? Diet change and insulin need

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Elizabeth B

Elizabeth B

Member Since 2017
My diabetic boy was diagnosed with stage II kidney disease, so we switched him from just low carb to two weruva flavors that were both low carb (under 5%) AND low phos. However, his insulin need greatly increased - from 2 units to 5 units BID. To be fair, he was losing some regulation before the switch (like low 200s instead of 180 preshots) which prompted us to do a full workup (labs, xrays, scans) where we found no concurrent issues. However, the diet switch pushed him into the 400s before we got him re-regulated. Is this normal with a diet switch, even if it's still low carb? He's only been regulated again for a couple days, but he's already getting back to his old happy self.

As he is a Maine Coon, my vet is wondering if he has acromegaly. However, he was regulated at 2 units before - which made me think we could rule it out. Do they develop acromegaly after regulation? I would greatly appreciate any thoughts. I suppose I might need to post this in the acro section, but I wanted to hear info on the diet change, too.

Thank you so much!
 
Hi, sorry about his diagnose, even though the new food is low carb is it higher that what he used to have? If so it could influence his numbers he may be very carb sensitive but if not there may be some underlying issues like an UTI (quite common in CKD and diabetic cats ) or some other infection did the vet said anything about it
 
I don't know enough about kidney disease to know how it might have affected insulin needs, but as for the acro possibility, if he has acro, the tumor can definitely change over time, in either direction, so it's not uncommon for insulin needs to change. And just in general, insulin needs can change over time in any diabetic cat (though this change, from 2U to 5U, is a pretty big one).
 
Veronica & Babu-chiri said:
Hi, sorry about his diagnose, even though the new food is low carb is it higher that what he used to have? If so it could influence his numbers he may be very carb sensitive but if not there may be some underlying issues like an UTI (quite common in CKD and diabetic cats ) or some other infection did the vet said anything about it
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All tests were negative. And his kidney value (BUN, creatinine) hadn't really changed. We ran a full panel, did chest xrays, and scanned something...I can't remember what they were checking for. And I should mention the carbs are actually lower than his old food.
 
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I don't think the diet change is responsible for the higher numbers. Cats with kidney disease can just have wonky numbers sometime. Bandit's been stressing me out because he's had wonky blood sugar all week (180-200) for no discernible reason--but I've found usually it goes back down to normal after a week or so. If he's eating, drinking, pooping, and acting normal, then I would just keep on with the TR and adjusting his insulin as needed according to the numbers. He gave you some pretty good numbers yesterday and today, I think you may see that dose start to work its way back down soon.

The one thing that could be diet related--has he had a lot of fish in his diet before? La Isla Bonita is pretty much all fish, and fish is a common food intolerance in some cats (which is why it's good to limit fish to once or twice a week). You could try subbing it out for something like Double Dip or Fowl Ball just to eliminate that possibility? If there's no change, you can reintroduce it into his diet.
 
Thank you! I usually feed the the la isla bonita once for every four meals, just so he doesn't tire of the one flavor. I chose it because it was the lowest in phos. I'll be sure to leave it out for a week, as suggested. Those other two flavors are great options. I'll order and give them a try!
 
@Elizabeth B Does he like Pates? Bandit's been a little pickier with his foods lately (it gets worse as the CKD does), but he's been digging the Whole Earth Farms Duck Pate (4% carbs and only 130 mg/100 kcal phos). I aim for less than 250 mg/100 kcal with Bandit's food, with varying success lately. Thank goodness I have another cat to eat the 5 cases of Bandit rejected food sitting at my house right now.
 
That's a great suggestion. I will try the whole earth duck. I can so relate to the leftover game! Rooney, our non-diabetic is still working on a combo of dry DM and weruva truluxe (the dry I purchased before finding FDMB and learning about cat diets). Of course, she's convinced the truluxe (the most expensive food in the house) is absolute poison.
 
Elizabeth B said:
That's a great suggestion. I will try the whole earth duck. I can so relate to the leftover game! Rooney, our non-diabetic is still working on a combo of dry DM and weruva truluxe (the dry I purchased before finding FDMB and learning about cat diets). Of course, she's convinced the truluxe (the most expensive food in the house) is absolute poison.
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How much of the DM is left? Prescription diets are guaranteed so you can return it to your vet (or wherever you purchased it) for a refund--just say that your cat wouldn't eat it.
 
Elizabeth B said:
As he is a Maine Coon, my vet is wondering if he has acromegaly. However, he was regulated at 2 units before - which made me think we could rule it out. Do they develop acromegaly after regulation? I would greatly appreciate any thoughts. I suppose I might need to post this in the acro section, but I wanted to hear info on the diet change, too.
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Having a maine coon doesn't make them any more likely to have acromegaly. My girl had some maine coon heritage, but most of the current members here with acros now have short hair cats. However, one in four diabetics cats has acromegaly, so it's not uncommon. There are acromegalic cats with low doses and some with high doses. The tumour can pulse up and down. My Neko's good dose ranged from 8.75 units, down to 0.75 units, back up to 7 units, then back down to 0.25. That was over 5 years.

There are some secondary conditions that make it harder to regulate a cat, but not typically require the change of dose you've done. Are you sure he's not stealing some of Rooney's dry food? That can explain the difference in dose.
 
I just want to second what @Wendy&Neko said--getting into dry food would explain those numbers and current dose a lot better than CKD wonkiness. I helped treat a cat a few years ago named Sidney--his owner called me super upset because he was about to go into remission, then all of a sudden his numbers started shooting up 300 points. I asked if there's any way he was getting into the other cats' dry food--she insisted there was no way because it was all upstairs and he couldn't climb the stairs because of his neuropathy. Sure enough, a few days later she came home from work early and found him upstairs, munching on the other cats' food. Not only could he climb the stairs, he was specifically doing it during the day while she was at work.
 
There is no chance he is stealing food. They are supervised at every meal and have no access to food otherwise. (We learned that lesson early on.)
 
Julia & Bandit said:
Not only could he climb the stairs, he was specifically doing it during the day while she was at work.
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:woot:

Elizabeth B said:
There is no chance he is stealing food. They are supervised at every meal and have no access to food otherwise. (We learned that lesson early on.)
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That's kind of too bad (probably the easiest fix of all the possibilities), but I'm glad you guys are on top of the situation!
 
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