Chapman - new member 6/8/22 - acromegaly & diabetes

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Chapman

Chapman

Member Since 2022
Hello, Chapman is 13 years old and developed acromegaly with the corresponding diabetes. First signs were eliminating outside the litter box. A trip to the vet showed elevated Blood Glucose (BG) and all other signs ( as tested in the senior blood work) were normal. Chapman was not overweight and had maintained the same weight for many years. His BG was elevated but we were not sure if it was stress from being at the vet or another issue. After changing his diet a couple of times over the course of a couple of months, his BG shot up to the 500's. At this point we started insulin. This was in November of 2021. We went to the vet 3 times a week to get his BG tested and adjust, if necessary, his insulin. Unfortunately, his need for insulin was increasing every time we went to the vet. I had started home testing and keeping a log of Chapmans BG. I was changing his insulin based on his BG levels but also trying to be consistent and not change it too much. I would rather it be a little high than too low. By January, we were up to 17 units of insulin twice daily and still had high BG. My vet had mentioned but kind of dismissed acromegaly. I did some research on my own and decided to take Chapman to a vet that specialized in cats to get an opinion. They sent blood off to the lab and it came back with a diagnosis of acromegaly. At this point, I went back to my veterinarian to take next steps. We are now into February 2022. We needed to get an MRI/Cat Scan (no pun intended ;0) ) to confirm the diagnosis. These are super expensive in my town. I was working with two Universities to get Chapman in for radiation on the tumor. In the end, we went to Auburn University. This is a whole story for another time, but we did get Stereotactic Radiation Therapy (SRT) for Chapman. The oncologist veterinarian at Auburn is fantastic! She has been a great help to me in managing Chapman's care after the treatment. Chapman's BG leveled out for a while in the 100's and I was down to 3 to 4 units of insulin twice a day. I was feeding him hills w/d canned food. Unfortunately, you cannot get the w/d canned food right now and his BG has shot up to as high as 550. Mostly it is in the 250 to 350 range but I am up to 5 units of insulin twice daily. I have transitioned him to Hills DM canned food but it does not keep his BG as level as the W/D. The dry W/D does not work - too many carbs. He does not appear to like the Royal Canine Glycobalance. I am trying everything to get his BG stable again, while also watching to make sure his BG doesn't suddenly fall. I am told that there is a chance that he could go into remission because of the SRT that he had. In any case he should stabilize. This has been a stressful ordeal for my family which includes Chapman. This also shows that, just as you would for your own health or a human family member, you must be ready to research and push for a diagnosis. I was frustrated with the whole process and while I understand some of the delays, it does not alleviate my frustration. Now, I am striving to find a food that my cat likes and will help stabilize his BG. Thanks for listening.
 
Welcome. Sometimes after STR BG/insulin needs will fluctuate before getting consistent.
Why are you feeding canned W/D? Most of us here feed a low-carb Friskies or Fancy Feast or other commercial canned food.
I am on my second confirmed acromegaly cat. Looking back now my first diabetic cats likely also had acromegaly from what I know now. I would give him 3-5 units of R insulin and BG would not go down and the vet I had had no suggestions and then he went into DKA.
My first confirmed acromegaly cat got up to about 50 units or so twice daily then, not unexpectedly, he had other health problems.
My current acromegaly cat, Snuffles, is on about 12 units twice daily with daily cabergoline @10mcg/kg and I can maintain his BG below 130.
You can also join the closed FB group on feline acromegaly
https://www.facebook.com/groups/acromegaly?sorting_setting=RECENT_ACTIVITY
 
My girl had SRT (twice, first one failed after 3 years. She did stabilize for quite a bit of those 3 years. I too struggled to get my vet to do the acro testing in the beginning. We've got a few other people here who have more recently gone through SRT as well.

As Larry said, no need for expensive vet food. Any commercially available low carb wet or raw food will do. Any food under 10% carbs is considered low carb. Here is a food list with a number of commercially available options.

What can we help you with?
 
Chapman said:
I was feeding him hills w/d canned food. Unfortunately, you cannot get the w/d canned food
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I found this posted by 2 of our members about the Hills W/D wet

The canned W/D is about 25% carbs as well as having some pretty lousy ingredients, including my personal pet peeve ingredient they laugh

The wet Hill's W/d is still 26% carbs when diabetic cats only need 10% carbs or less.

The W/d food is also meant for weight LOSS, and many diabetic cats have already lost plenty of weight before diagnosis and do not need to lose more.

The Hills w/d carb content is 26.4 % which is very high carb
Here is the website for you to see. Scroll down and click on the ‘average nutrient and caloric content’ to find the number of carbs.
https://www.hillspet.com/cat-food/pd-wd-feline-canned
 
Chapman said:
I have transitioned him to Hills DM canned food
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The Purina Pro Plan DM canned is 6% carbs but it's expensive and not great quality. No need to feed prescription food, take a look at the food list Wendy gave you
Most of us feed Fancy Feast Classic Pate or Friskies .Most of us try to stay with 6% carbs and under
 
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Wendy&Neko said:
My girl had SRT (twice, first one failed after 3 years. She did stabilize for quite a bit of those 3 years. I too struggled to get my vet to do the acro testing in the beginning. We've got a few other people here who have more recently gone through SRT as well.

As Larry said, no need for expensive vet food. Any commercially available low carb wet or raw food will do. Any food under 10% carbs is considered low carb. Here is a food list with a number of commercially available options.

What can we help you with?
Click to expand...
Thank you. I am looking at the list you gave the link to. I wish I had found this site months ago. Thank you for all of your advice. This is my first diabetic cat and unfortunately my vet has not been as helpful as I would have liked. I was following his recommendations for feeding and just decided to do my own research on it. Thanks again.
 
How much do you feed your cats? Chapman is not overweight. In fact he lost about 2 pounds with his illness. His diabetes makes him voraciously hungry! I was feeding him 2 cans of the W/D a day and the Fancy Feast is a much smaller can. Is 2 cans of Fancy Feast a day sufficient for a 12-13 pound cat?
 
Chapman said:
How much do you feed your cats? Chapman is not overweight. In fact he lost about 2 pounds with his illness. His diabetes makes him voraciously hungry! I was feeding him 2 cans of the W/D a day and the Fancy Feast is a much smaller can. Is 2 cans of Fancy Feast a day sufficient for a 12-13 pound cat?
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The rule thumb is about 20 calories per pound of ideal weight.
So if Chapman's ideal weight might be 14 lbs
14x20= 280 calories
Yes the Fancy Feast Classic Pates are about 100 calories each
So I would say you can give him 3 cans of the Fancy Feast Pates
We feed the bigger meals in the morning AMPS ( AM Pre Shot) then smaller meals during the day cycle , maybe about 2 tablespoons
Then the bigger meal at night PMPS (PM Pre Shot) and 2 smaller meals after that
Always add some warm water to his wet food
It would be help if you could fill out your signature, it's at the end of everyone's post in gray
Tap on your name above , the tap in signature
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

We also have a spreadsheet where we track our cats BG to see how the insulin is working and how low they are dropping. The inky time you withhold food is 2 hours before the first test in the morning (AMPS) and the PMPS so its not food influenced
If you need help setting up the spreadsheet just ask , we have a member who will do it for you.
I'll give you the link which will also explain how the spreadsheet works
We also adjust the dose on how low the cats BG drops ( the nadir) not the Pre Shot numbers
Once you do your signature and spreadsheet you can fill in the tests you have been taking so in case you need some advice ,the members can help you
If it wasn't for the advice the members have given me Tyler wouldn't be in remission today ( knock on wood) There are a lot of experienced members here
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Chapman is a cutie :cat:
 
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Chapman said:
How much do you feed your cats? Chapman is not overweight. In fact he lost about 2 pounds with his illness. His diabetes makes him voraciously hungry! I was feeding him 2 cans of the W/D a day and the Fancy Feast is a much smaller can. Is 2 cans of Fancy Feast a day sufficient for a 12-13 pound cat?
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That’s probably not enough food for an acro kitty. I had to feed my acro boy a lot of food. When his numbers were high he was voraciously eating. He was able to gain back some of the weight he had lost. An unregulated cat has a difficult time making use of the food he takes in. If he’s really hungry, I would feed him (except in the two hours before insulin so that you can get an accurate pre-shot BG reading.)
 
Suzanne & Darcy said:
That’s probably not enough food for an acro kitty. I had to feed my acro boy a lot of food. When his numbers were high he was voraciously eating. He was able to gain back some of the weight he had lost. An unregulated cat has a difficult time making use of the food he takes in. If he’s really hungry, I would feed him (except in the two hours before insulin so that you can get an accurate pre-shot BG reading.)
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Thanks @Suzanne & Darcy :cat:
 
My aero Snuffles is maintaining his 17lbs on 150gr canned Frieskies and 10 pieces low-carb dry twice daily. He eats the dry at the end when I give him his shot.
 
If you have a pet or baby scale, I'd use it to track if he's trending in the right direction for weight. What each cat needs can differ based on activity level, age, etc. My acro girl (around 14.5 lbs) needed around 220 calories to maintain her weight once she got regulated. Before then, I fed pretty close to the same amount. The 280 calories Diane quoted above would have been way too much food. The 220 calories I gave was about 125 gm or 4 oz of raw per day, depending on protein. Or a 5 oz can of the higher calorie foods like Wellness. The cat food chart says the w/d is 127 calories per 5.5 oz can. The Fancy Feast Classics range from about 80-95 calories per can.
 
Chapman is not regulated and his BG is still running high but he seems to be maintaining his weight at about 12.5 lbs. His BG was more stabilized in May and he was not as hungry. Still had a good appetite but did not act like a starving maniac. I am going to change to a FF diet and hope the lower carbs will help stabilize his BG again. Just weaning him off of his steroid which may help with his BG. I text his BG in the morning before he gets any food and then again in the PM before dinner. It has been running in the 250 to 370 range with an occasional spike or lower 200 number. When he was more stable he was eating the w/d 2 cans a day so I will try to start with that level of calories (about 254 a day) and go from there. He is currently confined to a single large room for most of the day and at night due to his peeing outside the litterbox habit. Hoping to get him back to the box eventually. He gets to go on our large deck for some outside air and comes in a limited portion of the house for family time with supervision.
 
Why is he on the steroid?

Was he tested for IAA?

It can take quite some time to regulate an acro cat, especially post -SRT. SRT neuters the tumor, so you just have to wait for the natural lifecycle to run its course for some of it to die off, then you usually see a need to decrease the dose. Then it stalls out for awhile, and you often need to increase again. Remember insulin is a hormone, the dose needs can and do fluctuate over time - it does not necessarily depend completely on the tumor. Most of us with acro cats have the best BG stability when keeping them under 120-150, depending on the meter.

It can take.up to 2 yrs to fully see the effects of SRT, with variable results at that point (remission vs not, high vs low dose, etc).

We can definitely help you get him better regulated in the meantime with the BG testing/spreadsheet and being methodical about increases and decreases; numerous acro cats here, quite a few post-SRT.
 
Is it possible for you to get BG tests mid day or at night before bed? We like to see how low the dose is taking the cat, as well as the preshot numbers you are getting now.
 
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