Cedric, detoxing from high carb dry food. Cold turkey good idea?

[Matthijs]

Last week I introduced Cedric and myself on the FDMB.

On November 2nd, we started giving Cedric 1,5 IU insuline (Caninsulin), twice a day. At 7:30 and at 19:30.

His response to insuline seems good. We measured his BG a few times, 4 hours after his morning dosage and we were happy to see a blood glucose level of 5,6 mmol/l.

More problematic is that Cedric appears to stay extremely hungry. With the exception of the short duration of peak insuline effect, he is constantly scavenging for bits of food.

Current diet: Royal Canin Veterinary Diet - Urinary S/O Moderate Calorie (dry food)
@07:30 - 24 grams
@15:00 - 16 grams
@19.30 - 24 grams
Total food: 64 grams per day. Cedric weighs about 5KG.

I must note that Cedric needs this special diet food because he had urinary bladder problems (struvite) in the past. We definitely don’t want to have those issues again, it was very painful for him.

This is a day curve from last week, when we experimented with a lower insuline dosage of 1 IU. Currently with a 1,5 IU dosage, the lowest BG point measures 5,6 mmol/l instead of 8,8 mmol/l.

It does align with the behavior that we are seeing: After he finishes his meal, he continues to search for more food. It takes about three hours until he calms down and finds a cozy spot to lay in the sun (like any normal cat). At least one and a half hours before his evening meal, he starts crying and meowing loudly for food again.

Normally he would lie sleeping on a blanket for hours. Now the best he can do is to lie down on the blanket, but fully awake, with big eyes, waiting for someone to walk towards the kitchen and take a sprint to be first.

This evening Cedric is outside for the first time in weeks. I see that as a good sign, he must be starting to feel more comfortable.

Still I am curious what we can do to extend the duration of the acceptable blood glucose levels?

Much appreciated.

Oh, almost forgot: Cedric keeps drinking a lot of water as well. What can we do to check if he has acromegaly?

I read somewhere that 25% of the diabetic cats have acromegaly, so that worries me a bit.

 

[Bron and Sheba (GA)]

If you could set up a spreadsheet with your BG data we will be able to help you with dosing.
Here is the link. If you have any trouble setting it up ask for help
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Until Cedric's BG levels are more regulated he will probably remain very hungry. That is because his body can't utilise all the nutrients in the food. So unless he is overweight, you can feed him more.

In regards to the food you are feeding......it is very high carb food. I do note that you said he has had bladder problems in the past.
However feeding a high carb diet like S/O is like feeding junk food and candy.
Dry food is not a good food for cats as it has very little moisture in it (7% compared to 78% for canned food) and I can't see how any dry food would help at all to stop crystals forming in the urine. I would imagine that the most important thing would be extra fluids.
We have had people here with the same issue, change over to a wet diet, and not had a problem.
If you would consider that, it would make a big difference to the BG levels and the amount of insulin needed.
If you do decide to trial swapping overto a low carb wet diet, you will need to be testing frequently to see the BG does not drop too low. People who swap over to a wet low carb diet find their cats often drop 100 or more points.

Drinking extra water is common with diabetic cats....but also feeding a dry diet also means they have to drink extra water to try and keep hydrated. I would seriously consider swapping to a wet diet.

At this point there is no need for you to test for acromegaly. He is responding well to the insulin,despite being fed a very high carb diet. Testing is not advised until the cat reaches 6 units of insulin.
If you are wanting longer duration,you would be best to swap to a longer acting insulin such as Lantus or levemir.

I am going to tag @MrWorfMen's Mom to help with the insulin as I have not used caninsulin.

 

[MrWorfMen's Mom]

I agree with Bron about the food. The dry food appears to be around 40% carbs. Even the canned SO diet is around 20% but would be a big improvement and certainly improve Cedric's water intake and insulin requirement. There have been many other folks switch their kitties off SO food to a low phosphorus low carb all wet diet without setting off urinary problems but that of course is your decision to make. Given the results you are currently getting on the high carb diet, I can't help but wonder if you might be able to control Cedric's BG with diet alone if you made the switch to low carb wet food (under 10% carbs).

The curve you shared is actually looking pretty good for a cat on Vetsulin. Seems Cedric is getting a little more duration from the Vetsulin than some cats do but as Bron mentioned, a longer lasting insulin like Lantus or Levemir would help soften the curve and extend the duration.

I doubt that acromegaly is something you need to consider at this point. While all acro cats do not need large doses of insulin, Cedric is showing a normal curve which in the case of an acro cat, even if only a low dose were needed, might not be as consistent as you are reporting.

Without seeing data over a week or so, I really can't offer any dosing advise.

 

[Ann & Scatcats]

Last week I introduced Cedric and myself on the FDMB.

Now the best he can do is to lie down on the blanket, but fully awake, with big eyes, waiting for someone to walk towards the kitchen and take a sprint to be first.

Sounds like Cedric has a plan there


Are you sure he hasn't become an dry food addict?


I'm only familiar with Hill's 'prescription' foods, but have you tried to give Cedric the wet food version of the Urinary you are feeding?
The wet food version should normally have less carbohydrates than dry food while also providing more water in the food and thus have impact in automatically lowering the blood glucose level. And require less insulin too.

 

[Sienne and Gabby (GA)]

This is a link to information on urinary tract problems from a vet who has written a great deal about feline nutrition.

 

[Matthijs]

Thank you all for taking the time to reply so extensively!

Dry food is not a good food for cats as it has very little moisture in it (7% compared to 78% for canned food) and I can't see how any dry food would help at all to stop crystals forming in the urine. I would imagine that the most important thing would be extra fluids.

Yes, I read some more background information about pet food and it makes sense that cats are perfectly capable to get their nutrition and energy directly from proteins. They are an obligate carnivore after all. Rice is the main ingredient of the Royal Canine S/O. They seems to add salt to Urinary S/O food to make cats drink more, thus helping in stopping crystals to form.

I did ask/confront at our veterinary clinic about this, but the reply was that canned food was mostly fat and carbs. The advice is to use the diabetic version of the dry food: Royal Canin Veterinary Diet - Diabetic DS46

At this point there is no need for you to test for acromegaly. He is responding well to the insulin,despite being fed a very high carb diet. Testing is not advised until the cat reaches 6 units of insulin.

Thanks, that brings us relief.

Given the results you are currently getting on the high carb diet, I can't help but wonder if you might be able to control Cedric's BG with diet alone if you made the switch to low carb wet food (under 10% carbs).

We can only hope for that to happen! Giving Cedric insuline injections twice a day is quite taxing. With full-time jobs, this strict schedule is a big commitment for me and my girlfriend. Of course we do whatever needs to be done for Cedric. He has been part of our family for almost 10 years. But I am sure he agrees on any valid alternative for poking him with needles every day.

It would even allow us to go on a holiday, as we have yet to find a neighbor comfortable with an insuline pen.

The curve you shared is actually looking pretty good for a cat on Vetsulin. Seems Cedric is getting a little more duration from the Vetsulin than some cats do but as Bron mentioned, a longer lasting insulin like Lantus or Levemir would help soften the curve and extend the duration.

I doubt that acromegaly is something you need to consider at this point. While all acro cats do not need large doses of insulin, Cedric is showing a normal curve which in the case of an acro cat, even if only a low dose were needed, might not be as consistent as you are reporting.

That's good news! There are no insuline pens for Lantus/Levemir that allow the dosage to be increased with .5 IU, are there? It took me a lot of courage to handle the Caninsulin VetPen. Definitely not looking forward to be using syringes.

I'm only familiar with Hill's 'prescription' foods, but have you tried to give Cedric the wet food version of the Urinary you are feeding?

No, we haven't. You mean this one: Royal Canin Veterinary Diet - Urinary S/O Moderate Calorie ?

I would love to know which wet food we could start to try out. Maybe that we can combine it in his diet? A pouch of wet food in the morning and a dry food in the afternoon and evening?

 

[Matthijs]

This is a link to information on urinary tract problems from a vet who has written a great deal about feline nutrition.

Thanks! That website is very informative. Brings me back to the time when Cedric was unable to pee because of a blockage in his bladder. He was in a lot of pain and I am glad the SO diet prevented this from happening again.

Little did I know that switching to properly hydrated canned food, would probably serve the same purpose!

I still need to read the linked pdf: Transitioning Feline Dry Food Addicts to Canned Food, but I bet it provides answers to most of my questions.

 

[MrWorfMen's Mom]

I did ask/confront at our veterinary clinic about this, but the reply was that canned food was mostly fat and carbs. The advice is to use the diabetic version of the dry food: Royal Canin Veterinary Diet - Diabetic DS46

The vet's comments make no sense whatsoever. There is protein in canned food too and most are far lower in carbs than dry food including the one they are trying to convince you to use. There are only 2 maybe 3 low carb dry foods available and none of them are prescription. Cats do not have a high thirst drive and an unregulated diabetic is usually putting out a lot of urine therefore further depleting their fluids. Dry food will only add to the dehydration.
Vets don't get a lot of nutritional education in vet school and most of what they do get is provided by the big food pet companies who brainwash vets into thinking those food brands are in some way better than retail. Read the list of ingredients on canned food and compare it to the label of the dry food. Not many cats are going to crave dehydrated chicken protein, barley and gluten in the dry compared with actual wet meat in a can.

 

[Wendy&Neko]

I doubt that acromegaly is something you need to consider at this point. While all acro cats do not need large doses of insulin, Cedric is showing a normal curve which in the case of an acro cat, even if only a low dose were needed, might not be as consistent as you are reporting.

Not true. My girl had acromegaly and showed normal curves. Many acros do have normal curves, She was also on low doses at times. Depending where you live, your vet takes a blood sample and either sends it to the Royal Veterinary College in London, or Michigan State University in the US. When people get to 6 units of insulin, on wet or raw food, and no other issues, we suggest getting the tests done. If a person suspects acromegaly before then, no need to wait. As long as it had been at least 73 days since starting insulin therapy. Otherwise there is a risk of false negatives.

One week after my girl’s diabetes diagnosis, my non diabetic got his cystitis diagnosis. He was put on high carb vet food. She would try to steal it. I asked the vet for a compromise both could eat. The answer was raw food, which is high water content. In truth, any low carb, low phosphorus food works, with water added to flush things out.

 

[Ann & Scatcats]

Thank you all for taking the time to reply so extensively!



Yes, I read some more background information about pet food and it makes sense that cats are perfectly capable to get their nutrition and energy directly from proteins. They are an obligate carnivore after all. Rice is the main ingredient of the Royal Canine S/O. They seems to add salt to Urinary S/O food to make cats drink more, thus helping in stopping crystals to form.

I did ask/confront at our veterinary clinic about this, but the reply was that canned food was mostly fat and carbs. The advice is to use the diabetic version of the dry food: Royal Canin Veterinary Diet - Diabetic DS46



Thanks, that brings us relief.



No, we haven't. You mean this one: Royal Canin Veterinary Diet - Urinary S/O Moderate Calorie ?

I would love to know which wet food we could start to try out. Maybe that we can combine it in his diet? A pouch of wet food in the morning and a dry food in the afternoon and evening?

You have a cat food Bozita I think in Holland. You can look into that and see if its suitable.

 

[Matthijs]

If a person suspects acromegaly before then, no need to wait. As long as it had been at least 73 days since starting insulin therapy. Otherwise there is a risk of false negatives.

I don’t have a strong suspicion. Sometimes I think that one of his paws looks bigger, but it might just be my imagination. I will not worry too much about it for now and wait a few months to see how Cedric is doing.

You have a cat food Bozita I think in Holland. You can look into that and see if its suitable.

Yep! That brand is available from Zooplus: Bozita Canned Food 6 x 410g

Any specific flavor that is most suitable for diabetic cats with (past) urinary tract problems? Otherwise I will just order the chicken, he usually likes that.

 

[Ann & Scatcats]

I don’t have a strong suspicion. Sometimes I think that one of his paws looks bigger, but it might just be my imagination. I will not worry too much about it for now and wait a few months to see how Cedric is doing.



Yep! That brand is available from Zooplus: Bozita Canned Food 6 x 410g

Any specific flavor that is most suitable for diabetic cats with (past) urinary tract problems? Otherwise I will just order the chicken, he usually likes that.

If he likes chicken try with that one first.

 

[Matthijs]

The delivery with canned food will arrive any moment now. I was wondering what the best way is to smoothly introduce a wet diet to Cedric?

We already replaced his 15:00 dry food "snack" with half a pouch of Sheba. Since we want to completely switch to wet food, we cannot use the automatic cat feeder anymore that is set to three feeding moments a day. Because of our work schedule, we can only feed Cedric twice a day after the Christmas holidays end.

Instead of Bozita, I opted for the following brands as they are lower in KCals from carbs and seem higher quality.

• Granatapet - Chicken Pure (2.4% Kcals from carbs, 10.8% Protein, 80.0% Moisture)
• Wild Freedom - Deep Forest, game & chicken (1.1% Kcals from carbs, 10.5% Protein, 81.0% Moisture)

According to the dosage information from the manufacturer, the daily amount should be 200 grams for a cat weighing 5KG for both Granatapet and Wild Freedom. We will start with this amount (it might be a bit too much for a castrated cat).

This is the transition schedule I have in mind. Any comments or suggestions?

My idea is to only give the prescribed insuline dosage when he eats his (high carb) dry food. And to skip it when giving wet food. Starting with morning feeding moment.

We can obviously reduce the amount of dry food and give it together with some wet food, but this would make it difficult to know the correct insuline dosage in advance, so I would rather keep things simple.

Now we want to keep an eye on the blood glucose level during this transition. At what times should we do a measurement? And what can we expect? Am I correct that we do not need to worry about a low blood glucose level (hypo), since we only give insuline when also feeding high carb dry food?

As always, tremendous thanks for all the help!

 

[Matthijs]

Excuse me for bumping this thread so quickly. Because Cedric’s symptoms aren’t reducing on dry food (drinking, peeing a lot, hungry all the time), I want to introduce wet food as soon as possible.

I don’t feel comfortable without confirmation to execute the above plan and could use some advice and feedback.

How can I gradually switch to wet food, while reducing the insuline dosage in a safe way?

 

[Ann & Scatcats]

Excuse me for bumping this thread so quickly. Because Cedric’s symptoms aren’t reducing on dry food (drinking, peeing a lot, hungry all the time), I want to introduce wet food as soon as possible.

I don’t feel comfortable without confirmation to execute the above plan and could use some advice and feedback.

How can I gradually switch to wet food, while reducing the insuline dosage in a safe way?

Yes, that's the way to do it. Lower the insulin dose and start with giving the wet food.

 

[Matthijs]

Yes, that's the way to do it. Lower the insulin dose and start with giving the wet food.

Thank you for your quick response.

I think the question that remains is: When I stop giving insuline in the morning, can I assume Cedric still requires 1.5 IU insuline in the evening combined with his normal portion of dry food?

 

[Ann & Scatcats]

Thank you for your quick response.

I think the question that remains is: When I stop giving insuline in the morning, can I assume Cedric still requires 1.5 IU insuline in the evening combined with his normal portion of dry food?

What current Caninsulin dose morning and evening do you have?

 

[Ann & Scatcats]

Thank you for your quick response.

I think the question that remains is: When I stop giving insuline in the morning, can I assume Cedric still requires 1.5 IU insuline in the evening combined with his normal portion of dry food?

This is the protocol for Caninsulin. Insulin is always given twice a day, BID

'
STARTING DOSE - CANINSULIN (VETSULIN)

• Usually it’s best to start with a low dose of not more than one unit, twice a day.
• For those new to dealing with feline diabetes we recommend that no insulin is given if the BG is below 200 mg/dL [11 mmol/L] on a human glucose meter. (For more information on what these numbers mean see ‘Home Blood Glucose Testing’ information below.
• If, after a week, and having reviewed your cat’s BG levels, the dose doesn’t seem sufficient, dose increases can be made in small increments of 0.25 or 0.5 of a unit. (If you use a VetPen the smallest increment that can be measured is 0.5 of a unit.)'

 

[Si am cat mom]

The delivery with canned food will arrive any moment now. I was wondering what the best way is to smoothly introduce a wet diet to Cedric?

We already replaced his 15:00 dry food "snack" with half a pouch of Sheba. Since we want to completely switch to wet food, we cannot use the automatic cat feeder anymore that is set to three feeding moments a day. Because of our work schedule, we can only feed Cedric twice a day after the Christmas holidays end.

Instead of Bozita, I opted for the following brands as they are lower in KCals from carbs and seem higher quality.

• Granatapet - Chicken Pure (2.4% Kcals from carbs, 10.8% Protein, 80.0% Moisture)
• Wild Freedom - Deep Forest, game & chicken (1.1% Kcals from carbs, 10.5% Protein, 81.0% Moisture)

According to the dosage information from the manufacturer, the daily amount should be 200 grams for a cat weighing 5KG for both Granatapet and Wild Freedom. We will start with this amount (it might be a bit too much for a castrated cat).

This is the transition schedule I have in mind. Any comments or suggestions?

View attachment 50328

My idea is to only give the prescribed insuline dosage when he eats his (high carb) dry food. And to skip it when giving wet food. Starting with morning feeding moment.

We can obviously reduce the amount of dry food and give it together with some wet food, but this would make it difficult to know the correct insuline dosage in advance, so I would rather keep things simple.

Now we want to keep an eye on the blood glucose level during this transition. At what times should we do a measurement? And what can we expect? Am I correct that we do not need to worry about a low blood glucose level (hypo), since we only give insuline when also feeding high carb dry food?

As always, tremendous thanks for all the help!

Late to the party.

My cat has a History of urinary issues- struvite crystals, cystitis and FLUTD. He was originally on C/D dry then we went to C/D canned with the occasional kibble. Once he was diagnosed, my vet recommended the Glycobalance prescription diet because of the med carb levels and the lower phosphorus levels. It supposedly creates an environment where crystals and then stones can not form in the urine...that came from the company when we called to see how this diet would affect his urinary tract.
Now, I just feed canned foods with similar nutritional breakdowns- low phosphorus, good protein and fiber levels and lower carbs ( 10% or less). I switched my guy over to canned in about 3 days, then to a no carb food over the course of a week...mixing the two and phasing the old food out slowly.
I freeze his canned food into ice cube trays and leave them in his automatic feeder overnight since I work. Sometimes I had some stock for more fluid if I'm using a pate.

It's been 2 months but his urine pH is better than it was when he was diagnosed. I have urinalysis strips and test every week to make sure he isn't starting to have any issues.
You do the best you can, but I just wanted you to know that its possible to treat the diabetes and urinary issues.
Good luck

 

[Matthijs]

What current Caninsulin dose morning and evening do you have?

The current dose is 1.5 IU insuline in the morning and in the evening.

See proposed schedule for transitioning to wet food without any insuline. I will take a day curve at day 5 to check if the BG actually stays low.
View attachment 50328

This is the protocol for Caninsulin. Insulin is always given twice a day, BID

Correct, but that's currently also based on high carb dry food twice a day. If during the transition, I switch to low carb wet food in the morning. Would it be the safest to omit insuline in the morning as well?

Current reading at 7:30 in the morning is 15.1 mmol/l.

 

[Matthijs]

Late to the party.

My cat has a History of urinary issues- struvite crystals, cystitis and FLUTD. He was originally on C/D dry then we went to C/D canned with the occasional kibble. Once he was diagnosed, my vet recommended the Glycobalance prescription diet because of the med carb levels and the lower phosphorus levels. It supposedly creates an environment where crystals and then stones can not form in the urine...that came from the company when we called to see how this diet would affect his urinary tract.
Now, I just feed canned foods with similar nutritional breakdowns- low phosphorus, good protein and fiber levels and lower carbs ( 10% or less). I switched my guy over to canned in about 3 days, then to a no carb food over the course of a week...mixing the two and phasing the old food out slowly.
I freeze his canned food into ice cube trays and leave them in his automatic feeder overnight since I work. Sometimes I had some stock for more fluid if I'm using a pate.

It's been 2 months but his urine pH is better than it was when he was diagnosed. I have urinalysis strips and test every week to make sure he isn't starting to have any issues.
You do the best you can, but I just wanted you to know that its possible to treat the diabetes and urinary issues.
Good luck

Thanks! Great to hear that your cat is doing well now!

How can I check the phosphorus level of food? The UK Cat Foods spreadsheet, for example lists: (P) 1.7, but there is no legend telling me if that's too high or low. I'm going to feed Granatapet (Chicken Pure), but there are no phosphorus details for that brand in the spreadsheet. Are they simply not known?

Can you tell me how you adjusted the insuline dosage during the switch to no carb food?

I read that if you switch to low carb wet food abruptly (cold turkey style), then you should stop giving any insuline for the first 24 hours.

How does that work if I want to switch gradually? Do I give wet food and no insuline in the morning, and dry food with 1.5 IU insuline in the evening?

Or is it better to give half a portion of dry food, half a portion of wet food together with 0.5 IU insuline*, both in the morning and evening for a few days?

* this dosage is just guesswork, so not my preferred way to do it.

My hope is that switching to a low carb wet diet (with 2.4% Kcals from carbs) would by itself lower Cedric's BG enough, so that he will not require any additional insuline.

 

[Ann & Scatcats]

The current dose is 1.5 IU insuline in the morning and in the evening.

See proposed schedule for transitioning to wet food without any insuline. I will take a day curve at day 5 to check if the BG actually stays low.
View attachment 50328


Correct, but that's currently also based on high carb dry food twice a day. If during the transition, I switch to low carb wet food in the morning. Would it be the safest to omit insuline in the morning as well?

Current reading at 7:30 in the morning is 15.1 mmol/l.

15 mmol in the a.m is still over the renal threshold (13 mmol)

You still need to check the bg in the morning as usual, and in mid day and evening to know what he has without any morning insulin.

Is an insulin dosage schedule of 0,5 U at feeding time in the a.m and 1,5 U in the evening out of the question?

 

[Matthijs]

15 mmol in the a.m is still over the renal threshold (13 mmol)

You still need to check the bg in the morning as usual, and in mid day and evening to know what he has without any morning insulin.

Is an insulin dosage schedule of 0,5 U at feeding time in the a.m and 1,5 U in the evening out of the question?

No, I am open for all suggestions.

So if I understand you correctly, your advice would be to do the following until Cedric is used to a wet diet?

Morning (7:30)
Measure BG. if above 13 mmol, give 0,5 U insuline dosage.
Feed low carb wet food.

Evening (19:30)
Give 1,5 U insuline dosage.
Feed his usual (high carb) Royal Canin dry food.

 

[Ann & Scatcats]

No, I am open for all suggestions.

So if I understand you correctly, your advice would be to do the following until Cedric is used to a wet diet?

Morning (7:30)
Measure BG. if above 13 mmol, give 0,5 U insuline dosage.
Feed low carb wet food.

Evening (19:30)
Give 1,5 U insuline dosage.
Feed his usual (high carb) Royal Canin dry food.

Yes. What do you think about that?

 

[Ann & Scatcats]

I can teach you about Amylase. Everyone has Amylase which is what breaks down the carbohydrates already starting in the mouth saliva. Cats have that too.
But one huge major factor difference with cats, is that cats are obligatory carnivore, so cats have just 5-6 % Amylase.

So that means that any carbohydrate content above the cats Amylase level 5-6 %, is going to force the cats body to need a more insulin, and both the Amylase and Insulin is produced by the pancrea. And when the cats pancrea can't produce enough insulin, then is when we have this with too high blood glucose.

I hope Cedric will like his wet food.

 

[Matthijs]

Yes. What do you think about that?

Sounds like a plan! I just want to make sure Cedric does not end up in a hypo with too low blood glucose levels.

With 1.5 U insuline and regular Royal Canin S/O, his BG is 4.1 mmol/l at 11:30 (+4 hours after his meal and insuline)

So I need to be sure that, when I switch diets tomorrow morning and Cedric's BG is again around 15 mmol, that 0,5 U will not be too much.

 

[Matthijs]

Anyone else willing to contribute some advice in regards to switching from high carb to low carb food, while on Caninsuline?

I believe I just woke up from a bad dream in which my cat went hypoglycemic, because even the 0,5 U insuline dosage was too much.

 

[Matthijs]

This morning went far better than I had expected!

The preshot at 7:30 was 10,5 mmol/l. Since this is below the renal threshold (13 mmol/l), I decided not to give any insuline.
First time feeding low carb wet food was a success! Cedric enjoyed every last bit of it.

Immediately this showed an enormous improvement on his behavior. Gone was the begging for more food. He did not sit in the kitchen sink anymore, waiting for someone to tap some water. He is less thirsty.

He has been relaxed all morning, purring and sleeping for hours. It's like I have my old cat back.

Took a second BG test at 9:30 (+2) with again 10,5 mmol/l as a result. Now I hope his pancreas kicks in and we will have a lower BG in a few hours.

That does make me wonder what type of food I should give Cedric tonight? We are in detox mode, and this morning was his first low carb wet meal. He liked it, but will it do good for his stomach to abruptly switch to all wet diet?

Should I give him the high carb dry food again this evening? And if his evening preshot test is still below 13 mmol/l, should I skip that insuline shot as well?

 

[Matthijs]

BG at 11.30 (+4) was 10.0 mmol/l, so it's kind of a flatline. Decided not to "help" it yet by and wait with injecting insuline.

Added the data in the spreadsheet template (see signature), so you can all follow along.

 

[Matthijs]

Another positive update!

BG at +6 was 8.7 mmol/l. All without any insuline, just by swapping a single meal from high carb dry food to low carb canned wet food.

Strongly thinking about switching cold turkey to a wet diet. Any objections?

 

[Deb & Wink]

Since you are not giving your cat insulin, there is little risk of hypoglycemia (hypo).

Switching a cat to only wet food sometimes causes stomach upset and the cat will vomit the food. This would be of greater concern if your cat is getting insulin, but he's not.

Another possible side effect of cold turkey switch to wet diet is the feces may be looser or smellier than normal for a while.

Try the 'cold turkey' switch and see would be my suggestion.

 

[Bron and Sheba (GA)]

Have you started to swap over to a low carb diet yet?
If not I would start now but I would do it slowly over a period of several days to prevent a tummy/bowel upset.
You may find that once you have swapped over to a low carb diet he is staying in green numbers.

Does your kitty have a history of ketones at all? Did the vet mention ketones at all?
If you are not going to give any insulin at all I think it would be a good idea to go out and buy a bottle of Ketostix from Walmart or a pharmacy and test the urine daily. This is a safely measure.
It is an easy test. You just collect a specimen of urine then dip the test strip into the urine, then 15 seconds later compare it against the colours on the side of the bottle. Anything above a trace needs vet attention.

Also don't neglect the pm cycle for tests. It is just a simple important as the am cycle.

 

[Matthijs]

Since you are not giving your cat insulin, there is little risk of hypoglycemia (hypo).

Switching a cat to only wet food sometimes causes stomach upset and the cat will vomit the food. This would be of greater concern if your cat is getting insulin, but he's not.

Another possible side effect of cold turkey switch to wet diet is the feces may be looser or smellier than normal for a while.

Try the 'cold turkey' switch and see would be my suggestion.

Great, thanks for your reply. Cedric responded really well to eating the wet food. Not only did I see an immediate big improvement in his behavior, he did not require any insuline to keep his BG below 10.5 mmol/l during the day. In the afternoon it was even 8.7 mmol/l.

So I decided to go for it and stop with the high carb dry food. This is his second day on the wet food and so far so good. No vomiting.

Weirdly his BG increased this morning after eating his food, so I decided to give him a small insuline dosage of 0,5 U. It's dropping now, but I need to decide on a new treatment protocol. Will open a new thread for this.

Have you started to swap over to a low carb diet yet?
If not I would start now but I would do it slowly over a period of several days to prevent a tummy/bowel upset.
You may find that once you have swapped over to a low carb diet he is staying in green numbers.

I found it difficult to decide on the best mix of dry food, wet food and the correct (reduced) insuline dosage. I proposed a schedule and posted that several messages above, but I didn't get much feedback about it.

So I decided it might be best to swap over as quickly as possible. Cedric is only eating low carb wet food for one and a half day now. So far he is doing well. Although I hoped his numbers would continue decreasing.

Does your kitty have a history of ketones at all? Did the vet mention ketones at all?
If you are not going to give any insulin at all I think it would be a good idea to go out and buy a bottle of Ketostix from Walmart or a pharmacy and test the urine daily. This is a safely measure.

No, the vet didn't mention or test this. If I make sure the BG is below the renal treshold, I do not have to worry much about this, right?

Also don't neglect the pm cycle for tests. It is just a simple important as the am cycle.

Yes, you are right. Currently it still takes two people to get a test. One to hold him still and one to perform the test. I'm glad Cedric tolerates it and even purrs a bit during the test (he knows he gets a treat afterwards), but it's still a hassle.

 

[Bron and Sheba (GA)]

I am going to tag @MrWorfMen's Mom to see us she has any ideas about what dose you should give. I have no experience with caninsulin.

As far as ketones go, if you are not giving any insulin to a diabetic cat who needs insulin, the potential is there to get ketones.

 

[JanetNJ]

That's amazing that it went down to 8.7 on its own. That's a normal number! I'm inclined to suggest that you get her off kibble completely and just test her for a couple days. If you do need insulin id start really low. 0.25-0.5

 

[Matthijs]

That's amazing that it went down to 8.7 on its own. That's a normal number! I'm inclined to suggest that you get her off kibble completely and just test her for a couple days. If you do need insulin id start really low. 0.25-0.5

Yes, I am so proud! I will continue with the wet food.

Even this morning preshot test was positive at 9.5, but what scared me is that the number went up really quickly.

At 08:00 it was 9.5 mmol/l
At 10:00 it was 13.2 mmol/l

That number is too high to ignore, so I gave a small dosage of 0,5 U insuline. But I can't continue with this ad-hoc style.

So that's why I just opened a thread to ask for specific dosage advice: http://www.felinediabetes.com/FDMB/threads/need-urgent-help-on-correct-dosage-and-protocol.223827/