New Diagnosis - Problematic Vet Clinic + Timing issues....could use help

Hello again ~ I found and signed up for this forum last weekend (thank heaven I found it !). Apologies in advance for a long post but I'm pretty freaked out and dealing with multiple problems in addition to the devastation of knowing that my little pal is really sick and all the ramifications of FDM. I'll try to be succinct as I can. Any advice or tips are welcomed.

My beautiful kitty guy, Kohl, was diagnosed last week after I noticed excessive drinking of water and then he peed in my bed (!). I had seen a gradual increase of out-of-box peeing but he had never ever done so in my bed before. I was super-hesitant to make the appt. with his current vet as I was not happy about my experiences with them. However, this felt like an emergency plus he was a month or two overdue for the laundry list of vaccines and other items they wanted me to bring him in for so I called them. They told me neither of the two vets I'd seen previously was available but I could see Vet #3 the next day. I booked the appt and we went in to see the new dr. with optimistic hopes for a better experience. That was not to be and, long story short, I have now concluded that this clinic operates on an extremely corporate basis to maximize profit at the expense of humane treatment towards pet owners. The vets and techs seem nice and caring but they seem to have to operate under this boiler-plate approach or 'protocol' which results in squeezing the maximum $$ out of patients. As I have to be extremely careful and conserving of funds, I questioned everything at the time but still (because I was so upset and freaked out) ended up paying them for worm medicine it turned he didn't need ! It was a small part of the whole bill ($537.00 !) but still.
Anyway, it turned out Kohl's numbers are all good except for his glucose which was 510.

I took Kohl in on Tuesday afternoon - got a voice mail from vet on Thursday around 5pm with diagnosis - was unable to call her back until 2:30pm Friday - was told she (and her asst.) were in surgery so I asked to be called back that day and that I felt some urgency - no call back. [By this time, I'm getting an idea of what Kohl and I are in for and it feels imperative to have a vet I can trust who will work with me. So I started scouting other vets in the area, asking friends, etc. I immediately got some low-carb wet food from my wonderful pet food shop and began introducing that in tandem with his dry food. A while back I researched organic food and he's been on that for a year plus - before that he really only liked Purina Natural dry food (which I now regret).] I finally got another VM from vet about 4:15 - didn't know she was in and frankly, I was hoping I could find another vet over the weekend - what a mess ! Spent Sunday researching and calling around to friends and on this forum. Monday, I called the clinic back and was able to speak to the vet tech, Krysten. I'd decided to wait to speak with her and find out their protocol before I sought out a whole new vet/clinic. She actually turned out to be good: well-informed, answered all my questions, sent me pdf's of Kohl's lab reports for this year and last year, listened to my concerns about finances, told me the clinic would charge me $100 for an AlphaTrak2 meter but that I could get it on Amazon for $50. She asked if I wanted to make an appt. and I hesitated wanting to process the info before deciding but THEN she told me that if I waited to make the appt. I would have to be really firm about asking for HER specifically. The "Front Desk" really didn't like it when the pet owners asked for a certain person !!! Holy Cow !! So I immediately decided to go with my gut and make the appt. with her. That was for yesterday. Fortunately I had called in early in the morning with a question and learned that Krysten hadn't come in due to a family emergency. The gal I spoke to said, oh, no you can just come in - I'll be taking on Kohl's case and can get you going ! Uh.....No. I sort of had a melt-down on the phone, told her what I thought of the clinic, how freaked I was, how close I was to looking elsewhere and said that neither Kohl nor I could deal with the stress of being traded around among different care-givers - that I was comfortable with Krysten and needed to see her. An appointment was set up for today (Friday) with Krysten at 10am (an hour from now). I phoned them around 8:15 to make certain my appt would be with Krysten. The front desk guy was listless, clueless and didn't even know Krysten's name - eek !! But he said he would have someone call me back and I got confirmation calls from both Krysten and someone else. So I'm getting ready for appointment now - really don't need this extra layer of stress of vet probs. I know I'm not the only one.

Since I'm short on time, I will just briefly summarize my concerns re: timing - this will be the real challenge for my situation, I think. I am self-employed with two jobs: a musician (night job) and an accountant (day job). Divorced 7 years ago, I live alone. Having 2 jobs makes my schedule erratic and different every week. For example, if I have a gig at night that goes late I typically allow for sleeping in the following day etc. So the daily schedule of every 12 hour shots is going to be nigh unto impossible for me to do - I have no idea how I can pull that off. Ongoing, my music career requires travel. I have no idea how I will pull that off either. Funds are limited and I'm just barely able to pull off this dual career financially as things stand. Once the reality sank in, I had to cancel my performances at a regional music festival, bow out of a music gathering for this weekend and forgo a planned trip to Portland to visit family. I want to care for Kohl as I love him to bits and he's the best kitty ever - wonderful temperament - sweet - fantastic company - the best ever. I have to stop now but wanted to at least put my concerns here with grateful thanks.

Nancy K & Kohl

ps....will hopefully have time to make a signature over the weekend....no time right now.

 

Let us know how the appointment goes. What a headache this clinic sounds like!

 

Hi Nancy,

Many of us can understand how you are feeling. Hopefully this will help calm some of your concerns.

1) If you are willing to learn to hometest, which means checking Kohl's glucose levels before every shot, there is some flexibility with the timing of the shots.

2) Is it possible to take Kohl with you when you travel? There are several people here that take their cats on trips. If not, can you find someone near you that is willing to learn to hometest and give insulin? Often the vet techs are willing to do this and will either come to your home or be willing to take care of him in their home.

3) There are ways to keep the costs under control. Hometesting is the biggest saver. If you hometest, then it eliminates unnecessary trips to the vet just to be tested to see how well he is doing. It also lets you know how well the dose is working and if a change is needed. If you use a human glucose meter, that also saves money over using the pet meter the vet may want to sell you. If you are in the US, many of us use Walmart's Relion brand meters.

If the vet prescribes Lantus or Levemir, ask for the prescription for pens instead of the vial. With the vial, it becomes ineffective long before you can use it all. With the pens, you will be able to use almost every drop. You can also buy your insulin from Canada. It is a lot cheaper than buying it in the US.

4) Food. Don't let the vet try to sell you the prescription food. Most of it is higher in carbs and many cats stop eating it. If you already have bought it, you can take it back for a refund. Many of us feed our cats Fancy Feast or Friskies canned food. Dry food is high in carbs and you want to eliminate it from his diet as soon as you can. However, if you have already started giving insulin, you need to be hometesting also. Removing the dry food can significantly lower the glucose levels and your risk hypoglycemia if you are not monitoring the glucose levels.

Hopefully this helps to relieve some of the stress.

 

Hi Nancy

I live reasonably close to Seattle. Please let me know if I can help you at all - whether that's taking care of Kohl when you have to travel, helping you learn to home-test or even just help with finding a boarding kennels who can handle diabetic cats for the times when you need to be out of town. I would be happy to help you while you get your needs matched up with Kohl's needs to find a routine that works for both of you.

 

Thanks SO much for your replies. I will answer each one.

First: Janet, the appointment this morning went pretty well. I'm glad I was armed with as much research and information as I had and also that I had the instinct to insist on seeing Krysten rather than get switched to someone new and unknown. K is genuinely kind, knowledgeable, listened to my list of concerns and seems to 'get it'. She also was willing to stand up to the "Front Desk" in advocating for my and Kohl's interests. For instance, she had told me (incorrectly as it turned out) that there would be 'no charge' for this initial training and informational visit so she honored that even though the F.D. told her she was supposed to charge $25. There is a palpable tension there between the corporate feeling vibe of the business folks and the more caring attitude of the vets and vet techs. I get the sense that the latter have to follow prescribed protocols to keep their jobs, protect the clinic from liability and so on. I get that. It's just I'm used to a more friendly, warm, caring small office environment which is what I've always had before with previous kitties.

The information Krysten provided was about as expected: a by-the-book, very rigid testing/insulin protocol [every 12 hrs test/shot (1 unit) for 2 weeks - a strong admonition to change his diet to 2 feedings per day of vet-prescribed food w/no in-between food out (Kohl has always been a free-feeding guy) - then a curve at 2 weeks - then a vet review after which the vet may change the dosage and for which I will be charged an 'interpretation fee" (amt. unknown at this time - K will e-mail with cost info). Vet exam to occur after any change in prescribed dosage. In addition, I'm to call them if there are any red flags or danger signs. After stabilization, I am to re-visit vet every 3-6 months for Exam - Senior Wellness blood panel - sugar & urine tests. All this seems designed to tie you into a rigid schedule, ongoing vet visits, expensive prescription food, etc. I took down all the info and was given a 'treatment plan'. I pushed back on the prescription food and so Krysten spoke to the vet and has e-mailed me with a link to food I can get on my own following their dietary guidelines (based on Hills m/d food content %'s). Unfortunately the link isn't working: http://binkyspage.tripod.com/CanFoodNew.html. So not much help.

More in a while...

 

Hi Nancy, I live in Seattle (North Beach) and would be willing to help out too, if I can - PM me if you'd like. We recently switched vets to Cats Exclusive, in Shoreline. They are not cheap but I felt it was worth it after wasting time and $ with my previous vet. Don't know if that works out for you geographically or not, but thought I would toss it out there. I know they do take Care Credit as well. The vet there took one look at my spreadsheet and told me "I wish all my diabetic patients had owners like you. You're doing everything right." Ahem, yes I like compliments.....but it was really nice to have a vet who gets it and didn't push a bunch of prescription food and further exams.

BTW I free-feed Plum. It's what he's used to and seems to work better for him. If I could get him to eat Fancy Feast I'd be very happy (our kitten loves it) but he's a stubborn kibble addict. There is a current food list floating around here somewhere but I can't seem to quickly locate it.

 

Wait, wait wait. There are 4 of us nearish to Seattle!!

That is awesome.

It sounds like you are doing the right things in advocating for your kitty! I am willing to help with cat boarding too if need be - sounds like we could do a rotation around these parts! (I am in Lynnwood)

 

Thank you, Lisa. I appreciate knowing I'm not alone. I literally burst into tears when I saw the first line of your post this morning - thank you xo

Testing: I'm fine to do the home-testing (well, sorta fine ;-). My dad had Type 2 diabetes and was insulin dependent. I took a class with him once to help support him and to inform myself since genetics is a risk factor. My last blood workup showed me to be the very low end of 'pre-diabetic' spectrum. So it's sure strange timing with Kohl. I'll use the opportunity to see if I can get my numbers down too. I bought an AlphaTrak2 based on vet recommendation although the wonderful Krysten did let me know that I could get it on Amazon for half the cost the clinic would charge ($50. at Amazon). I sort of wish I'd gotten the human tester so I could also test my own levels. Oh well.

Vet is adamant about being the one to call the shots on any changing of the dose. I plan to start the testing tomorrow and injecting Lantus using their recommended dosage (1 Unit). I'll see how the next week or two goes as I get in the groove with everything.

Travel: Never done it with kitties since my move to Seattle from Oklahoma years ago. My kitten LOVED the car trip - my older boy HATED it and spent the entire trip with his head jammed between the side of the driver's seat and the door plus he escaped into a field and then a culvert once. Ai-yi-yi. That made me nervous to travel with cats.

Kohl is a homebody. When he came to me as a kitten there were 2 of us in the house so much easier to cover all the care. Before Kohl, I'd always had very independent cats. I could leave for a few days leaving out food and water and they were fine. Not so with Kohl. The first time I tried something like that, I returned home to find him hiding in a cubby in the basement not having eaten or pooped or drunk any water for quite a while. He was a wreck and I was, of course, horrified and never did that again ! After that, I had several house-sitters I could call on. Last summer, I had to travel a lot and managed to codge together enough "Friends of Kohl" with an online 'doodle' schedule to cover food, water and company. It's seems like that last is as crucial as food & water for Kohl. I often say that he's more like a dog than a cat in some ways: He's very social and likes company especially people he knows well or instinctively likes.and he will follow my verbal requests. I've NEVER had a cat that would do that. All my cats before were, like, "You want me to do what ??? Right.....No." Might try the travel thing to see how it goes. He might be okay in the car - I just don't know.

Boarding: Not so much. I think it would totally stress Kohl out environmentally and emotionally. And it would certainly stress out my pocketbook. I'm scouting out some potential house-sitters who might be up for the testing/injections. That will come later once I feel things are more stable.

Food: As soon as I got the diagnosis and did some research, I bought lo-carb canned food. Kohl has never liked wet food before but he is all over it now - phew ! I went to All the Best Pet Care and a lovely man named Andy helped me with looking at labels and purchasing several different types to try to see what Kohl liked. He also sent me home with some free samples . I started mixing or alternating his Taste of the Wild dry kibble with the various wet foods. He is in heaven with his food right now . I don't anticipate any trouble transitioning him completely to the wet food by next week. I balked on the prescription food at the vet's today and they backed off. They sent me a link to a webpage with nutritional content of various canned & dry foods but the link is dead: http://binkyspage.tripod.com/CanFoodNew.html. One bright spot (maybe to do with the food change ?) is the drop between his BG number based on blood draw at his vet visit on 8/9 (510) and today (325). That seems somewhat heartening. Also, he seems to be feeling a bit better in general and drinking WAY less water.

Thanks again, Lisa, for such helpful info and the reassurance. Much appreciated ! I expect there some path through this maze of medical needs, personality and scheduling issues - just not seeing it quite yet. I expect some sleep will help

 

[Oops....just figured out how to use the REPLY function !]

Thank you manxcat419 - that is so kind of you ! Very much appreciated indeed.

 

Hi, PlumsMom ~ Thank you so much. I am the the North End of Seattle a bit north of Northgate Way and a little west of Lake City Way. The lovely clerk at All the Best Pet Care at 85th & Roosevelt mentioned he had heard good things about Cats Exclusive. I also got a recommendation from a friend for a family-owned vet in Kenmore that I may try - she says they are not as expensive as most. Their website looked good too. Having a vet that 'gets it' and someone willing to work with me so I can be a participant (Kohl is my family member after all !), is paramount. I'm glad you found one you like for Plum ! I am going to spend some time tonight trying to master the spreadsheet format. Do you use the one posted here ?

I will poke around for the food list too. Good to know that it can work to free-feed. That's what I've always done with Kohl but the vet tech was really discouraging that route. I know that is just to make it easier and more consistent for the vet so I may try it. I'm not committed to using this current vet but may proceed (cautiously) until I feel more confident on my own. Very happy to be in touch....thanks again.

 

Hi, Deb: Thank you ! I really hate getting bullied into things I don't want to do or don't seem in my (or Kohl's) best interest. But, holy cow, it's been stressful to have to be on my guard with the vet on top of everything else ! I'm grateful the vet tech ended up to work out as well as she did. Once I get my feet under me a bit, I'll find a vet I'm happier with.

Wow -4 near or in Seattle - that is amazing ! As mentioned above, I'm in the North End of Seattle.....Pinehurst/Northgate area just west of Lake City Way. More later...thanks so much !

 

We're pretty close! I'm just north of 85th, near Golden Gardens. Do let me know if I can help you out with Kohl (great name, by the way!) Cats Exclusive charged me $89.50 for an initial visit, plus $25 for a blood draw. I thought that wasn't too bad.

 

I'm in Covington, but as I don't work at the moment I do have time available if you need help.

We should arrange a Seattle-area meet up too - so many of us in such a small area, it would be a shame not to.

 

I'm in Cle Elum and half the time on Vachon Island. I let my vet office know that I would be willing to cat sit for cats with needs and diabetes specifically.

 

Here a cheat sheet list of low carb foods someone compiled from a few sources. Low carb is considered less than 10%. A lot use Fancy Feast which is 4-5%.

Theses listeners a good starting point. They are out dated and the newer foods/brands are not on them.

http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/

http://www.felinediabetes.com/FDMB/threads/dr-lisas-food-charts.88162/

Here are ones I use and know:

Sheba perfect portions are under 3% carbs.

Purina One Smartblend chicken pate is 2% carb.

Purina One Smartblend beef pate is 5% carb.

ProPlan Savor Beef with carrots pate is 2% carbs.

Young Again dry is 4-5% carbs. Can only be ordered directly from company. They will send free sample.

https://www.youngagainpetfood.com

You can also use automatic feeder. Petsafe 5 is very popular, also multiple feedings and can be used with wet food.

https://www.amazon.com/PetSafe-5-Meal-Automatic-Pet-Feeder/dp/B000GEWHNS
Hope this helps.

 

Nancy, if you don't already have one, I have an extra lancing device (bought one not realizing that one came with the meter I purchased.) They're pretty inexpensive but if you can use it you're welcome to it. I'd be happy to help you get started with home testing too. My one bit of advice would be to start just rubbing/fiddling with Kohl's ears (without poking him) to get him used to that. You can give low-carb treats after doing this too, so he associates the ear fiddling with something good. Plum now plops down quite willingly for "poke time."

Since he's a black kitty it might be just a little more difficult to see where to poke, and to give injections, but folks here are happy to help with that too. I do use the spreadsheet here; it's also quite easy but if you have any troubles we can help you get that set up too.

 

I agree!

Vet wise, I used Value Pet Clinic in Shoreline. They were ok for intial blood work and patient with me over the phone but the vet didnt seem concerned with follow up. Let me know how the exclusively cat place does!

Deb

 

Yes, we are pretty close ! I love that area and enjoy getting to Golden Gardens when I can. Cats Exclusive sounds waaay better I'd have expected. My bill was $537. for exam, vaccines, Senior Wellness Panel (which I think includes the BG test), Urine test, Revolution dose for fleas, a stool sample kit and worm medicine. I was in shock.

 

Thanks, Suzanne !

 

Oh, great, thanks ! That helps a lot.

 

Thanks, PlumsMom: Great idea about the ear-rubbing and treats ahead of poking. Have you tried poking paw pads ? My tester says that is an option for cats.

 

I get Revolution from here. No script needed. Takes 2-3 weeks. They run specials whether is free shipping or free doses. Been ordering since 2009.

http://www.vetshopmax.com/Cat-Supplies-C17.aspx