Drowning in guilt, questioning my decisions

I'm Joy, and I've been lurking here for a couple of months, trying to hang on to my sanity. In April 2016, my sweet baby Ianto was diagnosed with diabetes. I didn't even know that was a thing for cats until then, and, in retrospect, I absolutely should've done more research on my own. At the time, I just took everything the vets told me and went with it. We started Vetsulin. They never talked to me about changing his diet (except for making sure he was fed before receiving his insulin). They never mentioned home testing. We were going to the vet for a curve every other week, more or less. His doses got... really high. Seven units each dose kind of high, and I thought we were in a good place. He seemed to be regaining some weight. The litter box stopped being crazy. He wasn't trying to climb into the shower with me to get water.

In August 2016, my wife and I went on a short trip to celebrate the start of my new job. We didn't want to leave Ianto's shots to a pet sitter, so we boarded him at the vet. He was there for a long weekend. I picked him up Monday morning, and no one mentioned to me any particular difficulty with his diet or his insulin. I took him home. He was glued to me all day, which was pretty typical for any time we'd gone out of town in the past. I fed him his evening meal. I gave him his evening insulin dose. We went to bed. Around 4 AM, he woke me up making a noise that I don't think I'll ever forget. I came out to check on him, and he was collapsed in the floor. I couldn't tell if he was breathing. I panicked, woke my wife, wrapped him in a towel, and we rushed to the emergency vet. They told me there that his blood sugar was basically a flat zero, that he'd seized, and that they thought they might be able to stabilize him, but already suspected brain damage. Hours later, they confirmed to me that he appeared to be blind. I took him to my regular vet when they opened, which the emergency vet encouraged me to do, and for the next week, we were in and out of the office and the emergency vet. He kept seizing. He never regained his sight. He developed some strange neurological ticks, where he would rock and walk in circles and cry. No one could confirm to me that he would ever improve, and the seizures were... they were horrifying. During this process, they told me that he didn't seem to need insulin anymore at all, and again, I had no idea that could even happen. I just thought diabetes was sort of a lifetime thing and it wouldn't get better. I started to get the impression that I was really, really remiss in not doing my own research, and felt incredibly guilty about the whole thing. Like I'd basically managed to overdose my cat, and contribute to all of this. Two weeks after his first seizure, we made the incredibly difficult decision to let Ianto go.

Fast forward to July 2018 and my current meltdown. My cat, Sherlock (6 years of age, long hair domestic), was diagnosed with diabetes. I was heartbroken, because it felt like a death sentence after my experience with Ianto. I had taken Sherlock into the vet because of a growth on his chin that we were hoping to get removed. The pre-op blood tests turned up the problem with his blood sugar (525). My wife and I consulted at home and decided... we couldn't do insulin again. We just couldn't. I still feel so guilty about what happened to Ianto, and couldn't imagine doing that to another cat. So I started looking into other options, to determine if they even existed. I found some websites, eventually stumbled this way, and started reading. I changed Sherlock's diet. We bought a ReliOn to start tracking his blood sugar at home. We told ourselves, if we could get the numbers down, maybe. Maybe we could manage this without insulin.

Since July, his numbers have NEVER tracked above 300. They've been consistently between 200 and 300. We've tested at all times of the day. Before food. After food. Early. Late. We've switched to all wet food. We eat four times a day, every six hours. He seemed to be getting better to us. The litter pan stopped being crazy. He wasn't water-fixated. He seemed to have more energy and wanted to play chase in the mornings with his brother. I was feeling kind of optimistic.

Today, we went back to the vet to talk, again, about the growth on his chin. I brought my numbers. I talked to them about the improvements I felt I saw. The vet kind of rolled her eyes at me, said that he couldn't just "magically" not be diabetic anymore, and said she wanted to re-run his labs. We'd been in the office for about an hour by that time. Dogs barking. People shouting. The AC is apparently out and Sherlock was hot enough to pant. He's been trying to hide behind me the whole visit, trembling and unhappy, and when they whisk him off for tests, I'm wary. They come back and tell me, nope. No improvement. His blood sugar is testing again around 525. I tell them, no way. It's because he's here. He's stressed. His test pre-vet was at 234. The vet tells me that stress *might* account for a bump of 100 in his numbers, but not enough to double it. She asks if I'm using an AlphaTrack, I tell her no and explain the ReliOn and that I've read about it here and several other websites. She tells me that I shouldn't believe everything I've read online and that I absolutely need a glucometer calibrated for a cat. She tells me that he's diabetic. He's being poorly managed. That I'm essentially starving him to death (from July to September, we're down from 17.6 to 14.4 pounds). That he's in poor shape and it's my fault because I won't give him insulin. I explain to her about Ianto (she was one of the vets that saw him during that period, but I get it, she sees lots of animals and maybe doesn't recall us) and she says that while she can understand my concern, there is absolutely no other option.

I come home in tears. I'm devastated at the idea that I'm starving my cat. That I might be hurting him. That I'm doing this all wrong. I panic that I haven't been using the ReliOn correctly, so I check his blood sugar now that we're home. It pings at 465. It has NEVER been that high since I've started testing. I'm in a weird place where I'm relieved that it does seem to read numbers correctly... but also horrified because I don't know what to do. I very seriously do not want to do insulin again. I don't want to hurt my cat, either. I need to get this spot on his chin addressed, but the vet won't do it unless I can get his numbers stable... but his numbers are never stable when I take him to the vet.

I don't know what to do. I'm second guessing everything. I'm guilty. I'm afraid. I need some advice and perspective from people who get it. Please. Thoughts? Advice? Direction? I'm at the end of my rope with this and don't know where to go from here.

 

First matey. You need a hug

Second: Any chance of changing vet ? No-one should be told they are not caring of their pet when they clearly are. A vet should enpower you to make good decisions , not tear you to bits for being fearful.

Third: You know absolutely that it is OK to home test BGs and that is 100% OK to use a human meter. You know that. Do not let this vet tell you otherwise.

Next: Yes. BGs can be all over the place with a vet visit. Silly vet should know this.

More nexty bits: She should be addressing the growth. Not giving you a not needed lecture.

Lastly - and this is the thing that everyone here can really help you with - the insulin.
It may be that pusscat does need insulin. Let us help you to figure that one out. Let us all help you to help pusscat. As a group and a community we would all monitor together so you would not be alone with this. If pusscat needs insulin then he must have that for his well being.

Here is another hug.

Now I wish you to breath in and out & once feeling a little better come back and lets see if we can get Sherlock on track.

 

Hugs, virtual or not, are very much welcome. I am calling another vet in the morning. My wife uses a different vet entirely for our dog, and while Sherlock hasn't been there before, I'm game to talk all of his labs and records and relocate. I'm hopeful that we can maybe use the labs that have already been done to get his chin taken care of, and then we can go from there. I don't want to have to keep taking him back and forth to the vet since is absolutely seems to freak him out something awful.

Though I'm very, very frightened of the insulin... I will start doing some research on it. So at least I know the options, since... again. Two years ago, I thought insulin was insulin and that was it and you just followed the directions and it would be okay. Now I do know there are different types and that you can home monitor, so I'm already better informed than I was.

Tonight, I'm going to try to breathe and stop feeling like a failure and tomorrow is a new day. Thank you.

 

You're not a failure. You are simply someone that loves your cat .

Vetsulin is a good enough insulin. Especially if you are able to get the supplies easily. Lanctus is the one many here seem to use.
Have you been keeping a written list of Sherlock's BG results when you have tested?

If so , maybe tomorrow you could set up a spreadsheet. <--- click the link. People here can use that to help you figure out if Sherlock needs a bit of insulin at the moment or not. If the spreadsheet thing seems too much someone can help you with it.

Get some rest. You've been blasted from left field. Tomorrow you will have a clearer head.

 

I haven't been on in a while, but happened across your post. I really don't know where to begin, maybe to say first I'm sorry that you are going through this. Some things I keyed in on...weight and feeding. Great! Multiple meals a day, and all wet food, sounds good to me. Maybe just wondering about carb content, if you can keep it under 10%, that would be ideal. Sometimes kitties lose weight if they have been given dry food, then changed over to wet...How does Sherlock look? You want to see a bit of slimness, not seeing ribs, I wouldn't think 14.4lbs is a bad weight. How many calories is he getting? I think most cat health sites say around 20-30 calories /lb depending on activity and age.

Your vet visit bothers me, yes, absolutely after an hour at a clinic with barking dogs, etc. there is extra stress on any kitty, and can certainly elevate BG levels. My kitties (both my diabetic and non-diabetic) open mouth breathe in the car on the way to the vet's! Many cats show signs of stress by panting, I suspect the air con had nothing to do with it. Your vet could have run a glucosamine to see average BG if they didn't trust your BG readings or whether stress affected the number they got. Yes, human meters run lower than Alphatrak. No argument there, but what you achieved in your testing was seeing the BG patterns over time, still very useful information, it's concerning your vet dismissed that. One thing your vet did get right, no, cats don't magically become non-diabetic....once diabetic, always diabetic, BUT...cats CAN go into remission, their pancreas can start working again, unlike humans. Yes, once diabetic, you will always need to be mindful. Don't be afraid of insulin, if you decide you need it, a range of 200-300 is ok, but still outside ideal ranges, some insulin may help bring those numbers down, but that's up to you. At those numbers, there is likely some blood sugar being processed through the kidneys, and spilling into the urine, which puts a bit of strain over time on the kidneys. There are so many people here experienced with diffferent types of insulin who can help you. Good luck, hope this helps.

 

Hi Joy and Sherlock and welcome to FDMB
First of all I want to say how sorry I am to read about what happened to Ianto. It was definitely NOT your fault....your vet obviously knows next to nothing about FD and I would definitely be looking for another vet for Sherlock.
You need a vet who is willing to listen to your concerns and ideas and who is willing to work WITH you in a partnership looking after Sherlock.

Don't be frightened by the thought of giving insulin.......I know you have had an awful experience but it shouldn't be like that.
With you testing the blood sugars and giving a low carb wet/ canned diet and insulin, Sherlock will feel much better. The Relion meter is absolutely fine. Most of us here use human meters ....that is what our two protocols are based on.

In my opinion Lantus would be a better insulin for Sherlock to go onto. It is a much more gentle insulin than Vetsulin and does not normally drop the blood sugars so quickly and sharply. It is also a longer acting insulin. But if you are testing you will be able to keep Sherlock safe. We have two protocols here that you can choose from and our number one priority is to keep our kitties safe.
We are a community here and we all look out for each other's kitties and offer support, help and ideas.

So please think about looking for another vet who knows more about FD than your current vet.
Research insulin and think about restarting it.
And don't be hard on yourself. You are already doing great things for Sherlock........posting on this forum and looking for answers.
Ask lots of questions....we are only too happy to help and support you.
Bron

 

I will send you hugs also. So sorry you're going through this.

Your vet visit bothers me also. Is there another vet you can see? Your vet should support you and partner with you in helping your kitty to be as healthy as possible.

Stress will definitely have an effect on their BG numbers and make the numbers higher, sometimes a lot higher.

There are a lot of supportive knowledgeable people who can help you. I just read back and saw that you plan to see another vet. Please let us know how it goes.

 

I do have his numbers written down from my testing so far. I'm not totally sure about setting up the spreadsheet, since looking at them, they seem to be mostly organized around insulin doses (which I haven't done for Sherlock to this point), but when I get home and get my numbers in hand, I'll see what I can do. More information is always better, right?

 

Hi, thank you, and let's see. Erm. I think we're in the ballpark of around 270-300 calories daily, depending on which type of food we've got, exactly (and whether he nips a bit of his brother's plate, or his brother steals from him). He's not exceptionally thin. I can tell he's lost weight, but it doesn't appear unhealthy to me. I don't see ribs. He isn't bony. Prior to the vet turning up the hard numbers from his lab, she was actually congratulating us on the weight loss and telling me he looked healthy, so it did my head in completely when we took a hard turn into, "Well, now that I have the numbers, clearly the weight loss is because of mis-managed diabetes and not diet and he's starving."

Her recommendation to me was to get an Alphatrak and use it to collect numbers, compare them to my ReliOn (she wants me to test him twice daily, once with one device and again with the second to compare) and then come back to her in two weeks so we can talk about "real numbers" and what they really mean for him. She mentioned a type of insulin that I haven't used before (something with a G?) and that it would be her recommendation. She did also tell me we couldn't keep waiting to do something about his chin, so I need to get on top of decisions quickly, so I'm a little frazzled about the whole thing right now.

I'm calling the second vet this morning to see if I can get his records to them for a second opinion. I've never been there, nor has Sherlock, but it's where my wife takes our dog and she seems to like them. I'm trying to stay calmer today and take in information, and so far this is very helpful, thank you.

 

Thank you very much. I do already feel better, talking to people who understand what's going on. My wife is very supportive, but I worry that she's maybe a little (understandably) biased and telling me what I want to hear about how we're doing the best we can. So it's helpful to hear from outside folks that I'm not absolutely mucking up everything and causing harm to my cat.

I do intend to call another vet this morning. My wife takes the dog to another clinic and recommended I try them, so that's currently the new plan. Hopefully the labs from yesterday can be popped over for a second opinion without my having to take Sherlock in again so quickly. I don't want to stress him out unnecessarily after yesterday's mess.

I will do some more research on insulin. I know that logically it's unfair to Sherlock to withhold something that could help him just because I had a bad experience prior. That's not his fault, and there's nothing to say that it'll happen again. I am already more informed than I was a year ago. It's just going to take me a little time to find a comfortable place with it. Thank you again.

 

What happened before was absolutely not your fault. You took your cat to the vet and you even boarded your cat with the vet because vets are professionals and we rely on them, especially when kitty is sick (chronic and acute conditions). So if something went wrong, it was absolutely not your fault. With this cat, you recognize inadequate veterinary care and are seeking a new veterinary professional, along with seeking help here. You are absolutely not at fault, and should be commended for doing the absolute best you could and can. And just like human medicine, veterinary medicine gets better as more knowledge is gained and more vets are educated.

 

Welcome! Jones has been on Lantus for 2 years. With the approach and support here...I never done a curve at the vet, adjusted doses based upon the method here and he has never had a hypo incident! I printed the hypo information sticky on the fridge and used it in a few low number incidents but he has never required an ER visit. My vet is ecstatic over his FD status.

Your vet's approach and manner is beyond needing a comment except you need to find a new vet.

Lantus is a more gentle insulin then Vetsulin.

You can't change the past and you can't blame yourself for the faults of the veterinary system that failed you. All you can do is deal what is in front of you now.

Ask us a bunch of questions. Once you have your insulin ready, let us know and we can help get you started.

 

Insulin with a g - was it glargine?

 

Yes! That is what it sounded like.

 

We are totally here for you. The big difference this time around its that 1. You are home testing. This is critical. 2. You have a support group here to guide you.


This will not be like the first time. We've got your back. Most vets have only basic knowledge of how to treat a diabetic cat. It's not your fault, you were only following Dr's orders.

 

That is Lantus. It’s one of two Insulins used most often here. Max was on it for three years and never had a symptomatic hypo. One of the best things about this board is there is always someone around to get guidance 24 hours. We are from around the world. I too never had a curve done by my vet except for after his first shot.

I am so very sad to read of your experience with your other cat. I too would be using a different vet. I used a Relion Micro meter. My vet had never used it but was so supportive and he’s been in practice over 30 years. He used to show my spreadsheets to his second year vet students that spent a week with him. With the help of people here I learned to manage Max’s diabetes and my vet felt comfortable with that. He handled all the other issues.

 

Thank you. I wanted to have some information in hand when I do go back to Sherlock's vet to talk about insulin, and it sounds like Lantus is a good option from what I've read so far. I think what I've learned is basically more information is better, and that vets are not infallible and it's okay to question them. I'm feeling hopeful about moving forward now that we've spoken to a new vet, and have an appointment this week to get Sherlock's chin growth removed.

 

Keep reading and asking questions. We will help you navigate diabetes.

 

There is no doubt that FDMB will help Sherlock...I still come to FDMB for help even though Suzie is a dog on Vetsulin!! Let me tell you...THESE "CAT PEOPLE" SAVED ELLIOTT'S LIFE!!! The DVM put him on NPH and he was a mess. FDMB members guided me minute by minute, even at 2am--4 am 24/7!!! They had me switch Elliott to Lantus (Glargine) and boy did he get better!!!! I stopped consulting the DVM and spent all of my time listening to the members here. Elliot went into remission 4 months after diagnosis..I later asked my DVM. "Why did you start Elliott on NPH when Lantus is most often considered best?" He replied, "Clients don't want to pay for Lantus." But he never offered me the best treatment and I spend most all of my money to the DVM as he knows it (18k in 2016)so...now that I have a diabetic dog, switching from NPH to lantus to Vetsulin because (IMO) many DVM's have little "real" knowledge and don't really want to get involved after initial diagnosis where they can collect a decent sum of money..After diagnosis, the office visits do not pay them as much. I wanted to try Levemir on Suzie but DVM does not have experience with it and so I am stuck with Vetsulin making sure I do 6-8 BG tests/day. Overall my point:..Stick with FDMB and the good DVM that cares!!!..They will guide you "correctly" Depending on many DVM's for surgery.etc is fine..very lucrative business. even MSU DVM's love to do surgery but don't seem to think more studies needed on pet diabetes..but do more so with cats than dogs, I must say (IMO). Elliott remains in remission after 2 years..thanks to all of these "cat people"!!!! I will never forget!!!!

Suzie: https://docs.google.com/spreadsheets/d/1O1YNDHz-t4REns_tbAN6D_M3AYT6_kgqbHE7JWo6kSM/edit#gid=0
Elliott: https://docs.google.com/spreadsheet...2rAeC4FxEqoeAUlnBPqganucis/edit#gid=361360320

 

Hi. I would still recommend the spreadsheet even without insulin shots to record. You just won't have the AMPS or PMPS to enter, but you can pick a time to be your AM test time standard and put NS in the dose box. For example, even if I don't give Grandpa a shot, I have set 7 am as his first test of the day. That gives me a BBC basis for entering +1 (8am), +6 (1pm), etc.

The spreadsheet color codes the test numbers which makes a great visual to spot patterns.

Welcome and good luck!