? Asking for prayers for Garfield

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Catcrzymom

Catcrzymom

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My sugar baby has had bg readings bouncing all over since he was diagnosed the end if January. I've been doing the bg tests as his vet has requested they be done. I've done some extra testing just for my own peace of mind.
He eats nothing but FF Classic and his treats are Pure bites or the Orijen treats. He was given antibiotics about 2 weeks ago for ear infection. He goes back tomorrow to see his vet to see how his ears are doing.
His bg readings the last couple days, especially today, have me concerned.
3/13 pre shot 675. 3/13 7hr post shot. 725. 3/13. Pre shot pm 698
3/14 pre shot 475. 3/14 4 hr post pm shot 209
3/15 pre shot. HI. 3/15. Pm pre shot. HI. Guide says HI means 750 or above.
I will do a 4 hr post shot test this evening.
He's been acting fine and eating well. He uses the litter box ok. Today though he acts like he's not feeling good. He did eat a couple treats. The last couple evenings he will become rather vocal for a few seconds but when I talk to him he lays down and purrs.
I called the vet today and she said to continue giving him his injection tonight and in the morning and to do a pre shot bg test tonight and tomorrow morning. She will see him in the afternoon.
I am really worried about him. I keep praying and crying that he will get better. I just don't see much improvements.
Any suggestions? I also would appreciate your prayers for Garfield, me and that his vet would be wise in knowing how to treat him.
Thank you for taking the time to read this and for any suggestions. :/
 
I am not familiar with Vetsulin but 6 units seems like a very high dose. Your spreadsheet only has a few readings showing but on March 7 he got down to 177 on the AT2 meter. This is not low, but shows that he could be dropping lower during the cycle (time between shots) and you may not be catching it. Vetsulin is a faster acting harsher insulin than the long acting ones like Prozinc, Levemir and Lantus. Vetsulin can bring the numbers down very quickly and sometimes quite a bit so it is possible he may be going much lower than you think and doing a "bounce" when the numbers go up much higher after low numbers or large drops. It is possible that the dose may be too high for him. Testing before each shot and then again at +2 and +4 after shot would give a good idea how the insulin is working.

If you change your title to something like "Vetsulin user needs dosing advice" you will get more replied from people who use Vetsulin and could gibe some insight into it. Also if you out the "?" icon in your title you will get more attention on your post. To the right of your title there is a drop down box called "Thread tools" if you click on it it will give you the option to edit your title. When editing your title there is a box on the left that says "No Prefix" If you click on it it gives the choice of putting a "?" in the title, which will get more attention.
 
I am so sorry Garfield is having trouble. I am sending prayers and healing vibes his way, and hugs for Mom, who sounds like she really needs them! As Tuxedo Mom says, it may be possible that he is bouncing, but without having the numbers in your spreadsheet it is impossible to tell if this might be the case. I don't know what to recommend, except asking your vet if maybe it's time to try a different insulin. We just switched from Vetsulin to Lantus and so far (anti-jinx, anti-jinx!) everything is going really well. It might be something for you to look into.
 
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Tuxedo Mom said:
I am not familiar with Vetsulin but 6 units seems like a very high dose. Your spreadsheet only has a few readings showing but on March 7 he got down to 177 on the AT2 meter. This is not low, but shows that he could be dropping lower during the cycle (time between shots) and you may not be catching it. Vetsulin is a faster acting harsher insulin than the long acting ones like Prozinc, Levemir and Lantus. Vetsulin can bring the numbers down very quickly and sometimes quite a bit so it is possible he may be going much lower than you think and doing a "bounce" when the numbers go up much higher after low numbers or large drops. It is possible that the dose may be too high for him. Testing before each shot and then again at +2 and +4 after shot would give a good idea how the insulin is working.

If you change your title to something like "Vetsulin user needs dosing advice" you will get more replied from people who use Vetsulin and could gibe some insight into it. Also if you out the "?" icon in your title you will get more attention on your post. To the right of your title there is a drop down box called "Thread tools" if you click on it it will give you the option to edit your title. When editing your title there is a box on the left that says "No Prefix" If you click on it it gives the choice of putting a "?" in the title, which will get more attention.
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I was using the wrong spreadsheet when I entered his bg numbers. I've since updated it.
Thank you for your suggestions.
 
Squalliesmom said:
I am so sorry Garfield is having trouble. I am sending prayers and healing vibes his way, and hugs for Mom, who sounds like she really needs them! As Tuxedo Mom says, it may be possible that he is bouncing, but without having the numbers in your spreadsheet it is impossible to tell if this might be the case. I don't know what to recommend, except asking your vet if maybe it's time to try a different insulin. We just switched from Vetsulin to Lantus and so far (anti-jinx, anti-jinx!) everything is going really well. It might be something for you to look into.
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I will see what his vet thinks about changing his insulin. It's apparent that the Vetsulin isn't working for him. Thank you for the prayers and healing vibes. I hope things continue to go well for your sugar baby!
 
Catcrzymom said:
My sugar baby has had bg readings bouncing all over since he was diagnosed the end if January. I've been doing the bg tests as his vet has requested they be done. I've done some extra testing just for my own peace of mind.
He eats nothing but FF Classic and his treats are Pure bites or the Orijen treats. He was given antibiotics about 2 weeks ago for ear infection. He goes back tomorrow to see his vet to see how his ears are doing.
His bg readings the last couple days, especially today, have me concerned.
3/13 pre shot 675. 3/13 7hr post shot. 725. 3/13. Pre shot pm 698
3/14 pre shot 475. 3/14 4 hr post pm shot 209
3/15 pre shot. HI. 3/15. Pm pre shot. HI. Guide says HI means 750 or above.
I will do a 4 hr post shot test this evening.
He's been acting fine and eating well. He uses the litter box ok. Today though he acts like he's not feeling good. He did eat a couple treats. The last couple evenings he will become rather vocal for a few seconds but when I talk to him he lays down and purrs.
I called the vet today and she said to continue giving him his injection tonight and in the morning and to do a pre shot bg test tonight and tomorrow morning. She will see him in the afternoon.
I am really worried about him. I keep praying and crying that he will get better. I just don't see much improvements.
Any suggestions? I also would appreciate your prayers for Garfield, me and that his vet would be wise in knowing how to treat him.
Thank you for taking the time to read this and for any suggestions. :/
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Big hugs to you....
Wondering if any BW has been done to rule out any other possible issue?
 
First of all, he is adorable.

That sounds like what happened to Diego. He was on Novolin 2u twice a day and kept having very high readings before each shot. Last friday I just happened to be off work due to heavy rain and flooding in the area, and something about him seemed off. I checked his BG and it was 48. The Novolin had been dropping his numbers to what I can only guess were dangerous lows like this every time, and his body would respond by triggering his liver to release more sugar into his bloodstream, causing the very high number later that night and in the morning. I switched both his vet and his insulin that day and he has Lantus coming from Canada. In the meantime, his new vet and I agreed that reducing his dose is the smartest thing to do to prevent any more harsh dips in BG and bouncing. The last couple days he has still been high but not in the 550s or 600s like he used to be. Maybe talk to your vet and suggest that Garfield may be bouncing. I agree that 6 units is a lot of insulin and that something like Lantus or Levemir may give you much better results, and him a much more gentle and flatter 12 hour cycle.
 
Catcrzymom said:
I was using the wrong spreadsheet when I entered his bg numbers. I've since updated it.
Thank you for your suggestions.
Click to expand...


Thank you that will be more helpful. I put a post on the Vetsulin forum asking for some input from Vetsulin users but there are not a lot of memebers who use Vetsulin so it may take a while before you get some feedback.

Many people find that the longer acting, gentler insulins like Prozinc, Lantus and Levemir give much better results than Vetsulin, since they tend to act longer. Squalliesmom who posted above switched to Lantus and is having good results so far.

ETA If the dose is too high and Garfield is "bouncing" into higher numbers it can look like the insulin is not working for him. Adjusting the dose may be helpful but I can't offer any suggestions on what sort of dose may be best. The best would be to do more testing at preshot +2 and +4 which would be when you would see the greatest effects with Vetsulin normally.
 
jayla-n-Drevon said:
Big hugs to you....
Wondering if any BW has been done to rule out any other possible issue?
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Yes a complete blood work up has been done. There was a slight infection and he was put on antibiotic right away.
Then he developed the ear infection and has been on antibiotic for two weeks now.
 
I just did his bg test (3hrs post) it's 242. Much better number than what he's had all day. This is only 3 hrs after his evening injection though.
 
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Tuxedo Mom said:
Thank you that will be more helpful. I put a post on the Vetsulin forum asking for some input from Vetsulin users but there are not a lot of memebers who use Vetsulin so it may take a while before you get some feedback.

Many people find that the longer acting, gentler insulins like Prozinc, Lantus and Levemir give much better results than Vetsulin, since they tend to act longer. Squalliesmom who posted above switched to Lantus and is having good results so far.

ETA If the dose is too high and Garfield is "bouncing" into higher numbers it can look like the insulin is not working for him. Adjusting the dose may be helpful but I can't offer any suggestions on what sort of dose may be best. The best would be to do more testing at preshot +2 and +4 which would be when you would see the greatest effects with Vetsulin normally.
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Thank you. I will watch for postings under the Vetsulin.
 
The nadir, or lowest glucose post-shot, is what is used to adjust the dose. This is often in the +3 to +5 hours after the shot has been given.
Some of the high numbers you may have seen could be in response to bouncing, as noted previously. Dropping fast, dropping to an unfamiliar level, or dropping into a hypo level may all cause the body to release stored glucose, jacking the levels back up again, for as much as 3 days. Whatever you do, do NOT raise the dose based on the pre-shot tests!

We have a guideline for using Vetsulin, aka Caninsulin, effectively here.

Was 6 units the initial dose first prescribed?
 
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BJM said:
The nadir, or lowest glucose post-shot, is what is used to adjust the dose. This is often in the +3 to +5 hours after the shot has been given.
Some of the high numbers you may have seen could be in response to bouncing, as noted previously. Dropping fast, dropping to an unfamiliar level, or dropping into a hypo level may all cause the body to release stored glucose, jacking the levels back up again, for as much as 3 days. Whatever you do, do NOT raise the dose based on the pre-shot tests!

We have a guideline for using Vetsulin, aka Caninsulin, effectively here.

Was 6 units the initial dose first prescribed?
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When he was diagnosed he was started on 2 units twice a day.
A week later he was increased to 4units twice a day. Then about 2 weeks later he was increased to 6 units.
 
Catcrzymom said:
I just did his bg test (3hrs post) it's 242. Much better number than what he's had all day. This is only 3 hrs after his evening injection though.
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Vetsulin is a blend of amorphous and crystalline insulins. The amorphous fraction typically reaches peak effect at about +3 after injection time. The crystalline fraction reaches peak effect around +7 but it is not as strong an effect.

I agree that 6 units BID is a very high dose for a very recently diagnosed cat - especially when he's on a low carb diet. It would help you a lot to fathom out what's happening if you could get a preshot test before every insulin dose and also get as many +2 and +3 tests as possible because that is typically the time that Vetsulin will really have hammered numbers down. Like other members above I am wondering whether the high numbers you are getting could be bounces. That you are catching lower BGs on some mid-cycle tests shows that the insulin is viable (working) and that Garfield is responding in some way to it.

Point out to your vet that you got a drop from HI down to 242 on the PM cycle of 16 March. That's a drop of about 500 POINTS!!! No wonder Garfield's not feeling good today: the Vetsulin is absolutely hammering his system. Also, massive drops like that are yet another reason to suspect that Garfield's bouncing. Badly. His poor liver must be going nuts!

Does Garfield have any history of DKA or testing positive for ketones in his urine?

With the infection present and the crazy high BG numbers it is vitally important right now that if you're not already doing so you immediately start testing Garfield's urine for ketones. (Use Keto-diastix or similar - available from pharmacies.) If you get a trace result contact your vet immediately to discuss how to proceed. Anything more than trace and you need to immediately seek emergency treatment.

I strongly recommend that you discuss with your vet doing at least a short trial for a few cycles at a lower dose of Vetsulin to see if his preshot numbers come down. It's an in-out insulin so you won't have to deal with waiting for a depot to drain before (hopefully) seeing any improvement that may occur. You need to know Garfield's ketone status in order to determine a suitable trial dose with your vet.

It's hard to judge with such little data, but if I was a betting person I think I'd put an each-way on Garfield being on too high a dose at the moment. Preshot numbers are trending upwards. Not good.

In closing, I'd like to add my voice to those weighing in in favour of gentler, longer-acting insulins as typically better choices for the treatment of feline diabetes. Some cats do OK on Vetsulin but if the traffic we get here is a guide they are very much fewer in number than the cats that do well on the likes of Lantus, Levemir and Prozinc.

I hope for both of your sakes you get a good result with the vet today.


Mogs
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Critter Mom said:
Vetsulin is a blend of amorphous and crystalline insulins. The amorphous fraction typically reaches peak effect at about +3 after injection time. The crystalline fraction reaches peak effect around +7 but it is not as strong an effect.

I agree that 6 units BID is a very high dose for a very recently diagnosed cat - especially when he's on a low carb diet. It would help you a lot to fathom out what's happening if you could get a preshot test before every insulin dose and also get as many +2 and +3 tests as possible because that is typically the time that Vetsulin will really have hammered numbers down. Like other members above I am wondering whether the high numbers you are getting could be bounces. That you are catching lower BGs on some mid-cycle tests shows that the insulin is viable (working) and that Garfield is responding in some way to it.

Point out to your vet that you got a drop from HI down to 242 on the PM cycle of 16 March. That's a drop of about 500 POINTS!!! No wonder Garfield's not feeling good today: the Vetsulin is absolutely hammering his system. Also, massive drops like that are yet another reason to suspect that Garfield's bouncing. Badly. His poor liver must be going nuts!

Does Garfield have any history of DKA or testing positive for ketones in his urine?

With the infection present and the crazy high BG numbers it is vitally important right now that if you're not already doing so you immediately start testing Garfield's urine for ketones. (Use Keto-diastix or similar - available from pharmacies.) If you get a trace result contact your vet immediately to discuss how to proceed. Anything more than trace and you need to immediately seek emergency treatment.

I strongly recommend that you discuss with your vet doing at least a short trial for a few cycles at a lower dose of Vetsulin to see if his preshot numbers come down. It's an in-out insulin so you won't have to deal with waiting for a depot to drain before (hopefully) seeing any improvement that may occur. You need to know Garfield's ketone status in order to determine a suitable trial dose with your vet.

It's hard to judge with such little data, but if I was a betting person I think I'd put an each-way on Garfield being on too high a dose at the moment. Preshot numbers are trending upwards. Not good.

In closing, I'd like to add my voice to those weighing in in favour of gentler, longer-acting insulins as typically better choices for the treatment of feline diabetes. Some cats do OK on Vetsulin but if the traffic we get here is a guide they are very much fewer in number than the cats that do well on the likes of Lantus, Levemir and Prozinc.

I hope for both of your sakes you get a good result with the vet today.


Mogs
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This gives me a lot to think about. I've been going to this vet for a long time and they're one of the highest rated in my area. I will discuss the lower dose of insulin with her. I believe they tested his urine when he went for his first visit and they did all the blood work, and it was ok. I will talk with her about that too.
One thing he's been doing the last few nights is he will start yowling for a little bit. I talk to him and it seems to calm him down. What could be causing that? I have even given him some of his treats and that seems to satisfy him. I really am totally stumped with what to do. I will do the bg tests as you suggested and see how they turn out.
Thank you!
 
Catcrzymom said:
One thing he's been doing the last few nights is he will start yowling for a little bit.
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How long after the dose?

Vocalisation could be a hypo symptom. Be sure to tell your vet.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

FWIW, you'll see many reports here of people who go to vets who are great at an awful lot of stuff but not feline diabetes. If you've got a good vet perhaps you might discuss with your vet more of a partnership approach to Garfield's diabetes treatment based on more regular home testing. The two-unit hikes really are nuts. Insulin is a powerful hormone, not a dose-to-effect medication. You need to assess how the cat is responding mid-cycle. Basing dosing decisions for in-out insulins exclusively on preshot BG levels alone is not wise and has the potential to be very dangerous.


Mogs
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Just adding an extra vote for you to strongly consider dropping his dose and getting more tests in

ProZinc is another "in and out" insulin (although it's much better for cats than Vetsulin) and we just recently had someone join us that was giving 8 units twice a day and their vet kept increasing the dose like yours has

We suggested he drop way back and he listened.....he dropped from 8 units to less than 1....that was on 2/29

As of today, he's been in totally normal numbers since 3/7 and is over halfway to being able to say he's in remission (we consider them OTJ when they can stay in normal numbers without any insulin for 2 weeks)

No, it doesn't happen like that to most, but we've seen so many cats come through here that were raised too quickly and getting no control at all, and when a smaller dose was tried, it made a world of difference.

There's no such thing as a "feline diabetes specialist" when it comes to vets like there are in human medicine, and you have to remember that vets get only a few hours of formal education when they're in school on diabetes, and those few hours cover every type of animal they see. Vets just don't have the time to stay up to date on the latest treatments in every type of disease in every type of animal they see, so most of them treat their feline patients the way they treat their canine ones (same insulin, same treatment) since they see lots more diabetic dogs than they do cats.
 
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Garfields pre shot bg is 424 this morning. I will test him again in a couple hours.
His bg for post 2 1/2hrs HI. I am going to try and test him every 2-3 hrs until I take him to the vet this afternoon.
 
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My vet also increased my Woody's dose by 2 units. When I landed here he was on 13u twice a day! Granted I was free feeding dry w/d because he kept showing signs of hypoing. After I started home testing to check his hypoing I realized that he was crashing every single time! The folks on here helped me through the dose reductions (not only with Woody bur also Buzz). If you look at my first spreadsheet, which is Woody's! you can see he was hypoing at +3 and +4. Granted he didn't bounce as much as Garfield, but he could be bouncing. Would you have time to check his BG every 2 hours for a day? That would give so much information. I really hope your vet is open to working with you. Mine was not and I had to go find one that would half way listen to me.
 
ja9390 said:
First of all, he is adorable.

That sounds like what happened to Diego. He was on Novolin 2u twice a day and kept having very high readings before each shot. Last friday I just happened to be off work due to heavy rain and flooding in the area, and something about him seemed off. I checked his BG and it was 48. The Novolin had been dropping his numbers to what I can only guess were dangerous lows like this every time, and his body would respond by triggering his liver to release more sugar into his bloodstream, causing the very high number later that night and in the morning. I switched both his vet and his insulin that day and he has Lantus coming from Canada. In the meantime, his new vet and I agreed that reducing his dose is the smartest thing to do to prevent any more harsh dips in BG and bouncing. The last couple days he has still been high but not in the 550s or 600s like he used to be. Maybe talk to your vet and suggest that Garfield may be bouncing. I agree that 6 units is a lot of insulin and that something like Lantus or Levemir may give you much better results, and him a much more gentle and flatter 12 hour cycle.
Click to expand...

Much like Woody's was doing!
 
Catcrzymom said:
One thing he's been doing the last few nights is he will start yowling for a little bit. I talk to him and it seems to calm him down. What could be causing that? I have even given him some of his treats and that seems to satisfy him.
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[Emphasis mine]

He calms down when he gets your attention and when you give him something to eat. More evidence to support a hypothesis that he may be yowling because his blood glucose levels have dropped a lot.

I know that we don't have a firm reference number to use with your Glucogauge meter but for the sake of argument let's say that the bottom of the normal blood glucose range for a cat is 80mg/dL. (FDMB has a reference point at 68 for an Alphatrak meter but I'm adding a few extra points to allow for the fact that your meter reference range is an unknown). It is important to know that big drops down to numbers ABOVE the bottom of the normal BG range can sometimes trigger symptomatic hypos (i.e. symptomatic hypos can occur while a cat is in nominally safe low numbers; it is not always necessary to be below the bottom end of the normal BG range).


Mogs
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Critter Mom said:
[Emphasis mine]

He calms down when he gets your attention and when you give him something to eat. More evidence to support a hypothesis that he may be yowling because his blood glucose levels have dropped a lot.

I know that we don't have a firm reference number to use with your Glucogauge meter but for the same of argument let's say that the bottom of the normal blood glucose range for a cat is 80mg/dL. (FDMB has a reference point at 68 for an Alphatrak meter but I'm adding a few extra points to allow for the fact that your meter reference range is an unknown). It is important to know that big drops down to numbers ABOVE the bottom of the normal BG range can sometimes trigger symptomatic hypos (i.e. symptomatic hypos can occur while a cat is in nominally safe low numbers; it is not always necessary to be below the bottom end of the normal BG range).


Mogs
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According to the guide for the meter bg lower than 20ml is LO
Bg higher than 750ml is HI
It says normal range for cats without diabetes is 75-120ml.
 
Catcrzymom said:
According to the guide for the meter bg lower than 20ml is LO
Bg higher than 750ml is HI
It says normal range for cats without diabetes is 75-120ml.
Click to expand...

That's really helpful! Thank you for posting these details. :D

From a belt 'n' braces point of view, I'd suggest getting a rubber stamp from your vet that you need to make sure that Garfield doesn't go below 75 as measured on your pet meter, i.e. intervene to raise BG if he reaches or goes below this threshold. (Also, once you sort out the current issues over Garfield's Vetsulin dose level you might also want to have a serious discussion with your vet about possibly setting a slightly higher threshold number than 75mg/dL (pet meter) as a trigger for dose reductions.)


Mogs


(@MrWorfMen's Mom, @Chris & China - Tagging you because I thought you'd find this info helpful if you come across other members using Vet Glucogauge meters.)
.
 
It's great that you're getting more tests. The front part of today's AM curve is completely upside down. The amorphous fraction of Vetsulin can really kick in anywhere from about three quarters of an hour after the dose was injected. Saoirse often nadired on Caninsulin at +2. The HI you got at +2 is a completely a**ways response to the intended action profile of Vetsulin. If it was working properly for Garfield you would be more likely to expect a drop of 300 points around the +2 - +4 part of the cycle; certainly not a rise of 300.

Any chance you might be able to get a +10 test? It would help to see if Garfield's BG is rising or falling at that point.

Did you have any dialogue with the vet yet?


Mogs
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Critter Mom said:
It's great that you're getting more tests. The front part of today's AM curve is completely upside down. The amorphous fraction of Vetsulin can really kick in anywhere from about three quarters of an hour after the dose was injected. Saoirse often nadired on Caninsulin at +2. The HI you got at +2 is a completely a**ways response to the intended action profile of Vetsulin. If it was working properly for Garfield you would be more likely to expect a drop of 300 points around the +2 - +4 part of the cycle; certainly not a rise of 300.

Any chance you might be able to get a +10 test? It would help to see if Garfield's BG is rising or falling at that point.

Did you have any dialogue with the vet yet?


Mogs
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Getting ready to leave for the vet now. I will try to get another test in.
 
Critter Mom said:
Wishing you a safe trip and a productive consult. :)


Mogs
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Had a very good session with our vet. While we were there she called a specialist at an area animal hospital and reviewed all tests and results with him. Also reported all my bg tests. Discussed my concerns about the dose of Vetsulin Garfield is on. Asked this doctor, who is very experienced in diabetes, what he would recommend for Garfield. This doctor said that since Garfield still has a bit of infection in his ear, has some mild dental problem, that these could be contributing to his higher bg readings. He wasn't alarmed about the readings and feels that the dose Garfield is on is fine for him. He said every cat is different. He said he's treated some diabetic cats with higher doses of Vetsulin than what Garfield is on and had very good results. Our Vet and the specialist answered all our questions to our satisfaction. And ,We weren't charged for the specialist consultation. Our vet said she could tell we were very anxious and upset about many issues and she felt that calling a specialist who treats cats with diabetes would be the best way to put our minds at ease and help save us some money. She could have referred us to a specialist and it would have cost a lot!
Garfield has mild "dandruff" for lack of a better word. He was given another small dose of antibiotic for his ears and that should take care of his ears. He will have his dental work done in a few weeks and that should help with his bg numbers.
The vet said we are doing everything right with feeding him, watching for signs of problems, bg tests and giving him his insulin. Hubby and I are happy with today's visit and feel we are ok with how things are at this time. Garfield is gaining weight back and looks much healthier than he did the end of January when we first took him to the vet. He was about 11lbs ( down from about 30 lbs) and today weighed in at 15!
Our vet said we can call her or email her anytime if we have questions. She's been our vet for a few years now so we feel she is doing right for our sugar baby.
Thank you for all the suggestions and advice. I had a long list I took with me to the vet! She was impressed with a lot of my questions and information. :)
 
Catcrzymom said:
This doctor said that since Garfield still has a bit of infection in his ear, has some mild dental problem, that these could be contributing to his higher bg readings. He wasn't alarmed about the readings and feels that the dose Garfield is on is fine for him.
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Is the dose fine for Garfield?

I have a lot of time for our current vets but they put Saoirse at great risk of developing diabetic ketoacidosis recently because they withheld insulin from her while she was hospitalised with them for rehydration despite her numbers being sky-high. Saoirse had urinary tract inflammation/infection at the time and also the wound from her recent surgery had become inflamed and also she was not eating enough. They had data from her blood ketone meter to prove she was throwing ketones (and she's not a ketone-prone cat). They had BG data to show that it would have been safe to give her insulin. They would not even give her a token dose on the grounds that the infection might clear. This was an UTTERLY wrong-headed treatment decision by our vets. If a diabetic has an infection it is even more important that they get insulin!!! I'm still very, very angry about this because they demonstrated lack of true clinical understanding of what can lead to DKA (and many vets do). Saoirse would not have survived the treatment should she have tipped over into DKA. I could have lost her.

Some so-called feline diabetes specialists aren't all that much cop either. Our local vets get an external 'FD specialist' to review curves for their patients. This 'expert' pronounced Saoirse a "true diabetic" who would "always be insulin-dependant" and who had "no hope of remission". Well, 'no-hoper' Saoirse went into remission less than three months later thanks to me applying what I learned here. Also, the ONLY symptomatic hypo Saoirse has experienced was when, in the early days, I caved to a vet's advice to hold a dose when everything I had learned from my research here and on other reputable FD/cat nutrition sites screamed at me that the dose should be reduced. Thankfully I was home testing. Had I not been able to monitor Saoirse's blood glucose at home I could have lost her that night.

While it is true that some cats do require high doses of insulin, time and again we see cats arriving here who have had their doses increased far too quickly - usually based on very little data from tests in vet offices where the cats are stressed and therefore running abnormally high - and these cats have problems getting regulated or are at great risk of having a hypoglycaemic episode. Frequently the higher doses are being driven by some vets' insistence on prescribing foods with insane carb levels (e.g. Hill's w/d dry). In such cases they are fitting patients to treatment protocols instead of tailoring the treatment to the patient's needs.

I do appreciate the dichotomy facing members here who get conflicting views on dosing levels/treatment approach - especially when the divide in opinions is veterinary professional v. a bunch of relative strangers on the internet. (Granted, there is much craziness on the net but thankfully that does not apply to FDMB - as you will come to appreciate over time. :) ) There is one completely independent voice you can listen to: Garfield's. With every observation you make and every test you carry out Garfield's body will tell you what is/isn't working to help him. Read and learn all you can yourself and be guided by Garfield's clinical signs and data. If there is a marked discrepancy between how Garfield is and what your vets are telling you, I strongly recommend that you 'listen' to Garfield. And be a strong advocate for him. :bighug:



Mogs
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