Feeling Helpless

So we took Victor in to the vet for the second week to check his glucose levels and I'm not happy with how it went.

When he was first diagnosed (6/25/18), his glucose number was 433 and the vet put him on 2 units of Humulin N. When we took him in the next week (7/2/18) his number was 510 and the vet wanted us to increase his dose to 3 units, which we did not do because we weren't home testing. Today at the vet his number was 435 and she wants us to increase the dose again to 4 units, even though we mentioned that we hadn't even been giving him the 3 units. To me that just doesn't seem like a wise thing to do, and I would appreciate some input from you guys here.

I really don't care for this vet we have. I would like to know, when you guys have taken your kitties in to your vets for testing their blood glucose levels, do they actually take you back into a room with them and your cat? Cause ours just takes Victor to the back while we wait out at the front desk, then the nurse brings him back, tells us what his levels are and any instructions the vet has, but the vet herself doesn't come out to tell us, which doesn't seem right. We even mentioned we had questions but the nurse just had us ask her and she gave the answers. I asked again about the home testing and again she strongly discouraged it, saying that the readings would be different from theirs because different meters are being used and that the home testing results wouldn't be accurate, and I am just so frustrated by it. Please give me your thoughts about these things.

Getting our home testing supplies has been delayed until tomorrow, unfortunately, and we will most likely try to start testing in spite of the vet's being against it. I'm not sure how well it will go because Victor still gets uncooperative/angry occasionally even when getting his insulin shot. I really hope things start to get better/easier cause the stress and worry from all of this is really taking a toll on me and my mom; we've both had pretty much no appetite/barely been eating, I'm almost afraid to sleep, and literally all I can think about is how are we ever going to handle all of this? My mom and I are both not very good at handling high-stress situations, and this has just been one of the worst.

 

Oh Geez do you ever need a new Vet. Are you the poster that pre paid for a care plan with this vet? If it is, can you ask to see another Vet, transfer to another clinic. I urge you to find out.

Please find a way to test glucose. It will save kitties life! Wrap Victor snuggly in a big towel like a burrito. Have one person hold him while the other does the testing. My Zoe turns into a raving, slashing demon on manicure day. It takes two people in battle armor (big, fluffy robes) to get it done. Hold snug and make it quick. Zoe actually likes the "hug" and settles down.

Also, visualize the blood lines on the ear with a flashlight. Shine the light from each side and you will be able to see the vessels very well.

I also think others have posted that Humulin N is not necessarily appropriate for cats, but I am not really sure. I am on Novolin N and I paid $25.00 for a vial from Walmart (or close to that amount).

 

And give a treat (a favorite food, or some brushing, or lovings) at every attempt to test (successful or not).
Make it a positive experience.
I know it's so scary and frustrating at first. Keep on. And Keep on posting. We are here for you.
Soon, you will all be doing fine, and Victor will be coming to you to be tested and to get his treat.

 

I just noticed what you are feeding: Hills Prescription W/D. On their web site that is for "Digestive and Weight Management". IMHO that is oh so NOT for Diabetes. The listed carbohydrate count is 24.2% Ideally carb count should be less than 10% or lower. Canned food is best. I notice many people (including me) on this site use Friskies Classic Pate. Very low carb and inexpensive at about .50 cents per can; the most reasonably priced in my experience. Never feed a canned food that states "gravy" in the name.

https://www.hillspet.com/cat-food/pd-wd-feline-canned

 

Info about dry food/water.

http://www.felinediabetes.com/FDMB/...r-more-than-just-carbohydrate-content.175004/

Suggested foods list:

https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

We do have a wellness plan with this vet, yes. And my mom did go to another clinic that we had taken our dog to years ago to see if we could possibly go there instead, but apparently from what they said my mom would have to pay off out of pocket the charges that have been put on the wellness plan (which is currently over $2,000) for us to even be able to get off of it and go to a different vet/clinic, and that is just impossible for us with our financial situation. I don't know what else we could do in regards to that.

I've read as well that Humulin N isn't a good insulin for cats, and that's another thing that has me extremely concerned and makes me dislike this vet we currently have. She just doesn't seem to be well-versed in feline diabetic care, which is extremely troubling, to say the least.

 

Your vet is completely irresponsible not communicating with you properly but through a vet nurse. The vet nurse would not know as much as a vet.
I would ring the company that you have the plan with for your car and see if you can transfer it to a new vet as Michelle suggested.
Increasing the insulin to 4 units is dangerous. Your vet obviously knows very little about feline diabetes. Sorry to be so blunt but it needs saying!
Please find a new vet who will work with you not against you. Ask for Lantus insulin. It is a better insulin for cats.
Remember you are paying the bills.
Try giving a treat as you test the ear and hum a song as you do it. It might relax Victor and you as well!! We understand the stress

 

Is there another vet at that clinic you can go to?

 

Oh, don't worry about being blunt about our vet, I completely agree! During one of our visits, I remember my mom had asked her a question (I can't remember what the question was) but the vet's response was I don't know, you tell me. That instantly put us off. We had already decided we are not going to increase Victor's dose to 4 units, but it's nice to see some confirmation that it wouldn't be safe for our kitty. We'll just stick with the 2 units and hopefully be able to find some way of going to a different vet.

 

We could try, but it seems like whichever vet happens to be there on the day of your appointment, that's the one you see. I don't know if we can actually request an appointment with a specific vet.

 

It’s worth a try
Heavens... you are paying the bills. I’d definitely try another vet. Ask when they are all on duty. Lots of us do that. Perfectly reasonable request.

 

Hello Heather

It sounds like Victor has a vulture masquerading as a veterinarian. I know what that's like . I took Sammi in once for a blood glucose check; he'd just been diagnosed and the clinic was basically holding the insulin (that I'd had to prepay for) hostage until they ran their own test. It was $11 for the technician visit, and $20 for the test, for a total of $31 dollars. For a bit of perspective, I just bought a backup AlphaTrak 2 meter that came with 25 strips for $37.80. That makes a single BG test $1.51. The AT2 is the exact same meter most veterinarians use, and from experience I know it takes less than a minute to test Sam. So my vet made a very nice profit of $30 for a minute's work -- although the technician kept Sam in the back for more than a half-hour. $30 for a BG# that was raised from stress from the nightmarish trip to the clinic.

I don't think veterinarians can treat diabetic cats. They can diagnose them, and write a prescription. A very good, very kind, very wise vet may offer advice and point you towards online resources (like the FDMB!) which will help you learn how to treat your own cat. Veterinarians can be wonderful with so many different illnesses, but the daily management of diabetes is up to each cat parent.

Test at home instead of at the vet's. A human meter is perfectly fine, it will tell you everything you need to know. It will tell you if Victor's BG is too low, and it will show you trends. Trends will tell you when you need to increase insulin and when to decrease according to whichever protocol you choose. Home testing will keep Victor healthier, happier, and far, far safer. Save money, and save the veterinary visits for issues that they are better able to handle.

When I get especially upset with my vet, I start calling other practices to ask how they handle things. I'd swear the clinic has my phone tapped, because Sammi's Dr. usually calls within the next 2 days suddenly willing to capitulate on issues we'd previously stalemated on Maybe get a copy of all of Victor's records, and call around. See if another veterinarian would be willing to write a prescription for a different insulin with just a single office visit. Don't let your current veterinarian back you into a corner; when it comes to Victor, you have the power. You ultimately make all the decisions regarding treatment, never forget it. As my vet said to me on one memorable occasion (in a very loud voice and with a finger pointed in my direction), "I obviously can't control what you're doing in your own home! But you will never get Sammi regulated this way!"

Mmm... yeah He got to yell, and I got the prescription I needed, and Sammi is doing just fine A bit of learning, a bit of patience, and soon both Victor and yourself (and your mom) will be doing just fine with the sugar dance.

 

I will say that when it comes to who talks to you and gives you information, it depends very much on knowledge levels within the clinic. I've regularly been sent in to rooms by one of our vets to give advice and help on FD because she knows I've handled it at home for so long that I have more (and better) information on a lot of aspects - where to buy meters, how to test, what food to give, etc. And I'll quite often have been asked about how I would change the dose (if at all) in the back before she goes in to give new dosing instructions. However, if the vet nurse doesn't seem to know her stuff, then that's a different story entirely. I will say that your cat shouldn't be taken to the back for a spot glucose check - it raises a cat's stress levels (and therefore BG number) too far. Anything where stress needs to be avoided should be done in the room with the owner present as most cats are less stressed that way.

With all of that said, if your vet is trying to increase the dose by a large amount based on a single reading, then she's doing it wrong. Dose changes should be based on curves, not spot-checks because you've no way of knowing whether or not the reading you're getting is the high or low point in the cycle or somewhere in between. I also have a huge issue with any vet saying that home-testing readings won't be accurate. Yes, it's a different meter and (if you buy a human meter) a different scale. But the readings are actually MORE accurate regardless because the cat is at home and comfortable instead of being at the vet and stressed.

As it sounds as though you can't transfer to a new clinic, what I would recommend is that you simply take control of the situation yourself. Start home testing, refuse any further requests for you to take kitty in to be tested in-clinic...just tell the vet you're testing at home and managing it yourself. Let them know what numbers you're getting and what the range for your meter is. Make yourself seem as though you know what you're doing (even if to begin with it's people here giving you the information you need to sound confident). And definitely ditch the w/d diet - much too high in carbs. Fancy Feast classics work just fine for diabetic cats and most that are overweight will lose weight gradually on any low-carb wet food diet.

 

@manxcat419
I probably worded the 'nurses don't know as much as vets' comment badly. Apologies.
I think mostly that is true, but in cases like yours where you have lived with and treated FD, I am sure you know a huge amount more than most vets about it.
I think for you to give advice and experience to newbies in the clinical setting after being 'recommended' by the vet is great, and it is a great shame that there is not more harnessing of the fantastic knowledge that is here on the FDMB for the benefit of newly diagnosed FDs.......but for a vet to regularly communicate through a nurse and the client not to be able to talk to the vet and ask questions after a 'consultation'.....if you could call it that with the owner not even present!.....is very bad practise....and totally frustrating for the client and asking for mistakes to be made.

 

@Bron and Sheba - I absolutely didn't take offense at your comment. In a lot of cases, you'd be right...but I always try to explain why some vets may send the nurse in to talk to the client in their place as there are sometimes good reasons for it. I do agree that the vet should also be available for questions, even if they then refer some of those questions right back to the nurse for further clarification - no vet should ever make themselves unavailable to paying clients. At the very least, it's unprofessional...at worst it can be life-threatening for a pet.