Vet is not supporting home testing...

I am a newbie to this message board. Bailey has had diabetes for 3 years now. Poor guy is only 7 years old now! I know he is young, sadly.
I have been going to the same vet since my cat has been diagnosed with diabetes. I'm a little leary leaving them, but they are not supporting me in doing the home testing. I can't figure out if its just because they want the $$ from me bringing him in every 2 weeks to do a curve, or they don't feel confident in letting their clients do this themselves. Either way, I am considering starting this on my own, but have no idea where to start.
The other problem I have is the vet also has Bailey on Hills M/D (dry formula) I'm just reading now that this is not good, but isn't it much better than wet foods with high carbohydrates?
I am struggling with keeping my cat's BG levels stable and consistent. We have him on a steady eating schedule and giving 7 units 2x's per day (Lantus/Glargine.) This seems very high compared to other's! I am starting to wonder if I need to look in another direction. We started off 3 years ago giving 3 units, now we are up to 7.
Any suggestions on what I can do differently would be appreciated. I brought him to the vet last month and we finally got his BG levels stable with 7 units. The highest # was 220 lowest was 60.

 

Welcome. The 220/60 is a very good range. Switching Bailey to a low carb canned food should reduce his insulin needs. Yes seven units bid is a little high but not unreasonable for being on dry food. If/when you switch to canned you should reduce the dose.

Yes some vets do not like client's home testing because of two concerns, the first is that you might change the does without knowing what you are doing. The second is that you will be calling your vet with many questions and using your vet's time without compensation. I know one woman whose vet would only allow home testing if the woman bought the AlphaTrac animal meter from the vet.

 

This is YOUR cat - not your vet's cat. This is your baby - not your vet's baby.
So what if they are not supportive of home testing? Do it anyway...(and log the numbers so that you can later wave them under the vet's nose)
If you know what your baby's pre-shot numbers are before shooting insulin, you are being a caring, CAREFUL, thoughtful pet parent.
And, if you had a human child who was a diabetic, do you think his/her doctor would tell you not to home test before shooting? Nope, never.

Methinks if Baily were changed to a canned low carb food, you would not need to dose so much insulin as Hills M/D is 13% carbs, (dry food chart: http://binkyspage.tripod.com/dryfood.html), and diabetics should be fed foods UNDER 10% in carb value, (ideally, 5% of less is even better).
And wet food is always healthier if your baby will eat it, (and 95% of them will). Canned food charts: http://binkyspage.tripod.com/canfood.html

Please do not change your baby's diet UNTIL you are home testing. 7 units of insulin, twice a day, on a low carb diet, without testing, could lead to a HYPO and those can kill!

Where are you located? City/State? It is very possible that another board member might live close enough by to come show you how to home test.

~M

 

I too am a newbie but I am so sorry that the vet is taking this position. Other FDMB people please correct me if I am wrong but... I would get a second opinion. Even if you chose to stay with your current vet talking to another might not be a bad idea. However I must say that I would learn to home test no matter what your decision on vets.

If you can, try and get all your cats records from your current vet. In my newbie opinion you need to know the blood glucose numbers the vet is getting at the very least... The collective wisdom here is wonderful but without numbers it is difficult.

One thing I am SURE of though is that you are in the right place. The people here are great!!!!!

Welcome

 

Welcome Jen.

My idea is that most vets think cat parents will freak out with the info they get and it will cause problems for the vet - dose changes, stress, etc. They just don't realize how competent we can be.

So, if I were you, I would set out to show them. Start hometesting, get numbers on a spreadsheet and share with your vet. My vet didn't know anything about hometesting. Once we got results, she wanted us to help others.

The best argument for me was that no human parent would just give insulin, without checking bg levels first, and plan to take in their child every week or so to check levels. We just treat our diabetic cats the same way we would treat our diabetic kids.

 

Unless Bailey can talk and tell the vet himself there is no reason the vet even has to know. You also DO NOT NEED the permission from your vet to hometest. Before switching food to all canned, you NEED to learn to hometest because your numbers on Bailey will go down. There is no way on this earth I would ever shoot one of mine without testing first. Hometesting is a lifesaver and it is coming out in more vet journals promoting it.

 

Welcome fellow Newbie.

I can't comment on your vet's intentions in discouraging you from hometesting, but it sounds kinda wonky to me; this is good stuff - but don't let yourself get overwhelmed! (*cough*Bee'sahypocrite*cough*) There are tons of resources available through this board - including every member - and while it may take a while (I'm still studying) reading will arm you with a lot of tools you need.

Have you bought your testing equipment yet, or are you looking around for recommendations? If you already have your supplies you might want to test on yourself to get an idea of what the lancing device feels like (if anything), how much blood you'll need to draw each time, and also to get the routine down, too. I found doing this very helpful (and interesting!).

We had Rufus on the Hills M/D for a couple days when changing vets/insulin. While it could definitely be worse, it can also be better. I second the Janet & Binky's list suggestion it sure beats calling/emailing individual pet food companies for their occasional assistance.

I wish I could tell you more about regulation, but Rufus is new to the concept also and we're not doing so hot on Lantus either! :YMSIGH:

 

http://www.aahanet.org/resources/Diabet ... lines.aspx Scroll down to cats and read about hometesting and canned food. Maybe give your vet a copy.

 

Thank you all for your replies and support. I will start shopping around for test kits. Does anyone have any suggestions as to what monitor works best for them? I am confident in doing the home testing myself. I don't think I will be nervous doing it, but I just need to get started. The other concern is the cost. Are the test kits expensive? Not that it REALLY matters. Bailey's happy, healthy life, to me, is priceless We have the best bond any pet owner could have with their cat-I think my husband is jealous :lol:

After looking at the food chart, I was feeding Bailey 9 lives canned food (which is quite low in carbs) when he was first diagnoses with diabetes, along with some cheap dry food. He loved the canned food! Funny how he needed more and more insulin after switching to the M/D formula! That makes sense now...

 

Hi there
welcome to the FDMB. You are officially in a much better place now that you've posted.
You've received a lot of good feedback!
I agree with everyone here - your cat is your cat - you do not need permission from your vet to home test.

First thing's first, learn to home test. You really need to know what the numbers are at home.
Lori & Tom is the resident Newbie Kit supplier. If you look at the top of the health forum, you will see a stickie with a heart icon and called "Newbie Kits"
Info in there about Newbie Kits.

This link will help you decide on a meter if you wish to purchase a meter sooner rather than later.
Consumer Reports Meter Reviews
Home Testing Links

Does your cat have any history of ketones? You'll need to confirm this. If your vet tested for this - it should be in your cat's records.
Ketones

Print these out in case of hypo:
Jojo's Hypo Tool Kit
How To Treat Hypo


DIET: please read through this link about how to transition to wet food:
Very important to be home testing FIRST before you A)switch diet B) lower dose
Dr Lisa's Feline Nutrition

How are you handling your Lantus? This link will help:
Proper Handling & Storage of Lantus/Levemir

Lastly, if you visit the Lantus forum, you'll see this along with many other information stickies about Lantus.
This is the protocol used in the Lantus forum of this board:
Tilly's Protocol: Modified Version

You are welcomed to post there and here in health as much as you need to!
Please keep us posted, lots of members here have been in your shoes, as you can see a few newbies have come by to lend their support.
It's going to be ok - so breath!!

.

 

Lots of people here like the ReliOn from Walmart. Both the strips and meter are inexpensive. Most meters aren't expensive - some are free. It's the strips that can cost. We got a PrecisionXtra free at Walgreens and then bought our strips on ebay for less than half of the store price. It's up to you - just get a meter that sips the blood and takes a very small amount.

The whole process is certainly a lot less expensive than a visit to the vet, and the numbers you will be getting are much more reliable. (No vet stress which can raise bg levels.)

Don't take away the dry food until you have the hometesting down. Oliver went down 100 points overnight when we switched from dry to wet. If we hadn't been testing, we would have overdosed him.

Another reason for the increase in insulin could be that he started too high. We like to see newbies start at 1 unit twice a day. If he started at 3 units, you may be over the ideal dose which can result in a rebound situation: http://petdiabetes.wikia.com/wiki/Somogyi_rebound This is not always the case; sometimes some cats require more insulin than others. As soon as you are hometesting, you can do some experimenting and find out if he is getting too much insulin.

Lots to learn; steep learning curve but very doable. Keep asking questions and reading.

 

jen hello and welcome. you need never have your vet test blood glucose again. we will teach you how and if you'd like i will happily send you all you need to test him with ok.
press on the newbie kits button on the bottom of my post and it will show up with your address in my personal email right away. i will get it our first thing in the morning. depending on where you live you should have it in 2-4 days max.
i did'nt read your entire postings, ronnie contacted me, has your cat been tested for ketones and does it seem like this would be an appropriate part of the kit? i'll go back and check reading thru. it's free and you will become a pro in no time
lori and tom tom too!

 

u can get the free kit as described above which is great but if cost is a factor then one of the cheapest meters and strips out there is the relion from walmart. the micro or macro whatever it is called. takes a very small amount of blood and sips super fast. used by many here and I have used it when testing a friends cat. Love it
just some thoughts here

 

If there's history of ketones, this will be something to consider when dose comes into play.
Others will be by to add input on that.
So please keep checking back with us when you can.
And let us know if there is a history of ketones in the urine.

 

i was looking to see if i have relions. i have several contours...are'nt those cheap strips too?
i know the one touch and the accu check have pricey strips...and i have some of those too.
wonder why i don't have any relions??????

 

probably cause there has never been a free give away with those. not sure about the contour strips. but hocks has the maxima ast. meter is 6.99 right now and strips a little cheaper than the relion but only comes out cheaper if you buy $79 for free s/h. down side is you must always make sure you order soon enough. whereas locally is quicker wit the relion.

 

Key with meter choice is:

cost of test strips (figure on using 3 or 4 per day in the beginning)
"sipping action" strips (easier to get the blood drop)
tiny amount of blood

I personally like the Maxima AST which I have ONLY seen online - never in stores.
www.hocks.com
The test strips cost $16.50 per 50ct, so $0.33 per test
it requires 0.5 microliter of blood which is almost the tiniest --

(the least blood required by any meter is 0.3 microliter, but the test strips run $1 or more EACH)

To reach the $79 free shipping, I also buy syringes and lancets from Hocks
200 syringes $34.98 (17.49 per 100) http://hocks.com/hocks-healthcare/hocks ... 40030.html
300 lancets $4.47 (1.49 per 100)
300 test strips $99.00
Meter $6.99 (one time buy -- though I replace ~once per year or so when battery wears out)

this order makes supplies for 100 days with 3 tests per day average.

Hocks ships to me from Indiana (I live in Michigan) and I get the stuff less than a week from time of order.

 

Thanks for all of the information. I think I am going to order from Hocks, sounds like the best option right now. I will update everyone once I begin. I'm glad to know I can go somewhere for support. I've watched a few online videos on how to do the testing. I'm sure there will be a few practice rounds needed, but I'm confident I can do it.
I felt so alone for awhile now and have come across a lot of people think I'm crazy for doing all this for a cat, but I could not imagine just giving up; that is not even an option! In fact, I had my prescription sent from the vet to a local walgreens and the pharmacy tech even made a comment about how much I am spending just for a cat...I almost went off on him! He was trying to joke around saying I shouldn't feed him so much sugar! The nerve of some people!
I'm so glad I came across this board where everyone is so willing to help and knows exactly what I'm going through. I'm sure you all started in my same position and I will becaught up in no time.

Thank you again!
Jen and Bailey

 

I got my meter from Target for a great price and the strips aren't pricey either... it seems to be working well. If you are using Lantus you definitely need to hook up with the Lantus message board, they are INCREDIBLY helpful!! Just last week I was giving my kitty 7.0u of Lantus and the group members helped me to reduce that to 1.0u. His numbers are much more consistent now and they are going to help me find his perfect dose. Home testing is really no big deal once you get used to it.

viewforum.php?f=9

I am not extremely internet savvy but that link should send you to the right place! Good luck!

 

oh yea. make sure your syringes are the ones with 1/2 unit markings. 3/10 cc 31 gauge and I use the short needle 5/16 length. The 1/2 unit markings make for easier dosing of smaller doses instead of eyeballing.
good luck.

 

my thinking is, i don't need a prescription for the glucometer and test strips, and i'm testing at home and it doesn't hurt my cat. what my vet feels about it is his opinion and i just don't agree with him. i know i've saved thousands of dollars not having to bring cleo in for curves at the vet, and her dose is set by testing how she does at home in her own environment rather than while stressed out at the vet. (actually my vet loves how i'm managing my cat's diabetes. he's been very happy with how she's done on insulin, and now he actually asks my advice on other diabetic cats he's treating. NOBODY at that vet office even told me i could test my cat's blood sugar at home -- i had to learn that here on fdmb.)

as well as i know my cat, and despite all the BG tests i've done over the past 3 years, i can never truly know whether she's high or low without testing her. before i started testing i was taking notes on everything she did and just driving myself crazy worrying about how she was doing. admittedly, she was very sick when we started her on insulin, and she had a severe hypo from the vet's first insulin injection.


especially because their insulin need can drop substantially once diabetic cats are switched to a low carb canned food diet, it is very important and useful to keep testing while switching the diet. my suggestion would be to cut the dose in half when doing the full switch to canned food and get some high carb canned food in the house as backup in case your cat's blood sugar goes lower than expected.

when cutting the dose that much it's important to test for ketones. the test strips are relatively inexpensive at the pharmacy, and you just dip them in the urine while your cat is peeing, in a ladle you stick under the urine stream to collect the urine, or in the wet litter before the cat has a chance to cover it up right after peeing. if the blood sugar level stays high, or if you even see trace ketones (the stick will practically glow in the dark if any ketones are present), you go back up in dose.

 

My cats are as important to me as if they were human, and we know that human diabetics test 5 or 6 times a day, and will test before giving themselves shots, so what makes it OK to shoot insulin blindly into our cats?

Both my cats have had much lower than usual numbers and I have had to feed them HC to try and bring them up, and neither of them show any symptoms of being lower than usual.
Better safe than sorry.
Ask how much a curve costs, then put all that cash into a piggy bank every time your vet says, let's do a curve. Plan to buy something nice, like a new car or house, with all the cash you will save!

OK, it may not be THAT much cash, but it will add up!

 

Gayle, I think us cat people do more testing on our cats than the humans do on themselves. We are more careful and take better care than human diabetics do. I've met some that don't always test before shooting and some that only test when they feel a little funny. Have no idea why they would take risks like that but they do.

 

You're cat is on 7 units of Lantus twice a day, so he's getting 14 units of insulin each day?

Do you know if your cat has ever experienced a hypoglycemic episodes?

You're already getting great advice on hometesting, and this is your cat, if you want to hometest and make sure your cat is safe, you are the one who is allowed to make that decision, not your vet.

You noted that your cat's insulin dose seems high and yes it does seem high to me, but has your vet ever mentioned any conditions that may cause a cat to need higher doses of insulin?

Eating the dry food could also cause a need for more insulin, but I don't think that high of a dose would be called for.

After you get your glucometer and start getting blood sugar readings on your own, I would encourage you to take a look at the high dose forum here and read some of the information.
viewforum.php?f=12

 

Hi Jen,

Welcome to the board, with more information than you can imagine! Great place to be when you have a diabetic cat.

I just want to relate a story about my own Pharmacist that used to poo-poo the idea of me even giving insulin to my two diabetic boys. (sadly they both died last year after treating them for 3 years, many health issues involved).

Well, he found out his DOG who is 14 now has diabetes. Now that the "SHOE IS ON THE OTHER FOOT", he does not want to put down his dog, but is treating him with Humulin N insulin. BUT, he will NOT test him prior to the shots. He is up to 8 units twice a day now, and he does not even test his urine.

But, he thought I was nuts because I kept a log each day of the times I would test my cats, and believe me, I NEVER shot insulin without testing first.

My vet said he wished all his clients did what I did, because he knew that it helped them do a better job, and vets get so bogged down with so many other emergencies, etc. that a lot of them don't always want to deal with diabetic cats that much.

My Pharmacist said that his vet (not mine) said he needs to bring his dog in every 2 weeks to be tested, and the pharmacist said, when he looked in the eyes of the vet, he could see '$$$$' signs rolling around! Some vets love to make money off of clients who are willing to do anything to save their cats (or dogs) and they don't mind taking money from those who can afford it.

PLEASE learn to home test, and you will feel so much better about your boy, and you will have 'peace of mind'.

I could never have given a shot of insulin without testing before the shot.

Take care!
Jean and Charcoal (GA)

 

Hi Jen,

I just wanted to say Welcome and I'm waving Hi from Oshkosh!! It is nice to see another person from WI here.

Hope you can get the testing down and it works out for Bailey. You've come to a great place and will get lots of help.

 

hi there
do what you think is right, my vet didnt support me doing the testing on my own, they actually wouldnt even speak to me unless i brought patches in for an emergency visit. i had called them the day he went off insulin because he shot so low and i just started up with this board and was just freaked out, they said they wouldnt even speak to me on the phone, he was in there that day and tested at 45 and it took 6 calls to find out if i should shoot that evening (pre-FD board) needless to say i have NEVER been back i called and got his records and was done....one yr later (after them telling me he will NEVER EVER go off insulin) we are insulin free and doing so well....so my advise, these people on here really know their stuff and helped me and patches get to where we are today.....

good luck!

 

I decided to take the plunge! Just went to Wal-mart and got everything I need. Gave him his insulin and food at 10:30am this morning. Tested 4 hours later after I got all the supplies and his reading is 62. That's a good number now, but I'm going to check every hour or 2 to make sure it doesn't go lower since he is on Lantus.

Thanks again for all of your help! I am in the process of creating a spreadsheet too.

Jen and Bailey

 

Testing my spreadsheet...

 

Good for you on hometesting. As for that 62 at +4, please continue to spot check every hour.......don't want him going down much further.

 

Hi.. I got a msg to check out this thread in case you had a hi dose condition, but I see you don't seem to. Congrats on your first test! I'm proud of you for taking the initiative so quickly!

Now onto the serious stuff.. On Lantus that 62 is way too low, way too early in cycle with such a high dose. I would recommend you:

1. see if he likes wet food and switch him cold turkey if he does, while *simultaneously dropping his dose to 1u*
2. check out the lantus board, there's TONS of info on Lantus action that will help you and many people who can talk with you
3. start transitioning the food to wet, and reduce to 3.5u while getting as much data as you can

Again, congratulations! Welcome to FDMB
..Carolyn

 

Your right, the number went down to 31 after 1-2 hours. I assume this is probably the lowest point for the day being it was 6+ ? I did feed some food so will be checking every hours to see how it changes.

I was reading that the human monitors read lower for cats ...Does anyone know how much lower?

This makes me nervous that all this time we were giving 7 units and his BG levels were that low! I never saw any signs of hypo though...

 

At 31 you need to be spot checking every 15 minutes....you DO NOT want him to go any lower. You are getting too close to hypo range. I know you fed but please test again and post back. If he is ever lower, start a new thread with a 911 button in the subject line.

 

No one really knows how if, and how much human meter real low. The accuracy of the human meters is no better than +/- 20% so it is hare to make a real comparison.

 

About 20 minutes ago it was at 36, just checked again and it is at 40.

 

Okay, 40.....but that could be from food spike and he might start going down again. Please continue to test and would suggest starting a new thread so others can get on board with this.

 

Hi there,

please update when you can. You can start a new thread too as suggested.


With the 40's you'll want to be re-testing at least every 15 minutes till you see numbers rise 50 and up.
Don't over feed too much each time, or you may see scarf and barf.

 

i'm heading out the door here in a couple minutes but wanted to add that you are gonna need to test a bit more tonight. you got plenty of strips?

if or when a lantus overdose happens, it is possible for it to work for much longer than the "usual" time frame so even though you are 8 plus hours after the shot (i think?) it is possible for the lantus to keep working for much longer than usual if indeed the dose is an overdose.

 

WOW whatta catch!.. I think it would really be in your best interests to SKIP the dose tonight and restart tomorrow at 1u BID - you can work on the food switch safely then too. The Lantus ISG has stickies that explain the "shed" concept of Lantus.. basically it builds up in the body and can easily be working long after +12, especially in cases of too much insulin.

 

Welcome to the board - I'm just seeing this and see that you have received excellent advice. I'm soooo glad to see you got some testing equipment immediately and tested - what a catch that was.

I use WalMart supplies - have used others when I first started - and find that W/Mart are the least expensive. I test Dude often so use a lot of strips - in addition DH (husband) is diabetic and uses strips also.

Dude was diagnosed 6 years ago and I found that when I switched from dry food (which he loved and was free fed) to the low carb wet foods he dropped 100 points immediately. So do be careful if you change the food - it will make a difference as others have told you.

Good luck - will be watching for your updates. I think you'll be decreasing the dose very soon - if not immediately - I would never give insulin without testing to be sure of the number before eating.

Emmy & Dude (& Mittsi too)

 

Holy Canoli! Wow - SOOOOOO glad you are hometesting right now! I can't wait to see how your kitty will do on the lower dose now

 

the vet i had been going to for a long time also did not support hometesting. i no longer go to her. after several diabetic cats and much research and using this board, i began to realize how to properly treat a diabetic cat. she did not know how to do this. i had cat's with diabetes that i followed her advice with and several after that i did not follow her advice. i know the later bunch are much better off. with my vet it was a matter of not being well educated and then with other vets - where i took more control of their care - i think it was a control issue and some are not used to owners disagreeing. i've been through it all and will disagree and do what i know is best for my girls and boys. i can't believe how many times they've been wrong or off with their diagnosis and treatment. read, learn, listen to this board. good luck!!

 

Adding my 2 cents....

As someone who is an avid tester with both my cat and dog, testing at every fasting day in and day out as well as once or twice if not more through out the day I will say that home testing is absolutely one of the most valuable tools you can have.

Important to remember that you do NOT need your vet's permission to learn to home test.
I couldn't imagine just blindly giving insulin without first knowing the glucose range of my pet.

My cat has also been in and out of remission over the span of 4 years. Had I not been testing I would have blindly continued to give him insulin which could of caused serious issues.

All meters are not created equal with certain ones found to be more consistant and reliable.

The Freestyle Lite meter has been found to work well with our cats and small breed dogs.
If you join the Freestyle Promise Program Abbott will send you a free Freestyle Lite meter.
Test strips can then be purchased on line for about 25.00 for a vial of 50.

http://www.myfreestyle.com/promise.html

Personally I use the Alpha Trak with both of my pets.
It is being found that the Freestyle LITE test strips are working with the Alpha Trak meter. I have used these in my meter and have done meter to lab comparisons to know that it works well.

 

Get another vet. OR teach him about it. Some vets are "old school" and need to be brought up to date.
Either way, I would print out the "convert a vet" stickie and send/give it to him.