? Feeling Discouraged

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jacereske

Member Since 2014
This is Keno's 6th day on 4 u twice a day and she is eating the d/m food (14% carb) with her AM shot and PM shot. She gets Weruva (3.3% carbs) at +3 & +5. No food after +6 until her PM BG which is over 400 every day.

I am still seeing high BG's at +12. Stopping food before +6 does not seem to have helped.

I guess I either need to get her off the d/m or increase insulin. Changing her food has to go slow - she is CKD and her stools are still soft right now from the food change from k/d to d/m.

We just adopted her 3 months ago, she's 16 years old - an owner surrender at the shelter who was scheduled for euthanasia the next day. I thought I would be able to get her diabetes managed, but it has been over 3 months and her numbers are awful. I feel like I'm failing her.

I have another diabetic cat who also has asthma, IBD & pancreatitis and another cat was just diagnosed with IBD yesterday. Feeling very down and discouraged tonight.

Jeanette
 
Jeanette...
I am so sorry your having such a rough time.
We do try to keep the food under 10% carb so you may want to rethink the DM.
Many of us here have cats with CKD as well and it takes a little while but you will get there AND how amazing are you for saving this baby!!
Many cats do well with pumpkin for the tummy as well as slippery elm bark.
6 days seems like forever but patience as you know is key with diabetes.... we usually hold a dose for 6 cycles (12 hours is a cycle) and if the numbers are not moving into a healthy zone we increase by .25 for another 6 cycles or longer if you start seeing good numbers. Sometimes adding a +9 snack (like freeze dried chicken or something very low carb) will stimulate the pancreas ... many actually do well free feeding and have gone off insulin both ways-
I am sure more expert eyes will be able to help you more.... hang in there your her angel:bighug::bighug::bighug:
 
Jeanette, you certainly have enough on your plate! I think it was absolutely wonderful of you to adopt Keno! You are most assuredly NOT failing her, you are giving her the chance her previous owners denied her. It can sometimes take quite a while to get kitty regulated; you have to remember this is a marathon, not a sprint. :)

A couple of things spring to mind when I look at Keno's spreadsheet. I noticed you have increased/decreased her dose by full units; we usually recommend changing the dose by only 0.25 U at a time, and holding that dose for at least 3 days (6 cycles). There's a possibility that you may have gone past her optimum dose, and this could cause her numbers to be almost impossible to control. And as you mentioned, the dry food doesn't help. If you can slowly wean her off of that you will probably see a change in her numbers, as well, but please test often and monitor her closely if you do this, as her numbers may drop rapidly, requiring a dose reduction.

I know you have an awful lot going on with her and your other kitties, as well, but if there is any way you can get any more tests in it would give you more information about when her nadir is, how she handles the insulin, etc., and this would be helpful for you, too.

Please don't be discouraged, you are doing a wonderful job for Keno and your other kitties, and you have a lot of people here who would love to help you! :bighug::bighug::bighug:
 
Jeanette, you certainly have enough on your plate! I think it was absolutely wonderful of you to adopt Keno! You are most assuredly NOT failing her, you are giving her the chance her previous owners denied her. It can sometimes take quite a while to get kitty regulated; you have to remember this is a marathon, not a sprint. :)

A couple of things spring to mind when I look at Keno's spreadsheet. I noticed you have increased/decreased her dose by full units; we usually recommend changing the dose by only 0.25 U at a time, and holding that dose for at least 3 days (6 cycles). There's a possibility that you may have gone past her optimum dose, and this could cause her numbers to be almost impossible to control. And as you mentioned, the dry food doesn't help. If you can slowly wean her off of that you will probably see a change in her numbers, as well, but please test often and monitor her closely if you do this, as her numbers may drop rapidly, requiring a dose reduction.

I know you have an awful lot going on with her and your other kitties, as well, but if there is any way you can get any more tests in it would give you more information about when her nadir is, how she handles the insulin, etc., and this would be helpful for you, too.

Please don't be discouraged, you are doing a wonderful job for Keno and your other kitties, and you have a lot of people here who would love to help you! :bighug::bighug::bighug:

Thank you. She is not eating dry, the m/d is wet food.

I work full-time so the earliest I can do more tests will be this Saturday.

I was increasing the dose based on her internist's advice and I realize now it was not the best way to proceed. However at the time she was on kidney food which was 35% carbs and her numbers were not dropping.

So I am not sure what to do. Should I decrease or increase her dose? Or try a food change to lower carb?

Jeanette
 
I work full-time so the earliest I can do more tests will be this Saturday.

If you can't get mid-cycle tests on the AM cycle due to work, that makes it even more important to get some tests on the PM cycle....If at all possible, getting a +2 and a "before bed" test may really help to know what's going on with Keno's BG

I think there's room for an increase to 4.25, but please start getting some of those PM tests in....most cats go lower at night and we want to keep Keno safe.

It can only help to reduce the carbs too. M/D isn't bad, but the ingredients are no better than most "over the counter" foods like Fancy Feast and Friskies....why pay $2 for a can of cat food?

Have you read the sticky on "is Tight Regulation possible with a full time job"? Some good tips there that might work for you too!
 
Thank you. She is not eating dry, the m/d is wet food.

I work full-time so the earliest I can do more tests will be this Saturday.

I was increasing the dose based on her internist's advice and I realize now it was not the best way to proceed. However at the time she was on kidney food which was 35% carbs and her numbers were not dropping.

So I am not sure what to do. Should I decrease or increase her dose? Or try a food change to lower carb?

Jeanette
Okay, that's good, the wet is better than the dry! And it looks like she's off the kidney food, now? I don't know as much about CKD as many of the other folks here, but I do know you don't want to give her foods that are high in phosphorus. Here's a link to a great food chart that gives you the percentage of protein, fat, carbs, and phosphorus in lots of popular foods:

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

I can't really help you with the dosage without seeing more numbers on her spreadsheet - I would not want to steer you the wrong way.

I see Chris from Chris & China has weighed in (everybody types so much faster than me, it takes me forever and by the time I'm finished, half a dozen other people have already posted the same things, lol). She's been in this sugar dance longer than me and has me beat, hands down, on experience! I suggest following her advice, it's what I do, anyway, lol! :bighug:
 
If you can't get mid-cycle tests on the AM cycle due to work, that makes it even more important to get some tests on the PM cycle....If at all possible, getting a +2 and a "before bed" test may really help to know what's going on with Keno's BG

I think there's room for an increase to 4.25, but please start getting some of those PM tests in....most cats go lower at night and we want to keep Keno safe.

It can only help to reduce the carbs too. M/D isn't bad, but the ingredients are no better than most "over the counter" foods like Fancy Feast and Friskies....why pay $2 for a can of cat food?

Have you read the sticky on "is Tight Regulation possible with a full time job"? Some good tips there that might work for you too!

Chris, she has stage 2 kidney disease so I can't feed Fancy Feast. I have to feed low phos and it is very hard to find low phos/low carb. There are some Weruva's I am going to try but she is sensitive to food changes so I have to go slow.
 
You're right that Fancy Feast is too high in phosphorus for a kidney cat, but there are other foods that are low carb/low phosphorus. I used to have a chart bookmarked that had a list of them but my old computer bit the dust and I don't have it on this one yet. (If I can find it, I'll post it for you)

You can also use phosphorus binders like aluminum hydroxide so you can feed higher phosphorus foods without causing any problems.
 
Hi Jeanette,
Which Weruva are you feeding her? I ask because I started giving Bunny Weruva Paw Lickin' Chicken because their website showed it to be very low carbs. He started having surprisingly high BG numbers. Closer inspection of the weruva label showed potato starch as an ingredient. I switched to Merrick chicken pate and his numbers dropped again. I don't know if Merrick is low enough in phosphorous for you, but you might want to check the weruva labels. I have had good luck with their Mack & Jack flavor.
Angela
 
Hi Jeanette,
Which Weruva are you feeding her? I ask because I started giving Bunny Weruva Paw Lickin' Chicken because their website showed it to be very low carbs. He started having surprisingly high BG numbers. Closer inspection of the weruva label showed potato starch as an ingredient. I switched to Merrick chicken pate and his numbers dropped again. I don't know if Merrick is low enough in phosphorous for you, but you might want to check the weruva labels. I have had good luck with their Mack & Jack flavor.
Angela

That's the one I am giving her - I wonder if that is the problem. I can check the Merrick on Tanya's site. Thank you very much!
 
You're right that Fancy Feast is too high in phosphorus for a kidney cat, but there are other foods that are low carb/low phosphorus. I used to have a chart bookmarked that had a list of them but my old computer bit the dust and I don't have it on this one yet. (If I can find it, I'll post it for you)

You can also use phosphorus binders like aluminum hydroxide so you can feed higher phosphorus foods without causing any problems.

I have the chart, it's on Tanya's site, and there are very few that are low carb/low phos. I have ordered a binder and it should be here today or tomorrow.
 
Have you looked at Tiki Cat? I know they have several that are lower in phosphorus and, of course, in carbs, too. I also used Nature's Variety Instinct Raw, which has mostly low phosphorus flavors, and my cats all loved it. :) :bighug:
 
Hi Jeanette,
Which Weruva are you feeding her? I ask because I started giving Bunny Weruva Paw Lickin' Chicken because their website showed it to be very low carbs. He started having surprisingly high BG numbers. Closer inspection of the weruva label showed potato starch as an ingredient. I switched to Merrick chicken pate and his numbers dropped again. I don't know if Merrick is low enough in phosphorous for you, but you might want to check the weruva labels. I have had good luck with their Mack & Jack flavor.
Angela

OMG - today I did a little experiment and she got half the amount of Paw Lickin' Chicken than she normally does. Her BG tonight is 270!! It has been over 400 every night. It must be that food. I am so grateful that you posted this Angela.

This weekend when I can be home to do a curve I am going to switch her to something else for her mid-day food.

Thank you! Thank you!
 
I have ordered a phos binder, but I will only use it if I have to. It brings its own set of issues such as constipation. Thank you.
I got it over a month ago but still have not used it.... My guy is high end normal but I would like it lower.
Life gets so complicated sometimes!! So many things seem to happen at once.
I hope your feeling better today :bighug:
 
weruva makes a food called mideast feast that is low carb and most like it-- I have not heard of a spike (if you wanted to try another experiment)
:cat:
 
I got it over a month ago but still have not used it.... My guy is high end normal but I would like it lower.
Life gets so complicated sometimes!! So many things seem to happen at once.
I hope your feeling better today :bighug:

Thank you.

Actually I am feeling better tonight. Angela shared that Weruva Paw Lickin' Chicken raised her kitty's BG even though their site says it is 3.3% carbs That's one I've been giving Keno for her mid-day meals. Today she only got half of the it and her BG tonight is 270. It has been over 400 - so I think that is the problem.
 
Angela shared that Weruva Paw Lickin' Chicken raised her kitty's BG even though their site says it is 3.3% carbs That's one I've been giving Keno for her mid-day meals. Today she only got half of the it and her BG tonight is 270. It has been over 400 - so I think that is the problem.

This is really concerning considering they are supposed to be low carb :( . My Wiley was just diagnosed with CKD and I just bought/began feeding him a variety pack of Weruva. I haven't been able to test enough to figure out if it has changed his BGs, but now I'm concerned. I looked at the ingredients of all the ones listed on Tanya's list and they all have potato starch. Not sure if that is the cause. I've been trying to wean him off Fancy Feast - which he LOVES - and can't find a suitable substitute. He prefers the pate style over the flake/chunk style so I've started putting his food in a food processor to make it more consistent texture. I've bought some Tiki Cat and will be giving that a try this weekend.

I hope you can find something that works too!
 
I'm glad to hear Keno's BG is lower! I really thought I was doing Bunny a favor with the Paw Lickin' Chicken--I researched all the flavors and decided on that one because of their stated nutritional analysis (and Bunny's love of chicken). His BG levels kept climbing despite increasing doses and I didn't know what was going on. Thankfully, a wise forum member, @Sue and Oliver, asked what was listed on the label and noticed the potato starch. If it weren't for her, I would've kept thinking I was feeding him a low carb food and wondering why his BG kept climbing. Glad I can pay it forward a bit!
 
I've bought some Tiki Cat and will be giving that a try this weekend.

I just did more research on Tiki Cat and realized that their website lists the phosphorous levels "% as fed", not "% dry matter." So I just did the calculations of the ones I bought and only 3 flavors of the 8 have less than 1% phosphorous dry matter. :banghead: Ugh. Here are the three flavors in case you or others are interested:
  • Manana (.83)
  • Puka Puka (.91)
  • Napili (.91)
Edited to add - I now see these foods on Tanya's list.
 
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