I'd cry, but I can't spare the moisture. ([info]minjo) wrote in [info]felinediabetes,
@ 2007-08-13 11:41:00
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FD website
Have any of you visited http://www.yourdiabeticcat.com?

I've been reading Dr. Hodgkin's thoughts on feline diabetes, and I have to admit, her Protocol makes sense. The gist of it is: Use PZI insulin, give wet food only, and home test (and give the appropriate amount of insulin, not just a blind amount).

I was just curious if any of you have followed this, and if so, if you've seen any success.

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[info]ananda_ren
2007-08-13 04:49 pm UTC (link)
I haven't visited that site, but that does seem to be the standard protocol. Although I would also include bloodwork done at the vet (fructosamine, another glucose, perhaps a glucose curve) and more guidelines about what kind of wet food to give - some do still have more carbs than is desirable. But basically, that is the treatment approach that seems most effective in the diabetic cats I know.

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[info]minjo
2007-08-13 04:53 pm UTC (link)
My vet has been having me give Max .5 units of insulin 2x a day no matter what his blood glucose level, no home BG testing (I do that anyway), and thinks that dry food is fine. Max, however, is not showing any signs of improvement, and trips to the vet have left us frustrated, with an empty wallet, and Max still showing signs of high BG levels (neuropathy, excessive urination, etc).

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[info]ananda_ren
2007-08-13 05:19 pm UTC (link)
Although I don't know the particulars of Max's case, that definitely doesn't sound like the best, or even standard, practice. I would recommend getting a second opinion from another vet, and a cat-only vet if there's one in your area. It can be challenging at first to determine what works best for each cat, and you definitely need to be cautious with diet and dosage changes at first to make sure you don't overdo it and cause a hypoglycemic episode. But if you've been treating the diabetes for several weeks or months with no improvement in symptoms or test results, something else should be considered. At the very least, the vet should be able to explain his/her reasoning for the approach and how it is best in your cat's case.

At my clinic, we've seen a switch to wet food alone can help some cats go into remission, and we recommend it for all cats (although many clients just don't want the expense and inconvenience of wet food). We do fructosamine tests at least 2x a year on cats that are regulated. We do fructosamine and glucose more often as needed when we're still working out ideal dosages.

If Max is still symptomatic and unregulated, his dose or insulin type or diet just might not be working and need changes. And any time your vet visits are frustrating and not helpful, it's always good to try someone else. You can easily get your cat's charts and labwork so the new vet isn't starting blind.

A good vet won't be threatened or pissy about you wanting to consult someone else - the good ones like to hear what others think and try, because it's a learning opportunity, although you do need to establish consistent care so you don't get a case of "too many cooks ruining the soup." I work at a cat-only clinic where I have access to 3 great vets, and I still sometimes take my kits to 2 other places as needed, for expertise and/or approaches my vets don't use as much.

Sorry to be so long-winded, I just hate it when I hear stories about people not having good experiences with their vets, and the impact on their cats' health.

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[info]vicious_wench
2007-08-14 04:04 am UTC (link)

I think Dr. H's protocol has some valid points. I'd dispute her claims that PZI is the only insulin that works (even with her protocol) and that it's impossible to have a clinical hypoglycemic episode on her protocol. However, the basics of "long-acting insulin, low-carb wet food" are important for treating cats w/ FD. There's a lot of debate about whether sliding scales and/or more frequent shooting are appropriate or necessary techniques, but the basic concept is sound. I'd personally avoid the message board (and similarly, the message board over at FDMB (felinediabetes.com) until you have a thorough knowledge of FD; both have some very smart, knowledgeable posters and both have some people who think they know a lot more than they do.

Basically, I think, from reading the other comments here, that you need to learn a bit more about FD yourself, and be more proactive with your veterinary care. 0.5u is quite a low dose, especially for a cat eating dry food -- how long has Max been on insulin? How'd the vet choose that dose? I'm a fan of "start low, go slow" on the increases, but not TOO slow.

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[info]finding_neo
2007-08-15 05:45 pm UTC (link)
In my experience, one of the best ways an owner of a diabetic cat can educate themselves IS to get on the feline diabetes message board at felinediabetes.com

Very seldom do I see someone giving radical or harmful advice there. Dr. Hodgkins advice/protocol IS radical IMO, because the realities of life make it extremely difficult for anyone to follow it. I would love to be able to shoot on a sliding scale and be able to do the frequent BG tests which that protocol requires, but I have to be able to afford the stuff to begin with, meaning I have to work.

From my own experience, anyone who is having difficulty regulating a diabetic cat would benefit from advice given on FDMB, especially if their vet's advice is not working, as it obviously is not in Max's case.

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