Diabetic cat with CKD

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TinaMom

TinaMom

Member Since 2023
What are people feeding their diabetic cats that also have kidney disease? My 17 yr old Tina has had CKD (stage 1-2) for a year, and was on a Rx diet that was high carb, and now she is diabetic. She is not a fat cat, just 8 lbs. Looking for a food that is ok to feed a cat with both issues.
 
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TinaMom said:
What are people feeding their diabetic cats that also have kidney disease? My 17 yr old Tina has had CKD (stage 1-2) for a year, and was on a Rx diet that was high carb, and now she is diabetic. She is not a fat cat, just 8 lbs. Looking for a food that is ok to feed a cat with both issues.
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You can check these out from Weruva BFF like
One of our members put it together
BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 129%
BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5%
Phosphorus 129%
BFF play chicken cherish
Protein 31%
Carbs 5%
Phosphorus 135%
BFF chicken & turkey tiptoe
Protein 31%
Carbs 5%
Phosphorus 136%
BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5%
Phosphorus 149%
BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 154%
BFF play chicken & duck destiny
Protein 32%
Carbs 5%
Phosphorus 165%
BFF play chicken & beef best buds
Protein 33%
Carbs 5%
Phosphorus 171%

weruva has low carb and low phospherous wet food
With weruva foods
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts.
https://weruva.com
Will also give the protein and fat %


For diabetic cats and cats that have elevated kidney values
You want to feed low phosphorous wet food

When you go to the weruva site and click on one of the pics of the food , click on Detailed Nutrition information that is under guaranteed analysis to the left
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS
@TinaMom
 
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Are you home testing the BGs.?
Swapping to a low carb diet…which is the thing to do……if Tina is already on insulin, could drop the blood glucose a lot and could potentially cause a hypo….so you really need to be monitoring the blood glucose closely when doing any swap over of food …and be doing it slowly. Just blood glucose checked even every week during a swap over is not enough.
Please ask any questions
 
Yes prescription diets for CKD cats are very very high in carbs, which is not good for diabetic cats, actually most CKD cats especially ones in early stages like Tina, usually do better in non prescription diets with higher protein content, as long as it is low in phosphorus, there are some comercial non prescription foods you can use that actually will meet both conditions, but if Tina is already on insulin you do need to monitor her closely when changing diet since you will be going from a very high carb one to low carb and her numbers will probably drop.

As they mentioned weruba has some options and also you could check in Dr Lisa's list, you just need to choose one that fits you, that Tina likes and that is 10% or less in carbs and 250 (ideally 200) or less in phosphorus, and there's also the option of home cooking the food if you are up to it

Here's the link to the list

https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Could you give us more information on Tina does she have any other issues besides CKD and diabetes?, do you home test for blood glucose? What insulin is she on if she's on insulin?
 
Thank you for all the info... I am home testing for blood glucose. I have her now on wet food only, Royal Canin Renal D and a tsp of Weruva low phos in the morning to up the protein, and Hill's Glucose control M/D in the evening with Phos-Bind added. She was diagnosed in early Jan, has been on long acting glargine insulin since then, she started at 1.0 unit BID, but I now have her down to .5 unit SID, in the am after breakfast for the past 10 days. Her glucose numbers were swinging wildly on the 1.0 unit between 400 and 55 (she had glucose monitors on her for 4 weeks before I started home testing, and she had two mild hypo events). My faith in my vet is greatly diminished. She wanted her to stay on the high carb Hill's K/D and just treat the diabetes with insulin, with no option to try to get her to remission. I found a great article about using long acting glargine insulin on the vin.com website titled "Using Glargine in Diabetic Cats"... explains how to react to glucose numbers, whether to decrease insulin etc. To answer other questions, yes Tina has other issue, she has been hyperthyroid for several years and takes medication for that, and she has allergies that require a small amount of Atopica once a week.
 
TinaMom said:
She wanted her to stay on the high carb Hill's K/D and just treat the diabetes with insulin,
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Unfortunatedly a lot of vets take this aproach going for the kidney problem and neglecting the diabetes, when in my opinion both issues have to be addressed, and that can actually be done by giving them an appropiate diet.

TinaMom said:
Royal Canin Renal D and a tsp of Weruva low phos in the morning to up the protein, and Hill's Glucose control M/D in the evening with Phos-Bind added.
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This scheme can seem like you are addressing both issues but since royal canin renal D is high in carbs (around 16% if I'm not mistaken) you are causing her blood glucose levels to spike during the day so the insulin dose may not be enough during the day and then you give her a somewhat lower in carbs food in the afternoon, (still as far as I know Hill's glucose control M/D is not low carb, around 13% even though is lower than the renal) so either her dose is not enough during the day or it could be too much during the night.
Bottom line all those changes are making regulation more difficult, my suggestion based on my experience with Babu and my CKD civies ( non diabetic) would be to find a low carb low phosphorus food that you can give her all the time maybe go all the way with Weruba instead of just a tsp

You do not mentioned what her CKD stage is and what her phosphorus levels are but if you can find a low phosphorus diet and delay using the phosphorus binder is always a better approach, if that is not possible or her phosphorus levels are high then giving them is just ok

TinaMom said:
I found a great article about using long acting glargine insulin on the vin.com website titled "Using Glargine in Diabetic Cats"... explains how to react to glucose numbers, whether to decrease insulin etc.
Click to expand...
You could also take a look at the protocols and all the information regarding glargine insuline here at the forum

https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
 
Tina's breakfast is half the Renal D canned and half the Weruva low phos chicken. My intent is to cut the carbs of the Renal D in half, up the protein, but still provide a meal that is complete of all necessary vitamins. The Weruva is not intended as a stand alone food since it is not complete with all the necessary vitamins. Tina gets one dose of .5u glargine after breakfast and a tbsp of Fancy Feast with some Phos Bind in it around 2pm, then dinner at 8 of the Hills M/D canned ( no dry at all). No night time dose. I know this is a bit unusual, but she seems to be doing well on a .5 unit SID.
For the past two weeks her glucose has been in the normal range. She is around 140 in the morning before breakfast, around 80-100 at 2pm, and around 120 at night before dinner. Not having to give her a night time dose means I have a life too! If I'm out for dinner, I don't have to race home. I put her evening meal in a timed release feeder so she can eat at 8 (of course I can't test her glucose, but I only skip that test maybe once every 2 weeks). I firmly believe I have to balance the needs of my 17 year old cat as best I can without giving up my life completely.
 
Bron and Sheba (GA) said:
Are you home testing the BGs.?
Swapping to a low carb diet…which is the thing to do……if Tina is already on insulin, could drop the blood glucose a lot and could potentially cause a hypo….so you really need to be monitoring the blood glucose closely when doing any swap over of food …and be doing it slowly. Just blood glucose checked even every week during a swap over is not enough.
Please ask any questions
Click to expand...
Yep, I did switch her to lower carb foods than the Hill's K/d, and I monitored her for 4 weeks using 2 Freestyle Libre's. We had 2 technical hypo events early on in her treatment when her blood sugar was under 60, although she did not exhibit any symptoms, I just fed her some high carb kibble right away and she was fine. She was having wild swings in her blood sugar and my vet and I both think she was showing the Somogyi effect with wild highs and low lows. We reduced her insulin from 1 unit glargine BID to .5 unit BID and her BG settled into a flatter pattern. After 2 months, I believe her pancreas has healed to the point where she is now on .5 unit SID, and it seems to be enough to keep her in the normal range. All the time she is on food that is perhaps not super low carb, but at least half the carbs she was on with Hills K/D for her kidneys. I personally think it was the K/D that pushed her into diabetes. She's a tiny cat, never more than 8 lbs, so she didnt' become diabetic because she was overfed. Makes me angry that the Hills K/D food might have caused her diabetes.
 
For what it’s worth, it probably wasn’t the Hills. My cat has also been a healthy weight his entire life and 90% of his diet was moderate carb wet food, 5% raw, and 5% dry. Still developed diabetes. Old age is often a factor (my Meeko is 17 too). Male cats tend to have a higher risk for some reason. Often it’s nothing that could have been prevented. But it’s important to make the switch away from high carb foods now.
 
I agree that the hill's probably was not what caused it but it is certainly not helping and I think she could be so much better if you switched to the low carb food completely, I'm not sure what Weruba product you are using but most Weruba products (not treats) are complete well balanced food that will give her all the nutrients she needs and that are low carb and low phosphorus so you could probably just look for one, there are other brands too, Instinct for example
 
I have found 2 Weruva types that I use as part of her diet, the truluxe steak frites, and the ultra low phosphorus WX chicken in puree. I actually have to puree all of her food anyway, she hates chunks.. I am still using some Royal Canin Renal D and Hill's M/D chicken - all wet food, no dry. Between these foods I seem to be able to keep her interested in eating. I believe she is now in remission too. I glucose test 2-3 times a day and she has consistently tested between 89 and 138 for the past 3 weeks. I have had her down to .25unit SID for 2 weeks, and the last 2 days 0 insulin to see if her glucose stays in the normal range. She started insulin mid Jan, so I don't know if remission is possible after just 2 months, but a total diet change seems to have made a huge difference.
 
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