"Regular" Vet Vs Internal Medicine Specialist?

Once again I have emailed Tigger's IM specialist concerning further testing or other follow up we should be doing at this point - Tig had his DKA almost 8 wks ago! Once again they have ignored most of my questions and suggested NOT testing his BG aside from doing a curve after 2 weeks on each new dose. Obviously I am NOT going to be listening to them, but I do like knowing a vet is involved in his care.

I am considering going back to his primary vet for the time being. There is nothing immediately worrisome going on but before the diabetes diagnosis he was being treated for elevated liver levels with Denamarin. At the time of onset Pancreatitis was considered. Also, the dry food Fiber Response was AMAZING at controlling his constipation/vomiting. Now he is back on miralax and although doing well, continues to have ups and downs. It was suggested he have a full GI panel done to learn more. It was also suggested he never had elevated liver levels but Triaditis masking diabetes. Am I the only one wanting to know for sure? How can this so called specialist not want to investigate further?

I feel like his normal vets go above and beyond with their care and concern. I have already found out they can do any blood test and/or fecal testing he needs and have the results shared with the specialist. Not too mention the specialist office want me to give him gabapentin before his visit because he got pretty worked up last time (the boy doesn't even have teeth to bite with lol) and it was mentioned they may need to sedate him to get blood. Now, I dunno if he acts completely differently with them because of the trauma of being in the ICU there for 4 nights, but he is FINE at the regular vet. They have never had an issue getting anything from Tigger. This really just seals it for me that they are not the best vet for my baby - which is very disappointing as the emergency department is amazing! (Plus they are 45 min away and his regular vet is 5 min away!)

Do most of your kitties see a specialist? Always/ever/just until regulated?

Side note, we are increasing Tigger's dose to 1 full unit tonight. It's one cycle ahead of time but still seems warranted and my thinking is, I can get a +5 or +6 the next 3 cycles (GF is off tomorrow). That will make me feel much better about leaving him alone all day Thurs and Friday. I sure hope he doesn't bounce off the face of the earth with this increase!

(sorry about the long-winded rant)

 

I sttarted out with the regular vet that I had a long standing relationship with. She prescribed the wrong insulin at first, so I thought about changing, but couldn't find a good match personality wise. When Neko got diagnosed with acromegaly, she wanted to send me to an IM vet, but I refused the local IM and drove three days to Colorado to see the specialist IM and get radiation therapy based on what I learned here. My regular vet was learning with me. First person to home test, first with an acro to her knowledge (diagnosed another in practise shortly thereafter), first with the radiation therapy. My regular vet also worked with me when kidney disease later entered the picture. It wasn't until heart disease and lymphoma entered the picture that she decided it was above her pay grade. She said she could do it, but I would be better served with an internal medicine vet. They are great at balancing multiple conditions. Long story short, if you have a relatively simple case of diabetes and a good relationship with your regular vet,stick with him/her.

I think you were fine with the increase. Good luck with the new dose,

 

It sounds like it is a problem with this particular IM vet. If it were me, I wouldn't want to stress out my kitty by taking him to a vet who it is clear that he doesn't like (may even be afraid of). Your regular vets sound very good and practical. If an IM vet is needed, try to find a different one.

Good luck with the dose increase.

 

Max had chronic pancreatitis for several years before the diabetes diagnosis. I wouldn’t think you need a specialist at this point and wouldn’t use that IM unless it’s your only option.

 

I'm going to email the IM vet and ask what tests they recommend but let them know I'm gonna have them done at the regular vet down the road. I'm sure they'll understand the 45 min ride is no fun for kitties. The regular vet already knows I'll be calling to schedule an appointment in the next week, so I think this will work out well. I will keep the specialist involved if they want, and definitely call them if anything gets "out of control."