BOB UPDATE - PLEASE ADVISE!

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Lkldcatlady

Lkldcatlady

Member Since 2013
Well, I had a phone consult with the cat-only vet from Tampa and now have more decisions to make. I really like this vet and wish I could take Bob to her but she's an hour away and I am just not comfortable with that. I may still use her though - I could always take Bob in on a saturday and then do phone consultations. Anyway, there are a few interesting things she told me that I was not aware of.

PANCREATITIS
She said the level of pancreatitis that cats have can affect how the insulin works. She said an abdominal ultrasound and this FPLI test can give more information on Bob's pancreatitis. She said it's not absolutely necessary right now - just watch for insulin not working and whether or not he has bouts of serious "not feeling well". Anyone have any experience with this?

PROZINC VS. LANTIS (SP?)
She recommends Lantis (twice a day) - especially after looking at Bob's spreadsheet. She thinks he would do well on 3-4 units, but I would have to start out at 1 unit for 5-7 days and then go up 1/2 unit at a time (for 5-7 days for each increase) so his numbers would probably be very high in the beginning for a few weeks. right now his numbers are pretty high, but at least I'm seeing some consistency. She said that Lantis would be keep him in the lower numbers longer and that sounds like a good thing to me! She said one of their main goals is keeping the variances in blood glucose during the day within 100 points. Any thoughts on the benefits of one or the other?

And, last but not least, Bob is still not feeling well and I just want to find out if this is normal. He's definitely not himself. I understand his numbers are still high, but shouldn't the insulin be making him feel a little better by now? It's been 3-4 weeks and he still looks half asleep all the time. Still drinking lots of water. He really likes to lie on the kitchen or bathroom floors, which he never really used to do. I know they are cooler than the carpet, so maybe that has something to do with it. One good thing - he is eating like normal and he's almost at 100% of the dry dm. Still not wanting to eat the wet food....I'm trying to be as relaxed as possible and I don't follow him around or poke him or wake him up - but it's STRESSING ME OUT!!! I just want to see a little of his normal behavior again.
 
It sounds like you had a good visit. It's encouraging that they use Lantus - that means they are pretty up to date.

Pancreatitis usually affects appetite and overall well being. (it can be painful). Here is some info:

http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=83108

I know you don't want to change too many things at once but I don't think you will see the results you would like with any insulin until you get rid of the dry DM. It is too high in carbs and will continue to keep his levels high regardless of the insulin you are on. There are lower dry carb foods you might consider. Some people like Young Again. It is only available on line. You might try it until you can concentrate on a food change to wet low carb. This vet explains why dry food is not good, regardless of the carb count: www.catinfo.org
 
I just ordered a free sample! Thanks for that info. I will definitely give it a try. I think I mentioned he seems to like the tuna canned food, but I know I shouldn't give him fish all the time. He just will not eat anything else! I bought almost all the flavors of the classic FF and he just sniffs it and walks away. :sad:

So, do you think Bob's behavior is normal for what his numbers are? I'm taking him to the vet tomorrow for an exam just to make sure it's not anything else. The vet keeps telling me that it's normal for him not to feel good when his bg is going up and down like it is, but they say it looks very similar to many other cats they have treated and it just takes time. I just want to know it's normal...
 
Wow! It sounds like you have found an informed vet. That's great. I am new to the board (2 weeks) fostering a sugarcat for the first time. The rescue representative showed me to take the FF food while still in the can, put a split in the middle and add a packet of FortiFlora. Cats love this probiotic because it reminds them of dry food, so I am told. Then I mix the FortiFlora into the food real well with a spoon and add water and mix that in as well. After it is mixed - I poor onto a plate. My sugarkitty likes his food really wet so I continue to add water to it while he is eating. He no longer uses the water bowl for water since he gets all the water he needs in his food. You may want to try this. I get a box of FortiFlora online at SimplyPets for $22.99 for a box of 30 packets. The most important thing to do for any cat is to get them off the dry food. I didn't even wean mine off... I just stopped buying it and put up with bad behavior for about two weeks. I found out that I have to add a third feeding to get them through the night which is when they relied on the dry food the most.

We are here for you and Bob and hope that all this attention and care can lead to him feeling better.
 
Lkldcatlady said:
I just ordered a free sample! Thanks for that info. I will definitely give it a try. I think I mentioned he seems to like the tuna canned food, but I know I shouldn't give him fish all the time. He just will not eat anything else! I bought almost all the flavors of the classic FF and he just sniffs it and walks away. :sad:

So, do you think Bob's behavior is normal for what his numbers are? I'm taking him to the vet tomorrow for an exam just to make sure it's not anything else. The vet keeps telling me that it's normal for him not to feel good when his bg is going up and down like it is, but they say it looks very similar to many other cats they have treated and it just takes time. I just want to know it's normal...
Click to expand...

Alrighty, here we go....

Drop that dose and dump the dry food. If Bob is very carb sensitive, the dry food alone can drive up the numbers.
I am not sure why you upped the dose from 2u to 4u, but that's no good at all. Look how he bounced and you got a blue from that increase..... it's too high, provided you were feeding the proper food.

My guys preferred the Friskies pates to any of the Fancy Feast which is just a good, and lots cheaper.
If you look at all the other low carb wet foods on Dr. Lisa's list, I am sure you can find something that is wet, low carb, and agreeable to Bob's taste.
catinfo.org/docs/FoodChartPublic9-22-12.pdf

Pancreatitis is VERY painful; ask any human who has had it.
You WILL see higher numbers with pancreatitis and the fPLI test is good to have done, but just like a temperature, you need to test when the problem is present. Why take your temperature after your fever is gone, yes?
Treatment for pancreatitis is the following:
1. pain meds for sure - something like buprenex is best,
2. upset stomach/nausea - most people give pepcid AC / famotidine - get the plain 10mg kind and cut the pills into quarters, giving 1/4 am and pm.... the daily max is 5mg/day for cats.
3. subQ fluids - you can easily give fluids at home.... just like your giving shots only there's a line and bag attached to the needle, easy peasy. They are needed to flush the system, and you will see a very noticeable improvement as soon as you have given the fluids.... Bob will perk up like a wilted flower. Get the vet to show you how to check for dehydration as well. Pulling up the scruff, then watching if it snaps back to the body quickly or slowly is a good way for you to tell. Don't go by your cat drinking lots of fluids; they ALL do but it's not enough.

For insulin, I would definitely switch to a longer lasting insulin.... yes, Lantus is very good, but I prefer Levemir as it is not acidic like Lantus ..... some cats like one of mine do much better on Levemir.
They are both fine, but wanted to mention that some cats truly do better on Levemir.

Yes, you should not do too many changes at once, but I think dropping the dose to 2u and going to the better wet food, forget about any expensive vet food, will be a good start. You will hopefully see how the 2u dose is working with better food. Give it at least a good week on better wet food and lower dose, then step back to look at how things have changed. Please watch Bob closely because you will see changes in the cat before you do in the numbers.

Gayle

ETA: I forgot to mention.... my Shadoe had frequent problems with pancreatitis but one thing that almost eliminated her flares was to give her B12 shots weekly as it helps a great deal with inflammation. I gave her 25u cyano B12, not the one for neuropathy, and within a few weeks, she was better and had only one minor flare in the months that followed.
 
Ideally, it would be great to wean him off dry food. I know how challenging it can be, Maui was a dry food addict and it took me weeks to teach her to eat wet food. It wasn't easy and there were many times I was tempted to put a bowl of dry food in front of her.

I had to spoon feed her to get her to eat and yes it was a chore and a huge mess. But one day it worked, she licked the spoon and I no longer had to force feed her. This took weeks and it was frustrating as .... well you can imagine.

Then my civvie who always ate both canned and dry, refused to eat the canned food and would go a day without eating if there wasn't any dry given. I used the technique of counting the kibbles and placing them on top of the canned food just to get her to eat. And each day removing one kibble from the bowl.

For the past year, I have been using a freeze dried raw food in addition to the canned food, because my civvie was still stressing over not having any crunchies to eat. This raw food has not affected Maui's BG's and is something you may also want to try to transition Bob.

I feed it dry, but you can add water to it (as per the instructions) to re-hydrate the food. If you have to feed dry food (and yes I get it), I would rather see you use a freeze dried raw food vs. dry food kibbles. This may be enough to trick Bob into thinking he is getting kibbles and will eat for you willingly. It also may help with the pancreatitis flare ups - since it is raw food and not dried food.

The magical food is:

Stella and Chewys Freeze Dried Chicken Cat Food, it does come in other flavors (we just get chicken) and here is where I found it be the cheapest online: http://www.petfood.com/item/stella-and- ... od/498360/

You may be able to find it locally in a pet specialty food (not petsmart or petco however)

their website is: www.stellaandchewys.com and they have a "where to buy" button so you can do a search locally.

My civvie got pancreatitis and it was tough - she refused to eat anything (not even her beloved kibbles) and it took a week before she would start eating on her own again.

When pancreatitis happens, the animal feels nauseous and while it's hungry, it just can't bring itself to eat. This is when vet intervention is needed with anti-nausea meds and even appetite stimulants.

All insulin - prozinc, lantus or levimer should be given twice a day (every 12 hours). All three insulins are good insulins, prozinc just works differently than lantus/levimer. Before you make the decision (and the investment) to change insulins, let's get the food issue resolved and see if that drops the BG's any.
 
OK - so what I am hearing is instead of changing insulin right now, maybe I should try the food change instead? (of course, I've been hearing this the whole time, Bob and I are just a little resistant to change....). UGH - it makes my stomach hurt just thinking about it. I can't stand to see him not eat and it's been drilled into my head to make sure he's eating well while he is on insulin so if he goes without eating I get scared. Isn't there something on the site with step-by-step instructions on how to change to wet food completely? If someone could direct me, I would appreciate it. Both vets told me that they had really good results with the ProZinc/DM dry and Lantus/DM dry combinations so I was hopeful that bob could still do ok without the wet food. Maybe I could give it another college try!

Regarding the pancreatitis, Bob is eating well and no vomiting or anything. Should I still look into the pancreatitis thing? I've been told the test is pretty expensive. I don't mind the cost if it's something I should be doing and makes sense. I don't want to be a hysterical mother tho... @-)
 
There are entirely too many cats who are DIET CONTROLLED diabetics, so the first course of change will be diet.... I am betting that both you and Bob would be delighted if a diet change would end up meaning no need for insulin?
Bob may not be in that group but try for it.... at the worst, he will need just a bit of insulin, and you can then think about switching to a better insulin.
 
does anyone know how canned food would effect a cat who develops crystals in the urine? My other kittie, Hector, gets struvite (sp?) crystals and that's why he was initially put on the Purina UR and we haven't had a problem since.
 
Is that a dry food? If it is, it's the last thing you should be feeding for that problem.
 
My kitty got struvite crystals many years ago and we put him on prescription Royal Canin Urinary S/O and never had another urinary issue. Unfortunately, he got diabetes about 6+ years after that. :evil: I was feeding mostly dry, with some canned food once or twice a week. I think what did him in is that we would free feed him when we would go out of town for long weekends.

After reading the nutrition articles on catinfo.org, I dumped the prescription stuff and switched Buster to canned Wellness. I add a little extra water to his meals as an extra precaution. It has been about 9 months since the food change and he hasn't had any troubles so far (anti-jynx!)
 
Raw food is also a good choice for both diabetes and crystal problem.

let's start with removing the dry food and that includes the dm prescription food.

like I posted earlier, if you want to try an alternate to dry - stella and chewys is a good choice and you may find that over time you can add water to it and transition to wet food completely, even wet raw food.

you can always change insulin, but I would suggest waiting until you change the food. you know change one thing at a time.
 
edit: If Bob switched from rx food and off dry, you will have improvement

If the diet is on the canned for a few weeks, then you can start working on the insulin switch.
 
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