? New and cat mom frustration

Hi,
So I'm new to diabetes as of this week. Right now, my confidence level in my vet is faltering.

I'm not sure if I want reassurance that this is the normal process, or advice on how to handle it... so, I'll take it all lol.
Monday we had blood work drawn. She was at 450 and the vet wanted her back Tuesday evening to keep her and get her glucose stabilized. They expected a 3 day stay. Monday's visit alone cost $350.00 without any treatment - just for testing and visit.
The vet hasn't called me once to offer any updates.
I called on Thursday just before lunch. They said she tested at 350 that morning and was given 1 unit of insulin and they would be testing throughout the day to monitor her.
Today I called just before lunch again for an update. They said she was in the 100's last night so they did not give her a second dose, but this morning she was at 480. So she's received another 1 unit of insulin this morning and they are monitoring to try and figure out the dosage to do a 2x a day insulin dose. She said plan to pick up Fabby today because I can give her insulin over the weekend just as good as they can, but they would like to see her again on Monday.

I am screaming inside my head! What am I paying them for??? Why did I have to leave my cat with them if they haven't got it figured out yet, but I can do it just as well at home??? And why on earth would I bring her back on Monday if it's just as good at home???

This really seems like an either or situation. Either she needs to have round the clock monitoring at the vet, or I can give her quality care she needs at home. THIS is why my confidence has dipped. I'm about to go pick up Fabby, and for this week alone she'll out almost a grand in vet care, and as of this morning they've changed nothing for my poor kitty!

But I have to keep all these feelings in check. I need the vet to give me the insulin script, and I need him to teach me (or I'd be way more comfortable learning from him than just YouTube videos).

This wipes out what little savings we've amassed, and the vet office doesn't seem interested in keeping me informed, nor what an inconvenience it is to drop off and pick Fabby up from the vet. (I can't drive, so my spouse has to take unpaid time off work with a 90 mile commute.) and it all translates to dollar signs... and even after paying out all this money for a cat that's not even stable I need to go spend more money to get a meter and other equipment. Please don't misunderstand. I would do anything for my animals. They are my family. My number one priority is a healthy happy Fabby. But I'd really like to feel like the grand I'm spending in one week did something, not just a waste!!!

Maybe I'm freaking out over nothing and this is just the normal procedure when you get a cat that develops diabetes. 2 hours till I go get my kitty.

 

Most of us here test our cat's BG at home using a human meter like Walmart's Relion Confirm or the smaller micro Confirm. Some use a pet meter like the AlphaTrak but the strips are much more expensive than for a human meter. A pet meter is more accurate (a human meter reads lower) but a human meter is more accurate.
Most of us record our reading and other info in a spreadsheet. This allows others to review the data and make suggestions if you ask. For info on setting up a the spreadsheet see:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Thanks Larry.

I do plan on getting a meter on the way home from picking her up. I'm pretty sure I've decided on the ReliOn model, and if I want to switch her after we get her stabilized to the AT2, but I don't see that happening if the ReliOn is working.
I also likely won't use the spreadsheet that many in the forum use, but instead track it by a phone app.
But I'm really new - so that might change too, lol.

 

I'm so glad you're planning on home testing. Testing at home is vital to keeping your kitty safe!

I hope you will reconsider using our spreadsheet. It is a really important tool to have, and it also helps us to help you. It is very easy to use and gives you the ability to quickly discern patterns and trends in your cat's blood glucose levels, and helps determine whether or not a particular dose is working or having the desired effect. It provides us with crucial information at a glance if you need help or advice.

As far as you vet goes - my personal opinion is that they have taken you for quite a ride. Once you get your insulin and he shows you how to administer it, I would start looking for a new vet! Just my two-cent's worth.

 

Outside of the initial show and tell for home testing and injection. I have not taken Jones back to the vet in regards to either again. Just general check ups for other issues. I found the information and advice here more then required for dealing with his diabetes. Wish I had found this site sooner.

 

So we're home.
We won't be going back to this vet unless we find ourselves in an emergency without other options. They charged me $30 for every time they tested her glucose, which over 3 days was apparently only 4 times. The price for the overnight was higher than they quoted and listed as emergency, instead of boarding. If I can help it they won't see any more of my money.
That said, I will stick with the vet's advice through the weekend in case we have any issues, I want to be doing what I was told.
1 unit of vetsulin 2x per day 8am & 8pm.
I purchased the ReliOn glucometer.
She's eating friskies wet food (flavors that are listed as only 3 or 4 carbs from the big list we found here).
Fancy feast salmon treats for each glucose test.
I have her quarantined in my bedroom so I can watch her fluid intake and output.

So far she's had 2 tests at home. 6pm she was 399 and 8pm she was 426. She ate 3/4 of a can and got her shot.
I'll give her the remaining 1/4 of supper in about an hour and test again right before. I'm trying for every 2 hours so I can watch the curve (hoping I used the lingo correctly there, lol).

When she came home and I let her out of the crate (just before 6pm) her hind legs were a bit wonky. That's since self corrected... but of course I was all - "What did they do to my baby!!!"

 

Curves are nice to do. I usually end up doing one each weekend. Sometimes every 2hr and other times every 3 hrs. I don't tend to do one at night on him anymore as he get prednisolone that bumps him up but then he give a low number @ +2.

She may have some high numbers from the stress at the vet.

That is just plain robbery and that isn't curve testing. Like I said before, I never went back to the vet in regards to Jones diabetes, handled everything through the advice received here. My vet was absolutely happy with the results and was amazed that I did what I did. I believe sometimes just don't have faith in pet guardians.

 

You are doing great! I normally don't complain about vet fees, but that vet is a highway robber. $30 per test, when you're already paying for boarding and paid $350 just for the initial visit? And they only tested 4 times over the course of 3 days?!? You are going to be so much better off doing your testing at home.

I'm not experienced enough to comment on the recommendation of that insulin and dose, but if you're testing before each shot, I would think you should be safe. Fantastic job on having learned to do it so quickly!!!!!!! Like @Tracey&Jones , I haven't taken my kitty back in since his initial diagnosis. My vet looks at his spreadsheet when I ask her to and makes recommendations over the phone or by email.

 

Definitely no need to leave her at the Vet if they couldn't get a dose for her in 3 days, you can absolutely take care of her at home . The most important BG tests are AMPS and PMPS (morning and evening pre-shot). Make sure she has not eaten for 2 hours prior to this time. Since your shot times are 08:00 / 20:00, Pre-shot time will be about 30 minutes before, so take away food 05:30 / 17:30. Correct, curve is a test every 2 hours after shot. Vetsulin is a shorter acting insulin, so you may see her nadir (peak insulin / lowest BG number) between +4 and +6 (noon -14:00 / midnight - 02:00). Forgot if you mentioned in introduction, she has a roommate? Figuring this is why she's being quarantined .

Like Tracey&Jones, Maury has not been back to a Vet for his diabetes. I've managed it with this forum as well. He will only go if there's an issue or annual checkup . The members here live and breathe feline diabetes (FD) 24/7 and I believe in experiences over any school.

Keep an eye on her back legs, some kitties do get hind leg neuroapthy (leg weakness) from high blood sugar that can cause nerve damage. Best thing to reverse the nerve damage is getting BG under control. There are also supplements, but we can talk about that later

Lastly, her numbers may settle over the weekend since she is home. Numbers may be elevated from stress at being at the Vet clinic but you will catch any changes like this with home testing . Actually, you may want to try curve tomorrow or Sunday. Still may be stress influenced tonight.

 

...it's bad that two people were simultaneously writing comments using the word "robbery"...shame on that vet.

 

Thinking the same thing @Squeakycats. I thought my clinic was bad.

 

Thank you all for confirming my suspicions that this was excessive.

I appreciate that a couple of you have advised my high numbers may just be from the stress of the vet. I'll stop torturing her and start my curve monitoring on Sunday. (I'll still test before insulin until then.)

Yes @Yong, we are a multi animal household (updated my signature as I've been talking about the others here as well when applicable). So she's quarantined as on the regular it's my best guess as to who's urine is who's, lol. She's been standing over the water dish since she's got home, so I expect to see a large amount of urine. Hopefully, we can get her managed appropriately so she can go back to being a cat instead of slave to the water dish.

The best part about today (aside from all you wonderful people - seriously, thank you!) was when I let her out of the carrier and she walked around the room, she came and stood right in front of me and did the "shakey bootie" action that means love/happiness. When my spouse came in the room to hang out a few hours later, Fabby went right over and did "shakey bootie" again. The purrs after the glucose test letting me know she was fine with it rank pretty high too.

Her last test was 2 hours after insulin and it was 398, next check will be before breakfast in the morning. When I get my first curve reporting completed I'll post all her readings to get further input. I'm sorry y'all are so experienced, but I'm also so thankful!

 

The only reason for a diabetic cat to stay several nights there is if there are ketones present and they need to give iv fluids.
Being there stresses them out so the readings aren't accurate anyway.
It sometimes takes weeks or months to regulate a cat! They can't keep her that long!
Get her and bring her home.

Get a monitor and test at home. We will help you with dosing.... Many vets aren't good at it anyway. Lol.

 

Good plan. Just so you know, you can use our spreadsheets on the phone too.... I do. You just need to download the Google Sheets app.

 

Vetsulin usually peeks about 4-6 hours after injection, so try to get some readings at that time. Well done taking charhe of the situation. We are all here to support you.

 

In addition to the above great info provided I think it would be good idea to test Fabby's urine for ketone presence. You can buy ketone testing strips at any human pharmacy, not expensive. Did you vet check her urine at all or mentioned anything about ketones? When my kitty was tested positive for ketones her BG very high and she drank A LOT. Getting rid of ketones at the clinic is very expensive. I'd keep an eye on it at home especially if your vet is good at reaching to the wallets , might serve him well to omit the fact. It's good she drinks - you have plenty of easy samples then.
And I also wanted to add my voice to all of the above who asked you to reconsider setting up a spreadsheet - THE most important tool. I had no clue how to do it and someone else on this Board set it up for me and trained me in using it until finally I got it some weeks later. I am sure she would do the same for you if you ask.
Best of luck to you and Fabby!

 

I put ketone test strips on her shopping list on introduction thread

 

I already had the ketone strips due to human illness.
I did check with the vet about them when I got the insulin instruction yesterday. He said her tests did not indicate any ketones in her urine, (only glucose) and at this point he felt comfortable telling me I didn't need to test for ketones.

Then he went into a thing about, her body is still producing its own insulin, and it would be easier on him if it weren't producing at all because then we would know the amount of insulin required. But because she is still "working" we have to adjust the insulin we provide her to compensate for what her body isn't doing.
The doc said the treatment for ketone issues is insulin and access to water - both of which we are providing.

Do y'all have a good reason or better information as to why I should go through the extra effort? At this point it'd have to be a pretty amazingly compelling reason for me to want to add in more. I'm pretty sure I've hit my threshold of new challenges. (Because while I have the strips and know how to use them, the effort to catch her pee is just a bit too much.) I'm already interrupting my own illness care to make the necessary changes. We can't continue down this spiral of one's health at the expense of another... I know it will get better/easier with time as the routine develops and gets normalized, but that moment isn't right now... sorry for my frustration spilling over.

Also, I did try to set up the spreadsheet and add it in my signature. Can someone check it for me to make sure it's working? The last update I added so far was today's +6 reading. I have no idea if it's publishing publically with the info. (I set it up with my android phone, and for the life of me I can't find the option the instructions State to publish with every update, so I'm hoping that's an automatic feature from the phone.)

 

Your sheet is working for me. And it totally makes sense to be frustrated--even once things get pretty routine, taking care of a diabetic pet can still be time-consuming, anxiety-provoking, and expensive. I think everybody here feels that from time to time, and I'll bet pretty much everybody felt it at first. You are already doing much more for your little one than most people would--you are working really hard to learn about her condition and manage it well! I'm not experienced enough to say anything about how important the ketone testing is, but is sounds to me like you need to be taking care of yourself right now and not trying to master ever single kitty thing at once.

If I understand correctly, it is a VERY GOOD thing that her pancreas is still producing its own insulin...the hope is that eventually it will heal and start producing enough that she goes into remission, or at least needs smaller injections.

If you decide you do need to catch some pee, I can say that I've had the best luck with a ladle--I was astonished to find that my cat didn't really mind me shoving it under him while he was peeing. But I still have to be aware of when he's headed to the litter box, which can be hard to do.

Hang in there! You are doing a really great job!

 

^^^ This indeed is my hope too!

Thank you for checking out the spreadsheet! That is good news!

Thank you for all of your help and your kindness!

Off to feed the rest of my demons their lunch... I mean loving furry family members.