advice please: diabetes with new diagnosis of renal disease

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simbyboobop

Member Since 2017
Hello,
My name is Rachel and I'll primarily be operating this account with my partner, James, who is the co-owner of Simba, "Simmy". This is my first post.
Two years ago, during the summer months, Simmy suddenly started chugging water and urinating large, odorless volumes of pee; he seemed incontinent and just stood up in the bed and did it there one time. It took less than a week for us to realize what was going on; that incident made us bring him to the vet for help. We started out on Lantus at 1 unit BID and then after a fructosamine test, we were told by our vet to bump it up to 2 and then to 3. We had a hypoglycemia incident at 3U and have had a couple close calls. I am several states away for school; James takes care of Simmy by himself and works full time. We know we should be checking glucose to avoid hypoglycemia but our vet had told us that Simmy's patterns seemed to generate insulin for himself at random and unexplained times; glucose checking might not be worth the stress for anyone. As more expierenced owners of a diabetic kitty, we are considering adding this to the regimen. Simmy has been at 2U BID and doing well.
About a month ago, we were told our boy has chronic kidney disease. We went in for a dental cleaning and many days and many tests later were told that his BUN was 42 and his creatinine was 2.6. His urine values had a 'low concentration' and despite prying, I didn't really get more info. (If you live in the Boston area and know a different vet we could see, please let us know). We currently feed Simmy half a can of Friskie's pate after doing much research on the carb content and avoid dry food (so he gets adequate water/less carbs). We also feed him some pate between meals when he is hungry. Due to the development of CKD, we are confused in how to proceed. Our vet recommends prescription kidney disease (low protein) food and to prioritize this treatment over the diabetes (low carb intake). Please let us know of your experiences and any resources you might have found helpful in treating these comorbidities.
 
Hello,
My name is Rachel and I'll primarily be operating this account with my partner, James, who is the co-owner of Simba, "Simmy". This is my first post.
Two years ago, during the summer months, Simmy suddenly started chugging water and urinating large, odorless volumes of pee; he seemed incontinent and just stood up in the bed and did it there one time. It took less than a week for us to realize what was going on; that incident made us bring him to the vet for help. We started out on Lantus at 1 unit BID and then after a fructosamine test, we were told by our vet to bump it up to 2 and then to 3. We had a hypoglycemia incident at 3U and have had a couple close calls. I am several states away for school; James takes care of Simmy by himself and works full time. We know we should be checking glucose to avoid hypoglycemia but our vet had told us that Simmy's patterns seemed to generate insulin for himself at random and unexplained times; glucose checking might not be worth the stress for anyone. As more expierenced owners of a diabetic kitty, we are considering adding this to the regimen. Simmy has been at 2U BID and doing well.
About a month ago, we were told our boy has chronic kidney disease. We went in for a dental cleaning and many days and many tests later were told that his BUN was 42 and his creatinine was 2.6. His urine values had a 'low concentration' and despite prying, I didn't really get more info. (If you live in the Boston area and know a different vet we could see, please let us know). We currently feed Simmy half a can of Friskie's pate after doing much research on the carb content and avoid dry food (so he gets adequate water/less carbs). We also feed him some pate between meals when he is hungry. Due to the development of CKD, we are confused in how to proceed. Our vet recommends prescription kidney disease (low protein) food and to prioritize this treatment over the diabetes (low carb intake). Please let us know of your experiences and any resources you might have found helpful in treating these comorbidities.
Sorry about the two diagnosis...

Definitely start home testing!!!! So so important to keep your cat safe.

The ckd is stage 2... Too soon for low protien. If you do low protien now it will lead to muscle wasting. Ideally find a low carb low phosphorus food. Check dr. Lisa's list in the yellow stickies at the top of the forums.

If you can't find a food he likes that's low in both then you could always use a phosphorus binder if the levels are creeping up.

Around the same stage as your kitty is when I started giving my ckd cat sub q's a few times a week.... It helps it flush the kidneys, made him more comfortable, and stalled the progression of the ckd.
 
What container did you draw your sterile subq fluid from? Also, do you rotate your insulin site?


Thank you for your reply!
 
What container did you draw your sterile subq fluid from? Also, do you rotate your insulin site?


Thank you for your reply!
Sub q's come in 100ml bags like iv bags... But the needle goes under the skin not in a vein.

This is a great video about giving them....


My cat is in remission now but we would try to inject in a slightly different area each time.
 
Personally, I would stick with the diabetic-friendly diet, especially for a cat in early CKD. Restricting protein too early can lead to muscle-wasting and is often now thought not to be the best way to proceed. With that said, Friskies is pretty high in phosphorus, and phosphorus is now thought to be a bigger issue for CKD cats than protein (the protein restricted diets were based on human studies, not on obligate carnivore studies). If you happen to have a copy of Simba's blood work, hopefully showing things like phosphorus and potassium levels as well as the standard CBC, I would be happy to take a look at it for you. There is also a CKD Facebook group where there are several members who have cats with both diabetes and CKD that you may wish to join for additional support - this is the link https://www.facebook.com/groups/felinecrf/ Other resources that may be helpful for you are the Tanya's CKD site, which is here http://www.felinecrf.org/ and also has an associated support forum. And Dr. Lisa Pierson's food list, which is here http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf - for a cat with both diabetes and CKD, you are looking for foods that contain less than 10% calories from carbs and also less than 250 mg/100 kcal phosphorus (if you can go quite a bit lower than 250 mg, that's even better).
 
April listed some great resources and I second her recommendation for low carb, low phosphorus, good quality protein wet or raw food. And I would NOT start fluids unless the vet says it's OK to do so. Fluids can be dangerous if kitty has a heart condition. I found out the hard way.

I did give subq fluids for a while, and gave them in a different side/site than the insulin, and preferably a couple hours apart.
 
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