimes it is best to tell the vet your are following their orders and don't mention you are using other sources for dosing guidance. My 1st vet got real annoyed when I told her I was on this board and saying things like "they think...."
He was impressed with the spreadsheets that I have shared in the past. It was just one I made in excel. So I plan on emailing this spreadsheet before Gizmo's appointment and hope all goes well. I'm not comfortable with giving Gizmo 6.5 units and him only thinking he is getting 5 units. I feel that could led to more problems down the road. I have to be honest with what I am doing and hope for the best.
Hopefully I'm worried about nothing. Bottom line is Gizmo's numbers are better than ever before and that should be all that matters!
Thanks for the info. I glanced at that website yesterday. Will look closer. Gizmo has always been like this. It's nothing new, but I will defiantly talk with his vet about it. I never knew it was a problem until now.Please keep your observations about constipation on the list for discussion with the vet. I'm worried about the description yesterday of small / hard stool. One thing to think about is pumpkin is more of a maintenance or preventative. With small / hard stool, he may need something more like Miralax to soften the stool. My vet taught me to feel the abdomen of my cat and differentiate normal from "rock hard" nuggets that were very difficult for her to pass. You might be on top of this, but in my case, I really wish I would have learned this sooner! I was too focused on her BG spreadsheet and the fact there was at least one bowel movement each day. Several days in the hospital were required to clear up what felt like a basket of rocks. If you haven't already seen this reference, it would also be helpful to review in advance and discuss any questions with your vet.
Wishing the best for you and Gizmo!
I really hate to use miralax because I feel it is addictive. My daughter has been on it since she was a baby and despite her eating a very healthy diet (full of fiber), I am unable to remove her daily miralax without issues. 
I would venture to say the collective wisdom here on high dose cats is more than what the vet has too. Neko's clinic owner conceded that to me that I knew more than him about acromegaly. If Gizmo has acromegaly, then bowel issues are not uncommon. Carol's suggestion to discuss with the vet is a good one.
No, vet doesn't know yet. I have saved the file on my phone for reference if needed.Does your vet know you are following the TR protocol? If not, you could print of the paper called Management of Diabetic Cats that is in the protocol sticky, and give it to him. That way he can see you are following a scientific approach, and not just some random thoughts from a bunch of people on the internet.
