Please advise! Newly diagnosed cat with diabetes on Lantus

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Valentina

Valentina

Member Since 2021
Hi folks,

First of all, this website is incredibly helpful for a concerned cat-mom that has just discovered her 14-year old baby has diabetes. She was brought it to the vet with BG above 500. As a starting dose, the vet suggested 1 unit of Lantus Insulin every 12 hours and Hills Diabetes wet canned food. Since then, I have been monitoring her closely and have spot tested her BG with a vet specific glucometer. Her BG was always above 400, near 500 but I have read that cat calibrated glucometers can give higher values. After talking to my vet, he suggested to increase dosage to 2 units of Lantus insulin every 12 hours. I have started yesterday evening, and have tested her BG after the shot which was around 170 BG after 2 hours and 150 BG after 4 hours (she had eaten before the shot).

I am concerned about the dosage - do you think it is appropriate? She weighs around 5kg, but has lost some weight after her diagnosis. Moreover, I am concerned that the vet trusted my BG levels that I did myself at home with the glucometer and didn't test her again as he said she was nervous and BG would have been influenced by that.

What should I do? I don't want her to go into hypoglycemia. She seemed fine yesterday evening. She sleeps a lot, but has never been a very active kitty. She still drinks a lot of water though.

This is the glucometer I have used: (https://www.amazon.com/Cera-Pet-Glu...able/dp/B0722WYTVS/?tag=felinediabetesfdmb-20)

The insulin I have been prescribed is Lantus SoloStar, Insulin Glargine (https://www.alamy.it/foto-immagine-lantus-solostar-penna-per-insulina-siringhe-87741592.html).

Thank you for your help, I really need someone to give me advice as I am very anxious about my baby.
 
Valentina said:
Hi folks,

First of all, this website is incredibly helpful for a concerned cat-mom that has just discovered her 14-year old baby has diabetes. She was brought it to the vet with BG above 500. As a starting dose, the vet suggested 1 unit of Lantus Insulin every 12 hours and Hills Diabetes wet canned food. Since then, I have been monitoring her closely and have spot tested her BG with a vet specific glucometer. Her BG was always above 400, near 500 but I have read that cat calibrated glucometers can give higher values. After talking to my vet, he suggested to increase dosage to 2 units of Lantus insulin every 12 hours. I have started yesterday evening, and have tested her BG after the shot which was around 170 BG after 2 hours and 150 BG after 4 hours (she had eaten before the shot).

I am concerned about the dosage - do you think it is appropriate? She weighs around 5kg, but has lost some weight after her diagnosis. Moreover, I am concerned that the vet trusted my BG levels that I did myself at home with the glucometer and didn't test her again as he said she was nervous and BG would have been influenced by that.

What should I do? I don't want her to go into hypoglycemia. She seemed fine yesterday evening. She sleeps a lot, but has never been a very active kitty. She still drinks a lot of water though.

This is the glucometer I have used: (https://www.amazon.com/Cera-Pet-Glucose-Monitor-Owners-Switchable/dp/B0722WYTVS/ref=sr_1_3?crid=2QV7G60PO8281&dchild=1&keywords=cera pet glucose monitor&qid=1631091721&sprefix=cera pet glucosi,aps,367&sr=8-3)

The insulin I have been prescribed is Lantus SoloStar, Insulin Glargine (https://www.alamy.it/foto-immagine-lantus-solostar-penna-per-insulina-siringhe-87741592.html).

Thank you for your help, I really need someone to give me advice as I am very anxious about my baby.
Click to expand...

Welcome, welcome.

First off, you're not in hypoglycemic territory yet. There's nothing super serious to worry about on that front! Take a moment and thank yourself like the cat will for helping them to get under control. It's a normal side-effect of diabetes for a cat to lose weight until you get their blood sugars under control and I'd say is one of the most obvious signs they've got diabetes if nothing else has changed. I'd keep testing and looking for the lowest point of the dose every 2 hours if possible. That's called the Nadir and the number you really need to focus on to find proper dosing. We track everything in a spreadsheet including type of food, how often and when insulin is administered, and BG values. @Bandit's Mom helped me set up a very good one and we link it in our signature so others' can quickly scan it when we ask for help.

Secondly, testing at a vet is generally higher because of stress-related hyperglycemia. My cat was regularly testing 3-400+ until I started home testing. The at-home numbers you should be focused on. I'd recommend picking up Karo syrup for a fast-acting way of raising BG if for any reason they do go hypoglycemic. That vet is very wise to recommend you test at home and knows of this affect on their BG.

Third, and probably the scariest choice, I would recommend picking up syringes to inject the cat with past this point, I know it's a scary thought if you're not used to them. However, there's plenty in guides for everything you need here. Here's one I used.

I, and most of the rest of this community, have switched to human meters to test their blood for consistency in number reporting. I use the Contour NEXT One meter, however, there's plenty good ones. ReliOn makes decent meters and the test strips are much more affordable. I use that pen myself, however, I draw the dosage I need out of it. As with the pen itself you have to waste 2U to properly prime the dose, and it only works in a full unit dose instead of half-units like a good syringe is marked. You can even get smaller than that using the methods in the guide I linked to control the BG levels even more.
 
Hi Valentina!

Welcome to FDMB! :)

What is your furbaby's name? And are you from Italy? The link you shared is from an Italian website. If we know which country you are in, we could possibly help with country specific recommendations for food, glucometers etc.

Hills "diabetic" cat food is actually too high in carbs for a diabetic cat! She needs to be eating a low carb food with less than 10% carbohydrates. It's great that she is eating canned food. It would be easier to switch her to a low carb wet food. I am going to go ahead and assume you are in the EU and share a link for low carb foods available in the UK and most of EU:
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

A change to a low carb diet can significantly impact a kitty's BG numbers and greatly reduce the need for insulin. So any transition in diet when already on insulin, has to be made gradually and with careful monitoring of the BG (with home testing) and insulin requirements. We have had cats that have gone off insulin with just a change from high carb food to a low carb canned diet.

Lantus is an excellent insulin for cats and your vet was right to start her at a dose of 1U. However, we increase only by 0.25U and not whole units. I guess you must be using the Lantus Solostar pen and pen needles to give her the insulin? We ask our members to buy syringes so that they can give insulin in doses between entire units (like 1.5U). These are the syringes used by our members in the UK and EU and come with half unit marks:
http://www.alldaypharmacy.co.uk/pro...3ml-Syringe-0.3mm-(30G)-x-8mm-Box-of-100.html

Hometesting is the best way to keep your kitty safe. Testing done at the vet's office is expensive and can be unreliable due to stress, which can significantly raise the BG. By testing at home, you get more accurate results. Most of us use human meters rather than pet meters since we test a lot and the strips for pet meters are much more expensive.

The normal range for blood sugar for a cat is 50-100 mg/dl on a human meter (70-120 on a pet meter).

The excessive thirst (and urination) is a symptom of diabetes and that will resolve once her blood sugar comes down.

I can help you with setting up a spreadsheet to enter you test results. Once we are able to see her test data we would be better positioned to help you with dosing.

If you have visited the Lantus / Basaglar (glargine) and Levemir (detemir) forum, there is a wealth of information in "stickies" at the top of the page.
 
Hi all,

I'm an Italian member and am beyond relieved to have found this incredibly helpful forum! My 15-year old kitty was diagnosed with diabetes this summer with BG above 500... The vet advised on 1 UI every 12 hours using the Lantus Glargine pen as a starting dose. We have been using such routine for about 3 weeks, then I purchased a glucometer (calibrated for cats, the Cera-Pet one, but have now also purchased the AlphaTrek which will be delivered soon as I read it is more accurate). I started spot testing her and always got very high BG readings, above 400, close to 500. Went back to the vet concerned about my readings and he didn't even measure the BG himself, but just advised on upping the dosage to 2UI every 12 hours with Lantus.

I have been doing that for the past 3 days but have always monitored her for hypoglicemia signs. I did some spot testing after the PM insulin shot and her BG was significantly lower, always below 200. Yesterday it was around 130 at 6 pm, at 8pm I was concerned about the insulin injection as BG was low, so I tested her again and she was at 89 BG pre-meal!! I skipped the shot, because I was too concerned. This morning BG was very high again, around 500 but I am concerned that my glucometer gives me numbers that are too high sometimes, because I have seen her with such a high BG the day we brought her to the vet and she was diagnosed, and I could see she was not herself and not feeling well, whereas now when I get these high readings she seems completely fine (still, drinks a lot, but pees less since we started with insulin). Could it be that my glucometer is faulty? I really don't understand how numbers are so volatile, from low to high.

What should I do? Also, after starting with 2UI, I am feeding her small meals more often (the Royal Canin Diabetes wet food, which advises on 3 packs per day), so I give her one throughout the morning, one throughout the afternoon and one at night when I give her the next shot.

I am so frustrated and confused about her volatile BG readings - I cannot sleep well at night because I am afraid of potential hypoglicemic episoides when I am asleep. I am obsessing over my cat's health because I want to get her under control but feel so helpless...

Please help - should I feed her less often even when she asks me for food? Also, testing her too often is so hard, I even bruised her ear once and have been feeling very bad :( But I am trying to always test her pre shot to not risk any danger.

These are today's readings:

8:30 AM – Small feeding
9:00 AM – BG: 530, Insulin shot with 2 UI
10:00 AM – Feeding with remaining dose of morning meal
12:00 AM – BG: 514

Thank you so much for your help!!
 
Hi all! Thank you so much for your replies and for your help. I have just seen the replies as I did not get the notification for some reason.

My baby's name is Lilli, will be adding a picture as soon as I realize how to do it as I am very new to the website :) (But now I am noticing she looks very similar to your Bandit!!)

Thank you for your suggestions on the diet, I will buy the new food today and start her off with the new diet. Is the Royal Canine Diabetes food also not suitable? (https://www.arcaplanet.it/royal-can...9I33SyfajBYVwQ-jBdp8tInS8GgdTR6RoCkfQQAvD_BwE).

And yes, indeed I am Italian and it's hard to find some of the supplies I have seen mentioned on the website here in Italy. Anyways, I will do my best to keep my baby under control. Since upping the dose to 2UI, I have monitored her BG with the cat-calibrated glucometer (will buy a human one today), and have always gotten numbers below 200 which I was happy about, but also a bit concerned. Yesterday I tested her at 6pm (her shot is due at 8:30pm), and she was at 130. Tested her again and she was at 89 ?? So I skipped the dose. This morning the AMPS reading I got was crazy - around 500. Is that even normal to bounce from such low numbers to high? Could it be that my glucometer is faulty or maybe it didn't get enough blood yesterday and that's why I got such a low reading?

I am so frustrated about not being able to keep her under control and my vet is not collaborative at all. He just upped the dose without even measuring BG himself. Should I now go back to 1 and restart with the monitoring? I really don't know what to do :(
 
Hi Valentina ,I see in your previous post which I copied and put above you are from Italy and one of our members gave you a food list and also will set up our spreadsheet for you so you can enter your kitties BG numbers on so we can see what's going on, how the insulin is working and how low it's dropping her
I see she is on Lantus and you are using the pen.
We use syringes with half unit markings so we can increase or decrease by 0.25 units at a time, with the pen you can only adjust by full units
You just insert the syringe in the little gray rubber stopper and draw your insulin from there. I am going to tag @Chris & China (GA) and
@Bandit's Mom to set up your SS and your signature if you are having trouble doing it
 
I see that Bhooma gave you the link fir some food and the syringes

Hills "diabetic" cat food is actually too high in carbs for a diabetic cat! She needs to be eating a low carb food with less than 10% carbohydrates. It's great that she is eating canned food. It would be easier to switch her to a low carb wet food. I am going to go ahead and assume you are in the EU and share a link for low carb foods available in the UK and most of EU:
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

A change to a low carb diet can significantly impact a kitty's BG numbers and greatly reduce the need for insulin. So any transition in diet when already on insulin, has to be made gradually and with careful monitoring of the BG (with home testing) and insulin requirements. We have had cats that have gone off insulin with just a change from high carb food to a low carb canned diet.

Lantus is an excellent insulin for cats and your vet was right to start her at a dose of 1U. However, we increase only by 0.25U and not whole units. I guess you must be using the Lantus Solostar pen and pen needles to give her the insulin? We ask our members to buy syringes so that they can give insulin in doses between entire units (like 1.5U). These are the syringes used by our members in the UK and EU and come with half unit marks:
http://www.alldaypharmacy.co.uk/pro...3ml-Syringe-0.3mm-(30G)-x-8mm-Box-of-100.html
 
Can you fill out your signature please so members won't have to keep asking you
the same questions over and over again:cat:



Go all the way up top to you name tap on it and a drop box will appear , you will see the word signature, tap that and just add all your information about Nani and hit save.

Take a look at my signature all about Tyler all signatures are at the end of everyone's posts in gray

Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
 
Hi Valentina! Lilli is a lovely girl! :kiss:

Food:
What food is she eating right now? Hills Prescription as well as Royal Canin are too high in carbs. The only low carb prescription food is Purina ProPlan DM wet food. All prescripton dry food is too high in carbs. You could try and see if some of the low carb foods in the UK/EU list I sent can be ordered through Zooplus (https://www.zooplus.it/). Some of our members in the EU also order from Zooplus Germany since they have more options.

Please find the low carb food but do not make any changes to the diet as yet. I will set up a spreadsheet for you to enter the data you have and let us see how she is doing on insulin.

Insulin:
Can you please look for the syringes I suggested in my previous post. Increasing by 1U is too much for cats. Like I said, we increase by 0.25U.
Here are the 2 dosing protocols we follow: Dosing Methods: Start Low, Go Slow (SLGS) & Tight Regulation (TR)

Meters:
You can return the AlphaTrak and just buy a human meter. Just see what the price of the strips are when choosing a meter since that is an ongoing cost.

All the swings in her readings are what we call bounces. Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver".

As next steps, I suggest that we set up your Spreadseet and Signature. I will send you a PM (private message) with the details I need. Look for it in the Inbox at the top right corner of this page.
 
Thank you so much everyone - I have now purchased a human glucometer. But what should I do with tonight's dose? Still go with 2 UI as advised by the vet? I just tested her and she was at 368 BG (on human glucometer). Her shot is due at c. 9pm, will of course test her again prior to shooting. Thank you so much for being patient with me - I have been feeling very overwhelmed since her diagnosis and inability of getting her under control.
 
Valentina said:
Thank you so much everyone - I have now purchased a human glucometer. But what should I do with tonight's dose? Still go with 2 UI as advised by the vet? I just tested her and she was at 368 BG (on human glucometer). Her shot is due at c. 9pm, will of course test her again prior to shooting. Thank you so much for being patient with me - I have been feeling very overwhelmed since her diagnosis and inability of getting her under control.
Click to expand...
I have sent you a private message and can quickly set up a spreadsheet for you to enter data in. Once we have that up, we can help with dosing.
You can check messages here:
https://www.felinediabetes.com/FDMB/conversations/
 
Valentina said:
Hi Bhooma - I have inserted the data I have in the spreadsheet. I know my testing was not consistent, as I mainly did spot testing, but I will now test more consistently to have proper BG curves. To make it clear:
- when yesterday's reading was 89, I skipped the insulin (so effectively, yesterday she only got her 2 UI AM shot)
- I switched to Bayer's Contour Next Human meter this afternoon, so this morning's AMPS and other readings were still done with the per meter (I have added a row for the same day, hope it makes sense)
- Also, I have ordered the syringes, but for today and the weekend, I will only have the Lantus pen to use

What do you think I should do with tonight's dose? Should I go ahead with 2 UI as advised by the vet and monitor her closely? Also, for the PMPS she has to not have eaten anything for the past 2 hours right? If she had something 4 hours prior to the PMPS reading, it's fine?

Thank you so much.
Click to expand...

Hi Valentina,

I can see the data in your SS. Great! :-)

A few things to note:
  • Lantus works best when given 12 hours apart. 15 mins here and there is OK.
  • Going forward you get tests before the shots (AMPS and PMPS) and also some tests during the cycle
  • You also want to get tests in the PM cycle since many cats go lower at night
  • You can choose a shot time such that you don't have to stay awake too late to get tests at night.
  • You have to ensure she does not eat 2 hours before her shots. So yes, it is okay if she has had something to eat 4 hours or even 2.25 hours prior to the AMPS/PMPS
On the dosing front, it's possible that 2U is too much for her and 1U too little. Hard to say with the data on hand. Better to shoot less and have her higher than to shoot more to have her drop low. Once you get the syringes we can increase and reduce by 0.25U.

What is her food like? Both the wet and dry Royal Canin are too high in carbs but the wet is only 14% carbs while the dry is at least twice that much. Has she been eating both in the last few days?

How long till her PMPS?

@tiffmaxee
 
Hi Bhooma and thank you all for your support and patience with a beginner like me.
  • I will do her PMPS test in 1 hour and a half (8:30 pm CET). Will let you know and ask for advice on tonight's dosing, whether to go with 1 unit or 2 as I did this morning..
  • Regarding her food, she has been mainly eating Royal Canin Diabetes wet food (I have given her the dry one only when she refused the wet one and had to feed her for the insulin shot).
Thanks again for your help :cat:
 
Valentina said:
I have given her the dry one only when she refused the wet one and had to feed her for the insulin shot
Click to expand...
It's okay if they don't eat at shot time. The onest of Lantus is usually around +2 (though some cats can onset as early as +1 or as late as +3) so you have time between the shot and onset to get food into her. It also helps if she eats 2-3 small meals through the cycle.


Lantus dosing is based on the nadirs - that is, how low the dose takes the cat and not based on preshots. The higher numbers you see after lows are "bouncing". Her liver's protective reaction to a perceived threat of hypoglycemia. As she spends more time in lower numbers, her body adjusts and she will not swing so wildy between highs and lows.

We know that a 2 unit dose took her as low as 89. We don't know if she went any lower in cycles where there were no tests nor do we know how low she was going on the 1U dose. Not a criticism for not testing, but just explaining the dosing methodology.

I would suggest that till the new syringes arrive, keep her at 1U. See if you can avoid feeding dry food. And like I said earlier, keep getting as many tests as you can in every cycle.

Here's a basic rule of thumb for testing with Lantus:
  • We usually suggest getting a +2 because it can act like a crystal ball for what the rest of the cycle will look like - since most cats onset around then.
  • If the +2 is lower than the PS, that's an indication that the cycle will be "active" and numbers will go lower later in the cycle and you want to get more tests.
  • If the +2 is a lot higher than the PS, that means there's a bounce starting and you can take a break from testing.
 
Hey Hey - thank you so much for checking.

Yesterday her PMPS was around 300, gave her 1 IU only as per your suggestion as I want to check on her with the lower dosage (as opposed to 2 IU, which I think was too high). She was at 209 PM +3, which I was very happy about, although this morning her AMPS was again very high.. around 400. Will be doing an AM +3 in half an hour.

I want to change her diet as I think the Royal Canin chicken gravy that I am feeding her is too high in carbs and might influence my readings. Should I switch to it gradually? I think I will keep her at 1 IU for at least 3 days to see how it goes and test her.

This is the list of ingredients: https://www.royalcanin.com/au/cats/products/vet-products/diabetic-wet (I am NOT giving her any dry food anymore).

Also, I found this, and I bought some to try it out: https://fetch.co.uk/almo-nature-hfc...A4Ivd3gIpzFuxgrApXRoCfpEQAvD_BwE&gclsrc=aw.ds

Seems low in carbs, but maybe too low?

Also, throughout the night she asks me for food at least once... I usually give her the remaining of her PM meal, but is it wrong? Should I leave her the whole night without food? Because she hardly ever eats the whole portion at once, but prefers smaller portions that are a bit more spread out.

Thanks so much :)
 
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Oh yes, the RC chicken gravy is too high in carbs. I don't know if I shared this food chart with you before. It has the carb% of various cat food available in the US. You should be able to check the carb% of brands available all over the world like Royal Canin, Hills, etc here: https://catinfo.org/chart/index.php

The RC diabetic food is 14% carbs. You want to be feeding less than 10% - ideally less than 5%. Just stopping the dry food first will make a difference. Then gradually change the gravy wet food to a low carb wet food. Make sure you get enough tests because removing carbs from a cat's diet can cause their BG to drop quite a bit because the insulin dose is too high.

The higher numbers you are seeing this morning may also be due to her bouncing from the lower numbers last night. Even though 200 is not a low number, it is lower than what her body is used to, so it is reacting by flooding her blood with sugar! :rolleyes: The bouncing will stop with time.

And yes to several small meals through the day and night. A diabetic cat cannot process it's food and is therefore always hungry. Small meals several times a day helps with that. We all feed mulitple times in the day and night. Just make sure you don't feed 2 hours before the shot.
 
Welcome to FDMB!!

Bhooma has provided wonderful information.

I looked up the Almo food you've been feeding Lilli. I don't think it's a nutritionally complete food. It's only ingredients are chicken, chicken broth, and rice. Cat's need certain supplements -- vitamins, essential fatty acids, and especially taurine -- in their diet. The Almo may be good as a treat but it's not adequate for a regular diet.
 
Hi hi - thanks a lot @Sienne and Gabby (GA) ! :) I am not feeding her with Alma Nature only, for the time being I am feeding her 1 portion of Royal Canin in the morning, 1 alma nature throughout the afternoon and 1 Royal Canin in the evening. Do you think it is alright? I will switch diet in the next days, I was thinking about buying the Purina Diabetes Management as I saw it in the file @Diane Tyler's Mom kindly shared.
 
Valentina said:
I was thinking about buying the Purina Diabetes Management
Click to expand...
The Purina DM canned (not dry) is low carb - around 6% - so it is okay.

Are you not able to find any of the foods in this list of UK/EU low carb foods in Italy? On Zooplus or other online/offline stores?
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

I looked at the site https://www.arcaplanet.it/ that you had shared earlier and I see it has some of the brands that are in the UK/EU food list - Felix, Sheba and Whiskas. But I could not read the names on the food since they were in Italian.

Zooplus Itay (https://www.zooplus.it/shop/gatti/cibo_gatti_scatolette) seems to have quite a few of the brands in the UK/EU list but I don't know how that compares price-wise?
 
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Hey hey - update on Lilli: I have been giving her 1 IU and her BG has always been > 300 BG. It seems 1 unit is hardly effective, although I don't know how her BG would be without insulin. I am struggling to test her often as making her ears bleed is hard and she HATES it, she always runs away when she sees me approaching with the supplies :(

However, I still see some improvements such as her furr being shinier and she pees a bit less.. She has developed some diabetic neuropathy in her back legs which makes me very sad everytime I see her struggling to walk longer distances.

How many cycles should I wait before increasing the dosage? Also, I have not yet changed her diet but will start tomorrow, maybe I could try doing that first and seeing if her BG drops and how she does with 1 unit and diet change.
 
Bandit's Mom said:
The Purina DM canned (not dry) is low carb - around 6% - so it is okay.

Are you not able to find any of the foods in this list of UK/EU low carb foods in Italy? On Zooplus or other online/offline stores?
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

I looked at the site https://www.arcaplanet.it/ that you had shared earlier and I see it has some of the brands that are in the UK/EU food list - Felix, Sheba and Whiskas. But I could not read the names on the food since they were in Italian.

Zooplus Itay (https://www.zooplus.it/shop/gatti/cibo_gatti_scatolette) seems to have quite a few of the brands in the UK/EU list but I don't know how that compares price-wise?
Click to expand...

Thank you so much Bhooma, I can indeed find some of those foods online and will buy it, do you not suggest the Purina Diabetes one? Also, just a quick question: is it okay if I change between types of meets/flavors? Vet suggested to stick with one type mostly,such as chicken.
 
Valentina said:
do you not suggest the Purina Diabetes one
Click to expand...
You can give the Purina Pro Plan DM canned food - it is low carb. But it's expensive and many cats don't like the taste. If Lilli likes it, there is no problem!

Valentina said:
Also, just a quick question: is it okay if I change between types of meets/flavors? Vet suggested to stick with one type mostly,such as chicken.
Click to expand...
Yes you can. I don't see why not provided all are low carb.
 
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