Newly diagnosed, advice welcome!

Jennifer & Rhubarb

Member Since 2017
Hi everyone,

My account is from my last cat, Splunk, who was diagnosed with diabetes back in 2017. Splunk was on Prozinc, and went into remission quite quickly. So my experience with feline diabetes has been a relatively easy one... until now.

I'm here now with a new feline friend, Rhubarb, an orange tabby who was just diagnosed in late January. (I'll change the profile name and pic if I can figure out how.) Rhubarb was a stray; he followed me home two years ago, when he was outside in -25C weather and decided he'd rather be inside (fair!). We think he's about 4. He's been healthy except for constipation (he's taking Lactulose) and having to have an eye removed due to a congenital problem which caused dangerously high intra-ocular pressure and blindness (he was already blind when he adopted me, and his globe was over-sized and at risk of infection/rupture/etc., so we thought removing it was the best course of action).

Late in January, I noticed Rhubarb was drinking and urinating to excess, so I checked his sugar, only to find it was 33 mmol/L (~599 mg/dL). Fructosamine was also high. (Bloodwork done a few months before had been unremarkable). I rushed him to the emergency vet, and found he was not in DKA (phew). They prescribed 1.5 units twice daily of the long-acting insulin Lantus (glargine). I asked at the time about bringing his sugar down with a shorter-acting insulin, and was told it wasn't something routinely done in cats. They warned me it would take a couple of weeks for his sugar to come down, and advised me not to check his sugar neurotically (as I am prone to do) in the meantime.

I checked his sugar only a few times over the two weeks, and found that after 14 days his sugar was still in the high 20s any time I checked. I had to wait for another vet appointment, so I increased his Lantus to 2 units twice daily while I was waiting, because I was so worried about damage being done by his sugar being high... and worried about the possibility of him going into DKA.

At 2 units twice daily, his sugar is still in the 20s. The vet wanted a curve before increasing his insulin again, so I hooked Rhubarb up with a Freestyle Libre sensor. The sensor suits me, because I have a lot of anxiety about his sugar levels, and this lets me check any time. (He's a superhero and is tolerating it really well). I did the curve yesterday, and it's showing "HI" (>22.2 mmol/L / >399 mg/dL) most of the time, with occasional dips into the 20-21 range. Obviously still much too high overall.

I've sent the vet his results, but it will likely be a few days before I hear back, so I've made the executive decision to increase his insulin to 2.5 units twice daily in the meantime (with regular sugar checks for safety). That sugar has to come down!

Currently, Rhubarb is eating Purina Pro Plan Dietetic dry food. I know, it's not ideal. The vet wants him on this food, but I'm hoping to switch it up to something better, and suggestions are appreciated. I'm aware of the benefits of wet food, and Splunk was on wet food exclusively, but Rhubarb would rather go hungry than eat wet food, which is clearly no good.

Anyway, sorry this is a bit long, and thanks if you've read this far. I'm feeling quite desperate about his sugar being so high (his poor little kidneys, etc.!), and I'd really appreciate any thoughts anyone has regarding how I can help him better.

I should say that his appetite is good, he's still drinking and peeing to excess, but less than previously, and his energy levels are good. His weight is holding at 7.3 kg (16 lb). He's not behaving like a sick cat; he's a happy, snuggly, perfect boy.

All the best to you and your kitties,

Jennifer & Rhubarb

P.S. Working on getting the spreadsheet going for Rhubarb... will attach to my signature asap.
 
If Rhubarb is a dry food junkie, you have limited choices for low carb food. Unfortunately, the dry Pro Plan is high carb which is likely contributing to the high numbers. The Pro Plan dry is around 18% carb. We consider under 10% to be low carb although most members here feed their cat a diet that's around 5%.

The two dry foods that are low in carbs are Dr. Elsie's Clean Protein and Young Again Zero Carb. (The Young Again isn't zero carb but it's low.) Other possibilities may be ZiwiPeak that has an air dried raw option or Stella & Chewy's dinner morsels which are a freeze dried raw food.

When switching to low carb, please do so slowly. You don't want your cat's numbers to plummet which can happen if you switch to low carb and your insulin dose is based on a high carb diet.
 
If Rhubarb is a dry food junkie, you have limited choices for low carb food. Unfortunately, the dry Pro Plan is high carb which is likely contributing to the high numbers. The Pro Plan dry is around 18% carb. We consider under 10% to be low carb although most members here feed their cat a diet that's around 5%.

The two dry foods that are low in carbs are Dr. Elsie's Clean Protein and Young Again Zero Carb. (The Young Again isn't zero carb but it's low.) Other possibilities may be ZiwiPeak that has an air dried raw option or Stella & Chewy's dinner morsels which are a freeze dried raw food.

When switching to low carb, please do so slowly. You don't want your cat's numbers to plummet which can happen if you switch to low carb and your insulin dose is based on a high carb diet.

Thank you so much for this; I really appreciate it. I’m trying to transition him to wet food, but it’s not going well.

I previously tried the YA dry with my last cat, and, despite a very slow transition, all three of my cats at the time became quite ill after eating it for a few days. I know a lot of people have success with it, so maybe it was a bad bag, but I’m feeling very wary of that brand now.

I’ll definitely try Dr. Elsley’s with Rhubarb and see if it makes a difference. My only concern is that as he’s already prone to constipation, it may worsen on a very low carb diet. But I can increase his psyllium & lactulose if that’s the case.

Thanks a million for your advice!
 
The Lactulose you can give twice a day 1 ml in the meal, please note that when Rhubarb is on full low carb the pooping pattern will change, since there’s no waste in the wet low carb he will most lily poop every other day, not like with dry that sometimes can poop twice daily, make sure you check the BG Numbers often when you start the transition, since it can lower the BG in that process, you are using the CGM so keep an eye on the numbers😉
 
Will Rhubarb eat the dry food if you add water? That's another option. Also, if you don't have a water fountain, that may encourage your cat to drink more which can help with constipation.
 
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