Changes in diet - not working well.

[indyleslie]

Hey, folks!

We (Shane and I) are new to this message board. We are also new to the diagnosis of feline diabetes. I have already spent many hours on here and really enjoy the plethora of information available to me. I do, however, have a concern about Shane and need advice/tips. I thought I would see what I could get here.

Right now our biggest struggle is with food. As you all know, cats go into a supposed “starvation mode” early on in the disease. In the beginning, we were feeding her more often to satisfy her. She would follow us until we gave in, which was about every 2-3 hours. Now we are trying to scale back again as we attempt to regulate her blood sugars.

The biggest issue is that she doesn’t want to change foods. She has been a picky eater her entire life and I knew this would be quite the challenge. She has always eaten the variety of offers from Fancy Feast with gravy. I know that’s not the best food for a diabetic cat, and after 11 years, she simply turns her nose up at anything else. We switched to a brand called “Almo Nature” that is very low carb/raw inspired.

She wakes us up during the night by causing havoc. She will push things off of bookshelves/tables, smack the blinds to create noise, paw us in the face, meow at us very closely in our faces, etc. It’s very exhausting when I can’t get a good night’s sleep anymore. We are all struggling with these changes. She won’t stop until she gets food, but won’t eat her new food. Not even if you mixed it with a bit of something. It ends up that she gets a pack of her old food and we all get a bit of peace for a few hours. Horrible solution, I know.

I’m trying so hard not to give in to her. I know her diet needs to be improved. Tonight as I was eating pasta, she desperately came up me and quickly swiped a long noodle off of my plate and ran off with it. As funny as this may sound, this is behavior she has NEVER exhibited. She’s 11 years old and has always had zero interest in human food.

I’m trying not to wave the white flag over here; however, this is tough.

 

[Larry and Kitties]

What are her current BGs (at shot time and about 5 hours after shot).
How is Shane's weight doing? Increasing? Staying the same?
Decreasing?

 

[FurBabiesMama]

This made me feel sad for her... especially the pasta stealing part I understand how hard the food transition is. I think it probably was one of the hardest - if not the hardest - part of all of this for us. My girls had happily eaten dry food their entire lives, so it was a major change for them. Don't give up. You are just starting. It CAN be accomplished, but it takes perseverance and patience.

We went through so many different foods to get to something they would eat. So, you may not be able to just switch to your desired brand and 'make' her get on board. You may need to start considering other options. I jumped through so many hoops to get them to eat. I started making chicken bone broth to add to their food as well as home-cooked chicken breast to add as a topper. Since texture was a big thing for my girls, I had to add a few kibbles of dry food (lowest carb I could get) to the top of the wet food to get them started. For Mia, I had to do that for several months. Then, I was able to switch to using PureBites freeze dried chicken to provide the little bit of crunch. To this day, Mia will not start eating her wet food until I crumble a little of the PureBites on top of it.

Are you feeding multiple times a day? That works out best for a lot of cats. You can determine how many calories she should have (one common formula is 20 calories x every 1lb of their ideal/healthy body weight) and how much food that is then break it out into maybe 4 means a day. It's not 'every 2-3 hours', but it gives her food frequently enough that she may not feel so 'starved'.

 

[Dusty Bones]

This made me feel sad for her... especially the pasta stealing part I understand how hard the food transition is. I think it probably was one of the hardest - if not the hardest - part of all of this for us. My girls had happily eaten dry food their entire lives, so it was a major change for them. Don't give up. You are just starting. It CAN be accomplished, but it takes perseverance and patience.

We went through so many different foods to get to something they would eat. So, you may not be able to just switch to your desired brand and 'make' her get on board. You may need to start considering other options. I jumped through so many hoops to get them to eat. I started making chicken bone broth to add to their food as well as home-cooked chicken breast to add as a topper. Since texture was a big thing for my girls, I had to add a few kibbles of dry food (lowest carb I could get) to the top of the wet food to get them started. For Mia, I had to do that for several months. Then, I was able to switch to using PureBites freeze dried chicken to provide the little bit of crunch. To this day, Mia will not start eating her wet food until I crumble a little of the PureBites on top of it.

Are you feeding multiple times a day? That works out best for a lot of cats. You can determine how many calories she should have (one common formula is 20 calories x every 1lb of their ideal/healthy body weight) and how much food that is then break it out into maybe 4 means a day. It's not 'every 2-3 hours', but it gives her food frequently enough that she may not feel so 'starved'.

Yes! Purebites did the trick for me and I still use it when they raise their nose at their regular food. Just crumble a bit on top of his wet food and stand back! LOL They're pure freeze dried meat, no carbs.

 

[indyleslie]

What are her current BGs (at shot time and about 5 hours after shot).
How is Shane's weight doing? Increasing? Staying the same?
Decreasing?

Her blood sugars range from 300-390 right now. Whether at shot time or in between. They are all over the place right now.

Shane‘s weight is stable right now. She lost quite a bit in the beginning, but within the past month her weight is steady at nine pounds.

 

[indyleslie]

This made me feel sad for her... especially the pasta stealing part I understand how hard the food transition is. I think it probably was one of the hardest - if not the hardest - part of all of this for us. My girls had happily eaten dry food their entire lives, so it was a major change for them. Don't give up. You are just starting. It CAN be accomplished, but it takes perseverance and patience.

We went through so many different foods to get to something they would eat. So, you may not be able to just switch to your desired brand and 'make' her get on board. You may need to start considering other options. I jumped through so many hoops to get them to eat. I started making chicken bone broth to add to their food as well as home-cooked chicken breast to add as a topper. Since texture was a big thing for my girls, I had to add a few kibbles of dry food (lowest carb I could get) to the top of the wet food to get them started. For Mia, I had to do that for several months. Then, I was able to switch to using PureBites freeze dried chicken to provide the little bit of crunch. To this day, Mia will not start eating her wet food until I crumble a little of the PureBites on top of it.

Are you feeding multiple times a day? That works out best for a lot of cats. You can determine how many calories she should have (one common formula is 20 calories x every 1lb of their ideal/healthy body weight) and how much food that is then break it out into maybe 4 means a day. It's not 'every 2-3 hours', but it gives her food frequently enough that she may not feel so 'starved'.

Thank you for the great tips.

She is fed multiple times a day, but I’ll be the first to admit it’s not on a schedule. I’m trying to get the hang of it all. She used to be fed twice daily (morning and night), but I think with diabetes it’ll be better to give her more frequent, smaller meals.

 

[Sybil and Zoe]

I certainly feel your pain as my girls turned their nose up at everything in the beginning--one diabetic and one not. I can't tell you the number of cans/flavors/brands I would open just to get them to eat, esp the non diabetic one, Bella. I got so sick of scraping grose uneaten food into the trashcan everyday. Now Zoe the one with diabetes eats voraciously anything I put down. She eats like she hasn't been feed in days. If I have to give treats because Bella is asking for them, Zoe hoovers them up without breathing or chewing. It is disturbing. That being said, if you need some peace and can afford it, there is a Cat mate c500 timed feeder on amazon you can order that has 5 slots and you can program it to open at 4 different times. https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01AUYLVU8/?tag=felinediabetesfdmb-20 It comes with two ice packs and you can freeze one while other is in use. Zoe was diagnosed last October so it hasnt been a year but the food stress only lasted a month or two. I tried sprinkling the fortiflora and even crushed up temptation treats and sprinkled on the food. Bella is still persnickity about what she eats but Zoe eats ANYTHING. I have purchased the timed feeder and then had to purchase the much more expensive microchip feeder for Bella to keep Zoe from accessing her food! It definitely is not a cheap endeavor, these sugar kitties.

I will say I went the route of multiple feedings thinking it would be better for her and me and was feeding her 4xday. I have gone back to the twice daily routine because it didnt make a difference in her BS readings and the online vets I follow say it is better for them to have a fasting period between feedings, much like they would have in nature. I follow Dr Karen Becker and then ofcourse the writings of the vet here on the catinfo.org (I will say even though I am an RN, I don't fully understand why some diabetic cats act like they are starving all the time like Zoe).

 

[FurBabiesMama]

(I will say even though I am an RN, I don't fully understand why some diabetic cats act like they are starving all the time like Zoe).

It looks like Zoe's glucose still runs high, so that could be contributing to her 'starving'.

I guess you have already seen this article where Dr. Becker explains the hunger: https://healthypets.mercola.com/sites/healthypets/archive/2016/05/24/cat-excessive-hunger.aspx

 

[Sybil and Zoe]

Yes her blood sugars have NEVER been under 300 except during some curves and even then it was never under 200. I haven't done them(curves) too much lately as it seems the last few spot checks post shot never changed too much. It is weird. Last year I kept increasing her insulin and had her up to 5.5 units and they still were the same--300s. She spent 4 days at vet in January and they put her back on 3 units and it still was in 300's. They did a fructosamine a few weeks ago and this just jogged my memory that they never told me the result. I just called and the tech said no calls usually means it was ok. NOt acceptable. I am at a loss what else I can do. She is on Vetsulin and maybe would do better on Lantus but I just cant afford more expense. It is just me and I have spent a small fortune on vet visits and food and feeders etc. I have given everything to these cats and I am drained. I am on here because I was going to post about stinky poo because my daughter came in my house during the day to get a package and said it smelled like poo. I scoop at least twice a day or every time they go but someone poo'd while I was at work and that was it, one solitary poo causing the issue. I am at my wits end because I cant have this issue too. banghead:)

 

[Celle]

I'm new to feline diabetes, but I'm an RN and I have had experience with treating diabetes in humans, particularly children.

The explanation about ravenous hunger and loss of weight in the article that FurBabiesMama linked certainly applies to humans as well as cats.
Based on my experience in treating humans, I would say that changing to Lantus - which is long-acting and produces no great peaks or troughs in the blood sugar - and giving a consistent dose might help your Zoe.

I realise that many of the posters here won't agree, but I don't like the idea of frequent testing and basing the insulin dose on a pre-dose blood sugar. That's because I believe that your cat needs a dose at the same level consistently, so that her body can get used to it and react to it more predictably. Giving different doses of insulin seems to me as if it would confuse her body and not allow it to adjust.

My Sophie has been on 2 units of Lantus since April 16th and her sugar levels have come down into the yellow zone for the past 4 days. Her appetite has decreased as well and I'm changing her diet gradually.
With Lantus, it's OK to let a cat graze, so you can leave food down for your her when you go to bed.

My vet says the Lantus is still taking effect, her body is still getting used to it, and Sophie's sugars will come down still more, without changing the insulin dose.
While she was still ravenous and would eat anything in sight (like your Zoe wants to) it was easy to feed her the right foods. I did feed her whenever she was asking for food. It seemed unkind to not feed her when she was so hungry.

Now that her sugar levels have come down some, she's wanting to eat less. She's more discriminating and I'm having to note which foods she actually likes.
She's also peeing less and she's not so thirsty - all good signs.

 

[Sybil and Zoe]

Thanks so much for that thoughtful reply. I may have to consider lantus. I talked with the vet when they did her fructosamine test and the cost stopped me because I had google lantus and it can be $300 a vial. If it might give her some relief I may check into it. I don't think the vet I use likes to write rx and ‘Im not sure what the true cost might be from their office. The vetsulin is $58 a 10 ml vial. Do you use the pen or the vial? It looks like pens are about $80-90 and vials are $250ish. Ugh.

 

[Chris & China (GA)]

I had google lantus and it can be $300 a vial.

Most of us have been buying our Lantus from Canada because it's 1/3 to 1/2 the price.

Here's the information on buying insulin from Canada

 

[Celle]

I had google lantus and it can be $300 a vial.

Wow! That's some price! I use a Lantus pen and, here in NZ, the vet only charged me $32. He also told me that the blood sugar testing strips are cheaper at the local pharmacy than they are when dispensed by the vet's office.

 

[FurBabiesMama]

I realise that many of the posters here won't agree, but I don't like the idea of frequent testing and basing the insulin dose on a pre-dose blood sugar. That's because I believe that your cat needs a dose at the same level consistently, so that her body can get used to it and react to it more predictably. Giving different doses of insulin seems to me as if it would confuse her body and not allow it to adjust.

I just want to chime in here. I think that, for the most part, people here would agree with not changing dosing on a pre-shot-test by pre-shot-test basis. (The protocols on this site for Lantus do not tell you to do that.) Sometimes that is done, but that is usually with insulins with a shorter action than Lantus. I often 'preach' about consistency myself, but one cannot clump all insulin types together since they behave differently. Even with 'in-and-out' insulins, I believe in being as consistent as possible, but sometimes, dose reductions based on pre-shot test results are absolutely necessary to prevent hypoglycemia. Also, there is no reason to stay at a dose for several weeks if the data shows that more or less insulin is needed.

People here often say 'this is a marathon, not a sprint' which is so true. Holding doses for a reasonable amount of time is important to allow things to 'settle' and to evaluate the true impact. 'Rushing' dosing changes can create volatility. However, there is not much to be gained from staying at a dose for several weeks if the data is showing that it is not getting the desired result. If after a couple of weeks the cat's glucose is not in the desired range, staying on that same dose is most likely not going to suddenly start getting them in the desired range. (Assuming the cat is already on a low-carb wet food diet before starting insulin. If that diet change happens while on insulin, the glucose levels will usually drop just from that.)

I think one's goals factor in here, too. If just seeing a reduction in clinical symptoms is the goal, someone may be fine with going extra slow or even sitting stagnant. On the other hand, if the goal is to get the glucose levels below the renal threshold for as much time of the day as possible as soon as possible and to have the greatest chance of remission, there is probably going to be less willingness to stay at the same dose more than a couple of weeks.

 

[Sybil and Zoe]

It looks like Zoe's glucose still runs high, so that could be contributing to her 'starving'.

I guess you have already seen this article where Dr. Becker explains the hunger: https://healthypets.mercola.com/sites/healthypets/archive/2016/05/24/cat-excessive-hunger.aspx

I had read the article you notated. You seem so knowledgeable and so I turn to you since you brought up the starving issue. Sadly I just got a call from the vet and the fructosamine done two weeks ago had fallen through the cracks and didnt get to his inbox until I called and asked about it last night. It was 516 which they wanted to hospitalize her and do more curve and increase dose. I told him I want to just bite the bullet and look at switching her insulin from vetsulin to lantus since most seem to be there on this site. How did you land on levemir? I am not sure the vets at my clinic are well versed enough in diabetic cats to lead me and so I am going to try and get there with the experts here. He will write me the rx for me to purchase elsewhere but I dont want to wait for something to come from Canada.
I did go ahead and order the supplement from foodfurlife with intent on trying to do the raw or semi raw deal if it will help her. Bless her heart.

 

[Sybil and Zoe]

by the way, I am at the vet now. I didnt want to stress overnight knowing her bs is high, so i just brought her in to get looked after and give me a good nights sleep.

 

[Sapphire Skye]

by the way, I am at the vet now. I didnt want to stress overnight knowing her bs is high, so i just brought her in to get looked after and give me a good nights sleep.

I stumbled upon your post looking for something else. I felt I was reading my situation, previous vet was not well versed and kept increasing her dose and about to pawn me off to an internal medicine ver. I just recently changed to a feline-specific vet who wrote the rx for Lantus and said I was right to not keep increasing the dosage. Safie is not doing well on Vetsulin either She weighs 10lbs down from 14.8 lbs and heartbreakingly thin. I am able to get Lantus at a very good price ($60 for brand, less for generic, YES there is a generic version) in Mexico and so I will have by sometime next week. I have a friend who visits often and so I asked if he could investigate if Lantus was available down there. I wish I had asked soon and avoid all the melt down I had over Safie. I too have been trying different foods to see what she like just so she can eat. The Vet also suggested baby food (chicken w/ckn gravy) only 1/2 a jar. Turns out I was underfeeding her too. Oh my that made me feel awful. Thank you for posting the link on the auto feeders. I hope i don't have to resort to that. I have 2 cats, only Safie is diabetic. I am looking forward to getting out the black/red BS readings soon.

 

[Sybil and Zoe]

We do the best we can with what we have to work with. There is a lot of information on this site but so much goes untouched unless you spend an entire day just reading! I am sorry about your kitty Safie. Zoe has never lost weight but her fur looks ruffled and unkempt which makes me feel like she doesn't feel well, though she doesn't show it in her interactions with me. I have purchased a Lantus pen from someone on the site that had some that their cat was not using. I am anxious for it to arrive so I can hopefully help her feel better. It is sad that we have to go to such measures to get the meds our kitties need for survival at such a high cost. I am going to place my order with my Rx for Lantus from Canada. (I first have to figure out how to do it) but it is gonna take 2-3 weeks to arrive.

Anyway I am glad my post touched you. I think vets (rightly so) go for the cheapest alternative treatment as so many people are not willing to invest the kind of money it takes to treat these animals especially without insurance. Some ( my friends ) certainly would not make the investment. But these animals are dependent on us to care for them. Anyway, it was a shock for me at first with all the investment in vetsulin ($58) syringes and the strips to test their blood!! oh my if he had looked at me and told me that her insulin would cost nearly $300/month , which Lantus is here in the states, I would have fainted.

The timed feeder is good, but I too have a non diabetic cat and I have to protect her food from Zoe, so I had to buy that microchip feeder as well. It is an investment but can bring peace to a competitive feeding situation.

I had a terrible time when I switched Zoe to wet food from Kibble. Bella still eats it from her protected feeder because she is so picky. Now Zoe will eat anything. Since her hospitalization last week i am feeding her when she begs though the suggestion of unflavored metamucil sprinkled on the food by the vet has actually helped quiet her down. good luck with Saphie. She is beautiful.