vets opinion

Discussion in 'Lantus / Levemir / Biosimilars' started by Anyname, Sep 28, 2011.

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  1. Anyname

    Anyname Member

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    Jun 8, 2010
    New vet says symptoms suggestive of mild pancreatitis. Blood test showed nothing. Says that is not unusual in mild pancreatitis. Can do ultra-sound or biopsy for 100% accuracy.

    AMP today 288 - pretty much hovering around 250 to 290 all the time regardless of insulin given. Up to 5 units. Vet wants to change diet to Royal Canin special diet for intestinal problems. Along with raw rabbit and kangaroo. WE're talking 2/3 cup of dry a day.

    Vet seems to think the issues came first and then the diabetes. He is extremely well versed and knows of FDMB, and told me various things to counteract what I might read on the forum. He is far more knowledgable than our local vet. He wants me to increase insulin with the dry until stable on the addition of dry. He says the diabetes is 3rd on the priority list at the moment. Digestive issues no. 1. Allergies no.2 and FD no. 3.

    He says they have a access to the special diet Royal Canin even though its in shortage everywhere because of a recall pertaining to egg in it. Says they are lucky to have it available. nailbite_smile
     
  2. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    i know there is a blood test specific to pancreatitis from hearing people mention it, but i don't know enough about it to comment. perhaps others will offer some thoughts on that.

    i'm curious what things the vet thought that FDMB is wrong about. we follow the protocol that came from the University of Queensland - does he disagree with the protocol?

    does little boy always eat the same amount of dry or does it vary from day to day? what about the canned food - i know you've had to change types because of his intestinal distress (poor guy) - are they all low carb, if not, does the type & amount of food vary from day to day?

    i understand that he has to eat, and the gut issues have to be addressed first. i guess what i'm wondering is if you're just going to need to continue to raise his dose to compensate for the food problems. if the kind of food and volume of food (ie, the carbs that he gets every day) varies by much, then i could see why you can't get on top of his BG.

    also, if he does have mild pancreatitis - i don't know what the symptoms would be on that, but i would think it would include pain from what others have said - if there is pain involved a cat's BG will rise. any inflammation can cause a rise in BG as well.

    all of that put together might explain why you're having such a hard time getting his BG into lower ranges.
     
  3. Anyname

    Anyname Member

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    Jun 8, 2010
    What vet told me was complicated - I had trouble keeping up let alone repeating it. The vets wife trained with the Queensland people (maybe he did too). They support the protocol. I am wondering wether to make an appointment with him along with my husband so he can explain it all to us there together - he talked to me on the phone last night. The gist was that he believes LB has pancreas issues. Since the start of the year LB numbers went up for no apparent reason. Very few carbs as can't find anything he can eat with carbs that he isn't allergic to.

    The pattern is he loses his appetite. Sometimes he vomits. He eats grass. He vomits brown stuff. His number go higher. He looks unhappy and agitated. This happens fairly regularly.

    I give LB approx the same food every day around the same time. Very little dry - a couple of weeks without it.

    This site is wonderful, but when there are more issues besides FD - multiple issues, I don't think I have any choice but to give his program a shot.
     
  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    I commented yesterday that if the medical issues are not manageable without some form of intervention that could raise BG, then your alternative is to raise the insulin dose to counterbalance the problem -- in this case, the dry food.

    You might want to read these two links regarding pancreatitis.
    Jojo's post
    Pancreatitis roundtable

    While the fPLI is the best test for diagnosing pancreatitis, it is not infallible. With mild cases or if the cat is recovering, you may not get a significant result. I would, however, ask if this is the test that was run. Some vets will still use a blood test for lipase or amylase and the results from these two tests are unreliable.
     
  5. Blue

    Blue Well-Known Member

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    Dec 28, 2009
    The vet may seem knowledgeable but how dry food can be recommended to a diabetic pretty much proves that the vet is not all that smart about feline diabetes. Tons of cats have been shown to be FOOD CONTROLLED once dry is removed and low carb is fed. Ask your vet for the carb % in that dry food. 'Nuff said on that part.

    Why would a vet want to have you get u/s or biopsy for pancreatitis? That's ridiculous. There is a blood test, PLI, that will tell you EXACTLY if the cat is affected by pancreatitis or not. Think of it like your temperature.... if it's high right now, why make an appt to have some procedure in a week or so? By then your temp will likely be back to normal!
    The same goes for the fPLI or PLI test; draw blood and have the test done WHEN THE CAT IS HAVING THE ISSUE.

    If the vet thinks the cat has pancreatitis, was the cat given fluids, and were you given pain meds? Were you advised to give pepcid? Pancreatitis is painful and makes the cat nauseous. The fluids, along with pepcid for nausea and buprenex for pain, should clear up the pancreatitis attack. You don't need any u/s or biopsy for pancreatitis.

    You don't need any expensive rx food from the vet either. Stick with the usual wet low carb foods.

    Get some pepcid AC regular 10mg strength. max dose per day for cats is 5mg. Cut a pill into 4 pieces, giving 1/4 am and pm. I had frequent issues with Shadoe and pancreatitis; I was giving her pepcid BID daily, and if it did not seem to clear the problem, I would give her a small amount of bupe, as well as fluids, if she seemed a bit dehydrated.

    New vet does not sound like a good vet if unable to properly test and treat a common condition such as pancreatitis.
    Look for another vet.
     
  6. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    The best test now for pancreatitis is the specific PLI. However, it also is not infallible and IMHO, the best diagnostics for pancreatitis include the sPLI and U/S.

    I do agree that I would question the knowledge of a vet who does not immediately have you put your cat on low carb canned food. If it is pancreatitis, then the treatments mentioned...fluids, pain meds, pepcid are extremely warranted and should be started immediately.

    Sending LB healing vines and snowflakes.
     
  7. julie & punkin (ga)

    julie & punkin (ga) Well-Known Member

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    Feb 17, 2011
    i think what LB's mom is saying (sorry i can't remember your name - is it marilyn?) is that LB is allergic to the typical low carb canned food - she's having to work to find food that he can eat.

    i'm confused by your statement that he doesn't eat very many carbs because of his allergies - do you mean not including the dry food? because dry food nearly always has a lot of carbs in it. that's why we're all big advocates of the low carb canned food - you can get quite a few options for fewer than 5% carbs.

    perhaps the vet doesn't understand that we follow the protocol. I'd print this out and take it to him, or if you have an email address you could email him this link: http://felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf
     
  8. Christie & Willie (GA)

    Christie & Willie (GA) Well-Known Member

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    Dec 8, 2010
    I'm just curious... what are the suspected allergens, and is the Royal Canin intended to help with that or the digestion issues... or both?

    You had mentioned that you also plan to feed raw rabbit and kangaroo. Are you planning to feed straight meat, or will you be balancing out with supplements? When Willie was first diagnosed, he had a horrible skin condition that the vets first thought might be allergies, so I switched him to a raw venison diet. While it was pricey, I had Dr. Lisa create a balanced diet with the venison for me that would address both Willie's diabetes AND his skin issues (and the fact that he is 15 and likely in early stages of renal failure). She gave me a great deal of insight on Willie's health, what blood tests mean, etc., and while the up front cost was high, I've easily recouped that over the past 8 months in what I've spent on supplements (I am blessed to have a source for free venison) and organ meat vs. what I would have paid for a prescription diet. It might be an option worth considering as it would allow you to exercise a very strict control over what LB is consuming while still addressing all of his health problems concurrently. from everything I've read, cats with digestive issues tend to thrive on raw diets. Beyond all the stuff we typically talk about with dry food, one thing that gives me pause about your vet's recommendation is that dry food creates greater burdens on a cat's digestive track. You're talking about a great deal more waste having to be pushed through the system, as opposed to raw, which puts little to no burden on the intestinal tract because the cat processes and uses such a large percentage of the food. I think Willie has bigger poos than most on raw, but they are still tiny. My Miss Belle's poos were often the size of a pinky nail.

    I'd consider doing a second opinion consult with Dr. Lisa. I have found that working with her has really empowered me to make good decisions in situations where I was being pulled in many directions... she's not just about giving you "the" answer, but rather explaining all the factors and considerations in a way that you can understand so that you can converse on a more in-depth level with your vet and can make decisions with confidence.

    Good luck!
     
  9. Karrie and Maverick

    Karrie and Maverick Well-Known Member

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    Oct 22, 2010
    This group helps thousands of cats with diabetes. They follow a proven protocol. If I had to chose a vet over this group it would be this group hands down. Vets talk like they know but they don't. They are old school and are not up on the latest knowledge. It is your cat, but I think your gut knows that high carb is just wrong for diabetes. You will never ever be off insulin on high carb food. Maverick was off of insulin for an entire year just eating low carb wet food. We put him on kibble to help with constipation (long story) and within a month he was back on insulin. Following this protocol cats go off of insulin - its the whole point of this forum. Tight regulation to help the pancreas get back into working order.

    There is an amazing yahoo group on pancreatitis. Have you joined it?

    The internet has put knowledge in our hands. Vets are generalists and just cruise on what they learned in vet school which is very outdated. These groups like FDMB and the Pancreatitis group and Tanya's CRF site involve thousands of members that are up on the latest treatments and knowledge. Many vets do keep their knowledge current or do listen to us when we bring in journal articles. With some vets it's "my way or the highway". I chose to find a vet that was open minded and read the Rand Protocol for diabetes management. She was on board with the treatment plan of this group once she read it.

    There are options for cats with food sensitivities. You are your cat's advocate though. You have to be strong for them. You wouldn't listen to a doctor that sold snake oil. You'd go on the internet and learn about your disease.

    Welcome to LL. We have all been where you are right now and understand the discomfort. Stick around and you will see its a wonderful place and the experts here know what they are talking about.
     
  10. Angela & Blackie & 3 Others

    Angela & Blackie & 3 Others Well-Known Member

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    Mar 15, 2010
    PLEASE consider switching LB's food to wet. It will be much healthier for him if you do, and certainly much easier for his system to handle.

    Dry food is not good for a diabetic cat, especially the vet's pet food (either wet or dry). I know. I've been there. We all have. I could write you a story about what happened when Blackie was on the dry, and then switched to the vet's wet food (both products were Hill's Prescription Diet W/D formula).

    All I can say is that I'm now feeding her a no carb diet of Evo 95% Chicken & Turkey, and because of it, her #s are improving nicely. You can look at everyone's spread sheets and see what's going on with their kitties. The same thing can happen for LB if you let it. Some of the kitties on here are being fed nothing but a raw diet whereas others (including Blackie) are being fed nothing but wet food, with perhaps cooked boneless skinless chicken as a treat or a midday meal. If she finds kibble, I'll know it. :lol: Trust me, she can't hide from the Momma Bean.

    I trust my vet... To a point. With regards to Blackie's diabetes, I trust the FDMB more. I have more confidence with this board, and trust that they'll help me to help Blackie, and will continue to help me with her for many years to come. And for that, I'm eternally grateful. We all are. I'm just glad that I found them.

    You'll be cutting down the vet costs, too, if you're not taking him every weekend to get his BG checked. :smile:
     
  11. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Marilyn:

    I can't remember (and, frankly, didn't want to try to plow through a year of your posts) if you had ever tried an elimination diet with LB? I know there's at least a couple of cats here where the vet suggested a plan like this to narrow down what the allergen(s) were.

    Also, Royal Canin has a GI diet but also several varieties for cats with food allergies. If you Google the product, the different formulations are listed. Also, several of the allergy formulas are available as canned food. I don't know what's available in Australia, though. I'm sure if you contacted Royal Canin, they would be able to tell you what's available in your area and who may supply the food.
     
  12. Angela & Blackie & 3 Others

    Angela & Blackie & 3 Others Well-Known Member

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    Mar 15, 2010
    Please consider following Sienne's advice with regards to the wet foods. She won't steer you wrong. She's helped me and others on here numerous times, and she continues to help us all.
     
  13. Marje and Gracie

    Marje and Gracie Senior Member Moderator

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    May 30, 2010
    Correction to my earlier post; the newest test for pancreatitis is specific FPL.....I put specific PLI. ...sorry.

    Also..Iams has a low residue GI diet, too, if you can get Iams....canned.
     
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