Introducing remi, my Burmese boy

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phlika29

phlika29

Member Since 2014
Hi all

I am new to the group but unfortunately not new to cat related issues. Remi is a fifteen year old Burmese boy. He is the love of my life. A couple of years ago he was diagnosed with acute pancreatitis and in fact triaditis and this has lead into chronic issues with the odd flair. In the summer of 2012 he had a bad attack of cholangihepatitis and it took months to recover. He also has asthma.

Over the years me and the vet settled him on a number of supportive medications including:
Ondanestron
Zantac
Antepsin
Destolite
Occasionally and antibiotic and pain relief.
Flixotide inhaler
Ventolin

He has also been on prednicare (most recently 5mg eod) and a dried royal canin hypoallergenic diet. anyway to cut a long story short he very recently began to suffer symptoms that led me to think he might be developing diabetes(drinking more, peeing more, losing weight quickly) .i also did a urine test that showed glucose. At this point I had cut the steroid dose to 3.75 eod and now down to 2.5 eod.

I got him to the vets this morning and had his blood And urine tested. The urine was negative for ketones, blood, white cells and protein. His SG was 1.030. His blood ranges were normal for urea, crea, bun/crea, TP, ALB, ALB/GLOB, ALT AND ALKP. The levels were high for GLOB 52g/L (range 28-51) and glucose is 25.12 (range 3.95-8.84).

My vet thought his overall condition looked good and he was still eating okay. So we agreed a plan of action
1) change to a wet low carb food
2) reduce his steroid dose over the next week - down to 1.25 eod and then off
3) home monitor his urine for glucose and ketones
4) retest his blood at the vets next Monday.
5) monitor his symptoms

So at the moment I am on a massive learning curve and looking for advice, support, info, etc. I am concerned that I should be starting insulin but We decided it was better to change the food first and see how it goes.

I am looking for a good quality food wet food that is grain free, single species with a fat content on the lower side -less then 45%. Remi's liver problems seems particularly affected by fat.

A big Thankyou to Crittermom has been a great help on all fronts after I reached out to her as a fellow uk resident.

Ps I live in the uk
 
Only paying it forward. :smile:

I hope that other members will be able to suggest additional foods for Remi. The low carb/low fat requirement really makes things trickier diet-wise.
 
You'll want to review this list at Cat Info for candidate foods. Also, you can add 20-25% plain meat, poultry, or fish to a canned food to shift the balance more towards protein and away from fat and carbohydrate.
 
Is your vet concerned about Remi being off his hypoallergenic diet? Might I ask which Royal Canin diet he's on? It could give a good starting point for you in terms of which direction to head. The US Royal Canin hypoallergenic options versions are: venison or duck, then there's also a hydrolyzed protein option too. Let me know & I will look them up for you. (I'm a dietitian who has also studied animals nutrition so I like this stuff :) One option worth looking into is a food called Fussie Cat that has worked great on our diabetic house cat at the vet. It's human grade high protein, seems very lean. You open it and it's real cuts of meat or little shrimps. There's no hidden junk. Squishy (our vet kitty) used to be on 4 units of insulin twice a day, now only 1 unit in the mornings. I am planning to order some for my kitty - he is also asthmatic and just recently diagnosed.
 
BJM said:
You'll want to review this list at Cat Info for candidate foods. Also, you can add 20-25% plain meat, poultry, or fish to a canned food to shift the balance more towards protein and away from fat and carbohydrate.
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Hi BJM

Yes I have been desperately looking through all the lists and each time I think I have found something suitable when I look at the ingredients it turns out maybe not so. There is either an added oil that makes me nervous or a grain or too much mixed protein sources or half the time not available in the uk.

I like the of adding the just a plain meat. I guess you just poach it in plain water?

Many thanks

Sarah
 
nutritiongirl22 said:
Is your vet concerned about Remi being off his hypoallergenic diet? Might I ask which Royal Canin diet he's on? It could give a good starting point for you in terms of which direction to head. The US Royal Canin hypoallergenic options versions are: venison or duck, then there's also a hydrolyzed protein option too. Let me know & I will look them up for you. (I'm a dietitian who has also studied animals nutrition so I like this stuff :) One option worth looking into is a food called Fussie Cat that has worked great on our diabetic house cat at the vet. It's human grade high protein, seems very lean. You open it and it's real cuts of meat or little shrimps. There's no hidden junk. Squishy (our vet kitty) used to be on 4 units of insulin twice a day, now only 1 unit in the mornings. I am planning to order some for my kitty - he is also asthmatic and just recently diagnosed.
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Hi nutrition girl.

The vet wasn't too worried as we had been discussing him trying a new food in case it helped his pancreatitis. We were never sure with remi what his actual intolerance was so I have just decided to stay away from the main culprits and stick to a simple food as possible so no grain, meat from a single source, a novel protein if I can find it, no egg, etc. in addition I feel that that remi does react to oil/fat and so don't want any added salmon oil, sunflower oil, etc (if possible)

As I live in the uk some foods aren't available but of the ones that are I have considered (and then discarded)
Granatapet-great but it has fish oil and this concerns me
http://www.happykittycompany.co.uk/coll ... icken-200g

Kattovit sensitive but this seems a little high in fat for remi
http://t.zooplus.co.uk/shop/cats/canned ... ive/376953

Thrive complete but again the added sunflower oil concerns me a little
http://t.zooplus.co.uk/shop/cats/canned ... e_complete

So at the moment he is transitioning on applaws tender chicken breat with liver in a tasty jelly but this is not a complete food as all it has is chicken breast, liver, and vegetable gelling agent. He loves it though. There complete foods contain rice :sad:

Another food that I got yesterday from my local Pets At Home is there purely brand chicken selection. It seems to contain a lower fat than some of the others and is composed of chicken (min 49%), minerals and tapioca. Crittermom looked at this yesterday and thought something didn't seem right with the labelling. I wonder what your thoughts are.
http://www.petsathome.com/webapp/wcs/st ... n-12-x-85g

To actually answer your question remi has been on the hypoallergenic DR 25-hydrolysed protein.
http://about.royalcanin.co.uk/catalogue ... r-2523768/

I am not sure how much fat that actually works out but I would defiantly like to keep it lower than the protein content.

When I switched last time it was to venison and pea or duck and pea (can't remember it was two years ago). Anecdotally his pancreatitis level fell then but his cholangihepatitis flaired very badly. It might have been a co incidence but I feel that the higher fat does affect him. It left me traumatised about switching foods and so this is why I just stuck to the hypoallergenic. But of course feel terrible now.

I would like to try to get a high quality food that has calories from fat that are lower than from protein which is low carb. Preferably low residue as he does suffer acid reflux and I also read on one of the forums links that might be better for pancreatitis. Would fussier cat fall into this category? I wonder if you can get it in the uk.

Any help gratefully received

Sarah and remi
 
Hi Sarah,

I am also a Sarah! Headed off to work but thank you for the detailed message. I will work on this tonight and get back to you. :)
 
Hi Sarah,

Just a thought. Dr Lisa (of catinfo.org) offers a consultation service. It might be worth enquiring with her about designing a suitable diet for Remi.
 
Phlika29 said:
...I like the of adding the just a plain meat. I guess you just poach it in plain water?..
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Baking, poaching, steaming, broiling - all could work. The moist cooking methods may result in a softer result.

Or use baby food that is pure meat/chicken/fish with nothing else added.
 
Critter Mom said:
Hi Sarah,

Just a thought. Dr Lisa (of catinfo.org) offers a consultation service. It might be worth enquiring with her about designing a suitable diet for Remi.
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Yes I have been in contact but unfortunately I can't afford the consult fees at the moment what with all the vet and medication costs. Am hoping that this is something I can do in the future.
 
nutritiongirl22 said:
Hi Sarah,

I am also a Sarah! Headed off to work but thank you for the detailed message. I will work on this tonight and get back to you. :)
Click to expand...

Many thanks

I actually went ahead and ordered the thrive food that I linked so it is between that brand and the purely one I also linked.
 
Just wanted to give an update and a couple of questions.

Remi is still showing glucose in his urine and so I am going to start a low dose of insulin injections with the vet (one unit of the insulin twice a day-the one that that begins with a c). I will go in with him tomorrow and get myself set up. I have ordered a blood glucose monitor alphatrak 2 which should be here tomorrow. He will then due a blood curve thing on Monday.

In the meantime remi is a little quiet. Not sure it is the diabetes or pancreatitis but I can tell you my nerves are really frayed now. I just feel like crying all the time.

My questions are-with the urine glucose strip test it says to read after 30to 60 seconds yet the colour continues to darken after that time. Do I ignore this continued colour change?

I am sure I have another question but no idea what it is!
 
Phlika29 said:
Remi is still showing glucose in his urine and so I am going to start a low dose of insulin injections with the vet (one unit of the insulin twice a day-the one that that begins with a c). I will go in with him tomorrow and get myself set up. I have ordered a blood glucose monitor alphatrak 2 which should be here tomorrow. He will then due a blood curve thing on Monday.
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Probably Caninsulin. It's not a very good insulin for cats (made for dogs), but it's the first insulin they use in the UK.

As a heads up, the strips for the AlphaTrak are fairly expensive and it might be cheaper for your wallet if you went with a human meter. Or, what some people do is use the AlphaTrak when they're running curves for their vet but then use a human meter the rest of the time.
 
KPassa said:
Phlika29 said:
Remi is still showing glucose in his urine and so I am going to start a low dose of insulin injections with the vet (one unit of the insulin twice a day-the one that that begins with a c). I will go in with him tomorrow and get myself set up. I have ordered a blood glucose monitor alphatrak 2 which should be here tomorrow. He will then due a blood curve thing on Monday.
Click to expand...

Probably Caninsulin. It's not a very good insulin for cats (made for dogs), but it's the first insulin they use in the UK.

As a heads up, the strips for the AlphaTrak are fairly expensive and it might be cheaper for your wallet if you went with a human meter. Or, what some people do is use the AlphaTrak when they're running curves for their vet but then use a human meter the rest of the time.
Click to expand...

Hi thanks for your reply. I am sort of half hoping that when intake remi in his blood glucose will be normal and I won't have to start at all. But I guess the odds are against me. I tested his ketones tonight and it was negative.

Will take on board what you said about the testing kit. I ordered the animal one as I am not good with numbers and don't want to get involved with having to convert numbers. I just had a quick look at your round up link. What a great roundup. I noticed you mention a figure for newbies to watch out for of 200 when you are starting insulin. That's a US number isn't it? My vet mentioned 20 on the phone I think. I didn't mention to him that the caninsulin wasn't held in high regard by others but he thought it was okay to start with and has had some good results from it. He is a very nice open vet and I will discuss it with him when I go in.

Cheers

Sarah and remi
 
Larry and Kitties said:
Yes, you ignore any color change after 60 seconds. You use the color show between 30 and 60 seconds
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Thankyou. In the past when he was negative it didn't really matter how long the test ran so I just sort if counted in my head. Now it makes a difference!
 
Phlika29 said:
Will take on board what you said about the testing kit. I ordered the animal one as I am not good with numbers and don't want to get involved with having to convert numbers. I just had a quick look at your round up link. What a great roundup. I noticed you mention a figure for newbies to watch out for of 200 when you are starting insulin. That's a US number isn't it? My vet mentioned 20 on the phone I think.
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You don't have to convert numbers with meters; just make sure you specify in your signature that you're using a pet meter since most people here use human meters and will assume you are, too.

200 is the "non-metric" US cut-off pre-shot number for new members as to when to give shots vs. stalling. To get the "world" number, just divide by 18. So, for you, that would be 11.11 mmol. (And you can also multiply by 18 to get the US number. ;-) )

Phlika29 said:
I didn't mention to him that the caninsulin wasn't held in high regard by others but he thought it was okay to start with and has had some good results from it. He is a very nice open vet and I will discuss it with him when I go in.
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You might want to see if he'd be open to you using a different insulin. The three insulins that have been shown to work well in cats are Lantus, Levemir, and PZI. Lantus and Levemir are both human insulin and PZI is another animal insulin that he might be willing to try.
 
Hi Sarah,

Very sorry to hear you've had a rough day (goes with the territory, but as you learn more it does get less overwhelming). Good news on Remi's negative ketones! (Keep that up, Remi! :smile: )

Some cats do OK on Caninsulin, but remember that if it doesn't suit Remi, you can always ask your vet to prescribe a more kitty-friendly insulin through the cascade system. It's great that you've got such a good relationship with your vet.

BTW, the human meter beginner's no-shoot 200 number would be about 12.8mmol/L on the Alphatrak.
 
Hi Sarah,

I'm glad you were able to go ahead and pick something. I think that food will suit your needs at 80% protein and 10% fat (dry matter). The Fussie Cat I was telling you about is very similar in composition. It has 77% protein and 9-16% fat (min-max range).

I already looked up some stuff for you so I'll just go ahead and send it for you, in case it happens to be of use to you at some point down the line. These are all dry matter content so just keep in mind that the calorie percentages would be slightly different, but relatively close. I stuck to UK Royal Canin products so far, found a couple of alternatives.

Current Hydrolyzed Protein Dry: 26% Pro, 20% Fat, 39% Carb (Nitrogen-free extract)

New Alternatives:
Royal Canin Diabetic Dry: 46% Pro, 12% Fat, 26.7% Carb (NFE)
Royal Canin GI Dry: 32% Pro, 22% Fat, 26.8% Carb (NFE)
They, of course have lower carb wet alternatives, but if you're gonna go wet you've already found other options. The nice thing about Royal Canin is that their formulas are consistent. If you are feeding dry and you have specific dietary needs, it's a good way to go. Either one would be a significant reduction in carbohydrate as well, cutting it by ~1/3 :) Seemingly small changes like that can have a big impact. Good luck to you and Remi! Let us know if you need anything :)
 
I notice that nutritiongirl22 has had good experiences with Royal Canin foods.

I cannot say the same. Sometimes it isn't until the damage is done that one can ascertain a cause for problems. Saoirse was fed a number of Royal Canin prescription veterinary diets - all dry - for the last few years. Wlth the benefit of 20-20 hindsight, I consider the RC foods to be at the root of all of Saoirse's health/condition problems since she was switched to them. After starting on RC, she put on weight and also gradually lost the fur on her tummy and this was put down to boredom-related stress/age by the vet she was registered with at the time. Since removing RC foods from her diet, all of her fur has grown back and her coat condition is the best it has been in several years. (I wish that the same could be said for her pancreas and digestive tract but the universe is not that forgiving.) The regrowth is indisputable evidence that something in the RC food was really bad news. In addition, Saoirse is able to eat more each day of her quality wet foods while maintaining her ideal weight without any difficulty.

In particular, I would like to give a caution about the Royal Canin Satiety diet. I tried Saoirse on that while trying to help her lose the weight that the RC Urinary s/o piled onto her. Her coat was in pieces after a fortnight. I felt compelled to post a review on the website of the supplier I bought it from to warn other people about it, it was that bad.

I would not wish anyone to see their cat go through what Saoirse has gone through over the last few months (and the years beforehand where she was on ridiculously restricted portions of the relevant - highly ineffective - RC prescription diets) so I would not recommend RC foods to anyone unless it was a diet of last resort. I apologise to Saoirse every day for taking it on trust that the food I was giving her was good for her (especially with the veterinary professional endorsement of same) instead of educating myself about what food she should have been eating. I fed her well-marketed rubbish and I inadvertently harmed her. I failed her. Sorry for the rant, but I would save others from the costly mistakes I have made and that Saoirse is paying for.
 
A dry diet puts more stress on the renal system. It is better for the kidneys to feed a canned or raw diet.
 
Crittermom, It's funny that you would say that because my dog also lost the hair on her back on Satiety. I got her thyroid tested because I was so worried! New food and hair grew back just fine. My theory is that it has something to do with the high cellulose content but I don't recommend it to anyone. I have had mostly positive experiences with RC but that is not why I was sharing info on it - it was because Remi had been using it for disease management.

Having a nutrition background, I feel like nutrition is a key component of health and treatment of many diseases. There are certain illnesses in which it's vital and veterinary diets really are important. Diabetes is one that has more options than some others. FYI - there is a lower calorie S/O diet version. For my cats, I have tried the GI high fiber, hypoallergenic hydrolyzed protein, renal prescription diets and the spay/neuter OTC food. All have been very good. I just started the diabetic and I'm not sure that is going to be a winner for us - but it's allowing us to transition to a lower carb diet gradually. We'll probably end up on Orijen & Fussie Cat.
 
Nutritiongirl22, I'm sorry to hear that your dog had similar problems on the RC Satiety. I was horrified at what it did to Saoirse. I might as well have been feeding her cardboard. I'm glad that your dog is better.

Saoirse was on the S/O moderate calorie for a time, but all that did was halt the weight gain.

I don't doubt that there may be times when certain veterinary formulas may be the food of last resort for a cat, but I deeply regret not educating myself about proper cat nutrition sooner. Like you, I thought Saoirse was doing ok on the RC foods and I accepted our then vet's opinion that the deterioration in Saoirse's overall condition was due to normal ageing and the weight gain was due to her not getting enough exercise. I had not prior experience of how cats age, so I accepted that professional opinion without question. Now, based on the evidence in both Saoirse and my civvie, Lúnasa, I realise to my shame that I was wrong to do so and to continue feeding them dry, species-inappropriate food (for the sake of their teeth) and i deeply regret my choices. Even with Saoirse's current health difficulties, she looks years younger and healthier after only a few weeks on the right nutrition. Both of them have softer coats, they are happier in their general bearing and their fluid intake is finally at a healthy level.

Like you, I firmly believe that proper nutrition is critical to health and well-being. I'm just ashamed that it took me so long to start feeding my little furry childer genuinely nutritious, species-appropriate wet food. I can't recommend transitioning to it highly enough. :smile:

I don't know who I'm more upset with for getting it wrong: myself or the pet food giants for making food that can harm animals. Probably myself, because the responsibility for what food my cats ate lay with me. I feel all the worse for knowing that I (unwittingly) shortened the lives of two of my beloved and nearly lost Saoirse because I didn't feed them properly. :sad: :oops:

(Apologies, Sarah, for being slightly off-topic.)
 
Thanks everyone for your comments. They are all helpful.

Remi is doing ok. I still think that the glucose in his urine is decreasing but have got an appointment with the nurse tomorrow lunchtime to start the insulin injections. In the meantime remi has definitely choose the wet food over the dry to the point he is just refusing the dry and so his transition is going quicker than I had wanted. It makes me very nervous due to a previous bad experience switching foods. I am probably more nervous of the food changes than the insulin.

My latest question: I am transitioning remi to wet and started with a simple food Applaws but it is incomplete. So now I have to switch him again to a complete wet food-thrive. I would like to do it slowly so how long is it ok for cats to not have a complete food?
 
Know what you mean about the food changes, and Saoirse's requirements are far more straightforward than Remi's.

Out of necessity, Saoirse was on chicken breast and broth for a couple of weeks. I was very uncomfortable about that, but she seems OK. I was very relieved when I managed to find something she could tolerate that had all the nutrients she needs (big 'thank you' to Eliz for suggesting Liquivite). Even at that, it has taken several weeks to complete the transition. I'd be inclined to check with your vet, and i'm sure other FDMB members will be able to advise you more.

Bring an orange with you to the vets. It's far less nerve-wracking - and gentler on both of you - to do the saline practice jabs on a fruit than on your beloved Remi. ;-)

Glad to hear that Remi's doing OK. If he's transitioning to wet very fast, I'd be inclined to ask your vet about starting him on a very conservative dose of Caninsulin (especially as it can drop the BG level very hard and very fast). If the vet says it's OK, it might be worth doing a couple of home tests ASAP to get a baseline of what Remi's BG levels are like in the absence of possible vet-stress elevation prior to commencing insulin treatment. You could then let your vet know these values in case the dose might need tweaking. I'd certainly try to get a few tests tomorrow when he's relaxed and hasn't eaten for a while to see what his fasting BG levels are like - both in the morning and the evening. (I wish I had been able to do that. I had to go on faith alone when I started giving Saoirse her insulin at home. Not good. Terrifying, in fact. nailbite_smile )

Is the vet going to start the insulin treatment and run a curve at the practice first to see how Remi responds to the Caninsulin? it might give you more peace of mind to have him monitored at the vets after his first dose so that you'll have some idea of how low the starting dose will take his BG levels.

A heads-up on starting Caninsulin (or adjusting doses). Remi's body may need a little while to adjust to the insulin (and possibly again after dosage changes) and it can be unsettling. Saoirse became very, very lethargic and it scared the pants off me. I consulted regularly with the treating vet over the phone at the time (and needless to say you'd do the same in such circumstances) and the vet was very patient with my worried calls, but I really wish that I had been warned me about how Saoirse's clinical signs might change. It was even worse not knowing what on earth her BG levels were at. I think I aged 20 years in that fortnight. Thankfully you've got your meter sorted. As well as keeping Remi safe, It will hopefully save you from much unnecessary angst. :smile:
 
The blood glucose meter hasn't arrived yet. I arranged for it to come express delivery but it did say that it might take a couple of days to send the order out :sad: . It will hopefully come tomorrow but I don't think in time to try it before we go. Plus I have no idea what I am doing.

I feel very unprepared to start insulin injections especially after reading the hypo risks. It is the nurse who is going to take his blood tomorrow and the. Teach me how to do the injections. My vet is off for the rest of this week so it is rather unfortunate time to start. He said he would take remi in on Monday to do the curve thing. So it will be up to me to monitor him until then and ring the nurse I guess if there is a problem. I can't blame him for taking a few days off but I nearly cried when he told me.

I am sort of used to injecting remi because of the buprenex he used to take and the bit b injections so as long as it is similar to that then I should be okay.

Re the food change I crushed up the dried food and mixed it in with the wet but he still seemed to manage to avoid eating it. I am concerned that it is happening too fast and that he seems to be in some discomfort now with his belly. I think it is probably too late or maybe he really is allergic to chicken. I hope it settles down otherwise we are in for a rough ride.

Thanks for the warning about the side effects of the insulin. May I ask about feeding. I currently feed remi at least four times a day. This vet indicated that this was probably better for BG levels. Is that unusual for this group and will it affect the insulin? Also when I've read about the low point four to five after the insulin shot that will be when remi has his next meal. Is that good or bad?
 
I've only given insulin injections. With your experience, Sarah, I think they'll be easy-peasy for you. Bit of a bummer about your vet going on hols.

I'm sorry to hear that Remi's rushing at the wet food. That's nerve-wracking. Alas! but our kitty childer don't always do what they're supposed to. I hope his tum settles down quickly and that he doesn't have a chicken allergy. it might be the sunflower oil. Saoirse was fine with chicken breast and broth. She's also OK on the Liquivite which contains chicken and chicken liver (relatively high in fat, but none from vegetable sources). The Thrive just didn't agree with her.

I don't know about Remi choosing the wet and refusing his dry food. Hopefully someone else will be along with some suggestions. The only thing I can think of is maybe giving him most of his meal as dry food, and then giving a teaspoon or two of the wet food after he has finished the dry. Maybe try nuking the dry food for 10 seconds in the microwave to intensify the aroma? On the plus side, at least you know Remi likes the wet food.

On the subject of hypos, I had trouble sourcing glucose for Saoirse's hypo kit. I eventually got some liquid glucose from a supermarket's cake-making range (Sainsbury's online). It's a good idea to keep some of Remi's current higher carb food in his hypo kit, too (good for raising numbers, but hopefully you will never need it).

From the Caninsulin FAQ page:

How Does Caninsulin Work in Cats?

A lente (intermediate-acting) form of insulin, Caninsulin contains approximately 30 percent amorphous insulin for rapid onset of activity. The remaining approximately 70 percent of the formula is crystalline insulin which is absorbed more slowly. This formulation allows for a more continuous utilization of glucose to support the body's basic functions. In cats, the peak activity following subcutaneous administration of Caninsulin occurs between 1.5 and 8 hours (with an average of about 4 hours), and a duration of activity varies between 8 and 12 hours. Caninsulin should be administered subcutaneously twice a day in diabetic cats.

(Emphasis mine)

Responses vary from cat to cat. Saoirse usually reached nadir on Caninsulin somewhere between 2 and 3 hours after injection time. I could tell when the Caninsulin started to kick in because there would be an uptick in her appetite and she would come looking for food. As you gather more data from your home testing, you'll learn Remi's response and pattern.

You need to make sure that Remi eats quite well before giving him the Caninsulin because it does most of the lowering in the first few hours after administration. The mid-cycle feed for Remi should be fine, since that's during the period when Caninsulin is still active. When Saoirse was on Caninsulin (prior to her pancreatitis flare-up), I fed her six times a day, four hours apart. Each 12-hour cycle she had three meals. I set the portions as large (pre-injection), medium (during period of maximum Caninsulin effect), and small (while Caninsulin was wearing off - she needed to eat in order to to stop stomach acid from building up and triggering a vomiting episode).
 
No, don't worry if he's not eating dry. That is a good thing, per Dr Lisa Pierson of Cat Info.

Dry food is a water depleted diet that puts an extra workload on the kidneys and may result in such concentrated urine that the cat gets uroliths (kidney stones). Those can block the urethra if big enough, requiring emergency surgery to get the stone out. The stone can serve as a reservoir for bacteria and make it difficult to treat a bladder/kidney infection.
 
Thanks you both

I have found a way of slowing the transition. I have put a few of his old dried food crushed up into the new wet food. So he sort of eats it as he goes. He is about 3/4 wet to dry ratio which is okay with me. I wasn't clear though-he isn't on the thrive food yet. He is still on the applaws chicken breast that I began the transition with. I would happily keep him on this but it isn't complete. Shame there isn't a liquid supplement we can just add to it with all the vitamins and minerals.

He has been making a little moan when he lays down. This seemed to start up when I gave him a big meal all in one go. I wonder if it is the bulk of the food that causes him discomfort as he gets acid reflux, so maybe this means that the weakened valve is worse with a bigger mass. I know when I looked it up it mentioned low protein, low residue food but of course with his diabetes I won't go down that route. So will go for little and often.

Will try to source some glucose today. Thanks for all the suggestions.
 
Mini-meals may be the way to go if too heavy a meal puts a strain on the heart. a 2/3 at shot time, 1/3 3 hours later pattern might work.
 
I wanted a gentler insulin for Saoirse from the get-go because I had read about the more cat-appropriate insulins here and elsewhere on the web. I didn't understand why the vet insisted that Caninsulin was the only treatment availabe. Thankfully Eliz (Elizabeth and Bertie) explained that vets are legally required to use Caninsulin first before they can prescribe other insulins according to cascade rules. I don't know much about the legalities but from what my vet explained I think Caninsulin needs to be demonstrably unsuitable for the patient before another insulin can be prescribed (but don't quote me on this).

Remi's feeding regimen (quantity and frequency) are critical to his well-being and stability. The need to give larger pre-dose meals to support the use of Caninsulin is fitting the cat to the treatment and it should be the other way round. (I get really angry about the current EU regulations regarding the prescription of insulin for feline diabetics .) Remi is already experiencing digestive discomfort by switching to the larger meals. Therefore, I think you have a prima facie case to argue for the unsuitability of Caninsulin as part of Remi's diabetes treatment plan because the feeding schedule adjustments required to support it use run counter to Remi's continued well-being. I had exactly the same issue (although less severe) with Saoirse. Our previous vet put her on the dog-appropriate Caninsulin protocol (two meals of w/d Dry per day just before insulin). I reluctantly went along with it but only for a few days because Saoirse would predictably vomit if she had to fast for more than three hours. I switched back to feeding her six times a day but even that wasn't ideal as the last meal in each cycle needed to be a very small one because the Caninsulin action was wearing off). Saoirse has done much better with the longer-acting insulin and mini meals and her BG levels are much better regulated.
 
Crittermom is right - you have plenty of experience to handle the insulin injections. I was very stressed out that 007 would get low when we started insulin, especially because I don't check his blood sugar daily. My meter was giving me readings of 160-180 (essentially normal) that first week, which made it even worse. It's been almost a week now because I am waiting on my new glucometer to come. But I also work with vets who are very experienced in feline diabetic management and have their own diabetic pets. We also medical board a lot of diabetic cats which helps too.

Your vet will likely start Remi on a low dose of insulin (lower than he expects he will ultimately need) to avoid hypoglycemia. That's why they do a curve soon after starting and slowly work up on the dose based on the results. If your vet is experienced and Remi is eating well and taking his pred, he will probably do just fine. If you are going to be a nervous wreck no matter what and you must do something, here are a couple of things you can do in the meantime to be extra safe.
1. At your vet visit tomorrow, you can also ask them to check his blood sugar with their glucometer to see if he's responding to his diet change so far (since you don't have your meter yet).
2. You can always leave some of Remi's dry food out during the day in case he does start to get low. If he starts to drop and he's not too low, he may feel hungry in time to eat himself into euglycemia. A few nibbles here and there can go a long way. Once you've got him on a stable regimen, you can take them away if you plan to feed him only wet.

Every week gets a little better. I still come home everyday and check out 007. I think, "Okay, he's walking around normally, looks bright and alert." A hiding cat is no longer acceptable! I have to know where he is. It's a whole new norm. But so far, so good :) You will do a great job with Remi!
 
Take a look at my signature link Secondary Monitoring Tools for some supplemental assessments you can make while you work on blood glucose testing. The 5 Ps, or "whole cat report" are good to mention in your post. When the 5 Ps are going well, chances are the cat is doing well, too. Plus, vets often ask these kinds of questions when you take your cat there.
 
nutritiongirl22 said:
I still come home everyday and check out 007. I think, "Okay, he's walking around normally, looks bright and alert." A hiding cat is no longer acceptable! I have to know where he is. It's a whole new norm.
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Same sort of thing here. ;-)
 
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