Today was eye opening to say the least. Too much to even cover, so I will only touch on the "highlights" & ultimately, it made me realize that it is time to vet shop, just like many have had to do.
*I was made to feel like I was doing something wrong by home testing. She said point blank "those meters are not accurate at all." And that they don't make a home meter for pets.
I responded by informing her that the Alpha track glucometer was specifically calibrated for pet use. I also told her that I know home glucometers have an acceptable range, so they are not dead on. However, the numbers, whether dead on or not, are still valuable for looking at trends, etc. And that I brought my meter to test against their number, which will tell me how off our meter is. They tested with blood drawn from the inside of the rear leg & got a 196. I tested his ear prick (because they didn't want to test my meter for me, with the same blood drawn from his leg & I got a 140. Keep in mind that at 8:30 pm the night before he only got 0.25, got no insulin in the morning today. And had free fed all day, plus of course the stress of the car ride & vet clinic.
*I was told that diet will not make that big of a difference. And that dry food is not a bad option either. As long as he was consistently eating, that was the main goal.
I explained that carbs are essentially glucose to a diabetic, which she agreed with. So I asked her how my changing his diet to 100% wet food, low in carbs is a bad thing, since I am reducing his carb intake, which makes it easier for the insulin to work. Or more importantly, reducing the workload on his pancreas. She basically agreed to disagree, even stating that we should stick to one flavor, unless he doesn't want to eat it. Even if both the chicken & turkey are 9 grams of carbs.
*She made me feel guilty for skipping doses, because that is going to throw off the fructosamine test schedule, where they wanted him on insulin for 2 solid weeks, so they could run the test.
I explained that I realize skipped dosing is not great by any means, which is why we have reduced the dose & also why we made a follow up appointment, as soon as I identified the need for a reduction. I explained that we have gotten some #'s in the 100's & even a 76, if I would have pushed 1 full unit yesterday morning when he hit that 76 & then went to work, we may not be here talking about what we should do. I might have been walking in the door for cremation services & second guessing what we should have done. I point blank told her, I am not here to work against you, I am not here to find ways to skirt around coming to the vet, & I am not trying to find a way to save money. I even pointed out, that we usually use our vet, who's prices are lower than the clinic we are working with Ernie on. The only reason we took him to this clinic, was that the Monday after I realized something was wrong, our vet was booked solid, so I started calling for an alternative. And I could have switched back to them already, but I trusted their experience & the fact that they looked at him as "just another diabetic cat" which put me at ease. I have an appt next week to go back to our normal vet. But it is a small town vet with a couple of older Dr's & a couple of younger Dr's, so I want to make sure they are knowledgeable on current diabetic standards & make sure they are willing to work together.
*She said that Vetsulin isn't known to be harsh & has been their "go to" since it came back onto the market. And it works very well most of the time unless the patient seems to reject it.
I asked her about PZI being a Bovine insulin & being closer to the natural make up of feline insulin. As where Vetsulin is Porcine based & has multiple amino acids which are different than the feline makeup. She disputed that fact & said that Vetsulin is meant for both dogs & cats will likely work just fine. At this point, she was getting kind of snotty, so I got a little smart & asked her why is it marketed under the name Caninsulin in the UK, if it wasn't originally intended for canine use. Then in the US, they decided to go with a species friendly name of Vetsulin. Besides irregardless of the name, if Bovine is better at mimicking feline insulin & has published studies with better remission odds than Vetsulin, wouldn't you want to explore it a little deeper, especially if the client is saying that he realizes what it costs, etc. I didn't get a solid answer from her!
So, I am off my soapbox now. Yes my meter is off 50 points from their testing, however the number isn't as important as the trends in the numbers. Which, unless I am looking at something wrong, the numbers & multiple skipped doses were screaming for a reduction.......or else! Her plan at this point was to take him off insulin period for a week or 2 & then run a fructosamine test to see what he has been doing. And told me that she didn't think the home testing was important for now, because the fructosamine test would paint us a picture. And then decide where we go from here. I am not sure I feel comfortable stopping insulin period, because I feel like he still needs some support, even if it is drips or very low doses. She told me that pancreases don't really "restart" given time to catch up & lowering the carb load.
Frustrated & feeling confused. However, I refuse to feel bad or guilty, because I know I have been doing what I thought was best for my son based on the info I was gathering. Ughhhhhhh!
for challenging that (idiotic/poorly educated/egotistical) vet!
Wish I could have been a fly on the wall ... (I thought you handled that whole situation beautifully!) You are PAWESOME!!!
) But please do make sure you are consulting the reference range specifically for this meter - see 
