Vets

Hello,
I have a newly diagnosed cat and am having lots of issues with my vet about my part in the management of her diabetes. My vet discourages home testing, but will reluctantly agree only to my using an animal monitor. She will not allow U-100 syringes (my cat is on Pro Zinc U-40 syringes). She will "fire" me if I start changing dosage on my own based on home testing results. Bottom line: what are other's experiences with vets? Have many of you had to shop around for a vet who is willing to involve you in the process?
Thanks!
Sandy

 

Dear Sandy,

Sorry to here you are having such a hard time with your vet. FWIW I would shop for a new one, personally I want to be a partner with my vet regardless of what is going on with my animals, not just my diabetic. For ultimately they are my babies and if you aren't going to work with me, and keep me in the loop when it comes to tests, and treatment, then I will find someone who will. I know my animals best I live with them day in and day out, a vet does not and cannot ever know my animals as well as I do.

You do not need your vet's permission to test your cat at home. And depending on where you are located you might not even need them to write a script for the u100 syringes. I know where I am in Nebraska, I can simply go to any pharmancy and just purchase what I want.

And you certainly don't need a specialized meter for pets only, almost all of here use the same ones that humans use. I personally use the Relion mini from Walmart and have had excellent results with it. With the advice of this board and home testing currently my Max is in remission. We are more than willing to help you in any way to make sure your baby gets the very best care. Lori & Tom run a newbie kit program here that can get you all the testing supplies you need to get started for the cost of the shipping, if you would like to go that way. We can help you learn to test at home, help with diet and dosage until you can find a vet that you are comfortable with and beyond.

Welcome to the FDMB family.

Mel, Max & The Fur Gang

 

It is difficult when someone you would like to see as a partner in your cat's care wants to control everything, even things you feel aren't going to help. My vet didn't know anything about hometesting and not much about the value of a wet lo carb diet. But, she was willing to work with me.

And I think that is what you need - someone who will respect your opinions and be willing to work with you. Hundreds of us have used human meters and been successful treating our kitties. There isn't anything wrong with the AlphaTrac. It is just too expensive for most of us to use and the strips can be difficult to get in an emergency.

If you want to add your city and state to your subject line, maybe someone will know a good vet near you.

 

If you feel that you can't work with the current vet, then go ahead and find a new vet who is supportive of your choices. Here is a site that you can look at to see if you do need a new vet: http://gorbzilla.com/decisions_decisions.htm

Here are questions to ask a new vet: http://gorbzilla.com/questions_for_your_vet_.htm

Where do you live? There may be a member who lives nearby and can recommend a good vet.

You *can* use U100 insulin syringes with ProZinc. With U100 insulin syringes you can fine tune the insulin dose. Be sure to use this chart to ensure that your cat is getting the right amount of insulin: http://felinediabetes.com/insulin-conversions.htm

You can buy U100 insulin syringes at any pharmacy. Some pharmacies do require a prescription. If you live in the US, You can buy insulin syringes online from places like Hocks.com with no prescription.

You don't need an animal blood glucose meter. A Human one works just fine and is less expensive.

The vet who DXd my cat with diabetes was ok. She was ok with hometesting and a low carb diet. She wasn't all that familiar with the different insulins so we started with Humulin N for a couple months before changing to Lantus per my suggestion and frustration with how Humulin N was working. 4 years later my cat's bgs weren't really going anywhere but vet said he was doing well. So I switched to a great vet at a different vet hospital. With the new vet, bgs became better regulated and we even tried Levimir insulin which the previous vet had never heard of and was reluctant to use.

 

at the time i didn't have a lot of choice in the matter so i'd just smile and say yes to the vet but do what i wanted at home. problem is this vet expects you to buy your syringes from her as they're animal syringes? U40? you'll have to let her know you've found cheaper suppliers online and do not intend to purchase from her. or say nothing. she probably has a lot of clients and won't even notice whether or not you're getting syringes from her.

it's easy to do the conversion at home and you can dose more accurately with the tinier increments of the half-unit U100 syringes for U40 insulin.

the only problem is if your vet expects to run curves at her office and stick to the dose she recommends. that could be an issue if your cat ends up on a much lower dose. if she's at the vet in an emergency or while you're on vacation or away, the issue could become critical. you're going to have to tell the vet that you will be doing curves at home because your cat's numbers are more realistic in her home environment and you cannot afford the expense of curves at the vet.

i'd just say look for a new vet and in the meantime if you feel you're getting good advice and know what you want to do, you're going to be in charge of your own cat's treatment. it's so much better to learn on your own what your specific cat requires, anyway, and that can necessitate dose adjustments at home. what's good about this is that most of us adjust doses in 0.25u increments rather than the 0.5u or 1u increments used by many vets. in addition, some vets don't remember that cats can test at much higher blood glucose levels at the vet because of stress, so the dose at home may end up being much lower.

the vet we originally went to didn't know what she was doing re diabetes and was arrogant. i switched vets 2 times at her practice til i found one who trusted me enough to discuss what i was doing at home and okay dose changes i was making. i'd fax him cleo's readings periodically and we'd discuss the dose on the phone every couple of weeks. when he saw how great she was doing on the dose changes i decided on, he pretty much let go and just asked current dose whenever i brought cleo in for something.

 

It's best to find a vet that you can work together with. Although you can get the proper syringes without a scrip, insulin still requires a prescription in most countries. Unless you're in the UK or Europe, you might end up considering Lantus or Levemir at some point because cats do so well on it. Some of the old school vets haven't gotten current on the best treatment protocol for cats and refuse to prescribe Lantus or Levemir because they never got familiar with it.

Another issue with some vets is that they just don't like treating cats--the ECID (every cat is different) caveat drives them nuts. I'm lucky that the two vets at my local practice (five minutes from my house) love the challenge, but one of them remarked that feline veterinary medicine has a way of making him look stupid on a regular basis even though he knows what he's doing because the symptoms overlap for so many conditions, and cats are so good at hiding their symptoms altogether.

Short term, do what you need to do to give your kitty the needed treatment. Long term it might be best to shop around.

 

I am so sorry that your Vet is not supportive of your wanting to manage YOUR cats diabetic needs at home. For quite a few people there would be no way of financially working with a Vet when YOUR cats BG's should be checked before the am insulin dose and before the pm dose along with mini curves or spot checks. How does your vet expect YOUR cat to become regulated. Having an acro cat there is no way I would not do checks quite a few times a day. If it were not for a dynamite vet who totally supports and encourages home testing, on going education about feline diabetes and mostly this website I do not know how I would handle treating my sugar kat and I am a Vet tech.

If you notice I am capitalizing YOUR when I mention YOUR cat,it is because the vet cannot "permit" you to not test at home.
They do not own your cat, you do. It sounds like an ego problem with your vet. Also sounds like a way to make sure you spend money with them. Can you say "control". In my humble opinion, time to find a new vet who will support your wanting to do what is best for both you and YOUR cat. Most vets who are comfortable with their teaching abilities and their knowledge of feline diabetes will not have a problem supporting your wanting to provide the best care your cat can get and that is with you at home. Only the owner can provide those weird spot tests in the middle of the night, extremely early in the mornings, on the weekends,and supply special feeding times and with all the personal ways you know your cat. There has been so many times that I notice something way out of the norm for my cat that his vet would not notice and she knows him well.
I know when his numbers are high just by the little way he twitches his tail, the way he lays on the carpet by the front door and the way he is impatient with his civvie buddy who he loves. Your vet will not know those little things that trigger you to do a spot test and increase or decrease your insulin. They will not be there when you notice a possible hypo.
If anything go for a second opinion or call around and ask how the vets feel about home testing, if the vets do not like it move on. You are your cats voice and you supply the best care especially with the help of a supportive vet.
Best wishes. Follow your gut feelings.

 

Hi Sandy,

Home testing has been heavily promoted in all of our vet journals for the past many years. My more 'enlightened' colleagues would STRONGLY urge you to home test - not discourage you from doing so.

You may have to search for one of my colleagues who is more willing to work with you on this issue. It is my strong opinion that the only way to *optimally* manage a diabetic cat is with home testing. No question.

Also, you do NOT need to get locked into the expensive "animal monitors". The strips will break your bank.

 

Your vet needs to update his education about Feline Diabetes.

Not only does my vet support hometesting, they also give newly diagnosed patients meters for testing. I have donated a lot of meters over the years and they greatly appreciate and look forward to my donations.

Where are you located? City and state only. Maybe we have a member in your area that can recommend a vet.

 

Well, first of all, I am just blown away by the knowledge and support from this website. Thank you all so very much for your input. It is invaluable to me!

Now that I am home testing and adjusting doses accordingly (with the help of an experienced local FDMB member), I know I have to find another vet. Unfortunately my DH's mother passed away this morning, so it's going to be a hectic and emotional next few days. So, I am going to postpone my vet appt. for tomorrow, and start making calls to other vet clinics. I have to get something lined up because I'm running low on insulin--maybe have a couple weeks' worth left?

My location is rural Iowa, but I am 15 minutes from Omaha, Nebraska. I have been researching vet clinics' websites in Omaha and found two who look pretty good. One has a vet who has a special interest in nutrition, and even has a link to this website in their "Links" section! Only problem is the woman vet on staff (Tessie prefers women) has only two years' experience. I wonder if that's enough? There is a wonderful looking "cats only" clinic in Omaha, but it is at least 45 min. away from me, so that won't work. Tess gets too stressed in the car. But I may call them for information anyway.

Thank you all again so very much. I still haven't gotten my spreadsheet done, but fully plan to do it asap.
Sandy

 

Welcome Sandy and Tessie from a fellow CornHusker!

Glad to hear you 1) are home testing. 2) That you hooked up with a FDMB member...your off to a fantastic start.

Wish I could help you more on vets, we have a great one down here, but I'm thinking 3 hour drive just isn't worth it...lol (I'm in Hastings).

Just wanted to pop in to say Hi and welcome to the best place you never wanted to be, but so happy you are.

Mel, Max, & The Fur Gang

 

A young vet who is willing to learn and communicate might be better than one that has been working for 30 years and stuck in old ways.

 

I would at least give the young vet an interview.

An opportunity to get a young vet started on the right foot.
Probably more open-minded than an older vet.




Have you read the 'questions to ask' link someone else posted
in this thread ?

 

If the traveling stress prevents you from getting the kind of care you want for your cat or significantly impairs your cat's health, you might consider doing some training to make the whole carrier, car, motion, etc a less stressfull process for the cat.

If so, continue reading.

Positive reinforcement and positive associations with travel-related stuff may reduce travel-associated anxiety when used in a systematic desensitization program.

You might start by leaving the carrier out, with a comfortable towel or blanket, lightly spritzed with Feliway or sprinkled with a bit of catnip. The carrier can become a regular, safe place to hang out and that helps reduce stress when used for traveling.

Active training sessions are typically 5-15 minutes 1-2 times a day.
You might have short sessions where the crate door is shut for a minute or so, then opened and the cat given a small, low-carb treat. Repeat several times per session. Do this for as many days ... or weeks even ... until this can be done with the cat relaxed.

Progress to lifting the cat in the carrier with the door shut, putting it down and treating the cat.
Repeat several times per session. Do this for as many days ... or weeks even ... until this can be done with the cat relaxed.

Then on to picking up the carrier, walking a few steps, putting it down, and treating.

Picking up the carrier, walking outside to the car, putting carrier in the car, {treating here may help} removing carrier from car, back to inside home, and treating. It may help to have the car spritzed with Feliway ahead of time.

Add the car turning on, then off.

Car moving a bit, then back

Car moving and extending time a few minutes.

And so on - each new step is a small progression to the final desired result of a cat who will tolerate travel by car and not become overstressed.

Its very definitely a process, not an event. And anything that helps reduce future stress in traveling, is one less problem if you have to go to the vet in a hurry.

 

One of my cats that is aggressive with strangers does much better if we carry him in a cat sack instead of putting him in a crate/cage. http://www.flickr.com/photos/26710695@N07/2588999898/

This cat sack is slippery, so I hold him in my arms while hubby drives.

 

Thanks to everyone for the great ideas and suggestions. Our old vet was great but he retired two years ago. I will let everyone know what happens in my vet search over the coming days. Wish me luck--at least I know what I'm looking for in a vet now. Oh, and regarding syringes, my current vet says non-vet manufactured syringes are not made the same and can break off in the animal, which is really a bad situation. She says the "hub" of the vet syringes are reinforced to avoid that. Anyone heard of that, or had the needle break off?

 

Ask anyone here who uses U100 and U40 insulin syringes and they will tell you that needles do not break off while inside of a cat. You tent the skin, stick the needle in, inject, and pull the needle out. There is no way a needle can break off, even if a cat is fidgety.

 

the thing about hub reinforced needles gave me a chuckle.
in the thousands of hours i've spent here i've never seen a single post about a needle on a syringe breaking off. that sounds like a scare tactic, plain and simple.

 

what utter bullsh*t. If they aren't good enough for our cats, do you really think that they would allow people to use them? good lord, this is a new one (and I've been here since 2002...)

Jen

 

I have had a few needles bend on me, but they have always been when I was uncapping them before even drawing the insulin because of something I have done inuncapping them but never has one broken on me. Plus I can't see how the "hub" would make a bit of difference as we are taking about the needle breaking not coming detached from the hub. I honestly think if there was any problem with them as long as this board as been around and as many sugarcats that are here, and using human syringes there would have been some kind of warning here about it.

This sounds to me like a vet that is just trying to squeeze an extra dime anywhere they can out of their clients. /sigh

Mel, Max & The Fur Gang

 

Get another vet - sooner than later! Your vet sounds like my old one who nearly killed my cat and then wanted to put him to sleep to cover up her errors. This vet did not want me to home test and obviously her interest was only monetary.

Judy & Jake (in remission now for 7-1/2 months due to the input from this board, hometesting, and a new vet)

 

Wow. Maui's former vet actually forbade me from home testing. And refused to treat her if I didn't leave her there for several days to get regulated. I won't go into the rest of the story, but you get the idea.

I took the time and called the vets in my area to get a better understanding of their practice and then made an appt with one office who said what I wanted to hear. Maui and I never looked back.

And regarding the syringe thing, I was in the local walmart pharmacy picking up syringes for a cat I was caring for and asked the pharmacist for short needles not long. He asked if this was a pet (cat's name was Blue), I said yes a cat. he said well you can't use a short needle, why not I asked, he said, because what if the cat moves and it breaks. ohmygod_smile

I told him, that won't happen and has never happened with my own cat. I insisted on the short needle and just ignored this uninformed pharmacist.

I've bent syringes, but that's been when I carelessly tried to put the cap back on after use and didn't pay close enough attention (I usually stuck my finger in the process). :lol:

So, yes, start making those calls and find yourself a new vet who is willing to partner with you.

As I said to the new vet, I need you to join Team Maui and not be an opponent.

 

ok, i have to fess up about something. waaaaaaaay back when, i read about what i thought was a brilliant idea about using an empty insulin vial to "break" off the needle part of the syringe for easy disposal. HAHAHA! the idea was something like stick the syringe into the rubber part of the empty vial and wiggle back and forth and it would break off, allowing you to then toss the syringe and then later safely discarding the needle ends. think taking a paper clip and straightening it out, wiggle wiggle and it snaps right? again HAHAHA!! i stood there for over 5 minutes trying to get that stupid needle to snap off the syringe. i'm sorry, but i simply don't have time for that crap morning and night.

fwiw, i've been sticking insulin needles in Mousie at least twice a day, sometimes three times, since september 2006 and by quick calculation, minus the first 3 weeks when i was using U40 syringes, that comes to roughly 3100 syringes. not once have i had an end break off of one, except that one night when i was stupid and tried the experiment above :lol:

yes, vets make some profit on anything they sell you and yes that allows them to pay their bills so they can keep their doors open and be there when we need them. and to be honest, as a business owner, that's totally sensible to me and i have absolutely no problem with it. buttttt, i respect the vet more that just tells me that and doesn't bother with the load of crap. :smile:

 

I had to laugh about what your vet said about "veterinary syringes" being different from human syringes. I find this so amazing being as the vets use the exact same syringes as human doctors use. Monoject, BD, Terumo etc, etc, they are all the same syringes used with humans andddddd....they are made by the same companies. Veterinarians use quite a few of the same medications as humans. I believe the only insulin that is different is Vetsulin, PZI but the syringes are the same. Some human insulins are U40 some are U100. What is your vet talking about??? He certainly does not give you much credit in the knowledge dept but he does show that he is full of himself. Too bad that makes his entire clinic look bad and clients look elsewhere. I am glad you found FDMB. This website is so great.

 

Interesting feedback on the syringes! Well, nuff said. I fired my vet yesterday, and Tessie has an appt tomorrow afternoon with a new, "enlightened" vet who spent about 20 minutes with me on the phone yesterday. She sounds very knowledgeable and up to date on feline diabetes, and is open to home testing. She zeroed in on the fact that the vet I just fired never did a culture on her urine. Since she has had 5 UTI's in last 2 years, coupled with the fact that Tess is only 4 years old, the new vet wonders if something else is going on.

Wish us luck! I'll keep everyone posted.
Sandy and Tessie

 

FIVE UTIs and NO CULTURE? Yikes.

 

I actuality there can be differences between human and veterinary medical supplies. At least they are labeled differently. I have seen Monojet syringes and needles labeled as for Veterinary Use Only. Regarding the needles they were physical differences between the vet needles and the human needles previously ordered. have also seen (am looking at one now) Terumo 3 ml syringe with needle whose packagings says "...law restricts this device to sale by or on the order of, and under the supervision of, a licensed veterinarian."

 

Had a great first appointment with new vet. Tess has another UTI, but this time, vet did a culture so we will know if it is infection or inflammation.
Compared my One Touch Ultra with her Alpha Trax monitor. My reading was 164, hers was 160--yay! So, she is willing to work with me on home testing. Plan is to get infection under control first, then change from ProZinc to Lantis. To think this whole thing might have been prevented by a simple culture and appropriate treatment of antibiotic. Time will tell...

Regarding the syringes/needles, I have tried, but have been unable to find anything on the net that explains any differences in the manufacture of vet and human ones. Would really like to know the truth, so will keep researching that one.

Thanks again for encouraging me to change vets. It was definitely the right move, and I think I found a really good one that I can work with comfortably.
Sandy

 

I think you should probably bow to the collective wisdom of this message board that if there was any real chance that using human syringes was dangerous to your cat - that "we" (as a unified group) would know about it. I think its safe to say that if anybody here had a syringe needle break off in their cat there would have been a thread the size of Texas which somebody would remember.

I remember once we took in a just rescued dumped kitten - and we took him to our old vet to get blood tests/first shots etc. He had been a very sweet kitten until the car trip and arrival at the vet, and then he went nuts. It took 1 experienced vet, 2 experienced vet techs, and 2 pretty darn experienced (just not with him) owners to pin this 8-10 week old, semi-dehydrated, semi-starved kitten down in order to get the blood tests done. I'm still not sure what happened - at one point he was standing there quietly letting them shave his neck and the next thing I knew he was just about hanging off the light that hangs from the ceiling. It took all of us to pin him down while the vet tried to pull the syringe out. When he did manage to get it out, the kitten had bent the needle at a 45 degree angle and there was blood all over the table, the kitten, the vet, the techs and even us - and none in the damn syringe. If anything was ever going to snap a needle off that would have been the time. And in case anybody wonders, the cat was and is fine. Within 5 minutes he was snuggled up in my arms purring and falling asleep, although everyone else who was involved remains traumatized to this day but he has since had the same vet/techs and everyone else do several blood tests on him without incident.

 

Gina, you are so right about this board, and I didn't mean to imply I was discounting the group's experiences. I am in awe of this board and already deeply indebted to its members for all the advice, both here and on the PZI forum. I was just referring to Larry's post from yesterday about them being labeled differently. It would be interesting to find out exactly how they are each (vet and human) manufactured, and if they are exactly the same thing, just with different labels...? I'm not afraid to use the U-100s, and have been using them for a few weeks now. The new vet adjusted Tessie's dosage to 1.4 units yesterday, and I just referred to my conversion chart (provided by a FDMB member) and no problems. She had initially said 2 units, and I said I wasn't comfortable with that, and suggested the 1.4. She asked me if I was comfortable with using the U-100s to get the right dose and I told her yes, and that I had the chart to go by. She was cool with it.

As far as your little guy, and that terrible experience at the vet, I am amazed at how fast cats "get over" things. My Tess hates her tests and shots, and lets me know it, but is happy to cuddle with me minutes later.

 

soooo glad you have a better vet!

Jen