? Feed i/d or not?

[jorda1re]

Spider had been in remission for about 2 years, eating Fancy Feast classics. The last few days, he's been feeling down (not playing with his sister, somewhat lethargic), and two days ago started vomiting. Thursday morning he didn't eat but was vomitting bile. I was worried that his sugar may be high again or that maybe he was having another pancreititis attack (he had acute pancreatitis in Dec 2014 and I was warned it would probably be chronic). The pancreititis test came back unconclusive, but he had an abnormal kidney test from his bloodwork (his sugar, however, was totally normal). The vet said it was unusual, and he doesn't want to say that Spider is having kidney problems yet. However, he said that his high protein diet will cause his kidneys to work harder, and eventually this will eventually cause kidney problems.

He asked me to feed Spider some perscription food (i/d) to try and settle his stomach and get him eating again. I feel like I've heard bad things on here about the Science Diet perscription food and diabetes. I boiled him some chicken and he ate it last night, but vomitted it all up about an hour later. I did not give any i/d yet. I fed him a tiny amount of chicken this morning. He didn't get sick for the hour before I left for work, but he did appear nauseous because he sniffed the rest of the chicken, licked his lips, but refused to eat it. Should I try to feed him the i/d food? I am concerned that he hasn't been able to keep anything down for 2 days.


As a side note, the vet seems to feel that it will be better long term to feed spider different food, even if it causes him to require insulin again. He says diabetes is treatable, but kidney failure is not. Spider is the first cat with diabetes in their office to go into remission (first to use Lantus, too). I know kidney failure is terminal, but I guess it just concerns me to change his diet around and put him back on insulin when I know he's been so healthy and active since being in remission. Has anyone else faced this dilemma between balancing other health issues with the diabetes?

 

[Sue and Oliver (GA)]

Until someone comes along with direct experience, Iwanted to link Tanya's site which is a great resource, if you haven't seen it.

http://www.felinecrf.org/

 

[Anitafrnhamer]

Which pancreatitis test? Snap or SpecfPLI? It really does sound, despite the "inconclusive" test that Spider is having a flare of pancreatitis.

First, he needs Cerenia for the nausea or you can try Slippery Elm Bark Powder------1/8 or 1/4 tsp per day sprinkled in food--it coats the digestive tract. He also needs famotidine for stomach acid 1/4 to 1/2 tablet once or twice a day. You use 10 mg tablets and can get the generic version at Walmart, 10 tablets for about $1.

B12 injections also help a lot during pancreatitis flares.

If, you change foods, you still need to keep the diabetes under control. Squeaker is in Stage 4 renal failure and has pancreatitis every six months, also a heart issue, and diet controlled diabetes. Diabetes complicates kidney disease, it is much better to control it through diet than through insulin. Here is a food list you can refer to: http://www.felinecrf.org/canned_food_usa.htm. The belief that high protein is bad for kidney cats is questionable. The biggest threat is phosphorus. If your budget will permit, some very good foods are Weruva Steak Frites, Paw Lickin Chicken, and On The Cat Wok. DMA of these foods here: http://www.weruva.com/truluxe-nutrition.php and http://www.weruva.com/weruva-cat-cuisine-nutrition.php.

For now, if there are appetite problems you can feed baby food meat just make sure they don't contain onions or garlic; meat and broth only. This is not nutritionally complete so this should only be used during periods of crisis.

With repeated vomiting comes the risk of dehydration. So please monitor carefully and ask your vet if sub-q is needed at this time. Part of the standard treatment for pancreatitis includes daily sub-q in addition to nausea control, acid control and pain meds.

 

[Chris & China (GA)]

Actually, from what I've read, your vet is a little "old school" in his thinking...Staying away from high protein diets is more important for dogs but with cats, it's more important that it's high quality protein and LOW Phosphorus

From Tanya's site:

Because of the potential downsides of protein restriction, it is not necessarily a good idea to feed low protein food in all cases. For cats in Stage 1 or early Stage 2 of CKD under the IRIS system (creatinine between 1.6 and 2.8 mg/dl, or 140 and 250 mmol/L), the risks of low protein food may outweigh the benefits, and therefore many vets do not advocate protein restriction in these stages. In Managing chronic diseases in cats(2005) Veterinary Medicine Dr S Little states "Don't restrict dietary protein for cats experiencing mild to moderate chronic renal insufficiency (creatinine 1.6 to 2.8 mg/dl, 140 to 250 μmol/l) because it can lead to protein malnutrition. These cats require adequate protein and calories to maintain body weight and to avoid muscle wasting and anemia."

In contrast to the protein debate, there is no dispute about the importance of controlling phosphorus levels for CKD cats. High phosphorus levels are very damaging to their health and can make the disease progress more quickly.
This is such an important topic that I have an entire page devoted to phosphorus control. Please read it and do everything you can to keep your cat's phosphorus levels low - it can make all the difference to your cat's health and prolong survival.

Getting extra water into your cat will also help keep his kidneys healthier...a lot of us add as much water to our cats canned food as we can (and still have them eat it)

 

[jorda1re]

Which pancreatitis test? Snap or SpecfPLI? It really does sound, despite the "inconclusive" test that Spider is having a flare of pancreatitis.

First, he needs Cerenia for the nausea or you can try Slippery Elm Bark Powder------1/8 or 1/4 tsp per day sprinkled in food--it coats the digestive tract. He also needs famotidine for stomach acid 1/4 to 1/2 tablet once or twice a day. You use 10 mg tablets and can get the generic version at Walmart, 10 tablets for about $1.

B12 injections also help a lot during pancreatitis flares.

If, you change foods, you still need to keep the diabetes under control. Squeaker is in Stage 4 renal failure and has pancreatitis every six months, also a heart issue, and diet controlled diabetes. Diabetes complicates kidney disease, it is much better to control it through diet than through insulin. Here is a food list you can refer to: http://www.felinecrf.org/canned_food_usa.htm. The belief that high protein is bad for kidney cats is questionable. The biggest threat is phosphorus. If your budget will permit, some very good foods are Weruva Steak Frites, Paw Lickin Chicken, and On The Cat Wok. DMA of these foods here: http://www.weruva.com/truluxe-nutrition.php and http://www.weruva.com/weruva-cat-cuisine-nutrition.php.

For now, if there are appetite problems you can feed baby food meat just make sure they don't contain onions or garlic; meat and broth only. This is not nutritionally complete so this should only be used during periods of crisis.

With repeated vomiting comes the risk of dehydration. So please monitor carefully and ask your vet if sub-q is needed at this time. Part of the standard treatment for pancreatitis includes daily sub-q in addition to nausea control, acid control and pain meds.

I am surprised that my vet didn't give me any medication for nausea, but he did call to check on spider this afternoon and has decided since there's been no improvement, he is going to get me something for the nausea that I can pick up after work today. He felt that feeding the bland food would be sufficient, but he has also called the specialist that he's been working with since Spider was diagnosed with diabetes, and they are telling him to keep Spider on the Fancy Feast, especially since the kidney test was not really conclusive, either. Also, I'm not sure which pancreatitis test he did. I think it was a Snap test.

Spider was checked for dehydration and he was ok, so that's good news. I asked about sub-q fluids at our appointment. He has been drinking water, and still producing urine fine.

Thanks for your help and suggestions!