Visit to new vet - is my cat not really in remission?

Discussion in 'Honeymooners / OTJ' started by Jennifer R., Feb 29, 2020.

  1. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    Our old vet was not very responsive, and was in a chain so I decided to bring my OTJ sugar cat to a new vet. She ran an in-house quick fructosamine test, which she said was 300 and that that meant he is needing insulin, and said very few cats ever go off insulin, and that I needed to put my cat back on Lantus, and to give him daily shots of Lantus without testing, and to get an Alpha Track meter and start testing him one week after I started him on insulin; that a human meter doesn't work on cats and that I was probably getting invalid results with it. I was too floored by the statement that he's not really in remission to question her recommendations, but now that I'm home, I'm seeing that 300 isn't really necessarily bad.

    What should I do? I am thinking I will order the meter, and test him, and then decide from there. What do you all think? I have been testing his blood sugar with the Relion Prime once per week, and it was in the 72-74 range every time, though I'm thinking the test strips have been open over a month so they may not be good anymore (I will test them with the control solution after this to check).
     
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  2. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Reference Ranges for Fructosamine Test
    Jennifer - Please open the above document. It lists fructosamine test values and what they mean.

    Looks to me like the range your cat falls into is this one:
    Normal non-diabetic cat 190 - 365
    300 is right in the middle there.
    In the normal non-diabetic cat range.
    NORMAL


    Now why is this new vet claiming your cat is diabetic?
     
  3. Deb & Wink

    Deb & Wink Well-Known Member

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    A fructosamine test has very different ranges and meanings than a blood glucose test.

    What symptoms was Simba exhibiting that prompted you to take him to see a vet?
     
  4. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    He has been acting extra hungry, and crying a lot. He has been waking me up at 6 am, when he used to let me sleep until 8 am. After he eats, he acts like he hasn't eaten. I think it's partly because I went out of town and my husband fed him every time he begged, but he was already pretty hungry between meals. I typically feed him a 8 am, 11 am, 2 PM, 5 PM, and 8 PM, but sometimes the 2 PM meal gets pushed back due to my not being home (mainly Fridays), so it's more like 4 PM (I then feed him at 6 and 9). I know he's getting plenty of food based on the calories in the food he gets (2 1/2 cans of fancy feast).
     
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  5. Deb & Wink

    Deb & Wink Well-Known Member

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    Do a few BG tests on Simba at home.
    You still have your meter and test strips and lancets?

    Is he peeing large puddles again?
    Does his coat look good still? He's grooming himself?
    Is he playing or more lethargic?
    Pooping normal?
    Still purring?
    Is his weight steady? not gaining too much, not losing too much?
    You haven't switched the foods he was eating?

    Waking you up earlier. That could just be because the sun is rising early now that spring is approaching.
     
  6. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    I will do some more blood sugar tests. His coat is somewhat shiny, not super shiny but not dull, he's slowly gaining weight, he grooms himself all the time, he is full of energy and plays, he does do a lot of yowling but I think it's boredom. He poops normally, pees fairly normally - he did pee on a pile of laundry but I think it was when I was away. He never peed large puddles in my care as he was already on Lantus when I brought him home from the shelter. He's still eating Fancy Feast, though he pretty much only likes the turkey and giblets one. He has been waking me up at dawn, yes, but also frequently at other times (1, 2, 3 am).
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

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    If Simba starts to get some higher BG numbers, it's time to start posting in the Feline Health (Welcome & Main) forum for other opinions as to what is going on.

    Probably best to do that now, since he is yowling so frequently. Other people there to give you more ideas.

    Some interactive play time every day. Laser pointer, "Da bird", fishing pole type toy, toss a crumpled up bit of paper down the hallway for him to chase, etc.

    You may want to think about a timed feeder.
    How much does Simba weigh now?

    If Simba only likes the FF T&G, you might also try one of the other flavors with organ meats. Like Fancy Feast Tender Liver & Chicken or the Fancy Feast Tender Beef & Liver Feast. Both classic pate style. Both low carb.
     
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  8. Deb & Wink

    Deb & Wink Well-Known Member

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    Your old test strips should still be good. They last more than 1 month. Try testing Simba with your old meter.
     
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  9. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    I had tested him on Monday and he was 74. I will try again today. Do you think I should do both a fasting and a not-fasting one? He doesn't go long before meals so I would have to wait until tomorrow to do a fasting one.
     
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  10. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    He weights 14.5 ounces now. I do play with him, he doesn't even seem to notice the laser pointer, but he likes to chase balls with bells in them. I have a feather on a string that he sometimes chases. He has several other toys that he plays with sometimes, sometimes not. He gets bored with toys quickly. The only one he really likes is a stick with a boa style feather directly attached to it that he got for Christmas, and he's torn it up. I should see if I can find something similar.
     
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  11. Deb & Wink

    Deb & Wink Well-Known Member

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    I'd simply feed and test normally. No need to fast him, as that rarely happens in real life. Except if a cat is going under for anesthesia, dental, surgery, etc., then a cat may be fasted.
     
  12. Deb & Wink

    Deb & Wink Well-Known Member

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    14 and a half pounds.
    A typical healthy cat requires 15-20 kcal (Calories) per pound of healthy body weight per day.
    So if Simba is at his ideal or healthy body weight, 14.5 x 15 = 217.5 calories to 14.5 x 20 = 290 calories
    Average can of Fancy Feast contains 85-95 calories.

    2.5 cans of food times 90 calories is 225 calories.

    Sometimes our cats can come to associate food with attention. So redirect Simba's attention with something other than food. Snuggles, playtime, talking to him, brushing him. Anything else he likes.
     
  13. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    His blood sugar before he ate was 89 this morning, three hours later was 67. How often should I test him?
     
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  14. SullivansDad

    SullivansDad Member

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    Jan 17, 2020
    I'm not an expert, but after looking at your spreadsheet, I would just get a pre-breakfast (AMBG), mid-day (any time works), and pre-dinner (PMBG) test all in the same day maybe once a month. Your numbers look perfect for no-insulin, especially coming down that much three hours after a meal. Seems to indicate that his pancreas is working perfectly well.
     
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  15. Deb & Wink

    Deb & Wink Well-Known Member

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    @SullivansDad

    Brand new vet wants her to put her cat back on insulin. After BG readings like this.
    Still think your new vet might need to go back and see what a fructosamine level of 300 says. That is within the normal range.

    Jennifer, did you go ahead and get the more expensive Alphatrak meter and test strips?

    p.s. Those numbers obtained with the Relion Prime human meter all still look good.
     
  16. Deb & Wink

    Deb & Wink Well-Known Member

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    Just to clarify, a fructosamine test of 300 is within the normal range for a cat.

    Blood glucose range of 300 is not normal.

    Did your new vet do any other bloodwork tests?
    Do you have a copy of those bloodwork results?
    If not, you are entitled to the results, since you paid for them.
    Ask the vet office to email you the results. Call the receptionist, and ask for that info.
    Or ask them to print them out and you will come and pick them up.
    While you are there, ask for a copy of all the hand-written notes in your cat Simba's chart.
    Or get those emailed to you also.
     
  17. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    Thank you for all your feedback. Yes, the numbers are with the Relion Prime, not the Aphatrak meter. I will call the vet's office and see what they will send me. I used their "email us" form but got no response. I have copies of the blood work from November and December at the other vet's office. I only see one Fructosamine test from them, and no blood sugar tests.
    11/26/19 FRUCTOSAMINE 276 umol/L 143.000 - 373.000 umol/L
    Which is normal for a non-diabetic cat, right? He was on Lantus then, 2.5 units.
     
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  18. Deb & Wink

    Deb & Wink Well-Known Member

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    Yes, a fructosamine of 276 is normal also.

    Which lab does your old vet and new vet use for testing?
    Different labs can use different reference ranges.

    Most common labs used for testing include Idexx, Antech. Idexx in-house equipment is used by some vets also, so they do not have to send out the blood and urine and wait if they need quick test results.
     
  19. Deb & Wink

    Deb & Wink Well-Known Member

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  20. Jennifer R.

    Jennifer R. Member

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    By that range, 300 is high, then. I will call and ask.
     
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  21. Deb & Wink

    Deb & Wink Well-Known Member

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    You need to know what lab equipment was used.
     
  22. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    I called, they will be emailing me what they have soon. They said when they send out the test they use Idexx, so maybe that's the reason 300 is now high?
     
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  23. Deb & Wink

    Deb & Wink Well-Known Member

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    That could be.

    Idexx did change the reference ranges, with their own laboratory equipment.
    Vet office in-house equipment, even if it is from Idexx, could have a different set of reference ranges.

    Talk about complicating things.
     
  24. Jennifer R.

    Jennifer R. Member

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    Dec 20, 2019
    They never emailed me. I am going to call again tomorrow
     
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  25. Deb & Wink

    Deb & Wink Well-Known Member

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    Keep bugging them. You know the old saying "the squeaky wheel gets more attention."
     
  26. Jeff D / Sketch

    Jeff D / Sketch Member

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    Mar 21, 2017
    I think my inclination may be just to continue testing with the human meter. Maybe pick up some new test strips if you feel your current ones are compromised. And I probably would not go back to that vet. The numbers indicated both BG and Fructosamine are not indicative of a cat needing insulin. Even with a correction figure those numbers certainly don't indicate a diabetic cat. Hard to say on his eating if he is an active guy and you are only feeding 2 1/2 cans of Fancy Feast maybe its just a little low. Cat metabolism like peoples can vary. Maybe cut down the number of times you are feeding him per day and feed a bit more at those times to see if it changes his begging for food pattern? My current cat (13 Lbs) that is in remission is fed 4 times a day and consumes 3.0 - 3.5 cans of FF Classic Pate (Chicken / Chicken and Liver) He is active and plays a lot so haven't seen any real weight gain. Often he will act like he is starving between normal feeding and I will offer a snack of FF and he walks away...he wants me to play with him so that is how he has "trained me" Probably straight from the how to train your hooman cat book bestseller...Chapter 1..."play the starving kitty card and get the hoomans attention so he will play with you". I haven't caught him reading it yet or listening to an audio book but they get this stuff from somewhere. I think Pavlov should have watched cat/human interaction to show his conditioned response theory rather that human / dog.!!!! Would have taken less time.
    I think Deb (and Wink) certainly are giving the best advice here. I know when I had me first diabetic cat she was always knowledgeable and never steered us wrong.
     
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