Advice on vets

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Kathy & MiddieMittens, Jan 14, 2020.

  1. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

    Joined:
    Aug 26, 2019
    Hello there guys i just took mittens in to see the vet i dont really like and he was pretty mad at me that i lowered the dose ( i was so nervous i lied) she was on 3u when she was diagnosed in September. i told him she was getting the 2u that was last prescribed when i got the new inslin. (But you gugys know better because of the spreadsheet) we been seeing a hollistic vet that i LOVE but getting to see her is sometimes hard and im not sure if she could get regular shots with her i can ask tho.

    The vet also said that cats usally or very rarely ever come off insulin which i know from this forum thats definitely NOT true. I am just flustered because i really dont want her to be on it forever but if thats the way it has to be then so be it.

    Would you guys get a new vet? I really dont want to leave the practice i currently go to they are very nice and are always accommodating. I just feel like i shouldnt be scared to take my animals to the vet. Thanks guys sorry for the rant.
     
  2. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    Keep doing what you're doing, if you like the practice then stay, you are the one with Mittens 24/7 and the decrease seems to be working for Mittens. You are the one holding the syringe, not your vet. Maybe down the road you can show your vet how good Mittens is doing on the dose you are giving Mittens. Is it possible for you to get more tests during the night cycle
     
  3. Sarah&Soph

    Sarah&Soph Member

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    Jun 18, 2019
    I agree with Diane. If you like this vet and you don’t have any problems with them other than how you are managing Mitten’s diabetes, then I don’t see the harm in a little fib. Unless there’s a situation where they will be the ones giving your cat insulin, I don’t see why it matters that they know what dose she is on. I think that the 45 today shows that she definitely should not be getting 2 units right now! If it were me, I would just smile and nod when they suggest a dose and then keep doing what I was doing :rolleyes:
     
  4. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

    Joined:
    Aug 26, 2019
    I have been trying but i will try harder. She is in/ out so its hard sometimes to find her but ill definitely try
     
  5. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

    Joined:
    Aug 26, 2019
    I just worry that eventually he might not fill her rx anymore which i wont need for a while and on such a small dose it should last a while.
     
  6. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    That will be really helpful to see how low the insulin is taking her, maybe on weekends if you have off from work you can keep her in for awhile and get some tests in, most cats usually drop lower at night, maybe a+3, +5. a+7
    Then fill in some of the other test at different times,maybe a +6 and +9. you are doing great
     
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  7. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    If he ever did that, which he probably wouldn't do that, I would tell him that is really crappy of him.You are the one seeing if he ever dropped really low and had to intervene and feed him a small amount to bring his BG up to safe levels, not him.
    Don't be afraid to speak up, because some vets don't know squat. I told my vet that I have been going to for many many years and she is fine with what I'm doing. She agreed with me that I know what I'm doing and I told her about the support group and how many experienced members know more than some vets, I have to say I love my vet and she is always willing to hear me out. But I really don't think your vet would ever not fill your . scripts when needed. Maybe you can show him how well he is doing on the dosage you are giving him
     
    Last edited: Jan 14, 2020
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  8. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    I think it would be better to be truthful with your vet.

    1. Would it help you to give your vet some of the recent vet journal published research on feline diabetes?

    (2018) Whats New In Canine And Feline Diabetes Mellitus .pdf
    (2018) AAHA Diabetes Management Guidelines for Dogs and Cats
    (2015) ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats
    If you read some of these articles,you could pick out some talking points to discuss with your vet.

    2. You can tell your vet you are doing this because you love your cat and you feel the dose is too high and here is your SS to prove it. Many vets will be absolutely blown away by our home testing data.

    3.Build your case as to why you are doing what you are doing. Explain your reasoning to your vet.

    For instance, many of us have found that feeding a low carb food makes a big difference in treating the feline diabetes. AAHA diabetes guidelines say <12% carbs, >40% protein but most of those veterinary diets do not meet those guidelines.

    FYI There are more vet journal articles at the bottom of the Index over in the Health Links/FAQS forum.

    ECID Every Cat is Different. Your vet should realize that too.
     
  9. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    @Deb & Wink hi Deb, I agree with her being truthful with her vet,I am no expert at all , I see Mittens is on prozinc. I am wondering why on @Kathy & MiddieMittens SS sometimes she is shooting 1.2 units (does that mean 1.25) and then sometimes 1u, and then sometimes 1.5 u, aren't you supposed to stay with the same dosage for awhile
    I just want to if that's correct and not switching back and forth
    I just want the best for her kitty
     
    Last edited: Jan 14, 2020
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  10. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

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    Aug 26, 2019
    I work weekends and 2 jobs, so its hard but im trying my best i live with someone unwilling to help with anything to do with the meds. Or testing.
     
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  11. Lisa and Witn (GA)

    Lisa and Witn (GA) Well-Known Member

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    Dec 28, 2009
    When I had Witn and Spot, both diabetic, I was assigned a new vet in my vets office. Witn and Spot were my 2nd and 3rd diabetics and when Rascal was diagnosed several years before the owner of the clinic not only taught me how to home test, she gave me my first meter. The new vet I was assigned to was new to the clinic and tried to tell me home testing was not necessary and I should not adjust their dose. I politely but firmly told her that I would continue to home test and would gladly provide their test results each week for their records. It took a few months before she finally realized that I knew what I was doing.

    Continue to test and give a copy of your spreadsheet whenever you visit the vet. Hopefully your vet will eventually realize the importance of testing and why the dose changes were needed.
     
  12. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

    Joined:
    Aug 26, 2019
    That was a typo shes been on just over 1 this whole time just dont know how to write it down because im sure shes not getting the same dose as i cant get 1/2 marked syringes. Also keep in mind shes indoor outdoor cat. Which is another BIG NO NO.. but that is one thing i cant change.

    I couldn't show him the spreadsheet he would yell at me for lowering the dose. He said no adjusting no matter what. But he also doesn't recommend home testing either. I told him she was 45 before i came and he didnt even seem to care... so i dont know. Im almost thinking about trying to fimd a vet that specializes in diabetes. He said what he had to say n i had no time to ask him questions he just waltzed out of the room.
     
  13. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

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    Aug 26, 2019
    I am to afraid of them yelling at me agian and telling me im wrong. What he had done before. It almost seems like he doesnt want us as a client because i research and learn things without them wish i could share the emails he sent to me before youd be blown away.
     
  14. Lisa and Witn (GA)

    Lisa and Witn (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    With his attitude, I think you and Mittens would be better off with a new vet. On this site https://catvets.com/ you can search to see if there is a cat only vet in your area. They would have a better understanding of how FD should be treated. You can also start a new post to ask if anyone near you can recommend a good vet.
     
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  15. katiesmom

    katiesmom Member

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    Mar 1, 2013
    I think you just answered your own question. You should not be scared of your vet. And you shouldn't have to lie to him. He is suppose to be there to help. He says no adjusting insulin, or home testing? Get rid of him. If it were me, I would find someone else - fast.
     
  16. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

    Joined:
    Aug 26, 2019
    I dont mean to have attitue its just sad becuase i want someone to understand why thats all. and that i hate being told im doing it wrong when ive learned so much from all the great people like your self. if it wasnt for this fourm i would of given up and she wouldnt of been treated at all. like my first diabetic cat. which ended up in tragic results as you probally know. but it was a lesson learned. i dont want her to end up like my first diabetic cat. i do love her and i want the very best for her.
     
  17. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

    Joined:
    Aug 26, 2019
    thank you @katiesmom i am crying over this because shes been doing so well. next time she needs to go in i will be changing her vet to the one all my other animals see.
     
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  18. Lisa and Witn (GA)

    Lisa and Witn (GA) Well-Known Member

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    Dec 28, 2009
    We understand. Unfortunately we have seen too many vets that have a god like attitude and think they know more than anyone else. A good vet encourages their pet owners to be very involved with their pets care and is always willing to learn new things, even when it comes from the pet owners.
     
  19. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

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    Aug 26, 2019
    thats so unfortinate because im sure they are loosing clients over it. i thank you guys for all your help i really do appricate all of you
     
  20. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Kathy -

    No one should be afraid of dealing with a health care provider whether it's an MD or a DVM. If a practitioner can't make you feel comfortable and can't empathize with you in the first 5 minutes, they are badly trained and don't know how to listen. I have been with MDs who have had to deliver horrible news to patients or their families. Some do so with compassion and genuine caring. And there are others who come across as jerks (which is far more polite than what is running through my head but I'm keeping it "G" rated) because they are uncomfortable, feel guilty, are poorly trained, or just don't care. This latter group are the ones who get sued for malpractice. You and Mittens deserve a vet who is compassionate and who listens.
     
  21. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    @Diane Tyler's Mom - with Prozinc, you are able to adjust the dose based on the pre-shot numbers. It's a shorter acting, non-depot type of insulin which allows you to adjust the dose. It's one of the differences between Lantus and other types of insulin.
     
  22. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

    Joined:
    Aug 26, 2019
    @Sienne and Gabby (GA) thank you and thats what ive learned over this journey. im not perfect and do make mistakes but i do try to keep dose constiant thats why i added the food types and shot times on my spredsheet because i think i was getting no shoot numbers becasue my timing was off
     
  23. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Kathy, we are here to help you, not make you feel bad. Please don't ever think that.

    Kathy knows her cat and situation better than any of us here can. Kathy is the ultimate decision maker. Let me say that again. Kathy makes the choices for her cat Middie Mittens. No one else. ECID. No one should be treated as shabbily as Kathy has been by her vet. Scathing emails? I've gotten them too from my (thankfully) former vet.

    We give alternate points of view, ask questions, see if there is something that can be changed. We may not always have the right words and sometimes there is no way to get that tone of voice across to people only using the written word.

    Although we tell people how close of a bond they will develop with their diabetic cat, it's a tough decision to make in the first place, to treat the diabetes. It's a financial, social, emotional, stressful choice and can be a real roller coaster. Most people would choose to euthanize their cat or try to re-home their cat, or dump the cat in a rural area or at a shelter upon the diabetes diagnosis. Anyone that finds their way here is to be applauded for deciding to treat their cat and make that commitment. Kudos to you all.

    @Diane Tyler's Mom We can all learn something new, so here are 2 links to some documents over in the Prozinc forum.
    There is no scientifically studied 'dosing protocol' for Prozinc. We have a BEGINNER’S GUIDE TO PROZINC/ PZI INSULIN FOR DIABETIC CATS in that ISG forum. There is a PROTOCOL FOR PROZINC / PZI but that was developed here with input from many members, not formally tested in a scientific study. The TR protocol for lantus was adapted from the original Roomp & Rand study and was adjusted and tweaked over many years of experience here. Not formally published either.

    Prozinc is one of those 'in and out' insulins, rarely lasts for more than 12 hours or so. If you were using a 'depot' type insulin like Lantus or Levimir, changing the dose all the time would be more of an issue. Some people do use a sliding scale for dosing Prozinc. Not recommended. When member Sue & Oliver where still able to assist people, she would try to help with that. Maybe not the best way for every cat on Prozinc, but one way. There is no one way of doing things here.

    I don't know the ins and outs of using Prozinc (no pun intended). I have never used that insulin for one of my cats, so I'm reluctant to help with the dosing for Prozinc. Other members have been helping her over in the ISG Prozinc/PZI forum. Without reading through all the posts from Kathy, as well as some closer looks at the SS, I would only be 'second guessing' what she is doing and why. I do see some room for improvement, BUT would want to ask questions about why things were done a certain way.

    I don't know why Kathy doesn't like her main vet (yelling at me would be a big turnoff and I would have dumped him in a New York minute). I don't know why her vet doesn't want her to home test (has he kept up with the latest research and vet journal articles that encourage pet owners to do just that?). I don't know why he does not want to change the dose (he could be sued if something happened?). I don't know why she is doing so many of the dosing changes she is doing. I don't know a lot about her situation.

    We all have busy lives, with jobs or maybe we are unemployed or retired and money is tight. Maybe we have children or elderly parents to take care of. Maybe we are going to school, work 2 jobs, work weekends, live alone and have no one else to help us manage the situation. We need to be aware that we do not know what all of those other commitments are. Everyone needs to do laundry and grocery shop and all those other daily life chores. We all need to renew and refresh our minds and our spirits. Maybe that is going to a movie with friends. Maybe it's going out to lunch. Maybe it's catching up on our sleep so we don't get so exhausted we can't take care of ourselves, let along a sick cat.

    Vets can be sued. If Kathy thinks that lying to her vet about how she is treating her cat for the diabetes I think that is risky. It's risky because what would happen if complications develop like DKA and her cat needs to be hospitalized? Or what happens if her cat Middle Mittens develops other concurrent medical conditions like IBS, thyroid, heart, kidney, pancreatitis or a host of other diseases? Where the vet needs to have a full understanding of what is happening to decide on the best treatment? Or since Middie Mittens is an indoor/outdoor cat, what if she gets savaged by a wild animal or a dog or hit by a car and needs emergency medical treatment? Or her cat needs a dental and the vet would be dosing the higher dose while her cat is at the vet clinic for the day?

    Vet practices can refuse to treat any patient for any reason they deem fit and do not have to provide a reason. If her vet found out she was lying, they could terminate her as a patient at their clinic. She would have the right to get a copy of the vet records. But then what does she do when she finds a new vet and the new vet asks her about the insulin dose AND who her old vet was and asks for a copy of the vet medical records? Catch-22.

    There are a number of us that have decided to ignore how the vet tells us to treat our diabetic cats, me included (37% carb dry food, stop home testing so much, use Metacam and risk acute kidney failure when there are safer alternatives after a dental). Sometimes ignoring what our vet says works out ok, sometimes it doesn't. Sometimes when we tell a vet what we know, and can back that up with evidence, the vet says to keep doing what we are doing. But if they really knew how we are treating our cats, would they agree?

    We give the best suggestions we can, and try to include the reason why we are making a particular suggestion. It's always the choice of the caregiver to decide what to do. ECID Every Cat is Different, Every Caregiver is Different.

    There are ways to dose a U40 insulin like Prozinc using U100 syringes. You have to be very careful if you are doing this and use a conversion chart. NOT for the inexperienced. Don't think she has U100 syringes, because she commented in one of her posts that her vision isn't that good to see some of the tiny amounts in the U40 syringes.

    Kathy is trying her very best to help her kitty Middie Mittens. So I'll repeat one thing I said earlier. ECID Every Cat is Different, Every Caregiver is Different. We are here for you Kathy. :bighug::bighug::bighug:
     
    Last edited: Jan 14, 2020
  24. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

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    Aug 26, 2019
    @Deb & Wink that is a very good point, i guess if an emegency happend i would use a differnt vet. (dont know were becasue all the ones around here ive seen and they all think alike) i am also concerned about that now you say that but how would they know what dose im giving her? they dont hold my hand when i give the shot. i couldnt use the u 100 id be way to nervous to give the wrong dose. ive looked at the chart before. and thats kinda were i was at in september but the dumb emergency vet wouldnt treat her as i thought she was hypo. but he wouldnt even test her bs for me. (at that time i wasnt home testing). Mittens does have a second vet that was working with me to lower her levels and she was giving me dosing advice but she hasnt responded to my last email so i may say if you need me to pay you to tell me what to do i have no problem with that. it would cover my butt incase something major happend.

    a little about our life style i am a pet sitter/ and i work part time at an spca. I also volunteer a lot with my dogs as they are certifited therapy dogs, which is on my days off currently so curves can be a little stressful. also the person i live with my mom isnt willing to test her when im away or give her shots so i offten have to drive home werever im staying just to give her a shot and test.

    i havnt changed her dose since the last time it was at 1.5. i lowered it because i was getting low preshot number but i dont think it was the dose i think it was my timeing was off. to early for a shot. so maybe the 2u is the right dose i dont really even know right now. when i dose her atm i put the top of the plunger just below the 1 mark thats the dose shes been on since the 1.5 i just dont know how to put that on the spreedsheet.
     
  25. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    @Sienne and Gabby (GA) thanks for explaining it to me, always trying to learn
     
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  26. Juls and Billy

    Juls and Billy Member

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    Dec 28, 2019
    Kathy, first off, you are one awesome mama to your very lucky cat, MiddieMittens. The way you talk about your vet--chastising you, giving you a hard time, not working with you on treatment, walking out when you have questions--I don't think that vet is doing you any favors. You should be able to tell your vet the truth about your treatment and goal of remission without him treating you like a naughty child.

    Vets are like people doctors. Some act like they know absolutely everything and don't even listen to the patient. They decide they know best and that's that. They can't admit they might be mistaken, or listen with an open mind to new information. You and MiddieMittens deserve a vet who treats you with respect, who has time to answer questions, and who is interested in having you as a partner in MiddieMitten's recovery. Even if your vet has helped you with other issues, they are not doing so now.

    My sweetie and I love Billy's vet, but his knowledge of cat diabetes isn't where it could be. Our vet has been very kind to our animals, given us a discount because he knows we've rescued a small herd of furbabies, and given them excellent treatment for other issues.

    I'm still going to fire him if he won't work with us when it comes to Billy's diabetes treatment. Because quite frankly, if we had done exactly as the vet said, we would have lost Billy on day 5. On the 30th, Billy goes in for a blood test (not a curve, because we demanded to do that at home, though the vet tech argued with us). I'm going to take Billy's spreadsheet in, and see if our vet will work with us. He's never yelled at me, so we've got that going for us. If he works with us, awesome. If he gets stubborn, I'll find a vet that will work with us.

    It's your decision. You are MiddieMitten's voice and her only advocate. Don't be afraid to find another vet if you decide that's best.
     
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  27. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    These U40 syringes are supposed to have half unit marks. You may want to call to be sure but it's what I've heard in the Feline Diabetes group on Facebook.
     
  28. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    You are doing the best that you can do, hang in thete ok
     
  29. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    You can get the U-40 syringes with half unit markings at ADW Diabetes.com
     
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  30. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    As far as recording the dose of insulin, this may be helpful to you.
    Fine dose gradations:

    • 0.5U = exactly half a unit
    • 0.4U = skinny 0.5 touching the line
    • 0.3U = skinny 0.5 with daylight under the line
    • 0.2U = fat zero with daylight over the line
    • 0.1U = fat zero barely touching the line
    Pictorial guide using a U-100 syringe marked with half units:

    [​IMG] [​IMG]
    [​IMG]

    Don't get too obsessed about what you record as the dose. Do the best you can.

    Some questions to ask a new vet before you decide to use them.
    I've got a document for that!
    Vet Interview Topics
    (Just call me the reference librarian around here.) I would add "is willing to treat you as a partner in treating your cats" to that interview topic.

    Tour the vet office first. Look for reviews online. Sometimes the vet office staff can clue you in to who is better with cats in a multi vet practice. Cat only vet practices are another possibility. Ask your friends with pets for recommendations. Ask your pet sitting clients what they like about their vet and what they don't like. Ask at the SPCA for vet recommendations from people, both your coworkers and visitors.
     
  31. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

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    Aug 26, 2019
    Thanks!
     
  32. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Everyone needs moral support and encouragement. To know that we are there, reading their posts. Maybe you don't know much about some of the insulins other than lantus. You can still go over to the Prozinc forum and make a comment to uplift her spirits, ask how her day was going, share your experiences with her.
     
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  33. Kathy & MiddieMittens

    Kathy & MiddieMittens Member

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    Aug 26, 2019
    @Juls and Billy thank you so much for your sweet words its very great to be able to have a support group here when you just feel alone in this. I just made an appt with my hollistic vet for February 1st we love her so and ill get her to write up something that says she told us to adjust the dose so it will save my hiney if anything were to happen to her.
     
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  34. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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    May 18, 2016
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  35. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Hi Kathy, Hope you and Middie Mittens are doing well. Love the idea of putting an extra column at the start of your SS and color coing it so we can see your 'days off'. Although, who ever really has a day off, since that usually means we need to grocery shop, or do laundry, or one of the hundred of other things on our 'to do' list.

    Took another look at your SS. Certainly don't' think that you should be giving more than the 1.25U dose you are now. Heck, Middie Mittens got down to a 45 at +5 on 1/14/20 during the AM cycle. I think you should have reduced the dose to 1U.

    What about Oneonta Veterinary Hospital in Oneonta?
    Heritage Veterinary Clinic in Cooperstown?
    Community Vet Center in Oneonta?

    Maybe there is another vet in the same practice that is better for you? Check on-line reviews too. There will always be negative ones.

    Not sure what your transportation is like. If you have a reliable way to get to the vet. Your own car or a friend to drive you. These may be too far away from you.

    It's not always so easy or quick to "get from here to there" when you live in a rural area. Or to find good vet care.

    p.s. Lived in that area many years ago, for over 10 years. Know how far away things can be.
     

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