Chuck @ 140 now

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Chuck and Susan

Chuck and Susan

Member Since 2010
I just tested Chuck (poor lil ears aren't used to so much poking!! Time to get out the Neosporin) and he's at 140. I'm much happier with this number, although his "normal" is upper 80's/low 90's (because I leave food out all day and he grazes). I'm planning to test at least once more today and then twice tomorrow and Saturday, if his numbers continue to look good.

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I took all food away from the cats last night and tested Chuck this morning around 4:45. He gave me a 202, which still isn't great, but much better than the 302 from last night. WC: He's eating better and is more sociable, not hiding under the bed. We had rain last night and it's cooler this morning, so the windows are open and he's enjoying the fresh air.

Not sure if I'll take him to the vet or not. Not sure I want to take him to a vet that says it's OK to throw him out of a 3 year remission in order to bring his BUN down... His BG is coming down, and even though he didn't have more than a cup of the dry food over 2 days, I'm sure it will take more time to get back to normal. I haven't tested for ketones because I haven't caught him in "the act," but will keep watching and maybe I will catch him.

Thanks again, LL, for holding my hand last night...

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This isn't an emergency by any means, but I'm ready to kick myself!! Chuck's vet wants to switch him to a senior diet because his BUN came back high. He recommended Purina Pro Plan Senior 11+, but only has it in dry. I expressed my concern about dry food, and the vet thought that since Chuck has been insulin-free for 3 years, this would be fine.

He's not been switched over entirely, I've been giving him a little at a time, whenever he wants it. Today he seems "mopey", so I checked his BG. It's 268 right now. It's not been that high since 2009, when he was diagnosed with an infection.

I've picked up the Fancy Feast so no one eats and I'll test him again in a couple of hours. PLEASE tell me I haven't thrown him back into active diabetes!!
 
Re: Have I just thrown Chuck back into active diabetes???

Susan: I don't know if you've thrown him back into diabetes but cats should not have dry food whether they are diabetic or not and certainly a cat with an increased BUN should not have dry food. BUN is typically an indication of dehydration and why give a dehydrated cat a DRY food? I cannot figure out why vets do not "get it" about diet. Just because Chuck's BUN is up does not mean he needs a senior diet. Remember that any bloodwork is just a snapshot in time. BUN can be elevated because the cat may be a little dehydrated THAT DAY or because of a high protein diet. Or because there are some initial renal things going on as the cat ages. I do not subscribe to "age specific" diets and I've really looked alot into feline nutrition. Chuck needs a good quality protein, low carb, low phosphorus diet; even if his kidneys are fine, if he's aging, a low phosphorus diet will not hurt him (you mainly do not want young, bone-forming cats to have a low phosphorus diet). Here is a GREAT website with foods for renal cats BUT you must check the foods lower in phosphorus against Janet and Binky's charts so you give him a low carb diet as well. Perhaps just eliminating the dry will bring his BG back down:

Renal Canned Food Charts

I have two elder civvies, both with elevated creat and BUN so they both are starting renal issues. I feed them very high quality foods as low in phosphorus as I can. They aren't diabetics so I don't have to worry about super low carb but I also don't feed them any of the prescription diets for kidney cats as I believe they, like DM, are junk. Plus Teddi is allergic to the pork in those diets. :-D So maybe try first to get Chuck onto a high quality protein canned food with low carbs and as low as phosphorus as you can that is decent protein quality; monitor his BG and see if it comes back down. And ditch the dry food :-D :-D Please keep us posted. Paws crossed that this was a blip caused by the dry food and he is not coming back from the falls.
 
Re: Have I just thrown Chuck back into active diabetes???

oh boy! keep testing him susan. i did a quick check on the food lists, but i'm not seeing purina pro plan senior. the other pro plan diets range from 27 - 41% calories from carbs. if the pro plan senior is running in that range, it could certainly throw chuck out of remission.

if it were me, i wouldn't feed it to him and i'd be discussing other options with my vet. continue testing. if you take away the food he might come back down.
 
Re: Have I just thrown Chuck back into active diabetes???

ps --- click on the link to alex's ss. then click on the low carb/low phosph foods tab at the top of the page. i feed some of these to alex because of renal issues.
 
Re: Have I just thrown Chuck back into active diabetes???

I just spoke with the vet who said one high number isn't necessarily a cause for alarm and to test him tomorrow before feeding. Well, I'm testing him TONIGHT in just a couple of hours. He also said he'd rather control Chuck's diabetes with insulin and bring his BUN down with the senior diet, than control his diabetes with diet and not control his BUN.

The dry food is in the pantry and will not be given to Chuck again (or the other cats, who seemed to love it).

I'm going back to Janet and Binky's chart to look for the low carb, low phos., high protein again. He's been on Fancy Feast the last 3 years and done extremely well.

I also talked briefly about whether they would do Lantus and was told they prefer Humulin. I'm comfortable with Lantus, and if it comes to that, I'm pushing for it.

I'm just sick! We're going to the Virgin Islands early next month and I know my cat sitter wouldn't be comfortable giving insulin shots. That means I'd have to kennel him at the vet, and may have to fight for the Fancy Feast and Lantus!! Kicking myself over and over again, because I hesitated about the dry food, and should have gone with my gut!!
 
Re: Have I just thrown Chuck back into active diabetes???

i don't know about the food issues, but just wanted to suggest a pet sitter instead of kenneling. i had a vet tech from the vet's office come this past weekend while we were gone - she charged me $15 per visit and she tested, shot, fed, scooped the litter box for both cats and brought in mail & newspaper.

The way i found her was to call the vet's and just ask if any of the techs would be willing to come and give him insulin when we were gone one night.

you should be able to get what you want with this vet. he can suggest, but Chuck is your cat.
 
Re: Have I just thrown Chuck back into active diabetes???

Susan: not trying to bash your vet but Humulin??? Yikes. I also am not thinking that diet is going to necessarily bring his BUN down...esp a dry diet. How about more water? That usually helps a dehydrated kitty. I put extra water in my elders canned food...but they both also get squids and we've kept their BUN under control with those.
As far as restarting the insulin, I'd listen to Jill first....she had great comments.
 
Re: Have I just thrown Chuck back into active diabetes???

i mix my cat's fancy feast with nearly equal amounts of water - they both eat it just find. nom nom nom gravy!
 
Re: Have I just thrown Chuck back into active diabetes???

Looks like you have already been given good advice,
I would stop with the dry & find a wet/raw alternative & suspect the #s might come on down on their own.
Remember, once a diabetic always a diabetic, some are just dependent upon insulin while others are in remission.
 
Re: Have I just thrown Chuck back into active diabetes???

One other quick thing, Susan. Remember that it takes a while for the BG to come back down after eating dry food. The dry food will elevate the BG and keep it high for several hours so if you fed it to him this morning, don't be surprised if his BG is still high tonight. Like Jill said, just keep checking him but realize it may take a while for his numbers to come back down after eating dry food.
 
Re: Have I just thrown Chuck back into active diabetes???

Chuck and Susan said:
I just spoke with the vet who said one high number isn't necessarily a cause for alarm and to test him tomorrow before feeding. Well, I'm testing him TONIGHT in just a couple of hours. He also said he'd rather control Chuck's diabetes with insulin and bring his BUN down with the senior diet, than control his diabetes with diet and not control his BUN.

The dry food is in the pantry and will not be given to Chuck again (or the other cats, who seemed to love it).

I'm going back to Janet and Binky's chart to look for the low carb, low phos., high protein again. He's been on Fancy Feast the last 3 years and done extremely well.

I also talked briefly about whether they would do Lantus and was told they prefer Humulin. I'm comfortable with Lantus, and if it comes to that, I'm pushing for it.

I'm just sick! We're going to the Virgin Islands early next month and I know my cat sitter wouldn't be comfortable giving insulin shots. That means I'd have to kennel him at the vet, and may have to fight for the Fancy Feast and Lantus!! Kicking myself over and over again, because I hesitated about the dry food, and should have gone with my gut!!
Click to expand...

Fortunately, there are a number of foods that are both low in phosphorus and carbs. I have a diabetic(OTJ) and a CRF cat and I've combed through the lists to find a food that I could use for both of them. Even some of the low carb, medium phosphorus foods would work if you add a phosphorus binder. Since only his BUN is elevated, even that may not be necessary. FYI, from what I've read, Fancy Feast classic is high in phosphorus, like 2%. To give you an idea, the prescription diets are in the .5% range.

Good luck, and I hope Chuck's high number comes down. In any case, you'll have no trouble finding an appropriate food.

Jason
 
Re: Have I just thrown Chuck back into active diabetes???

How high do I let him get? I just tested him and his meter read 302 Ketones. I gave him his regular Fancy Feast, mixed some water with it and he ate well (first time today that I know he's really eaten much). I tested him within minutes of eating, so I know the BG isn't a food spike that soon. I'll wait a couple of hours and test him again, but I'm really concerned about the BG and ketones.
 
Re: Have I just thrown Chuck back into active diabetes???

why don't you change your subject line on the first post to ask about ketones? i don't know much except that if it's more than a trace you need vet care quickly. was it just a trace or more?
 
Re: Have I just thrown Chuck back into active diabetes???

and i can only speak for myself, but if he were mine, i'd ask the vet for the lantus prescription now and go get him started. then if the food change helps resolve you can always go off again, but in the meantime it wouldn't hurt him to get insulin with numbers like that.
 
Re: Have I just thrown Chuck back into active diabetes???

is your meter one of those which flash "ketones" above a certain number? some of them do that. it means the person is at greater risk of developing ketones in this range. however, we know from experience kitties do not have to be in high numbers for ketones to develop. in any case, get some ketostix and start checking his urine for ketones.

as far as getting him to eat, here's some suggestions from cheryl/winnie:

Remember -- getting to the bottom of why he is not eating is most important. That way you can treat the underlying cause ( or symptoms of underlying cause) . It is always very important to get cats to eat, as they can quickly develop hepatic lipidosis from lack of food.

Here are some things you can do do entice your cat to eat:

-sometimes in order to get a cat to eat you even have to resort to dry it is more important that they eat. there are a couple low carb / grain free brands -- EVO and wellness core.

-making a buffet to give him choices
- heating food

sprinkle food with :
- forta flora -- a probiotic you can get at vets or online. is very smelly and cats love the taste of it.
- parm. cheese
- smashed crumbles of dry food
- bonito tuna flakes
- halo chicken treats -- crumble into dust over food -- my Wolfie loves this stuff.
- poor a little water from tuna in water over food ( I use low sodium/no sodium added as other kinds in water has veg. broth in it and I assume that means onions, which are toxic to cats-- check labels)
-powdered oregano. yep sounds weird . but some cats like it and it will entice them to eat.

other ideas of foods to offer your kitty to stim appy:
- trader joe tuna for cats
-baby food -- beechnut turkey and broth or chicken and broth. they have no onions or other additives. some babyfoods have onions . please read labels if you can't find beechnut.
- kentucky fried chicken
- deli turkey /chicken
- plain cooked ( boiled or baked ) chicken breast
-canned chicken for people (watch the label that their are no onions)
- chicken broth -- low sodium

If enticements don't work, you should consider:
-assist feeding ( syringe or make little meatballs and place in mouth)
-and/or talking to your vet about appetite stimulents ( mirtazapine or cyproheptidine)

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=26965#p273790
 
Re: BG 302 & ketones on meter

if he's throwing ketones in his urine i would call your vet and ask about starting him on insulin asap.
 
Coming down... was BG 302 & ketones on meter

Just tested and he's "down" to 299. I let him eat after I tested. I have ketostix, but he hasn't been to the litter box yet - is there a way to make him go? The pharmacies around here all close at 5 p.m. except for Wal-Mart which closes at 8 p.m. I talked with them; they have Lantus but require a prescription for it.

All in all, he seems to be doing OK. He's grooming himself, and while he's not overly social, he has been laying on my desk and purring. He had been hiding under the bed most of the day; he's in my walk-in closet now and I can see him if I go to the door, so he's not hiding.

I'll probably test at least one more time tonight and first thing tomorrow morning. If he's not down to "normal," I'll call the vet and see about getting a script for Lantus (even though they like Humulin). Since they aren't familiar with Lantus, and Chuck did have a hypo and seems to be a little insulin sensitive, what would the suggestion be for a starting dose, assuming he's still in the upper 200's/low 300's? 1/2 unit? 1/4 unit? I still have syringes but of course no Lantus...
 
Re: BG 302 & ketones on meter

What's Chuck's "ideal" weight? A starting dose of Lantus can be based on ideal weight:
initial dose = 0.25 x ideal weight in kilograms​

In the words of my vet, Humulin is a good insulin for dogs. It's not a good insulin for cats. This is an article from a vet journal that has the dosing protocol we use. It may carry more weight with your vet if you provide him with information from a source he respects.


The only way to encourage a cat to use the litter box is to get the cat to drink! You could add water to the canned food.
 

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Re: BG 302 & ketones on meter

Siene:

Thank you for the article. If I need to take Chuck to the vet, I'll be sure to take the article with me. I've been mixing water with his FF today and will continue to do so. All 3 of the cats kinda gave me the "huh???" look, but they all eat the FF with water. Guess I'll just have to follow him around for a while...
 
Re: BG 302 & ketones on meter

how old are your ketostix? i believe they expire about 6 months after opening. it should say on the package insert. if they've expired, you'll want to pick up some new ones.

as far as a starting dose of lantus (if started)...

there's no way my friend sienne would know chuck's history. chuck had a hypo event complete with seizures when he dropped so low the number did not register on the vet's meter. this was on 1u bid back in 2008. while what happened then may have absolutely no bearing on what happens today, i think it might be a good idea to start with a conservative dose since chuck was so sensitive to lantus last time. you can always fast track up the dosing scale if it becomes clear that he's grossly under dose. between chuck's history and removing the dry and switching back to low carb wet food... i think i'd be more comfortable with a very small starting dose. something like 0.25 unit bid.

what do you think?
 
Re: BG 302 & ketones on meter

Jill:

The ketostix are brand new, I just got them tonight. If it's necessary for him to go back on insulin, I do want to be conservative, but would probably have to make a suggestion to the vet since they do Humulin. I would be VERY uncomfortable with 1 unit BID given his history, that's why I thought 1/2 unit or 1/4 unit would be best. Of course, I can do what I think is best regardless of what the vet says, right? Speak of the devil, he's hanging out on my desk again, checking out the window at the rain. I'll probably have to shut down the computer because we're getting power fluctuations and my UPS is beeping madly at times.

I'll post tomorrow if I can't get back tonight with a BG update.

Thanks, again, to the Lantus Land folks for words of encouragement and hand holding!!
 
Re: BG 302 & ketones on meter

sorry about the power fluctuations.
ok. you're good on the ketostix. :-D

once you get the vet to write a prescription, you can start at whatever dose you want.
 
I just tested Chuck (poor lil ears aren't used to so much poking!! Time to get out the Neosporin) and he's at 140. I'm much happier with this number, although his "normal" is upper 80's/low 90's (because I leave food out all day and he grazes). I'm planning to test at least once more today and then twice tomorrow and Saturday, if his numbers continue to look good.

(I don't know how to bump the messages on this board, so I replied to my original posting, hoping that will bring it up closer to the top..)
 
Hi Susan, anytime you or anyone else posts a reply to your thread, it bumps it up to the top....so replying was good!

Glad to see Chucks' numbers are coming down...hopefully the trend will continue as the dry food gets out of his system. I bet you were happy to see the 140 on the meter instead of 300s! Everyone has given you good input, I don't really have much to add except that I'm keeping my fingers crossed that you won't need to restart insulin.

You could replace the litter with aquarium gravel to get the ketone test if you can't catch him in the act.
 
Vet is OK with stopping the Pro Plan (doesn't make any difference, I'd stop it anyway). We talked about adding Epakitin -- does anyone have any experience with that?

Thanks again, everyone!! Chuck sends kitty smooches to all of you!
 
So glad to see Chuck's BG down!!!

One of the best websites on CRF is Tanya's. Here is a link with info on Epakitin:

Epakitin

While two of my cats have elevated BUN, I don't use this; I do use aluminum hydroxide as a phosphorus binder but it seems your vet wants to use epakitin for the absorbent effects to bring down BUN. I'm not sure why your vet is so focused on this BUN. How high is it and how are all his other renal numbers like creat, phosphorus, calcium, potassium, HCT? Did he get a urine sample and if so, what is his urine specific gravity? If the only thing elevated is BUN and it isn't too much, I'd just leave it alone, give him some extra water in his food, and recheck it in a month. Keep in mind that BUN is not like creatinine...small increases in creat can be worrisome and should be paid attention to but BUN can have small increases and it isn't anything to get too excited about.
 
hi susan! just popped in for a minute and saw your condo. happy to hear chuck's bg numbers are coming down!

libby, sienne, and i were talking about chuck last night. sienne was pretty sure she remembered that higher protein causes more binding to water which in turn elevates BUN. libby did a little digging and found this page (among others) saying that a high protein diet can cause elevated BUN (at bottom of page): http://www.labtestsonline.org/understanding/analytes/bun/test.html. a high protein - low carb diet may be at play here. something you might want to talk over with your vet. it may not be anything to worry about at all!

also, marjorie brought up some excellent points in her post above....
 
Roller Coaster Ride (was Chuck @ 140 now)

Now we're on a roller coaster, I think. Here are Chuck's numbers from the last two days...
268 3:30 PM
302 4:45 PM
299 6:15 PM
202 4:45 AM
140 10:40 AM
211 2:15 PM

I don't know why he's bumping up this afternoon. He hadn't eaten for a few hours, so don't think it's a food spike. I was hoping to stop torturing his poor lil ears, but looks like there's more torture ahead.

I haven't picked up the Epakitin from the vet yet. His BUN was 38 and his creatinine was high normal. According to the last full records I have, done in June 2008 (just after he came off insulin), his BUN was 40 (so it's actually come down), his creatinine was 2.2, phos was 4.5, urine pH was 6.0, and his T4 was less than 2.0. I'm not sure he needs a phosphorus binder. I'm going through Janet and Binky's charts, looking for low phosphorus/protein/carb foods, but am not sure what's considered low phosphorus... under 300? Under 350?

I currently give him only FF Tender Beef and Chicken Feast Classic, Turkey and Giblets Feast Classic, Tender Beef Feast Classic, and Tender Liver and Chicken Feast Classic. His only treats are Liv-A-Little Chicken a couple of times a week, a little more often now, because I'm using that a reward for ear pokes... I'm also mixing water in his food, and still free feeding, with fresh food twice a day.

And, this thread really doesn't belong in Lantus Land, does it? Where should we go?

Thanks!!!
 
Chuck @ 266 now

Is it possible he has an infection going on? He was at the vet's for a checkup and shots on the 4th of this month (rabies, RCCP, leukemia); based on the results of the Antech Feline Adult Wellness blood tests, I started him on Purina Pro Plan Senior 11+ (Monday, the 9th) and he seems to have started this BG spiking yesterday, the 11th. I took him off the Pro Plan and he's getting only the FF now.

I had hoped the 140 this morning was a good indicator of continuing to drop, but he's only gone up since then (211 at 2:15 and 266 at 4:45 Central). It's warm outside, the low 80's and I have the windows open. He's sitting in one of them now, checking out what's going on, so I don't think he feels all that terrible. He ate after I tested him just now, too.

Any ideas???
 
this thread totally belongs in Lantus Land. This is your home, now and forever. :smile:

I'm not sure how you're feeding, but I wonder if you give smaller meals throughout the day if that might help keep his numbers down. It's similar to the idea we use when a cat is starting an OTJ trial and their pancreas needs to be coddled a bit so it can get strong. Try feeding a little bit now and testing in a few hours to see if the food took him up or down.

Is there anything going on that would make you think he has an infection? When was his last dental? How about a pancreatitis flare, has Chuck ever had those? I can't remember...
 
Susan: we've been out and I have a couple things to do really quick but I'll send you a post regarding the renal info. BUT...insofar as BUN goes, 38 and 40 are basically the same number...did you have a different vet Jun 2008? If not, then your current vet is probably more concerned about the BUN now because the creat is up.
 
Libby and Lucy, no real reason why I'm thinking infection, just that these number are not normal for him. He's never had pancreatits; his ketones checked negative just a few minutes ago.

Marjorie and Gracie, this is a different vet. The 40 BUN was in Iowa in 2008, the 38 BUN is here in Texas, just last week. I don't have creat numbers from the current vet, just that it's high normal. The chart the Iowa vet gave me after his tests in 2008 looks like the creat is high normal.

He pretty much free feeds all day, I just make sure there's food for him because the "baby" will eat it all if given the chance. He's eating right now, but, unfortunately, when I tested him a few minutes ago, he was up from 266 at 4:45 to 270 (about 3 hours later).

So, other than mamma bean continuallly kicking her sitting down parts, what's next? I'm guessing I'll test him first thing tomorrow and see what's up, then call the vet. If he's not coming down 2 days after stopping the dry, he's probably back to needing insulin, right? (off to the corner to cry now)
 
Susan: it depends on what the reference range is for creat and BUN by the lab being used. It could be different in TX than in Iowa if different labs are used. For instance, for Antech,for creat 2.2 is a decent number; 2.4 would be high normal. I think it would be interesting to see what his numbers were like even before 2008...do you have those or can you get them? Some cats, like people, as they age might go up a bit but if it stays stable, then it isn't something to get too worried about. I always get all my cats' bloodwork results from the vets and keep them on a spreadsheet; especially my renal kitties. The other thing is that often the reference range for normal for phosphorus goes up to 7; however, that is taking into account kitten levels which are high. Normally, one would start thinking about using a phosphorus binder if the phosphorus hits 6 mg/dl or above or if the phosphorus level x the calcium level is over 70. Long story short, without knowing what the "normal" reference range is for the lab used in Iowa, it's difficult to know if his levels were at the high normal or not or where they are now. Also, with the T4, just having the tT4 won't tell you if the cat is hyperthyroid...you would have to also see the fT4 and they would both need to be above a certain level to diagnose hyperT. A tT4 of 2.0 is typically within a normal range, but again, depends on the reference range of the lab.

In terms of food, again, I'd recommend you look at the link I sent you for the renal foods with %phosphorus shown. That is more accurate than looking at mgs. You want to strive for a food that is less than or as close to 1% as possible. I have not had a lot of luck getting my renal cats to eat alot of those foods and so I use a binder but that's also because their phosphorus levels were creeping up a bit; now they are both running at about 4 mg/dl.

There is also a CRF group in yahoogroups. It is quite, quite good and several people in LL have, over the years, also been in that group if they had renal kitties.
 
not sure if this helps, but Binks' meter flashes a "ketones" msg over 260 so the manufacturer is covered legally with humans by suggesting they check for ketones.

also, when Binks makes a kibble raid...if he gets a good bellyfull it takes him 30 hours or so to get back down to normal numbers...
 
Chuck update

Well, I committed a cardinal sugar baby sin -- other than never feeding dry food -- I forgot to look at the WHOLE CAT. I looked at his numbers, didn't like seeing the 256 at 4:30 this morning, and took him to the vet.

WC: Eating and drinking normally, litter box normal, sociable, hanging out in the open window.

Vet: No phosphorus binder (tested today @ 3.7 mg/dL); continue feeding routine and check a couple times a day. He thinks he's still coming down off the dry food high. Chuck's BG at the vet today was 242 mg.dL, which is lower than I tested him at this morning, and doesn't factor in "vet stress"; BUN/UREA was 26 mg/dL, creat was 1.8 mg/dL -- these are all Vetscan results. His other results were from Antech Diagnostics (BUN/UREA was 38 mg/dL; GLU was 163 mg/dL; creat was 1.7 mg/dL). The only high readings he had today (Vetscan) was amyl @1558 u/l and glucose. None of his Antech readings were high; a couple were high normal (bun/urea and glucose).

So, I'm guessing he's just going to take a bit longer to come down off the dry food high. I'll call the vet with a report next week, unless he spikes some really high numbers, but the vet doesn't think that will happen. I went it at 8:30 this morning and didn't leave until almost 10, and the vet was in talking with me the whole time -- with a blood draw and talking with him for that long, it was less than $100, too.

So, once again, thank you LLanders, for holding my hand and putting up with my silly mistakes (I should know better and have posted a WHOLE CAT reminder on my computer monitor and the refrigerator)!
 
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