Stupid Vet Tricks

Does Your Vet Know What He/She is Talking About? What follows are documented examples of bad advice from vets on the care of diabetic cats.

WARNING: If your vet ever suggests anything close to something you read here, RUN, don't walk, to a new vet. The statements seen below are WRONG, and are the products of ignorance and/or greed. Remember there are ignorant people in all walks of life, just as there are bright, well-meaning people.

On Diabetes:

"I can't prescribe PZI insulin — it's illegal to use on cats."

This vet only uses Humulin U, and nothing else, regardless of whether or not it's working. A member of his staff admitted they don't know what PZI is, which explains why he won't consider any alternatives.

I'd be surprised if the vet hadn't at least HEARD of PZI, and doubt that he really thinks PZI is illegal (it most definitely is NOT), what's more likely is that he's sticking with what he knows, and is counting on his clients just believing his "wisdom" and never checking into the validity of his ridiculous statements. Then again, maybe the pharmacist where he orders his Humulin U has some compromising photos of him. If your vet won't consider an alternative insulin or tries to strong-arm you into using one particular insulin over another, especially if your cat is not responding well to the one it's on, get yourself a new vet. The vet in this situation claims to have 300 other cats all on Humulin U — and I'd bet a lot of money that most of those cats are NOT regulated, given his dosing technique of too much, too fast (the person reporting this Vet Trick is using 7 units per shot and their cat is not yet regulated).

"Home testing is illegal. It's illegal for you to prick your cat's ears at home."

Yes, the same knucklehead said this, too. He wants the $90 to do a curve, and that's the only reason he's discouraging home testing. Testing your cat at home is not illegal — in fact, it's a good idea and is the reason many diabetic cats are still alive — because knowing daily sugar levels allows the owner to make informed choices about diet and insulin dose. So home testing isn't illegal. But vets giving out stupid, dangerous advice ought to be!

"That insulin (a beef PZI compounded by Hopewell Pharmacy in Hopewell, NJ) is the only insulin I can prescribe because it is the only insulin approved for use in cats. If I change the insulin I could be sued if the cat dies or is injured."

Where do these vets come up with this nonsense? There is no list of insulins that vets can and can't use, and while some insulins have a better track record than others when used for cats, there are no hard and fast rules about specific insulins you should use what works, and keep trying different insulins until you find one that does. While we can't see into this guy's brain to know why he told such a whopper, one can only assume that he doesn't want to spend any time exploring alternatives, and is simply too lazy to develop a wider circle of resources.

The same vet went on to tell the client that she should use a large-gauge syringe needle to prick the cat's ear to do home testing — and advised her not to use a lancet. Why? Again, who the heck knows.

The needle is harder to handle because it can't be removed from the syringe itself — very unwieldy — and second, the lancet has a thicker tip, and thus gives you a better, bigger blood drop without having to prick the ear multiple times. If your vet ever tries to strong-arm you into using a particular insulin, from a particular vendor, and has some ridiculous story like this to support his "advice", inform him or her that you know better, and that your wisdom will have you seeking a new vet. Same goes for stupid suggestions designed to discourage home testing — take your cat's health and your business elsewhere!

"Sorry, but when you left your cat in our care, the person looking after the animals during off-hours gave him 30 units of insulin instead of the required 3 units."

Of course this should never have happened, and the vet didn't intend for it to happen, but the vet was ASKING for it to happen by not assigning an experienced tech to administer medications to animals being boarded at their facility. Can you imagine the outrage and news coverage if a hospital for humans let a nurse's aide or secretary give medications to patients overnight? If someone was harmed or killed, the hospital could be sued out of existence and all sorts of hell would break loose, and justifiably so. In this case, the cat was left horribly disabled — blind, unable to eat, walk, or even meow. There are tiny glimmers of hope that the cat will get some of his abilities and quality of life back, but the cat and his owners will never be the same. To avoid this same fate for your cat, always leave pre-filled syringes off with your cat, with stickers on the syringes, marked with the dates and times that the shots should be given. If other medications are required, get one of those containers with separate compartments for the days of the week, and put the pills in them by date, with instructions attached to the container. If your vet won't accept this, find a new vet.

Don't leave it up to the vet to make sure that his best and brightest techs are in charge when he's not there — assume the worst-case scenario so you can rest easier while you're away, knowing you've done all you can to eliminate potential mistakes in your pet's care. You shouldn't have to think this way, but given that these things do happen, it's clear that we have to think defensively. Our prayers go out to Toonces, the cat to whom this happened, and to his loving family who are understandably distraught.

"You are not going to get that kitty regulated by half doses! You'll probably end up having to go up to 8 or 9 units with her urine glucose so high, you'll kill her if you don't go higher quicker!"

This report (a direct quote from a vet) is representative of far too many reports of vets who overdose cats and scare the heck out of owners by making them think that their cats are in great peril if the cat's numbers aren't under 150 all the time. It's scary enough that vets don't realize that you're not striving for "normal" numbers when regulating a diabetic cat, and that numbers under 300 will be just fine for most cats, but the fact that this vet is prescribing based on urine tests is also frightening — urine tests show the sugar levels hours before the urine was excreted (and should never be used to establish an insulin dose), and are far less precise than blood tests. Another issue — 8 or 9 units is a very high dose, and needing that much is probably a sign that it's time to try a new insulin. Dosage increases should be implemented slowly and in tiny (half-unit) increments — not quickly or with huge leaps in dose. The high doses being used can often be the cause of high sugar levels (Rebound), and this vet should know this!

"You need to get her blood sugar down as quickly as possible. It's OK if her BG numbers go down to 30—she'll just get a little sleepy—It's the high BG numbers that are dangerous."

Sleepy?! How about unconscious! Having seizures! Dead! This vet's got it backwards.

It takes time for high blood sugar to kill — it does so by harming the major organs and systems over weeks, months, years. LOW blood sugar, on the other hand, if it goes low enough and nobody's there to administer syrup, honey, or sugar water, can kill in minutes. This vet needs to go back to school. Or something.

"I need to keep your cat here for at least a week to regulate him. You can't do it at home. And I'll be deciding which insulin you can use - don't give me anything you've read on the internet."

Hey, now there's an open mind for you! First, a cat does NOT need to be kept at the vet's to become regulated. The process of regulating a cat can take weeks, sometimes months. A lucky few are regulated within days or a week of starting insulin, but most need time for the owners (with the vet, as needed) to find the right dose and adjust the diet (if the cat's only used to having dry food, for example, and won't give it up).

As for not wanting to hear about any other insulin (other than the 1 or 2 the vet is accustomed to using), that's just nuts. Every cat is different, and no one insulin works for all (or even most) cats. Vets have to be willing to experiment and stretch their repertoire a bit if they're going to really effectively treat their clients' pets.This goes for all diseases/conditions.

"Your cat will not live long, but here's some dry cat food to use in the meantime."

Sadly, the vet who said this is not unique. Many vets consider feline diabetes to be a death sentence, and unnecessarily scare the heck out of the cats' owners. Not only is feline diabetes NOT an immediate death sentence, it doesn't even have to shorten the cat's life if you make the right dietary changes and monitor the disease the way human diabetics keep an eye on their sugar levels. Of course, if you're using a vet who thinks that dry food and high doses of insulin (without doing any home testing) is the way to go, you may be looking at a shortened life span for your cat.

"You have to use U40 syringes — otherwise you'll make a mistake."

Of course it should be noted that the vet who said this was also selling U40 syringes, at 60 cents each. The vet tried to convince the person reporting this story that using U100 syringes is too difficult, but luckily, the woman didn't listen. This vet also wanted her to use a full insulin dose even after seeing that the dose dropped the cat to a blood sugar level of 85. If your vet suggests giving insulin when your cat's pre-shot sugar level is under 200, ignore him or her and withhold the shot. It's a good rule of thumb to only give insulin when your cat is over 200 pre-shot — otherwise, you risk a hypoglycemic (dangerously low blood sugar) episode.

"We'll keep her cat and if it dies, bill her for disposal, too."

The woman who submitted this report had her frightening experience at a vet's office in Longwood, FL. Because her vet was on vacation, she went to the vet he recommended, a former partner of his. She called this vet's office ahead of time and told them that she had just gotten out of the hospital, and while her cat was in dire need of care, she'd have to pay them in a week, rather than at time of service (that day). She was told it was fine, and to bring the cat in. Once there, however, and upon telling the vet about not being able to pay for a week, the list of treatments, tests, and so forth dwindled to nearly nothing.

A cat suspected of having kidney disease (it turned out to be diabetes) was now going to get fluids and a urine test — not the appropriate scope of testing for what they suspected was wrong or to determine what else might be happening. When the woman went up to the desk to get her bill, she overheard the following when the receptionist went behind a partition to tell the billing clerk about the billing situation: "What kind of stupid c*nt comes to a vet with no money? We have her cat? Fine we'll keep IT until she pays; If IT dies we can charge her a disposal fee too." This is a direct quote, and is a very scary reflection of the attitude toward animals one can expect at this practice.

"Three units didn't bring the cat's glucose down enough and four brought it down too much. Use four. His system will get used to it."

OK, now this is scary. Any vet should know that this is just wrong. A cat can suffer brain damage and die in just minutes from too much insulin, and the cat's system will NOT "get used to it". If a dose is too high, it's too high. The dose a cat needs depends on how its body uses the insulin it's making, how much insulin its own pancreas is making, and a variety of other factors, including diet and weight.

Never increase a dose by more than half a unit at a time, and if you find a dose that keeps your cat in the 150 - 275 range, stick with it — don't strive for "normal" blood sugar with a diabetic cat — it's too much of a risk that their sugar will drop dangerously low.

"Ketones?" (didn't know what they were at first) "Oh, yes, we tested his liver, and I didn't smell them."

Didn't SMELL them? In a blood test of the liver? First, this vet, when asked, didn't immediately know what ketones were, and more frighteningly, didn't know how to test for them. He probably was thinking of the sweet smell that diabetics' urine sometimes has. If a cat's blood sugar is high for long periods, ketones can accumulate in the blood (but are diagnosed through urine testing), and ketoacidosis can develop, which is a painful, deadly problem. If you test your cat's urine regularly (for example, at least once a week if your cat is regulated, daily if he's not) with Ketostix (available at any drug store), you'll know right away if ketones are building up. ANY level of ketones in the urine should be addressed by an intelligent, well-informed vet. The cat's sugar will need to be brought down immediately, and he'll need an infusion of fluids to flush out the ketones. This should be done at the vet's, not at home.

"It's going to cost you $600 to get your cat started on insulin, and he only has a 25% chance of survival."

This is the terrible, greedy lie recently told to a woman whose cat had been undiagnosed for some time. The cat was dehydrated and sick, but not beyond saving. The vet scared the owner to the point that she had the cat put to sleep, understandably thinking she was ending the cat's suffering.

This vet should be slapped, and I wish I knew his name. There is NO reason for it to cost this much to put a cat on an IV (to re-hydrate him) and start it on insulin. Further, this vet demanded a 50% down-payment and said without it, he'd refuse treatment. Talk about greed and arrogance.

Diabetes is NOT a death-sentence, and this "25% chance" statement is pure nonsense. It's true if you take your cat to the vet who said this, because ignorance kills. If you hear ANYTHING like this from your vet, make him or her your EX-vet immediately.

"You have to buy your insulin from me, because I have to dilute it for you."

This vet was running quite a scam. He told his client that she had to give her cat 20 units of diluted insulin, when in reality, there is no need to dilute insulin for a cat, and this particular cat simply needed 2 units. The vet was buying vials of insulin for a few bucks (his cost) and then diluting them and reselling the diluted vials at a substantial markup. Based on the pricing in this case, he was probably making over $100 on each $10 vial of insulin he bought. Never let a vet tell you you have to buy insulin from him only — even if your state or province requires a prescription for it. A vet can write you a prescription that you can fill at any pharmacy.

"We need to run several tests to determine why your cat can't walk."

If a cat is diabetic and has weak legs, chances are it's neuropathy. While it's fine for a vet to cover the bases and test for some other possible causes, it's unethical and just plain stupid to test for things that common sense would rule out — FIV tests for an indoor cat who'd tested negative previously, repeated x-rays when arthritis or spinal problems have been ruled out by previous films, etc... If you think your vet is trying to cover for a lack of knowledge by running a lot of tests, say so. Ask him or her why each test is required, and demand a thorough explanation in terms you understand.

"We have to get her sugar down to zero."

Hello? You mean like no blood sugar at all? Are you trying to treat this cat or kill it? There is always glucose in the blood—a normal BG can be as high as 115, and for diabetic cats, the cat is considered regulated if its glucose is kept in the 200's most of the time, under 300 all the time. If this vet was referring to urine testing for sugar, he or she needs to be very specific so the client isn't striving for a zero result in blood testing, because such a result will be deadly.

"Diabetic cats don't live very long."

Well, that depends on your definition of "long". How about a normal life span? How about 3, 4, 5, even 10 years of life after diagnosis? A cat with diabetes and conscientious care can live many years, so don't take a diagnosis of feline diabetes as a death-sentence for your cat. It just plain isn't, and any vet who thinks it is needs to seriously rethink his or her line of work if they're that far behind on research and treatment of a not uncommon illness.

"I think he has allergies. Give'em this prednisone every day to stop it."

Prednisone may be the way to go for a non-diabetic cat with allergies, but it can be very dangerous for a diabetic cat. Extensive use of steroids can make a non-diabetic turn diabetic, so what the heck does this guy think it would do for a cat who is already diabetic? If your vet tosses pills at a problem rather than investigating causes and logical cures (how about removing the source of the allergy, if possible?), you need to evaluate your choice of vets.

On Home Testing

"Home testing causes anemia."

A vet tech at the University of Minnesota's emergency room told a woman that home testing her diabetic cat could cause anemia, because the loss of blood builds up over time. WHAT????!! Drawing a drop of blood (a DROP) twice a day for pre-shot tests, and every few hours on a monthly curve doesn't even fill a teaspoon. Does the vet tech not know that the body creates new blood to replace lost blood? And how does this rocket scientist explain human diabetics who test themselves several times a day for years?

Our theory? It's just pure arrogance, with the "experts" not wanting pet owners to take any control over their own pets' condition and care. We see this sort of scare-tactic time and again — read on for a few similar statements from other alleged professionals.

"You'll have to keep your cat's ears shaved if you're going to home test."

WHAT??? Shaving a leg or the cat's neck prior to a venous blood draw is one thing — it prevents infection and allows the vet to see the vein. But the EARS? They have very little hair on them, and on light-colored cats, you can see the veins without any problem (see our page on home testing). If your cat has very furry ears or dense, dark fur, you can shine a flashlight through the ear (from the underside) and take a mental picture of the vein layout.

There is NO REASON to shave a cat's ears for home testing. For Persians with very long fur on their ears, you can use a little vaseline to keep the blood drop from getting lost in the fur — instead, it will bead right up so you can sip it up easily with your glucometer's test strip.

"You can't use a glucometer to test cat blood, it was designed to test human blood."

Yeah, right. The meter intuitively knows the blood came from a cat, and won't be able to measure the amount of glucose in it. Come ON! The glucometer will measure the glucose in ANY blood, from any creature — dog, cat, human, or aardvark.

"The only good way to draw blood for a home glucose test is to cut the cat's nails so short they bleed."

This vet went to the Marquis de Sade School of Veterinary Medicine. Not only could the cat bleed buckets in the process, it will hurt like Hell. What a cruel and greedy MORON. Vets who makes suggestions like this are just trying to make the idea of home testing seem so scary that you won't do it.

"Only a vet can test a cat's blood."

I have nothing to say except... AAAAAAGH!

"You have to leave your cat here for a glucose curve. You can't do the testing at home, it won't be accurate."

Loosely translated, "If I frighten you into believing you can't do this yourself, you'll pay me large sums of money to save you from something you could have done yourself, with a lot less stress on your cat. Sucker."

However, if you have been unable to regulate your cat, or if the cat is suffering from other complications as a result of continuing high sugar levels, a vet may have to intervene and do a curve for you to establish an effective dose.

You'll know if your vet is offering to help with a difficult situation or merely strong-arming you into not testing at home.

"The Internet is the domain of crackpots and terrorists."

That's us! Eco-terrorist sociopaths out to dominate the world, one house pet at a time... This was a response to a client's desire to do home testing, something the client had read about online. The comment was made by a young vet, someone who should have been more open to the research one can do on the Internet (virtually every peer-reviewed medical journal in the world maintains a website).

Do idiots dispensing misinformation exist on the Internet? Yes.

They exist on Network television, in the mainstream press, and at Veterinary offices too. While it goes without saying that you shouldn't believe everything you read, if data can be verified through multiple, peer-reviewed sources, don't let a narrow-minded vet discourage you because they don't like the mechanism by which the information is transmitted.

On Insulin

"Give the insulin shot right into the cat's leg muscle."

This one is just unbelievable. Not only would it be extremely painful to give a shot directly into the muscle, but insulin that is shot into the muscle acts very quickly — therefore, if your cat normally peaks in 6 hours, he or she may peak in 2 or 3 hours instead, thus reducing the overall effectiveness of the shot, and putting the cat at risk of a hypoglycemic episode if you don't have a feeding scheduled for this premature peak time.

"Your cat's not regulating fast enough, let's increase her dose from 2 units twice a day to 3 units twice a day."

Never increase a cat's insulin dose by more than half a unit at a time. By increasing by a full unit twice a day, an extra 2 units are being administered, and the cat could be in serious danger of a hypoglycemic episode, especially if the cat is left alone for hours after shots are given. When adjusting a cat's dose, take baby steps. Regulation is important, but hypoglycemia kills, and a roller-coaster curve isn't good for the cat, either.

"You don't want to use insulin. What if the cat throws up after you leave for work?"

This is just a scare tactic. 99% of the time, if you test the cat's blood before the shot and he/she is above 200, you're safe to feed the cat (stay to see that the food is eaten), and leave for work. You have to get on with your life and do the best you can for the cat. Insulin is the best you can do.

"One shot a day is fine."

For a tiny minority of cats. Even long-acting insulins don't last 24 hours. Any time spent over 300 is damaging the cat's system, and should be avoided at all costs. Two shots a day is best for virtually all cats.

"You can use those needles several times before you throw them out. Why waste money?"

How 'bout we inject YOU several times with the same needle and see how YOU like it??? Needle reuse can cause infection, contaminate the insulin, and it HURTS because the coating is worn off the needle, and it doesn't inject smoothly.

"If your cat's not regulated within seven days, it never will be."

Well, the hundreds of cats who took much longer to regulate (and the many who go for years in and out of relative states of regulation) and are still alive show this to be a ridiculous statement.

"Don't worry if the cat hasn't eaten, give him the insulin anyway."

This statement should be followed by, "And don't worry if the cat starts wandering in circles and collapses; low blood sugar is a safe and fun experience for any cat." The damage done by high blood sugar takes time to occur. The damage done by low blood sugar (hypoglycemia) is done in an instant — cats can have seizures and suffer serious brain damage within minutes of dipping below a blood glucose of 50. If the sugar level isn't brought up promptly, the cat can die. If your cat hasn't eaten and won't eat, don't give insulin until they do, and call a vet (not the one who made this statement!) to investigate causes for the lack of appetite.

On Vitamins and Food

"Put the food down for the cat, and if he hasn't eaten it in 30 minutes, take it away."

This sort of tactic may work for dogs, who'll eat until they burst, but for cats, who should have several small meals throughout the day, it's really bad advice. Give your cat a meal with each shot and again at "peak" (typically 4 - 6 hours after a shot is given). You can always leave food out if you won't be home at peak, and certainly overnight. If you have non-diabetic cats in the house and don't want them pigging out, feed your diabetic cat in a separate area, or consider switching ALL your cats to canned food and feeding them all at the same time. Dry food isn't good for ANY cat — cats are true carnivores and need mostly protein to survive.

"This dry food is great for diabetic cats because it's low in fat, and your cat needs to lose weight."

Well, let's be careful here. Feeding dry food can raise blood sugar (dry food is high in carbohydrates), making it harder to regulate the cat. Better to feed a higher protein canned food and cut back on the amount you feed. Note, too, that despite a lot of vets' desire to slim your cat down quickly, make only slight reductions at first, as you don't want your cat on a crash diet — there are serious side effects from too rapid weight loss in cats. The fact is, you usually end up with a fat cat as a result of snacks and table foods, not normal consumption of cat food, so make your adjustments accordingly.

"I've never heard of it. It won't work."

Spoken like the open-minded scientist all vets can only hope to be. This guy's ancestors were the ones who told Columbus he'd fall off the Earth if he sailed past the horizon.

"Snacks are raising your cat's blood sugar."

Well, what are the snacks? If they're a spoonful of tuna fish or a slice of turkey breast, they aren't raising the cat's sugar enough to be a problem. Yes, carb-loaded snacks are no good, but some pure protein in small amounts isn't a bad thing, especially if it keeps your cat from begging and driving you nuts for a meal when it's not time to eat yet. The vet who said this may have been looking for something to blame for the cat's high glucose levels, when he had no idea how to explain them. A vet who can't say "I don't know" or "I'm not sure" is a vet you want to think twice about.

On Major Organ Failure and Disease

"Blood work? Well, if you insist."

If you take your cat to the vet with symptoms such as lack of appetite, changes in gait (way of walking), excessive urination, lack of urination, increased thirst, fever — anything other than something simple and identifiable like ear mites or a torn claw, be sure your vet does blood work. Blood tests can show problems with the kidneys or liver, infection, diabetes, even cancer. Don't assume your vet is some all-seeing, all-knowing guru who can't screw up. He or she can, and will screw up at some point, just like the rest of us humans. You just don't want it to happen when it comes to treating YOUR pet. If you think a test is needed, demand it. It's your pet, your dollar, and the vet works FOR YOU.

"There is nothing you can do for a cat whose kidneys are failing."

Wrong. Fluids and various medications can be of great benefit. Also, what has caused the kidneys to fail? If they're failing due to being taxed by another condition or toxin in the cat's system, addressing that can save the kidneys. Run from a vet who throws up his or her hands like this. At the very least, get a second opinion.

"Hmmm. I don't know why she's coughing and wheezing. Maybe it's an infection. Here are some antibiotics."

How about checking the cause of the congestion with an X-ray and and EKG? In this case the cat was on heart medication, and an adjustment in dose solved the coughing problem. If your vet isn't keeping other medications and conditions in mind when treating something new, find a new vet.

If your vet has said something dangerously stupid, please email me or post it at the Feline Diabetes Message Board. I'll be happy to post the misinformation and the accompanying correct information. The goal of this page is to prevent the pain and suffering cats (and their owners) often suffer at the hands of vets who don't know enough about feline diabetes to be giving advice to their patients.

Find a vet who cares about you and your pet, and who takes the time to learn the latest information before telling you how to take care of your cat — there are more good vets out there than there are bad ones, but you still have to keep your eyes and ears open, and rely on your own common sense. A good vet should see you as a partner in the pet care process, not as some child who must be told what to do and think. The lab coat he or she is wearing doesn't make them right, it just keeps their clothes clean.

NOTE: If you want to know more about the vets in these reports, email me. If I know the vet's name or can obtain it for you, I will tell you or find it for you. This page is not intended as any sort of "vet-bashing" — the goal of the page is to share information — to help people avoid the dangerous and painful advice and treatments that have been experienced by the pets belonging to people who've reported the incidents to me. Bear in mind, too, that for every one of the listed reports here, there are many duplicates. So the things I'm reporting here are NOT isolated incidents.

Email me at if you have suggestions for this page or questions about what you've read here or anywhere else on Jasper's pages.