10/07/2010 new: Spitzer - a 3 yr old neutered male, underweight

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BJM

BJM

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Spitzer was diagnosed while I was away from town on vacation. I'd been planning to take him in to the vet when I returned home. My pet sitter (a friend and former housemate) offered to take him in while I was away. His BG was > 400 @ the vet.

The sitter wasn't up to doing injections, etc., plus Spitzer would need monitoring while they titrated the dose, so I arranged for him to board at the vet until I returned.

He was discharged 10/10/2010 with D/M dry (50% protein) & canned, plus an Rx of 3 units insuline bid. So far, so good. No problem with sub-Q shots - I've done fluids for several renal cats in the past.

There are 10 other cats in the house, of various ages, eating a combo of dry and wet. I am transitioning all of them slowly to higher protein, lower carb levels in stages, so that cross-diet snacking and sudden changes don't risk blowing the diabetes management. I'm also having the vet check the 11 year old senior, Farrall, for weight loss evaluation - if its renal, she'll be easier to corral for a special diet than Spitzer is.

The dry food is currently Taste of The Wild (TOTW) Rocky Mountain formula (about 42% protein) 3/4 mixed 1/4 with Wellness Core (50% protein). I've phased the downstairs cats off the Iams dry (about 30%) protein in the past week; the upstairs are mostly younger cats and they were already eating TOTW. So far, no one is having major litterbox issues with the diet change. If I'm lucky, it may help Buster with his occasional mild diarrhea.

I'm holding the canned diet fairly stable until I've transitioned the dry. Spitzer doesn't like the canned D/M, so I'm mixing 1/4 can with a can of Friskies Poultry Platter (_not_ high protein). Warm it up slightly and serve - then all of them want a bite. I'll tackle upgrading the canned food once it is certain I can reliably obtain Wellness Core _and_ they'll eat it.

Its definitely a schedule hassle for me, so if I can get Spitzer to a diet controlled state, that would be terrific, though I'm not holding my breath.

If I seem calm, I am. I work as an epidemiologist at the state department of health, have a few friends with diabetes, and a coworker who does analyses on diabetes. It helps not to be entirely naive about the disease, though there are differences between humans and cats.

BJ
 
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Welcome to FDMB!

You may want to take a look at Janet & Binky's food chart here: http://www.felinediabetes.com/diabetic-cat-diets.htm As you will see, there is a wide variety of low carb wet food (ideal for diabetics), including Friskies, Fancy Feast, etc. The food often given by vets is very high carb and causes the cat's BG to remain high - and it is very expensive. Also, here is an article from Dr. Lisa concerning the transition from dry to wet food that you may find helpful: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=956

What insulin are you using? Are you home testing? You will find a great deal of helpful information here http://www.felinediabetes.com/FDMB/viewforum.php?f=14, including instructions on home testing, items you will need to have on hand in the event Spitzer has a hypo incident, and what to do in case of a hypo.

You will have many questions are you go through the information on the board...please post them and we will do our best to help.
 
WELCOME to the best site on the planet for you and your sugar kitty. There is a wealth of information here at your fingertips Jana has pointed you in the right direction. There will be others along to help and possibly guide.

My best wishes,
jeanne
 
It sounds like you have a plan for transitioning to wet, which would be great. You do want to be very careful changing the diet while giving 3 units of insulin. When we changed over from dry to wet, Oliver went down 100 points overnight. If we had just given the dose from the previous cycle, he would have hypoed.

That is a big starting dose. We like starting low and increasing slowly, based on blood glucose levels. When you start at 3 units, you could already be over his ideal dose. Vets who base the dosage on the numbers they get in their office often discount vet stress. With all the strange smells, noises and people, the kitty can be very stressed there, which raises bg levels. Then doses based on those levels can be too high when the cat gets home and relaxes again.

There are incredible resources and information on this site. Do lots of reading and come back with questions. We'll be glad to help you and Spitzer on this journey.
 
Hey, I've only been home 1 week from vacation! Change is a process, not an event! I work full time, too, and have numerous health issues of my own to address - like the current asthma flare which is leaving me exhausted from coughing.

As far as the dose goes - Spitzer was at the vet for an entire week before coming home. They were monitoring him and checking his glucose while he was there. I am not observing any symptoms of hypoglycemia, but I leave out the dry food so he can eat if he needs to do so. He does have either neuropathy or muscle atrophy in the hind end, with some stumbling going down stairs.

Because I am dealing with a household of 11 cats total, I am making food changes for all of them slowly. As you know, changing all the food at once would make it difficult to know where the problem is if any of the cats starts having issues with food. I'm am transitioning at a moderate pace. What I've observed so far is that they all prefer Spitzer's dry D/M (50% protein, formulated for diabetes) to the mix of Taste of the Wild Rocky Mountain plus Wellness Core.

I've been to Binky's page and have read the info on the canned foods; I'll have more time to get some shopping done this weekend to see what canned foods are available at the various pet supply stores in Columbus, OH ... and who has the best cost on these.

I will review glucometers and see what I can get, where, and cost of meter AND supplies, then make a purchase.

Plus, Spitzer has a 1 week follow up at the vet Saturday, so I can see how he is doing. We still don't know if it is transient or not. I may be able to do the stick there, to start getting trained on it.

BJ
 
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ps Spitzer lived 4 months at a shelter, the offspring of a humane seizure (overcrowding, possibly neglect or hoarding). He is very relaxed about crating, although he did not like the clinic cat and growled every time he saw her.

He most likely has genetic inbreeding - a photo I saw from the humane case showed numerous buff tabby colored cats. He has an underdeveloped lower jaw, with resulting overbite, which needed about $1800 in veterinary dental work so he could close his mouth. He has chronic feline herpes.
 
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I know this seems like alot to take in, but I'm confident this will all work out just fine. I'm sorry to hear about your asthma...my hubby has asthma, so I know what a pain it can be.

Sue is right about the change in diet and the insulin dose. Unfortunately, D/M is very high in carbs, so when Spitzer weans off the high carb food, you will need to monitor him very closely. There is a significant drop in the BG level with a low carb wet diet (some here have reported a 100+ drop with a change in diet alone), so learning to home test will be very important. Also, once you learn to home test, you will be able to provide the BG information to the vet. Home testing will also give you a much more accurate reading on Spitzer's BG levels...BG tests done at the vet's reflect the stress a cat is under and are usually higher than what is "normal" for your diabetic cat (B.K.'s BG can jump 300+ from vet stress, and even my mellow Chester jumps 100+ at the vet's office).

If you have trouble with home testing, I know there are people here that live in Ohio who may be able to meet with you and help you with that. As an alternative and if Spitzer has no intention of letting anyone mess with his ears, you can test using a paw pad. What is most important is that you test, not where you test.

Hang in there - we're all here to help and support you!
 
You are getting great advice, so I won't repeat what has already been said. You are in the right place, welcome!

As far as meters go, we use a Relion meter, Walmart's brand. It is inexpensive to use and accurate, and very easy to use. A lot of people here use the Relions. You don't need a special pet meter, although you can use one if you would prefer. If you want more info about other meters that are recommended, please just ask.

You mentioned that Spitzer has a chronic herpes infection. What has he been given to treat it?

Maybe I missed it....which insulin is Spitzer on?

One of the biggest problems I see going forward for Spitzer is dry food. It is the equivalent of giving a human diabetic donuts and expecting to be able to manage blood sugar. I notice that you are giving protein percentages on the foods, but what you need to focus on is the carb percentage....high carb is very bad for FD. You will not find the carb percentages on the bag, look at J&Bs dry food list: http://binkyspage.tripod.com/dryfood.html I know the vet will tell you that W/D is formulated for diabetic cats, but that's simply not accurate using current treatment protocols. W/D dry is 37% carb, much too high for a diabetic cat...we recommend staying below 10%, and I personally stay below 4% as much as possible. The best thing to do is eliminate dry food entirely, it really is not good for any cat anyway.

Here's a link to current FD treatment guidelines from the AAHA: http://aahanet.org/resources/DiabetesMgtGuidelines.aspx

You will notice that the guidelines call for feeding the lowest carb food that the cat will eat, and recommends wet food over dry.
 
re: chronic herpes
I put powdered lysine (from http://www.iherb.com) on both the dry and wet food. The vet told me that Spitzers symptoms had become worse due to his uncontrolled diabetes.

re: insulin
Spitzer is on a insulin glargine, U-100, 2 doses of 3 units roughly 12 hours apart

re: food
Spitzer's dry food is Purina Dry DM

http://www.purinaveterinarydiets.com/FelineProductDetail.aspx?prod=233
Guaranteed Analysis (Dry)
Crude Protein (Min) 51.0%
Carbohydrate (Max) 18.0%
Crude Fat (Min) 15.0%
Crude Fiber (Max) 3.0%
Moisture (Max) 12.0%

per AAHA Diabetes Management Guidelines for Dogs and Cats:
Carbohydrate levels can be loosely classified as
ultralow (< 5% ME)
low (5% to 25% ME)
moderate (26% to 50% ME)
high (>50% ME)
ME = metabolizable energy

so the Purina Dry CM does fall into their low category.

I'll be asking the vet about Hills m/d, as it is <15% carbohydrate on a dry matter basis
http://www.hillspet.com/products/pd-feline-md-feline-weight-loss-low-carbohydrate-diabetic-dry.html
Nutrient Dry Matter %
51.5 % Protein
22.0 % Fat
14.7 % Carbohydrate (NFE)
5.9 % Crude Fiber

Shifting incrementaly! At least 2 other cats have vomited with the food being upgraded, so I'm having to take it slowly.

BJ
 
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Welcome!!! A huge lover of cats- good for you!!! you are in the right place. I too have had 10 cats..and now have 5 -4 have special needs and I have a 3 yrs old etc etc.. just crazy.. This is the BEST place ever to help your cats with diabetes. I will never bring my cat to the vet for BG curves again..unless he must be hospitalized.. I have learned the hard way. I have seen my cat Khan change hugely in 6 wks due to the recommendations here. I am very knowledgeable about the prescription foods and was very set in my ways on feeding -- daily I have conversation about this for 8-10 hrs.. However when Khan was near being put down and 3 hospital stays I was in need of a different view. For me-If I didn't I would be saying goodbye to another one of my family cats.. (sad) soo Although very difficult for me since I am very confident in my knowledge base I tried the fancy feast low carb no grain and home monitoring.. within a week my cat was feeling much better-i knew because he was actually grooming himself. I have had to keep him in a spare bedroom but it has been worth it. Stressful very much in the beginning. I would feed all my cats at different spots in the morning, within 2 wks the cats were on a schedule. I keep the special food for each cat by the feeding area&placed a measuring cup inside the bag-I never forget then what I fed that day since I scoop 1/2 of the allotted measure out in the am.. if some food is left before I go to work I scoop it back up in the cup,place cup back in bag. Khan now sits by the bedroom door like clockwork for his morning BG check&food& shot. I must say I am very very thankful I have learned once again that this world has soo much to offer and there is soo much to learn. I no longer am surprised when others tell me what their approach is.. I just say.. how often has this approach been successful? if it has been over & over--who am I to say-no? if the pet become healthy again-regulated..isn't that the goal? I bought a meter from target -others have from walmart. it is how I've saved money. This morning Khan didn't even need insulin!! his numbers have come down HUGE!! all because of what I've learned here..not from my vet-my vet is onboard with monitoring my -Khan's BG numbers but he is learning along with me-he told me so. I hope this info helps--just FYI from the peanut gallery..one cat lover to another.. :) :)
 
As it goes for the prescription foods -- I can tell you many many vets across the USA believe in the low carb -over the counter food such as IAMS kitten food and fancy feast.. I knew about the Iams Kitten canned formula -directly from a gal with a PhD but fancy feast??? I for one was like --yeah rt!! until this happened to my own cat.. and now I understand since I see it first hand. I really would not have believed it unless this happened. Don't waste your money believe me from one cat lover to another .. this approach this site is talking about works.. and isn't that the main goal? I wish I could tell you what I do for a living but legally I can not. All I can do is say.. I feel blessed that I found this site and the people here have cared enough to keep directing me to the approach that has worked for many many many diabetic cats.
 
L-lysine is good, but don't use it forever...it loses it's effectiveness if you don't stop periodically. Your vet is correct, the uncontrolled diabetes will make it worse. We had wonderful results from a long course of Azithromycin after we got the BG somewhat under control. Tinkles is now completely symptom-free.

Guaranteed analysis is NOT the same as "as fed"....you're not comparing apples to apples. The percentages we go by are AS FED....below 10%. The guidelines from AAHA call for the lowest carb food the cat will eat and recommends wet rather than dry.

You can certainly choose to feed dry food, but you will need a higher dose of insulin, and remission is much less likely.

Keep reading the info here, there's tons of it.

Also, take a look at the Lantus ISG....read the stickies at the top of the forum, great info on the insulin and tight regulation protocol. viewforum.php?f=9
 
I can appreciate the fact that D/M and M/D seem like wise food choices for diabetic cats. After all, that is what Hill's tells all the vet's - and, if I'm not mistaken, the vet receives some financial benefit from selling Hill's, Royal, etc. Unfortunately, what the vets are not told is the level of carbs on an AS FED basis, which is the level that impacts the cat. I think we've all been there at one time or another and I do think our vets truly believe they are giving the best food available.

Certainly each of us can feed our cats anything we want; however, if the goal is to lower a diabetic cat's BG levels, then there is food that is far better and more economical than D/M and M/D for that purpose. D/M is lower in carbs, but everything else in D/M makes an alternative very attractive.

The transition from dry to wet can be hard sometimes. You may want to read Dr. Lisa's article on transitioning here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=956. Of course, it doesn't help that our furry friends can be so @#$ stubborn about things, so hang in there! :thumbup
 
I'd like to add that there are a few considerations when it comes to food

1. carbohydrate levels...DM canned used to have about 7% of the calories from carbs; under 10% is a very general guideline
2. quality of ingredients - its not just about the carbs. It is also about the fat levels, phosphorous and the quality of the protein source. Muscle meat (ie 'chicken') is better than biproducts (ie 'chicken biproducts)
3. whether your cat will eat it
4. dry vs wet - dry food can have an effect on the cat via dehydration; this can affect kidneys and the urinary tract system
5. other medical conditions
6. what you can afford
 
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