Wednesday, October 21, 2015

Tucker on the Battlefield

Tucker’s treatment for diabetes continues, though it has come up against a problem.

Last week, his veterinarian had me raise the roly poly’s insulin dosage to four units in the morning and three at night, and then take an individual reading at mid-day, half-way between the two injections. I did this on two days, Saturday and Sunday. Saturday’s reading was higher than expected; that on Sunday was 6.26. The difference, I believe, was caused by stress. The first day, I had great difficulty drawing blood, and had to poke my unfortunate cat numerous times before I found some. He was unhappy and worried. On Sunday, I positioned him with a flashlight in front of him, and, sitting behind him, stabbed his ear where I could clearly see the blood vessel shown by the flashlight’s beam. I managed to draw blood the first time.

The veterinarian thinks that 6.26 is too low for Tucker. I think it is, however, a number for which many people aim. Even so, the doctor ordered that the dosage be returned to three units twice a day. I am to continue this for another week and then take an individual reading.


I would not give Tucker insulin if his number - at the time of the injection - was below ten. So a curve will be done on the weekend following the next reading, in order to determine where the numbers start the day and where they end it. My veterinarian wants me to bring Tucker in to the animal hospital for this curve. He will stay over-night so that a reading may be done very early in the day, and then twelve hours later. This is being proposed because my glucometer and the doctor’s give different readings; that is to say, one is not right and the other wrong, they are simply set differently, and I must convert my results to the doctor’s, rather like converting two kinds of currency, or imperial measurements to metric. I worked out the formula for conversion, and there is no difficulty in doing this.

The doctor, however, thinks that the difference may be compounded as the number grows, perhaps believing that whereas I must multiply my results by 1.5 (for example) when the number is low, I must multiply it by a greater number if the results are a greater amount. I can understand her concern but this raises difficulties for me and Tucker.

It means that for what the veterinarian may consider an accurate reading, I would have to bring Tucker to the hospital every time a curve is taken. He would have to stay over-night, so that readings could be taken throughout a twelve-hour period. This has two effects: one, the cost would be prohibitive at the best of times - and right now, for me, this is not the best of times. Secondly, and more importantly, Tucker would be under a great deal of stress. He would be in unfamiliar and, to him, hostile surroundings, being kept in a cage and poked by strangers every couple of hours. I believe the difference between Saturday and Sunday’s readings were due to the stress of being poked too often the first day, and this was when I was doing that to him. I can’t see that the readings obtained under worse conditions in the hospital would be useful.

I will speak further with the doctor about this, but I don’t think I will allow this to proceed. I think I can perform a curve on Tucker more usefully at home. He won’t like it, but he won’t be afraid all day. I believe that even if my conversion of glucometer readings is inexact, those for a curve would still be significant because the resulting numbers would give an indication of his condition throughout the day, and how the numbers rise and fall, if only in relation to each other. Besides, I don’t think my conversion is wrong.

There are other indications by which to judge Tucker’s reaction to the insulin. When Tucker’s number at noon on Sunday was 6.26, he was still alert, cheerful, and mobile. He lumbered a bit, due to the diabetes weakening his rear, but it was no more than he had been. He did not act as if his numbers were too low, though I was ready with the corn syrup in case he required it. A diabetic cat is new to me, but I believe he was fine with the higher dosage.

So, Tucker’s treatment has not yet stabilised. There is more experimentation in store for the roly poly. I know that his veterinarian has his best health in mind, but she and I may differ over his treatment in this instance. I hope that Tucker doesn’t suffer while caught in the middle.

12 comments:

  1. Poor fella! I agree with you about his stress level at the vets, but I also have to wonder how they could be as accurate as you since while he's there he not only has the stress, but his schedule will be totally different. When he eats and when he litters will certainly not be his norm, or am I over thinking? Either way, good luck with everything, hugs to Tucker!

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  2. To take Tucker in every time a curve is done is ridiculous and NOT in the best interests of the cat, IMO. The vet might think so, or being cynical as I often am, perhaps her BMW (or whatever) payment is due. You know Tucker better than anyone else and you will do what's best for him. If at some point that does mean taking him in to stay overnight, I know you will. Otherwise, Tucker still will have the very best care from and with you.

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  3. dood....we iz sorree ya hafta go thru thiz.....we hope a "plan oh actshun" can be reeched by all concerned for yur benny fit....we noe itz knot eazee on dad....ore ewe ♥♥♥

    ~~~~~~~~~~ waves two de crew

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  4. I believe a more accurate or more useful reading will. E better obtained at home as Dear Tucker will be more comfortable. We hope the best for Tucker. From Jessica and Eileen

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    1. Yes, I can't see taking him in to the veterinary hospital for this. I will be talking to his doctor before the weekend.

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  5. that sounds stressful for Tucker and for you. It sounds like you know what's best for him, I hope your vet is understanding and kind. -- purrs

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  6. What brand meter is your vet using? Could you obtain the same meter for home use? I'm going through a
    financially tight time now too but would gladly contribute to a "kitty" to get get your kitty a new glucometer. Just say the word. That's what the cat blogosphere is about. People helping people.

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    1. Thank you very much for your generous offer, but I know what financial stringency is like, so please keep your funds for your own wonderful cats. The glucometer I have was given to me by a kind lady who used it for her diabetic cat until he died recently, and it is perfectly serviceable. As someone said to me recently, the vet may not be used to someone being able or willing to do all these things at home for his cat. This will get sorted out, and Tucker won't suffer in the meantime. You are right about the Cat Blogosphere, and I have received much help and encouragement through it. Having people such as yourself give advice and assistance is very gratifying. Thank you again.

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  7. Poor Tucker! I agree with you that the stress of being in the vet's office would be much more than at home. Hopefully the next curve will provide more accurate (and better) results.

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  8. I also agree with you. I understand the vet's point of view, wanting to double check your information and verify that what you are seeing is what they are seeing, but you are completely right that it is a strain on your kitty and it is a financial (and emotional) strain on you.

    Many cats also get white coat syndrome, and have higher glucose readings while at the vet, so having a curve done there isn't always the best idea.

    Yes, all glucometers read differently.. there are a lot of great articles on the variences in glucometers, this one I like because it doesn't have a lot of jargon http://www.healthline.com/diabetesmine/why-meters-cant-tell-us-our-blood-sugar-levels#2

    The FDA allows for a variance in the accuracy of the reading.. the allowed variance is smaller the lower the glucose levels.. so if your glucose readings are very high it is allowed to have a greater percentage of being off (I think it is 10% either way) and still be considered accurate, which is why it is a very good idea to use just one meter and stick with it. When changing meters the variance will be different and it might read higher or lower.

    I also heard more than once that some meters will purposefully read low when glucose levels are lower to spur the person being tested to eat and raise their levels to make sure they don't go too low.

    Anyway, I'm rambling, and you are probably sick of my comments anyway.. ;) but in closing I will say that one way I won my vet over was to bring my glucometer in and we tested the cat's blood glucose with their meter and mine.. when he saw how close they were he accepted my readings and things went smoother.

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    1. Thank you again for your pertinent advice and information. I suspected that glucometer readings would vary from one device to another more when numbers are greater. That makes sense.

      Today I performed a curve on Tucker at home, and I think the results were very good. He of course did not like being poked numerous times in the ears, but he was hardly stressed as he would have been in the alient and , to him, unfriendly, hospital environment. I will describe the day in detail in an impending post.

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