Need help. Frustrated with Vets

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Kiera

Kiera

Member Since 2021
After only a month after dx and a hypo scare, my cat went into remission. Going off insulin was a decision I made without a vet. When Bailey started showing symptoms of hypo, my vet said “he probably needs more insulin. let’s increase every dose by 1 unit”. That would have killed him! You guys saved his life!!! I will be forever grateful! That was in September.

He was doing great OTJ… but for over a month now, his water consumption has been excessive. A lot of days he drinks 14-17 fl oz (at least an entire water bottle). Some days more. He’s constantly flooding the litter box.

I was doing BG checks, but not recording the readings. Recently, I went back to more frequent tests and recording numbers (please see spreadsheet).

Took both cats to new vet for full checkup and blood work on 2/11. Cost me over a grand (which is an entirely different matter that I’m upset about since that seems like a lot more than I should’ve been charged and a lot more than I’m used to). Anyway, after all that, I have no answers. The vet agrees that Bailey is in remission. He gets very stressed at vets but his BG was 170 and fructosamine was 253. T4 was 2.7. We did a cystocentesis as well.

The vet has literally no explanation for the excessive drinking and peeing. No advice or direction was given. Just told me to come back and re-test in a month since certain tests were on the high end of normal. I’m so upset and now don’t know what to do. I can’t afford a second opinion. I will be paying this recent vet bill for months.

How can nothing be wrong? He drinks all day and night. I have to clean the litter box multiple times a day because it gets so full. Plus, my gut tells me something is wrong. Why is it so hard to find a vet I can trust?

They only suggestion made was a senior specific cat food (he’s 13). The reason was just because of his age and that he should be on a diet that’s geared towards older cats. Should I ignore this? I’m feeding fancy feast classic pates.

What should I do? Does anyone have any idea on what’s going on with all the water? The combined knowledge here is so incredible that I’m hoping you will once again prove more helpful than the “experts”.
 
Nothing in the labs point to any real problem.
Urine Specific gravity is 1.019 which is on the low side indicating soe kidney gradation. A relatively high phosphorus and creatinine also point to that. BUN/urea is above normal but diet (high protein) influences that.

Can you estimate how much he is drinking?
 
I don’t think he needs senior specific foods……high carb I would think!
What I would do is look for some low carb foods that are lower in phosphorus than the fancy feast which are quite high in carbs..
The Weruva brand has all the values on their website and THIS LIST from Lisa Pierson will give you phosphorus levels. Look for foods 250 to 200 Mg phos/100 kcal. Or lower.
Not sure why he is drinking so much.
 
Larry and Kitties said:
Nothing in the labs point to any real problem.
Urine Specific gravity is 1.019 which is on the low side indicating soe kidney gradation. A relatively high phosphorus and creatinine also point to that. BUN/urea is above normal but diet (high protein) influences that.

Can you estimate how much he is drinking?
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Thank you so much! He is drinking 14-17 fl oz a day. An entire regular size water bottle for a reference. I don’t know what to do. I’m very worried about his kidneys. The fancy feast is pretty high in phosphorus. Am I doing more harm than good?
 
Bron and Sheba (GA) said:
I don’t think he needs senior specific foods……high carb I would think!
What I would do is look for some low carb foods that are lower in phosphorus than the fancy feast which are quite high in carbs..
The Weruva brand has all the values on their website and THIS LIST from Lisa Pierson will give you phosphorus levels. Look for foods 250 to 200 Mg phos/100 kcal. Or lower.
Not sure why he is drinking so much.
Click to expand...
The vet also recommended Hills Prescription Diet m/d GlucoSupport. That’s not on the chart. Do you have any idea if that’s low in carbs?. It’s MUCH lower in phosphorus but I can never find carb info. It’s very frustrating

update: vet sent me nutritional info/breakdown (see photo) but I’m still not sure. The fancy feast I give now only has 3% carbs. Do you think it would be ok to try a non-prescription first? It’s so outrageously expensive. If so, any suggestions? Do you know of anything similar to fancy feast pates for consistency? Bailey is very picky. He will not eat food with junks or actual meat pieces.
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As long as the food you feed is low carb (and you need to look for low phosphorus as well)……a non prescription food is absolutely fine.
There are many other options. I am not up to date with pate type foods available in the US as I live in Australia and I feed my cats a raw home made diet but I’ll tag @Diane Tyler's Mom as she may have more of an idea of what pate, low fat, low phosphorus cat foods are available.
 
Kiera said:
After only a month after dx and a hypo scare, my cat went into remission. Going off insulin was a decision I made without a vet. When Bailey started showing symptoms of hypo, my vet said “he probably needs more insulin. let’s increase every dose by 1 unit”. That would have killed him! You guys saved his life!!! I will be forever grateful! That was in September.

He was doing great OTJ… but for over a month now, his water consumption has been excessive. A lot of days he drinks 14-17 fl oz (at least an entire water bottle). Some days more. He’s constantly flooding the litter box.

I was doing BG checks, but not recording the readings. Recently, I went back to more frequent tests and recording numbers (please see spreadsheet).

Took both cats to new vet for full checkup and blood work on 2/11. Cost me over a grand (which is an entirely different matter that I’m upset about since that seems like a lot more than I should’ve been charged and a lot more than I’m used to). Anyway, after all that, I have no answers. The vet agrees that Bailey is in remission. He gets very stressed at vets but his BG was 170 and fructosamine was 253. T4 was 2.7. We did a cystocentesis as well.

The vet has literally no explanation for the excessive drinking and peeing. No advice or direction was given. Just told me to come back and re-test in a month since certain tests were on the high end of normal. I’m so upset and now don’t know what to do. I can’t afford a second opinion. I will be paying this recent vet bill for months.

How can nothing be wrong? He drinks all day and night. I have to clean the litter box multiple times a day because it gets so full. Plus, my gut tells me something is wrong. Why is it so hard to find a vet I can trust?

They only suggestion made was a senior specific cat food (he’s 13). The reason was just because of his age and that he should be on a diet that’s geared towards older cats. Should I ignore this? I’m feeding fancy feast classic pates.

What should I do? Does anyone have any idea on what’s going on with all the water? The combined knowledge here is so incredible that I’m hoping you will once again prove more helpful than the “experts”.
Click to expand...


Tagging Wendy
@Wendy&Neko
Hi Wendy, looking at her SS doesn't look like her cat is in remission by looking at those numbers, but what do I know lol
Should she be starting insulin again, maybe that's why her cat is peeing so much?
I will link her previous post where she talks/about whether or not her cat is still in remission , and if she should start insulin again
Thanks Wendy
https://www.felinediabetes.com/FDMB/threads/no-longer-in-remission.258228/#post-2904248

Also will tag
@Bron and Sheba (GA)

@tiffmaxee

Thanks ladies
 
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Diane Tyler's Mom said:
https://weruva.com
When you click on the item go all the way to the bottom left and click on detailed nutritional info. They have many different pates to choose from


You want to look all the way at the bottom of the Weruva page where it says Minerals/100 kcal. The phos numbers need to be below 250. . Either that, or the Dry Matter needs to be less than 1%. Look at the carbs ( as fed section) and make sure you try and stay around 5% or less

Here are some of the pates
https://weruva.com/brand-summary/slide-n-serve/
Click to expand...
Thank you for the great info and links!
 
Diane Tyler's Mom said:
https://weruva.com
When you click on the item go all the way to the bottom left and click on detailed nutritional info. They have many different pates to choose from






You want to look all the way at the bottom of the Weruva page where it says Minerals/100 kcal. The phos numbers need to be below 250. . Either that, or the Dry Matter needs to be less than 1%. Look at the carbs ( as fed section) and make sure you try and stay around 5% or less

Here are some of the pates
https://weruva.com/brand-summary/slide-n-serve/
Click to expand...
It doesn’t seem like any meet that criteria, unless I’m reading the chart wrong. The protein also seems quite high. My vet mentioned reducing protein. Is that not something I should worry about?
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Note that while the Hills data is based on as-fed, the values are weigh % as directly from the the bag//can. That is it contains moisture
 
Kiera said:
It doesn’t seem like any meet that criteria, unless I’m reading the chart wrong. The protein also seems quite high. My vet mentioned reducing protein. Is that not something I should worry about?
View attachment 63536
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Hi I'm really not sure about the protein, I will tag
@Wendy again
@Wendy&Neko
and Katherine
@Katherine&Ruby

Hi Ladies can you please read all of the posts Kiera is looking for low carb/ low phosphorus food, but she is concerned about the high protein listed on the weruva foods she posted. Her vet suggested see #5
Thanks ladies

Would she go by The As Fed percentage? that I listed in #13?
 
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Surprise, your vet may be wrong again. :rolleyes: Lower protein for kidney cats is "old school" unless kitty is quite advanced in kidney disease. The problem with lowering protein in a food is that either carbs or fat have to go up, as those are the three main components of cat food. If you haven't been there yet, this site might be helpful for you. http://www.felinecrf.org/ There is also a page listing common commercial (and vet) foods with their phosphorus numbers. There is a LOT of info on this site, don't try to absorb it all at once.

And we don't know if kidneys are the issue, though with higher SDMA it could be in the future. Or not, I've had a cat with SDMA that went down significantly. I think the vet needs to do more investigation to find out why he's drinking so much.

Fructosamine was in normal range, I wouldn't be rushing to go back on insulin.
 
Larry and Kitties said:
Note that while the Hills data is based on as-fed, the values are weigh % as directly from the the bag//can. That is it contains moisture
Click to expand...
That was over my head. So you’re saying it’s not a good food to feed? Sorry I’m really confused by all of this.
 
Diane Tyler's Mom said:
Have you looked at any of these
WCC_PATES_NUTRITION_V1R8-pdf.jpg
Click to expand...
You said to look at the dry matter chart. Correct? None are below 5% carbs and 1% phosphorus. Thank you so much for all of your help. I’m sorry that I’m so confused. I wish my vet was right so I had a definitive answer on what to feed. But I have no idea still. Getting frustrated with myself for not being able to figure this out.
 
Wendy&Neko said:
Surprise, your vet may be wrong again. :rolleyes: Lower protein for kidney cats is "old school" unless kitty is quite advanced in kidney disease. The problem with lowering protein in a food is that either carbs or fat have to go up, as those are the three main components of cat food. If you haven't been there yet, this site might be helpful for you. http://www.felinecrf.org/ There is also a page listing common commercial (and vet) foods with their phosphorus numbers. There is a LOT of info on this site, don't try to absorb it all at once.

And we don't know if kidneys are the issue, though with higher SDMA it could be in the future. Or not, I've had a cat with SDMA that went down significantly. I think the vet needs to do more investigation to find out why he's drinking so much.

Fructosamine was in normal range, I wouldn't be rushing to go back on insulin.
Click to expand...
Thank you for the info! What is SDMA? After pushing my vet for more info she said he had early renal disease. Which has me terrified. She still insisted on the Hill’s m/d.

I am so worried because he now has this issue (that I don’t understand) on top of diabetes and being overweight.

I spent some time on the website you mentioned and it’s another language. Much like this site was at first. They provide diet recommendations (see below) but now I’m more confused than ever. For the life of me, I cannot find anything that is low carb AND that low in phosphorus. Then the protein issue is coming up again on this site (see below). I did find 2 that were around 1% phos and 6% carbs but for some reason they both had an excessive amount of calories and he has a weight issue. I just don’t know what to do. I’m worried I am hurting him by feeding the wrong thing. But I don’t know what the right thing is.
From the site you provided:
These data are calculated on the basis of dry matter analysis (DMA). The information on the cans or on most brand websites will not have been calculated in this way.

You can read about dry matter analysis and the various factors you need to consider when choosing a food here., but to summarise, your goals are as follows:
  • phosphorus level under 0.5%. No complete non-therapeutic food can be that low, but you should aim to get as close to that as you can.
    • protein level of 35% or as close to this as you can get.
  • sodium level not much higher than 0.2% but this is much less important than phosphorus and protein levels.
    • Fat and carbohydrate levels are provided, the latter mainly for people with diabetic cats, but are less of a consideration for most CKD cats.
 
Maybe I should just try Hill’s m/d. It has to be better than what I’m giving him now which obviously isn’t working. Right? Or do you think that could be worse? I don’t understand the difference between dry matter vs as fed %.


Diane Tyler's Mom said:
@Wendy&Neko
Thanks so much for the info :cat:
Click to expand...
You don’t think I should still be giving insulin, do you?
 
Have you looked at the full range of Weruva cat foods. There are many of them that are low carb and have low phosphorus. You need to look for the Mg/100kcals which is in the last part of post 13 above. Look for 200 mg phosphorus/100kcals or less.
I don’t think any of the lab results are very indicative of kidney disease at the moment. The SMDA, which is a new test which picks up kidney disease earlier than other tests, is on the upper limit of normal and the SG of the urine is 1019 which is starting to get a bit low.
The Hills MD canned food is OK…probably a bit higher in carbs than you would like but if you want to use that as part of the diet, give it a go and see how the BG goes. I would check out the Weruva brand ….I can see some suitable foods in what you have posted above.
 
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts. I made a tab on my Ruby's spreadsheet called Weruva where I have combined the two for easier reference. The low carb, low phos foods I have fed to Ruby are marked with an asterisk.
 
Katherine&Ruby said:
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts. I made a tab on my Ruby's spreadsheet called Weruva where I have combined the two for easier reference. The low carb, low phos foods I have fed to Ruby are marked with an asterisk.
Click to expand...
Thanks so much Katherine, I hope your trip is going well. Are you getting your tan on :p
 
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Kiera said:
You said to look at the dry matter chart. Correct? None are below 5% carbs and 1% phosphorus. Thank you so much for all of your help. I’m sorry that I’m so confused. I wish my vet was right so I had a definitive answer on what to feed. But I have no idea still. Getting frustrated with myself for not being able to figure this out.
Click to expand...
This is what you want to look at, Katherine just explained it to me above in post #21


You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts. I made a tab on my Ruby's spreadsheet called Weruva where I have combined the two for easier reference. The low carb, low phos foods I have fed to Ruby are marked with an asterisk.
 
@Diane Tyler's Mom I'll try explaining this a second way. The fructosamine values in the labs are 253, which is in the normal range of a non diabetic cat. A non diabetic cats tests between 190-365.

Something, and we don't know what, and the vet has to do more investigation, is causing him to drink and pee a lot.
 
Wendy&Neko said:
@Diane Tyler's Mom I'll try explaining this a second way. The fructosamine values in the labs are 253, which is in the normal range of a non diabetic cat. A non diabetic cats tests between 190-365.

Something, and we don't know what, and the vet has to do more investigation, is causing him to drink and pee a lot.
Click to expand...
The vet said it was because of his kidneys. It’s an early sign of renal disease. Is that not true? I spent a grand at a new vet after a horrible experience with my last vet. If I’m being told incorrect information (AGAIN), I will be so upset. How is it possible for them to be so uneducated? I can’t understand it.
 
First step in ruling out drinking/peeing a lot is bloodwork. Kidney numbers don’t look really bad. Even in stage 3-4 of CKD, Neko didn’t drink as much as your cat does. Did the vet rule out any kidney infection?
 
Katherine&Ruby said:
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts. I made a tab on my Ruby's spreadsheet called Weruva where I have combined the two for easier reference. The low carb, low phos foods I have fed to Ruby are marked with an asterisk.
Click to expand...
I tried a bunch of different Weruva and tiki cat foods but he wouldn’t eat any of them. He doesn’t like chunks or stuff that looks like people food. Very frustrating. I am searching for a pate option now which is difficult.
 
Wendy&Neko said:
First step in ruling out drinking/peeing a lot is bloodwork. Kidney numbers don’t look really bad. Even in stage 3-4 of CKD, Neko didn’t drink as much as your cat does. Did the vet rule out any kidney infection?
Click to expand...
Vet didn’t even mention that as a possibility. Is there a specific test for that?
 
Diane Tyler's Mom said:
This is what you want to look at, Katherine just explained it to me above in post #21


You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts. I made a tab on my Ruby's spreadsheet called Weruva where I have combined the two for easier reference. The low carb, low phos foods I have fed to Ruby are marked with an asterisk.
Click to expand...
I appreciate the advice. I tried a bunch of them and he would not eat any. So incredibly frustrating! I need to find a pate without large chunks or long strings I think. Or something that has very small pieces and looks like cat food. Similar to the fancy feast primavera or the ones with cheese (not sure if you have ever seen those—the food is in very small squares and sauce and is something he loved before I knew better).

For some reason, the more the food looks like something I would eat, the less he wants it. The Weruva had pieces that were a couple inches long. Seems odd. It was a no go. He licked a tiny bit of the sauce and then refused the rest. Even when I cut it into smaller pieces. He’s driving me nuts.

Back to the drawing board…
 
Katherine&Ruby said:
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts. I made a tab on my Ruby's spreadsheet called Weruva where I have combined the two for easier reference. The low carb, low phos foods I have fed to Ruby are marked with an asterisk.
Click to expand...

Are there any Weruva pates that are closer to fancy feast consistency/texture? Either the pates or medleys (he seems to hate actual meat pieces which is beyond frustrating)? The key I think is that it doesn’t look like people food. If that makes any sense? All the ones I tried so far have been a no go. He has always refused this type of food. If I offer meat off my plate he won’t eat that either. He’s so strange. The only people food he will eat is cheese.
 
Kiera said:
Are there any Weruva pates that are closer to fancy feast consistency/texture? Either the pates or medleys (he seems to hate actual meat pieces which is beyond frustrating)? The key I think is that it doesn’t look like people food. If that makes any sense? All the ones I tried so far have been a no go. He has always refused this type of food. If I offer meat off my plate he won’t eat that either. He’s so strange. The only people food he will eat is cheese.
Click to expand...
Try the BFF pouches. All of the chicken ones are low phosphorus and low carb.
 
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