On
12/29 I wasn't able to read through the thoughts and suggestions on my condo that day. Now that I've had a chance to, I did want to respond, fwiw, mainly to thank you for taking the time. And to
@tiffmaxee Elise who asked me about my concerns about the MC & HC foods, and who asked for suggestions. I've read them all.
Unfortunately, many cats are being & have been diagnosed with pancreatitis when often, there is also IBD & other organ involvement. There is also that pesky shared bile duct which makes it all the more interesting
.
This is really the double edge sword of an easy blood test like the Spec fPLI. Even with an ultrasound added to the initial diagnostics, depending on the level of inflammation at the time, organs, including the pancreas & intestines, may not appear thickened or changed on the initial ultrasound done. As a result, cats leave with a diagnosis of pancreatitis. Vets are becoming more aware of this issue & when they see the history, are making pet parents aware that there is more than likely more to the situation with added differential diagnosis.
Because the intestines, liver, pancreas, and gallbladder are so proximal to each other and closely associated in function, I wonder if the gravy could set off some upset in the intestines and perhaps trigger something more in the line of triaditis instead of just pancreatitis? Just brainstorming.
Correct me if I'm wrong but I think there is similarity to some of what you're both saying. And Butters' vet has also said similar. In simple terms (because I am a person with zero science background
trying hard to learn), he explained to me that the organs are closely associated in function. He, and the IM vet he consults with, isn't ruling out the possibility that IBD or Triaditis could be lurking and show up at some point even though the u/s did not show any markers for these conditions. I'm not yet sure what it means in terms of her future treatment/diet, just that he is keeping this in mind.
For this reason,
management of insulin dosing vs management of BG using various foods/multiple feedings/testing (aka “feeding the curve”) becomes the preferred strategy for some of these cats.
This just simply means not taking the risk and shooting lower #s at times &/or taking some dose reductions earlier or by a greater amount in order to to avoid being forced into the situation where you need to increase BG with food. Obviously, there will be some instances (hopefully not too many!) when a situation may happen & using honey, syrup or maybe a particular food you have found that will work without causing an issue, is fine
. However, the goal is, to the best of ones ability,
avoid dosing that results in these situations.
I believe this aligns with my goal for Butters of being "well-regulated".
I only prop her up with other foods when it is absolutely needed. It has been needed a lot, lately. I'm not sure why her numbers have been going so much lower. She isn't back to being regulated yet, which is what my vet wanted me to try to do as first order of business (while we work together on diet) I will continue to be diligent about taking any decreases,, BCS's and skipped shots.
Elise is correct that carbs and fat have not been shown to cause pancreatitis in cats but we’ve had cats here that could not tolerate gravy well including Sienne’s Gabby and my Gracie.
Neko couldn't handle gravy from wheat either, so I bought some of the Weruva products that made gravy with potato flour. In the 30's the corn syrup (which is called karo in the US) came out. We did have one member who gave maple syrup on bacon for HC treats. yumm! Another member who made her own gravy, can't remember if it was potato flour or rice flour.
Gabby couldn't tolerate gluten. Most of the HC food, at least at the time, had gluten in it. She was also a champ at vomiting up beef. I used either a drop or two of either corn syrup or honey to bump up her numbers.
If there's a possibility of IBD, you may want to consider novel proteins. Gizmo who does have IBD gets fed a combination of raw and ZiiwPeak canned food (either venison or rabbit and lamb). The ZiwiPeak has no gums or carageenan. If Butters is sensitive to fish/seafood, it does use green-lipped mussels for omega-3, though.
Butters' everyday LC diet is currently homemade raw pork with a premix. I hope to introduce other proteins down the road. I tried beef but that did not go well. Although she did okay eating a little beef ZiwiPeak from time to time in the past. I would sometimes use it as a higher low carb food.
I have some ZiwiPeak Venison from before Butters' CKD dx. I bought it because I thought it was an LC food but it is MC. That will be a better option for Butters than the MC & HC Weruva I currently use, so I'm going to try a switch to that. It has fewer ingredients. Her previous freeze dried raw, and canned food, had green lipped mussels and it seemed like that wasn't an issue. I will add some golden syrup (sugar syrup) to make it HC.
Thank you again.
. By the end of the day, she bounced up to 302.
Glad to hear she's feeling well (and earning her playing "P" without bending the definition!)
Take what you can get lol.
We talked before about glucose toxicity being a possibility. Breaking through that can sometimes a few quick reductions. At this point, just speculation. Follow what the numbers say to do.
...LOL.