Kitten with Type 1 Diabetes

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Joanna Duncan

Joanna Duncan

Member Since 2020
Hi, looking for some advice. My 7 month old rescue kitten Minnie was just diagnosed. I adopted her when she was 3 months old and was relatively healthy. She has always drank a lot of water, more than any other cat I have had but I thought nothing of it. She appeared to be gaining weight until about a month ago, and then 2 weeks ago she just appeared unwell. Not playing, lethargic, losing weight, threw up a few times and VERY hungry. Still drinking excessively and also very gassy. I took her to the vet and her BG was 300, they put it down to stress. At that time found a polyp in her ear, gingivitis and decided to treat those 2 things plus giving her a deworming Medicine in the event she had a parasite (GI symptoms and weight loss). 4 days later she deteriorated and I took her back to the Vet. She lost 0.5 of a lb ( weight 4.5 lbs), she is skin and bones, very lethargic, blood sugar was 350, positive glucose and ketones in urine. They admitted her gave her fluids and insulin. She stayed 2 days and came home. At discharge G still 300, I am giving her insulin 0.5 unit twice a day. The Vet said not to change her food just yet. I feed her wet food twice a day (Blue Buffalo, 1/2 can morn and night), blue buffalo dry food in between. She appears starving but has still thrown up.
I am overwhelmed not sure what to tackle first. Should I feed her more? Change her food? Feed only wet food? Should I monitor her BG? Her urine?

really need some advice
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Hi and welcome to the forum. I am sorry your sweet little kitty has diabetes so young.
Yes please do test the BG levels. A human meter is fine. If you live in the US you can get a ReliOn meter from Walmart, or a pharmacy.
While at the pharmacy also pick up a bottle of Ketostix to test the urine for ketones which you should do each day at the moment. It is very important to monitor ketones if your kitty has had them.

To prevent ketones reforming this is what you need to do:
  • Make sure Minnie is getting plenty to eat. Low carb food is best for diabetic cats. But the most important thing is she will eat, so if she will only eat food that is not low carb at the moment that is fine as we need her to eat. Offer her lots of small snacks during the day and night as well as her meals before the insulin. DO NOT change her diet at the moment until you are testing the blood glucose levels.
  • Try not to skip any doses of insulin. It is really important Minnie gets insulin twice a day. As I mentioned above it is really important you test the blood glucose levels to keep her safe. We can help you learn.
  • Give extra fluids in her food. Try a teaspoon of warm water in each lot of food. Give frequent small meals throughout the day and night.
  • Test daily for ketones in the urine. It is much safer to catch any ketones early and deal with them then to wait until she presents as sick and you find out she has a lot of ketones which can quickly become ketoacidosis (DKA). To test for ketones, dip the test strip into a urine sample you have collected from Minnie. Check it against the colours on the side of the Ketostix bottle exactly 15 seconds later. Anything above a trace needs vet attention.

Joanna Duncan said:
Should I feed her more? Change her food? Feed only wet food? Should I monitor her BG? Her urine?
Click to expand...
. In answer to your questions,
Yes I would feed her more...as much as she will eat, as long as she doesn't vomit.
I would not change her food at the moment until you are testing the BG levels as low carb can drop the numbers more than 100 points.
Yes monitor the BG levels?
Yes monitor the urine for ketones?

Link to home testing
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/



Keep asking questions. We are happy to help
Bron
 
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Thank you so much for the great advice.
I am in the US in fact in Georgia
She currently eats both wet and dry Blue Buffalo kitten food. I have increased the amount of wet a little. She is very malnourished.
Is there such a thing as diabetic kitten food?
Have you ever experienced such a young cat with type 1 Diabetes? My vet has not seen it before so if not really sure how to manage it.
I will get the ketone sticks. I have a BG monitor already ( human use!) how do I obtain a sample from her? Where do I stick her and with what?
Do you recommend any nutritious low carb snacks I could give her?
 
As far as I know, there aren't any diabetic kitten foods. If Minnie has been spayed, at 7 months, she's old enough to eat adult food. (I have a kitten who's the same age and spayed and my vet said she's fine to be eaten adult food.) The kitten food is nutrient dense and will help Minnie put the weight she's lost back on more quickly, though. You may want to check this chart of available canned foods. If you are looking for kitten food and/or low carb, the carb percent is listed and ultimately, you are looking for less than 10% carb. As others noted, though, don't make big changes in the carb value of food until you are home testing.

Regarding home testing, you want to test along the outer edge of the ear -- don't try to poke the vein. I'm linking information on home testing. The alternative location to test is a paw pad. You use the same lancets that you use for a human. In the beginning, you may need a wider gauge lancet (e.g., 28 gauge) but once the capillary bed in the ear develops, you can use a 30 or 31 gauge.

There are lots of freeze dried snacks around. Most people here use freeze dried chicken but your options include anything that's protein only. Many of us buy these treats in the dog aisle -- the bags are bigger and a little cheaper -- and just break them into cat sized pieces. Poached chicken is another option. There are also members who have use cooked shrimp or whatever is your kitty's favorite. Also, when starting to test, always give a treat. Regardless of whether the test is successful, give Minnie treats so she associates testing with a reward.
 
Did the vet do any blood work other than testing her glucose levels? If she has any infection or pain that also could be contributing to the high glucose levels.
 
Sarah&Soph said:
Fancy feast has two kinds of kitten foods listed on the chart that Sienne has linked that are good for diabetics
Click to expand...
If you look at the chart there are no significant differences between the FF kitten food and the FF classic varieties. Most cat foods today meet the requirements for both kittens (Growth and reproduction) and adults. All FF canned food that I have seen says on the label that the food is good for all life stages. The cat food that says for senior cats only will not meet the kitten requirements and the label will say for adults only. If you want to see the difference see:
https://www.aafco.org/Portals/0/Sit...osed_Revisions_to_AAFCO_Nutrient_Profiles.pdf
 
Much love to little Minnie. Your title snagged my attention because I've been a type 1 for 40 years.
Type 1 is an autoimmune disease, unlike Type 2 which all the kitties I've seen so far here, seem to have (?)

My primary thought is that this darling needs insulin for life. Was any test done to confirm Type 1 (destruction of beta cells in the pancreas), or is it being called Type 1 because of Minnie's age?

Not a huge difference in caring for Minnie, other than remission could not happen if she's truly T1.
She is so very precious!
 
Lisa and Witn (GA) said:
Did the vet do any blood work other than testing her glucose levels? If she has any infection or pain that also could be contributing to the high glucose levels.
Click to expand...
Hi, Sorry I am just getting back to you.
No signs of infection and kidney numbers looked good. Did have some elevated liver numbers. The vet is thinking that her pancreas maybe abnormal and is planning to do testing for exocrine pancreatic disease.
 
Tina Marie and Jan said:
Much love to little Minnie. Your title snagged my attention because I've been a type 1 for 40 years.
Type 1 is an autoimmune disease, unlike Type 2 which all the kitties I've seen so far here, seem to have (?)

My primary thought is that this darling needs insulin for life. Was any test done to confirm Type 1 (destruction of beta cells in the pancreas), or is it being called Type 1 because of Minnie's age?

Not a huge difference in caring for Minnie, other than remission could not happen if she's truly T1.
She is so very precious!
Click to expand...

Thank you....she is the sweetest kitty ever! I think the diagnosis is purely because of her age. Our vet has never encountered this before. I would love to find a feline endocrinologist if there is such a thing, but I dont know where to start.
 
Joanna - you are doing the best thing now though, and that is giving insulin!
I don't know if a specialist could do much more than what you are doing already. I know there is that curiosity though . . .
I had another thought about something potentially easier about T1. Once Minnie is an adult, she might float along nicely on a stable dose, only occasionally needing adjustments.
I'm so glad Minnie has you:):cat:
 
Kay Passa used to have a diabetic kitten, Michaelangelo. Not sure of her user name or if she posts here anymore. She might have some ideas.
 
Are you testing for ketones to monitor them?
Can you tell us what type of insulin you are giving and if you have started testing the blood glucose yet?
How is her appetite?
 
You may want to try and reach out to TinyKittens. They are a cat/kitten rescue in Canada and had a kitten named Stanley that was diagnosed with type 1 diabetes and exocrine pancreatic insufficiency. Maybe see if they can point you in the direction of any information. They're quite busy so they may take a bit to get back or not have time at all, but I think it's worth a shot. Their website is tinykittens.com
 
Poor kitty. Feed her as much of the wet food as she wants. Until her diabetes is regulated she will need extra food because their bodies can not properly utilize the nutrients so they are literally starving even though they are eating. Several small meals a day rather than two big meals.

I have a video in my signature showing how I test my cat CC at home. It's tricky at first but after a couple weeks should be easy.
 
Bron and Sheba (GA) said:
Hi and welcome to the forum. I am sorry your sweet little kitty has diabetes so young.
Yes please do test the BG levels. A human meter is fine. If you live in the US you can get a ReliOn meter from Walmart, or a pharmacy.
While at the pharmacy also pick up a bottle of Ketostix to test the urine for ketones which you should do each day at the moment. It is very important to monitor ketones if your kitty has had them.

To prevent ketones reforming this is what you need to do:
  • Make sure Minnie is getting plenty to eat. Low carb food is best for diabetic cats. But the most important thing is she will eat, so if she will only eat food that is not low carb at the moment that is fine as we need her to eat. Offer her lots of small snacks during the day and night as well as her meals before the insulin. DO NOT change her diet at the moment until you are testing the blood glucose levels.
  • Try not to skip any doses of insulin. It is really important Minnie gets insulin twice a day. As I mentioned above it is really important you test the blood glucose levels to keep her safe. We can help you learn.
  • Give extra fluids in her food. Try a teaspoon of warm water in each lot of food. Give frequent small meals throughout the day and night.
  • Test daily for ketones in the urine. It is much safer to catch any ketones early and deal with them then to wait until she presents as sick and you find out she has a lot of ketones which can quickly become ketoacidosis (DKA). To test for ketones, dip the test strip into a urine sample you have collected from Minnie. Check it against the colours on the side of the Ketostix bottle exactly 15 seconds later. Anything above a trace needs vet attention.

. In answer to your questions,
Yes I would feed her more...as much as she will eat, as long as she doesn't vomit.
I would not change her food at the moment until you are testing the BG levels as low carb can drop the numbers more than 100 points.
Yes monitor the BG levels?
Yes monitor the urine for ketones?

Link to home testing
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/



Keep asking questions. We are happy to help
Bron
Click to expand...
Bron and Sheba (GA) said:
Are you testing for ketones to monitor them?
Can you tell us what type of insulin you are giving and if you have started testing the blood glucose yet?
How is her appetite?
Click to expand...


Bron and Sheba (GA) said:
Are you testing for ketones to monitor them?
Can you tell us what type of insulin you are giving and if you have started testing the blood glucose yet?
How is her appetite?
Click to expand...


I have been attempting to test for ketones...catching her urine stream when I can. I have not started checking her BG yet, the vet said to just observe symptoms. Her appetite varies, as you can see she is VERY skinny and has lost weight. She has times when she will eat little bits and other times when she appears to be starving and nothing will satisfy her. She has quite mixed symptoms. She has had intermittent vomiting as well. It is hard to give her insulin as she is so thin.
 
Bron and Sheba (GA) said:
Are you testing for ketones to monitor them?
Can you tell us what type of insulin you are giving and if you have started testing the blood glucose yet?
How is her appetite?
Click to expand...
I have been attempting to test for ketones...catching her urine stream when I can. I have not started checking her BG yet, the vet said to just observe symptoms. Her appetite varies, as you can see she is VERY skinny and has lost weight. She has times when she will eat little bits and other times when she appears to be starving and nothing will satisfy her. She has quite mixed symptoms. She has had intermittent vomiting as well. It is hard to give her insulin as she is so thin.
 
Alicia & Chester said:
You may want to try and reach out to TinyKittens. They are a cat/kitten rescue in Canada and had a kitten named Stanley that was diagnosed with type 1 diabetes and exocrine pancreatic insufficiency. Maybe see if they can point you in the direction of any information. They're quite busy so they may take a bit to get back or not have time at all, but I think it's worth a shot. Their website is tinykittens.com
Click to expand...
Thank you I am reaching out right now!
 
Joanna Duncan said:
I have been attempting to test for ketones...catching her urine stream when I can. I have not started checking her BG yet, the vet said to just observe symptoms. Her appetite varies, as you can see she is VERY skinny and has lost weight. She has times when she will eat little bits and other times when she appears to be starving and nothing will satisfy her. She has quite mixed symptoms. She has had intermittent vomiting as well. It is hard to give her insulin as she is so thin.
Click to expand...

I would definitely check BG no matter what you were told! The intermittent vomiting could be from high BGs making her sick.
Are you giving the .5U every twelve hours?
Hugs for you and gentle hugs for your baby Minnie:bighug::bighug:

Don't let me stir up things; I'm sending you calming vines . . . just want to be clear on what's up!
 
Tina Marie and Jan said:
I would definitely check BG no matter what you were told! The intermittent vomiting could be from high BGs making her sick.
Are you giving the .5U every twelve hours?
Hugs for you and gentle hugs for your baby Minnie:bighug::bighug:

Don't let me stir up things; I'm sending you calming vines . . . just want to be clear on what's up!
Click to expand...

Giving her 1unit every 12 hours now. Same food Blue Buffalo, but I am feeding more often smaller amounts. How often do you think I should check the BG?
 
JanetNJ said:
Poor kitty. Feed her as much of the wet food as she wants. Until her diabetes is regulated she will need extra food because their bodies can not properly utilize the nutrients so they are literally starving even though they are eating. Several small meals a day rather than two big meals.

I have a video in my signature showing how I test my cat CC at home. It's tricky at first but after a couple weeks should be easy.
Click to expand...
Thank you so much the video is helpful. I hope my kitten will be as cooperative as your kitty :)
 
Joanna Duncan said:
Giving her 1unit every 12 hours now. Same food Blue Buffalo, but I am feeding more often smaller amounts. How often do you think I should check the BG?
Click to expand...
Great on the insulin dosing!
I would check every time before giving insulin, and log that BG number. (My experience is with Lantus.)
What insulin are you using?!
With Lantus, the lowest numbers/peak insulin time/nadir, is usually around 4 to 6 hours after injecting, but can vary by cat! The idea of testing during the cycle with any insulin, is to first, keep kitty safe from going too low, but to also see when the onset is (often 2-3 hours with Lantus), and when the peak strength or nadir is. Ultimately, we are looking for a good and safe dose. It can take a while.

You can look over my, or anyone's spreadsheet in our signature lines, to see how the BG numbers are tested and logged, and insulin doses changed, etc.

Please ask anything no matter what! I need to get to a bigger computer so I can see better!!
Also - you might want to review the first posts from Bron, and then Sienne, that are packed with good info!
 
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Tina Marie and Jan said:
Great on the insulin dosing!
I would check every time before giving insulin, and log that BG number. (My experience is with Lantus.)
What insulin are you using?!
With Lantus, the lowest numbers/peak insulin time/nadir, is usually around 4 to 6 hours after injecting, but can vary by cat! The idea of testing during the cycle with any insulin, is to first, keep kitty safe from going too low, but to also see when the onset is (often 2-3 hours with Lantus), and when the peak strength or nadir is. Ultimately, we are looking for a good and safe dose. It can take a while.

You can look over my, or anyone's spreadsheet in our signature lines, to see how the BG numbers are tested and logged, and insulin doses changed, etc.

Please ask anything no matter what! I need to get to a bigger computer so I can see better!!
Also - you might want to review the first posts from Bron, and then Sienne, that are packed with good info!
Click to expand...

We are using Prozinc.
 
Tina Marie and Jan said:
Great on the insulin dosing!
I would check every time before giving insulin, and log that BG number. (My experience is with Lantus.)
What insulin are you using?!
With Lantus, the lowest numbers/peak insulin time/nadir, is usually around 4 to 6 hours after injecting, but can vary by cat! The idea of testing during the cycle with any insulin, is to first, keep kitty safe from going too low, but to also see when the onset is (often 2-3 hours with Lantus), and when the peak strength or nadir is. Ultimately, we are looking for a good and safe dose. It can take a while.

You can look over my, or anyone's spreadsheet in our signature lines, to see how the BG numbers are tested and logged, and insulin doses changed, etc.

Please ask anything no matter what! I need to get to a bigger computer so I can see better!!
Also - you might want to review the first posts from Bron, and then Sienne, that are packed with good info!
Click to expand...

So the glucose testing didnt go well :(
I warmed her ear and massaged. I stuck 3 times before I got any blood and it was a tiny amount. Not enough for the glucometer to register a value. Her ears are paper thin and she was very squirmy and didn't like it at all.
I am taking her to the Vet tomorrow for her Glucose curve.
 
I'm so sorry it didn't go well. My cat was so unwell, she didn't even squirm as I was learning.
You are not alone - some people go through awful experiences, then end up with a cat that comes right to the testing spot, willingly! I ended up being able to test anywhere Tina was, but lots of people use one familiar area.
Any chance a second person could hold Minnie for you?
Next time you try, first breathe deeply and relax . . . Talk sweetly, and after a poke, give a little freeze dried treat. Don't despair . . . Right now, Minnie just thinks you are nuts! Keep associating treats with the process. It will get easier!!

Maybe you could use a bigger gauge Lancet? 28 is the larger one (30| 32, are smaller) until the capillaries bleed better. But 28 may be what you are using!
 
Tina Marie and Jan said:
I'm so sorry it didn't go well. My cat was so unwell, she didn't even squirm as I was learning.
You are not alone - some people go through awful experiences, then end up with a cat that comes right to the testing spot, willingly! I ended up being able to test anywhere Tina was, but lots of people use one familiar area.
Any chance a second person could hold Minnie for you?
Next time you try, first breathe deeply and relax . . . Talk sweetly, and after a poke, give a little freeze dried treat. Don't despair . . . Right now, Minnie just thinks you are nuts! Keep associating treats with the process. It will get easier!!

Maybe you could use a bigger gauge Lancet? 28 is the larger one (30| 32, are smaller) until the capillaries bleed better. But 28 may be what you are using!
Click to expand...
I actually used a 30 gauge as that is what we had at home. I will go to the pharmacy and get some 28s. Thank you, I will keep trying....she does think I am nuts!!
 
All,

I am researching food options for Minnie. Right now I am not changing anything but am starting to plan. She is very underweight, only 4.5 Ilbs. She has gained 1Lb since August. She has no fat at all just skin and bones and a little pot belly! So she will need the nutrition/calories but appropriate for diabetics? Any suggestions?
 
A simple answer & I have learned from others: Fancy Feast Classics pates! It is a pretty standard go-to for diabetic kitties, that isn't cost prohibitive.

You would be surprised at how many carbs are often in so much of the so called healthier foods. And it is difficult to even find the carb info on most food.

I happened to research the Weruva line - a few of their choices are low carb. However it is pretty expensive ($2 for a 5.5 oz can), and the reason I use it is Tina needs low phosphorus. YOU don't need to worry about that with your young kitten - I needed to go low phos for my Tina's kidney disease.

Once your baby has the diabetes under better control, she will gain weight!
 
Hi Joanna!

I saw you posting in PumpkinsGrandma's thread and wondered if you had your own. Here it is!!!

Some information in your signature would be really helpful. It only takes a minute to set up.
Info such as Your first name, cat's name, cat's age, cat's sex, Diagnosis date (abbreviated as DX:), insulin used, meter used for home testing, any additional medical issues (such as the EPI).

Go to the upper right hand corner of the screen, click on your user name, select signature from the drop down list, enter away, save changes. You're done. 250 character limit so you may need to abbreviate some.

Did you come over from our facebook group? Have you set up your own spreadsheet yet?
 
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Deb & Wink said:
Hi Joanna!

I saw you posting in PumpkinsGrandma's thread and wondered if you had your own. Here it is!!!

Some information in your signature would be really helpful. It only takes a minute to set up.
Info such as Your first name, cat's name, cat's age, cat's sex, Diagnosis date (abbreviated as DX:), insulin used, meter used for home testing, any additional medical issues (such as the EPI), time zone would be helpful also. Country too.

Go to the upper right hand corner of the screen, click on your user name, select signature from the drop down list, enter away, save changes. You're done. 250 character limit so you may need to abbreviate some.

Did you come over from our facebook group? Have you set up your own spreadsheet yet?
Click to expand...
I was actually on here first and then found the facebook group. I will set up that information now.
 
I knew a member on here years ago who's diabetic cat also had EPI. I'll see if I can dig up any of her old threads to help you.
 
"Diarrhea/soft feces, particularly if paste colored or pale, that can be a sign of exocrine pancreatic insufficiency, or lack of pancreatic enzymes. The blood test for that needs to be done in a fasting state.
The treatment is to supply additional pancreatic enzymes to help the food break down."

"In exocrine pancreatic insufficiency, the stool is pasty-colored, foul smelling, and voluminous because there are not enough digestive enzymes produced by the pancreas. The same thing destroying the insulin-producing islet cells of the pancreas may also destroy the enzyme-producing cells.
Another possible diagnosis is inflammatory bowel disease which may be treated with an oral steroid, budesonide, which doesn't cause as much glucose elevation as the injections do."

So we aren't shy about talking about poop color or consistency around here. What do Minnie's poops look like?
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LOL I would not do that!!
So here is the time-line:
Very healthy until about a month and a half ago. When she just didn’t appear to be gaining weight, not very interested in playing, excessive time drinking at the water bowl, always appeared to be hungry, occasionally vomiting, very gassy and smelly poops.
We are now 4 weeks into her diagnosis of Type 1 Diabetes. 2 weeks after this initial event she was still not gaining weight and occasionally throwing up, smelly poops etc... We started giving her pancreatic enzymes mixed in with her food. And the vet sent blood off to test for Pancreatic Enzyme insufficiency, ( TLI is the test I think)which the vet says she most likely has based on her clinical presentation.In just a week after adding the enzymes she gained 0.5 lb, no vomiting, and appears much more lively and normal poops. She eats Blue Buffalo kitten food both dry and wet at the moment as the Vet did not want to change her food just yet.
The TLI test came back a week ago as normal, the value was 18, the vet said normal was 12-80. We stopped the enzymes as she was not wanting to eat the food and the test was normal.
2-days ago her stool has changed and become abnormal again, soft, yellows brown and VERY smelly and once again she is acting like she is starving. I am very frustrated as the test was normal, however she was not fasting and she was been given the enzymes at the time so I am thinking that it wasn't an accurate result.
Her poop is a light brown soft consistency at the moment. It became normal when she was on the enzymes. I am beyond frustrated, we have made no progress and still not changed her food or got her glucose under control. She is at the Vets today for a curve. One positive thing is that she has gained a little weight and is quite playful.
My vet appears to have limited knowledge, I really like him but I am not seeing progress and I am running out of patience and money!! I am going to have to ask him to repeat the TLI and will probably have to fork out another $150 :(
 
EPI test has to be done fasted. If my mind is remembering correctly, giving the EPI enzymes and seeing improvements in the poops is an indication that the pancreas was not producing enough enzymes. Sort of an empirical test.

We don't get many kittens with diabetes, certainly not many with type 1 diabetes. You happen to be the second person with a kitten in the last 4-6 weeks with a diabetic kitten. The other person has a 10 month old kitten, lives in Spain, does not write or understand English. Her kitten also does not have EPI. Not really any help to you.

When the pancreas is not functioning well, that can affect both the production of insulin and the hormones that help with digestion. That is why the poop can be very loose, diarrhea, very smelly, very large, more of a tan or gray color.

It could be chronic pancreatitis also.
Ask your vet if he thinks B12 injections could be helpful.
 
Quoting to you from another article. Selective quotes. Here is the entire article for you. Exocrine Pancreatic Insufficiency in Cats from the World Small Animal Veterinary Association World Congress Proceedings, 2014

"An assay for the measurement of feline trypsin-like immunoreactivity (fTLI) concentration has been developed and analytically validated. This assay has been fully analytically validated, and the current reference range is 12.0–82.0 µg/L, with values of ≤ 8 µg/L being considered diagnostic for EPI."

"Thus, the current recommendation is to withhold food from cats for 12 hours before collecting a sample for measurement of serum fTLI concentration, whenever possible."

"In cases of EPI, which are caused by chronic pancreatitis, destruction of pancreatic tissue may not be limited to the acinar cells, and concurrent diabetes mellitus may be observed. Diabetes mellitus has also been reported in cats with EPI. Thus, cats with diabetes mellitus that have a chronic history of loose stools should be evaluated for concurrent exocrine pancreatic disease."

"Recently, it was shown that decreased renal function has a significant effect on serum fTLI concentrations and cats with renal failure may have falsely increased serum fTLI concentrations. Therefore, evaluation of serum fTLI concentrations in azotemic cats may obscure a diagnosis of feline EPI. However, no cases have as of yet been identified where a diagnosis of EPI was missed because of renal failure."

"Most cats respond quite rapidly to enzyme replacement therapy and show resolution of loose stools within 3–4 days.
When clinical signs have resolved, the amount of pancreatic enzymes given with each meal can be gradually decreased to the lowest effective dose, which may vary from patient to patient, and may also vary between different batches of the pancreatic supplement."

"Response to enzyme supplementation alone may not be satisfactory in some patients. This is not surprising if one considers that many cats with EPI have cobalamin deficiency and cobalamin deficiency can lead to gastrointestinal and systemic clinical signs. It is thus crucial to correct cobalamin deficiency in all cats with a decreased or low-normal serum cobalamin concentration. Since cobalamin deficiency causes cobalamin malabsorption, oral supplementation is not effective in patients with cobalamin deficiency. "

"In cats, 250 µg is given subcutaneously per injection. An injection is given once a week for 6 weeks, followed by an injection every other week for 6 weeks, one more dose a month after that, and a recheck a month after the last dose."

You can learn to do these subq injections of the cobalamin yourself. After all, you are giving your kitten insulin injections already. Simply choose a different spot to give the cobolamin injections.

Old article, from 2014. There may be something newer out there.

Maybe edit your thread title to ask about EPI, with the question mark prefix. To get someone else to comment on your thread.
 
Deb & Wink said:
Quoting to you from another article. Selective quotes. Here is the entire article for you. Exocrine Pancreatic Insufficiency in Cats from the World Small Animal Veterinary Association World Congress Proceedings, 2014

"An assay for the measurement of feline trypsin-like immunoreactivity (fTLI) concentration has been developed and analytically validated. This assay has been fully analytically validated, and the current reference range is 12.0–82.0 µg/L, with values of ≤ 8 µg/L being considered diagnostic for EPI."

"Thus, the current recommendation is to withhold food from cats for 12 hours before collecting a sample for measurement of serum fTLI concentration, whenever possible."

"In cases of EPI, which are caused by chronic pancreatitis, destruction of pancreatic tissue may not be limited to the acinar cells, and concurrent diabetes mellitus may be observed. Diabetes mellitus has also been reported in cats with EPI. Thus, cats with diabetes mellitus that have a chronic history of loose stools should be evaluated for concurrent exocrine pancreatic disease."

"Recently, it was shown that decreased renal function has a significant effect on serum fTLI concentrations and cats with renal failure may have falsely increased serum fTLI concentrations. Therefore, evaluation of serum fTLI concentrations in azotemic cats may obscure a diagnosis of feline EPI. However, no cases have as of yet been identified where a diagnosis of EPI was missed because of renal failure."

"Most cats respond quite rapidly to enzyme replacement therapy and show resolution of loose stools within 3–4 days.
When clinical signs have resolved, the amount of pancreatic enzymes given with each meal can be gradually decreased to the lowest effective dose, which may vary from patient to patient, and may also vary between different batches of the pancreatic supplement."

"Response to enzyme supplementation alone may not be satisfactory in some patients. This is not surprising if one considers that many cats with EPI have cobalamin deficiency and cobalamin deficiency can lead to gastrointestinal and systemic clinical signs. It is thus crucial to correct cobalamin deficiency in all cats with a decreased or low-normal serum cobalamin concentration. Since cobalamin deficiency causes cobalamin malabsorption, oral supplementation is not effective in patients with cobalamin deficiency. "

"In cats, 250 µg is given subcutaneously per injection. An injection is given once a week for 6 weeks, followed by an injection every other week for 6 weeks, one more dose a month after that, and a recheck a month after the last dose."

You can learn to do these subq injections of the cobalamin yourself. After all, you are giving your kitten insulin injections already. Simply choose a different spot to give the cobolamin injections.

Old article, from 2014. There may be something newer out there.

Maybe edit your thread title to ask about EPI, with the question mark prefix. To get someone else to comment on your thread.
Click to expand...


Thank you so much this is very helpful.
 
So new problem today. Minnie was so exhausted after the Vets yesterday, she slept all night and only ate a little food. This morning BG was 189 pre-insulin, she WOULD NOT eat her breakfast, it had the enzymes in it. I tried 3 different kinds of wet food and she only ate a couple of mouth fulls. I was planning to transition her diet this weekend as she is still mostly eating Blue Buffalo Kitten wet food, very little dry food, I typically just leave a little bit over night or if I am gone all day. My plan was to transition off the BB and onto Fancy Feast pate's and I just got a bag of Dr. Elsyes dry food. I have to try and get these enzymes in her. The Vet prescribed Purina DM for her both wet and dry and I did discuss this with him and the fact it still has carbs. He feels that she most likely will never go into remission as her pancreas is not working properly so its ok for her to have small amounts of carbs, in fact she should in the event of hypos.
I am so confused and frustrated and need a plan of action. I also have a healthy 7 year old cat and I really want them on the same diet.
Thoughts, suggestions anyone?
 
Poor, exhausted Minnie and poor exhausted Joanna too.:bighug:Hope you both get a nap today.

The Purina canned/wet food is actually a good choice for a diabetic cat (6% for the regular, 10% for the savory selects). The ingredients are pork based and sometimes cats will refuse to eat the DM after a short period of time. For that reason and others, it's a good idea to have a selection of canned foods. Something both your cats could eat.

Diabetic cats are already drinking so much water to replace what they are peeing out because of the excess blood glucose, that a dry diet leaves them open to dehydration and kidney issues. That is why I have chosen to not feed dry to my cats. You make choices for your cats, based on the knowledge you have.

Who cares if the carb levels are a bit higher than normal. You shouldn't. The more important point is that Minnie eats enough each day. If she likes the Blue Buffalo, then keep feeding the Blue Buffalo. If she likes some other type of canned food, then feed it to her. If she likes to graze and nibble, then leave out some of the Dr. Elseys' chicken flavor. "Best practices for most cats" does not mean practical for your cats.

When I fostered my diabetic cat, all the other cats were switched to the same low carb canned food as the diabetic cat. Kept a good selection of many different flavors for my cats to eat.

The Purina DM can be expensive, but if your Minnie will eat it, why not feed it to her?

The EPI makes managing your kitten a bit more complicated. You need to get those enzymes into her. Is there any sort of human food or pet food she loves? Could you hide the enzymes in that food? Not an entire, big portion, but a smaller portion of food?

Could you syringe feed some of the food mixed with the enzyme? Pick a flavor she does not like, so she'll still eat other flavors of food when you put them out.

Treat the whole cat. In Minnie's case, that may mean feeding her what she will eat, and managing the diabetes around those higher carbs with a bit more insulin. ECID Every Cat, Caregiver & Cycle is Different

p.s Have you seen the discussion of lowest carb vs lower carb? Click on the link to read it. Feeding Lowest/Zero Carb vs Lower Carb Foods
 
Hi and welcome I'm sorry to hear about your little one problems, and the fact that he's so young, given his age I do think you should try to give him kitten food because those are supplemented with nutrients she needs because she's still growing, specially calcium and usually higher in calories than adult ones which will help her gain some weight and there are kitten foods that are ok for diabetic (that is that they are 10% or less in carbohydrates ) lucky for you are at the US and taking a look at Dr Lisa's list (this is the link https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf) there are quite a few options, given her other issues you may need to try quite a few to find one that she likes and does not affect her, this are some I found:

Blue healthy gourmet kitten chicken, blue freedom indoor kitten, blue wilderness kitten chicken, blue wilderness kitten salmon, fancy feast kitten
 
Deb & Wink said:
Poor, exhausted Minnie and poor exhausted Joanna too.:bighug:Hope you both get a nap today.

The Purina canned/wet food is actually a good choice for a diabetic cat (6% for the regular, 10% for the savory selects). The ingredients are pork based and sometimes cats will refuse to eat the DM after a short period of time. For that reason and others, it's a good idea to have a selection of canned foods. Something both your cats could eat.

Diabetic cats are already drinking so much water to replace what they are peeing out because of the excess blood glucose, that a dry diet leaves them open to dehydration and kidney issues. That is why I have chosen to not feed dry to my cats. You make choices for your cats, based on the knowledge you have.

Who cares if the carb levels are a bit higher than normal. You shouldn't. The more important point is that Minnie eats enough each day. If she likes the Blue Buffalo, then keep feeding the Blue Buffalo. If she likes some other type of canned food, then feed it to her. If she likes to graze and nibble, then leave out some of the Dr. Elseys' chicken flavor. "Best practices for most cats" does not mean practical for your cats.

When I fostered my diabetic cat, all the other cats were switched to the same low carb canned food as the diabetic cat. Kept a good selection of many different flavors for my cats to eat.

The Purina DM can be expensive, but if your Minnie will eat it, why not feed it to her?

The EPI makes managing your kitten a bit more complicated. You need to get those enzymes into her. Is there any sort of human food or pet food she loves? Could you hide the enzymes in that food? Not an entire, big portion, but a smaller portion of food?

Could you syringe feed some of the food mixed with the enzyme? Pick a flavor she does not like, so she'll still eat other flavors of food when you put them out.

Treat the whole cat. In Minnie's case, that may mean feeding her what she will eat, and managing the diabetes around those higher carbs with a bit more insulin. ECID Every Cat, Caregiver & Cycle is Different

p.s Have you seen the discussion of lowest carb vs lower carb? Click on the link to read it. Feeding Lowest/Zero Carb vs Lower Carb Foods
Click to expand...

Thanks for this great articles. She LOVES boiled chicken so I mixed the enzymes in her wet food and topped with boiled chicken. She picked all the chicken out!!! I am at a loss. I am going to get some FortiFlora and add that on top (another user recommended this). So frustrating, if she wold just eat the food with enzymes she would feel a lot better!

Her BG numbers are strange today too:
yesterday during her fasting curve at the Vets they were:
6:30- 336 (at home) got 0.5 unit ProZinc and breakfast
8:30- 242
12:45- 177
2:45- 105
4:45- 79
5:45- 86
No food while at the Vets

Today:
7am-196 (fasting)
7:15 - got 0.5 unit ProZinc and breakfast (ended up only eating a little bit)
9:30-66
had 1/2 can of fancy feast pate throughout the day plus some boiled chicken
18:15- 320 (fasting for 2 hours)
Ate 1/2 can Blue Buffalo
18:35-ProZinc 0.5 units

She seems to be bouncing all over the place
 
We need you to get a spreadsheet started if you would please. So you can link it to your signature and we can view it. So much easier than typing all those numbers into a post. I think you'll love it.

Directions tell you how to do the setup on a smartphone, tablet, PC.......... Pretty detailed. Walks you through step by step.
Do you understand or know about the + hour system we use here?
AMPS is morning or AM pre-shot test +1 is 1 hour after giving insulin, +2 is 2 hours later, +3 is 3 hours later, etc..................
PMPS is evening or PM pre-shot test +1 is 1 hour after giving insulin, +2 is 2 hours later, +3 is 3 hours later, etc..................

Since we live in all different time zones in the world, this helps us understand the BG readings in context as to when you did the test, feed, shoot cycle.
Example from what you had in your post. I think this is right but you should verify.
AMPS 336 (at home) got 0.5 unit ProZinc and breakfast 6:30
+2 242 (8:30)
+6.75 177 (12:45)
+8.75 105 (2:45)
+10.75 79 (4:45)
+11.75 86 (5:45)
No food while at the Vets

Understand?
 
Last edited:
Do you think Minnie would eat some mashed up boiled chicken with the enzymes mixed in? No other food in the mix, only her favorite boiled chicken and the enzymes.

How much of the enzymes do you need to give her? Teaspoon, tablespoon? What is the measurement you use?
Does she need to eat the enzymes only at the beginning of the day, and end of day with her main meals?
Or does she need some of the EPI enzymes with each meal she eats?

What happens if your other cat eats Minnie's food?
 
Deb & Wink said:
We need you to get a spreadsheet started if you would please. So you can link it to your signature and we can view it. So much easier than typing all those numbers into a post. I think you'll love it.

Directions tell you how to do the setup on a smartphone, tablet, PC.......... Pretty detailed. Walks you through step by step.
Do you understand or know about the + hour system we use here?
AMPS is morning or AM pre-shot test +1 is 1 hour later, +2 is 2 hours later, +3 is 3 hours later, etc..................
PMPS is evening or PM pre-shot test +1 is 1 hour later, +2 is 2 hours later, +3 is 3 hours later, etc..................

Since we live in all different time zones in the world, this helps us understand the BG readings in context as to when you did the test, feed, shoot cycle.
Example from what you had in your post:
AMPS 336 (at home) got 0.5 unit ProZinc and breakfast 6:30
+2 242 (8:30)
+6.75 177 (12:45)
+8.75 105 (2:45)
+10.75 79 (4:45)
+11.75 86 (5:45)
No food while at the Vets

Understand?
Click to expand...

Yes I will work on getting a spreadsheet together tomorrow.
Her BG 3 hours post insulin was 89 this evening. She ate ok at dinner, not much with enzymes but I gave her some without. She is not herself today, maybe just an off day.
She is to get 1/4 teaspoon with each meal the vet recommends. I will try with the boiled chicken tomorrow. I am unclear if the enzymes actually stay available in the body to work on foods that maybe given later on.
 
Hi, a quick question for you Deb. If I put a little water from canned tuna on top of Minnie's wet food with the enzymes, would that be ok?
 
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