Need advice from a Vet PLEASE - Lipemia?

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MakenzieLove

MakenzieLove

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My cat Makenzie was diagnosed with Diabetes back in October; Makenzie was in Ketoacidosis when we first brought her to the vet, weighing only 10 pounds from her previous 12 pound weight and almost at death's door. We immediately changed her diet to a low carbohydrate formula, feeding her Innova EVO (dry food) and began testing her glucose levels at home and administering insulin. (We are currently giving her 6 units of Lantus twice a day.) Her current weight is 13 pounds and she seems to be very happy and doing very well.

We recently brought her in to see the Vet for a check up, who took her blood and ran some tests; I just got a call from the vet who received her blood work. He informed me that she has Lipemia, which he had never seen before in a cat. (The presence of an abnormally high concentration of lipids in the circulating blood.) He now is recommending us to switch to Purina DM. Not only is this food quite a bit more expensive, but the first ingredient is poultry by-product meal. He also said that a high-protein diet wouldn't work for my cat, but this confuses me since even though Purina DM's ingredients aren't high quality, it is still considered a high-protein food.

Can someone please explain what having Lipemia means regarding a cat's health, and if we really should be changing her diet to this other formula? I don't want to second guess my Vet, but if he has never seen this before, I want to make sure I'm making the right decision.

Thank you!
 
Please go to Catinfo to read some info on cat nutrition and see how that fits with what you want to do. We encourage the use of wet, low carb food for diabetic cats, and wet food for all cats, due to risks from consuming dry.

A good resource for lists of fat, carb, and protein %s in cat food is Binky's Page
Look there for a low carb (10% or less) AND lower fat food (as low as you can get and still afford!).
 
I would not switch to that expensive vet food, and I find it odd that your vet has never seen a cat with lipemia on b/w.
One of my cats almost always shows lipemia on her b/w and for some tests, I just need to fast her to bring that presence down. My other cat eats the identical foods and never shows any amount of lipemia.

Try a food that is lower in fat; I think EVO has a high amount of fat.
 
I agree with Gayle - the tests could be skewed a little by eating within 6 hours of the blood being drawn. My vet just understands that I am not going to withhold food from Oscar for 6 hours with him being on insulin.
 
First, there is only one vet who frequents this board and its not often that she has the time. We also have 2 vet techs who come here occassionally but are very busy.

Second, I believe as mentioned that there can be issues in the way the blood is drawn, etc. and you should research causes of lipemia before changing a thing

Third, any vet who prefers Purina DM and all its corn and liver over other foods should seriously take some nutrition courses....

Honestly, I'd do some googling and see what you come up with. And also ask your vet why he thinks a high/mod protein diet wouldn't help your cat...

jen
 
As some other have said, lipemia is not that uncommon in cats. For some blood tests fasting is required to lessen the degree of lipemia and thus less its effect on some blood values. Usually the blood-test results will say the decree of lipemia an give the effects on some of the blood values caused by the lipemia.
 
From Vetinfo.com (didn't get the url)

Lipemia is a vexing problem in blood samples. By far the most common cause of lipemia in blood samples is simply drawing the blood too close to the last meal. It can take up to 12 hours after a meal for lipid levels to fall to low enough levels to allow for good test results in some dogs and cats. Samples that are very lipemic may also have hemolysis since the lipids destabilize the blood cells. For routine blood testing it is reasonable just to redraw the blood sample after a 12 hour fast when it is apparent that lipemia is present. In emergencies it may be necessary to use lab results from a lipemic patient as a guide, remembering that it will cause false increases in sugar, protein, calcium and phosphorous levels and decreases in a number of blood tests, especially the liver enzyme test results.


If lipemia does not clear up after a 12 hour fast there may be naturally occurring lipemia. This can make it hard for a veterinarian to use in-house lab equipment but many commercial labs can clear most of the fat (lipid) from the blood using ultracentrifugation. There is small centrifuge (StatSpin tm) that can clear lipids in conjunction with a special test solution (Lipoclear tm) but many vets do not have this technology, either.


I think that most general practice vets tend to ignore lipemia and hemolysis unless they are very severe but this sometimes does lead to problems with interpretation of lab work. If there is reason to question lab results and one of these conditions is present make sure that additional blood samples are taken and analyzed if possible.
 
I don't have much to add to the great responses you have received (responses that come as no surprise from this great board...) other than:

1) Please see my Feeding Your Cat and Urinary Tract Health issues for reasons why you want to STOP feeding a water-depleted diet to any cat. Please take a long and hard look at Opie's pictures to see what happens to many cats when fed a water-depleted (ie DRY) diet.

2) Lipemia is very common and I, too, am perplexed by your vet's surprised reaction. Maybe there is just some sort of misunderstanding here.

3) We all need to keep in mind that lab 'normals' were obtained on cats that have been fed a high carb, dry food diet which is, sadly, a typical (UNhealthy) diet for a cat. Therefore, values are bound to be skewed and not terribly accurate in some instances - such as, with the lipid 'normals'.

4) As has been noted, fasting for 12 hours will usually help clear the fat from the blood.

(Jen - thanks for letting the OP know that I don't often have the time to respond to "I need a vet to answer" type of questions but you all do a fine job in my absence!)
 
Additional info:

In humans, carbohydrates are broken down ... then, if not used, re-arranged into triglycerides and stored in fat cells.
 
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