vet's questionable recommendations

Our cat's numbers have been staying in the 300's after jumping all over the place. (Yes, yes, I know we were only giving 1 unit of Lantus at the beginning in the AM. Yes, I know we did not always give the two shots 12 hrs. apart. These are things I learned about after coming onto this forum.) My husband sent the vet a copy of Spot's SS and spoke to her this evening. Here is her recommendation: 1 unit in the AM, and if his BG is over 260 in the evening, give .5. It it's under 260, no shot.

She also asked him why we're not giving him the Purina DM. He just said it was too expensive and we're giving Spot a low-carb diet.

So, what do you think? My husband and I are fighting about this now.

People keep saying this gets easier, but when?

Jennifer

 

Your vet has no clue how Lantus works...period end of statement. What she is suggesting works great for NPH or PZI/Prozinc which are basically in and out insulin, not an insulin like either Lantus/Levemir which builds and works off a shed or depot under the skin (sort of a spare tank) Plus by only shooting if Spot is over 260 he will remain an insulin dependent diabetic and lose all chance of becoming diet controlled. Renal thresh-hold is 250 anything above that and organ damage can happen.

I would also ask your vet to point out to you what special ingredients are in DM that make it so much better than what you are feeding him, bet she can't because there aren't any. In fact the vet that helped develop it no longer recommends it for her diabetic patients.

To be very frank at this point if Spot was my guy, I would be vet shopping.

After looking at Spot's spreadsheet I would up his dose to .75u and hold that for about a week then run a curve on a day off...You've have stopped his bouncing around now, and held the dose long enough for it to settle. it is showing that it isn't quite enough so it needs to go up, but you want to go up slowly and let each dose settle.

Mel, Maxwell, Musette & The Fur Gang.

 

Thanks. .75u in the AM and PM, right? This is what I was telling my husband. Unfortunately, it is hard to convince someone else that a dr. who trained for years doesn't know what you guys know.

One of the problems with .75 is being able to see it on the syringe. I must say, it's hard enough to figure out where .5 is.

I know, I want to vet shop. Wish I hadn't spent almost $900 there. She was someone we picked because our old vet said he couldn't handle cat diabetes. (He was just an old-time vet who did shots and the basics.) Worried the next one won't know much, either. Seems like most of them push the garbage food like Hill's. Guess I should see a specialist with internal medicine. Maybe I can spend $1000 there.

 

The vet is knowledgeable on animal insulins, but not human insulins, so you can't fault the vet for trying to apply the rules for animal insulins to a human insulin. I don't know why you are worrying about getting advice for dosing from the vet; I never got ANY dosing advice from my vets.

Lantus and Levemir need the same dose each shot, or you are going to have bumpy numbers. Why not make a deal with your husband to try the same dose each shot for a week and then see what the numbers look like.
And as for not shooting unless over 260..... some cats are always around 260 without insulin. I never heard of a vet saying such a thing..... over about 240 is causing damage to the cat's organs.... is that OK with this vet? Apparently so!

I have to agree; make a list of questions, and start vet shopping. There's no excuse for your cat to be in the 300s so much. Just tell the vet your cat won't eat that DM and when he does, he can't keep it down, so it seems to make your cat sick, and that's why your cat won't be eating DM, what's good about by-products, you can ask this vet.

Per Dr. Lisa:
Please understand that there is nothing 'magical' about the prescription diabetes-management diets. Several of them, such as Hill's m/d and w/d (dry and canned), Purina DM dry, and Royal Canin DS (dry) are all too high in carbohydrates. Purina DM canned is sufficiently low in carbohydrates (~7%) but it is expensive and it is predominantly liver which should not make up the bulk of a cat's diet. The prescription diets also contain species-inappropriate, hyperallergenic ingredients such as corn, wheat, and soy.
http://www.catinfo.org/?link=felinediabetes

Ingredients
Liver, poultry by-products, meat by-products, water sufficient for processing, chicken, salmon, oat fiber, salmon meal, guar gum, potassium chloride, carrageenan, salt, Vitamin E supplement, calcium phosphate, taurine, thiamine mononitrate, zinc sulfate, ferrous sulfate, niacin, calcium pantothenate, copper sulfate, Vitamin A supplement, manganese sulfate, menadione sodium bisulfite complex (source of Vitamin K activity), pyridoxine hydrochloride, riboflavin supplement, Vitamin B-12 supplement, biotin, folic acid, Vitamin D-3 supplement, potassium iodide.

 

I don't think there's any magic in that cat DM food.

Anyone else? My husband wants to do what the vet says. I go with what you guys say.

But, I don't know much. I am not sure what numbers he goes to where we DON'T give him a shot. I don't think it would be 260!

 

Jennifer,
The only "magic" in DM is how magically well it lines the pockets of Purina and the vets who prescribe it. The ingredients are no better than many foods you can buy at pet stores and grocery stores.

The normal "no shoot number" for newer members is 200. With Lantus, eventually you would shoot lower numbers than that. But generally, that is the "line in the sand" until you are comfortable with dealing with lower numbers.

Carl