Searching For Clarity

If you're reading this, whoever you are, I am grateful for it. I don't really know my purpose in writing this post; I think it is to gain clarity, it definitely is to help me process my thoughts and feelings, and ultimately, I think the words just need to come out of my head and into writing just so I can continue this journey.

Every vet I have worked with thus far has not been a help whatsoever. My kitty, Moby, was diagnosed on January 9 (geez, it's been only a month, what the $%*#) and the five vets that have treated him have all made incredibly horrid mistakes that, had I been more knowledgeable, I could have prevented.

I'm not going to get into the blame game. It's not worth it. Needless to say, I am completely un-confident of the five (Yes, FIVE) vets that we have seen.



Turns out Moby is incredibly sensitive to the insulin (we are on Lantus). We have him down to .5 unit, ONCE a day because twice a day just tanks his levels. I know this type of insulin isn't optimal for this. I have researched and studied food choices, switching him over to low carb wet food and treats only. Hell, I even contacted food companies asking for carb percentages, so I can buy him the most high quality food that fits into his parameters and mine. I don't want to put him on prescription diets and that's all the vets are pushing on me.

Today, Moby went down to 35 after just his normal .5 dose at 8 a.m. I gave him a snack of Fancy Feast turkey & giblets with a little karo and he perked up immediately. I called the vet. What was going on? Why so low, so fast? All she did was push a dry prescription diet on me telling me that fiber can help with the violent sugar swings. I literally sat there with my mouth agape. Silent. You're telling me to get dry food now?

All she keeps wanting to do is run curve after curve. How is this pinpointing anything?



I guess when it comes down to it I have no idea who to trust. The vets who have literally cost me $2,000 in testing and an ER visit. The only thing stopping me from questioning if he's diabetic in the first place is that his water consumption has dropped immensely and he has started to groom his gorgeous, sleek black fur again. He's feeling better. I can see it. Is it the diet? The insulin?

I'm so confused. You all have been so lovely and helpful. But I also need a vet who I can trust. I have feelers out in the San Diego area. We don't have much money to spend after we blew our liquid savings all last month, so I have to wait a little while before taking him for, yet another, consult.

I cried in the kitchen today after I spoke to the vet. I have a dog who is the sunshine of my life, but Moby is my heart animal. He has been with my husband and I since we were married (over ten years). We talk without speaking. He is my little heartbeat at my feet and I am bound and effing determined to make sure his life is healthy and happy.

It's just taking me a while to find that path.

 

I am sitting here at work, blinking back tears at this. I feel you. My Dweezy is my baby and my soul too, and I also don't know who to trust. I think everyone and no one really. My long time vet also seems to consider prescription dry food the best option, but I just don't get that at all. How can it possibly be? It's approximately one quarter carbs.

I think your beautiful boy is feeling better due to both the insulin and the nice healthy and low carb diet he's on. He is simply gorgeous.

 

You are so kind to comment, @monty_dweezil. Your "everyone and no one" comment made me chuckle, because that's so how it feels. I will tell Moby your kind words. It's nice to be heard and understood.

 

It's also nice to know that Dweezil is not alone in this. All of us and our fluff children are just trying to do our best. We love them so.

Edit - is Moby wearing a spiffy red tie in your avatar!? I only just noticed! LOL

 

What a beautiful kitty Moby is. I'm fairly new to this whole thing too and have also struggled with some of the information I was given by the vet. I was also told a prescription food would be best and was told to start on a high initial dose of Lantus for Rosa with home monitoring not being actively encouraged. Fortunately for Rosa, I found this site quickly and was soon able to get better information and start home monitoring with her.

Finding this site made all the difference for me. I find I can trust the people here much more easily than the vet as they're dealing with the same issues on a daily basis. Being able to home test really helps too - you spotted his 35 today and were able to bring him back up safely.

I've got no information on dosing once a day unfortunately, though on a regular twice a day dosing schedule, that 35 would have earned him a dose reduction. I hope that other people with more and longer-term information than I have can help you with this. You might want to post in the Lantus and Levemir sub-forum for more information from people who have more experience than I have - I just wanted to let you know that you're not alone in wondering who to trust and how to keep your precious baby safe.

 

Hi Marciegee! Moby is gorgeous!

I know all too well how frustrating it is to figure out this insulin thing! Here's to hoping the right answers find their way to us soon!

 

Thank you for sharing such beautiful pictures of Moby with us and also how much you love him.

I'm sorry that you currently don't have the veterinary support you'd wish for. I don't have experience to be able to suggest anything about Lantus dosing, but I would like to share with you that it is possible to achieve regulation - even tight regulation - and even remission without dosing twice a day. Saoirse did. I could not guarantee being able to monitor her safely should she go low on a night-time dose (I have PTSD plus chronic fatigue and my sleeping is a mess). I also used drop dosing (microdosing - less than 0.5IU) to extend her treatment until I could see strong signs of pancreatic activity before finally tapering down and off insulin altogether. I used the principles and dosing guidelines from the published TR protocol, the caution of the FDMB Start Low, Go Slow protocol and ultimately found a treatment plan that worked for my circumstances and - infinitely more importantly - worked for my girl (and she's a soul cat, too). Maybe if you looked at her 2014 spreadsheet from the end of September 2014 onwards, it might give you an idea of what is possible using once-a-day (SID) dosing and a tailored treatment plan. Ultimately, I let Saoirse's body and my limitations guide my treatment choices. Maybe you could ask more questions of the experienced members here about how to manage Moby's treatment in a way that suits him and you.

(((Marcie and Moby)))

BTW, I changed veterinary practices shortly after Saoirse was diagnosed. Our new vets are much more switched on about feline diabetes - it made a world of difference to have a collaborative approach with our vets, especially as they prefer to see their feline patients get as much of their care at home as possible because they're so sensitive to stress (the feline patients, not the vets!), and stress hinders healing. I hope that you'll be able to find a vet you're happy with, and soon!

 

What a wonderful expression of love for your Moby you have shared with us.

Amazingly, some cats only need a short course of insulin and a switch to low carb wet food to make a dramatic difference in their BG (blood glucose) levels. Looks like Moby may be one of those kitties. It is possible to dose less than 0.5U. There is also drop dosing. Moby may be trying to go OTJ (off-the-juice, insulin being the juice).

Do you have the 3/10 cc insulin syringes with half unit markings on the barrel? Those make it easier to measure those tiny doses.

Some people go it alone after not getting much help from the vets and draw on the experience of the people here on the board. I know it's hard to trust strangers you have never met, be we live this sugardance 24/7 and know alot about the possibilities and how to manage this disease from day to day.

 

Whew! That's a lot of vets!
So, some options.
We eyeball smaller dose of 0.25 or even determine how many drops we can get out of 0.5 units, then dose by drop.
ProZinc, a U-40 insulin, is less concentrated and using the u-100 syringes, you can dose in 0.2 unit increments. with the tiny doses, maybe switching would work better.
Chasing the numbers - this is where you test about every 2 hours or so from when you'd normally shoot, until you get a shootable number. That is really disruptive to one's schedule.
A slight increase in the carbohydrate calorie percent in the food might allow shooting twice a day. See the food list at Cat Info for ideas.

 

That is a lot of vets you had to go through! Good news, your kitty may not need to be here for much longer. Some of us use calipers for micro dosing.

 

Since he's your heart animal, I say go with your heart. Good vets are important (sorry you had to go through so many bad ones), but they are not the end all be all. I trust the information that I have gotten here, as well as my own intuition and research, more than just blindly following my vet's advice. Don't be afraid to question your vet's advice and follow you heart (and your glucose monitor's numbers).

The food link that BJM posted has been very helpful to me.

As I just posted on another thread, I find using the magnifying glass on the "helping hands" (Amazon link) to be very helpful in eyeballing those small doses.

 

I also changed vets after diagnosis since the vet we had thought it best not to worry about treating Vyktor since he was 15 (he's now 18 and has been in remission for three years) but, having done my research and knowing how I wanted to treat Vyktor, I rang around and spoke with vets until I found one that was prepared to work with me in how I wanted to treat Vyktor rather than expect me to do it their way. Maybe you could do the same...

A lot of vets have learned a lot from the people on this board - if they're open to it.

 

I'm newer than you are at this and I have a cat who seems to be quite sensitive to insulin, as well. I feel like the past week she's been diving down the dosing scale and we are down to .25u from 1u only a few days ago. It's scary and frustrating and hard, but it also means our kitties are responding well to treatment, which is a good thing in the long run!

Based on my limited experience, I'm inclined to agree with the more knowledgable members (who've helped me so much) that Moby might benefit from microdosing. The .5u is dropping him a lot from your 300+ AMPS like it did for my cat. Maybe decreasing to .25U twice a day will help him surf along all day in those good numbers rather than coming back up to pinks overnight. I'm hoping that's what I'll go home to tonight, personally!

I wish I could transport my new vet to the west coast for you to see! She's been great in the aftermath of Noodle's hospitalization. Despite that, though, I still had to do my research and insist on a few things they didn't want to do while she was admitted (syringe feeding for one) that I personally think saved her life. It's important to be your animal's advocate with vets you don't like and even ones you do, and I think you're doing a great job. It takes guts to go through 5 vets during a scary time like this and being able to say "NO, I won't do that" is important.

 

as you can see , lots of us are with you.... been there , done that....
all I used my vet for was a prescription....
I learned everything here....
found this my first night.....
everything my vet told me to do was contrary to what was said here.....


the first thing that would help us to help you is for you to have a spreadsheet. Show us the numbers....
here are the instructions http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
if you have trouble with that, there are many here who will do it for you.... just ask... (I'm not one of them)

second, scroll down to the bottom of this ( and read the whole thing later)
for pictures of syringes with microdoses.....http://www.felinediabetes.com/FDMB/threads/lantus-levemir-new-to-the-group-please-read.18139/

We literally shoot one drop of insulin in the final stages of remission.


and thirdly, tell us more history.
Has Moby had a dental recently ? That is one of the first issues that can keep a cat from totally going off the juice.
Any other medical issues? arthritis?

What are you feeding?

we can help refine all of this with you....and you really only need the vet for that prescription.

 

How are you feeling today, Marcie?

 

Hello everyone!

I have read your responses over and over again throughout this past week. I honestly was so exhausted by this up and down, I just couldn't respond in words until I processed each bit of information. I appreciate everyone's responses - it gave me a lot to think about but it also gave me a lot of hope, too.

Some more information on things you all brought up:

1. Moby does not have any other health issues. The only thing is a luxating patella which sorted itself out a few years ago. He takes glucosamine and omega 3 supplements and is, other than diabetes, a completely healthy boy. I do have his spreadsheet in my signature. His last dental was probably 2-ish years ago?
2. I am definitely looking into micro-dosing. I didn't even know there was such a thing! I have pulled back on his insulin these past few days (when I can actually get food in him) but it's been far, far short of anything scientific. More like, "It's somewhat between 0 and 0.5... ok." I do have the half-hash marked needles!
3. The Vet Issue. I found a group of internists in my area and we're looking into a consult. The five previous vets were from two hospitals, 3 from one, 2 from the other, and I'm amazed at the lack of experience in all of them! Each one made a bad decision that led down to an ER visit... I just wish I knew what I know now.

The most recent frustration is his eating. It's not for lack of appetite! We're rotating what he's eaten (and enjoyed) before and introducing him to new foods we think he will like, but he's a stubborn one. The past couple days he's gone without insulin since we can't get him to eat before injection time. One food he'll enjoy one day and the next day he snubs it. All the specialty and pet store clerks all know me by now!

To each person who responded: thank you for your kindness. It's so nice to be heard and understood. I send love and light to you and your kitties! You gave me a boost in hope - and I know I'll get better at this. Hugs to all!!!

P.S. Yes, my icon is Moby in a tie I made for him! I'm a novice sewer and that was one of the first things I learned to make!!!

 

join the club..... this is my girl to a tee.....

have you tried additives?
I highly recommend http://www.amazon.com/Fresh-Best-Fr...24112341&sr=8-2&keywords=fresh is best turkey


and when you put food down, is there any sniffing ... lip smack... and then turn away.
if so, that's nausea.... which calls for ondansetron.... ( most vets don't seem to think cats have nausea but this medicine really helps)
and often, get followed by an appetite stimulant like cyproheptadine....

 

Marcigee,

Lots of hugs and love to you and Moby. . Lolly is my heart baby too-- I think everyone on this board knows exactly how you are feeling. You and Moby will get through this with your determination, love, and the help of the loving and knowledgeable people on this Board.

I think a lot of vets really don't know or understand the latest research on this disease, and that many are just brainwashed by the cat food salesmen. The first vet I went to suggested putting Lolly on a 2u twice a day dose of prozinc, with no home testing. The next vet did recommend a Lantus tight regulation with home testing. This was very forward thinking, but without the home testing, Lolly would be dead, as the 2 u dose was way too high. I found this forum a day before Lolly's near hypo, and the board members walked me through it all night. Since then, I have relied completely on the board members, ones I came to trust, for dosing information. I would give my vet the bg readings, and get Rx, but that's all. Lolly is now in remission, after one month of insulin.

I can't tell you to rely solely on the FDMB, you should have a vet backup; and I was lucky that Lolly, like your Moby, that she didn't have complications. But you may want to run anything the vet tells you to do by the folk here first. Their collective years of hands on experience is amazing. The FDMB led me through everything, testing problems, microdosing, things my vet could not help me with. I got a standing magnifying lens, and calipers and was able to get doses as low as .12u. @Marje and Gracie is very experienced with microdosing. The most important thing though, is getting a consistent small dose in.

For eating problems this may help: http://www.felinecrf.org/persuading_cat_to_eat.htm#eating_tips

I'm too new, the experts are already on here advising you, but it does sound like Moby might be near remission. Lolly was diagnosed 1/2/15, and just went OTJ (off the juice) yesterday. And she was a very sick kitty when she was diagnosed. So it can happen very fast!

Martha

 

I'm glad that we were able to help you a bit and that you're now feeling more hopeful.

I second Rhiannon's suggestion to check whether Moby might be nauseated. There's a very useful nausea symptom checker on Tanya's Site. Saoirse has been treated with ondansetron, too, and it helps her a great deal with her nausea problems.

Give that gorgeous kitty of yours some scritches for me.

 

@Martha and Lolly - Congratulations on Lolly becoming OTJ!

 

Marciegee,

What do you think your next step will be in this sugardance?

 

After @rhiannon and shadow's suggestion, I did do some hard observation to see if he was nauseous. He was doing the lip-smacky thing, but we started to test the food... and found it was the supplements we add to his food!!! We add glucosamine and omega 3 since he has some funky joints. They help him keep his mobility, but... I would rather him eat at this time than get those supplements, so we're going to stop those for a bit and return to them in a little while.

Thank you for the link, though! Definitely going to add that to my bookmarked resources!

I am doing a happy dance for you, Martha!

We bought the little calipers/magnifying glass and started drop-dosing. I think Moby's levels are regulating, though, so hopefully we won't need to keep giving him the juice for much longer!

 

I'm so glad that you were able to work out what was upsetting Moby's digestive system and that he's eating again: it's such a relief when they do! I'm pleased you found the info on Tanya's site useful.

What is the source of the omega 3's? I ask because I tried giving Saoirse a salmon oil omega supplement last year and it didn't agree with her at all. If it is the omega supplement, perhaps you might be able to find a supplement derived from a different source?

 

These are the two we give. I have a suspicion it is the omega 3; derived from anchovies and sardine oil. I would like to give him the glucosamine if we can't get the omega 3 down him!

 

Thanks for the happy dance Marcigee. I'm so glad you pinpointed the nausea problem. We've got paws and fingers crossed here for Moby!!

 

I have the same problem with additives to the food.... the omega 3 is available in a capsule form ( I just found it) so I'm going to try that instead.

I had just gotten a mushroom extract ( for cancer) that I would swear has no smell at all and put it on her food.... and she took a sniff and wouldn't eat it so I'm going to have to make
capsules to get it in her.



so glad you figured it out....

 

I've read your post (wiped a few tears) and can relate on so many levels ... especially on the frustration. There are so many kind and knowledgeable people here that I know you will have lots and lots of help and support.

As an alternative to the joint supplements, you might want to look into Diatomaceous Earth. It is a silica supplement (importance is second only to water) and all of my critters are on it and also my family members. There are several family members who take it for chronic pain and have found tremendous relief if not totally eliminated. A holistic chiropractor is who recommended it and now everyone in the family uses it. As I said, it can be used in critters, too (even vets approve)-- it's used for parasite/worm control in heard animals and found in all feed stores -- and I know that my 18 year-old cat can jump and move around without issues. I mix 1 teaspoon a day (don't worry about too much .. will not harm them) in their food and if I feed multiple times, I just kind of loosely add it to each serving so that at the end of the day I know that each cat has had at least a teaspoon. (I also add extra water to all food) As an added bonus, it's supposed to help human diabetics keep their sugars level ... diabetes is new to me so I've not really researched this part of it. There's a tremendous amount of material out there if you google it. So many testimonials you can spend hours reading through them. I take it myself and my hair and skin has noticeably improved and my nails grow like weeds. Might be something you find helpful for your furbaby.

 

If you have success with that, please let me know! I would love to continue the supplements if we can.

Thank you so much for your kind validation. It feels good to be with people who are going through, or have gone through, the similar circumstances.

As for the Diatomaceous Earth, I am absolutely interested! I will add this to my studies for sure. Thank you for the suggestion. I would love to keep his mobility up so he's a healthy and happy boy. I appreciate your help!