Food and feeding advice please

[Swati]

Hi all! I'm new here. Mr. Stache is turning 11 on 10/24/21. He was diagnosed with diabetes on 10/14/21. I got him from the shelter when he was assumed to be 8 years old.

I haven't actually received the insulin yet but I'll be using Lantus at 2 units once a day, and I'll be home testing using the AlphaTRAK 2 (which I'm also waiting for it to arrive).

Currently I'm feeding Hill's prescription w/d wet and dry and Royal Canin glycobalance wet. All at the recommendation of the Vet. When I asked the Vet about low carbs, she said he actually does need complex carbs and fiber to feel full longer - but that seems counter to want everyone else is saying. I'm also trying to get him into scheduled meals. But he's eating 123 calories and I'm worried its not enough. I might switch over to mainly Darwin's Pet Natural Select raw food, which he already loves, and try to wean him off the kibble as much as possible.

He weighs 11.16 lbs and needs to be 10 lbs according to the vet, but maybe getting him to 9 lbs would be better? Anyway, I'm seeing a lot of contradictory advice about how many calories per lb to feed (some say 15 and some say 20-30). Either way he's eating less than that right now. He seems to be fine and plays and we go on walks in the garden and all that and if I put more food he will just let it go to waste.

On an aside, he was totally fine until this year. In 2020 the Vet thought he had too much plaque build up on his teeth and told me to feed him mainly Hill's Science Oral Care kibble. Which I did (with wet food supplemented at breakfast and dinner). Then they did his blood work in March 2021 and saw his glucose was high and ran a fructosamine and saw it was slightly elevated ... But that was it, didn't say or recommend anything after that. At the end of September was his second annual appointment and they saw his glucose was high and that the fructosamine was high and so now I'm trying get my head around cat diabetes! But the Vet wants him on prescription diet food but it doesn't seem to be all that healthy and the last time I changed his diet because of the Vet recommendation we ended up here ...

I don't know what to do. Any advice about food options and feeding only two meals a day vs 3-4 meals and just how many calories to aim for would be much appreciated!

 

[FrostD]

Welcome!

Great job getting started, and the spreadsheet!

There is some more info we like to see in signature, you can find more information here.

Yes we recommend low carb wet or raw diet. Plenty of cats here on it long term and are fine. Here is a link to a list that most of us use - for low carb we try to aim for 10% or less, most of us around 5%. It is better to feed smaller meals throughout the day, but if he's a grazer no harm in that for now. A lot of us use the 5 slot auto feeders with room for an ice pack underneath.

We also recommend a hypo kit, explained in the first link I provided. Medium carb is around 13-17%, high carb is above that but generally not to exceed 23% ish.

2U is too high a starting dose. And it's supposed to be dosed every 12 hrs. We usually recommend 0.5-1U depending on weight and the numbers you're seeing. Based on his labs results, his numbers aren't too bad. I would try to switch to completely low carb before starting insulin, provided there's no neuropathy or history of ketones/DKA. The switch will likely bring his numbers down, and you'll need a much lower starting dose (TBD once we see numbers after switch).

You do not need the AlphaTrak, a lot of vets recommend it but you'll find it pricey to use (cost of strips). People here do use it, but many of us use human meters for cost effectiveness. The ReliOn meters are probably most popular.

The general rule of thumb for calories is 15-20 calories per lb, daily. For ideal weight. If he's maintaining I wouldn't worry about the calorie intake; they shouldn't lose more than 2% per week. I'd transition his diet first. Then I'd weigh once a week, trying to be consistent (like before dinner + after poop) because 2% isn't a lot, easily affected by a meal, bowel movement, etc. If after a week or two he's flat or gaining, then maybe scale back.

I'm a bit tied up at the moment, but I just wanted to answer your direct questions. I know @Diane Tyler's Mom will come in with a lot more information for you

 

[FrostD]

Oh also - any other health conditions? Was he on steroids at all? Does he need a dental since.yoi mentioned plaque? Those are all things that can elevate BG

 

[Diane Tyler's Mom GA]

haven't actually received the insulin yet but I'll be using Lantus at 2 units once a day, and I'll be home testing using the AlphaTRAK 2 (which I'm also waiting for it to arrive).

Hi and welcome Mr Stache is adorable. I'm from N.J. also
by the Meadowlands Racetrack
You said 2 units once a day? Lantus should be given twice a day , AM and PM
I'll give you the link about using Lantus.
No need for the Alpha Track meter, the strips run about 54.00 for 50 strips

Most of us use human meters, that's what our numbers are based on
You can pick up The Relion Premier Classic at Walmart, 9 dollars
The test strips are 17.88 for 100
Lancets get 26 or 28 gauge to start off with
Cotton rounds to put behind his ears
Most of us free hand , just poking with the lancet, I have never used the lancing device
I'll post a pic of where to test on his ears

Most of us feed Fancy Feast Classics or Friskies Pate
Theses are mostly 2 or 3 percent carbs

We feed our cats multiple times during each 12 hour cycle the bigger meals when you test him first thing in the morning and at night. Smaller meals after that .

I've never fed raw but a lot of members do so I can't give you any advice about that

Like Melissa mentioned I would switch him to low carb before starting insulin and start testing him and recording it on your spreadsheet so members can see if switching him to low carbs lowers his BG

Did you get the U-100 syringes yet? Get the ones with the half unit markings
We increase and decrease by 0.25 units at a time
You can get syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
This is what the packaging looks like:

You can also buy them online at www.adwdiabetes.com

 

[Diane Tyler's Mom GA]

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming

Here is a video one of our members did
VIDEO: How to test your cat's blood sugar

 

[Diane Tyler's Mom GA]

Here is the link for lantus, it will also explain about the dosing methods and for you to choose one. The method you choose will tel! You when an increase or decrease is needed

Take a look at other members spreadsheets, you can look at mine before Tyler went into remission to get an idea about using the SS Look at my 2020 numbers at the very top it will say 2020 tap on that
https://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

There are many experienced and knowledgeable members here that know more about diabetes than most vets do. Thanks to them I got Tyler into remission

 

[Diane Tyler's Mom GA]

Always have on hand in case he drops too low
med and high carb food on hand in case she drops too low and you need to bring his BG up to safe numbers and some honey

If you are not able to be home most of the day to test your kitty it's a good idea to buy the automatic feeder like Melissa mentioned above, you can set it to open different times during g the day

Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs



Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any ones from the food chart

Feel free to ask as many questions that you have.

 

[Wendy&Neko]

Your vet did get the choice of insulin correct, so not all the advice was wrong. As others have said, in cats Lantus should be dosed twice a day. They have faster metabolisms than humans who dose it once a day.

Raw food is an excellent choice. That's what I fed Neko, though another brand plus some home made. Spreading out to smaller meals is easier on a healing pancreas. If he's used to multiple meals, you can continue that. Feed some at shot time, and spread the rest of the food into later meals, though ideally most in the first half of the cycle (time between shots), so first six hours.

As for amount of food, a scale will be your best indicator. You have a target weight from the vet so you want to feed so he'll very slowly lose weight to that goal. Raw food is more calorie dense than canned, so amounts will differ. Most manufacturers will give you some guidelines on how much to feed based on cat weight and whether you want your cat to maintain, lose, or gain weight. Weigh regularly, maybe once a week, to get an idea if you are going in the right direction. The Catinfo website, written by a vet specializing in feline nutritionm has some tips on safe weight loss here: https://catinfo.org/feline-obesity-an-epidemic-of-fat-cats/#Implementing_a_Safe_Weight-Loss_Program

 

[Swati]

Thank you all for all the information! I'm so thankful and will read through everything in a few hours.

Just for further information on Mr. Stache, he has tooth resorption of one of his teeth (he's showing no signs of pain at all when eating) and might need surgery when they reexamine his teeth in 6 months. That's his only other health issue.

His fructosamine results for 3/19/21 was 355 and for 9/29/21 was 434. And his urine glucose on 3/19/21 "above normal" at 5.500.

I'll pick up the ReliON from Walmart and start testing as soon as I can.

 

[Diane Tyler's Mom GA]

Just for further information on Mr. Stache, he has tooth resorption of one of his teeth (he's showing no signs of pain at all when eating) and might need surgery when they reexamine his teeth in 6 months. That's his only other health issue.

I'm pretty sure that tooth should be taken care of way before 6 months, it can become very painful
I'll going to tag a few members to see what they think
@Wendy&Neko

@Sienne and Gabby (GA)

@tiffmaxee

@FrostD

@Chris & China (GA)

Thanks ladies

 

[Wendy&Neko]

Tooth infection/inflammation is something you'll definitely want to get dealt with to help get him regulated.

There are several Relion meters. Look for one with a small blood drop requirement, and low cost test strips, as those are what you'll go through.

His Fructosamine isn't too bad yet, normal goes up to 365: Reference Ranges for Fructosamine Test

 

[Swati]

Most of us use human meters, that's what our numbers are based on
You can pick up The Relion Premier Classic at Walmart, 9 dollars
The test strips are 17.88 for 100
Lancets get 26 or 28 gauge to start off with
Cotton rounds to put behind his ears
Most of us free hand , just poking with the lancet, I have never used the lancing device
I'll post a pic of where to test on his ears

Thank you! I've put all this to be picked up from Walmart tomorrow so I can start testing and see how it all goes!

 

[Swati]

Hi and welcome Mr Stache is adorable. I'm from N.J. also
by the Meadowlands Racetrack
You said 2 units once a day? Lantus should be given twice a day , AM and PM

Hi! I'm near Roosevelt Park.

So my vet said she wants to start slow which is why 2 units once a day is her goal. But it sounds like that might actually be too much! And honestly, I'm a bit saltly about the fact that he seemed totally fine and then they asked me to change the diet (and recommended that I feed almost entirely dry) and now he's having issues. I use Banfield. Can I ask who you're pet's vet is or if you recommend some place different from Banfield?

 

[Diane Tyler's Mom GA]

Hi! I'm near Roosevelt Park.

So my vet said she wants to start slow which is why 2 units once a day is her goal. But it sounds like that might actually be too much! And honestly, I'm a bit saltly about the fact that he seemed totally fine and then they asked me to change the diet (and recommended that I feed almost entirely dry) and now he's having issues. I use Banfield. Can I ask who you're pet's vet is or if you recommend some place different from Banfield?

I copied what @FrostD said above
We usually recommend 0.5-1U depending on weight and the numbers you're seeing.
I go to Carlstadt Animal Hosp in Carlstadt , N.J.
I see Dr Sass been seeing her for many many years
When Tyler was diagnosed it was her associate that told her what to start Tyler on, it was a sliding scale which was all wrong
I then joined here and showed her how we go about dosing
She was very impressed and let me do exactly what I wanted to do
She's an excellent vet but when it came to diabetes I had actually taught her some things.
Do not start him on 2 units once a day. Like I said Tyler is in remission now
I only see my vet if needed for other things such as rabie shots or if he gets sick.
Other than that I will do a curve maybe once every 4-6 months and send it to her
Just tell your vet he will not eat any of the prescription foods
If you have any that is unopened you should get a refund, most manufacturers give refunds on their food.
I suggest to first start getting rid of the dry food , go buy the Fancy Feast Pates and start testing him before starting the insulin so we can see if the food change lowers his BG, start recording it on the spreadsheet.
What were you feeding him before the prescription food?

Also I would definitely get that tooth checked out way before 6 months
with another vet

Just curious did you get the Lantus pens or the vial? What did you pay?
I know Lantus is very expensive in the US, we can tell you where to buy it next time for the best price

@Wendy&Neko

@tiffmaxee

@Chris & China (GA)

@FrostD

@Bandit's Mom

Hi ladies can you please read @Swati introduction
I just want to know if there is anything else you can add to what @Wendy&Neko
And I suggested. If you can read all the posts that would be good
Thank you ladies

She also mentioned
Mr. Stache, he has tooth resorption of one of his teeth (he's showing no signs of pain at all when eating) and might need surgery when they reexamine his teeth in 6 months. That's his only other health issue. Post #9

 

[Diane Tyler's Mom GA]

You might want to start another post such as
? Can anyone recommend a vet near Roosevelt Park, N.J.
Where is Bandfield located?

 

[Chris & China (GA)]

There are several Relion meters.

The only one left is the Relion Premier. The "Classic" is only $9 but they have other models with various bells and whistles that cost more (and aren't really necessary).

The strips for them all require the same size sample. 0.5. They do still sell strips for the Prime which was recently discontinued so be sure to get the Premier strips ($17.88/100)

 

[Diane Tyler's Mom GA]

The only one left is the Relion Premier. The "Classic" is only $9 but they have other models with various bells and whistles that cost more (and aren't really necessary).

The strips for them all require the same size sample. 0.5. They do still sell strips for the Prime which was recently discontinued so be sure to get the Premier strips ($17.88/100)
View attachment 62830

@Chris & China (GA)
Hi Chris when ever you get a chance can you read all of the posts, I just want to see if there is anything else you can add to it, especially the dose, her vet wants to start her cat with 2 units once a day, I gave her the links about Lantus and Melissa @FrostD also gave her advice

 

[Chris & China (GA)]

As has already been said, Lantus needs to be given every 12 hours so 2U once a day won't give you the best results and may be too much. We usually recommend starting at .5 to 1U every 12 hours.

Getting that tooth taken care of sooner rather than later is important too. Not only because infection/inflammation can cause the blood glucose to be higher, but if you've ever had a cavity or abscessed tooth, you know how much they hurt. Cat's feel pain too! They just hide it better!

If your kitty like the Darwin's raw, there's no reason he can't continue to eat it. That's what China was eating after RadCat was driven out of business. A good starting place is 20 calories per pound of ideal weight and then weigh once a week and adjust as needed. If the vet suggested 10lbs, I'd go with that instead of trying for 9lbs unless once he's down to 10, he's still overweight. Go by the Body Condition Score

You can return the "prescription" food for a refund, even opened. It's 100% guaranteed. Most of us just told our vet that our cat refused to continue eating it.

 

[Swati]

Just tell your vet he will not eat any of the prescription foods
If you have any that is unopened you should get a refund, most manufacturers give refunds on their food.
I suggest to first start getting rid of the dry food , go buy the Fancy Feast Pates and start testing him before starting the insulin so we can see if the food change lowers his BG, start recording it on the spreadsheet.

Will do! Thank you so much!

 

[Diane Tyler's Mom GA]

@Chris & China (GA) Thank you Chris