Food Advice - Diabetic w/IBD, needs low fat/low carb

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Kelly & Logan

Kelly & Logan

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Logan was diagnosed with IBD a couple of weeks ago. He had exploratory surgery to get the diagnosis. They put in a feeding tube during the surgery and he's been eating Hill's a/d since - through the feeding tube. Logan was not getting enough calories and his liver was beginning to accumulate fat.

He will eat a little on his own, but so far I can only get him to eat some FF - he likes the "chunky" feast variets (turkey, chicken). Because his diabetes is unregulated, his body is not able to utilize his fat deposits and he now has a high lipemic (sp?) index and the excess lipase is spilling over into the fluid around his eyes - they're both very hazy/cloudy. The vet said this will clear up with some drops, but will be recurring until we get his diabetes under control. The IBD, however, is causing him to be insulin dependent.

Any ideas on what to feed him? He needs low carb, but he also needs low fat. And, the food will most likely have to go through the tube, at least until he's eating on his own, which probably won't happen until we get the IBD under control. He's on prednisolone right now - started this past Wed.
 
Los on sleep, so probably not really organised at the moment, but:

Which type of IBD -- diarrheal or constipating?

Also, given that he had surgery on his intestinal tract just a couple of weeks ago, the first thing I would ask your vet is whether there are any foods (or types of food) that Logan shouldn't be eating just yet. I mean, there are a lot of IBD cats (mostly the diarrheal form) that do well on raw food diets, but if that's not good for his digestive tract at the moment, then skip that ;)

You may also want to talk with your vet about vitamin B12 injections. IBD interferes with the absorption of B12, which aids in digestion. Adding B12 helps. Most folks start with the TAMU protocol here http://www.cvm.tamu.edu/gilab/research/cobalamin.shtml and then adjust it to their needs.

The steroids should help with his appetite, but have you talked with the vet about an appetite stimulant? Those can help a lot as well.

Will write more later, when my thoughts are clearer --

Jean and her Gwyn
 
I'd recommend too that you ask your vet about using Budesonide rather than Pred for the IBD. I don't know that it's appropriate in all cases (my guy has stomach issues, and the Budesonide has worked well for him), but from what I have been told it is a lot easier on the pancreas & BGs than Pred is.

I have an IBD guy, but have not had the concurrent issue of needing a low fat food, so sorry I can't offer any suggestions on that. My guy seems to do better on higher quality food - any shortcuts I try to take to save a little $$$ & he gets barfy. But ECID, with him I just tried different foods til I found what worked for him (Wellness in his case, but I think it is highish in fat).
 
I understand that IBD cats show improvement on a raw diet. Dr. Lisa knows a lot about this and she does private phone consults (she does charge for them). If I were in your shoes I would consult her.
 
> I understand that IBD cats show improvement on a raw diet.

It depends on the type of IBD. The diarrheal-IBD cats tend to do well on it, but it can be bad for the constipating-form IBD cats -- in 16 years of constipating IBD, the greatest progression in Gwyn's IBD-caused problems (such as megacolon) came during the handful of weeks we tried a raw food diet. I understand that some constipation-IBD cats do well on raw diets, but Gwyn most definitely was not one of them.

Also, raw food has bits of bone meal in it. Since Logan is still recovering from a biopsy on his intestinal tract (Gwyn's biopsy took samples from 16 places along her entire stomach), I'd strongly suggest checking with the vet *and* the surgeon to make sure it's safe for him to try a raw food diet first. This is particularly true as diabetics may have a harder time healing than normal folks.

I'm also not certain whether/how a feeding tube may complicate things; that's one thing we've fortunately managed to avoid.


If you do decide on a raw food diet, you can buy it at some stores. Some of the raw food diets are fairly high in fat; the values for raw food diets are at the very bottom of the canned food charts. The one time we tried raw food, we went with Nature's Variety, solely because they had a trial buy-one-get-one-free offer, which is still available here http://www.naturesvariety.com/tryit...[url]http://www.catinfo.org/makingcatfood.htm, and someone has a grinder for sale at the moment on Supply Cabinet. Making your own has its advantages -- you can control the percentage of fat, for one, and it tends to be cheaper -- but it is an investment and some cats simply don't like raw food diets.


The budesonide may be a good idea; we didn't try it initially with Gwyn (I forget why) and, when we did try it, it wasn't as effective as the pred. I do know that prednosone / prednisolone affects BG levels on some cats more than others; it's good that your vet has Logan on prednisolone (the form of steroids that prednisone becomes once it's been digested, much like cyanocobalamin becomes methylcobalamin) -- prednisolone can be more effective, so it often means that you can use lower doses, and may have a lesser effect on BG levels. Though my Gwyn did better on prednisone than prednisolone, and it didn't affect her BG levels as much *shrug*. ECID.

Anyway, I'd ask the vet what the benefits of pred over budesonide are (remind the vet your cat is diabetic); I'd also ask when s/he thinks the pred should kick in to help with the IBD, and at what point you folks should start thinking about a different steroid.

There's also a feline IBD group on Yahoo http://groups.yahoo.com/group/FelineIBD/. Their first recommendations are going to be the B12 injections and a raw food diet. I support the B12 injections; the raw food diet *may* be beneficial, but I'd most definitely check with the vet and the surgeon as to whether it's safe first.
 
Also: if you do decide to go with commerical raw food then, before you buy, you might post a separate message asking opinions of whatever brands / flavors you're looking at. I seem to recall some discussion about one particular company that wasn't grinding the bone fine enough and folks were having problems with it, but I don't recall the company and I haven't been able to find the post.
 
Low fat and low carb = high protein. (It's the only macronutrient left).

Good high protein foods are, in general, not available in commercial form, since they're very expensive to make. (Some of the premium ones are okay, like the ones that are just pure ground chicken breast or tuna, but they're not much cheaper than doing it yourself.)

There are two alternatives, and they're both going to cost you. Good protein is expensive.

One is, as suggested above, to try a raw diet such as shown on Dr. Lisa's site (www.catinfo.org)

The other, simpler one, for temporary use, is to feed half-and-half a good commercial canned food, and some ground chicken or rabbit or beef. The commercial food will provide the extra nutrients (like taurine and calcium) that would be otherwise low in the impromptu ground protein supplement.

Best wishes,
Steve
 
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