Diet versus insulin?

[David & Carole]

Hello - first post here.

We just picked up a rescue cat, which we knew to be FIV. He had been fostered for about 12 months prior to this, and we were told he eats a lot (he arrived a little overweight). Upon arrival we noticed he drank an excessive amount of water and urinated a lot. A trip to the vet this week confirmed diabetes. We were a bit shocked and annoyed, but we've previously managed to bring an FIV diabetic cat into remission (though it took 12 months of insulin) and he never required insulin again for the 3 additional years he lived before he died of other causes. According to this Board however, we managed this while doing pretty much everything completely wrong - on vet advice he was switched to a mix of Hills M/D wet and Hills (later Royal Canin) diabetic dry food, and we only tested occasionally via urine (no home blood testing - just periodic vet-administered blood tests). One day there was no glucose in the urine, vet confirmed blood looked OK and we weaned him off the insulin over a period of a month or so, a never a glucose problem ever again. Reading this Board, I'm now amazed we didn't kill him.

This time we'd like to do better, but it will have to be within some lifestyle constraints. In particular, we simply don't have the time for constant blood glucose monitoring, but cost of food, insuluin etc. is no issue. Hoping for some advice on that basis.

The new cat (Cedric) had been fed for the last 12 months on mainly Hills Perfect Weight dry food with a small amount of Fancy Feast wet food. Upon diagnosing of diabetes, we took vet advice and again switched to the Royal Canin dry and Hills M/D wet combination. He's been on insulin (Lanctus, 2 unit dose) for a week and he very quickly dropped back to seemingly normal drinking/urination pattern. Simultaneously, we have been slowly changing his food mix from mainly dry to mainly wet. Overall, he seems very healthy, with the only symptom in any way consistent with hypoglycemia being occasional and minor lethargy. But we've had him such a short time it's hard to tell if this is unusual.

After reading this Board, I want to change his food to wet/low carb only, but wary of the interaction with his insulin dose. I'm torn on what to do. The insulin seems to be working. On the other hand, he's eating the wrong food - maybe we'd be better off trialling him without insulin but on the right food, and seeing whether he really does need insulin (particularly since we don't want to home test for blood glucose)? Or maybe change the food and reduce the insulin dose.

I'm seeking out a vet who specialises in feline diabetes for a formal opinion, but in the interim would be keen to hear any thoughts?

Thanks

David

 

[FurBabiesMama]

Hi. First, good luck finding a vet that specializes in feline diabetes. In a couple of days, I am taking Mia to an internal medicine specialist who has 'an interest in' endocrinology, and I am hoping that means he at least has more knowledge than the other vets I have dealt with so far. Anyway...

If you do not want to do home glucose monitoring at all, I do not know what to tell you. I did not want to do it either but quickly realized I had to. There was just no way I could manage glucose levels without knowing what they are. Good thing I felt that way because Mia is proving to be a very 'bouncy' cat. Had I blindly given a vet-set dose based just on 'periodic vet-administered blood tests', I have no doubt we would have had a major hypo crisis by now.. or worse. Also, since being on this forum, I have seen a shocking number of cases where vets completely misdirected people on dosing - sometimes in such extreme ways that it is truly ridiculous - probably largely due to the fact that they are making decisions on some random point-in-time glucose level.

I wish you the best. You must be good people to take in a diabetic FIV cat.

 

[JanetNJ]

"constant" bg monitoring is not necessary. Get a quick reading before each shot (takes literally a minute to do), and get a mid cycle reading. I work during the day, so I try to catch a reading 4 or 5 hours after his evening shot before I go to bed. On the weekend or whenever you are home get extra readings in. That's all. for food most of us feed fancy feast classic or friskies pate foods.

 

[Kiki Thor]

I will never stop praising fancy feast for saving my cat. But you really need to check the glucose levels at home. I discovered my cat was dropping to a TWO because my dumb vet wanted him on a full unit of insulin while switching to a low carb diet. I switched vets and my new vet was shocked. Herbert's glucose today was an 8.5 with no insulin, just fancy feast.

 

[Wesley and Spicoli]

occasional and minor lethargy.

This can also be a sign his blood glucose is dropping to low. If you happen to be home when he is acting like this grab a test. This exact thing was what led me to start home testing and it turned out ours was on too high a dose (prescribed by a vet) and dropping too low at the time. Fancy Feast Classics are a great option. Here's the link for Dr. Lisa's food chart http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf I'm not very familiar with FIV besides immunodeficiency (my Aunt had an FIV kitty), but if he doesn't have any other underlying conditions I don't see why FF classics/roasted/flaked/chunky wouldn't be a perfect option.

I might pick a weekend to switch foods, when you know you can monitor closely, maybe testing every few hours. Reducing carbs can reduce insulin needs by a good amount.

But you really need to check the glucose levels at home.

THIS. I know you don't want to, but it's vital to make sure kitty isn't dropping to quickly, or too much overall, especially if you change foods. It's saved many cats lives, including mine.

 

[David & Carole]

Thanks all for your responses. I've booked him in with a vet who specialises in feline diabetes, so we'll see how that goes. There hasn't been any more sign of lethargy, and his drinking/urination is now normal. Overall, he seems in rude health on his curent insulin dose. Daily urine tests are showing him progressively coming down from the previous high, but still too high. How much better he'd be doing on the proper low carb diet, and what impact that woud have on the correct insulin dosage, and which of these factors should be the priority, I'm hoping the new vet can advise.

It might not be ideal, and I realise it goes against the prevailing orthoidoxy here, but clearly it is quite possible to get a cat into remission without daily blood glucose monitoring, because I've done it and I'd think that's the way most people would probably do it. Kudos to the highly-motivated people who can go the extra mile for their pets with the ongoing BG monitoring, but it's not for everyone. Poor litle Cedric's going to have to do his best here. At least now he'll have a loving home and a full belly while he tries to fight it off.

Thanks again - David

 

[tiffmaxee]

My first post here started off saying I would not be home testing. I was going to my vet twice a week around nadir at first. When it was 60 he felt possibly remission. Insulin was stopped. Big mistake. No remission. When insulin was restarted, I started home testing. Thank goodness. Had I dosed Max blindly, he would have gone hypo. He was a cat that often dropped throughout the night and his first green preshot was in the morning when I had to shoot and leave for the ER where my mom was. Had I not tested, I would have shot the regular dose and possibly come home to a dead cat. Please consider at least some home resting. I've seen too many cats lost to going hypo around here. Good luck to you.

 

[Wesley and Spicoli]

Dosing a cat blind is so risky. You wouldn't do that to yourself or a child would you? Please reconsider. Best wishes to you and Cedric.