Friday, March 30, 2007

Food spikes

The results are in. (Drumroll, please.)

Serving Isabella the same food at the same times every day did not smooth out her blood glucose numbers. She's still up, then down. Up, then up again, then down. I have to admit to feeling smug about this. I gave the report to the vet, along with a 12-hour BG curve, and said I thought a dose increase was in order. The curve (in which the poor cat’s blood glucose is tested every two hours for twelve hours to see how the insulin works) was intended as evidence that her overall numbers are still too high.

The vet’s response? He wants to run an expensive blood test. Which will tell him … (dramatic pause) …that her overall blood glucose is still too high. Not on my dime, darlin’. He also wants me to test her urine glucose.

Now, here I’ve presented him with the BEST information you can get, short of continuous glucose monitoring, and he wants info from less-revealing testing methods. I give up. Obviously he is just not interested in learning from the blood glucose numbers.

To that end I collected the phone numbers of three veterinarians recommended by friends. All have (or had) cats. None diabetic, but I’ve got to start somewhere.

Vet number one is not taking new clients. Vet number two is taking new clients and has a huge diabetic clientele. Further, they encourage it and teach owners to test blood glucose at home. This information I got from the front office gal. The vet was (is?) supposed to call me so I can ask more specific questions. Alas, she has not called. So …. I’m not impressed with that. Perhaps I need to make an appointment. I haven’t called vet number three, since the second sounded so promising.

I’m changing vets regardless. If I can’t get Isabella’s glucose down with insulin, she’s going to need other tests to figure out what’s going on and I’d like those tests to be done by someone I have more confidence in. I owe a huge debt of gratitude to my current vet, who removed Isabella’s cancer two years ago, but he’s not cutting it with the endocrine disease. We all have our strengths.

Que sera, sera.

Friday, March 16, 2007

Peaks & Valleys ... feline diabetes-style

I’m seriously frustrated with my vet. The cat’s vet, actually.

I took Isabella in for a check-up this week. I dreaded going because her blood glucose numbers have been high lately. Consistently high. I’ve spent the last month tweaking her insulin dose and getting nowhere. But, knowing I had an appointment coming up, I picked a dose and stuck with it for ten days prior to the vet visit. He (the vet) gets twitchy when I move the dose around.

I figured I’d go in, present her log of BG numbers, get scolded for a) tweaking the dose, and b) settling on a dose that’s too low, and then we’d agree to raise the dose and I’d be on my way.

What I had forgotten is that this vet isn’t used to seeing twice-a-day blood glucose numbers mapped out in a bar chart. While I’m able to focus on (and be ashamed by) the overall trend of numbers in the mid-300s, he fixates on the peaks and valleys of day-to-day variation. I see those daily variations reported by other kitty owners on the Feline Diabetes Message Board, so I know it’s not something unusual.

My vet, however, naively assumes that if I fed Isabella a strictly consistent number of calories each day, she’d respond with correspondingly consistent BG numbers. And! He wants me to feed the expensive prescription food (higher in carbs that what I’ve been feeding).

In the interest of decent relations, I’ve decided to compromise. I chose three flavors of grocery-store food. She gets three meals a day, so she will get those same three flavors, in the same order and at the same time, every damn day for the next two weeks. That will keep her calories consistent from day-to-day – both overall and within each insulin cycle. At the end of the trial, I’ll plot out her daily numbers so he can see that the same level of variation crops up even when calories are the same.

Unless, of course, he’s right and she suddenly smoothes out and start showing a predictable response to the insulin. It could happen, but I ain’t betting on it.

And, in the meantime, I’m going to interview other vets. It’s a big town. There’s got to be someone around who can work with a home-testing owner of a diabetic cat.