? Diabetes and chronic pancreatitis food?

[Vanessa Vanier]

Hello all!

I have some questions about feeding a diabetic cat that also suffer from chronic pancreatitis!
Here is some (lengthy, I'm sorry) informations about his situation:

Basically, my 10 years old kitty had his first "crisis" in December 2020 where blood tests revealed he was having a pancreatitis, and then it came back this July.

Since then, I noticed the diabetes signs so when I went to get scans done for the digestive issues (he was treated with Cerenia and buprenorphine for the pancreatitis, but once he was done with those he had new blood tests that showed the pancreatitis persisting, so we had scans done to see what else could be the culprit.), I asked that they run test for diabetes too.

The test came back and he does have diabetes, he has a bit of ketone in his urine BUT no sign of DKA with blood tests, so all good!

Saturday he had a FreeStyleLibre glucose sensor installed and he started insulin therapy sunday morning at around 11:50AM. His insuline is a pen type, 300units of glargine to be precise! (I am not looking for advice on dosing, justdding as supportive information)
Also to note, since I noticed the diabetes signs I started to cut down his dry food slowly because he was on Purina HA hydrolized proteins for his pancreatitis, which has something like 45% carbs!! I cut down the carbs by giving him some canned wet food (Fancy Feast Turkey and Giblet classic pâté, the best option for diabetic cats I could easily find) and I already knew I wanted to transition him on the Tight Regulation protocol if I found out he was diabetic, so it was the perfect time to start the detox before insulin therapy.

Now the thing is: The first shot of insulin was 3 units, and I feel like while it did its job, it also was too much for him and his BG got a bit too low for my liking! (at the lowest point he was at 3.7)
Since then, I continued to feed him ONLY the FF canned food, and did not give him any insulin (since my vet said not to give him any if he was below 5 on BG) and he has been at a somewhat steady 4.0 - 5.0 BG! The vet is very happy about it and says since he is doing so well, he might be a good candidate for remission which made me go YAY!

Im still keeping track of his BG every hour, since I know the glargine is a slow-acting insuline and the effects can take up to 24hrs to stop. So far it has been 27.5hrs and his BG isn't going up nor down, he is still steady between 4.0 and 5.0, sometime going up to 5.6-5.8 after a meal, but nothing more than that!
Are those good BG levels? Should I be happy about it? The vet says that anything between 6 and 3 is good, but I've seen people say they prefer between 8 and 6 so I'm confused.

And here come the pièce de resistance of my whole post: The vet says after his diabetes his stable enough, she want him to go back on the Purina HA to sooth his pancreatitis. She also gave other options like Royal Canin Antiallergic (kibbles), Hill's Z/D (canned and kibbles), Royal canin HP (kibbles) or Rayne Rabbit (wet I think?). I have researched all of those, and every single one of them are high in carbs.
I am not comfortable with feeding my diabetic cat any of those, especially kibbles since I've put the effort into switching him to only wet food!! (and it works soooo good too!!)

Does anyone has good alternatives for his pancreatitis? Something I could suggest to my vet?
I really dont want him to get another crisis like he had twice, it was so hard to see him so low on energy and loosing weight quickly (he refused to eat while he was sick) but I also don't want to feed him crazy high carbs food!! Every single one of the hydrolyzed protein food I see seems to have lots of them, even the wet kind.
I'm at a total lost here!

(Also, I'm adding a little bit of raw goat milk to his breakfasts for a boost of good probiotics! I was told this could help his pancreas, especially since it doesnt require more work to be absorbed!)

 

[Wendy&Neko]

We have many kitties here who have pancreatitis and diabetes, it is a common combination. Special food usually isn't part of the picture. There is a paragraph on food in this note: A Primer On Pancreatitis Tagging @tiffmaxee whose diabetic cat had chronic pancreatitis. Maybe tell us the country you live in, so we can suggest what food might be available there.

Typically we see suggestions for eating hydrolized food, z/d, etc. if the cat has food allergies or IBD. Has your kitty (name?) been diagnosed with anything like that? Maybe tell us the country you live in, so we can suggest

You aren't asking for help on dosing, but 3 units is a HUGE dose to start with. I'm glad you had a meter on him and caught the lower number. Normal numbers are typically in the 2.8 (50) to 5.0 (90) range so looking good so far.

 

[Vanessa Vanier]

Hi @Wendy&Neko ! Thank you for your reply

My kitty's name is Bibi! And we are in Quebec, Canada!

My boy doesnt have any known allergies but the vet did say there was some inflamation in the lower intestine too (seen on scan) and said there was a possibility of IBD, but it hasnt been confirmed yet. She said to know for sure we would need to do further test that would approximate between 2k and 3k CAD, which I sadly don't have right now.
She also said that of all the clients she sees that "need" those tests, only about 10% actually go through it so she wasnt too concerned if I decided not to do them. I dont remember the name of the test itself (and it was in french so translation might not be perfect) but she said he would need to go under anesthesia and have a camera do down his stomach? Not sure if Im explaining right.

But thats about it. From what the vet said, she seemsed more concerned about getting his diabetes under control, which it has been so far!

I dont know much about diabetes in cats but I dis find the 3 units quite a large dose, especially since he was on a low carb diet... It was also supposed to be administered twice a day, but so far I had to do it only once on the first day!! He has been maintaining his levels l, even today! The highest he went was 5.8 earlier but he always goes down just under 5.0.

I have been testing every hours and since 1PM his level have been 4.2, 4.6, 4.7, 4.7, 5.1 and 4.9 just now.

 

[Wendy&Neko]

His levels still sound within normal range.

My boy doesnt have any known allergies but the vet did say there was some inflamation in the lower intestine too (seen on scan) and said there was a possibility of IBD, but it hasnt been confirmed yet. She said to know for sure we would need to do further test that would approximate between 2k and 3k CAD, which I sadly don't have right now.
She also said that of all the clients she sees that "need" those tests, only about 10% actually go through it so she wasnt too concerned if I decided not to do them. I dont remember the name of the test itself (and it was in french so translation might not be perfect) but she said he would need to go under anesthesia and have a camera do down his stomach? Not sure if Im explaining right.

It sounds like an endoscopy - the procedure with a camera. I had it done on one of my cats by an endoscopy specialist for around $800, in the Vancouver area. The purpose of the endoscopy or a surgical biopsy is to take a sample of the intestine, to see if you are dealing with IBD or SCL (small cell lymphoma). The treatments for IBD vs. SCL are different, hence the need to determine which one you are dealing with. IBD is typically deal with a novel protein diet and probiotics. For small cell lymphoma, type of food doesn't matter, any low carb food will do. Small cell lymphoma is also treated with an every two weeks low level chemo. You can only do endoscopy if the inflammation is either in the first or last part of the bowels, you need surgical biopsy for the middle section inflammation. If you have the funds, I'd recommend getting a GI blood panel done, to see if he is low in B12, which many cats with Gi diseases can be. In which case he'd need B12 supplementation.

 

[tiffmaxee]

Diet is not usually what effects cats with pancreatitis like it is for dogs who benefit from a low fat diet. It isn’t the same for cats although it’s not suggested to feed a high fat diet. Many become inappetent which always happened with Max and that’s due to nausea. They don’t necessarily vomit. So you want to treat the nausea with ondansetron, a human RX. Some vets just give an appetite stimulant but if the nausea isn’t taken care of first they can develop food aversions. Feed small amounts more often because if they start to eat and eat too much they don’t feel well. It’s basically nausea meds, pain control, and fluids if at all dehydrated and treat the symptoms. Sorry you might be dealing with pancreatitis. It’s very common with cats and even more so when diabetic.