Knowing what you know now what questions would you ask Vet?

Discussion in 'Feline Health - (The Main Forum)' started by Tom Shooter, Jan 2, 2018.

  1. Tom Shooter

    Tom Shooter New Member

    Joined:
    Dec 28, 2017
    We are taking our cat Dusty to the vet toady. He has recently been diagnosed with feline Diabetes and we are going to start his insulin shots.

    If would appreciate it if you could you please provide me with some questions you wished you had asked the vet (with the benefit of hindsight) so that I can make sure we ask the right questions to get our baby the best care possible. Thank you in advance for your responses.
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    My vet was better informed than many but there were still things I wished I'd known earlier. Here are some suggestions:
    1. Why did you recommend that insulin?
    2. Why did you recommend that food?
    3. Do you recommend that the owner tests blood glucose at home? If not, why not?
    4. Is a fructosamine test needed if I test BG at home regularly?
    5. Are you willing to work collaboratively with me if I want to be more hands on with my cat's diabetes treatment?
    6. I want to do blood glucose curves at home. Are you OK with that?
    That's a start ... :)
     
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  3. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Kris has given some great suggestions. :)

    I wish I'd asked my vet:
    'How many diabetic cats have you treated', and/or, 'How many diabetic cats are you currently treating?'
    'What, in your experience, is the life expectancy of a diabetic cat?'
    'How many of the cats that you've treated went into remission and no longer needed insulin?'

    ...In hindsight, I think those questions would have told me a lot about the vet's experience and understanding of diabetes....
     
  4. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes to all Kris's points above and I would also suggest asking the vet how many diabetic cats he has treated (approx, obviously) and what kind of success rate he has had in helping them to become regulated. The sad fact is that not all vets have a lot of training or experience in FD, and you do want one that you have confidence in and feel that you are on the same page with as regards food choices, home testing, etc.
    Keep coming here and asking questions - it's the best site in the world for helping people and their diabetic cats!
     
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  5. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Ha ha we cross posted, Eliz! Great minds etc...
     
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  6. Tom Shooter

    Tom Shooter New Member

    Joined:
    Dec 28, 2017
    Thank you for your responses. Feel free to post any other questions for the next few hours as we have 3 hours until we leave for his appointment.

    Also if you want to post suggestions or concerns for his first 24/48 hours on insulin that would be helpful as well. I am very concerned that I might do something wrong to harm him.
     
  7. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    One thing I recommend highly is to buy yourself a human glucose meter and learn to test BG yourself. We can give you tips on that and links to how-to videos.

    It would also be useful for you to post here telling us what insulin, what dose, what food etc. your vet has recommended. We truly don't want to undermine your relationship with your vet. However, we've seen so many new people come here saying that some scary high intial dose was prescribed with no instructions to test BG at home - worse still, telling the owner NOT to test.
     
  8. Ann & Liz

    Ann & Liz Member

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    Sep 25, 2016
    Hi, just wondering if you live in UK? as we have an Alphatrak 2 blood glucose meter and some testing strips if you need them.
     
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  9. SueGeorgeandLuci

    SueGeorgeandLuci Member

    Joined:
    Nov 3, 2017
    I wish I'd posted here (or even found this group!) before seeing an inexperienced vet who advised me to 'put her down' - her BG was 374 and he doesn't have any feline diabetic patients (I know why!) So after spending two days crying about the fate of Luci - I started doing some research online and found this wonderful, well-informed group. We do about weekly BG checks at home - it was rough getting started, but once we got the hang of it we're able to get that little drop on a human meter and changed her diet to grain free - all meat from cans diet. She's lost about 2 pounds and her BG is under 200...and no I'm not going back to that guy ever again. He doesn't know what he's talking about when it comes to feline diabetes! So, read all you can, get information from multiple sources. If your kitties numbers are high then insulin is the next step to getting it down - we haven't had to go there yet. However, I'm getting ready to post in another thread my concerns about Luci's weight - just want to make sure we're still doing the right thing.

    Best of luck to you and your kitty.
     
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  10. Tom Shooter

    Tom Shooter New Member

    Joined:
    Dec 28, 2017
    I am in Canada. When we took him to the vet our human machine registered 25.3 Metric. We switched his food to Purina pro plan DM. The vet told us to only give him 1.5 cans per day. I saw later on the web site that the suggested daily input for a cat his size was 3.25 can (his is 9.0 kg). Over the holidays his registered 20.8 and then 19.3 but he seems to have stopped there. After reading this website I am thinking that we need to try insulin and that diet alone will not fix this problem. Since going on the strict DM diet has been lethargic and only moves off his bed if he thinks he may get food. Last night because I knew that he was going to the vet today I gave one Sheba perfect portions pate. I had read on this site that it was not a bad food for a diabetic cat. He almost immediately picked up his energy and chased his cat nap mouse all over the house. He was back to normal but this morning when I gave him the DM has was back to his lethargic self. I am going to see if we might be bale to give him one can of each a day. The vet wanted to keep his calories to below 300 I think.
     
  11. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I wouldn't hold off too long on insulin if the vet thinks he needs it. There's a risk of complications from the buildup of ketones in his system if his BG stays higher than it should be.

    Let us know how your vet visit went. :)
     
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  12. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Have a good relationship with the Techs. At our clinic they are "The Gate Keepers" and see a lot of lunatics. They know when to bother the doctors and can often answer a lot of questions if they have faith in you. Be patient with the recently graduated, a story for another day.
     
  13. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Kwestions for vets (in addition to those posed above):

    1. Have you tested my cat for ketones as part of the diagnostic work-up?

    2. Based on my reading so far, I plan to regularly check my cat's urine for ketones. What should I do if I get: (i) a trace result; (ii) a positive ketone test higher than trace?

    3. What out of hours cover do you offer in general? What cover does the practice offer if my cat needs emergency treatment for: (i) hypoglycaemia; (ii) ketosis/diabetic ketoacidosis.

    4. I understand from my reading that sometimes diabetic cats may get GI upsets. What is your normal approach to treating feline nausea / inappetence. (Should include anti-nausea as first line treatment with appetite stimulant meds in support of the former - NOT the other way round.)

    5. Ask your vet to tell you about which food is best for a diabetic cat and why. (Unless there are other major medical reasons why not to do so, a diabetic cat should be fed a wet diet with less than 10% calories from carbohydrates. If your vet insists on a prescription diet, the only Rx food with a carb load sufficiently low for a diabetic cat is Purina DM canned. Worry if a dry prescription diet is prescribed. Worry even more if it's Hill's w/d Dry (kitty cornflakes).)

    6. Ask your vet which insulins s/he has used to treat other patients. Ask about the remission rates potentially achievable for the different insulin types.

    7. Ask for the basis of the calculation of starting dose for the insulin prescribed. (Maybe ask for web links so you can learn more about feline diabetes and the different insulin options?)

    8. Ask about their approach to insulin dose adjustments. (Should typically be small increments - typically 0.25 IU per adjustment for average cats with dose held for several days before home curve and reevaluation.)



    Mogs
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    Last edited: Jan 3, 2018
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  14. Just-As-Appy

    Just-As-Appy Member

    Joined:
    Oct 17, 2010
    I would ask what the target range is for bg and what to do if it isn't there.

    How common is pancreatitis? How is it treated? What are the signs?
     
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  15. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    This!

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