Angel's bg up due to vet giving wrong food.

First the good news, Angel is doing ok, now the bad news.

I am so furious and upset with the vet hospital. When I took him last night, I took in a can of the purina dm and offered to leave it. They said oh it's ok, we have that here. I was told vet would ring at 9.30. Well I did not sleep until after 2 as I was worried, if I'd thought they would ring earlier I would've taken sleeping meds. 7.30 the phone rings. (this is the hospital branch of my vets, so not usual vet)

'oh Angel's doing fine but he's not on remission because his levels were high again this morning. He's eating the Hills MD'
'But he's not on the MD, he's on the Purina DM, no wonder his levels are high'
'We don't have that here'
'I was told that you do'
'well sorry you were misinformed'
'can I bring the food in later so you can start the curve with the correct food?'
'we've already started it'
'so the results will be meaningless'
'some cats go into remission on md, its a very good food'
'but the one he's on is less than half the carbs. I'll get him home, put him on the reduced dose, put him back on the purina and chances are he'll have another hypo.'
'well have another curve done in a week's time'.

I'm fuming and have been in tears. Not only because Angel's being messed around but also because I'm on disability and I'm going to have to pay a fortune for a curve that's absolutely meaningless, and for the next week I won't be able to let Angel out of my sight in case he goes into another hypo. Maybe if I left now with the food it would make a difference but I'm so tired and shaky, I can't afford £30 cab there and back, it would take me an hour each way. I feel I'm letting Angel down because I'm tired, but I'll be no good to him if I make myself ill too. I'm going to try to sleep now for a couple of hours, so I can be strong and maybe argue the point that I should not have to pay for this curve. And now I have an extra week of watching Angel and wondering if he's going to go into another hypo, maybe I shouldn't have taken him after all, I should have got him through this on my own and had the curve done with his proper food at my own vets. I'm going to call my own vets later anyway and tell them how unhappy I am with their hospital.

Not sure how I will sleep whilst I'm so wound up but I must so I can cope with fighting my corner (Angel's corner) at the vets. And now I'm worried why his blood sugars are all over the place if it's NOT remission.

Will check back in a couple of hours when I've hopefully caught up on sleep. Oh yeah, they were supposed to call me 20 mins ago to tell me the latest I could bring his food in by, they will probably call me just as I've got to sleep.

GRRRRRRR!!!!!

You have every right to be upset. i would have told them not to do the curve and picked up my cat. I wouldn't pay either. do you test at home? If you can test at home you can do your own curve. It will save you a lot of stress and money. More importantly, it will be done right. Tell these vets this story. A member here has a cat likely in remission. Her cat got into her chocolate milk and his BG went way up. It took a little detective work to find out what had happened. Tonight her cat is back down to 32 and will likely start a trial to see if he is in remission.It took about 24 hours for his Bg to go back to very low normal. Good luck.

Elise

(((Cassandra))),

I agree with Elise; you have every right to be upset. I'm so sorry that you're finding yourself in this postion.

You are absolutely not "letting Angel down". You are an amazing care-giver and are doing the very best that you can for him.

It might well be that Angel is going to go into remission. We can't be sure of that, but there are some hopeful signs of recovery.
As the pancreas heals it is able to produce insulin (or produce more insulin). Some cats produce insulin consistently and the blood glucose numbers get lower 'across the board'. Some cats produce insulin intermittently at first, 'in fits and starts'. I think Angel is producing insulin intermittently. But the chances are that it will become more consistent (no guarantees though...).

The fact that diabetic cats can recover enough to produce more insulin is wonderful. But it can also present challenges for the care-giver when it comes to dosing insulin. And getting 'spot check' blood tests during the first part of the insulin cycle can become vital.

My Bertie has a 'sputtering pancreas' that produces insulin intermittently, especially at this time of year. At the moment I find that doing tests early in the cycle, say +1 and +2, helps enormously in predicting how much his blood glucose is likely to drop.
Very often, if you spot early on that the blood glucose is dropping, it's possible to 'steer the numbers' with food to avoid the BG dropping too low. Sometimes a couple of low carb snacks may be sufficient. Sometimes higher carb is needed. (And sometimes even glucose is still needed if the food isn't enough to keep the numbers dropping too low (as happened to Bertie just a few days ago)).

Chin up, sweetie. All is not lost. On the contrary; Angel is actually doing very well. His improvement is just throwing you a few more challenges....

I hope you do manage to get some decent rest.

Huge reassuring hug to you,

Eliz

Yes, absolutely agree with the others, Cassandra, you have every right to be upset. We all manage these situations differently of course but I would probably be so angry that I would demand to speak to the most senior person there and explain the situation about the food and how you know its importance in treating FD from your own knowledge on the subject. Fact is, you probably know more than the vet - they have very little training in FD. I wouldn't pay for the curve either, I'd say it was carried out in circumstances (ie the food) not to your specification and as agreed before it started. Very bad practice on the part of the staff there. If you can manage it, stand your ground and don't let them bully you.

Try to get some rest and strengthen yourself. We've all been in a similar place and understand how hard it is. Keep writing - about anything...

Diana x

thanks everyone for keeping me sane!

I'm still furious. The vets never rang me back until about 1/2 hour ago and nothing about bringing food down. Angel's bg was 30 on an alpatrak (540) this morning, I have NEVER got such high readings but they did point out that he had been given no insulin between the 1.5 u at 2pm yesterday and the 1 u at 7am today.

Yes I do home test , but takes me so many stabs to get blood sometimes that I didn't feel I could put him through being tested by me every hour.

The vet I was talking to got called away on an emergency and I called back just now (over an hour later), spoke to her, and made the point that when I signed the consent form I believed that the curve would be done when he was on the purina, and had they called me and said they wanted to to a curve on the Hills I would have refused permission and asked them to wait until I could bring the food in (the food THEY told me to take back) She did say there were other factors eg stress but I pointed out that would just make the curve even more inaccurate than what I'd get if he was home being fed half the carbs.

I suggested they keep him in overnight (free) and do another (free) curve tomorrow seeing as the results for this one aren't going to be much use. Even if I wasn't on disability, why should I pay for THEIR mistake? (I didn't say that)

She kind of diffused the situation and asked me to call back at 4 for an update on Angel, so I think I'll have a fight on my hands. The vet in charge of the clinic is lovely Jeremy Stewart who used to be on Animal Hospital (with Rolf Harris....aaaargh!!) so maybe I will go in all dolled up and demand to see him and flutter my eyelids a bit.

Can't believe my poor boy is going through all this for nothing, they said he was a bit stressed there (he is the most laid back cat ever) and I felt like saying well I'm a bit ******* stressed here too!!!

AAAAAARGH!!!

Going to sit out in the sun for a bit and listen to chill out music.

Oh darn! Don't feel I can use the actually words here that I want to use to really express myself on this mess the vets left you and Angel in.

Sweetie, know that we are in your and Angel's corner too. Push back, and push back hard at the vet. They really did make a mess of things and it's no surprise to us that the curve being done at the vet is much higher than what you would get at home. You already said he was really stressed.

While he may not be in remission yet, he may be headed there. Will keep all paws and fingers crossed for you.

Sending you kilos of hugs and calming vines.

Hang in there. Vent here whenever you need to.

Sorry, have to head off to work now. Hope the news gets better as the day goes on.

Just my opinion, but I would pick up the cat and bring him home. You are doing so much better than the vet. I know you need to practice your hometesting, but you cant use the curve the vet are doing to anything good. The cat is stressed and have had carbs. I dont think most people with a diabetic cat bring their cat in for a curve unless they dont hometest. You tests will be so much more accurate.

The way you reacted with the hypo last night was so goodand you did all the right things. What the vet did after you brought him in you could do yourself, you were allready doing it, but in the beginning low numbers are scary, so i understand your reaction to bring him in.

You allready show so much more understanding in this dicease than what it sounds like your vet has, and within the next few weeks you will only learn more and be better at the bg testing.

Lower his dose to maybe only 1 unit and keep posting in here. So many experienced people that will help your cat in remission if it ispossible. And I believe it is.

Thanks Charlotte and Prop/Deb and Wink.

I'm supposed to call them in half an hour.

Being as they are doing the curve now I don't think it will make any difference how hard I have to fight to get a correct curve done. Meanwhile I called the specialist feline diabetic remission clinic who put him on the purina in the first place, and sent them a copy of his spreadsheet and what is happening. Ruth from the clinic called me back and is going to try to speak to Stan (my normal vet) who is lovely, and ask him to talk to the clinic. Stan knows I am on limited funds and is totally against any unnecessary testing for any animal, not just my babies. Ruth said worst case scenario they would send me home with a 'safe' dose of insulin and I'd have to get another curve done in a few days. (if ONLY I could get blood from his ear first time I would do it myself). She agreed with me that it was more than understandable that I took Angel to emergency, but I probably could have coped at home. After all I'd got his bg up from 2.5-3.4 (45-61) in 18 minutes, and 16 mins after that it was 3.6 (65) plus he was no longer ravenously hungry. Then I could have taken him (and his food) to my regular vets first thing today.

I meant to say this before, when I really thought he was going into remission, but if he does go otj and is fine, no way would I abandon this board, it has already given me so much and hopefully I can help others too.

UPDATE...rang vets, not entirely pleased with results but what can I do. They're sending him home on 1 unit and want to see him again on Thursday. 'as a gesture of goodwill' they have offered me 50% off his next curve, but I'm not sure if that still stands if I have it done at my local branch. I asked to see the head vet at the hospital but he is fully booked for tonight, but if I was to take Angel there on Thurs instead of my local vets, I could see him then. My lovely dad has paid today's bill of over £330.
x

Have you tried the suggestions in how to get the eats to bleed? Some warm rice in a bag. I rub Max's ear until it feels warm. I also use needles at times instead of a lancet, size 23g. My vet taught me that way. Do you have the lancets for alternative sites? They are a larger gauge, 25 or 26. Watch some videos on you tube. This will keep kitty safe and save you a bundle. I would be afraid to shoot blind after your experience so you have to figure out how to test yourself. I'm not trying to scare you but I am concerned. I'm so sorry you are going through this.

hi Tiff, thanks for your reply.

I would never shoot blind. If I have to get a blood sample I will do it somehow. Occasionally I can get a decent blood sample first go, but sometimes it's taken me about 10 goes, so that's why I'm not really comfortable doing it every hour. His ears always feel lovely and warm, but I will try the rice suggestion too. I'll watch all the ear testing videos too.

At least with it being a 24 hour vets my friends can take me to pick him up around 9.30 after we've had dinner at their place, will save Angel the stress of going in a cab.
x

I swear by the needles!! I almost never need to stick more than once. You would likely just need a box of 100. I use terumo but don't know if you can get them. Any size 23 will do. You can give them a try and if easier reserve them for curve days. They made all the difference for me.

Elise

Thanks Elise.

I'll have a think, still a bit nervous of freehanding tho.
Some slightly better news from the vets, they were feeding him the Hill's wet not the Hill's dry.

x

I swear it is easier free handing. You have more control.

When we do a curve, it's only testing every 2 hours. You may not feel that you have the testing down yet to get those curve tests, but soon you'll be an old hand at it.

oh...I'm twice as furious with the vets now.

When I took Angel in, I told them he'd had 2 units at 2 pm. I'd also e mailed them his up to date spreadsheet which I know they got because they discussed it with me. The last phone conversation I had with them they were like 'oh well we're sending him him on one unit because he had a hypo on 1.5 units.
'no, he had a hypo on 2 units'
'it's in his notes he had 1.5 units yesterday at 2pm'
'no, as I told you when I came in, and as it says on his spreadsheet, he had 2 units yesterday. He had 1.5 units on SATURDAY'
'oh, well in that case 1 unit is probably a bit low for him but we don't want to change it again.'

When I picked him up I found out who to complain to, and asked nurse 1 for a copy of his bloods. Whilst they went to get that, my mobile (cellphone) rang and it was nurse 2, obviously to see where I was. I said 'I am standing in your reception right now' 'oh sorry, no one told me, I'll be out in a minute.'
Nurse 1 returned with (high!) curve results scribbled on a piece of paper. Nurse 2 appeared and had a chat with me. I asked them what time he was given insulin, can't remember which nurse said what, but one said it was 8 and the other one said no it was 7, oh yes, sorry, it was 7.

AAAARGH!!

Anyway, I've got my big ginger bundle of love back, first thing he did when we set off was throw up bile, which he's never done before, but now he's home he seems happy. I've given him a 6.6% carb food rather than the usual night grazing of 0-2.2, coz I don't want to test him until pre shot, he's been through enough. First thing tomorrow I will be straight on the phone to my local branch talking to Stan the vet there who I trust, and I will have his curve done there on Thurs. What a nightmare!!! My poor boy. I'd be just this angry even if I was rolling in money, it's the fact I took my baby believing it was the best place possible and they're a load of scr*w ups.

xxx