? How to do glucose curve when OTJ? and fructosamine/A1C questions

My vet wrote in my cat's record he needs diagnostics--glucose curve or fructosamine level when we get to our new state (and find a new vet).

How do I do a glucose curve since we are OTJ? Do I just do a BG test every 2 hours for 12 or 16 or 24 hours and note the times of the tests and when meals occur (although he free feeds).

My cat's numbers are still awesome (60-89, with occasional 50s and low 90s).

Would one of the OTC A1C tests for people be helpful, even if it is just to show the vet that diet and home testing is working/is appropriate? Or show the new vet his BG numbers are representative of what is going on?

If fructosamine is in the low range like his BG numbers are, is this a bad thing? I expect slightly higher since I BG test before feeding, but not too much higher because I don't pick up his food (there is always wet out and he grazes freely/frequently).

Thank you.

 

If you are testing and the numbers are consistently within normal range, why do you need a fructosamine test or a curve? That makes no sense to me.

 

I can understand the vet wanting to see what your idea of in remission is, but I think showing them your spreadsheet should be enough. Maybe an at-home curve if they insist, but I certainly wouldn’t go out of my way for a fructsamine or in-office curve. Neither of those would be more accurate than at home testing....

 

Money Honey! Show your spread sheet to the new Vet; that should be more than adequate, IMHO.

 

The vet wrote it in my cat's record. He's of the insulin, prescription food, and no home testing camp. I want to do the curve myself so I have something besides normal BG testing to show the new vet in the new state. Maybe we can avoid some expense and discomfort/stress to the cat. And get both the BG and curve results added to his records. I figure if the stress of a ride and being at the vet's office can raise regular BG tests, maybe it would affect glucose curve and/or fructosamine test.

If we can get the results put in the records, I was advised it could help with the insurance, showing the diabetes is controlled, so less likely to have issues about pre-existing vs not pre-existing (resulting/not resulting from the diabetes) for any other issues in the future. Unfortunately, the diabetes will be pre-existing forever, but at least it's not as expensive to treat as a lot of other things.

 

If it is for insurance purposes I would suggest contacting the insurance carrier and ask what they actually require for documentation. You may be stuck getting Fruc or Curve done at the Vet. Otherwise just do a curve say every 3 hours for a few days to show a pattern; also throw in several random tests at night. Might help.

 

The insurance rep just said what was in the vet records would be used, and it would depend on the vet what he or she would add to his/her records. So, I'll have to find out from the new vet what he or she requires to include home testing results. I was thinking I could take a picture of the meter with a clock/watch next to it for each test (only for the curve) and submit them with the curve. If I do it electronically, the metadata in the photos would validate the times of the tests (as well as verify the date of the curve). And submit 30 days of BG tests.

I read the other thread about vetting a new vet, and will definitely use the suggested questions, plus the question about appending home testing results, and questions reference the dog. I'd like to use the same vet for both if at all possible.

 

I think the vet wants the test to check the wellbeing of the cat. He discouraged me from home testing and is unhappy I'm controlling with diet instead of insulin and prescription food.

 

Honest to goodness sakes alive! The wellbeing part is fine but the rest...…. Are these Vets nuts, arrogant, or just refuse to educate themselves on the latest care techniques? Now I have a headache again. Good night and good luck!!

 

Sorry if I upset you...

 

It sounds like HE wants to be in control and also he makes more money every time you bring kitty in for testing and/or buy insulin and prescription food.

It is YOUR kitty and ultimately you are the only one who can choose what is best for your cat. And for your wallet. You are your cat's best advocate.

 

Thank you. Vet doesn't make money on insulin... he sends everyone to Walmart for insulin and syringes The area is rural/small town and pretty poor, so he does try to keep costs down the best he can as a general rule. I just wish the American Animal Hospital Association (AAHA) would send something out to all the AAHA clinics/hospitals, and the American Association of Feline Practitioners (AAFP) would send something out to all their Certified Cat Friendly Practice vets/clinics/hospitals. Maybe AAFP could mandate some kind of a course on home testing and dietary control of feline diabetes as a requirement for certification Maybe AAHA could do the same

Hmmmmmmmmmmmmmmmmmmmmm…

Maybe an email campaign is in order Hahahahahahahahahahaha

 

OK, I just emailed AAHA and sent a message via web form to AAFP.


This is what I sent to AAFP and modified a little for AAHA:


Could you please develop a feline diabetes home testing and diet protocol and a feline diabetes home testing, diet, and insulin protocol online course for your certified cat friendly practices? Maybe CEUs or a requirement for certification? Many cats are going into remission and getting off insulin, and many other cats are getting better regulated, with home testing, etc. This is really no different than people taking responsibility for human diabetes testing, diet, and insulin at home. It saves money and there are better outcomes/quality of life for both cat and owner. This course would give veterinarians a better alternative to insulin, prescription food, and vet office testing that is the only way many veterinarians know. Please see http://www.felinediabetes.com for both information and forums that have been invaluable to me, and allowed my cat to go into and stay in remission. This website shows the kinds of things necessary for cat owner education, and the frustration we have with veterinarians that do not know about, or do not know the value/success of, home testing and diet. Thank you.

 

Print this off and give it to your vet
https://www.aaha.org/public_documents/guidelines/diabetes guidelines_final.pdf

They are not as forceful on the home testing as they could be but do mention it.

 

Thank you. Now I have to figure out a tactful way of giving it to him...

 

Which basically translates to your old vet was totally ignorant and/or stupid and/or just arrogant and did not like not being 'obeyed'.

 

The bottom line is that a vet can have their own 'philosophy' for handling diabetes. There are different schools of thought out there. So, you have to find someone with whom you are in agreement on the correct way to handle it, or you have to learn what you can and cannot share with your vet in order to continue to handle things in the best way for your cat.

If you need a diagnostic result on file for insurance, I would opt for the fructosamine test. They just take blood once so the cat is at the vet much less time.. it is stressful, but not near as much as spending 12 hours or more there. The fructosamine gives the average over a 2 to 3 week period rather than just numbers at a specific point-in-time, so the stress will not 'mess it up'. Based on your glucose test numbers, your fructosamine results will probably be great. There should be no doubt that your cat is in remission.

 

Thank you.