possible ACRO vet refusing to go over 10 U and argues about that.

Discussion in 'Feline Health - (The Main Forum)' started by Bonnie & Oreo Joe, Sep 14, 2018.

  1. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

    Joined:
    Oct 9, 2017
    I have posted here on the main board and on prozinc on the bumpy road with the vets. I will start here on the problem now and not go over all of that again.
    I was adding ½ unit every 5th shot as we here had decided he was insulin resistant. I was up to 12 U and getting no where. It was then the board over all the vets saw his journal and blew up. The trouble being I was treating Oreo Joe like an American would and not a Swede and the clinic was in trouble for letting me do it. His insulin was lowered slowly but down to 5 and if you check his spread sheet you will see he is purple and red and is getting worse. This morning 25.7 +3 21.9.
    The Vet, Ellen, said that on Monday we would start to treat him as an acromegaly cat. I asked if I should refill his insulin as we are getting low. She said yes we would be slowly raising his insulin. Today with the 25.7 I called and said I did not want to wait to talk Monday afternoon and then it would be Tuesday before his increase would begin. She called back she asked how he acted, ate drank etc. Except for the huge amount of water and food he acts like he always had. Not lethargic or sick acting. She said well he should not have to be above 6U. I said that some cats were up to 20 or 30 U twice a day from what I had been reading. She said absolutely not. I pointed out I couldn't consider 30 U bid because I don't have the money. But I wanted to try up to 20U if he had to go that far. She said I will not allow over 10U. I nicely argued that there were many cats on that high a dose that lived for years and didn't die right away anyway. She said, That is not possible. Once you are over 6U you are hurting his pancreas and the higher you go the more damage is done. He will feel miserable and you will find him dead or in a coma and I will not allow him to get that far. There comes a time when the cat comes before the owner.
    I said I agreed and as his owner I would not let him be in pain or sick or lethargic and I would then make the decision to put him to sleep. But I wanted to give him a chance since others have had success.
    We will try and I will see what happens but he won't go over 10 and I prefer not over 6.
    I can't find anything that comes from a vet school etc that says I can keep increasing slowly up to whatever number and the cat will be ok.
    Can anyone help? If I quote anything from here she points out she is the vet and this site is just a group of people I have never met and have no idea if I can trust. I did get a bit huffy when I said those people have had more experience with diabetic & acromegaly cats than all the vets in Sweden. I pointed out that not one vet in this clinic or any other within a 2½ hour drive has even gone further than saying he is diabetic and the owners saying put him down.
    "Well start on 5½ tonight and I will call you Monday and we will see what to do." I said I just spent $100 on glucose sticks, insulin, and syringes and I am keeping him and using this new insulin until I hit the last drop.
    That is where I left it.
    Unless I can figure out a way to make insulin in my kitchen this will be the last bottle I am getting. I need vetjournal info that will let me keep him. Any help?
    I can't stop crying. I am his mom and advocate and since he is not showing he is sick and awful feeling they have no right to refuse him care.
    Hugs, Bonnie
     
  2. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Bonnie,
    There are quite a few cats here with acromegaly and insulin resistance whose carers have successfully managed their kitty. Some of the cats do need more than 10 or 20 units of insulin. I am going to tag @Wendy&Neko as she has had an acro kitty and will be able to help you.
    Bron
     
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  3. Rardito

    Rardito Member

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    Jul 20, 2018
    Did you do the acro testing?

    My cat has Cushing's so is a bit insulin resistant as well. She had the test to confirm the Cushing's.

    Maybe if the acro test is done they will realize that the cat is insulin resistant?
     
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  4. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Aug 5, 2016
    Hi, I'm sorry to hear about this is there no other vet you can talk to? Letting him untreated is certainly not going to help him

    Have they tested him for acromegaly ?

    His thyroid problem is one of the things that can make regulating him harder, your vet should take that into consideration

    I'm not aware of any literature that says there´s a limit, and there's some people here giving pretty high doses

    You could consider changing to a long acting insulin (Lantus or Levemir) maybe those would work better and since they are human insulins in some countries they do not need a prescription to buy them

    I don't have much experience with high doses hopefully someone with an acro cat takes a look soon you could try adding "possibly acro" or "high dose cat" to your header to draw more attention to your problem
     
    Last edited: Sep 14, 2018
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  5. JeanW

    JeanW Member

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    Last edited: Sep 14, 2018
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  6. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    You are in a difficult position. Are you near a border and can possibly see a vet there? Start looking on internet to purchase insulin off market. Have friends or family in the States who can send it to you? I don't know what would happen at customs though. Would your vet be willing to talk with vets at RCV, they must see cats on high doses. Will they test for acro and IAA at least?

    See another vet, saying you are running out of insulin and hate to say it but lie about the dose you are giving. Get script with refills. Or vet hop if you have to.
     
    Last edited: Sep 14, 2018
  7. Olive & Paula

    Olive & Paula Well-Known Member

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  8. JeanW

    JeanW Member

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    Jul 24, 2017
    Can you order insulin from Canada? We can get you the link to Mark's Marine Pharmacy where many of us get insulin for a much lower cost.
     
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  9. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    Oreo Joe hasn't had hair loss and the paper from a vet said that it costs $100's of dollars for tests. I am barely saving enough each month for his insulin. The acro testing search using the USA as can't find anything here in Sweden said it can cost up to $400. For the blood test. Scans and such aren't even offered for cats unless one is very rich with a very expensive breed of cat. TY
     
  10. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    The board that watches over how vet clinics treat the animals stopped me from doing what I was doing. The vet, Ellen, said that he never had hypothyroidism and it showed he did because he had been so sick when the blood tests were done. She stopped the thyroid med and said that because he had been treated wrong it affected his pancreas and gave him diabetes when he really didn't have it. I know the hypothyroid group said this is not true. But she stopped the order for his pill, so he hasn't gotten any for several weeks.
    Customs checks any boxes with medication and dumps them. I can't even have Miralax sent in from the US. It isn't allowed in Europe. We are lucky that we can buy Tylenol here everything is doctors order. The pharmacy looks full but when you look under the colds and sore throat section, Tylenol, saline nose spray, vicks flavored cough drops and Listerine. Medications for cats are sparse and the rule of thumb is if they are sick for 2 weeks and not getting better they are put to sleep. Constipated give the cat liquid paraffin which the cat doesn't swallow and ends up looking like a cat candle. Besides it stops so many nutrients.
    I asked for Levemir but Ellen said she wanted him on Prozinc for 1 more bottle so a brand new one is in the refig. The first vet was very good until I hit 3 months of syringe feeding when she called and said make an appointment Monday morning to come in to put him down. Then he began to eat. He heard her I think. Then she hurt her back and has been out of work for months. The other vet keeps insisting he would be better off on Purina dry diabetic food and she had no idea how to increase insulin. Then she had a short vacation and I got Ellen. Big gal that runs right over you. The one vet I would like basically works with large animals, horses and such.
    Ellen won't let him go untreated she will stop any prescriptions and I will be forced to put him down. My other cat had diabetes but went off insulin the day the vet almost killed her and on the 1 diabetic friendly wet food and never needed insulin again. But I contacted 5 vets in a 2½ hour drive and basically they had never treated a cat with insulin and they suggested putting the cats down.
    I know I sound so negative but I have been fighting to keep him treated and alive since last October. It just gets worse. I will ask about the acro test although Ellen is convinced that is what he has and she argued that she wanted him on 6 U and flatly refused to go past 10U.
    I can ask if there is a head vet at the clinic, I think it is the one I like with large animals, and if so schedule a meeting with the 2 of them but I need to come armed with enough info to convince them. I didn't feel I could copy any personal things on this site to use. Think I need a sleeping pill tonight. I have spent the entire day trying to find something.
    TY.
     
  11. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    Thank you!!
     
  12. Wendy&Neko

    Wendy&Neko Well-Known Member

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    Feb 28, 2012
    Ugh, sorry your vet's are so behind the times. Even sorrier to say it's not uncommon. To have your kitty tested for acromegaly, the blood would go to London, to the Royal Veterinary Clinic. Here is the link, select the diabetic cat, difficult one. I might help to have your vet contact the RVC anyway, they have an acromegaly clinic and are probably the world specialists at the moment.

    This paper by the RVC folks showed how frequent the condition is, one in four diabetic cats, and they found acrocats with doses ranging from 1 to 35 units. That might help your dose argument. Of course, we have seen cats up to 100 units twice daily, though topping out at quite a bit less than that is more common. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127794

    I think a switch to Levemir (not Lantus due to the potential sting at high doses) would be beneficial for Oreo, not sure if you can get it cheaper there as it's a human insulin.

    The diabeticcat site that Paula linked is a little out of date with their data. We have seen some people have success with cabergoline, again just our experience here, but have had three acrocats go off of insulin using it. I just mentioned it because it's waaaaaay cheaper than pasireotide, which isn't even available in all countries.
     
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  13. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    I can try but not many vets to hop to, IF the board didn't already put me on a list about being to American. I understood that no vet would let me keep increasing the insulin and I thought it was through this board. I have put down RCV info and how they even have 1 Dr. who has had acro cats to talk to. Maybe that would work. She will get all info I can find on Monday via email.
    I will ask about the blood test for acro and say I must have a price. I read some on IAA and it said the test had to be done before any insulin therapy had begun.
    Do you think ordering on line is safe, they usually come from Thailand or China and I have heard the horror stories of finding everything but the medication needed in the pills. TY
     
  14. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    Thank you for links. I am working on a possible new vet but they are hard to find. Cats aren't treated for much. Thank you for the links.
     
  15. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    It sounds like you have done your research and are definitely not keeping Oreo Joe "alive" out of your own misguided guilt or any other reason. There was a time when doctors believed a good bleeding was sound medical practice and in general the medical powers that be are slow to embrace new ideas. Whether it's some kind of cultural difference or the resentment the doctor feels that you may know more than she does should be irrelevant. Ellen should be helping Joe, not helping you to face the facts that this is a lost cause. At one time a terminally failing heart became the doctor's duty to inform the family that they needed to be realistic and face the grim facts. Then Doctor Christiaan Barnard performed the world's first human-to-human heart transplant on 3 December 1967. My brain aneurysm was repaired with a scope and I was home the next morning.
    Doctors swear an oath part of which is to do no harm. How on Earth is this harming Joe or you? Is Joe suffering either physically or mentally? Cats are intelligent but do not hold out hope that this doctor can cure them and add years to their life.
    Noah should not be here but he is mentally aware and physically capable. We don't question his condition, we just accept the fact he is breaking all the rules and our vet is on board with this. If you are comfortable with his quality of life and he is not in pain it is not someone else's prerogative to tell you this is wrong.
    If you have to break some rules, do some cross border "shopping" (smuggling) and even fabricate a story about "Oreo Bob" then just do it. "Oreo Bob" may run out of the house one day never to be seen again. I seriously doubt the authorities would pursue this in legal terms.
    I don't know all the details and have no experience with some of the conditions you describe so this whole post is simply a moral boost. What are they going to do? Deport you and extradite me?
    I'm not disparaging your choice of vet or course of treatment but small minded arrogant people often mock those with the courage to think beyond established knowledge. I sincerely wish you and Oreo Joe the best.
     
  16. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

    Joined:
    Oct 9, 2017
    Great info thank you. Hugs, Bonnie
    I agree and Roger will be home on Sunday and said he would back me up with the vet. I am keeping a copy of what I am sending her and if I have to will see if the male vet will see Oreo Joe, if he is the head vet there. But I could go under a different cat name and pick up insulin in the town Roger grocery shops at weekly. I can even pay to have it sent to the house. Ahh I love people that think like me. He has no strange bone growth, walks and jumps just fine. Cuddles and actually purrs most of the time. The only symptoms I can see are his basketball tummy and he has a wheeze but it is not in his lungs it is like a stuffed sinus. He is acting like he did the years before he got sick. He doesn't seem to miss the thyroid med. He was scraggly looking and filled with dandruff before and that went away with the pill but since going off he still looks great. Thank you so much. Bonnie
     
  17. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Not true, my Neko tested positive for IAA after starting insulin. We've had some who tested positive months after starting. Note that the IAA (insulin auto antibody) testing, is only done at MSU in the US. It would be very pricy for you to send blood to Michigan and probably not worth it.
    Another paper by RVC folks, only 35% of acros showed symptoms on diagnosis. Neko's only symptom, other than super hunger and her dose, was one teary eye. Which I found out much later was due to soft tissue growth in her eye duct. Vet dismissed the eye issue as unimportant. Basketball tummy (which Neko never had) is very common, so is the stridor or wheezy breathing sound. Again, soft tissue growth in the pharynx. Try looking up cat stridor on Youtube. Neko only had that at the end (started after 4.5 years), and very mild. No two acrocats are the same in the symptoms, though there are common ones.
     
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  18. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    TY I will use this info also. Sure glad I have this group. Hugs,
     
  19. Candy&Company

    Candy&Company Member

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    Sep 12, 2018
    I have no idea what I'm talking about, only speaking from semi-related experiences... but my cat Lucky, he passed away March 31st, 2016 and he was only estimated at 8 years old. BUT, HE had a "basketball" tummy that didn't match up to the scope of his cancer via x-rays, etc. and the vet at the time asked me about his feeding habits. At the time my guys were all still on dry food (Purina One Indoor) and got wet food occasionally - the vet then diagnosed him with chronic sinus infections because he was stuffed up, had some mucus, sounded like nose-wheezing, etc. and suggested possible allergies but through further discussion, we had to agree that trying to test him for all that (blood work, skin tests, elimination diets, etc) just wasn't a good idea since he was in fact slowly dying anyway of the cancer. The pain, problems, etc. of it hadn't hit yet so we got him on pain meds and supplement medicines until it was "his time" which he let me know, not even a week later.

    Maybe your cat has something similar? It's been my experience with vets that they don't always know a whole lot about allergies either. Apparently one of the more odd side effects of some allergies can be gas/swelling in the stomach/abdomen. Something about messing their hormones, or hormones messing with them? I forget since it's been so long ago, and since he was dying I didn't really keep notes or pay too much attention since I was still in shock.

    I really hope Oreo Joe is okay, I feel your struggle on the finances and trying to balance everything plus trying to find people in your area - have you thought about a GoFundMe or something similar maybe? I've never done anything like that, but it might be an opinion depending on what you decide. 8.5 yrs. old is still so young for a cat. Sending all our love to you all! :bighug:
     
  20. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Aug 5, 2016
    Just sending you :bighug::bighug::bighug: hope the information helps with the stubborn vet and vent here all you need we get it.

    Regarding the food, when everything started my vet also pushed for the dry prescription food :rolleyes: what I did was buy one small bag which I of course did not gave him, and a few weeks told him I was still giving him the comercial food because he had totally refused to eat the prescription and yes I had to spend food on one bag but it was worthed that way he thought I had tried and after all cats are known to be very difficult with food
     
  21. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    Thinking like you is called common sense and the ability to see past what is sometimes referred to as "established knowledge" In archaic usage, the vapours was a reference to certain mental or physical states such as hysteria, mania, clinical depression, bipolar disorder, withdrawal syndrome, mood swings, or PMS. Notice the focus on these illnesses primarily attributed to women. Some things never change.
    You are thanking me? I'm more thankful I can voice my opinion in this forum where us mere mortals are allowed to speak without the attendant body language. We have no emoji for arms crossed or the more sinister :rolleyes:. Too bad "It takes a village" still includes the village elder. :banghead:
    @Wendy&Neko There was a time I could retain this stuff. Always wear a helmet.
     
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  22. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

    Joined:
    Oct 9, 2017
    Oreo was given a shot to see if his breathing changed. It was cortisone maybe. Vet said it wasn't good for a cat that was diabetic but one time to see if it made a difference wouldn't hurt. It made no difference at all. I have thought of Go Fund Me but so many people have that now. They do it to pay lawyer fees when they did commit a felony and people pour in money. But let someone ask for help with a hospital bill for his mother and he was on disability himself. He needed $2000 and never got 1 penny. Sorry about your boy. It seems that pets aren't really thought of as a family member here. People couldn't believe it when we took our puppy to class and I was to call him and I said Come to Mommy! When I call the vet now I say this is Oreo Joe's Mom. At first I would hear sort of a muffled giggle or choke but now everyone there knows I am his mom. But when we lose our baby it is just like a Mom losing her human baby. Except there the doctor wouldn't yank out the meds and say it is best this way. TY for the help.
     
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  23. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    I have done that! But Oreo Joe simply refuses to eat any dry food and any special foods. He wants Dreamies just 4 or 5 a day they look like Temptations but are $2 cheaper. He will only eat chicken or turkey pate' or at double the cost pieces in gele' and then only Chicken liver or beef or pork although not thrilled with beef or pork. He refuses even fresh fish, shrimp, anything from the table. He knows what he wants and he checked the price list so he could get the most expensive diabetic friendly food he could. TY
     
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  24. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    What human insulins are available to you?
    My MurrFee had acromegaly and was up to 50 units twice daily. To reduce costs of insulin I used both N and Levemir insulin, 30 units Levemir and 20 N. Some acromegaly caretakers have used R and a long lasting insulin.
     
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  25. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    Aug 5, 2016
    This seems awfully familiar :DI swear Babu looked at the price list before tasting the food and went for the most expensive one available where I live before even trying the food, I really don't know if Babu would have accepted the prescription dry food the vet gave me because I really didn't tried ( just in case he liked it and I really didn't wanted him to have high carb dry food) just told my vet I had so that he wouldn't keep pushing on me having it so one bag was all I bought from him
     
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  26. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Miralax is currently available without any issues from ebay UK (and I bought it in the past from Amazon UK without any difficulty).


    Mogs
    .
     
  27. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Just quickly scanning this thread so apols in advance for not knowing recent history.

    Have you tried crushing up the Dreamies treats and sprinkling the crumbles over the healthier food you want Oreo to eat? If not, it's definitely worth giving it a try. Better yet, try blending Cosmo protein treats (from Zooplus) into a powder and putting a sprinkling of that over Oreo's 'proper' grub to see if that might encourage him to eat better. And always monitor for signs of nausea (if present, ondansetron may often go a long way to helping maintain good intake of diabetic-friendlier food options).


    Mogs
    .
     
    Last edited: Sep 14, 2018
  28. Olive & Paula

    Olive & Paula Well-Known Member

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    Sep 6, 2015
    Sounds like this is doable, until you can find someone who will help through the proper channels. I don't know if sending it to you would be wise. If Roger could bring it when you need it, might be the safest way.

    My Olive is acro. She has the distended abdomen, whistling when breathing. Sometimes you can hear her from the other room and over the tv volume. And has the heart murmur. Appetite is insatiable, and her front feet are stubby. She is holding @ 8.75 units and has been as high as 9 units. Smokey had the breathing, (vets kept saying asthma), insatiable, he was always a large cat. Yet his Acro score was 76 which was high but still normal.
     
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  29. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    Since his non eating those 3 months now I can't keep his bowl filled and he always wants food. He has been eating 700 to 800 grams a day. 600 grams used to last him 2 days and maybe 1 meal the 3rd. I have had him on the good food for diabetic cats since we walked into the house with him. Do you live in Sweden? Thought Zooplus was only in Sweden. He has refused Dreamies all day. TY
     
  30. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I'm in the UK. Zooplus pretty much cover all of Europe.

    Current issues aside, I'm glad to hear that Oreo is eating so much better than he was earlier in the year. :)


    Mogs
    .
     
  31. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    I thought you were in the UK! Yes it is easier to get up to refill his dish every 45 minutes than it is to syringe feed. His beautiful white tuxedo is still stained from the day he decided if he held the food in his mouth long enough he could just let it dribble out of the corner of his mouth. I think he will always look like a dirty little boy. I wiped it with H2O2 and soap and water and everything that might get it off and not poison him.
    Nice to see you again.
    Hugs, Bonnie
     
  32. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    They get a lot of their money in selling food in their clinics. People think they are doing their best for their pets and are giving the cat with a history of crystals in the Urine that awful "special" dry food for it. They don't know that it is hurting their cat more than helping. I find it is best to lie whenever possible then there is no confrontation. lol Hugs, Bonnie
     
  33. Bonnie & Oreo Joe

    Bonnie & Oreo Joe Member

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    Oct 9, 2017
    It is shipped from the USA and cost of the $24 bottle would be $52.90. I didn't go further in checking if it would be stopped as I don't want it ordered and me paying for it! I don't remember if I checked on ebay or not. But the cost is prohibitive. If it did get sent and customs caught it they would dump it. I am checking out another powder I found but don't know if it is really ok for cats.
    Hugs, Bonnie
     
  34. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    @Bonnie & Oreo Joe - I feel for you. I know from talking to others in Sweden on Facebook about their cats that there are some laws pertaining to pets in Sweden that those of us from other countries find difficult to understand or to help others work within while still getting the treatment their cats need. I am aware the law regarding euthanasia without the owner's consent, and the reasoning being that no suffering of any kind is permitted, regardless of whether the condition may hold hope of improvement with better treatment. I do know that some have found one or two vets in Sweden who are prepared to go further than most with treatment, even to the extent of potentially risking the wrath of the authorities there to attempt treatment that would generally be frowned upon. However, some have had to travel for several hours to find one of these vets - if that is an option for you, then if you're on Facebook I may be able to find someone who can put you in touch with one of the more helpful vets there. You can either look me up personally on Facebook (April Murphy), or you can look for the group that I run (Cats with Multiple Medical Conditions). While I would still always recommend you get diabetes and acromegaly advice right here on the FDMB because there are many more people who understand both conditions here than in the group, we do have Swedish members who may just be able to help you to find a vet who would work with you on this.
     

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