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Bucasmom

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Hi there everyone!
My Name is Heather. I live in Northern Alberta Canada. Our 8 year old boy Buca (boo-ka) was diagnosed with diabetes on Thursday.

I had noticed that he had been sleeping more than usual, he hadn't been as much of a suck as he usually is...and had been eating and drinking a lot. He had urinary tract crystals a year ago and was very sick and has been on Hills W/D ever since, so we keep a water dish in our bedroom to make sure we can notice when he drinks and he started to sit there and drink for 5 minutes at a time.... he would actually wake me up in the night I could hear him drinking and drinking... and just a couple of weeks ago I noticed his rapid weight loss and he started to urinate outside his litter box. Earlier last week I weighed him and he had lost 1/3 his body weight. I made him an appointment (he was due for yearly shots also) and got him in right away.

The vet started to examine him and concluded that he was severely dehydrated and his coat didn't feel in as great as condition as usual. I feared the worst so when she asked if she could run some tests I told her to do whatever she needed. A veterinarian's dream client I'm sure lol but we live in a small town and are very fortunate to have an awesome husband and wife team vet clinic and they are so supportive and knowledgeable so I trust them :) And it's a good thing! Buca's BG was 31 mmol/L and I'm told normal range is 4-8. He was on death's door and the vet said we needed to make a decision soon. Treatment or sleep.

My head was spinning as I drove home... treatment? Like, as in forever? Every day? How can I go anywhere then? Will he respond well? What if he doesn't? Am I being selfish by thinking I can't possibly do this? Ugh.

My husband and I decided that we would start treatment the next day and the vet said that she could give us enough insulin to last us until Wednesday to get us started, and we could decide if we wanted to go ahead or if we felt we couldn't commit then we would end it on Wednesday. I called the vet today and we are going ahead with the curve tomorrow :) He is responding so well to the insulin even after only the weekend. He gets Caninsulin 0.05ml b.i.d.

So far all I've done is posted on facebook and so many of you responded. Thank you for the support. I look forward to reading the rest of the forum and learning more about this group :) Any advice is welcome! We are just starting out and learning as much as we can and this forum is full of awesome info! If I have missed out on anything just let me know and I'd be happy to give more info if I have it. I will continue to check back and keep updating also... Buca will be at the vet all day tomorrow, and they will be running the curve with him all day.
 
Welcome Heather!

So glad to hear you have a good vet who encourages home testing, etc.! That's a start.

Others here will be able to give you excellent advice, more than I can 'cause I'm pretty new at this, too.

Glad you made the choice to treat your Buca! The first couple of weeks are hard, especially since many of us go through a kind of shock period emotionally. But if I can do this, you can do this. And it sounds like you have a very supportive hubby to help you with this...that is wonderful, too!

Suze
 
Welcome! This site is full of wonderful info. We have a protocol that has worked for hundreds of cats. Some get regulated; some go into remission.

We test our cat's blood sugar at home. Stress raises blood glucose levels and most cats are really stressed at the vet with the strange noises, smells, people and animals. So we trust numbers at home when cats are less stressed. We wouldn't give insulin to our 2 legged children without testing. We do the same for our 4 legged ones.

We feed wet low carb food. See this website by a vet for the reasons: www.catinfo.org. But don't change until you are testing. (Oliver went down 100 points overnight when we switched from dry to wet)

We advocate gentle, long lasting insulin. Canninsulin is not one of our preferred insulins as it tends to lower the blood glucose levels hard and fast and it doesn't last as long as Lantus, Levemir or ProZinc. Are you in Europe? If so, it is often the first insulin prescribed. In the US and Canada, there are gentler longer lasting choices.

Let us know how we can help. We'd love to help you help Buca.
 
Thanks for your replies :)
We are in Alberta Canada... I think she (the vet) gave us the caninsulin because he needed something that would act quickly? I think we are getting something new tomorrow but I will let you know.... she just gave us the little glass bottle and some syringes and showed us how to administer the injection. She said that tomorrow she would have the pre-dosed syringes/needles that are good to go, no more pulling from the bottle. I'll know more about it tomorrow.

Since Buca is already on Hills W/D, I will keep him on it for a little while, like you said until he is out of the woods right? Don't want to upset him. He needs to maintain a certain pH in his system because of his history with urinary tract crystals... don't want to go through that again either! :s I do give him a little wet food though. When I get up in the morning I put dry food down for him, and let him eat a bit. Then I put about a tbsp of wet food down to eat while I (or my DH- see? I've been readying the glossary! lol) give him the insulin.

We are going to let the vet do the curve this time because the first test was done at the vet's office aswell... and to just have some kind of baseline to start from until we can get our own glucometer and test strips. The vet did recommend we get the glucometer for better accuracy and acknowledged that the clinic is stressful....
 
Keep reading. You may have questions for us and your vet. Let us know how we can help. I hope your vet will show you how to test before you take Buca home.
 
Heather, do a have a Walmart nearby? (I understand that northern Alberta isn't exactly like the Toronto area. ;-) )

The Relion blood glucose meters are sold there and are highly recommended because the test strips are much more affordable ($0.36 US each) than many other meters.

There are some great links out there about how to home test your cat, and overall information. This is one that I highly recommend: catinfo.org. If you scroll way down they give info on how to home test. The graphic of the area to draw blood from is a bit off...you want to aim for the outer ear, between the vein and the edge of the ear otherwise you might get too much bleeding.

I posted about how I got my Pumbaa used to home testing, and maybe this will help you: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=69340 .

Another great post to read was posted by Gayle Shadoe & Oliver @ Sun Nov 20, 2011 6:55 pm in this thread...scroll down to find it, but it explains the curve and provides some other very helpful links.

Low carb canned food is highly recommended, and I'm not sure but I think it's the phosphorous levels you want to watch for urinary problems...someone else will have to verify this.

Hopefully, your vet is going to switch Buca over to Lantus, Levimir or ProZinc. Again, I don't have a bookmark to share, but I do believe that there is a sticky post on these boards regarding the different insulins and how they work. Lantus and Levimir are long-lasting insulins, and have to be given every 12 hours. After everything I read about the insulins, I requested my vet prescribe Lantus for my Pumbaa, as Lantus is supposed to have the best rate of remission in kitties.

You might want to hunt through the member's list and see if there is anyone near you in northern Alberta, as I'm sure they would be happy to share the best place to shop for supplies, like food, syringes, insulin, test meters and strips, and lancets. I know many of the US people order their insulin from Canada because it's much more affordable. Oh yeah, and Canadians don't need a prescription for the insulin, like we do down here in the US.

Again, so glad you and your DH decided on treatment!

Suze
 
Welcome.

Being Canadian, you are very lucky. Go to a Shoppers DrugMart or some pharmacy and get yourself a good insulin. Ask the pharmacist for Lantus or Levemir 5-pack cartridges. Me, I prefer Levemir, but it's up to you. You will also need U100 syringes as the vet likely sold you the U40 for the Caninsulin which is a crappy insulin. Also, pick a container of KETOSTIX so you can test for ketones. Some cats are ketone prone and others, zip no problem.

Being in Canada, we can't get the Relion BG meters for home testing, but you can get maybe Bayer contour (my favorite), or a OneTouch or Accu-Chek, but just do NOT get any of the FreeStyle meters as they give false readings where you will get numbers much lower than your cat's actual numbers.

Food... scrap the expensive vet food as it's not as good as your much cheaper low carb wet foods like friskies or fancy feast pates.

There are plenty of Canadians around who can give you a helping hand.
Ask all the questions you like; someone will have answers for you.
 
I might be being dense...
He gets Caninsulin 0.05ml b.i.d.
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Isn't that 5u BID? Is so, that's a pretty stout starting dose. Or is it 2u?

Lantus, Levemir, Prozinc (and I believe compounded PZI is also available from a lab in Canada) are all good choices for insulin. Perhaps your vet is familiar with some or all of these. Any of the four, there are lots of people here who can help you out once you get a 'scrip for them.

Carl
 
OK, I think I have it....
Caninsulin is a U40 insulin, so .05ml would be "2u" in our lingo?

Carl
 
Hi Heather,
I just wanted to make certain regarding the dose. A couple of questions.
1 - what color cap do your syringes have on them? If you are using caninsulin, which is a "U40" concentration, then your syringes should have a red cap over the needle rather than an orange one. The package should say "U40" on it someplace.
2 - Are you certain that the vet stated the dose as ".05ml bid"?

Just because you are speaking "metric" and we are used to "US". Not a big deal as long as everybody understands that. We see "31 mmol" and we just muliply by 18 and think "ok, kitty's BG is 558 (which is a high number). "4-8" means 72-144 to us, which is in the normal range of 70-150 on a vet's meter. Eventually you can set up a spreadsheet we have templates for at googledocs, and it will do the math for you and us!

We just want to make sure we understand his starting dose from the get go.

Oh, and as far as caninsulin being considered a "crappy insulin", that would be because it was actually designed for use in dogs rather than cats, and cats metabolize insulin about twice as fast as dogs or humans do, so a more gentle longer lasting insulin works best for cats.

Thanks,
Carl
 
Carl & Bob in SC said:
I just wanted to make certain regarding the dose. A couple of questions.
1 - what color cap do your syringes have on them? If you are using caninsulin, which is a "U40" concentration, then your syringes should have a red cap over the needle rather than an orange one. The package should say "U40" on it someplace.
2 - Are you certain that the vet stated the dose as ".05ml bid"?

Just because you are speaking "metric" and we are used to "US". Not a big deal as long as everybody understands that. We see "31 mmol" and we just muliply by 18 and think "ok, kitty's BG is 558 (which is a high number). "4-8" means 72-144 to us, which is in the normal range of 70-150 on a vet's meter. Eventually you can set up a spreadsheet we have templates for at googledocs, and it will do the math for you and us!

SOrry for the confusion... I have no idea about conversions but will learn the ropes soon ;)

She didn't have the pre-dosed syringes at the time so I was pulling the dose from the bottle of Caninsulin. 0.05ml 2x daily. Today she will give me pre-dosed syringes and I'm not sure if it will be caninsulin or not. But he seems to be doing amazing on it so far... so maybe to regulate for now she might keep him on it I'm not sure. I will certainly discuss the other types with her, she is used to me looking up all sorts of stuff on the internet and is very open to chat about treatment, food, meds etc for my pets (another kitty named Mischief (2) and a bernese mountain dog named Toa (3))

She also suggested that giving him the shot by tenting the back of the neck and injecting there would prolong the absorbtion so it would last longer, whereas if you get muscle with more blood vessels obviously it's absorbed faster and won't last as long in his system.

As mentioned before, I can't take him off the food he's on right now at least until he's regulated. I can't have him getting sick from urinary crystals again, and he's done really well on the W/D thus far. I'm supplementing a little wet food... I didn't know what to buy so my DH got Whiskas but we will look at our options (only have 2 grocery stores). As for the glucometer, no Wal Mart. Nothing like that here. No Shoppers Drugmart either. We have a small IDA drugstore. I'll see what they have in stock, and I'm pretty sure they can order other brands in if they don't have what I'm looking for.

Thank you all for your comments and advice! It's so awesome to chat with people who know what they're talking about. I felt crazy for the first few days of his diagnosis :s lol. I still have a lot to learn and am reading lots about insulins and food, etc and just want to do what's best for his health of course :)

Thank God I found this group! :)
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I just want to make sure I'm right about this--is he on Dry W/D cat food?

If so, that food is about the worst thing you can feed a diabetic cat. Cats need less than 10% carbs in their diet, and W/D is one of the highest carb foods out there, at 39% carbs. It is very unlikely you will ever get your cat regulated with the food and insulin he is currently on. I honestly think W/D caused my cat Bandit's diabetes. Here's a link to the cat food nutrition charts, which lists the amount of carbs for many commercial cat foods: http://felinediabetes.com/diabetic-cat-diets.htm. The only prescription diet which is appropriate for a diabetic cat is canned Purina DM; however, if you look at the ingredients, this food is the same thing as cheaper grocery store foods like Fancy Feast, so all you're really paying for is the prescription label. There is nothing special about prescription diets that makes them better formulated for nutrition related diseases like diabetes. In fact, most of them make the condition worse.

For more information on Feline Nutrition, see the website http://www.catinfo.org. It's written by a vet who is an expert in feline nutrition, and she explains the connection between dry food and diabetes, urinary tract disease, and other nutrition related ailments.

Cats need moisture in their food. Dry food leaves cats chronically dehydrated and causes all sorts of problems over time, like urinary tract disease (and crystals) and kidney disease. Please see this page for more information about dry food and Urinary Tract Disease: http://catinfo.org/?link=urinarytracthealth. A properly hydrated cat on a 100% canned diet is not going to have crystals.

I would check out the food lists and find a canned, commercial food that is low enough in carbs for your cat. The grain-free flavors of Fancy Feast are pretty popular here because they are a decent, mid-grade food that's easy to find. However, and this is very important, do not change the diet without home-testing and lowering the dose. Switching to a low carb, canned diet can drastically reduce insulin need, and in some cases can even cause spontaneous remission. This can cause a dangerous hypoglycemic incident if you are not monitoring the dose.

As others have mentioned, Caninsulin is a good insulin for dogs, but not for cats because cats metabolisms are about twice as fast as dogs or people. They need a long acting insulin like Lantus, Levemir, or Prozinc. Here is a link to the AAHA diabetes guidelines: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf. Please see p. 218 (4), where it says "This panel does not recommend the veterinary-approved porcine zinc (lente) insulin suspension as the initial treatment for the cat, because its duration of action is short and control of clinical signs is poor." I would print this out and bring it to your vet to discuss. I've also attached two articles to print out concerning the using Lantus (glargine) with cats. The first compares the efficacy of Lantus (Levemir works the same way) to bovine PZI and Caninsulin (lente) insulins. 100% of cats went into remission with Lantus in the study, as opposed to only 25% on Caninsulin, and that 25% was likely due to diet change, not the actually insulin. The second study discusses the proper treatment of cats with Lantus (or Levemir), and found an 84% remission rate in newly diagnosed cats, when combined with diet change and regulation via daily home monitoring.






This research just came out a few years ago, so many vets who haven't seen it aren't aware that the treatment for diabetic cats has changed drastically. That's why I would urge you to print these out and bring them to your vet, so you can get Buca on the right treatment path. There's a window on remission, so the sooner you get the treatment and diet changed, the better Buca's odds of reaching remission. I speak from personal experience--my own cat has been in remission for almost 2 years now, and he is healthier today than he's ever been.
 

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Thank you Julia & Bandit! I will definitely bring this up to my vet. It seems that she has only had success with the caninsulin, but then again hasn't had too many kitties with diabetes either so she hasn't really had the opportunity to try the other brands to a certain extent. One of them went into complete remission. I asked her about Lantus and she said that for sure she could order some in if I decided that is what I wanted to do. She is very understanding and open to my suggestions.

I'm picking him up from the vet today, his BG levels went from 558 (THurs) to 450 (today) so he still has a way to go. Is this a normal rate of reduction from what you guys have seen? Or should/could it be faster with Lantus? Is it safe for it to go down more rapidly?

I hear what you're saying about the dry w/d. I've done lots of research on food too, and for the most part refused to feed a vet or grocery store brand due to quality of ingredients until he became sick with crystals. He's been in perfect health for the last two years since his episode so I didnt think anything of it. I agree that it is time to make some changes and continue my own research and consider all the great advise you gave. Thanks!

Unfortunately, there is no pet store here where I can get better quality food, so I am limited to the grocery store or the vet. I have never seen the gluten free wet food here but will keep my eye out.
 
Insulin is non prescription in Canada. You do not need to buy it through your vet... and you probably don't want to as they will likely mark up the price. You can go to any pharmacy (Costco and Walmart are the cheapest) and get Lantus or Levemir. The 5 pen cartridge pack of Lantus is around $105. You will also want to get u100 syringes to go along with it. The BD Ultrafine II are the only ones I can find here. They are pricy so you may want to order online if you can.

There is not really a guideline for how much a cat should "drop" on insulin. This is a marathon, not a race... it is a slow and steady process. It doesn't just instantly get better overnight. Scooter did not get regulated until he was on insulin for over 3 months, and sometimes he jumps in and out of it for no reason. Getting your cat regulated is going to be tough for you because of the dry high carb diet you're feeding right now. It's like feeding a human diabetic nothing but Twinkies and Coca cola. Dropping the carbs will show a drastic improvement... insulin therapy can be slow. Some cats have gone into remission in days, weeks, months... and some, it even takes years. And some never go into remission.

Sorry if this sounds blunt, but, grocery store brands of food are infinitely better than the junk food you're feeding right now. Any canned food is going to be better than dry. Fancy Feast classics is a very popular one because it is decent quality, decently priced, and there are a lot of varieties for picky cats. Special Kitty Select (Walmart's brand) is similar to FF but even cheaper. Special Kitty (big cans) and Friskies are also popular but I find in BC, some of them have corn/rice so you have to be careful. I recently raided Walmart's sale shelves and got a TON of Whiskas pate foods in little plastic resealable containers. They are 3.5oz of food for 50 cents. They are decent quality as far as ingredients go, and the resealable container is handy :lol: Otherwise we feed Special Kitty Select, turkey and giblets, chicken dinner, and duck delight flavors.
 
You can also choose a food by label reading: http://catinfo.org/?link=cannedfoods

If the canned food is mostly meat, and does not contain any grains (wheat, corn, rice, soy), or a large amount of vegetables (they're not listed until the third or 4th ingredient), then the food is likely low carb. Most pate style foods are low carb if they have no rice, flour, corn, or soy. Here's a link to the chart that has some Canadian foods on it: http://binkyspage.tripod.com/nonusfd.html

his BG levels went from 558 (THurs) to 450 (today) so he still has a way to go. Is this a normal rate of reduction from what you guys have seen? Or should/could it be faster with Lantus? Is it safe for it to go down more rapidly?[quote/]

It's hard to tell how the insulin is working unless you are home testing. You need to get multiple tests a day to know how much the insulin is lowering blood glucose, and how long it is lasting in the cat.

In my experience from what I've seen with MANY cats on these boards, as well as the two cats I've personally treated, Lantus (or Levemir or Prozinc, but I have only personally used Lantus) provides better control of blood glucose, meaning you'll be able to regulate faster.
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Before Buca had his urinary tract crystals two winters ago, he was on a very high quality low carb high protein diet - Acana brand (Champion pet foods). It was dry though... so is the secret in the wet food? It should keep his numbers at a good level to control the diabetes, and have enough hydration to keep him from getting crystals again?
 
Bucasmom said:
Before Buca had his urinary tract crystals two winters ago, he was on a very high quality low carb high protein diet - Acana brand (Champion pet foods). It was dry though... so is the secret in the wet food? It should keep his numbers at a good level to control the diabetes, and have enough hydration to keep him from getting crystals again?
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You got it! Moisture is the most important thing to prevent crystals. A properly hydrated cat will not have UT issues. Any canned food will prevent these problems. And there are a ton of low carb, canned options for the diabetes. So you're treating both problems with the same diet.

You'll find that this diet will be far more effective at preventing crystals than the W/D! There is nothing in W/D that actually prevents UT problems, so it's really just plain luck that he hasn't had a recurrence already. W/D is the weight control diet that used to be given for diabetes back when they used to think high fiber foods were good for diabetic cats. Studies have since shown that limiting carbohydrates (just like human type-2 diabetics) is far, far more effective. The Urinary diet is C/D, and even that is not as an effective treatment for UT issues as simply not dehydrating the cat. It's kind of like trying to beat a fire out with a dry, wooden stick rather than dump a bucket of water on it.

A couple tricks to get water into your cat (since they only get thirsty and drink from their water dish after they are already dehydrated): 1. Add a bit of water to the canned food to make it a little soupier--you can do this as much as he'll eat it. Some cats won't eat the food if it's too soupy, so you may have to experiment. 2. Get a pet fountain, like this one: http://www.amazon.ca/Drinkwell-FCB-...446M/ref=sr_1_2?ie=UTF8&qid=1336595752&sr=8-2. Pet fountains encourage cats to drink even when they aren't thirsty.
 
My vet said she can call the drugstore in town and get them to get me Lantus.... does it come in a little glass bottle or pens? Are pens like pre measured dosages or something? What can I expect to pay for it in Canada and how long will a pack last me ?

I'm confused about glucometers. All I have at my drugstore is OneTouch ultrasmart, OneTouch Ultra2 and Bayer Breeze 2. I didn't see test strips on the shelf though, and some types come with test discs.... are these the same as strips? The bayer one said it's for use with small amounts of blood. I'm not sure what unit of measure I should be looking for but I figured for a cat i would need one that wouldnt need a whole lot to test from...
 
Lantus comes both ways, in a 10ML vial or a pack of five 3 ML pens. The pens are great because you waste less insulin if you contaminate the insulin, and, they don't have to be thrown away after the recommended 28 days if stored properly in the fridge (not on the door) under the correct temperature. (Here's a good link for you to read.)

I don't know what the cost will be in Canada, but I paid $208.00 US for the Lantus at a Costco here in Arizona. There is a $25 off coupon here, but don't know if it's valid in Canada.

Down here, they keep the test strips behind the counter in the pharmacy due to frequent theft. A pack of 100 test strips for the Relion Micro are $36, so you can imagine the pilferage...when the meter only cost $9. And yes, an ideal meter requires less blood. Somewhere there is a link to a study on the different meters and how much blood they require.

Suze
 
I founnd a coupon online for a free AccuChek glucometer :) The Bayer one they had at the drug store was $80 and the other kinds didn't have a price tag and I was afraid to ask.
 
A 5 pack of Lantus pen cartridges should be around $105. Most meters are free if you buy a box of 50 or 100 strips. Even then, the meters themselves are less than $10 usually. The strips are the expensive part. The AccuChek is a good meter though. I use a Bayer Contour USB, personally, and that one is the $60 meter you saw at the store. I got one (well, two, actually) free with a coupon from a box of BD syringes. If you click the "Home Testing Kits" image at the top of the page, you can get a testing starter kit for just the price of shipping. However Canadian meters read different than USA meters so you would have to ask Rebecca about how the free kits work for Canadians.
 
So we increased Buca's dose because his numbers still were not good. He was levelling out at 432, which is still down from 558 but "low and slow" is what I keep hearing... we started with the dosage by weight but it wasn't enough.

My DH did some research on food and we don't understand how a dry food with corn as one of the first ingredients can be considered good for a cat with diabetes (ie the Hills W/D he is on).... corn is high on the glycemic index which would cause a spike in blood sugar. No brainer is it not? lol

I discussed switching to a wet food diet and she recommended a lot of the same ones that previous posters did also, so that was comforting... only thing is, that the food is keeping his urine at a pH of 7. If it goes above or below that then there is risk of him developing crystals again. I am going to substitute wet food for dry, but still offer the dry occasionally during the day. Sometimes, he seems to prefer it. I want to make sure he's eating at this point, but don't want the food to counteract what I'm trying to achieve with the insulin.
 
I would strongly recommend that you NOT raise the dose until after you've changed the diet and given it a week or so to settle. Changing to a low carb canned food is going to lower his blood sugar by a great deal--if you raise the dose at the same time you will most likely end up giving too much insulin. With insulin, it's better to be high for some time than too low for a second.

This is not a sprint--it's a marathon. Hypoglycemia can kill in a second, and you need to use caution in raising the dose, especially with a diet change. Cat's blood sugar levels will drop 100-300 points with a diet change. Some even go into spontaneous remission.

Please read the info on urinary tract disease I provided: http://catinfo.org/?link=urinarytracthealth. The main source of your crystal problem is NOT pH. When a cat is being chronically dehydrated from a dry diet, their urine is more concentrated, and they produce a lower amount of urine. Therefore, a high concentration of crystals will be in the urine. Crystals are incredibly common with cats on dry diets, because their urine is too concentrated. The more the urine is concentrated, you have a greater chance of the crystals forming stones or causing cystitis.

If your cat is properly hydrated because you've gotten rid of ALL the dry food, you will have no need to concern yourself with the pH of his urine, because the ROOT of the problem (chronic dehydration) will be solved. Trying to treat crystals by altering pH isn't treating the cause, it's treating a symptom.

Also, like I said before, the food you're feeding (W/D) is not even a urinary tract diet. It is doing nothing to control the pH of his urine more than any commercial food would. In fact, the high carb load and lack of moisture is likely contributing to the problem and it's pure luck you haven't yet had a recurrence of his urinary tract problems. If you keep feeding this food, even in smaller amounts, you will still have great difficulty getting the diabetes under control, AND it's not going to do anything to help with the urinary problems because he will still be eating half of a moisture depleted diet. If you give a diabetic child potato chips for half of their meals instead of all of their meals, their blood sugar is still going to be out of control.

This is from the Feline Urinary Tract Health page:

Many of the often-prescribed feline lower urinary tract diets are formulated to make the urine acidic but it is thought that these low magnesium, acidifying diets may actually exacerbate painful cystitis. Also, these acidifying diets often end up promoting calcium oxylate stone formation and can also lead to hypokalemia (low potassium in the blood) which can cause or exacerbate kidney disease.

It is also important to note - for those people still stuck on worrying about the urine pH - that there are many factors which determine the pH of urine and only one of them is diet.

Urine pH varies throughout the day and using one pH measurement from a single urine sample is very misleading and is not terribly helpful information.

With regard to dry food and urinary tract health, aside from the lack of water in this type of diet, there is also a correlation between the consumption of a high carbohydrate diet and the formation of struvite crystals as shown by this study because carbohydrate diets promote an alkaline urine.
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I hear you! This is my plan ... I discussed this with our vet.... She is great, don't get me wrong, but some of what she says totally conflicts with everything I've read (ie your link you posted for me. Thanks btw).

For right now (at least until my glucometer arrives and I can do home testing) I am going to do things her way. If things don't change I am getting him on the Lantus with a lower dose and feeding the wet diet. My hands are tied until I can get access to the proper food and I will be out of town next week for a couple of days and can get to a pet store or wal mart. The key will be being able to monitor at home when we put him back on low dose and change the food first
 
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