Advice feels "schizo"; contradicts itself

[MsBliss]

Despite reading all the Stickys here and dozens of threads from all the wonderful people here, and the incredible "residents" who are much more experienced and disciplined, who offer up terrific advice, I am more confused than ever. I have been told by a specialist and my vet, not to vary the insulin dose, not to fuss about the pre shot numbers, not necessarily test before each shot; to do a glucose curve after one week of a particular dose, even if that dose is not working; to instead "spot test"; to not shoot if the Pre shot number is below 150; to shoot no matter what because the number is not reflective of the future effect of the insulin.

For my kitty who is normalizing and going into remission, to wean him slowly by .25 units per week, but to not shoot if he is under 150, but he is often below that at shot time, so how do you get a solid remission if you are skipping shots, or shooting when the pre shot is low?

So much contradictory advice, I feel as if I am treading water here. I REALLY DON'T KNOW WHAT TO DO, and the more I read on this forum, the more confused I get. I am almost in tears. I have one kitty who is very unwell, despite taking her to the vet constantly, another kitty who is probably going into remission, and both have a low grade pancreatitis.

I am doing a curve today for both kitties, and will be adding Young Again food when it arrives next Tuesday. I will be keeping the kitties on their FF Classics despite the advice from YA to go solo, at least for the near future.

I am doing sub q fluids for both kitties--one has advanced CRF, one just starting, zobaline, B12 injections, Adequan injections intramuscularly, once a month to every two weeks, cool laser at the vet, DMG, Miralax for the kitty with advanced CRF, Cerenia, pepcid, Benazepril, Amino B Plex, D3 drops minimal dose, pre shot testing for both, plus other interventions. Even with all this effort, and so much cost I am living on potatoes, I feel as though I am failing with the one cat because she is basically unregulated with extreme highs and extreme lows.

Am I alone? What and how do people figure out the proper course of action?

 

[Julia & Bandit (GA)]

It's hard to give you specific dosing advice without seeing the test numbers--could you possibly set up a spread sheet so we can help you get your cats regulated? There are instructions here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/. If you find the instructions too complicated, please let us know and someone can help you set one up for your cats.

My experience with Lantus is with Tight Regulation, not SLGS, so I hope someone more experienced with that method can comment. However, if you're willing to hold off on feeding that dry food and you're testing 3 times a day, I would consider trying tight regulation. It's really the best method for safely getting BG under control as quickly as possible. There's a ton of knowledgeable people in the Lantus forum that can help you!

May I ask why you are adding the Young Again to the diet? It's strongly recommended not to feed dry food to cats with kidney disease--they need as much moisture as possible from food to help reduce further strain on their kidneys. A low phosphorus, canned diet is recommended for CRF cats, ideally with a high quality protein source. There are several options that fit this criteria and are also low carb, and I'd be happy to share some suggestions with you if you'd like! Mixing water in with the canned food is also a good idea. The YA is also high in fat, which isn't great for pancreatitis in many cats, and it can sometimes cause problems with regulation in carb-sensitive diabetic cats because it's not a low-glycemic food (and it has the same moisture problem as with CRF cats--unregulated diabetic cats have a lot of strain on their kidneys).

I would not listen to the Young Again person for diet advice--they are very aggressive in marketing their food to diabetic cat owners and it's really not the best diet for diabetic cats to be on, unless the cat refuses to eat any canned food.

 

[Lisa and Witn (GA)]

I never followed the tight regulation protocol for any of my cats. I gave the same dose for every shot and only changed it after I had sufficient home testing data to determine if I needed to increase or decrease the dose. If a change was needed, I would not make any other dose changes until waiting at least one week. The change was always in 1/2 unit per change.

Home testing prevents you from giving insulin if the BG levels are too low. It also gives you an accurate record of how well the dose is working. I look at home testing this way: if my cats were my child, would I give insulin to him if I did not know it was safe to give the dose? A lot of vets discourage home testing because they do not feel the owner is either not qualified to do it or they have not kept up with the latest information for diabetic care for pets. You are the person who is responsible for giving your cats the best care possible. Home testing does not hurt your cat, can prevent hypoglycemia and alert you how well the insulin or dose is working. I have had vets tell me not to test and I refused not to test. We agreed to disagree on home testing.

Most vets do not have the experience of day to day care of diabetic pets. I am pretty sure the ones who do would agree with the recommendations we give on FDMB.

 

[MsBliss]

It's hard to give you specific dosing advice without seeing the test numbers--could you possibly set up a spread sheet so we can help you get your cats regulated? There are instructions here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/. If you find the instructions too complicated, please let us know and someone can help you set one up for your cats.

My experience with Lantus is with Tight Regulation, not SLGS, so I hope someone more experienced with that method can comment. However, if you're willing to hold off on feeding that dry food and you're testing 3 times a day, I would consider trying tight regulation. It's really the best method for safely getting BG under control as quickly as possible. There's a ton of knowledgeable people in the Lantus forum that can help you!

May I ask why you are adding the Young Again to the diet? It's strongly recommended not to feed dry food to cats with kidney disease--they need as much moisture as possible from food to help reduce further strain on their kidneys. A low phosphorus, canned diet is recommended for CRF cats, ideally with a high quality protein source. There are several options that fit this criteria and are also low carb, and I'd be happy to share some suggestions with you if you'd like! Mixing water in with the canned food is also a good idea. The YA is also high in fat, which isn't great for pancreatitis in many cats, and it can sometimes cause problems with regulation in carb-sensitive diabetic cats because it's not a low-glycemic food (and it has the same moisture problem as with CRF cats--unregulated diabetic cats have a lot of strain on their kidneys).

I would not listen to the Young Again person for diet advice--they are very aggressive in marketing their food to diabetic cat owners and it's really not the best diet for diabetic cats to be on, unless the cat refuses to eat any canned food.

Yes, you make very good points. That is why I'm so confused! I wish I had known this before I ordered the 8 lb bag of YA.

Well, I'm trying the YA because feeding just FF is a bit of a struggle--they are hot and cold on it, and I usually leave a small bit of dry food out for any hypo events so they can kind of self-medicate with food when they need it. I was using Orijen Regional Red, but it spiked glucose, then switched to Wellness Core, but again, seemed to raise glucose. They mentioned at YA that renal kitties do very well on YA--but I would never feed it exclusively. I just don't agree with that concept. I wish I could though.....

The other reason I wanted to try YA is because of the micro nutrient issue. FF has standard vitamins, but lacks other micronutrients like probiotics, and fiber; one of my cats is constipated a lot, and I've got to get this under control before it escalates. When I add probiotics to their food, and I bought a good one by Mercola, they refuse to eat it. When I add fiber or give Miralax, it's a battle too. Plus, there's the phosphorus issue--YA has the lowest phosphorus for a tasty food, and phosphorus is a big deal for renal disease.

I agree with the salesmanship of YA.....they make a lot of statements that are not fully vetted, but based on experience, which is not always best. But I thought the food looked like a good quality, and the concept seemed reasonable.

One of my vets suggested getting kitty in hospital for quick acting insulin therapy and overlaying Lantus. Even if I could afford that, I don't trust the suggestion. I just cannot trust vets that much anymore, unless it's an emergency, infection, or trauma. It's an art form, and they just don't get it right too much of the time; I think they have too much to deal with patient to patient and can't micromanage all these issues.

I'm halfway through my glucose curves for both of these sick ones. I hope to post the results and get that clarity so much of you have. I can't do the online form--just can't maneuver through all that--it fries my incredibly feeble circuits.

 

[jayla-n-Drevon]

I am so sorry your going thru so much....
I also have a CKD kitty and a FD kitty and it is difficult in every aspect of your life.
You have some great advice here and I am sure some others will offer more...
I just want to add that YA has very skilled marketing people and that is not to say it is not a quality dry food but being a dry food it is not in the best interest of any cat especially a cat with CKD or FD. That being said sometimes you have to bite the bullet and if that is the only thing they will eat and your stress level is thru the roof then we do the best we can and tomorrow is another day.
Hang in there and if you see other questions and the advice givers response you will learn a tremendous amount of information....

 

[Chris & China (GA)]

I can't do the online form--just can't maneuver through all that--it fries my incredibly feeble circuits.

The spreadsheet we use is actually very simple....all you have to do is enter the numbers!! The rest it does all by itself!! So if you can type numbers, you can use our spreadsheet!

If you'd like some help setting it up and learning how to use it, I'd be happy to do it for you. Just click on my name and "Start Conversation"...that sends me a private message so I can get the information I'd need to set it up for you.

 

[Lisa and Witn (GA)]

I am doing sub q fluids for both kitties--

One thing I noticed when I was giving fluids to my diabetic cats was when I tested when next shot was due, the BG reading was lower than normal. I am not sure if others have experienced this, but wanted to let you know so you can watch for it.

 

[jayla-n-Drevon]

SQ can lower bg on some cats--doesn't affect Dre but I always wait a bit if he is low just in case....

 

[MsBliss]

I am so sorry your going thru so much....
I also have a CKD kitty and a FD kitty and it is difficult in every aspect of your life.
You have some great advice here and I am sure some others will offer more...
I just want to add that YA has very skilled marketing people and that is not to say it is not a quality dry food but being a dry food it is not in the best interest of any cat especially a cat with CKD or FD. That being said sometimes you have to bite the bullet and if that is the only thing they will eat and your stress level is thru the roof then we do the best we can and tomorrow is another day.
Hang in there and if you see other questions and the advice givers response you will learn a tremendous amount of information....

Thank you, I agree. I have a feeling the YA was a big mistake. They weren't even that crazy about the samples, I just thought it was the way to go and I posted a question to see if there was a consensus about it, but missed the critical comments by the time I ordered it.

I think I will just have to use it as a filler or treat. I know wet food is best, but can't help wondering about the other nutrients missing.

I noticed you give Adequan injections. Did they recommend it weekly or monthly after the loading doses were completed? I was given conflicting instructions and the wrong dosages as well.

 

[MsBliss]

One thing I noticed when I was giving fluids to my diabetic cats was when I tested when next shot was due, the BG reading was lower than normal. I am not sure if others have experienced this, but wanted to let you know so you can watch for it.

Thank you. I think that is what happened today.

 

[MsBliss]

The spreadsheet we use is actually very simple....all you have to do is enter the numbers!! The rest it does all by itself!! So if you can type numbers, you can use our spreadsheet!

If you'd like some help setting it up and learning how to use it, I'd be happy to do it for you. Just click on my name and "Start Conversation"...that sends me a private message so I can get the information I'd need to set it up for you.

I will try to get that set up but if I can't I will definitely take you up on your kind offer.....

 

[jayla-n-Drevon]

Thank you, I agree. I have a feeling the YA was a big mistake. They weren't even that crazy about the samples, I just thought it was the way to go and I posted a question to see if there was a consensus about it, but missed the critical comments by the time I ordered it.

I think I will just have to use it as a filler or treat. I know wet food is best, but can't help wondering about the other nutrients missing.

I noticed you give Adequan injections. Did they recommend it weekly or monthly after the loading doses were completed? I was given conflicting instructions and the wrong dosages as well.

After the loading dose I have been using it 1x a week but most people use it 1x a month-
It is effective either way. Because my boys are seniors is why I use it more frequently. My vet told me that I can give as much as 1x a week or wait as long as 1x a month but no longer. I may try every 2 weeks on Dre as he has responded very well but I think Rico is good on every week.

 

[Julia & Bandit (GA)]

The other reason I wanted to try YA is because of the micro nutrient issue. FF has standard vitamins, but lacks other micronutrients like probiotics, and fiber; one of my cats is constipated a lot, and I've got to get this under control before it escalates. When I add probiotics to their food, and I bought a good one by Mercola, they refuse to eat it. When I add fiber or give Miralax, it's a battle too. Plus, there's the phosphorus issue--YA has the lowest phosphorus for a tasty food, and phosphorus is a big deal for renal disease.

There's a probiotic made by Purina called Fortiflora, if you feel your cat(s) need a probiotic currently (are there antibiotics in the mix?), and if Miralax isn't working, perhaps you could try some psyllium powder for the constipation (and added fiber)? The YA dry food does not contain probiotics or soluble fiber is not going to make much of a difference. You can always add a little bit of canned pumpkin to increase their soluble fiber intake, too.

Low phosphorus is good for CKD, but it's not nearly as important as keeping the cat as hydrated as possible. Adding dry food to the mix will be dehydrating. There are also many canned foods that are low in phosphorus--Fancy Feast is not a good food for CKD cats because it is high in phosphorus, but Wellness, EVO, Weruva, Tiki Cat, and other companies make low carb, low phosphorus canned foods. Would you like some suggestions for these?

 

[Julia & Bandit (GA)]

I think I will just have to use it as a filler or treat. I know wet food is best, but can't help wondering about the other nutrients missing.

I'm confused on what nutrients you think there are missing --there are no nutrients in dry food that aren't in canned food. Most cats don't need a lot of fiber, and if they do for whatever health reason (e.g. constipation), there are many different types of supplements you can add.

Here's a link to the breakdown of many canned foods by phosphorus: http://www.catinfo.org/docs/FoodChartPhosphorus9-22-12.pdf. With CKD, you want to try and stay under 250 mg/100kcal of phosphorus, and for the diabetes, less than 10% carbs.

 

[MsBliss]

There's a probiotic made by Purina called Fortiflora, if you feel your cat(s) need a probiotic currently (are there antibiotics in the mix?), and if Miralax isn't working, perhaps you could try some psyllium powder for the constipation (and added fiber)? The YA dry food does not contain probiotics or soluble fiber is not going to make much of a difference. You can always add a little bit of canned pumpkin to increase their soluble fiber intake, too.

Low phosphorus is good for CKD, but it's not nearly as important as keeping the cat as hydrated as possible. Adding dry food to the mix will be dehydrating. There are also many canned foods that are low in phosphorus--Fancy Feast is not a good food for CKD cats because it is high in phosphorus, but Wellness, EVO, Weruva, Tiki Cat, and other companies make low carb, low phosphorus canned foods. Would you like some suggestions for these?

Yes, I would love to learn of that list of other wet food options. I have been feeding FF Classic, and since I just started YA, I'm putting a few bits of YA on the FF, and sprinkling a small amount of FortiFlora on top. I've tried the pumpkin gambit (kitty noses up in the air!), psyllium is a big no, but have had luck with Miralax.

The YA does have pre and probiotics, but I'm not sure if they are good doses and still viable.....

Neither kitty has has elevated phosphorus so far (anti-jinx) despite eating FF mostly. But now learning it is high in phosphorus, I shouldn't be tempting fate, so I would like to get going on other wet food options. I tried Wellness Core, but they refused to eat it.

 

[Jan Radar (GA)]

My little guy loves loves loves Tiki cat succulent chicken. It is lower in phosphorus than FF classics and it's really juicy which is part of why Radar loves it. He always drinks the juice first. The Tiki Cat with egg is another one of his favorites. Good luck finding something your kitty will eat.

 

[Elle & Squeak (GA)]

My little guy loves loves loves Tiki cat succulent chicken. It is lower in phosphorus than FF classics and it's really juicy which is part of why Radar loves it. He always drinks the juice first. The Tiki Cat with egg is another one of his favorites. Good luck finding something your kitty will eat.

Another vote for the Tiki Cat Chicken (Puka Puka Luau). I'm transitioning Squeak onto it and she's loving it! She's normally a slow eater, but since I started mixing the Tiki Cat into her regular food, she's much more enthusiastic about mealtime. I also find the quality to be really good. Might be worth picking up a couple of cans to try, if you get the opportunity.

 

[Erica & Carter]

My cats also loved Tiki Cat but the price was a bit too hard on my budget with 3 mouths to feed.

 

[billysmom (GA)]

You might want to try the Wellness grain free pates. My cat (and a friend's cat) didn't like the core but ate the pate just fine.

ETA: When feeding food such as tiki cat, weruva and bff make sure you are feeding enough calories. These are mostly lower calorie foods so you need to feed more volume.

 

[MsBliss]

Where do you buy Tiki Cat and Weruva? Mostly smaller pet stores? I never see that at Petsmart.....I thought they were "starchy", but I must have misunderstood.

 

[Erica & Carter]

Chewy.com is where I bought mine.

 

[billysmom (GA)]

I think Tiki cat is almost all meat/fat. Most of their original flavors contain fish so you need to check the ingredients. I think the chicken ones mentioned, are fish free. Their gormet carnivor line is fish free, if I remember correctly. Weruva varies. Weruva pouches are too high carb. Again, check for fish content. Weruva's website has all nutritional info including % cal from carbs . Weruva makes a line for Petco called Soulistic. I believe all of the original flavors have fish (could be wrong, check ingredient list) but it looks like there are some new ones that do not. Check the chicken pate. It also has a more normal calorie density. Soulistic also has full nutritional info on their website.

 

[Elle & Squeak (GA)]

Where do you buy Tiki Cat and Weruva? Mostly smaller pet stores? I never see that at Petsmart.....I thought they were "starchy", but I must have misunderstood.

I've found it in the specialty/independent pet shops here in Canada, but I assume the same would be true in the U.S. The store that I'm buying the Tiki Cat from doesn't carry all of the flavours, but they can order it in for me, so keep that in mind if you go into a store and don't see the flavour you're looking for. There are also the online shops, as already mentioned.

ETA: When feeding food such as tiki cat, weruva and bff make sure you are feeding enough calories. These are mostly lower calorie foods so you need to feed more volume.

That's a good point about the calories - a lot of the Weruva flavours are quite low, to the point of breaking the bank, given how much you'd have to feed. There are some that are higher than others, so you'd have to check their website and work out which ones would be best. I've been lucky that the two chicken flavours of Tiki Cat are right around the same calorie density as the pate I was feeding, so it hasn't been too bad. I'm not sure about the fish ones as I haven't looked at them.

I think Tiki cat is almost all meat/fat. Most of their original flavors contain fish so you need to check the ingredients. I think the chicken ones mentioned, are fish free. Their gormet carnivor line is fish free, if I remember correctly. Weruva varies. Weruva pouches are too high carb. Again, check for fish content. Weruva's website has all nutritional info including % cal from carbs . Weruva makes a line for Petco called Soulistic. I believe all of the original flavors have fish (could be wrong, check ingredient list) but it looks like there are some new ones that do not. Check the chicken pate. It also has a more normal calorie density. Soulistic also has full nutritional info on their website.

The majority of Tiki Cat's flavours do contain fish, but you're right that the two mentioned (Puka Puka Luau and Koolina Luau) are only chicken. The ingredients are fairly simple - shredded chicken breast, chicken consomme, sunflower seed oil, and vitamins/minerals. The egg one has the same ingredients, plus egg. All the nutritional stats are listed on Tiki Cat's website as well, which makes things easier.

Some of the Weruva cans are also too high in carbs, so taking a list of the suitable flavours if you plan to shop that brand would probably be a good idea.

 

[Julia & Bandit (GA)]

Here's the store finder for tiki cat: http://www.tikipets.com/store-locator/

And Weruva also has a store finder: http://weruva.com/stores.php