Should We Take Victor to His Next Vet Appointment?

Victor has an appointment with our vet tomorrow for them to do a glucose curve test and I just wanted your guys' opinions on if we should still take him in? As has been pointed out in previous responses to my posts, our vet doesn't seem very well-versed in feline diabetes, which makes me worried about continuing to take him to them. Please let me know what you guys think, as I'm pretty concerned about this.

 

Are you able to be home for 8-10 hrs to do the curve yourself? It's just a matter of keeping Victor off food and testing every 2 hrs for a min. of 8 hrs and preferably 12 hrs to see a full cycle. If not, the vet can certainly do this for a fee and they'll give you a dose for the insulin. I'd get Victor onto Fancy Feast Pate food as the W/D Vet food is very high in carbs.........it's a start and then many will post here once you enter the results.

 

Yes, we would be able to do it here at home, but my only concern with that is that I don't know how well Victor would take having to get tested every two hours over a full cycle. He still gets testy even just doing the pre-shot and mid-cycle tests.

When you say they'll give us a dose for the insulin, do you mean they'll give him his insulin while he's there at the clinic? Because I really don't know if I'd be comfortable with that. After only two follow-up visits to the vet to re-check his glucose levels, the vet wanted us to increase his dose from 2 to 4 units, which we haven't done because we hadn't started home testing yet and people here said it could be too high of a dose. Now that we have started home testing and seeing what his numbers are while at home, it seems to me that 4 units would be too high of a dose, but I am still new at this so I wouldn't know for sure. If it is too high of a dose, I wouldn't want to take him in to the vet and have them give him the 4 unit dose if it might put him in harms way. Also, our vet is one of those who discouraged home testing.

 

A curve done at the clinic might not give the best information. The stress of being there can cause BG to be higher than normal. The vet might then use those inflated numbers to make a dose recommendation and that dose can be too high. There's also the cost of leaving Victor there for the day to have them do the curve to factor in.

Most of us would recommend doing a curve at home to get more relevant BG values. The curve involves:

• removing all food at least two hours before the pre insulin BG test
• feeding a normal breakfast
• giving the current 2 u dose
• test every two hours through the day until you get to the evening pre shot test (at +2, +4, +6, +8, +10 then PMPS)
• avoid free feeding through the day but give a mid day meal right after one of the tests (maybe +4 or +6) so there's a two hour period before the next test to avoid the food influence
• no food as usual in the two hours before PMPS.

In the early days when you're just getting used to testing and kitty might not be fully cooperative this seems like a lot of poking. However, it gives good data and would allow us to give you better advice. Once you have a broader scattering of data on your spreadsheet curves can go out the window for the most part.

I've looked at your SS and it seems that 2 u is too low a dose but I wouldn't change anything yet. Here's why: you've just started a testing routine; the 2 u dose is taking his BG down, although only to yellow; if you undertake a food change to low carb wet food only it can have a dramatic impact o BG numbers. I would strongly encourage you to make that change. Many other members with diehard kibble addicts have managed to get there.

 

If poking him every two hours seems too much, try for every three hours (+3, +6, +9). That would still give you good info.

 

To answer your other question, no the vet would not give insulin. What Shawna meant is that the vet when done with the curve will tell you the dose to give from now on. Just a warning if they do it's usually to much of an increase. Most vets increase by 1 unit if not double what you giving already.

 

Thanks very much for the input. A couple of questions: We don't give any food as usual before the AMPS test, right? I'm assuming the +12 is a typo and you meant +2? So we test at +2, +4, +6, +8, +10 and then do his PMPS test as normal? The vet told us to only give Victor two meals a day - in the morning, and at night - so we don't free feed, so should we still give him a mid-day meal?

Also, we are planning to switch him to wet food, it's just a matter of needing to figure out how many cans we need to buy a month (as we only have a monthly income), and what his calorie intake should be based on his weight (which is going to tough for us as we're not very good at math), because he is overweight.

We will probably just go with either Fancy Feast Classics or Friskies Pate. Would you recommend one more than the other?

 

Okay, thank you for the clarification.

It would concern me if they did tell us to increase the dose, because first they increased it to 3, which we didn't do because we weren't home testing yet, then when we took him back a week later, we mentioned that we hadn't been giving him the 3 units and the vet still increased again to 4, which we still haven't been giving him, we've just stuck to the initial starting dose of 2 units, which seemed the safest thing to do until we started home testing and getting a better idea of his numbers.

 

Good morning Heather, I have been reading your threads with interest since you have joined the board. You and your mom are doing such a great job with Victor, and working so hard to find out what to do and what works for you. I just wanted to give you a high five on that! Re: the food. Just my 2 cents worth, we feed Idjit both, in fact, since he prefers the Fancy Feast, I have begun mixing the FF and Friskies, one can each, and then portioning it out. He's eating all the food offered, instead of leaving some Friskies in the bowl. That kind of offsets the cost difference for us also.

 

Good morning to you too! Thanks so much for your kind words, it really is appreciated Sometimes I've wondered whether we're doing a good job or not, so seeing this really helps to lift my spirits. Being able to come here with our concerns and questions, and receiving all the support, has been a godsend.

 

Yes, and yes to the typo - I corrected it.

Most of us feed mutliple small meals a day because most kitties are happier and it seems to help with stabilizing BG. Many vets recommend feeding only twice a day - mine did but I don't follow that. You can leave your feeding schedule as is for the curve. I only mentioned a mid day meal because many kitties get one.

There are formulas to calculate amount of food needed according to weight but the simplest thing is to weigh him now and continue weekly over time. Weight loss should be slow. The required daily calories can vary a lot cat to cat and a diabetic that isn't regulated is often overly hungry. A digital baby scale is a great thing to have to track weight but in a pinch you can hold him, weigh the two of you on your bathroom scale and then subtract your own weight.

Try a couple of cans of Fancy Feast and Friskies pates to see what he likes. Friskies will be more economical if your budget is tight. They're both low carb, easy to find and used by many here.

Here's a weight loss example: Teasel's brother is a big boy but was a little overweight at the time of Teasel's diagnosis in January 2016. When I switched Teasel to low carb wet food (at the time it was prescription ProPlan DM pate - 6% carbs) I put his brother on exactly the same. He got one 5.5 oz. can a day. Over the course of a year he lost 2 pounds on that feeding regimen and was at a good weight for his size.

 

You're doing a great job! You're testing, tracking data on a spreadsheet, asking good questions and coming here for help to keep your kitty safe.

 

As a bonus, if you skip the in-clinic curve, you will save the money it would cost you! That money is better spent on cat food and testing strips.

 

Definitely have to agree with that.

 

I really doubt we could afford to get a baby scale (from looking at the prices at Walmart), and we actually don't have a bathroom scale, but we could probably afford that, so would weighing the two of us and subtracting my own weight be at least a somewhat reliable way of keeping track of his weight? Would a digital scale be best, and would it matter what brand or anything?

Also, Victor threw up earlier this morning, but I'm assuming it will still be okay to give him his shot?

 

Using a bathroom scale would give you a rough estimate if you can't afford a digital baby scale (runs about $40-$50). Here's a more economical one:
https://www.amazon.com/Smart-Weigh-...coding=UTF8&psc=1&refRID=EG7JA70T1R1930SKHJFX
A digital scale for babies will allow you to measure the small weight decreases from a kitty more accurately.

When did he throw up relative to shot time? He needs to have a decent meal onboard before you give him his insulin because Humulin can act quickly.

 

He threw up about 2 hours or so prior to when we usually give him his shot, so he still has his AM meal to eat, which we'll be giving him in just a few minutes.

 

@Kris & Teasel I assume it will be okay to give him his shot then?

 

If he eats his usual meal, you can give the 2 u dose. If he eats quite a bit less you might reduce a little. Post here once he's eaten. His numbers are high enough and there's enough carbs in his food that he might be OK with 2 u on a smaller meal.

 

He did eat all of his usual meal.

 

OK. You can wait about 20-30 minutes then give him his 2 u dose. We advise that wait so the food hits his bloodstream before the fast-acting Humulin is given.

 

Thanks so much for all your help. He finished eating at 9:31 AM here, and we gave him his shot at around 9:55.

 

You're welcome!