1/17 Pasha AT3 AMPS 198,+2 119, +3 103, +4 108, +5 133, +6 133, +7 137, PMPS 137, +3 130, +7 106

[AYDA & PASHA]

Hello from Canada Dear Fur Moms and Dads!
I am Ayda, my fur boy is Pasha. Pasha is 11.5 years old. He was diagnosed on December 3, 2024. I was following FDSG but now I am here I am trying to learn how to post and follow the new protocol.
Pasha is suffering from Diabetic Neuropathy in his hind legs. I am giving him 2.6mg methylcobalamine and 200mcg Folic Acid. We cannot find Zobaline in Canada. If anyone out there has this problem with their kitty I would love to learn how you are managing it.
Pasha is on a low carb only wet food diet. He is eating Fancy Feast paté, Pro Plan Complete Essentials chicken and spinach and Pro Plan Kitten Salmon and ocean fish.
Although he has tested negative for ketones, being on a high protein diet, I am concerned about his kidneys in the long run.
I would appreciate your comments and thoughts.
Thank you so much.
Ayda.

 

[Chris & China (GA)]

Here's your post from Health, and Welcome to the Lantus forum!

I am giving him 2.6mg methylcobalamine and 200mcg Folic Acid. We cannot find Zobaline in Canada. If anyone out there has this problem with their kitty I would love to learn how you are managing it.

Lots of us use Methylcobalamine with or without the folic acid and it works just as well as the Zobaline. Methyl B-12 is methyl B-12....Zobaline is just a brand name. I believe I've heard that Lifelink ships Zobaline to Canada if you really want the name brand.

It does take time to see improvement though. Nerve cells take the longest to regenerate, so just keep giving him what you're giving and don't expect a miracle. Some cats improve faster than others but there's no way to predict which ones are going to improve fast and which ones are going to take more time. It can take months for some cats, but the most important thing you can do in the meantime is get his glucose under the best control possible. The high glucose is what causes the nerve damage, so the sooner you get it regulated, the less damage will continue to be done and the B-12 can work it's best.

Although he has tested negative for ketones, being on a high protein diet, I am concerned about his kidneys in the long run.

Cats were designed to utilize protein efficiently so unless you're getting bloodwork that indicates kidney disease, stay with the foods he's eating now. The sad truth is that cats just don't have the best kidneys and pretty much every cat will have some level of CKD as they get older. Newer research has also shown that good quality protein is more important than a low-protein diet. The idea of restricting protein is "old school". Good quality protein will help to prevent muscle wasting.

What's more important with cats with CKD is to limit the amount of phosphorus they eat. There are OTC foods like a lot of the Weruva foods that are both low carb and low phosphorus but for now, if his kidney levels are good, it's OK for him to continue eating the Fancy Feasts. There are also phosphorus binders you can add to food if necessary.

The next time you have bloodwork done, ask them to run an SDMA. It's a newer test that shows kidney disease sooner than watching the BUN and creatinine.

 

[AYDA & PASHA]

Here's your post from Health, and Welcome to the Lantus forum!



Lots of us use Methylcobalamine with or without the folic acid and it works just as well as the Zobaline. Methyl B-12 is methyl B-12....Zobaline is just a brand name. I believe I've heard that Lifelink ships Zobaline to Canada if you really want the name brand.

It does take time to see improvement though. Nerve cells take the longest to regenerate, so just keep giving him what you're giving and don't expect a miracle. Some cats improve faster than others but there's no way to predict which ones are going to improve fast and which ones are going to take more time. It can take months for some cats, but the most important thing you can do in the meantime is get his glucose under the best control possible. The high glucose is what causes the nerve damage, so the sooner you get it regulated, the less damage will continue to be done and the B-12 can work it's best.



Cats were designed to utilize protein efficiently so unless you're getting bloodwork that indicates kidney disease, stay with the foods he's eating now. The sad truth is that cats just don't have the best kidneys and pretty much every cat will have some level of CKD as they get older. Newer research has also shown that good quality protein is more important than a low-protein diet. The idea of restricting protein is "old school". Good quality protein will help to prevent muscle wasting.

What's more important with cats with CKD is to limit the amount of phosphorus they eat. There are OTC foods like a lot of the Weruva foods that are both low carb and low phosphorus but for now, if his kidney levels are good, it's OK for him to continue eating the Fancy Feasts. There are also phosphorus binders you can add to food if necessary.

The next time you have bloodwork done, ask them to run an SDMA. It's a newer test that shows kidney disease sooner than watching the BUN and creatinine.

Thanks very much for this @Chris & China (GA)
What's OTC food?
What's a phosphorus binder?
Sorry for asking too many questions. I am learning a lot in such a short time, my brain is fried basically, lol!

 

[AYDA & PASHA]

Also my vet does not think Fancy Feast is good for my cat. Here is what she said in her last email:

"Thanks for your questions - Fancy Feast can predispose some cats to developing urinary crystals due to it's effects on pH and mineral levels in the urine, so I would prefer overall Pasha is eating mostly the Purina diabetic soft food, but if you need to add just a little FF to flavour it that is ok."

Personally, I don't like the "dietetic" (not "diabetic") food. I believe it's higher in carb content.

At the moment I am feeding Pasha FF paté (various flavours such as beef flavour feast, turkey and giblets feast, salmon & shrimp feast, chicken feast and tender chicken and liver feast. Also feeding him Purina Pro Plan Savor Chicken and Spinach and Pro Plan Focus Kitten Salmon and Ocean fish.

For my non diabetic cat who is eating the same food as my Pasha, I will go out and get some medium carb food. I am scared that he will develop kidney disease if I feed him the same low carb food as I feed my diabetic cat.

Honestly, I am a little lost as what's best to feed them both.

Here's what my vet said about my non diabetic cat Anoush, Pasha's twin brother:

"I wouldn't recommend feeding the higher protein/lower card foods to Anoush as we do not have any recent bloowork on him and it might be too much protein on his kidneys."

On a side note, Pasha needs two of his teeth extracted. Here's what the vet said about that:

"And it's no problem to send the pictures of Anoush's teeth, I will have Aly do that, and ideally once we have his diabetes settled (and see if he goes into remission) we could discuss doing a dental with extractions to remove them as a possible source of infeciton and chronic inflammation."

 

[Chris & China (GA)]

Also my vet does not think Fancy Feast is good for my cat.

Most vets don't approve of the more affordable foods, but there are thousands of cats here that have been eating FF for years without problems. If you want to go with the Purina ProPlan urinary tract pates, they are low carb and may ease some of your vets concerns (although I still think they're being a little anal about it). Cats that eat canned or raw food have a lot less chance of developing crystals because they are eating what they were born to eat. A mouse is a cats perfect food and is about 80% water....just like canned foods. A lot of us even add a little extra water to the pate to increase the water our cats get. Water keeps the urinary tract flushed out which doesn't give crystals much of a chance to form or create stones.

We do recommend limiting fish foods to once or twice a week though due to the problems with heavy metal contamination found in fish. Fish flavors are also usually higher in phosphorus due to the ground-up fish bones.

The DM pate is low enough in carbs, but there's absolutely nothing special about it but the price. There's nothing in it that treats diabetes (which is why it's "diaTetic" and not "diabetic"). The ingredients aren't any better than FF or Friskies.

What's OTC food?

OTC is "Over The Counter"

What's a phosphorus binder?

It's an additive that can be mixed into every meal to help block the absorption of phosphorus from food but it's not recommended until the cat is in at least stage 3 CKD (or you feed foods that are low in phosphorus, like many of the Weruva foods) If your cats blood levels of phosphorus are still too high, you might need to add a binder but it doesn't sound like you're anywhere near that point yet. One of the most common is aluminum hydroxide (the active ingredient in Tums).

For my non diabetic cat who is eating the same food as my Pasha, I will go out and get some medium carb food. I am scared that he will develop kidney disease if I feed him the same low carb food as I feed my diabetic cat.

You're much better off feeding him the same low carb food that you're feeding Pasha. It makes it a lot easier when feeding multiple cats for them to be eating the same thing so you don't have to worry if one is eating the other guys food. Low carb food has nothing to do with kidney disease, just as high protein food is no longer a concern in developing kidney disease. Stick with low carb for both. It will also lessen your civvie's chances of becoming diabetic too.

"And it's no problem to send the pictures of Anoush's teeth, I will have Aly do that, and ideally once we have his diabetes settled (and see if he goes into remission) we could discuss doing a dental with extractions to remove them as a possible source of infeciton and chronic inflammation."

This is another problem we have with a lot of vets. Dental infection/inflammation or pain can raise the blood glucose. Getting the teeth professionally cleaned and removing any bad teeth may be the thing that allows Pasha to go into remission, not the other way around! Just make sure that it's a complete dental, which includes x-rays. 2/3rds of the tooth is under the gums so it's extremely important to know what's going on under the gumline. Be prepared....a good dental is expensive! $800-1200 is about average.

 

[AYDA & PASHA]

Most vets don't approve of the more affordable foods, but there are thousands of cats here that have been eating FF for years without problems. If you want to go with the Purina ProPlan urinary tract pates, they are low carb and may ease some of your vets concerns (although I still think they're being a little anal about it). Cats that eat canned or raw food have a lot less chance of developing crystals because they are eating what they were born to eat. A mouse is a cats perfect food and is about 80% water....just like canned foods. A lot of us even add a little extra water to the pate to increase the water our cats get. Water keeps the urinary tract flushed out which doesn't give crystals much of a chance to form or create stones.

We do recommend limiting fish foods to once or twice a week though due to the problems with heavy metal contamination found in fish. Fish flavors are also usually higher in phosphorus due to the ground-up fish bones.

The DM pate is low enough in carbs, but there's absolutely nothing special about it but the price. There's nothing in it that treats diabetes (which is why it's "diaTetic" and not "diabetic"). The ingredients aren't any better than FF or Friskies.



OTC is "Over The Counter"



It's an additive that can be mixed into every meal to help block the absorption of phosphorus from food but it's not recommended until the cat is in at least stage 3 CKD (or you feed foods that are low in phosphorus, like many of the Weruva foods) If your cats blood levels of phosphorus are still too high, you might need to add a binder but it doesn't sound like you're anywhere near that point yet. One of the most common is aluminum hydroxide (the active ingredient in Tums).



You're much better off feeding him the same low carb food that you're feeding Pasha. It makes it a lot easier when feeding multiple cats for them to be eating the same thing so you don't have to worry if one is eating the other guys food. Low carb food has nothing to do with kidney disease, just as high protein food is no longer a concern in developing kidney disease. Stick with low carb for both. It will also lessen your civvie's chances of becoming diabetic too.



This is another problem we have with a lot of vets. Dental infection/inflammation or pain can raise the blood glucose. Getting the teeth professionally cleaned and removing any bad teeth may be the thing that allows Pasha to go into remission, not the other way around! Just make sure that it's a complete dental, which includes x-rays. 2/3rds of the tooth is under the gums so it's extremely important to know what's going on under the gumline. Be prepared....a good dental is expensive! $800-1200 is about average.

So you're saying go ahead and do the dental now rather than wait for him to go into remission, correct?
I wish a dental cost $800-1200 here in Canadian dollars. Here I am looking at paying at least 2 grand to have his teeth cleaned/extracted.

 

[AYDA & PASHA]

Most vets don't approve of the more affordable foods, but there are thousands of cats here that have been eating FF for years without problems. If you want to go with the Purina ProPlan urinary tract pates, they are low carb and may ease some of your vets concerns (although I still think they're being a little anal about it). Cats that eat canned or raw food have a lot less chance of developing crystals because they are eating what they were born to eat. A mouse is a cats perfect food and is about 80% water....just like canned foods. A lot of us even add a little extra water to the pate to increase the water our cats get. Water keeps the urinary tract flushed out which doesn't give crystals much of a chance to form or create stones.

We do recommend limiting fish foods to once or twice a week though due to the problems with heavy metal contamination found in fish. Fish flavors are also usually higher in phosphorus due to the ground-up fish bones.

The DM pate is low enough in carbs, but there's absolutely nothing special about it but the price. There's nothing in it that treats diabetes (which is why it's "diaTetic" and not "diabetic"). The ingredients aren't any better than FF or Friskies.



OTC is "Over The Counter"



It's an additive that can be mixed into every meal to help block the absorption of phosphorus from food but it's not recommended until the cat is in at least stage 3 CKD (or you feed foods that are low in phosphorus, like many of the Weruva foods) If your cats blood levels of phosphorus are still too high, you might need to add a binder but it doesn't sound like you're anywhere near that point yet. One of the most common is aluminum hydroxide (the active ingredient in Tums).


You're much better off feeding him the same low carb food that you're feeding Pasha. It makes it a lot easier when feeding multiple cats for them to be eating the same thing so you don't have to worry if one is eating the other guys food. Low carb food has nothing to do with kidney disease, just as high protein food is no longer a concern in developing kidney disease. Stick with low carb for both. It will also lessen your civvie's chances of becoming diabetic too.



This is another problem we have with a lot of vets. Dental infection/inflammation or pain can raise the blood glucose. Getting the teeth professionally cleaned and removing any bad teeth may be the thing that allows Pasha to go into remission, not the other way around! Just make sure that it's a complete dental, which includes x-rays. 2/3rds of the tooth is under the gums so it's extremely important to know what's going on under the gumline. Be prepared....a good dental is expensive! $800-1200 is about average.

I did go ahead and ordered the Purina Pro Plan Urinary Tract Health Formula Turkey & Giblets entrée. Believe me I am as anal as my vet if not more when it comes to feeding the right food. The sad thing is most of the foods on these extensive elaborate lists I find in groups do not exist in Canada, or the labels are different than the ones in the US so I have no way of knowing if it's the same food or something else.

Thank you so much for your advice to feed my non diabetic cat the same food as Pasha. It sure will make my life easier. I am always worried that my cats will develop kidney disease, on top of diabetes for Pasha. My previous kitty Roger died of kidney disease. Poor cat, I fed him dry food ALL his life, I had no idea about feline nutrition at the time. He deserved better care, he was the best cat anyone could have asked for.

My son's 16 year old cat has stage 2 kidney disease. I will forward to him your recommendations about the additive binder. I believe he is feeding him special Vet food.

About the dental work for Pasha, if I understood correctly, you are recommending that we do the dental work now instead of waiting for him to go into remission, correct?

Thanks so much Chris.

 

[Chris & China (GA)]

About the dental work for Pasha, if I understood correctly, you are recommending that we do the dental work now instead of waiting for him to go into remission, correct?

Absolutely!! We have had a lot of cats who went into remission after they had a dental. No guarantees of course, but I'd definitely get it done ASAP. Here's a good post about Info on Dental Procedures

My son's 16 year old cat has stage 2 kidney disease. I will forward to him your recommendations about the additive binder. I believe he is feeding him special Vet food.

You wouldn't believe the number of people who joined the Feline Diabetes group who were feeding their cats Rx kidney diets. I don't know what's going on other than they are very high in carbs (but so are a lot of other foods people feed) but for some reason, I've just noticed a lot more who were eating kidney diets and then ended up diabetic.

There's not a lot any of us can do to prevent kidney disease. As I said earlier, pretty much every cat will have some stage of kidney disease as they age. I have to wonder if maybe it's because cats are desert creatures that don't have much of a thirst drive (they get most of their moisture from the prey they eat) which could put extra strain on the kidneys. More water is better!

The Facebook group highly recommends the Feline Chronic Kidney Disease group. We have many members in both so we tend to deal with the diabetes and they concentrate on the kidneys so we complement each other well. There's also the Kidney Disease "Bible", Tanya's Comprehensive Guide to Feline Chronic Kidney Disease but I'll warn you....if you get overwhelmed easily, Tanya's might make your head spin.

My previous kitty Roger died of kidney disease. Poor cat, I fed him dry food ALL his life, I had no idea about feline nutrition at the time. He deserved better care, he was the best cat anyone could have asked for.

Don't blame yourself. The vast majority of us believed the nonsense our vets were telling us about how kibble is better for their teeth and is a perfectly good diet for our cats. It took the diabetes diagnosis for us to learn for ourselves how best to feed our cats. Another great website, written by a vet with a special interest in feline nutrition, is catinfo.org. It's well worth the time to read.

 

[AYDA & PASHA]

Absolutely!! We have had a lot of cats who went into remission after they had a dental. No guarantees of course, but I'd definitely get it done ASAP. Here's a good post about Info on Dental Procedures



You wouldn't believe the number of people who joined the Feline Diabetes group who were feeding their cats Rx kidney diets. I don't know what's going on other than they are very high in carbs (but so are a lot of other foods people feed) but for some reason, I've just noticed a lot more who were eating kidney diets and then ended up diabetic.

There's not a lot any of us can do to prevent kidney disease. As I said earlier, pretty much every cat will have some stage of kidney disease as they age. I have to wonder if maybe it's because cats are desert creatures that don't have much of a thirst drive (they get most of their moisture from the prey they eat) which could put extra strain on the kidneys. More water is better!

The Facebook group highly recommends the Feline Chronic Kidney Disease group. We have many members in both so we tend to deal with the diabetes and they concentrate on the kidneys so we complement each other well. There's also the Kidney Disease "Bible", Tanya's Comprehensive Guide to Feline Chronic Kidney Disease but I'll warn you....if you get overwhelmed easily, Tanya's might make your head spin.



Don't blame yourself. The vast majority of us believed the nonsense our vets were telling us about how kibble is better for their teeth and is a perfectly good diet for our cats. It took the diabetes diagnosis for us to learn for ourselves how best to feed our cats. Another great website, written by a vet with a special interest in feline nutrition, is catinfo.org. It's well worth the time to read.

Hello Chris, hope you are doing well.

I am aware of the website catinfo.org, but thanks very much for poiting out to my attention.

I created a new thread just now, you might have seen it.

I want to go ahead and start TR. Would you be able to guide me? Also @DanaB is really wonderful guiding me and helping me on this diabetes journey. She is an expert. Thank you Dana.

So when a hypo happens do I ask for help here or in the Lantus discussion forum?

Thank you so much.

 

[Chris & China (GA)]

So when a hypo happens do I ask for help here or in the Lantus discussion forum?

This is the Lantus forum that this thread is posted in. You should post here daily and people will get used to seeing you and you'll get more people watching for you! You can always post here first and if you don't get a comment right away, you can also post in Health too (or like I said the other day, you can also post in the Feline Diabetes group on Facebook (not the FDSG) letting people know you need help and put the link to your post here so people can quickly find you).

Yes I know @DanaB . I've been a member here for over 10 years so I know most of the "old timers" and those members that give good, solid advice. I used to spend a lot more time here but I'm also the Admin of the FD group on Facebook which keeps me very busy too.

 

[AYDA & PASHA]

Most vets don't approve of the more affordable foods, but there are thousands of cats here that have been eating FF for years without problems. If you want to go with the Purina ProPlan urinary tract pates, they are low carb and may ease some of your vets concerns (although I still think they're being a little anal about it). Cats that eat canned or raw food have a lot less chance of developing crystals because they are eating what they were born to eat. A mouse is a cats perfect food and is about 80% water....just like canned foods. A lot of us even add a little extra water to the pate to increase the water our cats get. Water keeps the urinary tract flushed out which doesn't give crystals much of a chance to form or create stones.

We do recommend limiting fish foods to once or twice a week though due to the problems with heavy metal contamination found in fish. Fish flavors are also usually higher in phosphorus due to the ground-up fish bones.

The DM pate is low enough in carbs, but there's absolutely nothing special about it but the price. There's nothing in it that treats diabetes (which is why it's "diaTetic" and not "diabetic"). The ingredients aren't any better than FF or Friskies.



OTC is "Over The Counter"



It's an additive that can be mixed into every meal to help block the absorption of phosphorus from food but it's not recommended until the cat is in at least stage 3 CKD (or you feed foods that are low in phosphorus, like many of the Weruva foods) If your cats blood levels of phosphorus are still too high, you might need to add a binder but it doesn't sound like you're anywhere near that point yet. One of the most common is aluminum hydroxide (the active ingredient in Tums).



You're much better off feeding him the same low carb food that you're feeding Pasha. It makes it a lot easier when feeding multiple cats for them to be eating the same thing so you don't have to worry if one is eating the other guys food. Low carb food has nothing to do with kidney disease, just as high protein food is no longer a concern in developing kidney disease. Stick with low carb for both. It will also lessen your civvie's chances of becoming diabetic too.



This is another problem we have with a lot of vets. Dental infection/inflammation or pain can raise the blood glucose. Getting the teeth professionally cleaned and removing any bad teeth may be the thing that allows Pasha to go into remission, not the other way around! Just make sure that it's a complete dental, which includes x-rays. 2/3rds of the tooth is under the gums so it's extremely important to know what's going on under the gumline. Be prepared....a good dental is expensive! $800-1200 is about average.

Hello Chris,
I am sending you a photo of Pasha’s sore tooth. Both sides have the same thing.

I was t able to talk to my vet yet. She wasn’t in. However I did send her an email expressing my wish to have the dental problem sorted out now rather than wait for remission. Hopefully I’ll be able to talk to her tomorrow. cheers!

 

[Diane Tyler's Mom GA]

Hello Chris,
I am sending you a photo of Pasha’s sore tooth. Both sides have the same thing.
View attachment 72502

I was t able to talk to my vet yet. She wasn’t in. However I did send her an email expressing my wish to have the dental problem sorted out now rather than wait for remission. Hopefully I’ll be able to talk to her tomorrow. cheers!

@Chris & China (GA)