CKD & Diabetes- trouble controlling BG

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Skylarboy7

Member Since 2017
Hello: New to this site/forum. For last 2 years my 7 year old boy has CKD stage 2, now under control with high carb/low protein dry food diet. Diabetes diagnosed 6 weeks ago. Using ProZinc insulin. Started at 1.5; now up to 3.5 units. Crazy readings ie: 12 hours after last feeding, BG 110/120/73. Also will get levels of 225/300/400 then 4 hours after injection. Early on, a curve done at Vets shows no significant lowering or raising of BG. I would welcome any comments on this as to maybe a different diet w/more protein and/or change of insulin to bovine based which, from what I've now read, seems to be the choice of most vets. Thank you for your consideration.
 
Hello and welcome! You will get lots and lots of advice on here. :)

So my best bet is the food is the issue. Feeding carbs (same as humans) causes bg levels to rise. The lower carb the diet is, the less fluctuation you get. However please do NOT suddenly switch from high carb food to low or kitty will go hypo.

Better to change it slowly a couple of teaspoons at a time (over say 3-4 days substituting more lower carb for the high) while watching the bg levels very carefully. You will find as you momitor you will need to reduce your insulin accordingly.

Feeding any dry food will not really help things, if you must there are a couple of diets suitable for diabetic kitties. Youngs and Dr Elseys I believe they are called.

It's really helpful if you pop a few things in your signature and will save lots of similar questions e.g. Insulin type, food, kitties name/age and if you would set up a spreadsheet so we can offer suggestions based on the bg numbers. :)
 
Thank you Tempestsmum. attached is chart just last 7 days so you have an idea what I am talking about. Cat's name is Skylar. Male 7 years old. Part Maine Coon. I am using ProZinc insulin. U-40.

The tricky part will be increasing the protein & decreasing the carbs. His Renal disease is treated with a diet of higher carbs & lower protein. Thus the problem.

I hope maybe he can be treated with some measure of carb reduction as well as changing to a bovine based insulin.. Hoping can get someone to comment who has experienced this double whammy.

Thanks!
 

Attachments

Thank you Tempestsmum. attached is chart just last 7 days so you have an idea what I am talking about. Cat's name is Skylar. Male 7 years old. Part Maine Coon. I am using ProZinc insulin. U-40.

The tricky part will be increasing the protein & decreasing the carbs. His Renal disease is treated with a diet of higher carbs & lower protein. Thus the problem.

I hope maybe he can be treated with some measure of carb reduction as well as changing to a bovine based insulin.. Hoping can get someone to comment who has experienced this double whammy.

Thanks!
 
No problem, please Call me Tara ;) my kitty is stage 2 ckd and diabetic but in remission. She was just diagnosed a few weeks ago. I was directed to http://www.felinecrf.org
You may find Tanya's site helpful. It's very comprehensive and I'm still getting through everything there as it is.

Looking at your numbers Skylar (love the name!) is responding well to the ProZinc (which is the insulin I used.) Based on that I don't see any need to change insulins at the moment, and that working on his diet would be the main focus as no matter which type of insulin you use, the carbs will keep his bg high.
Diabetes is the illness that needs treated first and foremost, therefore it takes precedence over the ckd as diabetes is more complex and will do damage much faster than the ckd. It's one of those fine balancing acts and both things need considered.

The longer he sits in high bg numbers the worse he will feel.

In your control centre you can put that information in your signature so other people can see it. You can see where I have mine at the bottom of the post. :)

I will tag some people who can give you the link to set up your SS as I don't know how lol
@MrWorfMen's Mom @JanetNJ
 
Welcome. There are a number of us who have/had balanced CKD and diabetes. Tanya's site is the bible for cats with kidney disease.

It is a lot of reading.
You might want to first jump to the diet page: http://www.felinecrf.org/diet_and_nutrition.htm

Rx kidney food (especially the dry) is extremely high in carbs. A list of food options can be found here: http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
It is sortable.

Do be careful during any food change. Eliminating carbs can drastically drop a cat's glucose levels and very close monitoring is required during the transition.
 
I agree with Tara that the diabetes needs to be your first and primary concern right now. And Red & Rover has given you some leads to finding a more appropriate diet to help manage both conditions. You want to find a low carb food that is also low in Phosphorus. As mentioned dry food is generally too high in carbs for our diabetics however if you are located in the US, there are a couple of options one of which suggests it is good for kitties with kidney issues (Young Again) although I cannot vouch for that claim. Perhaps something to ask on the CRF site.

I'm not sure if I am interpreting your spreadsheet information correctly but if I am, the dose of insulin may need adjusting. A normal curve for each cycle would be a starting point at a higher reading, BG drops lower and then goes start back up again till the end of the cycle. Some of your readings are low at the beginning of the cycle and then go up. This could indicate the dose of insulin is too high. I would suggest you get some more mid cycle tests between +4 and +7 hours post shot to see how low the dose is taking your boy.

It would be very helpful if you could set up one of our spreadsheets and link it here so we can see the data you have so far in a format we are familiar with and won't misinterpret. The instructions for setting up the spreadsheet are HERE and THIS document explains how to use the spreadsheet. We don't deal in clock times here because our members reside all over the globe so we capture our BG tests as pre-shot tests and by the number of hours since the shot was administered.

It would also be helpful if you could set up a Signature (the light grey text below our messages). To do this hover over your screen name in upper right screen. This drops down a menu and you select Signature from the left column. A text box will appear into which you can type information like your name, your cat's name, medical history (ie CKD, any history of ketones/DKA etc.), the food kitty is currently eating, the type of glucometer (human or pet) you are using, the type of insulin and your general location so that any recommendations for food etc. are pertinent to you. When you get the spreadsheet set, you can put the link in your signature so the sheet is available to anyone here offering assistance. If you need any help with any of this, just holler.

As for changing insulin, it's still early days. ProZinc is a good insulin for cats as Tara can attest, and the best insulin is the one that works for your cat. I think you need to give the ProZinc a bit more of a chance before making a switch. It's quite possible with a little dose tweaking and a change of diet, you will start to see some improvement.
 
Hello: New to this site/forum. For last 2 years my 7 year old boy has CKD stage 2, now under control with high carb/low protein dry food diet. Diabetes diagnosed 6 weeks ago. Using ProZinc insulin. Started at 1.5; now up to 3.5 units. Crazy readings ie: 12 hours after last feeding, BG 110/120/73. Also will get levels of 225/300/400 then 4 hours after injection. Early on, a curve done at Vets shows no significant lowering or raising of BG. I would welcome any comments on this as to maybe a different diet w/more protein and/or change of insulin to bovine based which, from what I've now read, seems to be the choice of most vets. Thank you for your consideration.
Dry food is not good for either disease. Unless your cat is in stage 4 kidney failure it's not important to have low protien.... What is more imperative is low phosphorus! Ckd cats need lots of extra fluids to flush the toxins, so wet food (and sub q's if needed) will help with that. There are several choices.... One that I feed to my ckd cat was canned weruva bff... Both low carb and low phosphorus.

. Can you post your cats most recent labs?
 
Welcome. There are a number of us who have/had balanced CKD and diabetes. Tanya's site is the bible for cats with kidney disease.

It is a lot of reading.
You might want to first jump to the diet page: http://www.felinecrf.org/diet_and_nutrition.htm

Rx kidney food (especially the dry) is extremely high in carbs. A list of food options can be found here: http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
It is sortable.

Do be careful during any food change. Eliminating carbs can drastically drop a cat's glucose levels and very close monitoring is required during the transition.
 
Thank you Red & Rover. Sorry for my late reply but my business is very busy this time of year. It is good info on these sites & as you said, a lot to digest. I will review & comment more later.

Thanks again!
 
I agree with Tara that the diabetes needs to be your first and primary concern right now. And Red & Rover has given you some leads to finding a more appropriate diet to help manage both conditions. You want to find a low carb food that is also low in Phosphorus. As mentioned dry food is generally too high in carbs for our diabetics however if you are located in the US, there are a couple of options one of which suggests it is good for kitties with kidney issues (Young Again) although I cannot vouch for that claim. Perhaps something to ask on the CRF site.

I'm not sure if I am interpreting your spreadsheet information correctly but if I am, the dose of insulin may need adjusting. A normal curve for each cycle would be a starting point at a higher reading, BG drops lower and then goes start back up again till the end of the cycle. Some of your readings are low at the beginning of the cycle and then go up. This could indicate the dose of insulin is too high. I would suggest you get some more mid cycle tests between +4 and +7 hours post shot to see how low the dose is taking your boy.

It would be very helpful if you could set up one of our spreadsheets and link it here so we can see the data you have so far in a format we are familiar with and won't misinterpret. The instructions for setting up the spreadsheet are HERE and THIS document explains how to use the spreadsheet. We don't deal in clock times here because our members reside all over the globe so we capture our BG tests as pre-shot tests and by the number of hours since the shot was administered.

It would also be helpful if you could set up a Signature (the light grey text below our messages). To do this hover over your screen name in upper right screen. This drops down a menu and you select Signature from the left column. A text box will appear into which you can type information like your name, your cat's name, medical history (ie CKD, any history of ketones/DKA etc.), the food kitty is currently eating, the type of glucometer (human or pet) you are using, the type of insulin and your general location so that any recommendations for food etc. are pertinent to you. When you get the spreadsheet set, you can put the link in your signature so the sheet is available to anyone here offering assistance. If you need any help with any of this, just holler.

As for changing insulin, it's still early days. ProZinc is a good insulin for cats as Tara can attest, and the best insulin is the one that works for your cat. I think you need to give the ProZinc a bit more of a chance before making a switch. It's quite possible with a little dose tweaking and a change of diet, you will start to see some improvement.
Thanks
I agree with Tara that the diabetes needs to be your first and primary concern right now. And Red & Rover has given you some leads to finding a more appropriate diet to help manage both conditions. You want to find a low carb food that is also low in Phosphorus. As mentioned dry food is generally too high in carbs for our diabetics however if you are located in the US, there are a couple of options one of which suggests it is good for kitties with kidney issues (Young Again) although I cannot vouch for that claim. Perhaps something to ask on the CRF site.

I'm not sure if I am interpreting your spreadsheet information correctly but if I am, the dose of insulin may need adjusting. A normal curve for each cycle would be a starting point at a higher reading, BG drops lower and then goes start back up again till the end of the cycle. Some of your readings are low at the beginning of the cycle and then go up. This could indicate the dose of insulin is too high. I would suggest you get some more mid cycle tests between +4 and +7 hours post shot to see how low the dose is taking your boy.

It would be very helpful if you could set up one of our spreadsheets and link it here so we can see the data you have so far in a format we are familiar with and won't misinterpret. The instructions for setting up the spreadsheet are HERE and THIS document explains how to use the spreadsheet. We don't deal in clock times here because our members reside all over the globe so we capture our BG tests as pre-shot tests and by the number of hours since the shot was administered.

It would also be helpful if you could set up a Signature (the light grey text below our messages). To do this hover over your screen name in upper right screen. This drops down a menu and you select Signature from the left column. A text box will appear into which you can type information like your name, your cat's name, medical history (ie CKD, any history of ketones/DKA etc.), the food kitty is currently eating, the type of glucometer (human or pet) you are using, the type of insulin and your general location so that any recommendations for food etc. are pertinent to you. When you get the spreadsheet set, you can put the link in your signature so the sheet is available to anyone here offering assistance. If you need any help with any of this, just holler.

As for changing insulin, it's still early days. ProZinc is a good insulin for cats as Tara can attest, and the best insulin is the one that works for your cat. I think you need to give the ProZinc a bit more of a chance before making a switch. It's quite possible with a little dose tweaking and a change of diet, you will start to see some improvement.
Thank you Mr. WorfMen's Mom. I will update info as you suggest. I am not technically proficient on social sites but will learn. Good advice on ProZinc. Thanks!
 
Dry food is not good for either disease. Unless your cat is in stage 4 kidney failure it's not important to have low protien.... What is more imperative is low phosphorus! Ckd cats need lots of extra fluids to flush the toxins, so wet food (and sub q's if needed) will help with that. There are several choices.... One that I feed to my ckd cat was canned weruva bff... Both low carb and low phosphorus.

. Can you post your cats most recent labs?
Hi Janet & thank you for your response. Attached is latest spreadsheet I have on BG readings. Your advice on low protein; low phosphorus & what you use is well noted. Thanks, Jim
 

Attachments

Based on your data I conclude that 3 units twice daily is too high.
If/when you change diet to low carb insulin need will also decrease and thus a still lower dose will likely be required.
 
Hi Janet & thank you for your response. Attached is latest spreadsheet I have on BG readings. Your advice on low protein; low phosphorus & what you use is well noted. Thanks, Jim
Do you have any of the blood labs from the vet showing his creatinine and bun ect? If not you can ask them to email you a copy of his most recent cbc test.
 
Based on your data I conclude that 3 units twice daily is too high.
If/when you change diet to low carb insulin need will also decrease and thus a still lower dose will likely be required.
Thanks Larry: last 3 days have used 3 units & getting consistent readings of mid 200's to low 300's. Well noted to reduce units when diet changed. Meeting with internal medicine specialist from ISU Vet school on Monday. Will discuss diet & insulin.
 
Do you have any of the blood labs from the vet showing his creatinine and bun ect? If not you can ask them to email you a copy of his most recent cbc test.
Janet: I do can get a copy of his latest CBC & will send. Saw your video on BG test. Thanks
 
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