New Member - Stress, the great culprit of Noa's glycemic chaos?

Hello! Meet Noa. She is a 8-9 years old spayed tortie. She chose me, shimmying her way into my life 6 years ago when i was fresh off the plane in Buenos Aires, Argentina, living in a bit of a slum. For years and even as i moved to a better place, our relationship was comfotable: She could go out on her own, take care of herself, and return to me whenever she needed shelter, food and love. I had come to terms that one day she would meet her undoing outside and i would be none the wiser, i valued her freedom so much that i was okay with that.

It seems however i fell into the convenient trap of dry cat food being available 24/7. That seems to have coupled with the stress of her human family breaking apart, even if i moved to an apartment she could come back and forth from any time, i'm sure this change in status quo ended with her being diagnosed with Diabetes Mellitus two monts ago; Dramatic weight loss, ravenous hunger, lots of peeing, i'm pretty sure you're all familiar.

The endocrinologist put her on a dry food diet (Royal Canin Feline Diabetic) and 1U of Lantus every 12 hours. Hyperthyroidism was discarded first with her T4 values being slightly below normal ranges.

I'll try to cut the whole story to the most important bits.

After completely failing to get her glucose under control with 1U, being authorized to increase it to 2U, then eventually knocking it back to 1U, i have drawn the following conclusions:

-Constant stress seems to be the great culprit behind her seemingly uncontrolled blood glucose. Stress from her still ravenous appetite and from imprisonment.

-2 units of lantus every 12 hours leave her on the edge of hypo, giving the impression of control, while in actuality the poor thing might feel too out of fuel to freak out. She'd regularly wake up in the mornings on the high 300's, to violently crash to 50-60 in the afternoons.

-1 Units seem to solve the issue of morning hypers, but leave her high enough during the day that she has the energy to be utterly miserable and yowl, scream and protest her way into the 300's. I don't need to prick her ear at this point: I just know. There is no consoling her in this state. She's not in the mood to play, accept affection, and certainly she's not in the mood to sleep. More experienced cat owners might shut me down on this, but, try holding 44 grams of dry food in your hand, and imagine yourself having only this to feed your 6.6lb cat with for a whole day. It might just be too little, i'm afraid.

-After becoming a raccoon, trying to raid a neighbour's backyard, and having her butt cheek bitten by one of said neighbour's poodle on her hasty retreat, i have come to the realization that my cat is no longer able to take care of herself due to her ravenous appetite, it was delusional and imprudent of me to think otherwise. Though, that incident might've acted as a reminder to her. Either way this leaves me with the crushing reality of having to be her jailer from now on.

-Indeed i have read about wet food. The endocrinologist basically ordered me to keep on this diet until this last fructosamine test. I obeyed. It was 726, one month and a half after insulin treatment started. After that morale blow, i rebelled a little, and fed her the best canned wet food i knew and had access to. (Sieger's Energy Recovery) for a day and a half. Glucose readings were good, and she was relatively at peace that day, though still prone to food theft and general goblin behavior.

-Despite it all, her water consumption and peeing are normal, and she has gained weight. That leaves me thinking she might not actually be "starving", but rather, in the face of not having food available 24/7, she has regressed into an older programming, one in which she must hunt and scavenge to survive. It might be psychological. I don't know what to do about this.

-An ultrasound has revealed her adrenal glands are elongated, but according to the endocrinologist, not to the point of immediately suspecting tumors, claiming that it might just be stress from the illness. He ordered an igf-1 test, of which i'll have a result this coming june 27th.

-Blood glucose tests are not a factor. I strike swiftly, like a ninja. Before she has time to get angry, the blood is already on the strip. She is handsomely rewarded for her troubles.

So the questions are:

Should i fully tell the endocrinologist to stick it with his dry food? Living in Argentina, i might not have access to the same brands you all are familiar with, but i can provide nutrition labels. I can cook for her too if needed be.

If i can trust her not to tread into dog territory after that wake-up call, if i can somewhat safely say she doesn't have access to trash bags or nasty things when i let her roam around the encosed neighbourhood, if i know well she's too afraid of the streets to actually cross there, is it better to let her roam even with the risk that she might find something nasty to eat? or should i just admit she's not that kind of kitty anymore, and instead focus on making the best out of her new reality?

Anyways, i think this is all i have to say so far. Sorry if all this info is hard to parse. It's been some hard months for me. If she is miserable, i am miserable. I hope i can find some clarity. Thank you.

 

Welcome to you and Noa. . One oh my heart kitties was a tortie without tortietude! Tiffany looked a lot like Noa. Are you testing at home? Do you have the results for the last week or two that you can share with us? If so we have a spreadsheet you could download.

I would slowly dirt the dry food but you need to do it slowly as the bg will likely go down. Does the vet have her in food you have to buy at the office? It’s generally very high carb.

Will she eat low carb wet food? Here we increase and decrease in .25 increments. Have you been going between 1 and 2 units or taking smaller increases and decreases.

We do suggest testing before every shot with an ear prick to make sure it’s safe to give insulin. Then we do spot checks to see how low the dose is taking her. What kind of a meter do you have? Is it a human or pet meter?

She’s likely ravenous because her glucose is not controlled. We can help with that. Just ask questions and someone will respond.

Is it possible to keep her indoors and maybe make or buy a catio and put it outside for some fresh air?

 

Hello! thanks for the response. Yes, i blood test regularly, i used to do so before every shot, but nowadays i'm doing it at random intervals or when she's in a calm demeanor, to try to make sense out of her glucose cycles. That's how i found out that her BG is very mood-dependant, and that her BG was bouncing at night at 2 units. An otherwise predictable glucose curve goes out the window the moment she realizes she can't go out to scavenge and goes super saiyan. So yes i can provide her last glucose readings, i'll just take a bit to translate my notes from spanish. Right now i have an accu-check performa.

As to food, be it wet or dry, she will devour everything in her path. It's not much a matter of wether she likes it or not, it's more like how many seconds it will last in her bowl. She could, and has been in the mid 50mg/dl and still ravenous!

As to the dose, yes, right now i'm using my lantus pen as intended, that is, on whole units. 1U seems to be "okay" if i can only prevent her from losing her marbles. I'll consider using the pen as a vial as folks do here, however the prospect of extracting exactly 1.5 units with a syringe that reads up to 100 is a bit scary right now.

As to the "catio" the best i can do (and i'm in process of doing as of right now) is putting a fence around my balcony, which is like 2.3 feet x 10 feet.

 

Since 2 units has been too much and 1 not enough it will really help to get some U100 syringes with half unit markings. That’s why unless a cat nadirs at over 300 or on a high dose we increase and decrease in .25 increments. From what you say you need to do that to get to a good dose. I’ll link a sticky that explains how we can help you and directions on setting up a spreadsheet. No translation necessary. You simply plug in the numbers and the spreadsheet generates a color coded spreadsheet for you.

 

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

 

Good. I'm gonna be moving my data to this new SS in the meantime. My glucometer does mg/dl so i'm gonna be using the US one. Should i go with SLGL or TR?

Sorry i didn't quite answer your question about the food. Royal Canin Diabetic Feline, is sold by a few pet shops around Buenos Aires, it's only a bit more difficult to find than other products from the Royal canin line but you don't need a prescription to buy it. Noa loves it, but i've come to distrust it. Hopefully this'll shed some light on how good (or bad) it is.

 

As I suspected that’s not the food you want. You can get regular canned low carb food and that will make big changes in the bg. You have to switch food gradually for at least a week or even more to avoid stomach upset and so you don’t see too big a drop in her bg.to quickly. What were you feeding before diagnosis?

You will need to start with SLGS until the dry food is totally removed.

Can you get syringes at the pharmacy? Do you need a prescription for them?

Since there are more members from the US than other countries we ask that people post the US numbers so that’s good. For those who need world if they input on that sheet it converts to US on that ss for them. There are members from all over the world though. I’m not sure if there are any currently from your country though.

 

Hello and welcome to FDMB
I am going to tag @whitedecay who is from Venezuela (the only other person I can think of from South America) to see if she can help you with food and syringes.

It's great that Noa likes food. Do you get Fancy Feast or Friskies pates? They are low carb. Below are links to cat food lists from the US, UK/EU. Maybe some of these foods are available in Argentina? Less than 10% carbs is considered low carb.

US food list - https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
UK food lost - https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

 

Before her diagnosis i was free-feeding her Old Prince for Sterilized Cats. Dry food. So i'm quite guilty of getting her into this mess. However going up to the appointment that would officialy promote her "hyperglycemia" to "Diabetes Mellitus" i was also feeding her this wet canned food called Sieger Energy Recovery. It did wonders to her i think, before the endocrinologist commanded me to give her Royal Canin and nothing else. However i can't find the carb concentration on it. This is the closest i could find.




And yup, i can find 100u syringes, no precription needed. Don't know if they have half markings though

 

Here’s a food chart. .
https://docs.google.com/spreadsheets/d/17hF87V3ER1visK1H1Jg_b2iUsd0YT0NGO1wfib5Go1E/edit

 

If you can’t get half unit markings you will need to eyeball it or get digital calipers.

 

Oh hey! I am also from Venezuela! Noa however is 100% argentina

I checked real quick, we don't have Friskies Pates, here, we do have Fancy Feast, but the price tag nearly gave me a seizure, this is definitely an imported product... At that point i think i would be better off cooking for Noa myself.

 

Most foods don’t give the carbs. Here’s a list on calculating.
https://www.felinediabetes.com/FDMB...ories-from-carbohydrates.204051/#post-2533071

 

This info is golden. Thank you truly. I'll be studying this like an university assignment and get back to you with a proper spreadsheet (mine is quite basic). Noa, hitting a whopping 367mg/dl this early evening in one of her anxiety episodes, now goes to bed with me with a comfortable 83mg/dl.

 

Oh that's great! Then you can reach out to @whitedecay and see what she is feeding her cat whose name is Nao!

Here's more info on making cat food:
https://catinfo.org/making-cat-food/
https://www.foodfurlife.com/#/

 

Oh hi! A fellow Venezuelan! Nice to meet you
Noa is very lovely, btw!

These are the syringes I use, I get them from Colombia but they're really common in Latin America, maybe you can search online?



The food may be a tad more complicated, tho. Nao eats Pro-plan Urinary Tract Health wet food. I order it from Amazon and have it shipped here in Venezuela, otherwise it's impossible to find. I have seen some Friskies, however, and some Fancy Feast, and they're pretty affordable. I'm guessing if they can be found here, surely it can be found too in Argentina? I don't know xd. What are the more common brands there?

 

Neat! Found a very close match. BD Ultra-Fine, 30U, 8mm x 30g needle. I might go for those.

So we seem to have a bit of a different ecosystem here in Argentina, you'll see a lot of whiskas and cat chow, they're so cheap and common i just get a little suspicious about them. Pet shops tend to have Homemade Delights, Agility+ and Sieger products, the later seeming to be a local producer.

Royal Canin is everywhere here too. They seem to have a bit of a monopoly on the diabetic pet market, the dry variant specifically, i'm starting to think it's the go-to when your pet gets diagnosed with DM here, and it seems to be quite bad in diabetic pet support facebook groups, when a diabetic pet earns their wings, this dry food is what the owners give away. When i bring up the idea of switching Noa to a wet food diet, the doc is always adamant if not outright discouraging, though not entirely opposed. I guess that's the "safe and predictable" route for him. So i'm acting a bit outside of his consent here.

Of course i can import wet food from abroad, but the fees are so punishing down here it's practically unsustainable.

According to this, Sieger claims Energy Recovery has little more than 0.3% carbs, less than 2% calories from carbs, which is hard for me to believe unless i'm doing something wrong (It contains manioc starch). Though it is quite high in calories from fats at 63%-ish

 

Just make sure they have the half markings! It will make things much easier

 

The Spreadsheet is online and up to date I only have to punch the lab results in as well.

 

With the very high carb dry food he’s been eating if you follow our method which is SLGS you reduce to .75 because the BG went under 90.

 

Oh i intend to at least start regularly mixing her dry with proper wet food right now. If i knew exactly what rations to feed her, i'd be cooking for her tonight, but i think i'll consult a vet nutritionist for that. I think her hunger drive is psychological at this point.

For context, when i met her, i came to know her then owner occasionally starved her to force her to hunt mice and roaches. It's probable she's just operating on a "Better eat now!" mindset.

 

That’s awful. So glad she’s yours now.