Refereal Vet recommendation-- Dietetic Management Food

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Frimmel

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Hi, I recently had my cat to a referred vet regarding an abscessed tooth preliminary to the tooth's extraction. Much time in the appointment ended up being devoted to the cat's diabetes and 'getting it under control.' Primary to this seemed to be selling me Purina Dietetic Management cat food which it was suggested might eliminate the animal's need for insulin maintenance.

Our regular vet did not express any concern at the animal's present weight at the recent appointment to originally diagnose the tooth and when previously asked informed us getting the cat off insulin was not realistic. The new vet was also recommending a weight reduction of aprox. 35% of the animal's weight. The cat is not slender but fat doesn't seem 'right' and obese is not at all applicable.

So I'm a bit at a loss of what further inquiries and questions I should be making about this situation. While the cat could lose some weight I'm uncomfortable with starting this program so close to what will likely be a very stressful adjustment (tooth extraction.) And is it really realistic that we will be able to remove the animal's insulin need strictly from a change in diet? This cat food AND insulin is not economically viable.

Am I being fed pie in the sky as a mean's to get me buying very expensive cat food?

confused_cat
 
Yes, a cat can go off insulin on diet change alone, but not all cats will. Two of mine have, but a few others have not.

No, you do not need to buy prescription food. But what are you feeding now? If you feed dry food, that could be contributing to the FD. A canned food or raw food diet is lower in carbs, and much better for your kitty. Carbs for cats is like sugar for human diabetics. More carbs, the greater the need for insulin.

Regarding your current vet, it is realistic to think that your cat can go into remission and not need insulin, but once a diabetic, always a diabetic, meaning if you do get a diet controlled FD, diet is key or they may end up FD again. Also infections or underlying illnesses, even the need for a tooth extraction can cause the need for insulin.

How long has your cat been FD? What type of insulin do use? I'm assuming you do not hometest, since your current vet doesn't seem that concerned.

Hometesting not only saves lives, it saves money and will be your greatest tool in helping regulate your cat and/or help get your cat into remission, if your cat is not insulin dependent like my Tucker is. My other current FDs are diet controlled, but Tucker has other illnesses that cause him to be on insulin, probably for life, although he was off insulin for a year starting in May '06.
 
We haven't been doing any home testing. Last summer we had her in and the vet did the six week what the glucose has been test and was said 'no worries.' She was also very surprised that at the time of the visit her glucose was as low as it was considering how close we were to her next dose. So we've kept her on the same diet and dosage (over the counter Novolin N.) The animal has maintained her weight, activity and temperament and aside from the tooth otherwise remains 'normal.'

We are not adverse to making changes but as far as we're concerned aside from when we want to make any kind of trip we have something that 'works' is pretty easy on both the humans and cat and we aren't eager to change it even if our present system is not 'ideal.'

I just feel like the referral vet saw 'chump' on my forehead or something.
 
The expensive "Diabetic Management" food is not needed.

However, high protein, low carbohydrate diet IS helpful to reducing insulin needs.

Where do you live? We may be able to help with food recommendations.
http://www.catinfo.org is an excellent resource for FELINE NUTRITION information written by a veterinarian who is NOT SELLING anything -- just wants what is BEST for kitties.

In short - choose food that contains less than 10% carbohydrates -- avoid GRAINS and GRAVY.
The labels on the pet foods do not directly contain carbohydrate data.
Google "Janet & Binky's Food Charts" for this detailed information on many cat foods.

Some cats are able to be controlled by diet alone and no insulin. not all cats.

I have two diabetic cats now, both eating Wellness low carb canned food. Each cat needs 0.25u BID Levemir (aka detemir)
(needing the same dose is unusual)

Bad teeth can cause high blood sugar.

One of my cats just had a dental procedure and had bad teeth removed (more than one). His dose WAS 0.5u BID and now after the dental, he only needs 0.25u BID. It is possible that we may need to reduce his dose further -- we are testing his blood sugar several times per day.

So - Priority ONE is to have the bad tooth removed.

Priority TWO is to work on controlling the diabetes through insulin and diet.

Do you test your cat's blood sugar at home? We use a human glucometer to check a tiny blood sample from the edge of the cat's ear.
 
I would not say the referral vet saw chump at all. He is right that a diet change could help, but the referral vet knows most of what he does on nutrition from what he learned in school or from the food reps that come in.

The time they spend in school on nutrition is probably not a lot, I'm assuming, due to everything vets have to learn about many different species. Some vets do specialize, one that posts here occasionally, knows a lot about feline nutrition, Dr.Lisa Pierson. You can check out her website here: http://www.catinfo.org/ (catinfo.org)

If you do decide in the future that you might want to change food, I would recommend that you do look into hometesting at that point because a diet change will reduce the need for insulin. Also, if you want to look at other insulins, the N does not maintain blood sugar at lower levels and your kitty may feel a lot better on a longer lasting insulin like Levemir or Lantus.
 
Thank you both for the catinfo.org link. That is a pretty interesting site and the nutritional information was a great help.

I dropped the gal off at the vet this morning for her tooth extraction nailbite_smile and after she recovers from that we're going to look into adjustments to both of our animals' diets. I don't know that we can do a total convert to 'wet' food but I'm going to look into adjusting the budget to get a monitor and into decreasing their carbs in some way shape or form.

I certainly think the non-diabetic animal would appreciate less of the dry stuff given the face I get as often as not at feeding time. But she's still young and had more wet stuff in her diet before she came to live with us. The diabetic cat on the other hand may take a bit more effort.
 
The dry cat food and dry treats are very bad, so you get rid of them and you will see better BG numbers. Food makes a huge difference.

Where are you located, city/country? Look over the foods on the Binky's link below and see if you can purchase some of them in your area - please keep below the 10% carbs as it will make a big difference in your kitty's BG numbers.

The fancy food from the vet is not good food, and it's way too expensive.

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

If your cat eats some wet food, then you will be able to switch over to all wet easy.

When you get a glucose meter from the pharmacy to home test, you will be saving alot of money by knowing the numbers, and you may even save your cat if your test shows very low numbers.
Here are some links with info about low numbers and what to do:
List of Hypo symptoms
How to treat HYPOS – They can kill! Print this out!
Jojo’s HYPO TOOLKIT

Now, the tooth. Most definitely get the tooth done because a bad tooth can make a HUGE difference in your cat's BG numbers. My Shadoe had one tooth extracted, a right upper canine, and her numbers improved right away. I am sure you know how you feel if you have a toothache... not so good.... so the same for your gal.
When you get her home, she is going to be much better.
 
We're in the northern panhandle of WV in the US and have easy access to a couple of the Big Box pet stores but they don't have many of the more highly recommended brands. I'm still gathering information thanks to all the links being shared. We'd been discussing improving both of our cats' diets before the current situation and the whole idea can be a bit overwhelming but really seems it might be worth seeing through.

nailbite_smile The tooth is being taken care of as we speak. I await word that it is time to go and get her.
 
Sometimes kitties with teeth issues have higher bg levels. When the tooth gets fixed, they require less insulin. So it may be that you can change the food (and the tooth) and get some good results.

But to find out, you do need to hometest. Getting tests at the vet can mean stress induced higher bg levels, and dosage amounts based on those higher levels can mean too much insulin once the cat gets home. Also, if you are hometesting, you will get a true number without the insulin (It sounds like you haven't started insulin yet?)

Here is a great beginning site: http://www.sugarcats.net/sites/harry/bgtest.htm and a video to show you how: http://www.youtube.com/watch?v=_zE12-4fVn8
 
The cat has been on insulin since before I started dating her owner. She had a system in place which started getting a bit muddled and unreliable as we dated. It came to a point where I insisted the animal be moved in with me which is just over a year ago. At that point I kinda of took charge based on what my girlfriend told me were the Vet's instructions.

I reduced the cat's food intake and put her on a feeding schedule instead of ad libitum and got rigid about giving her the insulin on the schedule instructed by the vet. (And from reading here got away with a miracle apparently. ohmygod_smile ) The animal lost weight and became much happier under her new living conditions.

We had her in to the vet when she had a spell of not eating all of her food half of her total daily ration. So the vet gave us something for her eye which seemed plauged by an allergy and coincided with the not eating. The Vet did the six week glucose history check test and a BG test in the office.She was very pleased with the check in the office given where she should be in the cycle and that the cat is very nervous on her trips to the vet. The six week check came back, "Keep doing what you're doing. She's right where she needs to be." And right after starting her on the drops for her eye her appetite came back.

So as my Gal has been steady all the way around under our system (up until the abscessed tooth came up) I was a bit surprised with the recommendations from the Vet we needed for her tooth expertise.

So I just got the call from the vet that my Gal is waking up from her extraction and so far so good. She also mentioned that the animal seemed to be 'very well controlled' with regards to her BG so further news as it becomes available.
 
That's great -- depending on how long the tooth has been bad, you may be able to reduce the insulin dose now that the bad tooth is gone.

Rusty just had a dental two weeks ago and had several bad teeth removed.

Now his insulin dose is HALF what he was getting before. Good thing we're checking his blood sugar every day :)
 
So I brought her home this morning it just got to be too late for the 90 minute round trip last evening. She is on soft food for the next two weeks. She didn't eat at the vet's this morning but more or less scarfed down the canned food the doc sent home with me when I got her home. So the issue of 'finicky' doesn't seem like it will be too worrisome with regards to adjusting her diet. However, both the vet and I agree that since she is 'very well controlled' we need to be careful about changing something that works. It is not ideal but it is 'very well controlled.'

I'm going to see this evening if she'll eat her regular food 'mashed up' until we can get home-monitoring going and learning about adjusting doses et al and figure out what sort of better diet will fit in the budget. Looks like I'll be hanging out here a bit longer than I was anticipating. :smile:
 
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