question about CKD & diabetes

[sherrib]

short back story

skittles went into remission in 12/15, he was DX in 10/15. He came out in 2017, went back into remission 1/20.

last year he was stage 2 CKD. 3 weeks ago I found out he is now stage 3. Got new bloodwork today, results will be in tomorrow.

Skittles has lost a LOT of weight, he has been 16 lbs for 14.5 years. Today he was 12.6 lbs. The weight lost started in Feb ( remember this part ).

Here is what I am thinking and need ALL your feed back on.

Vet thinks he is still a diabetic, but his BG states otherwise. BUT sometimes his BG goes up. for months he his BG stayed anywhere for 170-200. When he was at or lower then 169 I did not give him any insulin. and at those numbers I would give 1 U. Then sometimes his BG would be really high. So I decided one day to stop giving any insulin to see if he was just bouncing, after a couple of days he numbers stayed low, so he was really was back of the juice. Ive been thinking this whole time that he was in remission before Jan and that I was the one making his BG go up when I was giving him insulin.

Sometimes when I spot check him, his BG will be up but I have not been giving anything. I wait and then test again hours later or the next day and his numbers are back down. today at the vets office his was 244. So his doctor said, he is out of remission and that's why he has lost so much weight. I told him that I think he is wrong and that he is high right now because he is here and I pulled out my chart and my meter and showed him all my numbers. My question...… what if he DOES need insulin, just not everyday? what if he only needs if every few days or longer? that would explain his rapid weight lost and maybe moving into in stage 3 CKD? Arent there some cats that need insulin " as needed" and not every day? If this is possible, what should I do?

Im wondering if the days he attacks his brother are the days that his BG is up and he feels like crap and this is his way of telling me? Im going to test his BG at 9:00 PM EST. if he is over 200, what do you think I should do?

I had to give him some Gabapentin before his appt today because he freaks out at the vet office and I didn't want him to have a FLUTD flare up from the stress. 6.5 hours later he is still VERY drugged up so I gave him some SubQ to help flush his system, I guess with his kidney disease its taking twice as long to clear his system

 

[sherrib]

and whats up with vets saying insulin should only be giving at 300 and over not at 200 and over anymore?

 

[sherrib]

WOW

 

[JanetNJ]

do you have any readings from the last week or two you could add to your spreadsheeT? I only see readings from last year. Are you home now that you could take readings mid cycle? Do you have the lab report from his most recent blood work? How often are you giving sub q's? What is he eating? You are still using a human meter, correct? If so the numbers you mentioned are all high. Normal on remission should be 50-120. If you are seeing 150+ then he's needing some insulin, even if it's only 0.25-1 unit.

 

[sherrib]

do you have any readings from the last week or two you could add to your spreadsheeT?——- Yes

Are you home now that you could take readings mid cycle?——— Yes, I still test at least once a week , more if he is acting off

Do you have the lab report from his most recent blood work? ———Yes, if will post them. But they are from 2 different labs so the numbers are a little different

How often are you giving sub q's?——- Just started this week and supposed to do it 3 times a week ( 100 ml )

What is he eating?——— He has been eating Pro Plan urinary health tract Turkey & Giblets

You are still using a human meter, correct?——— Yes

If so the numbers you mentioned are all high.——- When I say high, any numbers I get 200 and up. He stays around 140-150 , but has been in 170’s sometimes. So this whole time he still should’ve been getting insulin if he was over 120? If so... I’ve been literally killing him! The last 2 different vets he has seen in the last 2 months both said that the “ diabetic “ number have been moved to 300 and over

Normal on remission should be 50-120.——- He rarely gets 120 or below! I can not believe that I have done this to him!

He just ate, so I will test him in 2 hours and restart his insulin. I just have no idea how many units to start him.

I can not believe this! WTH, I am the reason why he has lost weight , and moved from stage 2 to stage 3 .... high stage 3 at that! I don’t even want to wait 2 hours now. I just want to give insulin right now! Do I have to wait? I know his food will make his BG high This morning at 11:06 his BG was 145

11: PM on 4/22 he was 206 but that was vet day
4/23 @ 11 AM = 145
4/18 @ 1 AM =124
4/23 @ 11 PM = 174
3/20 @ 11 AM= 137
3/17 @ 10 AM= 186
3/8 @ 1 PM= 188
3/4 @ 12:59 PM =137
3/03 @ 1 PM =200

I have reading all the way until the last date on my SS written down in my notebook. But sometimes it’s been 1.5- 2 weeks between test

So you can see that he bounces all over the place

I can already tell you without posting his BG numbers that he has not been 120 - 50 every day.

If you are seeing 150+ then he's needing some insulin, even if it's only 0.25-1 unit.

do you have any readings from the last week or two you could add to your spreadsheeT? I only see readings from last year. Are you home now that you could take readings mid cycle? Do you have the lab report from his most recent blood work? How often are you giving sub q's? What is he eating? You are still using a human meter, correct? If so the numbers you mentioned are all high. Normal on remission should be 50-120. If you are seeing 150+ then he's needing some insulin, even if it's only 0.25-1 unit.

Thank you for replying back to me. I am a member in one of the CKD groups on FB but sometimes I don’t feel “ the love” and support like everyone usually is here. I know this isn’t a CKD group but I’m just so much shocked and still upset. Frankly, I need my hand held and all the help I can get. I am the biggest baby when it comes to skittles because he saved my life less then 3 yrs ago ( suicidal )

 

[sherrib]

Second one is from 3/24. And that vet didn’t get phos, Potassium and calcium

 

[JanetNJ]

Thank you for replying back to me. I am a member in one of the CKD groups on FB but sometimes I don’t feel “ the love” and support like everyone usually is here. I know this isn’t a CKD group but I’m just so much shocked and still upset. Frankly, I need my hand held and all the help I can get. I am the biggest baby when it comes to skittles because he saved my life less then 3 yrs ago ( suicidal )

Really his bg numbers aren't terrible, please don't feel guilty... But it seems like A LITTLE insulin support would help him. Vets see higher numbers because they are using a pet meter and because the cats usually run higher when they are stressed at the vets office. I'm glad you are starting sub q's, that will help support the kidneys! The food you are feeding is 12% carb according to the food chart .... A bit on the high side. Let me tag a few to see if anyone else can offer suggestions.


@JeffJ @Kris & Teasel @Sharon14

 

[JanetNJ]

Ok just looked at the labs. He's boarderline anemic.... Did the vet mention that? He could use some b12 methylcobalamin for that. He may have been dehydrated to make the numbers rise so much. I'm glad you're starting sub q's. I'll tag @Marje and Gracie . She's good at reading labs.

 

[Bron and Sheba (GA)]

I don’t use prozinc so I can’t help with dosing with that, but to me he looks like he needs some insulin. If he was on Lantus for example I would say he does need some to support the pancreas. To get a strong remission you need to reduce the dose down to almost no insulin and be able stay in normal numbers.

What food are you feeding him?
I see Janet had tagged Marje, that’s good. Hopefully she will have some suggestions.
I understand your concerns.

 

[JanetNJ]

I don’t use prozinc so I can’t help with dosing with that, but to me he looks like he needs some insulin. If he was on Lantus for example I would say he does need some to support the pancreas. To get a strong remission you need to reduce the dose down to almost no insulin and be able stay in normal numbers.

What food are you feeding him?
I see Janet had tagged Marje, that’s good. Hopefully she will have some suggestions.
I understand your concerns.

She said she was feeding
Pro plan urinary health turkey & gibblets.

 

[Marje and Gracie]

short back story

skittles went into remission in 12/15, he was DX in 10/15. He came out in 2017, went back into remission 1/20.

last year he was stage 2 CKD. 3 weeks ago I found out he is now stage 3. Got new bloodwork today, results will be in tomorrow.

Skittles has lost a LOT of weight, he has been 16 lbs for 14.5http://felinecrf.org/phosphorus.htm years. Today he was 12.6 lbs. The weight lost started in Feb ( remember this part ).

Here is what I am thinking and need ALL your feed back on.

Vet thinks he is still a diabetic, but his BG states otherwise. BUT sometimes his BG goes up. for months he his BG stayed anywhere for 170-200. When he was at or lower then 169 I did not give him any insulin. and at those numbers I would give 1 U. Then sometimes his BG would be really high. So I decided one day to stop giving any insulin to see if he was just bouncing, after a couple of days he numbers stayed low, so he was really was back of the juice. Ive been thinking this whole time that he was in remission before Jan and that I was the one making his BG go up when I was giving him insulin.

Sometimes when I spot check him, his BG will be up but I have not been giving anything. I wait and then test again hours later or the next day and his numbers are back down. today at the vets office his was 244. So his doctor said, he is out of remission and that's why he has lost so much weight. I told him that I think he is wrong and that he is high right now because he is here and I pulled out my chart and my meter and showed him all my numbers. My question...… what if he DOES need insulin, just not everyday? what if he only needs if every few days or longer? that would explain his rapid weight lost and maybe moving into in stage 3 CKD? Arent there some cats that need insulin " as needed" and not every day? If this is possible, what should I do?

Im wondering if the days he attacks his brother are the days that his BG is up and he feels like crap and this is his way of telling me? Im going to test his BG at 9:00 PM EST. if he is over 200, what do you think I should do?

I had to give him some Gabapentin before his appt today because he freaks out at the vet office and I didn't want him to have a FLUTD flare up from the stress. 6.5 hours later he is still VERY drugged up so I gave him some SubQ to help flush his system, I guess with his kidney disease its taking twice as long to clear his system

Without an updated SS, I can’t comment on whether he needs insulin or how much. Your vet is right because even cats in remission are still diabetic. The ones in remission are just insulin independent.

A cat in remission might have the occasional blue AMBG or PMBG. If so, you should feed and test in three hours. If his BG is not green, he likely needs some insulin. Again, without an updated SS, for safety, I won’t guess at a dose. If you have BGs, I’d get his SS updated at least for the last few weeks and then ask for dosing advice.

It’s not common to see a cat that needs a drop of insulin here and there. I won’t say it never happens. Sometimes one will fall out of remission but then go back with a few weeks of the right dose of insulin. Usually, when they fall out of remission, it’s a bit more challenging to get them back to the Falls.

Have you ever tried Rescue Remedy for pets for the vet visit?

Janet is correct that he needs methylb12 but also a multiB to help with the anemia. It won’t work to just give one. You can read about Anemia on Tanya’s and be sure to scroll down to where she has the link to B Vitamins.

His phosphorus is ok but it should be lower. And his potassium is a tiny bit on the low side. You generally want it above 4.

 

[JanetNJ]

This is the b I've given my cat

Rx Vitamins for Pets Amino B-Plex for Dogs & Cats - Healthy Nutrients Enhance Energy Metabolism & Vitality - Bacon Flavor 4 fl. oz. https://www.amazon.com/dp/B003PQYLI8/?tag=felinediabetesfdmb-20

Plus I give half a zobaline a few times a week.

 

[sherrib]

Really his bg numbers aren't terrible, please don't feel guilty... But it seems like A LITTLE insulin support would help him. Vets see higher numbers because they are using a pet meter and because the cats usually run higher when they are stressed at the vets office. I'm glad you are starting sub q's, that will help support the kidneys! The food you are feeding is 12% carb according to the food chart .... A bit on the high side. Let me tag a few to see if anyone else can offer suggestions.


@JeffJ @Kris & Teasel @Sharon14

12% carb? Has the food chart changed in the last year? I picked that food due to the numbers on the chart. I had to find one that was not only low in *carbs but also lower in phos and had no seafood ( and pate )
*10 carbs & under

 

[sherrib]

This is the b I've given my cat

Rx Vitamins for Pets Amino B-Plex for Dogs & Cats - Healthy Nutrients Enhance Energy Metabolism & Vitality - Bacon Flavor 4 fl. oz. https://www.amazon.com/dp/B003PQYLI8/?tag=felinediabetesfdmb-20

Plus I give half a zobaline a few times a week.

I can go back to giving him zobaline, he used to get this back in 2015.

I’m gonna go read the links in the comments and be back.

Oh, the link to my SS isn’t working on my cell that’s why his chart isn’t updated . I’m gonna unpack my old laptop and see if the link still works . Hopefully it does so I won’t need help with another SS

Thank you EVERYONE!! Be back soon

 

[JeffJ]

You are getting good advice from others. I would be extremely concerned about that weight loss. Updated BG numbers would be very helpful.

Zobaline is easy to dose and it is cheap. Plus it won't hurt him at all. He will just pee out the excess.

 

[Sharon14]

12% carb? Has the food chart changed in the last year? I picked that food due to the numbers on the chart. I had to find one that was not only low in *carbs but also lower in phos and had no seafood ( and pate )
*10 carbs & under

Hi Sherrib looks like you’ve gotten some great help. As far as I know the Pro Plan Focus Urinary Turkey pate is fine. It’s what I fed my cat along with Organix Chicken or Turkey (not sure if there’s any seafood in these) How is Skittles feeling? How much and how often are you giving the sub Q’s?

 

[JanetNJ]

12% carb? Has the food chart changed in the last year? I picked that food due to the numbers on the chart. I had to find one that was not only low in *carbs but also lower in phos and had no seafood ( and pate )
*10 carbs & under

I thought You were giving the one at the bottom, no? if not then sorry I looked up the wrong one. If the one you are giving is a pate then it's fine

 

[JanetNJ]

My cat is also ckd (and hyperthyroidism)This is what I’m currently feeding.

Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb). Also Jeopurrdy Chicken (0.97 P 6.1 carb)

Weruva Steak Frites (0.57 phosphorus 7.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

weruva Fowl Ball chicken and turkey (0.89 phosphorus 0 carb).

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5
Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p and
Press your lunch 5.9 carb. 0.82 phosphorous

 

[sherrib]

I thought You were giving the one at the bottom, no? if not then sorry I looked up the wrong one. If the one you are giving is a pate then it's fine


View attachment 52981

Yes the pate only

Oh.... it’s NOT the RX one

 

[sherrib]

Hi Sherrib looks like you’ve gotten some great help. As far as I know the Pro Plan Focus Urinary Turkey pate is fine. It’s what I fed my cat along with Organix Chicken or Turkey (not sure if there’s any seafood in these) How is Skittles feeling? How much and how often are you giving the sub Q’s?

Every since his vet appointment Tuesday afternoon he looks like he doesn’t feel good but tonight he looks a little better. He ate better a few mins ago. I was starting to get very worried because he didn’t want to eat that much. Of course he will eat the Royal Canin Renal can food BUT I am not going to fed it due to the high carbs unless I have no choice . He vet told me again today that he HAS to be on RX renal food, but.....

Can’t get my link to work for this SS.

Last night his BG was 114.

I’m gonna give 100 cc 3 days a week. Actually his vet said 3 x weekly and also said every other day so I’m not sure which one. The new bad of fluid I picked up in NOT LRS, it has 0.9 % sodium chloride instead of LRS like my other bag ( name ) and skittles will not sit still when I giving it. I don’t know if I was given the wrong bag or what. As long as it won’t cause any harm, I will use it.

Skittles got another .50 cc of Calcitriol tonight and he hates it! The stuff smells so bad too!

 

[sherrib]

My cat is also ckd (and hyperthyroidism)This is what I’m currently feeding.

Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb). Also Jeopurrdy Chicken (0.97 P 6.1 carb)

Weruva Steak Frites (0.57 phosphorus 7.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

weruva Fowl Ball chicken and turkey (0.89 phosphorus 0 carb).

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5
Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p and
Press your lunch 5.9 carb. 0.82 phosphorous

How long has your baby has CKD? What stage is he? The only place around me is PetSmart and 1 local holistic store. I can try both of those places for food. The holistic store has Dr Lisa food list printed out for customers to use !
My cats only like Pate food though. And skittles has FLUID so I stay away from seafood. His thyroid numbers are good .
Very interesting food names, LOVE it!! If its the test for my baby that's all that matters But what about his brother. Should I feed him the same food? He bloodwork is good
Found out about 3-4 weeks ago skittles has stage 3 maybe low 4 ( his bloodwork is posted above) . I used 2 totally different veterinary practices. The second one was taken 3 1/2 weeks ago, March 24 th I believe but she left out 3 important test.

 

[sherrib]

How long has your baby has CKD? What stage is he? The only place around me is PetSmart and 1 local holistic store. I can try both of those places for food. The holistic store has Dr Lisa food list printed out for customers to use !
My cats only like Pate food though. And skittles has FLUID so I stay away from seafood. His thyroid numbers are good .

Found out about 3-4 weeks ago skittles has stage 3 maybe low 4 ( his bloodwork is posted above) . I used 2 totally different veterinary practices. The second one was taken 3 1/2 weeks ago, March 24 th I believe but she left out 3 important test.

Found out he moved from stage 2 because it was time for his yearly bloodwork and a dental appointment plus I noticed some weight lost. Now he can’t get his teeth cleaned and 2 that need to come out. He is back on pulse therapy . At least until or if we can get his level down. The vet feels to uncomfortable knocking him out. His bother was able to get his dental done and all his bloodwork is perfect to be 15 but does have bad arthritis in one of his front legs so now he is on medication for the rest of his life . I’m not even going to say the amount of money I have spend the past 4 months. 4/14 was my last day of work because my company closed down for good

 

[sherrib]

Found out he moved from stage 2 because it was time for his yearly bloodwork and a dental appointment plus I noticed some weight lost. Now he can’t get his teeth cleaned and 2 that need to come out. He is back on pulse therapy . At least until or if we can get his level down. The vet feels to uncomfortable knocking him out. His bother was able to get his dental done and all his bloodwork is perfect to be 15 but does have bad arthritis in one of his front legs so now he is on medication for the rest of his life . I’m not even going to say the amount of money I have spend the past 4 months. 4/14 was my last day of work because my company closed down for good

 

[sherrib]

And to clarify his food
The pro plan urinary tract health Turkey and giblet pate is NOT the RX one.

He is NOT on any RX food but his vet did give me some but it’s high in carbs and skittles BG has been mostly 120’-140’ with sometimes getting back up to 200+ but never more then a day. But I did go 2 weeks without checking him. But he gets checked once a week unless his number is high and then I recheck 2 hrs later

 

[sherrib]

Hi Sherrib looks like you’ve gotten some great help. As far as I know the Pro Plan Focus Urinary Turkey pate is fine. It’s what I fed my cat along with Organix Chicken or Turkey (not sure if there’s any seafood in these) How is Skittles feeling? How much and how often are you giving the sub Q’s?

The food you mentioned, are the low carb too?

 

[Sharon14]

The food you mentioned, are the low carb too?

According to Dr Lisa’s chart they are. I bought the Organix at Petco.

 

[JanetNJ]

How long has your baby has CKD? What stage is he? The only place around me is PetSmart and 1 local holistic store. I can try both of those places for food. The holistic store has Dr Lisa food list printed out for customers to use !
My cats only like Pate food though. And skittles has FLUID so I stay away from seafood. His thyroid numbers are good .
Very interesting food names, LOVE it!! If its the test for my baby that's all that matters But what about his brother. Should I feed him the same food? He bloodwork is good
Found out about 3-4 weeks ago skittles has stage 3 maybe low 4 ( his bloodwork is posted above) . I used 2 totally different veterinary practices. The second one was taken 3 1/2 weeks ago, March 24 th I believe but she left out 3 important test.

She has been CKD for a year (in three days it will be a year). I have my labs in my spreadsheet if you want to see. So a year ago her Creatnine was 1.7 (not terrible), then in November it was 2.3, and December it want up to 2.6. The sharp rise may be because she started getting treated for hyperthyroidism which can mask CKD issues... but then a month later after switching to the current foods in December the creatnine went back down to 1. 9. She's due for bloodwork this month, so I'll have to see what it is now. She's not on any sub q's at the moment... I just add a lot of extra water to her food.

 

[JanetNJ]

Found out he moved from stage 2 because it was time for his yearly bloodwork and a dental appointment plus I noticed some weight lost. Now he can’t get his teeth cleaned and 2 that need to come out. He is back on pulse therapy . At least until or if we can get his level down. The vet feels to uncomfortable knocking him out. His bother was able to get his dental done and all his bloodwork is perfect to be 15 but does have bad arthritis in one of his front legs so now he is on medication for the rest of his life . I’m not even going to say the amount of money I have spend the past 4 months. 4/14 was my last day of work because my company closed down for good

try Adequan for the arthritis! Makes a HUGE difference!!

 

[sherrib]

try Adequan for the arthritis! Makes a HUGE difference!!

He is on Dasuquin twice daily
Metacam 3 days a week
Gabapentin twice daily
And supposed to get a shot once a week , but that’s hasn’t started yet. All his labs were good. His kidneys levels were a tiny bit elevated but was told because he is 15 years old. Supposedly the Metacam is safe due to his labs ( just realized I don’t have his labs)

But I’m not giving the Gabapentin & Metacam daily anymore since he is not limping as much. I’m trying to see if the dasuquin is working. If it’s not I will go back to the pain & inflammation meds

 

[sherrib]

He is on Dasuquin twice daily
Metacam 3 days a week
Gabapentin twice daily
And supposed to get a shot once a week , but that’s hasn’t started yet. All his labs were good. His kidneys levels were a tiny bit elevated but was told because he is 15 years old. Supposedly the Metacam is safe due to his labs ( just realized I don’t have his labs)

But I’m not giving the Gabapentin & Metacam daily anymore since he is not limping as much. I’m trying to see if the dasuquin is working. If it’s not I will go back to the pain & inflammation meds

He had some teeth removed so I did give him everything listed for a week. He got his teeth done over a week ago

 

[sherrib]

This is the b I've given my cat

Rx Vitamins for Pets Amino B-Plex for Dogs & Cats - Healthy Nutrients Enhance Energy Metabolism & Vitality - Bacon Flavor 4 fl. oz. https://www.amazon.com/dp/B003PQYLI8/?tag=felinediabetesfdmb-20. Any carbs in this?

Plus I give half a zobaline a few times a week.