Changing diet, fighting neuropathy

[Deb & Wink]

Food info reply part 2:

Would you be able to take a picture of the back of the food label on the Royal Canin diabetic dry food you are using and attach it to your next post? The part I'd like to see of the label is where the min/max percentage values are listed for protein, fat, fiber, ash, any minerals. Also the part of the label that lists the ingredients would be helpful.

I'm trying to confirm that the Royal Canin Diabetic cat food available in Argentina is the same as the Royal Canin Glycobalance food I'm familiar with that is available here in the US. Royal Canin has a phone number to contact, but they are only open M-F 8 am to 4:30 pm central standard time. It may simply be a naming difference in different countries.

The Royal Canin Glycobalance canned food is about 14% carbs. Higher than we like to see, but about half the carb content of the Royal Canin Glycobalance dry food. I'm just not sure it's the same as the Royal Canin diabetic food you are feeding now.

If it is the same food, the canned Royal Canin Diabetic would be better than the RC dry (29% carbs).

 

[Deb & Wink]

Food info reply part 3:

Not surprised that Fancy Feast is not available in Argentina. It may be sold under a different name.

That Vitalcan Complete pate carne (beef) cat food looks good actually. In fact very good. Ingredients look good, no starchy sources. Vitalcan Complete comes in a chicken flavor also. Pate pollo.

Cat food can labels can look misleading. I use a cat food calculator to get a rough idea of what the cat food would be if you subtract the water content. Used the Centesimal Composition on the link you gave me, I put the numbers into this cat food carb calculator. I got 7% carbs on a dry matter basis (best way to compare dry cat foods with wet cat foods) for the beef (carne). Protein is 42% per 100 grams of food, fat is 44%. Chicken came out as 0% carbs, 46% protein, 52% fat.

Again, these are only rough estimates, but they are close enough.Either of these foods would be a good choice. Good amounts of protein to prevent muscle wasting.

Went to the other website you linked, The Natural Life one. Unfortunately there is no list of ingredients that I could find, so unable to see if these would be ok for a diabetic cat. For example, looked at some of the Felix cat foods. Don't know what the 'sauce' (en salsa) is made of, so not sure if it is good or not. Found another website (in Spanish, my Spanish is rudimentary but there is always google translate) that listed nutritional information (information nutricional) for the Felix pouches. From that I used the cat food carb calculator and the pouches are around 14% carbs. The Felix cans are higher 17% carbs. Good to have for your hypo tool kit, in case Tiamo ever goes really low with the BG, this food could help bring the BG levels up to a safer level.

 

[Deb & Wink]

Teo, we've given you lots and lots of information. Too much to absorb at one time. Here are some of the most important bits to summarize.

1. Vitalcan Complete looks like a good food. Get some of that, chicken or beef flavors both good.
2. Test every pre-shot and mid-cycle as time and your schedule allows.
3. Have enough test strips on hand before you start the food change.
4. Homemade food needs added vitamin and minerals.
5. Reread what has already been written.
6. Ask more questions.
7. When you are ready to change the food, slow change is better so Viamo does not get an upset stomach and vomit.

You have an upcoming vacation planned and would like to have the transition to lower carb food done by then. You would also like to see if the BG (blood glucose) levels can be decreased by that food change.

 

[Teo]

(edit: this was a measurement error) HELP: just did a test to make sure he was all right and got 95. I have never seen such a low value on him.

 

[Teo]

Instantly gave him some food

 

[Deb & Wink]

95 is ok. What food did you give him? For breakfast and just now.

 

[Teo]

WRONG NUMBER: I panicked when I saw such a low number all of a sudden but I did a second measurement and it was 454, a normal number for him. I did not have enough blood on the meter, I didn't know that could make it work so badly!

 

[Deb & Wink]

Always worth doing another BG test if you see a number much lower than you have ever seen before.

Deep breath, hold, release, deep breath, hold, release, deep breath, hold, release, deep breath, hold, release.

 

[Teo]

Good learning experience. Thank you for being so attentive.

 

[Deb & Wink]

I need to go have breakfast, although by this time of day, I should call it brunch.

What did Viamo have for breakfast?

 

[Teo]

Ha! Viamo ate his usual dry Royal Canin Diabetic food after his morning injection. He wasn't very hungry just now. I thought I saw him a bit off, but it was ok.

 

[Teo]

I have just read your reply about food. First, I cannot help but thank you again since it is evident you have put lots of effort into this.

Carefully handling of raw cat food needed, so you don't make you or your cat sick with bacteria contamination.

The food we prepared yesterday was cooked, so there should be less risk of contamination. Yet we are aware of the necessary dietary supplements that we're lacking. The list of ingredients you gave was actually pretty close to what we had, except for the vitamins, salmon oil, psillyum, etc.

Would you be able to take a picture of the back of the food label on the Royal Canin diabetic dry food you are using and attach it to your next post?

Here are the food labels, in both languages. I think there might be some small differences, that's why I upload both. (Tell me if you can see this images correctly. I'm still getting the hang of the forum.)

The Royal Canin Glycobalance canned food is about 14% carbs. Higher than we like to see, but about half the carb content of the Royal Canin Glycobalance dry food. I'm just not sure it's the same as the Royal Canin diabetic food you are feeding now.

If it is the same food, the canned Royal Canin Diabetic would be better than the RC dry (29% carbs).

I can guarantee there is no diabetic feline food sold in canned format here in Argentina. I have been told so by veterinarians.

That Vitalcan Complete pate carne (beef) cat food looks good actually. In fact very good. Ingredients look good, no starchy sources. Vitalcan Complete comes in a chicken flavor also. Pate pollo.

(...)

The Felix cans are higher 17% carbs. Good to have for your hypo tool kit, in case Tiamo ever goes really low with the BG, this food could help bring the BG levels up to a safer level.

Great! That is very good information.

You have an upcoming vacation planned and would like to have the transition to lower carb food done by then.

Well, yes, but not necessarily. Doing the change by then would mean that we have exactly two weeks to make the complete diet change. Would that be enough time? Or should it be slower? What I meant is that no changes in the diet should be made during our absence.

Vitalcan Complete looks like a good food. Get some of that, chicken or beef flavors both good.

If you tell us this food is correct, we would start tomorrow. We need instructions with respect to quantities and frequency. Viamo eats at irregular times, mainly because he has lost quite a bit of weight and muscle since his neuropathy and other symptoms started showing (he drinks a lot of water, pees frequently, and is hungry).

 

[Deb & Wink]

Go buy some of that Vitalcan Complete canned food (5.5 ounces). I'd suggest buying both the chicken and beef flavors. Viamo may like all foods now, but if we can get his BG levels down, he won't be looking to eat all the time. Test, feed, shoot insulin. No food for 2 hours before the pre-shot tests.

He may want to eat 2-3 cans a day of the wet food. (11- 16 ounces). Right now with his BG levels so high, he is unregulated and can not process the food correctly. That is the reason you have seen a big weight loss. At least 1/4 to 1/2 of a can of the Vitalcan food before insulin. A whole can if he will eat it without vomiting. More food as needed at around +3 if you are around or leave some out for him to eat if you are away from home.

Some cats really like canned food, some don't. Sounds like Viamo likes all food. There are 2 choices in switching food. Which way to use is up to you.
1. All at once. Stop all dry food. Give canned food only. May cause digestive upset. You may see some diarrhea at first.
2. Gradually over 4 days to a week. Day 1 Give 3/4 of normal amount of dry food, replace other 1/4 with wet food. Day 2 Reduce dry food to 1/2 of food intake, wet food should be other half. Day 3 Reduce dry food to 1/4 of food intake, wet food should be remaining 3/4 of food intake. Day 4. All wet food. Go slower with the food transition if digestive problems, severe diarrhea. Slower but less chance of digestive upset.

Do you have other cats? May make the food transition a bit harder.

The food transition from dry to wet food can dramatically change the BG levels. It doesn't always happen really fast, but sometimes it does. So testing during this time is important. You may need to lower the insulin dose, and sometimes by a lot.

You mentioned your mom. Is she willing to learn to test Viamo's BG levels? Or maybe she already knows how to test and or give insulin?
Are you available to test at mid-cycle (+3 to +7) hour timeframe. No idea what your work and life schedule is like and what responsibilities you have.

Thank you for the pictures. That was exactly the information I needed. Yes, that Royal Canin Diabetic is the same food, just a different name. Only sold by veterinarians. The vets CAN get the canned food but most probably do not choose to do so. Likely not much of a call for it and they do not want it sitting around unsold.

p.s. You are getting a crash course in Feline Diabetes.

 

[Teo]

Ok. I have been looking at the comparison of numbers between the Royal Canin that we're using now and the Vitalcan. I am not sure I understand completely why the vitalcan should better. On the calculator, I get 154 calories per 100g of nutrient on the Royal Canin, while for the Vitalcan I get 42 calories per 100g of nutrient. So, while having more carbohydrates, the Royal Canin still seems to have more protein... or am I missing something?

You mentioned your mom. Is she willing to learn to test Viamo's BG levels? Or maybe she already knows how to test and or give insulin?

Yes, my mom is taking part in all of this and knows everything well. We'll sort out the scheduling. It is summer here in Argentina so it is not a super busy time.

 

[Teo]

There are 2 choices in switching food. Which way to use is up to you.
1. All at once. Stop all dry food. Give canned food only. (...)
2. Gradually over 4 days to a week. (...)

The reason for us wanting to choose the gradual approach is not so much the possibility of digestive upset, but the possibility of it actually working to lower the glucose level too quickly and ending up with a hypo. I have read the big cautionary signs at catinfo.org's article about diet switching, which states "Caution: This must be done very carefully if the patient is already on insulin."

 

[Red & Rover (GA)]

It's the carbs you have to look at, not necessarily the calories.

https://www.vitalcan.com/productos/wet-gato-green-mix/
Ingredients:
Beef, water, olives, rice, vitamin premix mineral (Vitamins: Vitamin A, D3, E, B12, niacin, pantothenic acid, thiamin (B1), riboflavin (B2), pyridoxine (B6), folic acid, biotin Taurine. . minerals calcium, iron, zinc, manganese, copper, iodine, selenium), sunflower oil.
Protein: 11
Fat: 6.5
Fibre: 2
Moisture: 80

https://www.vitalcan.com/productos/wet-gato-orange-mix/
Ingredients: Beef, water, squash, cassava starch, vitamin vitamin premix (Vitamins: vitamin A, D3, E, B12, niacin, pantothenic acid, thiamine (B1), riboflavin (B2), pyridoxine (B6), folic acid, biotin Taurine Minerals: calcium, iron, zinc, manganese, copper, iodine, selenium), sunflower oil.
Protein: 13.29
Fat: 6
Fibre: 2
Moisture: 80

@Deb & Wink
@Marje and Gracie
- these look fairly low carb to me. Can you figure out the exact percentages?

 

[Teo]

https://www.vitalcan.com/productos/wet-gato-green-mix/
Ingredients...

Are you aware that you are linking a different product that the one we talked about earlier? I didn't consider that one because it says "olive and rice" in the package.

 

[Teo]

Sorry, I now see you did want to link a different product.

 

[Red & Rover (GA)]

I was not sure which Vitalcan product you and Deb were referring to. I went with the cans because cans are usually lower in carbs. I hope you can find a good low carb food for Viamo.

 

[Teo]

Oh, I understand. We were talking about the one named "Vitalcan Complete". It called my attention mainly because it does not show signs of rice, flour or peas. Thank you for the support.

 

[Deb & Wink]

There are 2 different kinds of the Vitalcan available in canned food form in Argentina. The Vitalcan Complete only has meat as the first ingredient and then added vitamins and minerals. A good choice for a diabetic cat.

The Vitalcan Balanced (the one Red & Rover linked to) is the one that has a number of carbohydrate ingredients. Not a good one for a diabetic cat, not the one that Teo linked me to originally. I did look at that one but did not save the calculation. I believe it was somewhere around 14% carbs. I'd have to check again, but don't think that is a good choice for Teo & Viamo. Olive and Rice are not ingredients we want to see in a food for a diabetic cat. The ash and mineral contents were high as I remember.

Viamo is currently eating the Royal Canin Diabetic (it's the same as Royal Canin Glycobalance here in the US, different name) dry cat food which is around 24-27% carbs. Teo knows it isn't the best food for a diabetic, and he has been getting a crash course in diabetes care for a diabetic cat, so he could safely do the food switch and get some ideas on appropriate foods.

After getting more test strips Monday, Teo will start the transition to canned food. He has decided to take the food transition slowly, taking a week or so to lower the possibility of digestive upset. Gradual is good.

There is so much information buried in this thread, it's hard to keep track of sometimes.

Repeating some of what I said earlier for Red & Rover's and Marje and Gracie's benefit. "Cat food can labels can look misleading. I use a cat food calculator to get a rough idea of what the cat food would be if you subtract the water content. Used the Centesimal Composition on the link you gave me, I put the numbers into this cat food carb calculator. I got 7% carbs on a dry matter basis (best way to compare dry cat foods with wet cat foods) for the beef (carne). Protein is 42% per 100 grams of food, fat is 44%. Chicken came out as 0% carbs, 46% protein, 52% fat." These numbers are rough estimates for the Vitalcan Complete canned foods. I used the Schyderweb cat food calculator to get those rough estimates. I don't think we would be able to get the 'as fed' values for cat foods that are available in Argentina.

 

[Deb & Wink]

Ok. I have been looking at the comparison of numbers between the Royal Canin that we're using now and the Vitalcan. I am not sure I understand completely why the vitalcan should better. On the calculator, I get 154 calories per 100g of nutrient on the Royal Canin, while for the Vitalcan I get 42 calories per 100g of nutrient. So, while having more carbohydrates, the Royal Canin still seems to have more protein... or am I missing something?

It's the lower carbohydrate % that makes a big difference in a cat's blood glucose, not the calories the food has. When we compare a dry cat food to a wet cat food, the labels give different information. There is more water content in the wet food. So we use a cat food calculator that accounts for the differences in moisture (humidity, water content) to get a comparison that puts these foods on an equal footing. Wet (canned) foods do not include the carbohydrate minimums or maximums on the food labels. So using a cat food calculator is a good way to find out how much carbs a canned food has.

Yes, my mom is taking part in all of this and knows everything well. We'll sort out the scheduling. It is summer here in Argentina so it is not a super busy time.

It's always nice to have another person to help with feeding, testing and insulin shots.

p.s. It's winter here in the north and cold here. Below freezing this morning. More snow soon too.

 

[Teo]

I don't think we would be able to get the 'as fed' values for cat foods that are available in Argentina.

I can always try to contact the company itself. So I should ask about the "dry" nutritional composition?

 

[Deb & Wink]

I can always try to contact the company itself. So I should ask about the "dry" nutritional composition?

Cat food can labels give a list of minimum or maximum amounts. These amounts can vary from batch to batch when the food is manufactured. Some companies test actual cans of food after manufacture, in a laboratory to get a more precise measurement of the values for the cat food, some do feeding trials, others do a calculation like I did. Only the feeding trials give an 'as fed' value.

Some companies will share that feeding trial information with a consumer. Some will not. There are standards that pet food manufacturers must follow. Different companies test in different ways.

Amounts vary from the minimum/maximums listed on the label because beef cattle (and chickens and other animals) can vary in how much fat they have in relation to muscle. Maybe there is a bit more organ meat mixed in with a particular batch. Maybe there is some chicken skin that gets mixed into a different batch. It's impossible to control having everything be exactly the same during manufacturing of each batch of cat food.

Even if you make your own raw food (or partially cooked) from ingredients you buy at the store and add the necessary vitamin and mineral supplements, you can not control all these variables. You are just trying to find a food that will meet your cat's nutritional needs. In Viamos' case, lower carbs and higher protein will help.

 

[Deb & Wink]

I know you have only recently started to home test, but it seems to be going well. Hopefully Viamo doesn't squirm around too much when you are trying to test.

When you get a chance, would you make a few notes on the SS (spreadsheet). There are a few blank lines at the top of the SS, before you started recording test numbers. If you could add on 1 line the approximate date of when the first insulin was given and how many units. Then on additional lines, if you could give approximate dates of when each insulin dose increase was done and how many units the new dose was.

Know you have been working with a vet, so this information is probably in the vet records. You could ask your vet for a copy of that information if you were not keeping track of the dates and insulin increases. We know that Viamo was raised to the 4 Unit dose over a period of time during the last 3 months since diagnosis. It would be helpful to have a general idea, and see that on the SS.

If your vet has any BG readings taken during office visits, you could enter them on the SS also.

 

[Teo]

I know you have only recently started to home test, but it seems to be going well. Hopefully Viamo doesn't squirm around too much when you are trying to test.

It is going well indeed! Viamo is not troublesome at all, he is mostly surprisingly good. It just depends on his mood wether he moves a bit too much or not. He mostly notices when we have to make him stay still or get him in a strange position, but the sting almost doesn't upset him.

Would you make a few notes on the SS

I added all the records I had, with some comments. I'm afraid I cannot find the exact times at which the dose was increased. I commented on some other things, including the fact that we actually tried two times with Caninsulin (one at the start of the treatment, and one in december 2019). Neither of those periods lasted long because my vet was trying to see if he would respond differently to that type of insulin, which he did not.

Yes, the story is a bit messy. But it is safe to say that he has been only on Lantus for at least two weeks, with the exception of the time this happened:

Please don’t give caninsulin and Lantus together! That was not a wise thing for your vet to suggest at all.

 

[Deb & Wink]

It is going well indeed! Viamo is not troublesome at all, he is mostly surprisingly good. It just depends on his mood wether he moves a bit too much or not. He mostly notices when we have to make him stay still or get him in a strange position, but the sting almost doesn't upset him.

That's good to know. Maybe a very tiny bit of that homemade food would be a good treat for him at testing time. When I say tiny, think the size of a kernel of corn or a green pea. It doesn't have all the vitamins and minerals needed because you could not get them, but is perfectly fine as a supplemental food or occasional small treat.

I added all the records I had, with some comments. I'm afraid I cannot find the exact times at which the dose was increased. I commented on some other things, including the fact that we actually tried two times with Caninsulin (one at the start of the treatment, and one in december 2019). Neither of those periods lasted long because my vet was trying to see if he would respond differently to that type of insulin, which he did not.

Yes, the story is a bit messy. But it is safe to say that he has been only on Lantus for at least two weeks, with the exception of the time this happened: Lantus and Caninsulin given in same cycle.

Thanks for adding that additional information on the SS. Any and all remarks and test data is useful as we see how Viamo does during this food transition. I'll be keeping my eye on your posts. Remember, you can always tag me, but I have set up my alert preferences so anytime someone comments on a post I am watching I get an alert.

 

[Deb & Wink]

Did Viamo get insulin today? I see by looking at the SS (spreadsheet) that he ate about 1/3 of a can of food this morning.

 

[Teo]

Of course, he got his insulin. But he didn't eat the new food until 2 pm.

 

[Teo]

I just noticed: I had forgotten to write the "4U" in the SS.

 

[Deb & Wink]

I just noticed: I had forgotten to write the "4U" in the SS.

That is why I asked about the insulin.

I found a post from one of our members (Mexico), that makes their own cat food. She said she buys the supplements individually on-line and buys them at either Iherb.com or Vitacost.com. Veronica said both these companies will ship internationally. So a possible source for the vitamins and minerals, if you want to make your own cat food.

 

[Veronica & Babu-chiri]

Hi and Welcome!

Sorry I didn't looked at the post before, I've been out of the forum for a couple of days, I'm glad there were so many experienced people helping you.

Regarding the food I know that in Latin america is not easy to find appropriate food and a lot of the companies do change the formulas from the ones they sell in the US, since they market different brands or recipes and they do not give out As fed values or phosphorus content even if you ask for it, apparently since the norms in Latin american countries do not require them to give it they won't do it so some times is hard to really find appropriate food.

Still some of us have been putting together a list for food that may help you, it may not be as accurate as we would like because of the lack of information and some inaccuracies of the information the food present in their labels but it may at least help you get an idea of some foods that may be low carb and of the ones that are very high and you want to stay away from them

Here's a link to the list https://docs.google.com/spreadsheets/d/1bbyeJ3lXjXT88InScWvbieqofWf04BREjHv5UTN1JMM/edit?usp=sharing

Since is a work on progress you may find it a bit confusing so please feel free to contact me or PM (private message me ) if you need help understanding it as with Dr Lisa's list you want food under 10% cabs in the metabolizable energy profile column

That being said I'm home cooking my cat's food using Dr. Lisa's recepy this is the link https://catinfo.org/making-cat-food/

 

[Deb & Wink]

Thank you so much Veronica. I've added your list to my personal bookmarks. I'll ask over in the Tech Support forum if your list can be added to the Health Links/FAQ Index for food lists.

I've been trying to help Teo and his cat Viamo to find a better food for a diabetic cat.

 

[Veronica & Babu-chiri]

I'm tagging also @Daniel Jerónimo Tobón , he's actually in Argentina so he may also be able to help

 

[Teo]

Thak you @Veronica & Babu-chiri and @Deb & Wink ! I am amazed at the level of detail and unconditional help that I have gotten from this forum.

I'm home cooking my cat's food using Dr. Lisa's recepy this is the link https://catinfo.org/making-cat-food/

Yes, that's exactly the recipe my mother followed when making the first attempt at home-made balanced food. We are currently thinking about the possibility of bringing the necessary supplements (vitamins, minerals, etc.) from abroad, so as to have all the ingredients we need.

I'm tagging also @Daniel Jerónimo Tobón , he's actually in Argentina so he may also be able to help

Whoa! Meeting someone here in Argentina who's also in this forum would be immensely helpful. Thank you.

 

[Deb & Wink]

I keep looking at Viamo's spreadsheet every day, to track his progress and see how he is doing with the food change. No big drops in the BG (blood glucose) levels but a little bit lower. It can take 10-24 hours for food to pass through a cat's digestive system. Plus you are still feeding some of the Royal Canin dry food.

So far so good in my opinion. If there are any digestive problems like diarrhea, please make a comment about that in the Remarks column.

One thing to think about when you go on vacation, is what insulin dose to have your pet sitter give to Viamo. Some things to think about are:
1. Have they given insulin injections before?
2.Does Viamo like this person and will he let someone else give the injection?
3.Do you want to lower the dose temporarily while you are away? Some people decrease the insulin dose down of someone else is taking care of their cat.
4. I thought you said this person would not be able to test the blood glucose. Is that correct?

 

[Veronica & Babu-chiri]

Yes, that's exactly the recipe my mother followed when making the first attempt at home-made balanced food. We are currently thinking about the possibility of bringing the necessary supplements (vitamins, minerals, etc.) from abroad, so as to have all the ingredients we need.

I usually have all the supplements sent to me from either one of this web pages, they ship internationally so they can probably ship to Argentina, it does take a bit longer to get than their estimates but they usually get ok

iherb.com

Vitacost.com

 

[Deb & Wink]

Checking up on Viamo today. I see his BG levels are dropping as you do the food change. Yesterday January 9th was the first day of all wet food. Seeing some more numbers down in the pink color code range, instead of up in those red and black colors on the SS is encouraging.

Pink is better. Let's see what happens in the next few days.

I think you start your vacation in 1 week and will have someone else taking care of Viamo. Is that correct?

Will that person be able to update the SS?

 

[Teo]

Hi! Sorry I've been posting less. Here's my update.

The transition to wet food has been completed successfully. Viamo didn't show signs of digestive problems, quite the contrary, his excrements have been more solid and less smelly during the last few days, although darker.

Indeed, Viamo's numbers seem to be dropping down to the 300-399 range. We think we are starting to notice him being less thirsty than before. He used to lay next to the water bowl and keep on drinking for very long. He has definitely gained a bit of weight, too.

All this seems very encouraging, but there are some bad news. His walking has not improved, and after observing him today I might even fear that the neuropathy has kept on developing and he is still losing motor skills. His back legs seem more out of control than normal. Anyway, I guess it is too soon to judge if the food change will have an effect on that. I've heard that remission processes usually take months (if there is any remission in this case to begin with!).

You are correct on the time of our vacation, we will be off to our trip in one week. Unfortunately, the person who will be taking care of our cats will not be able to make glucose measurements. That is exactly our problem: Viamo will get insulin without having his BG level inspected, for twelve days. This means we should agree on a stable insulin dose, so that he doesn't run risks while we are not here to watch over him. Bear in mind that, even though his caretaker is informed about the possibility of hypoglycemia, Viamo will be spending more time alone, unwatched, so we should be extra cautious with this. We have a week left to keep observing his reaction to the new food and the evolution of his BG levels, but I wanted to ask you if we could start discussing possible scenarios. Specifically, what should be done with the insulin dose if his BG values do not change much this week? Could you help us with this decision? Any other suggestions are also appreciated, since it is a delicate situation.

Anyway, we'll keep the SS updated for as long as we are here. Oh, and if you think another curve would be insightful before leaving, just tell me and I'll manage it. (It was kinda terrible but kinda fun last time ).

PD: Thank you so much for the ongoing support .

 

[Deb & Wink]

I had made some comments further back in the post, but I copied them here, and changed them quite a bit adding more detail, now that I know your pet sitter will not be able to test the blood glucose levels.

There are 3 concerns to think about with Viamo while you are away 1. Is he eating enough? 2. Viamo not being as closely monitored so maybe lowering the dose temporarily 3. What plans you have made in case of emergency?

The first thing to think about while you are away is making sure Viamo eats his food, and eats enough. Make sure you have plenty of the canned food in your home. Sometimes, when we leave our cats in someone else's care, they don't eat as well. If this happens with Viamo these are some ideas I have.

1. Viamo has to eat before the insulin shot. So I suggest your cat sitter feed Viamo first, give the insulin shot, and then take care of litter boxes and any other tasks you want them to do. Then check again on Viamo before they leave and put out some more food.
2. If he won't eat the new canned food, try the homemade food you mom made. While it's not nutritionally complete without all the added supplements, it would be ok for a week while you are on vacation.
3. If he won't eat either the canned food or the homemade food, feed him the dry food. Yes, this may be a setback, and increase the BG (blood glucose ) levels but you can switch back to the canned food when you return from vacation.

Second thing to think about when you go on vacation, is what insulin dose to have your pet sitter give to Viamo. Some things to think about are:

1. Have they given insulin injections before? If they are not very experienced, and don't think they have given the shot correctly, NEVER have them give more insulin during the same cycle. You never know how much insulin actually got into your cat and you do not want a possible overdose. "Better too high for a day, then too low for a moment".

2.Does Viamo like this person and will he let someone else give the injection? Hopefully, you have already had this person at your home and have walked them through how to do things and they have tried to give the injection.

3.Do you want to lower the dose temporarily while you are away? Some people decrease the insulin dose down if someone else is taking care of their cat. Depending on how low the food change drops Viamo before you leave, I think that while you are away on vacation you should drop the dose to 3 Units and maybe even 2 Units would be safer. Don't know yet. I'd like to see a few more days on the lower carb food before making a recommendation.

4. Your cat sitter will not be testing the blood glucose, so reducing the dose temporarily would be a good idea. A very, very good idea.

5. We have hypo instructions and How to treat HYPOS - THEY CAN KILL! Print this Out!!. Could you translate them into Spanish? Then print them out and put them somewhere your cat sitter can see them. (making an assumption that Spanish is your primary language and also for your cat sitter). This document explains some of the hypo symptoms to look for and is a good reference.

6. Try to keep the insulin shots as close to 12 hours apart as possible. If for some reason, shot times can't be done within half an hour of normal time, better to skip the insulin for that 12 hour cycle, and give the shot at the normal AM or PM time.

Third thing to think about when you go on vacation is what plans you have made in case of emergency.

1. If Viamo looks unwell, your cat sitter may need to take your cat to your regular vet or to the emergency vet. Leave a letter saying you authorize this person to seek medical attention for Viamo. How much and what kind of care you are willing to do may be something to detail in the letter.

(For example, I cat sit for a friend and have for a long time. She trusts me enough with both her cats care to make all medical decisions for her 2 cats. Including euthanasia if needed. With the stipulation that her cat would not be left alone. I am willing to do that, but would fight very hard for other options. But if that is the best decision for her cat, and I know my friend very, very well, I would hold her cat in my arms as they pass out of this world. And cry my eyes out at the loss of a beloved cat friend.
Worst case scenario, but it could happen.)

2. Leave a contact number for your pet sitter in case of emergency. If you are not available by phone or text or email, maybe there is another family member that can help out.

3. If your pet sitter needs help, they could log on here and ask questions.

You can't eliminate all risks in life. You have to do the best you can and I hope some of these suggestions help you manage some of the possible risks.

Tagging @Veronica & Babu-chiri to see if she has any other suggestions.

 

[Teo]

Good!

Regarding food: Viamo will eat anytime the sitter gives him food. He is still pretty hungry most of the time. The problem is not on the side of Viamo, but on the side of the sitter, who will not be able to spend so much time at home between the injections. It is a very good idea for him to give Viamo food more than once every time he is at home.
It won't be necessary to give him other types of food as you suggested, because he loves his new food and still has got a very good appetite. But it can be done if it were necessary.

We'll make sure the sitter never gives more injections between cycles. This person is not experienced with injections but he is with cats in general, so he is sensitive to conduct changes and understands them well. He shouldn't have problems giving injections, because we intend to be very clear and careful explaining everything to him. He also knows the cats and the house very well, and Viamo has no problem with him being around, so he can be easily treated by him.

I will translate those instructions in case of emergency hypo (into Spanish, correct!).

We will also leave him instructions for finding veterinary help in case of an emergency. Our vet will also be informed. The example you gave was pretty extreme, but illustrates the point well: he certainly is a person of extreme trust to us and would be entitled to make decisions in our absence. Anyway, in case of an emergency he might also call us right away, because my mother will not be out of the country.

The only thing left to do apart from organizing all this is to keep on checking Viamo's BG to make the final decision about his insulin dose.

 

[Deb & Wink]

You are fantastic! You have a good handle on what your plans are for when you are away.

Another curve before you leave please, at least a couple of days before you leave on your flight. So if you are leaving on Saturday, I would say another BG (blood Glucose) curve on Wednesday or Thursday. For that final decision on the insulin dose.

You still have to pack for your trip. It's been very rainy where you are headed.

 

[Veronica & Babu-chiri]

I think you have pretty much covered what you need to prepare for your trip, but I would still consider a second food option just in case he starts getting picky, this guys tend to be a bit temperamental specially when they are with other people

Regarding his nephropathy for it to improve you'll need his numbers to be a bit lower for a longer period but you can help him by giving him zovaline but since it probably is going to be very difficult to get in Argentina, you could give him B12 in the methylcolbalamine form ( this is important since most vets use cyanocolbalamin and that is good as a supplement but not for nephropathy) that you can either find on line or in stores where they have vegetarian food or as they call "tiendas naturistas" just make sure there is no sugar or flavor added to it and folic acid ( this are actually the two components of zobaline)

 

[Deb & Wink]

Or maybe pick up some Zobaline or Vitacost and Folic acid or methyl-B12 when you are in Canada on vacation. Not sure if you will be able to find these in Canada in where.

 

[Deb & Wink]

Hi Teo,

I know you will be doing a curve later this week before your vacation.

In the meantime, a test around mid-day in both the AM and PM cycles are important. With the food change, it's difficult to see how the BG's (blood glucose) numbers are being affected. Lantus doses are adjusted based on the nadir (lowest blood glucose) reading in the middle of the cycle. So testing around +3 to +7 helps us to see what is going on.

With that lower pre-shot yellow number of 276 on the SS (spreadsheet) on Sunday 1/12/20, it's very likely that Viamo was low overnight. So more testing if you can please. Thank you.

That pre-shot number was tested twice, and was very likely accurate. Food change is making a difference. Cats on lantus insulin will often show what we call a 'food spike' at around +1 or
+2.

I wish I had seen your SS with those notes earlier yesterday. Did not see them until this morning. I would have suggested you test again around +4 to +6 to see where the blood glucose numbers were. Not a full curve(testing every 2 hours), but a couple of tests in the middle of the cycle.

You did the correct thing, testing twice to make sure the BG of 276 was correct. Especially since that is the lowest number you have ever gotten with Viamo.

Having that bit more of test information will help us to make a decision on the dose for your pet sitter to give while you are away on vacation.

p.s. A nice way to let us know you have read our replies to you is to click on the Like button.

 

[Teo]

Great, Deb. I'll do those mid-cycle tests before making the complete curve.

What you said really made me think about yesterday's values. I read your reply just after testing Viamo this morning and today's BG was just as low (even lower) than yesterday. Yellow range. Then I realized that what you're saying must be true: he is probably having his nadir at night. I was concerned yesterday because the other tests during the day gave the same high results as always, so I didn't think the AMPS was really a sign until the result was replicated today. Oh, and today's test seemed like a good measurement. So I did not test him again, because it seemed a logical value taking this precedent in consideration.

So, should I test a +3 and +7 today? What about at night? Maybe I can do a night curve today. If not, tomorrow will be.

 

[Teo]

Edit: thread title.

 

[Deb & Wink]

Great, Deb. I'll do those mid-cycle tests before making the complete curve.So, should I test a +3 and +7 today?

Definitely a test at +3, and again at +6. I'll keep my eye on Viamo's spreadsheet, I have it open in a separate tab right now, refreshing to see if you have entered the test data. So keep the spreadsheet as up to date as possible please. If I see something in the +3 number to thing a test at either +5 or +7 might be better than a +6 test, I'll let you know.

What you said really made me think about yesterday's values. I read your reply just after testing Viamo this morning and today's BG was just as low (even lower) than yesterday. Yellow range. Then I realized that what you're saying must be true: he is probably having his nadir at night. I was concerned yesterday because the other tests during the day gave the same high results as always, so I didn't think the AMPS was really a sign until the result was replicated today. Oh, and today's test seemed like a good measurement. So I did not test him again, because it seemed a logical value taking this precedent in consideration.

Good, I'm glad that helped you to know a second test Pre-shot would not be needed. Any time you get a test that seems so much different than you usually get, it's a good idea to test again to make sure.

What about at night? Maybe I can do a night curve today. If not, tomorrow will be.

I'd love to see a night curve with Viamo! Especially since he has dropped into those yellow numbers the last 2 mornings. A curve would be testing every 2 hours. So pre-shot, +2, +4, +6, +8, +10, +12 (which is the same as pre-shot test for the beginning of the next 12 hour cycle). We hate asking people to stay up at night and test every 2 hours, but sometimes that information is so important. If you are willing to test tonight and get those curve tests I'd appreciate it.

Cats on lantus insulin have a low period or nadir with each 12 hour dosing and testing cycle and that time varies from cat to cat and cycle to cycle. So one nadir in the PM cycle and one nadir in the AM cycle. That time is usually somewhere between the +3 to +7 hour timeframe. That low could be +3 or +4 or+5 or +6 or +7. Each cat is different and unique. So you test more to find out when your cat has their lowest point. Cats often drop even lower at night because a cat is often more active at night.

Is Viamo still eating well?

 

[Teo]

We just did the +3 test. Surprising result, still on the yellow domain. Will try to do frequent testing today. Edit: the +5 also went very well! I know you can see it on my SS and I don't need to say it here, but I wanted to comment it because I think this are great news so far.

Viamo is still eating well, with the magnitude of his appetite varying from time to time. He's usually having his principal meals at +0, +3, +8 AM and at +0 PM.

 

[Deb & Wink]

Both the +5 and +7 are good for this AM test cycle.

Yes, I've been checking in on Viamo's SS today.

Would you try something for me? Using a new lancet, test yourself. Prick the edge of your finger. I use the little finger. Yes, it hurts because people have a lot of nerve endings in their fingers. Cats don't have many nerve endings in their ears, so it does not hurt them like it does to test ourselves. I'm asking because this is a way of testing your meter and test strips to see that they are good.

If you have anything such as a triple antibiotic ointment with pain relief, put a little bit of that on your finger after the test and it makes the pain less, topical anesthetic.

You'll want to use a new lancet when you next test Viamo. A different one than you used on yourself.