Reduced carbs lead to increased thirst and lowered appetite

Pumpkin appears to be tolerating her new diet (Tiki Cats Luau Chicken, 0% carbs) well, so I've been gradually switching her over from her old diet (Hills z/d, 40% carbs). She's now at a mix of the two foods that comes out to 20% carbs. I'm probably going to stop the transition when her diet is about 10% carbs (at least for a while) because I'm often not around to monitor her during the day.

My question is how long should I wait after changing her diet before continuing dose increases? Her blood glucose continues to be high and flat even as I reduce her carb intake. If I switched her to 10% tomorrow and then did a curve, would I be ready for another increase (assuming the nadir is high, of course)? Or should I wait a few days after the diet change completes before doing an increase.

I'm only home and able to curve on Friday-Monday, so my options are either to increase this Monday or this Friday.

 

I would drop the carbs at PMPS and see what Pumpkin's numbers look like tonight and if they look the same, increase the dose in the morning.

A lot depends on your comfort level and when you're testing. I worked Mon - Fri and wasn't home during the day. I moved my shot time to 5:00 so I was able to get a couple of tests before I left for work. That allowed me to know if Gabby's numbers were dropping. You may also want to consider a timed feeder so your cat has food available during the day when you're not home.

 

Thanks! I dropped her carbs last night. A bit of a change, but not much. She stayed in the pinks all evening, at least. I'm still going to play it safe and do a curve today, but if that's not showing a change I won't wait until Friday to increase her dose.

I've got her on an automatic feeder. Two, in fact. Pumpkin gets so dRaMaTiC if it's been more than a couple hours since her last meal, and even more so in the evening, so she's been on an automatic feeder most of her life. I keep telling her she has to talk to the machine if she wants her food faster, but I think she knows who's programming the machine .

 

Today I'm noticing that she's drinking more and her appetite is a bit lower.

I weigh her water bowl when I refill it in the morning and evening. She normally drinks 7 or 8 oz overnight. Last night after reducing her carbs it was 10 oz.

Her appetite is also a bit lower. She normally wakes me up 30 minutes before her morning meal, and then eats every morsel I put in front of her. Today she ate nearly all of her meal, but left a few grams of chicken behind (she lapped up every bit of broth).

It's worth mentioning that I'm giving her a lot more calories than she normally needs because of her weight loss. Before the diabetes started, she needed about 280 calories, but she's been getting more like 370 calories a day.

Is increased thirst + lowered appetite something to worry about after reducing carbs?

 

If she's been chillin in the higher bgs I'd say the increased thirst can be from that. I see it in my new diabetic. He chugs water if he's up past 350 but doesn't touch water under 300. Next time she's a bit lower bg wise monitor her water and see if that's the culprit.

 

She already had increased thirst from the diabetes. She used to drink about 4 oz of water per day, but after the diabetes that increased to 16 oz per day. From this morning's trend, she's on track for 20 oz.

 

Hmm, maybe there's more sodium in the tiki?

 

Oh what I was trying to say was that the small fluctuations in daily BG can drive thirst. All diabetics are thirsty yes, but I see differences daily as I do a LOT of BG checks and am home 95% of the time. My cat was at 410 at preshot and he was chugging. Yesterday his preshot was in the 200s and he didn't touch his water.

 

Her BG is lower than usual today, but her thirst is higher.

I'm also seeing a bit more lethargy. Hard to say for sure if it's worse or not because she's been generally lethargic since we started treating her. She did just get up and jump on her +2 meal.

I tested her urine for ketones, it was negative.

 

She is hanging out high alot. Curious I checked your labs but didn't see a result for lipase, do you have that result?

 

I don’t have a lipase result.

The hanging out high could be a result of her diet until recently being 40% carbs. It sounds like if she still stays high after the switch to the lower carb diet we should test for pancreatitis?

 

Well pancreatitis and diabetes just kinda go hand in hand. I read a study where like 80% of diabetic cats also had pancreatitis but I don't know if that was the right number. It was high. Idk if it's needed if kitty isn't clinical (decreased appetite, lethargy, nausea, vomiting, abdominal pain) that's why I was just curious about lipase. The best test for pancreatitis is a snapFPL and not a lipase result, but it gives you an idea.

How long has she been on the tiki now? Does she seem to like it alot?

 

I started feeding the Tiki as a small snack on February 19, increased the proportion on the 23rd, then from March 2 to 5th I completed the transition.

She seems to like it. She meows very excitedly when I take it out (as she does for all meals), and quickly inhales it when I put it out, finishing every bite (except this morning). She might like the broth a bit more than the chicken because even when she doesn't eat every morsel she does lap up all the broth. But, that could just be the diabetes thirst.

She had some minor GI upset when I was first trying it, but that could be a hangover from the other food I was trying. With the possible exception of the lethargy, which could be caused by so may things, I don't see any signs of GI upset. No burping, no diarrhea, no vomiting.

 

Do you know how how to do a skin turgor test? It's super easy and we can see how she's doing hydration wise

 

I know how to do one now . Looks pretty snappy and normal.

If looks like she might have just gotten a head start on her water Sunday. She's come in at 15, 17, and 15 oz the past three days. That isn't the improvement I'm looking for but at least it's not worse.

 

Well atleast she's drinking and flushing the yuck out of her bladder. Utis and such are very common with diabetics because of the increased glucose in the urine. As her numbers come down more and more the water chug will too. We're looking to maintain a nadir from 90 to 150 (at least for my dosing method with prozinc, im not a lantus person yet) and your sweet kitty has a bit to go until we're there it took my kitty 2 rounds of different antibiotics and were up to 2u of prozinc to break through that glucose and start seeing better numbers. Did your vet mention anything about infection possibly?

 

No mention of UTI. I don’t think there were any signs from the two urinalyses they did.

She did have some dental issues from a quick examination. He wants to get her blood glucose regulated before we put her under to look at those more deeply.

 

Well a dental issue can cause what we're seeing here. If there's an infection happening the easiest way to lower numbers is with antibiotics. Check out my spreadsheet. I went through 2 weeks of doxy before i saw any nadir activity, and then 5 days of azithromycin to start pulling better curves. Kitty had an upper respiratory infection. A dental reason could be why your kitty focuses on the juice of the tiki cat and not the meat.