Bouncing back but still bouncing!

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Zoey & Carol

Zoey & Carol

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I've been posting in the main forum for the past 3 weeks because Zoey had a really bad episode and almost died. While we were gone over Christmas, she stopped eating and drinking and became severely dehydrated. A friend was taking care of her, testing her, and giving her insulin. He told me she wasn't eating much, and then a day later, he said she was very sick. I called my vet (who has a mobile service) and he came and got her. It took us an extra day to get home because of weather and bad roads. He had her for 3 days and gave her IV fluids. He checked her blood and told me she was in renal failure. Her creatinine, BUN, and phosphorus were extremely high. After we got back, I took her to another clinic and they kept her for a week. She had a bladder infection, inflamed pancreas, and dehydration. She was on diuresis for 4 days, antibiotic, phosphorus binder, and anti nausea medication. By the 5th day, her blood levels were down to almost normal, so she came home. A week later, she went in for tests, and all was good! Amazingly, she has bounced back from the brink of death!

Now to the diabetes part... During this time, she was on high carb kidney support food, both wet and dry. She was not eating much, so whatever she wanted, she got. Now I've got her on lower carb food again - Hill's WD food which is low in phosphorus (per vet's advice), and some Fancy Feast. The problem is I cannot get her regulated. For the past 3 weeks she has been extremely high. My glucometer doesn't go above 600, it just says HI. The vet increased her dose to 2 units, but that was while she was still on high carb food. As you can see by her spreadsheet, she went down as low as 40 while on 2 units. Then I had to give her some high carb food to bring her back up. I have cut her back to 1.6, but she is bouncing. Do you have any suggestions, or should I just keep her at 1.6 for a while to see if she calms back down?

She is back to eating well, peeing normally (not bricks in the cat box), pooping well, and she is very snuggly! She is even able to jump up on the couch again. I'm so happy she got over the kidney issue. She is now worth over $300 per pound! Luckily she is a small kitty!
 
It does look like the 2 u dropped her too low and then she bounced very high. I suggest you gather a few cycles' data at 1.6 u and we can help you go from there. The+2 BG test is a good one to get because it often gives an indication of an active cycle to come if it's quite a bit lower than the PS.
 
Zoey & Carol said:
She is back to eating well, peeing normally (not bricks in the cat box), pooping well, and she is very snuggly! She is even able to jump up on the couch again. I'm so happy she got over the kidney issue. She is now worth over $300 per pound! Luckily she is a small kitty!
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Priceless! I’m happy she is recovered from her kidney failure. I’m sure the terrific minds here will help get her sugars regulated :bighug:
 
Carol - Wow! You and Zoey have really been through it lately! I went out and took a peek at your thread out there - what an ordeal!

So you'll need to manage both the CKD and diabetes in your food choices. Here is a list that has foods that are both low in phosphorous and low in carbs: https://docs.google.com/spreadsheets/d/1ooNFj_Fd7be3QQJ41bl8fXka3QkSo_H1UIONkEh_2I8/pub?output=html#

On your current foods, the w/d is 25% carbs which is unfortunately too high for a diabetic cat. When a cat is getting too many carbs, their BG will obviously be too high, but what also happens is that those carbs cause bouncing - dangerous lows and sky highs. So getting Zoey on lower carb food isn't just important to avoid those HI readings, it will also hopefully settle her down. Bouncing happens no matter what when a cat is on the road toward regulation, but on low carb foods, it will more often happen within safer ranges.

Also, the Fancy Feast is probably a bit too high in phosphorous for the CKD. You might consider switching to the Friskies pate which is lower phosphorous, or one of the foods from the list above (some are rather pricey for my taste, but they do help balance the two health issues). Another option may be Primal Turkey, although I see in your signature that you say no Turkey and Giblets, so that may not be an option. But if it is, the Primal Turkey is both very low carb and low phosphorous, and it has a healthy calcium to phosphorous ratio which is ideal.

I think as you are able to transition her to a food that will be supportive of both of her health issues, you may start seeing a little more stability and improvement in the numbers. Please keep posting and asking any questions you have. We are all here to help you get this worked out and keep Zoey moving in this good direction! You've done an amazing job of getting her through that dark time and onto a better road!
 
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Oh, when you click that link, you'll need to look for the tab that has the food lists.
When it first opens it will be a very colorful spreadsheet. :eek:
 
Thanks for the information on the lower carb foods that also are low in phosphorus. I’ll check into them. The vet tech gave me a copy of the nutritional info on the WD food and it gave a much lower % of carbs. I will double check. After dealing with the kidney issues I know it will be a while until I can get her back on track. I will update my spreadsheet and continue to post here. I appreciate all of your help! It’s been a very stressful month!
 
That's interesting that the vet info showed lower carbs. It's entirely possible that what I looked up was wrong too. Let me know what you find either way on that!
Hopefully things will settle into a nice comfortable routine now and that stress will melt away! :bighug:
 
I am pulling my hair out trying to find foods that are best for Zoey for both diabetes and kidney disease. Phosphorus is supposed to be < .5% dry matter analysis. Carbs are supposed to be <10% calories from carbs. I’m not understanding how to find that information on the food charts. It seems like I am looking for 2 different types of measurements. Am I just missing something?

The info I got from the vet on nutrient content from Hills w/d food is. 6.2% carb as fed, 26.4% carb dry matter, 7.6 g as fed calorie basis. Which do I use? Phosphorus: as fed .21%, dry matter.7%, and as fed calorie basis 197 mg.

I think my brain is fried!
 
I'm so sorry this is so difficult! And it really really is difficult. :( It would sure be nice if there was just one perfect food for our kitties. I have heard of people who just feed their cats mice.....!:eek::smuggrin:

Have you found Tanya's site yet? It's a wealth of information about CKD
http://felinecrf.org/diet_and_nutrition.htm

And maybe this list is easier to use?
https://docs.google.com/spreadsheets/d/112NvvzgxEBOtkb42rA0XR8GeShw9xXs9kccf9-olK7I/pubhtml

Have you also posted out on the Main forum and asked for food recommendations? There are lots of folks around here with cats who have both conditions, and they might have some suggestions for you on what might work to satisfy both requirements.
 
Hi Carol,

Here's another food list with low carb, low phos wet foods (prepared by April (member manxcat419) who you'll remember from your previous thread). There is probably a bit of overlap with the list Djamila linked above, but there are more varieties on April's list.

https://docs.google.com/spreadsheets/d/1nMBzt57Zi0PcAJ-gSt0NxrTyc3Twi7A0L8o2H2gGkoM/edit#gid=0

ETA: April sets the 'cut-off' threshold for phosphorus at 250mg/100kcal; Djamila's linked list has foods under 200mg/100kcal.


Mogs
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Zoey & Carol said:
The info I got from the vet on nutrient content from Hills w/d food is. 6.2% carb as fed, 26.4% carb dry matter, 7.6 g as fed calorie basis. Which do I use? Phosphorus: as fed .21%, dry matter.7%, and as fed calorie basis 197 mg.
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Use dry matter basis phosphorus content - no. of mg Phosphorus per 100kcal of metabolisable energy. (It's easy to read these values directly off the Hill's UK site links below, but double-check that the US product formulations are the same.)

On the carbs, the recommendation for diabetics is to feed varieties with less than 10% of total calories coming from carbs. This post covers how to calculate this value from the 'as fed' values (sorry about the maths!):

FDMB FAQs - How to Calculate Cat Food Carb Content

Also here's a web-based calculator for working out carbs as % of total calories:

Scheyderweb Cat Food Carb Calculator

From the Hill's UK website:

w/d Feline Dry Diet Analysis - As fed values:
Protein: 36.4%
Fat: 8.8%
Crude Fibre: 8.4%
Moisture: 7.0%
Crude Ash: 6.0% [Not itemised in the Hill's analysis but can be deduced by using the as-fed carb% provided.]

w/d Feline Dry % of Calories from Carbs (per Scheyderweb calculator): c. 36.5%

w/d Feline with Chicken Canned Diet Analysis - As fed values:
Protein: 9.0%
Fat: 3.7%
Crude Fibre: 3.7%
Moisture: 76.3%
Crude Ash: 1.5% [Not itemised in the Hill's analysis but can be deduced by using the as-fed carb% provided.]

w/d Feline Canned % of Calories from Carbs (per Scheyderweb calculator): c. 23.8%

m/d Feline Dry Diet Analysis - As fed values:
Protein: 37.9%
Fat: 13.0%
Crude Fibre: 9.1%
Moisture: 5.5%
Crude Ash: 5.98%

m/d Feline Dry % of Calories from Carbs (per Scheyderweb calculator): c. 28.9%

m/d Feline Original Canned Diet Analysis - As fed values:
Protein: 12.7%
Fat: 5.3%
Crude Fibre: 1.8%
Moisture: 74.6%
Crude Ash: 1.5% [Not itemised in the Hill's analysis but can be deduced by using the as-fed carb% provided.]

m/d Feline Original Canned % of Calories from Carbs (per Scheyderweb calculator): 16% (not sure about this - manual calc gives 13.3%).


Mogs
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Thanks so much to you all for the lists. After all of my research and everyone's suggestions, this is what I've decided to look for (using % calories):
< 35% protein, <65% fat, <10% carbs, and <200 mg phosphorus/100kcal.

The fat is the least important from what I've been reading, but the other 3 I'm sticking with. I've got a list of several brands and types, so my mission this week is to see what is available at my local pet stores. I'll see what Zoey likes and go from there.

She's doing so much better (almost back to her old "simply diabetic" self!). I want to be sure I'm giving her the best food for her health.
 
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