Advice needed on hard-to-regulate Tricky

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liewil

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Hi,
My name is Willie and I live in Belgium with my 2 indoor cats Zorro and Tricky, both 8,5 years old.
Tricky has been diagnosed with diabetes end of August. After losing a month (due to a vet who didn't know anything at all about diabetes), I started her on Lantus. Her sheet is here :https://docs.google.com/spreadsheet...E5wN3l1a3o3ODdBV0laODRxaHRpZ3c&hl=en_US#gid=8. The unit is mmol/l iso. mg/dl, so you should multiply by 18, or if you know that yellow = below renal limit, that's maybe enough.

Short history since diagnosis : first Tricky lost weight till 4,3 kg, then she gained weight up to 6,5 kg, now she's about 6,3. She used to be 4,9 kg before she was sick, and at 4,3 she felt "sharp" to the touch, so I think 5 kg is acceptable for her.
So :
September : lost month due to false start.
October : started on Lantus with tight protocol and home measurements. She gained weight again, insulin raised from 1,5 to 5,25 units, but still above the renal limit all the time.
November : started to have better values at 9 (!) units BID, but I got impatient, went to the vet for AB for her teeth (light infection of the gums), but she reacted very badly to the AB (stopped eating, diarrhea), first hypo values and panic, stopped AB.
December : started raising Lantus again from 5 to 8,5 units BID, making good progress in values, but she gained 1 kg weight :S
January : could slowly start giving a little less insulin, to 7,75 BID, and by the end of January was very happy : normal values all day, litter really normal again for the first time.
All this time I fed her Applaws Chicken dry food, 13,5% carbohydrates. She's been a dry food addict for a long time : although Zorro gets wet food twice a day, Tricky never touches it.
Then I started a new bag of Applaws (big bags of 7,5 kg), and madam decided she was not going to eat that anymore. Out of the blue. Result : tried every type of food I had in the house, and the Whiskas dry food that had been sitting there from before she was sick, was the only thing she would eat. 47,5 % carbo hydrates :S

Since then I visited another vet (who knows a bit more about diabetes, but still confuses cats with dogs) and gave her AB again for her teeth. Plan is to eventually get her teeth cleaned, but the new vet doesn't like to do it now when she's not regulated at all, and also she stopped eating again when I started the AB, so he's worried he can't give her AB. But that got better after I stopped giving it to her on cream, so maybe she just reacted to the lactose.

And now I need advice. I want to change her diet away again from the evil Whiskas, but if I mix even 3 kibbles of Applaws in it, she won't eat it. Tried to mix with a somewhat less evil dry brand yesterday, and during the day she eat it, but then overnight she didn't eat anything, so she dropped from 383 last night to 34 this morning :S Which also proves to me how evil the dry food is if not eating for 12 hrs has this much impact.
So this morning I found this link : http://www.catinfo.org/?link=felinediabetes and others, and now I'm thinking about trying to get her on wet food, at least partially. But I don't know how to handle it in combination with the insulin. I halved the 5 units she was getting (and which are not enough when she eats Whiskas) this morning. She's eating some wet food now, which is already good, and some evil dry food as well. But it's hard to monitor exactly how much she's eating of which.

I'm also on a Dutch forum for diabetic cats, where I get the comment that I'm irresponsible, and experimenting on my cat, and I should just keep giving her the evil dry food if that's what she wants. But I'm scared what will happen then if I have to raise the insulin to 7 or 9 or even higher, and then she suddenly decides she doesn't like that brand either anymore :S

Apart from all this, Tricky has been doing fine the past few days, apart from the heavy drinking/peeing again. She's social and active. Oh, and she's a "free feeder" : she only eats a small amount every time, Zorro as well, which will make complete transation to wet food not easy.

Sorry for the long story, but I just want to know if trying to change her diet is a good or a bad plan, and if any of you have done it with a cat on (much) insulin, and how to know how much insulin to give. Or should I try to regulate her again first on the evil dry food ? Or let the vet do her teeth first, if I can persuade him ?

Thanks for your ideas.
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Hello Willie & Tricky.
Glad you found us & decided to post some really good questions.
Someone with more experience will be able to answer your question more in detail then I could.

I just wanted to say welcome to FDMB.
Tricky is a beautiful cat. Thank you for sharing the picture.

Jenn & Baxter
cat_pet_icon
 
Oh gosh... you're not experimenting on your cat, you're trying to help her. Just because your kid wants to eat nothing but Happy Meals doesn't mean its healthy for them to do so, and you're not experimenting on your kid by making them eat healthy food appropriate for a child. Would you let your diabetic kid eat nothing but Twinkies, potato chips, and soda? Why do people think cats are so different than our own kids?

Dry food tastes so good to cats because it is coated in animal digest... that 47.5% carb food is going to make her a nightmare to regulate. You already saw what her refusing to eat it did... it might be the only thing saving her from deadly hypos on that extremely high dose. It also might be the only thing stopping her from getting regulated. I have heard some say once they have a severe hypo incident they tend to be more sensitive to insulin.

Check out this link on CatInfo about transitioning dry food addicts to canned - especially this part

Try a product called FortiFlora - feline version. Most cats LOVE FortiFlora and this has recently become my favorite trick. This is a probiotic made by Purina but you are not going to use it for its probiotic properties. You are just going to use it as a flavor enhancer. The base ingredient in FortiFlora is animal digest - the very substance that makes dry food so very enticing to cats. The directions say to use 1 package/day - and you can use this much if you want to - but this amount is not usually necessary. You may only need ~1/4 of a package - or much less - with part mixed into the food and part sprinkled on top of the food just as you would use salt and pepper on your own food.
 
Welcome Willie, Tricky and you too Zorro!

Yes EVIL Whiskas - if I give KT more than 5 small pieces of it, his BG soars 150-200 points. It was his favorite food and all he ate for years before becoming diabetic - I suspect it was THAT which finally caused it since he reacts so badly.

Diet change is a VERY VERY good idea - it will lower Tricky's BG's! Just keep working with him, he'll get to liking it. KT still asks for hard food every once in a while but here in the US, we can get hard food called 'EVO' that is only 8% carbs. Unfortunately you cannot get it there. Keep a close watch in his BG numbers when you get him on the wet food - you will certainly need to reduce that very high dose!

You are doing a GOOD thing for your cat - experimenting is how to find the RIGHT thing for him!!! Just leaving him in high numbers or giving him things that aren't good for him is irresponsible. GOOD JOB!!!!!

BIG hugs!
 
Welcome to the FDMB Family!

You have already gotten really good advice about diet for Tricky, so I'm just going to address the topic about free-feeding wet food...I have 13 cats here only 2 of which are diabetic, everyone here is free-fed canned cat food. I simply add about 1/2 a can of warm water to every can of food and mush it up which serves 2 purposes it keeps it moist longer during the day and also makes my gravy lovers think they are getting gravy. Others here will freeze the canned and put it down frozen so the cat can nibble at it as it defrosts or use a timed feeder so that they can eat throughout the day.

If Tricky and Zorro will both eat wet food there is no reason to keep feeding them the dry. if you think she will eat enough of the wet food, since you are already home testing I would personally ditch the dry food, get her on a nice low carb canned diet and start her completely over with the insulin, by dropping her back to 1u b.i.d. while watching her numbers through home testing and checking her urine for ketones.

I know my Maxwell went from 485 when dxed to diet controlled with only about 2 weeks on a very low dose of Lantus. Now not all cats will do that but diet plays a HUGE role in getting a diabetic regulated and hopefully eventually off insulin.

The other way to go about it would be to slow transition her over by slowly increasing the amount of wet and slowly decreasing the amount of dry. But you will want to be testing and testing often as you change her over to wet and be ready to quickly reduce that huge dose of insulin she is currently on.

Mel, Maxwell, Musette & The Fur Gang
 
Some folks have found that switching to a low carbohydrate, canned food will reeduce the glucose level 100 points (5.5).

It is best to make that food change slowly, so you can adjust the insulin as you adjust the food. It will be a bit imbalanced while you do this. It will get better once it is done.

To help the vet, we have some professional articles that you can share, like this one by Roomp and Rand
Lantus/Levemir testing & dosing protocol Roomp & Rand
 
So, Tricky had her teeth looked after yesterday, and apparently it was necessary, since 3 teeth were extracted :S
No luck so far getting her to eat wet food, only sometimes a little bit, and even now without molars on one side she prefers the dry. Will keep trying to get her to eat anything else, but since I can't safely starve her, it's not looking good ...
 
Welcome Willie, Tricky & Zorro -

My boy was not very happy about giving up his dry kibble... and would literally steal it from the other cats' bowls or scavenge where the messy eaters ate & spilled some (if the dogs didn't beat him to it!). We changed the food BEFORE starting insulin, and did see some significant changes with his numbers as described above. Now, after a little over a month, he LOVES his canned food, but would certainly devour a bag of dry if given the opportunity!

Not having the luxury of starting before-hand as I did, and since she MUST eat in order to give her the insulin, starvation (when she gets hungry enough, she'll eat) is NOT an option. Clearly the transition seems to be your best/only option. Perhaps if you go from free-feeding to specific mealtimes (right before shot times), then take the food up after 15 minutes, she will learn to eat while the food is out - regardless of the kind. Because I don't want to isolate Grayson from his dry-food-eating siblings, they are now on a feeding schedule. They figured it out pretty quickly too!

Good luck! It sounds like you're doing your very best for her. Please don't listen to the folks calling you irresponsible - that's why you're here, and trying to find what is best for your Tricky (who is absolutely gorgeous, by the way!!!) Post here and on the Lantus board as needed - there is an amazing collective knowledge here.

Lu-Ann
 
I'm just amazed at how picky and stubborn she is. Since I had to be careful with the insulin after the operation anyway, I thought it would be a good day yesterday to try to get her to eat something other than whiskas dry, anuthing else was fine. Even went to another sugarcat owner to get a sample of hill's M/D. But no luck, she just doesn't want to eat any other dry food, or any wet food. She hardly ate anything last day and night and my stress levels were through the roof. And then this morning she demanded her own portion of Felix wet food, like Zorro. She only ate a bit of it, but it's a start, I'll just try to keep offering. And I put the whiskas dry back, so I can restart the protocol with the insulin in any case. If I can make a "party" about giving them both Felix at the same time (and remove the dry food some hours before maybe), it's a start :)
 
Racci always looked at wet food like it was the most nauseating thing she ever saw. She's 15 1/2 and ate dry her whole life. I've tried to switch her so many times with no luck. Finally she is eating wet food! If I could get Racci eating wet anyone can. :lol: She is still extremely picky about which ones she eats and they must contain fish but hopefully we will overcome that too. Now I use the dry Purina DM (low carb) that she loves as treats when she is tested and gets shots and only if she hasn't eaten enough but even then it's just a little. I nearly threw in the towel several times but finally it worked.

I started out by making a big fuss over her wet food & treating it like a treat & giving a lot of praise. I don't know how much money I wasted on food she wouldn't eat buying all kinds of flavors of all kinds of brands but finally found 3 so far that she likes. I start new ones out mixed with tuna water also and water them all down to make it seem like gravy. I put a towel under her and feed her right where we test to make it a special treat also.

So far I was able to come down a whole 1.5 units of insulin on the canned food but she got an infection and that brought her back up so we're currently gaining back lost ground.

Welcome and good luck with the food.

Melanie & Racci
 
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