Losing my mind

My fuzzy was now diagnosed and began treatment over three months ago and he's still all over the map. Now I have a tough situation, I travel for a living so daily testing is impossible. I have a roommate who gets a reduced rent for giving shots twice a day but I can't ask her to also test. It's already too much to ask and I can't afford a further rent discount. She's type I though, and takes excellent care of him.

I went in to the vet recently for his 'post diagnosis checkup' and was pretty annoyed that all he really did was a blood test. Heck, I do that at home. I had to pay $50 for the honor... And all he said was "that's pretty high still (384) so let's raise him to 3IU. He was originally prescribed 2 IU but my roommate and I raised him when it was staying high to 2.5. He's been on 3 for 3 days now, and his BG is much higher. 533 today. The vet also told me to give him Glycobalance. When I mentioned I've researched cheaper options and feed him fancy feast Classic 0-2 carb food (with a raw chicken/liver blend added to help him eat and make him purry face), he shrugged as if to say I was dead wrong. But I couldn't afford glycobalance even if it was recommended anywhere else (which it doesn't seem to be).

I've spent countless hours online here and elsewhere trying to figure out what to do now. I live in the middle of nowhere, so another vet isn't an option. There is a VCA near but I HATE VCA. They've treated my pets so awfully at two other locations I won't ever go back. So, it's up to me at home. I try to test each day I'm home one or two times, but I just have no clue what I'm doing. I spend more time crying than I do anything else.

He seems bright eyed and bushy tailed most days. He's not gaining weight but he hasn't lost any either (he was 10 pounds when diagnosed, which is about 4 pounds lighter than he was two years ago). But his muscle wasting is still there, coat still oily, and blood sugar still too high.

The only time I ever had decent measurements was when he was about 2IU a day. The few times I've increased insulin, he BG went up. I know that can happen, I understand why, but 2IU also sees too high BG... so what's next?

I love this little jerk with every ounce of my being. I've spent easily over 10K on him in his lifetime because he's that cat that has urine blocks and other crap just to mess with me. I know I can get four more years of snuggles if I can just get this under control... He has stress in his life. He has a hard time every time I leave for work and sticks to me like glue when I'm home. My roommate is learning to snuggle him more. She's a great nurse but not a cat person. But she also wants to see him healthy.

What do I try next? I know some sites say to test every two hours but his ears are bloody and bruised from just a few days of tests twice a day, and the vet says I'm doing it right (and I follow all advice here). He's albino, so his wounds may be more obvious than those on a darker furred cat.

As the daughter and roommate of diabetics, and fur mother of another, F diabetes.

 

Hi. It can all be overwhelming but try to take a deep breath and relax a bit. Being overly stressed or upset about it won't help you or your baby. It is great that you are home testing. There is no reason to test every two hours all the time. When a curve is done, testing is done every two hours from pre-shot to the next pre-shot, but that is not necessary on a normal day-to-day basis. Testing should be done before every shot to make sure that it is safe to give the planned dose. Also, mid-cycle tests should be taken whenever possible since they are necessary for you to know the impact of the dose given. If you can get one or two tests in during a cycle, and if you vary the times you do it, you will be able to piece together enough data to help with dosing decisions.

If I understood correctly, your vet did a glucose blood test in the office and based a dosing increase on that. If so, that is not good. A test at one random point in time does not provide enough information, and tests in the vet's office can be impacted by stress, so they are not very reliable. It is also not good to raise the dose by a whole unit, so I am glad you ignored the vet on that one. Based on the limited data you have so far, it looks to me that he may have been responding pretty well to the 2 unit dose. I have no personal experience with Vetsulin, so hopefully someone who does will come along and comment on it. I do know that too much insulin can look like not enough insulin. So, it is possible the dose is a bit too high now and pulling it back some might help. Let's see what those with Vetsulin experience say.

As far as the 'wounds' from testing, are you heating the ear before you poke and being sure not to hit the vein? Applying light pressure after can also help. You have probably seen the tips here for picking a special place to always test and giving lots of love and a treat each time, even singing or at least talking to the cat throughout. These do work to make the experience a bit more pleasant for the cat and can help toward making it just something routine that they cooperate with. If this is the case, maybe the roommate would be willing to test when you are gone.

You are right on the food - low carb - the vet is wrong. Enough said on that. As far as not being able to change vets, as long as yours is not being completely unreasonable about things, you can make it work. Really, you have to educate yourself enough that you know when to follow the vets instructions and when not to do so. You are the one 'living' this with your cat, so ultimately, you decide what to do. You may decide that you don't always need to share everything with your vet. Finding a balance between not making your vet mad and doing what you have learned is best for your cat is key.

You can do this. There is so much support and information here.

 

Where on Earth did you hear you needed to test every two hours? That only applies when doing a curve.
FurBabiesMama is correct about the utter uselessness of a one time test determining your dosage. There's the stress of travelling, a stranger poking your cat in a place he doesn't want to be etc. These numbers are next to useless, they need to reflect as close as possible the cat's day to day life.
Testing is more art than science and few of us get it right every time. I've had two very patient sugar cats and over the years I have shredded their tiny ears more than once. It will come to you in time, I promise.
This is a little personal but here goes. When you say renter I'm assuming you mean roommate. Either way it's not really fair to extort you for money for this. If she can do shots she can certainly test. Roommates don't have to be best friends and she is doing something nice for you but she's not shoveling snow off the roof.
I live in Canada and have never seen or heard of VCA but they sound like the K-Mart of veterinarians, lots of corporate policies and no allowance to make decisions without consulting the big-boss-man. There's a way to deal with this just like you would a car dealership. It's your cat and your money. Tell them what you want done and what you do not need or want like the mysterious "wellness test" which has a different definition every where you go. Like any other big business their aim is to sell-sell-sell. I'd bet two minutes after you leave they'll have forgotten you and your cat's name.
I don't have time to go into specifics but all of us have been where you are now. I promise you this, stay with us and you'll get the best advice, the dosing suggestions we're really not supposed to talk about and a big dose of compassion.
And yes, diabetes can go suck an egg but it's a fact of life, not the end of life. We're your new best friends whether you like it or not. Cakes made from rainbows are not part of the deal. How does that sound?

 

If the roommate is type I, then she's well-versed in testing. Have you talked to her about it? It shouldn't take more than a minute or two each time. If you're subsidizing her rent, you have a financial arrangement so I'm not sure why you think it's already too much to ask. How much of the time are you actually gone? If on the days you're not there, you ask her to test twice a day, that's really very little. Given that she's Type I, that's what she does for herself, so she knows the drill.

As far as his ears getting shredded, I started putting a bit of antibiotic ointment on my little guy's ears just before I poke, they already look much better. Still a bit pink, but he's looking so much better overall that it's well worth it.

 

I generally agree with this! You may feel obligated to pay or reimburse your roommate somehow, but if she cares about the cat at all, and she already has experience via her own diabetes, it's really just a kindness for your furbaby.
It's not just about you and I'd love to believe other people in the world can understand that.... They don't all get it though. :\
I have a roommate who is squeamish about needles so though I've offered her a chance to try to administer shots, she has declined. But I'm also not paying her and I still expect her to monitor Alice for signs of hypoglycemia as long as my roommate likes keep her in her room. So. I'm the mom first and I make the rules.


As far as vets go, and most human medical doctors I feel like, education and advocating for yourself/your furbaby are the only ways to get what you need usually.

I'm new to this stuff so I can't answer any of your real questions. I'm just sad for your stress and wish I could give you all hugs. If you like hugs. Or give you cookies. Something. I hope it gets better for you both soon.

 

Truer words have never been spoken. I used to call the local "hospital" emergency room and ask if they had a neurologist on staff. My problems cannot be dealt with by a GP and interns like broken ankles, not broken brains. The reply was always the same, "What difference would that make?" Now we just don't go.
Knowing more than a doctor or veterinarian seems to be forbidden, it does not have to be that way.
When did everyone feel the need to be reimbursed for 10 minutes of kindness? I used to shovel my neighbors driveway because I was already out there all bundled up holding a shovel. I know not every situation is the same but sometimes I wonder what is going through people's minds.
@mialia
Hope this helps. I freehand with these big fat BD lancets. They're the same idea as those fat pens that make things easier for people with hand injuries and come in multiple gauges. And the mystery of a cat's ear.

 

@Noah & me (GA) ,

When one of my bunnies became deathly ill on a Sunday night, I called all over my area and couldn't find an exotics vet closer than about two hours away, and I couldn't afford the drive. Armed with only limited carecredit I had to convince the local ER vet to administer subcutaneous fluids for her just so I could buy time. The doctor knows how to read the info well enough to figure out how much to give her. He knows how to administer the fluids. He didn't know anything about GI stasis in rabbits and the fact that it can be deadly. It wasn't enough to save her but you know, advocating for her and making extra things happen is the only way I can be sure she was given all she deserved.

And kindness! Sometimes making someone's day a little easier, healthier, better, whatever.... It's just worth it.

 

I may talk to her. She's taking a new job soon so she'll be working from home and the new job will take a LOT of stress off her. I travel for a living so I'm only home 10-12 days a month. Trust me, if I'd known life would go this way, I would have made different decisions but I got my fuzzies 13 years ago and worked a normal job and had what I thought was a stable relationship. Things change. Now I'm a single mom of four fuzzies with a traveling life.

I did his first BG curve today. You can see in the chart but here it is, too:

01/17/2019 3iu 369 before administering.
+2: 328
+4: 291
+6: 260
+8: 338
+10: 351

He's been on 3 units for about four days now. I'm about to leave for four days so we're keeping him on 3 days and I'll do another curve when I get home to get an idea. Does that sound reasonable?

 

@mialia Yes that sounds reasonable. As far as planning your life it just can't be done that way and you should have no regrets. Around 1978 I was given two kittens in a cardboard box. Back then there were no big box pet stores so they ate crap, I was single and worked almost every night delivering pizza etc. without a care in the world. And they were outdoor cats. If you had told me then that 16 years later I would be on a plane with the same two cats off to start a new life I'd have thought you we're crazy. Crazier yet was irresponsible me being in a stable relationship with a 23 year old cat. Then we progressed to nine cats and a dog and I never regretted any of it.
If it helps I think you're doing the right thing. Finding the right vet is like dating, "If I'd known you were nuts there wouldn't have been a first date". We never planned on having two diabetic cats so where we lived and worked didn't really matter, you can't plan for everything. Our boys were low maintenance and by sheer dumb luck we have two smart and compassionate vets.
Sorry for the lack of medical insight. I did my own spreadsheets in Excel but soon enough you'll get feedback.

 

@CassandraCatface Not wanting to hijack the thread but I learned about advocating for Noah's brother the hard way. I should have made the admitting doctor at the ER clinic write this down, "Nervous cat, no unnecessary handling!". Someone yanked him from his cage at 2AM for a blood pressure test. He freaked and had a heart attack. Instead I got the eye rolling "Oh all cats are nervous blah blah". I've also pulled the plug on nail clipping when the two 12 year old techs failed to see the cat was mouth breathing and clearly in distress.
Advocating does not mean you're being rude, it only looks that way to someone who finished last in the class. Two years of community college and you still think a unit is "This many lines on the syringe".

 

@Noah & me (GA) agreed not to hijack the thread, but oh my goodness. I'm so sorry for that loss. I'd be livid at everyone and probably still more upset with myself. Rabbits can die like that easily. It's a huge fear for me.

@mialia no one plans because no one hopes for it. My diabetic cat was never overweight. I never thought she had risk factors. She and her brother were/are my first cats and I knew so little compared to now. You're doing your best. Keep doing that.

 

@CassandraCatface Okay, last hijack, I promise. This is the same clinic with an MRI in the basement, an enormous operation. We also had a cat die on the waiting room floor because the emergency clinic receptionist was no where to be found. It was also where the canine oncologist gave us the bad news about our dog. She was of course completely wrong and would not respond even to my "good news" e-mails.