Newbie in Costa Rica

[anavic]

Hello, everyone.
Took my dear lovely Sammy (he will be 10 years old this year) to a new vet last week because he had a blockage (second UTi) and they had to catheterize him. He had his first UTI back in 2006 and the vet said he should be fed with Hill's C/D or Royal Canin S/O for the rest of his life.

Years later, I found the catinfo site and wanted to switch Sammy and his two sisters (both now 16 years old and very healthy) to raw food. I consulted the vet and he said that if I didn't want him to die then I should stick to prescribed foods and he also recommended me to feed my oldest kitties with those prescribed foods if I didn't want them to die of renal failure :sad: So I was so scared to change of diet that I stuck to Hill's. Sammy did fine for a lot of years, but two weeks ago I changed the type of litter (changed to a clumping cat litter) and now he has this bout of UTI. The vets ran urianalysis and other tests and they called me to say that he has diabetes (in the test it said +3 but they didn't explain much what does that mean even though I asked). :-| I am so worried. Now they say that I should switch to Hill's w/d but so far, what I have read in this forum points to a canned or even raw food. When I asked these new vets about raw food they told me to not even try because the kitty could ingest a parasite etc. etc.

Vets also said that my kitty is super strong and has a very bad temper (4 people had to grab him so that they could perform the tests) so they decided that insulin shots were not advisable in his case and he should be treated only with diet. The previous vets also said that he is stronger than any other cat they have known and that it was impossible to handle him without assistance. Those vets are the most reputable vets for cats in my country, supposedly.

Per recommendation of Dr. Pierson (catinfo site), I have to run a blood test with a glucometer but I am afraid of how can I do it with my super strong kitty nailbite_smile he even freaks out when I try to put anti-flea spot treatment on him (probably because of all the trauma at the vets' offices); I keep him between my knees but he is super agile and usually manages to sneak out. The only person that I would think to ask for help when performing the test is my sister but she lives in another province (most of my friends in this country don't like cats and I can't recruit them because my kitty will sense the aversion).

Please I would appreciate any advice on how to perform the test on my dear Sammy given his temper and also about food for diabetic UTI-prone kitties. In my country it's hard to find good brands (we have Friskies, Cat Chow, Hill's, Royal Canin, Meow-Mix and others of lower quality); I could order from outside but it will be super expensive because I'll have to first request a vet permit (which they might not want to hand to me because they insist on the Hill's w/d).

Many thanks,
Ana.

 

[Dusty Bones]

Welcome Ana,
Wow, sounds like you have your hands full with that super cat! Nothing's impossible, I'm sure you can test your kitty's glucose using a human tester, you just have to sweet talk or give him treats, it's really painless to them but first things first.... You need to get your kitty on wet food or raw as you've been wanting to do. Dry food of any kind is the leading cause of urinary track obstruction. On top of that Hills is high in carbs and you'll never be able to control his diabetes by diet alone feeding that food. What kind of wet cat foods are available in Costa Rica? You might have to get some Fancy Feast or Friskies shipped to you through Petdirect, Petco, Petsmart or even Amazon.com. Switch his food first and foremost!!! See http://www.catinfo.org/?link=urinarytracthealth for more info on dry cat food effects on cats. And look here http://www.felinediabetes.com/diet.htm for more info on low carb wet food for diabetic cats.

My cat Dusty was on insulin for about a week and by having switched him to wet low carb food (Fancy Feast) he quickly went on remission and is now just diet controlled. There's hope for your kitty!

 

[Deb & Wink]

Hi Ana and sugar kitty Sammy and welcome to the message board.

Some of the Friskies pate style foods would be appropriate for a diabetic cat. Adding more water to the food can help to keep your cat hydrated and help to keep those UTI's from occurring so frequently.

Once I switched my diabetic Wink from dry food to low carb canned food, <10% carbs, he stopped getting frequent UTI's. I add extra water to the canned food and stir it up, enough water to make it the consistency of applesauce or even a soupy consistency.

The Hill's W/d food is a higher carb food that some vets prescribe for overweight diabetic kitties. Is Sammy a bit overweight? Canned would be lower carb (25%) than the dry W/d (37%)

The Hill's M/d food is lower carb than the Hill's W/d. Canned would be lower carb (14%) than the dry M/d (25% I think). All those vet prescribed foods tend to be more expensive than the commercially available foods and the ingredient quality is about the same.

There are people here that feed raw food diets to their diabetic kitties. Many do very well on that. You do need to add supplements to the food, so it is nutritionally complete or buy raw food already made with the added nutrients.

Here are a couple of documents with testing tips for you. Take it slow, in small steps and get him used to the process. Touching ears, warming them, a pretend poke, then a real poke. Low carb treats, anything pure meat, is good to train your kitty to accept the testing process.

Tips for testing: https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub
Ear testing psychology https://sites.google.com/site/michelangeloprofilefdmb/feline-diabetes/ear-testing-psychology

 

[anavic]

Thank you for the welcome and the reassuring messages. I really, really needed them I am reading the documents too.

I just called my sister for help with my super cat She will come next week. She is a pharmacist and told me that Sammy's test was not well performed because it was done few hours after he ate. I am still in denial, so I am kind of hoping that in our test his glucose levels will be normal... I know, not a productive behavior...

Sammy is very lean. He hasn't put on weight nor has lost any. He is very active. I certainly want to change the food to canned, completely. Is it ok to switch his food completely right now that he's under UTI treatment or should I do it gradually?

Here the only wet food brands are Friskies (regular pate), sometimes Purina (it's difficult to get it though), Whiskas Choice Cuts (with gravy) and sometimes Chicken Soup for the Cat Lover's soup (which they three tried once and didn't like at all); there are also Royal Canin and Hill's prescription canned food (which Sammy didn't like at all). It would be great if I could give the same food for my 3 cats just in case one of them wants to eat the others' food (it happens sometimes). In my country shipping of food requires a special permit given by a doctor or by the Ministry of Health; it's a big nuisance to get the permit but maybe I will have to do it.

Today I kept emailing the vets with so many questions but they insisted on Hill's and said that it's a big company that certainly wants their customers to prefer them by making only quality food and making pets' lives longer, etc etc.

Many thanks again,
Ana.

 

[BJM]

If he isn't on insulin, you don't need to be concerned about glucose levels changing with the food.

Change the food about 10-25% per day to avoid GI upsets of diarrhea, vomiting, or inappetance which may happen with sudden food changes.

Something you may be interested in is positive reinforcement training for shaping behavior. This approach is a way to desensitize your cat to being handled, tested, traveled, or whatever you most want to work on changing. The basic concept is one of giving a positive reward when desired behavior happens. You break down the desired behavior into tiny steps that work towards it, then work on a step for as long as it takes for the cat to feel comfortable with it. For example, insulin requires glucose testing for safety. We generally test on the outer edge of the ear. A logical first step towards glucose testing would be petting the head, with attention to the ears, and a low carb treat or play with a favored toy.

 

[Dusty Bones]

This is one time you don't want to listen to your vet. For some unknown reason they all push Hills food on us and it's one of the unhealthiest foods out there. Here's a short list of some wet foods that you can try, this isn't an all inclusive list by all means, I'm having trouble finding the good list that's posted here somewhere... http://binkyspage.tripod.com/nonusfd.html
Keep in mind you want to stay away from chopped or foods with gravy, get the pate style ones. You mentioned Friskies, that one in the pate style is perfect, you want to stay with 5 or 6% carbs at the most and minimize seafood versions. If you're cat(s) are willing to go cold turkey and switch to wet all at once that's fine but most will prefer a gradual change. Keep feeding your current food and gradually add more and more wet food until you get them all switched over. If you can get all your cats on wet food that would be great too, it's better for their overall health.
Keep asking questions and reading all material available here, there's lots to learn but before you know it you'll be an expert. Hopefully your kitty was just tested incorrectly and maybe it was just stress from the vet visit, that kind of stress can certainly push a cat's glucose sky high. It certainly sounds like your super cat was stressed!!! :mrgreen: That's the main reason home testing is better, less stress and a more relaxed environment. Keep reading and asking questions!

 

[Deb & Wink]

Is Sammy overweight? Did your vet say he needed to lose some weight?

Here the only wet food brands are Friskies (regular pate), sometimes Purina (it's difficult to get it though), Whiskas Choice Cuts (with gravy) and sometimes Chicken Soup for the Cat Lover's soup (which they three tried once and didn't like at all); there are also Royal Canin and Hill's prescription canned food (which Sammy didn't like at all). It would be great if I could give the same food for my 3 cats just in case one of them wants to eat the others' food (it happens sometimes).

Yes, very good idea to have all your cats eating the same thing. That way, like you said, if Sammy eats some of it, it would be ok.

Of the wet foods you listed that are available in Costa Rica, I think the Friskies regular pate is your best choice. Most of those are between 6 and 11% carbs. Still lower carb than the Hill's M/d canned which is 14% carbs. If your vet still insists on the Hill's you could try a can or 2 of the M/d, but you did say that Sammy did not like the prescription canned food. That's pretty common.

With the Friskies, at least you have a wider variety of flavors and should be able to find something he will eat.

As far as the Hill's goes, you could tell your vet it's too expensive for you and you are going to try something else for now. At least here in the United States, the Hill's is 4 to 5 times as expensive as the Friskies canned food. It's too much for me to afford so that is why I feed mostly the Friskies pates and Fancy Feast pates to my 3 cats.

 

[Dusty Bones]

Does your cat have any of the obvious diabetes symptoms? Excessive hunger, excessive peeing, and excessive unexplained weight loss? I don't trust whatever tests your vet did and like I said, it sounds like you cat was really really stressed out during that visit. Please try to get a home glucose test to see what's really going on.

 

[anavic]

Dear fellow kitty parents:
Many thanks again for your posts. Have read all your great advice. This forum is really wonderful.

Is Sammy overweight? Did your vet say he needed to lose some weight?

Nope, Sammy is not overweight; in fact, he is very lean. After they sent him the C/D prescribed foods he gained a bit of weight, but the vet said he has a good weight (not overweight, not thin). Tomorrow I will get more of the Friskies patés. They all love the turkey and giblets flavor. Each can is about $1.50 but prescribed is $4! (and on top of that, as you said, Hill's has a high amount of carbs :-| ).

Does your cat have any of the obvious diabetes symptoms? Excessive hunger, excessive peeing, and excessive unexplained weight loss? I don't trust whatever tests your vet did and like I said, it sounds like you cat was really really stressed out during that visit. Please try to get a home glucose test to see what's really going on.

Sammy is peeing more frequently than usual because he is recovering from the UTI (peeing drops), but before the UTI he was peeing twice or three times per day. Also, he is alert and active as usual (as seen in the avatar pic :smile: ), eating normally, hasn't lost nor gained weight.

The tests the vets gave me show a +3 in the glucose level (but it doesn't show the exact mmol/L or mg/dL of glucose) and they didn't explain to me what does that mean... My sister (the pharmacist) said she will come with a glucometer this weekend so we can do the blood test at home nailbite_smile . She said that a peak in glucose occurs few hours after eating and they made the mistake to take a sample three hours after he ate. That, added to the stress, might have influenced the results (i.e. if glucose is shown in urine).

Vets said that he won't need insulin and it can be treated with diet only; in your experience is that statement accurate?

I will tell you about the results of our test.

Kind regards,
Ana.

 

[Dusty Bones]

Dental and other infections such as his current UTI will also cause high glucose readings. It may be possible once he recovers from his UTI that his readings will be closer to or completely normal again. Hopefully that's all it is, get him on wet low carb food to eliminate future problems with diabetes, UTIs or obstructions and live a long happy life! dancing_cat

 

[BJM]

Not sure what you have access to in Costa Rico, but most of the following will be useful if you can test his glucose at home and get an actual number.

***************************************************************************​

We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WalMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each).

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

* * * * * * * * * * * * * * *​

Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)

 

[Wendy&Tiggy(GA)]

How did the testing go? Remember you don't need to restrain him - you can wait till he is comfy somewhere. Go up and rub his ears where he sits and poke him there. Thats what I do with my boys
And don't forget the treat!

 

[anavic]

Hello dear fellow kitty parents:
After a very stressful weekend (Sammy had to go to the vet again for an anti-inflammatory shot for his idiopathic cystitis/UTI and I saw how they grabbed him again between four people :sad: and they tried to burrito wrap him with no success ---plus the anxiety about the home glucose test), I now have a result.

How did the testing go? Remember you don't need to restrain him - you can wait till he is comfy somewhere. Go up and rub his ears where he sits and poke him there. Thats what I do with my boys. And don't forget the treat!

My sister (the pharmacist) came to my house very early in the morning. The day before, he had a big meal of canned food (Friskies, per your good recommendations). We tried to make him comfy but he suspected something and didn't let us touch him . An hour later, my sister was petting him, massaged his ears and he almost fell asleep so she poked him with the pen that she regularly uses with many of the diabetic patients that come to the pharmacy to get tested. The glucometer is a very precise one because it's for pharmaceutical use. No drop. Then I tried and got blood but he woke up and didn't allow us to collect it in the glucose test strip. After he was comfy again, we tried many, many, many times but we couldn't get a single drop enough for the strip! After numerous attempts she made a hole next to a previous one and luckily it bled enough for the strip :smile:

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

I am happy to report you that the value that we obtained in average was 81 mg/dL (his last meal was 12 hours before so it was a good hour to test); that value is equivalent to 4.5 mmol/L :razz: so...he is in the normal numbers range! My sister explained to me that if the test at the vet was performed few hours after he ate, if he was stressed (he was super stressed because of 4 people trying to get a hold of him) and if he ate rice or another carb that he slowly digests then it would probably show high values even in the urine. Well, the test was done 3 hours after he ate a prescription UTI diet (which has rice as main ingredient) so...it probably produced those alarming results. We are probably going to test him again soon, but she says that given her experience with human patients she thinks that this test was done in ideal conditions and we will probably get similar results.

I am a bit upset toward the vets because this weekend when I went there they insisted in the high glucose value and that I should immediately start a diabetes diet and get him on several supplements. :evil: I then told them many things that I've learnt in this great forum and in other sites that I've studied these days and they said that the tests don't lie etc. etc. I don't know if I should write them with regard to the home-test results; my sister said that sometimes in the medical professions the professionals don't like it if you tell them about a mistake and might tell other colleagues about my crazy cat but I think that with something serious like this they should be totally sure before attempting to put a kitty (or a doggie) on any kind of treatment.

Anyway, I am going to continue feeding Sammy wet food, the ones that you have recommended in this forum. It is a good preventative treatment not only for diabetes but also for his bladder inflammations (I think that in addition to the change of litter he might have gotten the UTI because we have been receiving the visit of a neighbor's kitty and Sammy is kind of territorial). I think that in some days he will manage to transition completely to wet as each day he is eating more and more wet food.

Again, many, many thanks for listening, for your support and your great advice. Words aren't enough. I am going to spread what I've learned here (and in the catinfo site): will tell my crazy cat friends/acquaintances in this country and will share the information with several organizations that work with rescue animals (and which I regularly support) about the importance of an appropriate diet :razz: .

Kind regards,

Ana V.

 

[Dusty Bones]

Great news! Hope you and Sammy enjoy a long, stress free, and healthy life. Hopefully his switch to wet food will prevent future UTIs and obstructions too. dancing_cat

 

[Deb & Wink]

Stress induced hyperglycemia in cats is well know. With the handling procedures that your vet used to get a blood sample form your cat, it's no surprise the BG (blood glucose) levels were severely elevated.

Did the vet run a fructosamine test for your cat?

Perhaps you could share some of these links with your vet.

http://www.ncbi.nlm.nih.gov/pubmed/11899027
http://www.ncbi.nlm.nih.gov/pubmed/11899026
http://www.vetsulin.com/vet/cats_diagnosis.aspx The following quote is from this link to the Veetsulin insulin website.

Because stress-induced hyperglycemia can result in blood glucose concentrations of 300 mg/dL to 400 mg/dL, it can confound the interpretation of blood glucose results. Persistent hyperglycemia and glycosuria should therefore be present to definitively establish diabetes diagnosis. It’s useful to measure serum fructosamine concentrations because they remain normal in stress-induced hyperglycemia and elevated in sustained hyperglycemia.

http://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.1996.tb02081.x/abstract Serum Fructosamine Concentration as an Index of Glycemia in Cats With Diabetes Mellitus and Stress Hyperglycemia

 

[anavic]

Great news! Hope you and Sammy enjoy a long, stress free, and healthy life.

Thank you! :3 :RAHCAT Kitty kisses to you and gorgeous Dusty! I hope all our kitties in this forum enjoy a happy life too.

Stress induced hyperglycemia in cats is well know. With the handling procedures that your vet used to get a blood sample form your cat, it's no surprise the BG (blood glucose) levels were severely elevated.
Did the vet run a fructosamine test for your cat?
Perhaps you could share some of these links with your vet.

Hi Deb & Wink :razz: The vets apparently don't know this and they are supposedly some of the best vets in my country :? . Most people have dogs in this country so they might know a lot about doggies but not about cats.

They didn't run a fructosamine test and I definitely won't take my kitty there again for that test (or for any other thing...Sammy has a very good memory and he just saw them and started to hiss). I'm pretty confident about our home tests as it was done by a pro (my sister) with lots of experience testing human patients. Too much stress in the past days for Sammy and stress is not good for such an emotional kitty. I was so worried by seeing how they (mis)treated him. They threw a heavy towel on him and they were yelling to each other because they couldn't grab my sneaky and unusually strong cat. I will mail them, but given their reaction when I challenged their opinion I don't think they'll like it, but it's important for the sake of other kitties.

In the future I plan to test him from time to time with urine strips and will continue with a low-carb wet diet that all the cats should be eating; but for a while no more tests for my feline friend :smile:

 

[Deb & Wink]

They didn't run a fructosamine test and I definitely won't take my kitty there again for that test (or for any other thing...Sammy has a very good memory and he just saw them and started to hiss).

Well, I was just thinking that if the fructosamine test had been done, that was why your vets were insisting that your cat must be diabetic. A single blood test in the stressful situation those vets put Sammy in, it's no wonder his BG levels were high.

I'm pretty confident about our home tests as it was done by a pro (my sister) with lots of experience testing human patients.

After the nice low BG (blood glucose) reading you got with the help of your sister, I'm not so sure that Sammy is or ever was diabetic. The UTI/idiopathic cystitis along with the stress of being mishandled at the vet could have been a big reason for the high BG reading that the vet got.

In the future I plan to test him from time to time with urine strips and will continue with a low-carb wet diet that all the cats should be eating

Sounds like a good plan. The food change to the low carb Friskies pates food is going to benefit his overall health, so I'm glad to see you will continue with that food. It could very well have helped to bring his BG readings into more normal numbers. Plus, any cat that gets UTI's needs more water in their diet and you get that easily with the wet food.

Here is a great link to an article by vet Dr. Lisa Pierson on Feline Urinary Tract Health. Good reading for you to learn more about one vets take on treating Cystitis.

In the future I plan to test him from time to time with urine strips and will continue with a low-carb wet diet that all the cats should be eating; but for a while no more tests for my feline friend :smile:

Some other "clinical" signs you can watch for with Sammy, are the 5 P's (peeing, pooping, purring, preening, playing) and his appetite. They gave a pretty good picture of what is going on and help you to see if something seems off. As long as Sammy is not drinking tons of water, peeing lake sized patches of urine in the litter box, has a good appetite but is not ravenous all the time, still grooms himself, likes to play and purrs his little heart out, I'd say he is doing well.

I was so worried by seeing how they (mis)treated him. They threw a heavy towel on him and they were yelling to each other because they couldn't grab my sneaky and unusually strong cat.

Oh my god!!!! :shock: I think you are much better off trying to find a new vet that will treat both you and your Sammy with respect and dignity, not with yelling and disdain. Sorry you and Sammy had such an awful time at this vets. Yelling? Grabbing? Throwing a towel at him? I don't know of any cat that would sit still for that kind of behavior, either from friends or strangers.

Please let us know how Sammy is doing from time to time. Wishing you two all the best.

 

[anavic]

Some other "clinical" signs you can watch for with Sammy, are the 5 P's (peeing, pooping, purring, preening, playing) and his appetite.

All 5 P's checked!
Thank you for the link. In fact, I emailed Dr. Pierson (catinfo.org) and she was the one who redirected me to this wonderful forum last week.
With the previous vets (and they are supposedly also some of the best vets in town) it was the same...Sammy would not let them touch him. The difference was that 3 people (instead of 4) had to grab the sneaky cat and that the vet's assistants didn't yell but once one of them hid behind the doc while Sammy was hissing I haven't gone back there because last time he scratched the vet badly.

Please let us know how Sammy is doing from time to time. Wishing you two all the best.

Thank you <3 and I will hang out in this forum with wonderful people frequently because the information that I have learned here about how to take care of cats is much better than anything the vets have told me. I love all the kitties and I'm so happy to see when they are doing well.
Regards,
Ana.