Vets, new vets, yearlies.. etc..

[kitten68]

hello!

so.. we are on the market for a vet, as nugget needs new scripts, etc for the year for his medicines. ..

when it comes to the vet, how should things be approached?.. because with TR most if not 99% have not heard or use it.. SLGS even. they don't deal w this properly. fortunately, one of the few things anyway, w the first vet that was used when things first were started was that they'd heard of TR and we could talk about it, etc.. they eventually wrote scripts for our Lantus, no problem.. frankly I could tell they were kind of apologetic about it. started us on Vetsulin, pfft (didn't work for him well at all.. unsurprisingly). took us for a little ride at times too so whatever..

anyway. when you guys talk to your vets, do you openly talk about TR or let it go that way naturally..? do you bring up the Board? I'd imagine probably not but idk.. because, for example, when bloodwork is done, and depending on the time of day/cycle.. numbers may look normal.. and I've heard most vets are like, keep em high 100s.. etc.. maybe lower.. they're gonna notice. (one we saw was like, yeah should be 200s/300 at shot time, etc... ugh. ) does this matter?.. I'm not sure if some might be in my face about it. im contemplating going back to the first one just to get our scripts cuz they were a little familiar.. but I don't want to do that at the same time cuz I don't like them lol. they are close by tho..

how to go about this w a new vet, or a vet that you've seen that didn't diagnose but you'd like them to be going forward w you on it? (which is also where we are..) maybe we should go back to that vet just for scripts?.. ugh.

our choices are go back to the first vet, see our other vets for this who didn't initially diagnose and see how that goes, go a long distance to someone who uses Lantus in their practice and see how that also goes (just remembered now there's someone closer by who uses Lantus, too, but I didn't like the office.. haha, alas.. but that's an option as well)

we don't know.

any thoughts/suggestions much appreciated..

 

[Sienne & Gabby (GA)]

As a place to start, this is a post on choosing a veterinarian.

When I moved several hundred miles from Chicago, I obviously had to find a new vet. I was spoiled by using a cats only practice and was able to find a similar practice in Columbus. The vibe is very different than in a general veterinary practice mostly because there are no dogs barking in the waiting room and no dogs trying to stick their nose into your cat carrier.

I asked the vet how much input she wanted to have in managing Gabby's FD. And then I showed her my spreadsheet. She looked at the spreadsheet and asked if I always kept such meticulous records (Uh....yes!) and then said there was very little she could add to what I was doing. We got along great! This is not a vet who felt the need to be in control and wanted to work with me.

When Gabby was first diagnosed, TR was relatively new. I have access to a lot of resources most vets or caregivers don't. I have access to medical and veterinary libraries. I brought the vet a copy of the published journal article describing TR. She was intrigued and then converted all of the other vets in the office to it's use.

I would think about choosing a vet in much the same way as you would think about selecting a pediatrician. You want someone who listens to you and talks through the ins and outs of what their recommending.

 

[Wendy&Neko]

My vet had heard about the "U of Queensland" research when I started, but they still prescribed Caninsulin. It was a locum vet who got me started on Lantus and pointed me to FDMB for dosing help. I found the spreadsheet a very useful tool to show the regular vet that I was handling Neko just fine on Lantus and TR. I too printed off a copy of the TR article. After that, our total discussion on FD was the vet asking "what is her current dose". I still needed the vet to handle Neko's other conditions, but wanted her to let me handle the diabetes side of things.

When Neko got complicated enough to need an internal medicine vet, he fussed a bit about Neko's numbers on her spreadsheet being low (to him) and thought her inappetance could be due to low numbers. I knew Neko well enough that I told him to test her while she was there for the blood work and ultrasound, and that she would be mid 100's that day. She was. And she was diagnosed with small cell lymphoma and congestive heart failure - which was what caused the inappetance. After that the vet became a fan of the spreadsheet. I typically took in my tablet, showing both the BG spreadsheet and the Labs spreadsheet so we could see trends. We never discussed her diabetes again.

 

[Staci & Ivy]

I have now worked with 4 vets (one was an internal medicine specialist) since Ivy was diagnosed with FD.
They all prescribe Lantus, and have all been in favor of using a Libre for her (given her spicy personality).
They have all been happy to prescribe insulin when I need a new script.
I don’t discuss TR or SLGS or any methods.
They all have asked what her current dose is and what her BG trends/curves tend to be.
Pretty much that’s about it for FD.

I think if you can find a vet you can work with, it’s close to home (even better) and will prescribe the insulin you like, you’re off to a good start

 

[Lauren & Esse]

One of the vets at the practice we go to actually pointed us to felinediabetes.com, which is how we found FDMB in the first place! He is not our primary vet now, but our primary vet at that same practice has been very understanding and receptive to my questions. She suggested/prescribed Lantus initially but once I told her we'd be home testing (rather than shooting blind and coming in for periodic in-office curves) it sort of seemed like she was handing over the reigns, so to speak. They have a link to our spreadsheet in their records so they can reference it when needed, e.g. in preparation for our upcoming dental procedure.

 

[Mary & Jude]

FWIW, this has been my experience, which I will preface by saying that the main takeaway is this: find a vet who is okay with shared decision making between patient caregiver and doctor and one who is not threatened by non-professional (laymen) medical perspectives. Following Jude's initial diagnosis, I began educating myself about FD, which led me to the forum, and I knew that, based on the initial vet visit when Jude was diagnosed, based on the scant treatment information I received in that visit (no discussion about dosing methods or home testing) that the vet wasn't used to caregivers taking much of an active role in their cat's FD treatment. We didn't discuss dosing methods or pre-shot testing at all when Jude was first diagnosed, just that I should shoot every 12 hours and that I should rub Karo Syrup on Jude's gums if he were to pass out after an insulin shot (and to be clear, they only offered that information about the passing out and Karo syrup application after I asked them if there was anything I should be concerned about with Jude's treatment). After I began reading the information on the forum, I met with the vet again to ask for a Lantus script (we had been using Vetsulin), and he was supportive of that, and I mentioned to the vet that I had joined an online forum with a number of other FD caregivers and some folks who were knowledgeable about FD, and that the forum encouraged home testing, and he was encouraging of that as well. Quickly after Jude's diagnosis, with food change and the switch from Vetsulin to Lantus, Jude went into remission. When Jude came out of remission, I continued testing and gathering data, and we had some situations where I needed to work more closely with the vet. It was then that I brought out the spreadsheet which the vet was both impressed with but which also caused him and the vet tech to look at me like I was a cult-member, but I think in the end the data and record keeping won him over. To this day, I don't think he and I have ever actually discussed Jude's dosing method (TR), but he has a shared link to Jude's SS, and he occasionally looks at it when I ask for guidance. I make sure to communicate to him nearly every time we talk that I value his input--that he's the expert; I'm not--and that I want him to tell me if he disagrees with anything I'm doing. He rarely disagrees with me, though, because I think he recognizes that the decisions, most of which come from this forum, are solid.

 

[kitten68]

thank u so much all ..
sounds like its a non issue and I don't even have to offer it up unless asked and can refer to the SS and explain if needed..
so nice to hear some of the vets are how the Board was found to begin with!