Diabetic remission but still no weight gain...

[Leo-Misty]

Hello! Firstly, this forum has been a great help every since Leo was diagnosed with Diabetes, so thank you! I could not post for a while, but finally managed and Idjit's mom asked me to post in this main forum (thank you.)

Sorry in advance for the really long post..

Leo is around 13 years old and was diagnosed with diabetes (BG 343) a couple of months ago after a period of weight loss (went from 4.5 kg to 3.2 kg!) and vomiting. The vet started him on Mixtard 1 unit/day and he responded well so he asked us to increase to 2 units/day. Along with this, he put Leo on Diamel syrup 1ml twice a day, which we mix into his food. Leo has been on urinary s/o diet due to his recurring cystitis issue so the vet asked us not to change his diet yet. But we have introduced one meal of wet food (also urinary).

Within a week of increasing the insulin dose from 1 to 2 units/day, his home testing started to show very stable readings of around 90. We decreased to 1 unit and BG still remained low so stopped the insulin but continued the Diamel and his readings have been stable between 80-95 for over a month now!!

He does seem better - his coat has improved a bit but not fully back to normal- he throws up a lot less and in general is in better spirits. But his weight gain has been minimal. He had dropped quite drastically in a short span to 3.2 kg, then stabilized but is still around 3.3-3.4 kg. His coat still does not look like it used to when he was healthy, despite regular brushing...After his weight loss, I can feel his ribs when I stroke him

Still checking BG at home regularly and it remains stable. I wonder if the Diamel is helping stabilize the levels (?)

I have two questions:

1. How long would it typically take for cats in remission to gain back the weight? Should his weight be increasing at a faster pace?

2. I am trying to increase his wet food intake but since he has the urinary condition, I am sticking with Royal canin urinary s/o (which is now thankfully available as wet food).

Has anyone dealt with a diabetic cat who also has cystitis and therefore needs a urinary health diet?

I also have another cat (Misty) who also coincidentally needs to be on urinary diet, and does not like the new wet food much so she still has the royal canin urinary s/o dry. I am also concerned that being on this dry food might make her prone to diabetes. She is now 6.

Having read so much about wet vs dry food, I would like to switch them both to wet food, but am very worried about moving away from the urinary diet as they have both had severe episodes of cystitis in the past.

Thanks for reading, and I look forward to your advice.

 

[Bron and Sheba (GA)]

Hi and welcome,
The S/O renal Royal Canin is high in carbs (20 % carbs) and is not really suitable for diabetics.
Diabetic cats need food to be 10% carbs or lower. If you continue feeding carbs that high, you run the risk of putting Leo out of remission. I would also change over Misty to a low carb wet food even though she is not a diabetic. High carbs is stressful on the pancreas. Dry food is high in carbs and is bad for all cats...apart from being high carb, it has only about 7% water content; wet food has 79% moisture and is far better for cats kidneys and bladders.
Do you know what is causing the cystitis? Is it caused by crystals or stones or is it an unknown cause.
My diabetic cat Sheba had idiopathic cystitis and I fed her a homemade diet of raw and cooked food. A wet diet and plenty of fluids and reduction of stress is important for cats with cystitis and if they are also diabetic it needs to be a low carb, wet diet with plenty of fluids.
Also giving SlipperyElm Bark powder made up into a slurry is good for cystitis. If you are interested I will tell you how to make it....it is simple.

I have no experience of Mixtard insulin or of the Diamel.
Are you testing the blood sugars at home yourself, or only at the vet occasionally?. You really need to be still checking his BSL each day this early in the piece after coming off insulin. A good test to see if the pancreas is working is to take a BSL before you feed him and then take another BSL 3 hours later. If the BSL has reduced, it means the pancreas is doing its job.

I don't know why he is not putting on weight. Most cats once they are regulated, start to put weight back on and certainly by the time they are OTJ (off insulin) they are putting on weight.
Are you feeding him several small meals a day or just one or two meals. Most of us here feed several smaller meals a day.
It would be worth getting his thyroid checked as hyperthyroidism causes weight loss.
Keep asking questions. We are happy to help.

 

[jayla-n-Drevon]

have you considered a appetite stimulate?
It is important to be sure he is not nauseous before giving it.
I give my Rico ondansetron (for nausea) and cyroheptadine (stim) in same gel cap and he eats much better now. He was not diabetic but for a very short time (steroid induced) but he is 20 years old this month so I try to keep weight on him. He remains about 10-11 pounds with the meds.
Mirtz is another stim that can be used but dosage needs to be precise and monitored in the beginning. I have used that as well with good results. In too high of a dose it can cause seratonin syndrome (the antidote is cypro)

 

[Leo-Misty]

Thank you so much for your detailed response!

Ok. Am planning to switch them both to the s/o urinary wet food which is now available. I checked the composition it has 82% moisture, 6% protein and rest crude fiber etc. Do you know of any other commercially available wet food that might be good for urinary health? This one says "moderate calorie" food...don't know if that's preventing him from gaining weight?

Leo's cystitis was due to struvite crystals. Misty's is unknown.

Regarding the testing, we are testing him at home now, every 3-4 days. Have also tested at different times, before meal, after meal etc. Since he eats small portions through the day (free fed till now), the BG levels don't really spike up by much I guess. So far all his readings for over a month are between 80-95.

We had checked his thyroid levels too and they are ok. Only his liver enzymes were slightly elevated, but still not too high. The vet had prescribed a liver tonic which brought down the enzyme level to within the range.

Both have been free fed till now because it was dry food. Now if I switch them I guess I cannot leave the food outside as it goes bad, especially in the summer. I am at work between 8 a.m. and 6 p.m. so cannot feed them during the day. So will have to slowly transition to feeding twice but they really don't like to eat much in one go...

Thank you once again!

 

[Idjit's mom]

Perhaps an automatic feeder would be a consideration? Some people make food sicles, and some feeders have ice packs under the trays. Although you said " cannot leave food outside" are they outside all day while you are at work?

 

[Leo-Misty]

Oh that's a good idea....didn't think automatic feeders would work with wet food but will check it out. The ice pack idea is also great - thanks!

No they are both indoor cats so they are at home. By "outside" I just meant outside the refrigerator . The climate here is warm, and during the summer it gets even warmer so food at room temperature goes bad very quickly.

Will certainly explore the options you gave.