Chloe's vet visit

Okay, so I'm texting Peter like crazy from work, trying to get info out of him about the visit. He said that the vet said I may have very well saved Chloe's life by monitoring her and choosing not to give her the insulin. He also made Peter buy insulin and syringes anyway, and said that she is on it "for life." He said that her numbers were too low (the tests that I took. He sent bloodwork in and we'll get results tomorrow), and that she needs to drink and maintain her weight. He also said that if her numbers go below 70, not to shoot. You guys say 100, right?

I asked Peter if her numbers stay low, then she should be off insulin and we can just maintain with her diet change, and he said the dr. implied she'd always need insulin. How can he say that? She dropped SIGNIFICANTLY in just a week with a little insulin and a good diet change. It was only ONE unit twice a day, not even a lot, and her pancreas kicked itself into gear.

I still feel very unsettled. confused_cat

 

just remember vets are mostly used to what goes on in a clinical setting and not what goes on in real life.

DO NOT give insulin if she's anywhere under 200. if you one day get a number like 167, give her a bit of food and test an hour or so afterwards to see if her pancreas brings her down by itself. if you shoot insulin AND her pancreas reports to duty that day, you could end up with a hypo on your hands.

and NO, cats are not always on insulin for the rest of their lives. they go into remission yes, but they are still considered diabetic and still have to have a proper diabetic diet. another member, lori and tom, for instance is a perfect example. tom was diagnosed nearly 3 years ago i think it was. he was only on insulin for 28 or 29 days and went into remission and hasn't had insulin since, until a week or so ago and for some reason he's throwing odd numbers again and getting a drop of insulin so yes, they always have the potential of needing insulin again but it's NOT a guaranteed thing that they will need it every day of the their lives.

please make sure Peter understands all this too so he doesn't harm her by giving insulin when she doesn't need it.

 

Peter wrote down something that the vet said that is confusing me. He said that in cats, PROTEIN is sugar because they're obligate carnivores, and low carb is less important for a cat. Um. What? This is completely throwing whatever I know about diabetes on its head. So the protein in a cat also turns into glucose because of their carnivore status?

He also said her numbers were kind of low (58-63ish) and that we are "tightly controlling" her numbers, which might not be a good thing, because we don't want her to slip into hypo (but I haven't given her insulin, so how is she going to do that? These last two days her body has been producing the insulin and doing its job). If her numbers are a bit above normal, he said, that's okay, like 170-200. If that's the case, why is he making me shoot her if she's a little over 70??? That's insane to me. He said we want to keep her under 300, with a maintained weight and making sure she isn't thirsty.

So these are my questions:
- - If her numbers are kind of low (50s-60s for the last two days), should I maybe feed her a wet food that is a bit higher in carb %? I've been using the Fancy Feast Gluten free list to get stuff for her. They're all under 10%.
- -If she consistently maintains these low numbers, how often should I test her BG? I can test before food but I can't always test after an am feeding because of work.
- - How often do you reuse lancets for BG testing?

 

Maybe Peter misunderstood what the vet said ..........about the protein and carbs.
IF NOT, I'd get a new vet.

My cat was recent diagnosed as diabetic, but now the vet thinks maybe she was wrong about it.
Her first blood test of 460 could have been caused by an infection or something else.
Now her BG is around 75-80. (she had ONLY one insulin shot and got very sick)

I plan to start testing her BG myself.

 

I think the vet was trying to explain that cats unique metabolism uses protein, broken down into building blocks, to create glucose (sugar) which ALL body cells need to live and function.This GLUCONEOGENESIS occurs in the liver, and is a slower, more round about way of creating glucose for cat's cells (as opposed to eating carbs which turn immediately into glucose rush). Glucose is needed by our bodies to provide an energy source. Insulin is the chemical that lets the glucose floating around our blood to enter our cells, so they don't starve. I may not have that exactly right but you get the gist.

This came from a pet food web site about Purina DM and how it is metabolized by the body. They probably explain it better:
http://www.petfooddirect.com/Product/58 ... d-Cat-Food

As for what number to shoot, I agree with don't shoot under 200. You and Chloe are way too new to this, you don't have much history on how she usually reacts, and you can't be there every minute. Be safe ...

Cats can tolerate high numbers surprisingly well even though they are not ideal. Sounds like he said HIS goal is to keep her under 300 and over 70, holding her weight, not peeing or drinking a lot. I'm sure he didn't say shoot if the number is over 70. This is all very confusing and I'm sure Peter was nervous.

Fancy Feast sounds good to me. If your not giving insulin, and the cat is eating, her sugar should stay in a safe high enough range.

I may change a lancet 4 x /month, maybe. I would test a couple time everyday for awhile and then daily until you know this is for real. In the future if you notice weight loss, drinking and peeing- guess what?

Didn't you buy insulin when you first went home with her, why did you have to buy more?

 

Your vet sounds a little fishy to me.....he should be congratulating you guys on those numbers! Ditto to what has already been said. An obligate carnivore has very little need for carbohydrates, you do not want to shoot unless numbers get close to 200 (this is a 'newbie' rule), and you do not need to get those numbers up!! YIkes!

 

> These last two days her body has been producing the insulin
> and doing its job
[...]
> - - If her numbers are kind of low (50s-60s for the last two days),
> should I maybe feed her a wet food that is a bit higher in carb %?
> I've been using the Fancy Feast Gluten free list to get stuff for
> her. They're all under 10%.

If you're not giving insulin, Chloe's not going to hypo. Stay with the low-carb (under 10% carbs) foods to keep Chloe's blood sugar levels down, especially since it looks like her pancreas is kicking in.

Also: Congratulations on home-testing, saving Chloe's life by deciding *not* to shoot, and having a cat who may go into remission!

 

The best way to protect Chloe from your vet is to learn all the FACTS about FD for yourself. Go to the health links and start reading.

 

We didn't buy insulin when she was first diagnosed, he gave us a small bottle to take home for free.

She was 69 last night before food. I tried to test her again afterwards, but she was NOT having it. I tried to test again this morning before work and she ran under the bed (and of course she's not near the edge of the bed, she's in the middle of it. Ugh). She SEES the sock with the rice in it, her tail starts to flick, and if I don't get the test done the first attempt, she bolts. Eeesh. I don't know whose cats purr during this process, but Chloe definitely does NOT.

Peter is pretty sure the vet said not to shoot if under 70. I'm going to call today for her test results (not have Peter call, even though she's under his name), and the info straight. How can he tell me that 70-150 is normal, then tell me to shoot if she's a bit over 70? That's still the low end of normal.


And I have been reading.. I've been stalking this board everyday. I'm even on it at work right (though I keep minimizing when someone walks by). I just wasn't aware of how protein also gets converted to glucose in her liver. The way Peter said Dr. V explained it, was that low carb wasn't important. I don't buy that... I gave her low carb and a few shots of insulin and she's fine now. I bet the HIGH CARB deli cat is what put her in this predicament to begin with.

And silly me, I was throwing out the lancets after one or two uses. I'll hold onto the one I'm using now before buying another pack.

And this is a very sad statement to me - - "The best way to protect Chloe from your vet..." Realistic...but sad.

 

Do NOT give insulin unless closer to 200! Giving insulin lower than that, especially to this cat, would be very dangerous.

 

Lancets- You technically are suppose to change them, and they are very inexpensive, but i've never had a problem. I wonder what others do...

 

Nancy,

You did a great job of explaining the glucose/insulin dance. I'm a human diabetic so I've seen lots of explanations over my 30+ years. Insulin is like a key - when it is in the cell, the cell can absorb the glucose that is in the blood stream. No insulin, the cell starves for glucose.

 

69 is a great number for a cat that has not had any insulin. Keep doing what you are doing. :mrgreen:

Don't change the food and don't give insulin unless the BG level goes over 200.

 

One more thing to add and hopefully not confuse:

IF you are NOT giving insulin and the cat has low numbers (say under 50) - DO NOT PANIC! This is actually a good thing and what it means, is without insulin, the cat is taking care of itself - pancreas kicked in and is working and a cat CANNOT hypo if you do not give insulin

 

I didn't get my call back from the vet, so I went there myself. The vet was "dealing with an emergency," so the technician told me that yesterday at the office, Chloe's BG was 120. 120, and she was probably stressed out!!!! (She was 69 in the morning.) So, the technician said to continue to give her insulin like I have been. She apparently wasn't aware that she didn't HAVE INSULIN SINCE TUESDAY. I said, "Okay, I know you guys are busy, but you're telling me 70-150 is normal range and she's 120 and you want me to give her insulin??" And she said yes, that we made her come in 7 hours after to see how the insulin worked at its highest point. I wanted to tell her I knew that already, and only after I got home did I realize...maybe she didn't know that Chloe was 120 yesterday after 2 days of no shots.

Needless to say, I just got home..tested..and she's 81. Another fine number, but it's slowly creeping up. We will feed FF at 9, then I'll test +1 or +2 after to see how she's handling the food. She's been 60ish for a few days. Do you think it's possible that her numbers will continue to creep up? Maybe her insulin is working, but it's not 100%? Either way, no shot tonight. Peter is bringing our civvie Frankie to be neutered tomorrow, so he's going to talk to the vet face to face. He keeps trying to defend the vet, because I'm flipping out that they're telling me to give her insulin when her numbers don't warrant it. We'll see if he changes my mind tomorrow. If not, I'm looking into switching vets.

 

Just my 2 cents. In our situation, Margaret (OTJ since July) typically runs anywhere from the 50's to the 80's without insulin. She's even thrown me a 28 and a 36 (while off insulin) just for fun. :razz: The numbers may fluctuate depending on when she ate last or how much I've ticked her off by testing her. :lol: I'm just glad you know enough to question things when they tell you to shoot on such low numbers. Our vet told us to shoot blindly, 1 unit twice daily for 2 weeks before testing again at the office and Margaret would NOT be too low because she's a big cat and her numbers were in the 400's. Needless to say I didn't listen, started testing at home, adjusted doses based on numbers, switched to low carb FF, and by the time the two weeks was up, Margaret was completely off insulin. We no longer use that first vet and now see one that supports testing at home and low carb food among other things.

I'm so glad you found this board and can safely treat Chloe. Trust your gut instinct. You've done enough reading to know that something is not quite right with the vet's instructions. ;-)

BTW Didn't want to bother you in your first thread on the board but I read that you and Peter were both librarians. Very cool! I'm working on finishing up my MLS degree as we speak. ;-)

 

We'll see if the vet gets back in my good graces today, when Peter HOPEFULLY talks to him face to face. Her numbers have been so great (81, 77 last night, 65 this morning 2 hours before meal). And NO insulin since Tuesday night. My amazing little girl

Sending a PM on librarianship!

 

So... how did the vet visit go?

 

I think the vet is just so damn busy that he isn't completely comprehending or REMEMBERING what we're telling him. She was 120, at the vet's, in the early eveing, after having no insulin for 2 days and his technician told me to shoot her. I didn't, of course, because I came home and she was at 69. I had Peter ask the doctor (to see what he'd say), if it's possible for her BG levels to rise because of stress and he said yes.

He said not to shoot unless she's over 150, and in that case only give 1 unit a day (which I still don't agree with, if you're telling me that's just the high end of NORMAL), and to not give insulin until Tuesday. Keep giving her food 2x a day and test 2x a day. He said to bring her in Tuesday, we'll do a test, then when we go home IMMEDIATELY test her, to compare the numbers. She's going to be ticked off, I don't know how I'm going to test her immediately. But at least now he's telling me not to shoot.

And him telling me that low carb isn't as important as protein is crap. The high carb Deli Cat was sending the glucose riiight into her blood stream. Now that it's low carb and high protein, like it should be, her liver is dealing with the protein and sending it out in a more controlled, natural manner. While he did say that protein=glucose for a cat, CARB=fast glucose too, and telling me low carb isn't as important is perplexing.

I'm going to continue as I've been doing. Her BG this morning ws 81 before food. A great number! I ordered more strips, control solution and lancets from Hocks last night. Thanks for the advice, guys. I dunno if the vet is fishy so much as old school and really overwhelmed by all his patients. Which isn't a good thing, either.

 

You can ask many of the old timers here, vets were taught to use high fiber foods? for diabetes, I think. While that worked ok for dogs whose digestive enzymes are completely different than cats, it didn't do the trick for felines.

I would consider one variation from what he told you this time- and again its up to you (ultimately she's your cat) Since you are really close to staying OTJ, I would feed the same amount and type you have been, broken up into more frequent meals. This might let her pancreas do its job to produce her own insulin a little at a time.

I just bought a 2 meal timed feeder (Petsafe.com) and I think its gonna be awesome. I set it to feed mine at 12 and 4, and I feed a larger meal about 8 when I do the shot. I think many people use the Petsafe 5 which lets you feed even more frequently. It's extra awesome for those who work.

As for the 1 u dose at >150, I don't feel like I can advise, sorry. She might do ok on even less than that...some people use tiny drops and see a result. (my kitty is one of the high dose crowd, so I'm out of bounds on this).

You're doing great, your such a good mama!

 

Chloe was gobbling up the wet food in the beginning (maybe because her number was so high?) but now she more or less grazes on it, so she kind of makes her own meals throughout the day and night, as opposed to once in am and once in pm.

 

Gotta tell you --- AWESOME spreadsheet...... I'm jealous :mrgreen: :mrgreen:

 

Really, Nancy?? flip_cat

Her numbers are slowly creeping into the 90s now, though... we'll see what tonight's test brings