Should I start the insulin or try RX food first?

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Mieke

Member Since 2012
The vet wants me to start Gypsy on insulin (Lantus) right away. Her glucose is 257. I have read on your website that some people start a RX diet first coupled with Dia-lonX first before the insulin to see how it goes. Right now Gypsy is on Eukanuba. I was thinking of trying Wellness Core dry with some Fancy Feast Classic mixed in. I am so confused with all the food. I am so afraid of foods with high protein because I lost my precious baby to CRF a few years ago, which is such a horrible disease.

Also, the insulin (Lantus) is $155.00 with Gypsy starting .5 unit 2x's a day. The pharmacy told me the insulin is only good for 28 days. One bottle would almost last a year. Does anyone know?

I am so upset and overwhelmed. Thank you for your help.

Mieke

Mommie to Pirate and Gypsy
 
Was her glucose 257 at home or at the vet? If at the vet, I would definitely try wet low carb food first. (Most cats test higher at the vet because stress raises bg levels.) You also need to start testing at home to see if the levels lower or go up - that will help you decide about the insulin. We can teach you over the internet; we have taught hundreds of people.

Most of us feed under 8-10% carbs - Fancy Feast or Friskies if money is an issue. Merrick or Wellness if you like the higher quality foods. See this food chart for info on carbs: Janet and Binky’s chart

And breathe. We have helped lots of people with diabetic cats and we would love to help you. It seems completely overwhelming at first, but you learn a little bit at a time and pretty soon you are posting to newbies about what worked for you!
 
Welcome Mieke and extra sweet Gypsy!

Food - if you are going to feed dry, I would definitely suggest that you go to Wellness CORE or EVO....KT doesn't care for CORE but he LOVES the EVO. PetSmart carries CORE but not EVO. Wet is much better for them but some cats just LIKE their dry food. I sprinkle a few pieces on top of his soft when he goes on a 'hard food' chant.

Insulin - technically it's supposed to last 28 days so they have to tell you that. For humans that take more units than we give our cats, that's no big deal. As long as you treat it respectfully - keep it in fridge (not the door!), don't roll or shake it, it will last a LOT longer. I keep mine in it's box wrapped in a washcloth standing in a plastic cottage cheese container. That way I just grab the whole thing and have something soft to hold it all over as I draw the dose.

BIG HUG! And BREATHE!!! This is do-able!!!!
 
Rather than purchasing the vial of insulin, we recommend purchasing the pens. It works the same as the vial, only it is a smaller container and you get 5 pens. So, the chances are you will use the pen completely before it goes bad. And if it does go bad, then you are losing a smaller amount of insulin than if you purchased the vial.

HEre is a link to a coupon for Lantus that will help with the cost as well: viewtopic.php?f=15&t=36964

Also, call your local pharmacies to find out who sells it the cheapest. For me, I found that Costco was cheapest (not sure if they will take a coupon), but I got mine before coupons.

There are three key factors to managing diabetes: food/nutrition, home testing and insulin

1) Feline Nutrition: Now, as far as diet - definitely dump the dry food (if you are feeding any) and if the vet recommends purchasing prescription food like DM just say "no thank you". ALL cats, and especially those with diabetes, do best on a species appropriate diet that is high in protein and low in carbs. Dry food DOES NOT fit that bill and DM food, even canned, just really isn't that great as far as quality. Most here on FDMB feed low carb/high protein canned, raw bought from a pet store or they make there own.

Here great links, one is to a food chart put together by one of our board members that breaks down the carb % and protein % of most of the commercial brand foods. You want to keep the carb % below 10% and around 7% is great. The other link is to a site by a vet "Dr. Lisa DVM" ... who also posts on this board from time to time ... there is in-depth info. there about many things, including nutrition and how to make raw food.
Nutrition/food info

The good thing with feeding your diabetic cat this way, is that it is ALSO good for any non-diabetic cat too. All your cats can safely eat the same food without worry and it may save you some costs and headaches of having to do separate feedings and keeping track of what they are eating.


2. Home testing: It is impossible to convey the value of testing your cat's BG (blood glucose) level at home. Some vets will "suggest" this, but most won't even mention it. They will send you home with insulin and an amount to shoot and maybe some instructions about hypoglycemia (blood sugar dropping to a dangerously low level).

Well, the thing is, human diabetics don't EVER give themselves insulin without checking there BG to make sure it is safe to do so, so why shouldn't it be the same for our kitties. Here on FDMB it is. You will notice that the vast majority of people here test their cat's BG at least 2x/day (before giving each shot to make sure the level is safe enough) and periodically at other times to see how the cat is responding to the current dose. We use a human glucometer, test strips and lancets - which are all very readily available and easy to use.


Whether you decide to try food first or go straight to food and insulin, please be sure you home test as this is vital to knowing what's going on and whether A) it is safe to give insulin and B) if the food alone is working.
 
High Protein does not cause kidney disease. From the LBC website:
Recent research suggests a link between vaccination for feline distemper and immune-mediated inflammation of the kidneys, which is thought to be the cause of CRF. Annual boosters for distemper are completely unnecessary. Be sure to discuss all recommended vaccines with your veterinarian. A cat with kidney disease or kidney failure should not be vaccinated at all.

Long-term feeding of an all-dry-food diet is also suspected as a factor in Chronic Renal Failure. Cats' kidneys are highly efficient and adapted to life in the desert, where they would get most or all of their water from eating their prey. Cats eating dry cat food take in only half the water that cats on a canned or homemade diet get; this chronic dehydration can cause stress on the kidneys over time. Dry diets also predispose cats to lower urinary tract disease (FLUTD, LUTD, FUS, crystals, stones, cystitis) because they force such a high degree of urine concentration.

Chronic or recurrent bladder disease may also be a factor in the development of CRF.
Click to expand...

Low protein diets are useful in alleviating the symptoms of a cat in late stage renal failure, but they are NOT recommended for healthy or early stage cats with Chronic Kidney Disease because they cause muscle wasting and adversely affect the cats' overall health. Current research shows that a high-quality protein (no byproducts), low phosphorus food is better suited for cats with kidney disease, with the exception of end-stage cats. A higher quality protein source means that the kidneys don't need to work as hard filtering the protein metabolism residue.

Because one of the key factors in the development of kidney disease is\ chronic dehydration, you do not want to feed any dry food. Dry food is moisture depleted and contributes to chronic dehydration.

Kidney disease is often not detected by vet tests until the cat has lost about 70% of their kidney function, so it may be a good idea to feed a high quality, low phosphorus canned food to an senior cat. A low phosphorus diet won't prevent kidney disease, but it will help slow the progression if it's already there in an early stage. And reducing strain on the kidneys will help prevent further damage as well.

Fancy feast is very high in phosphorus and contains byproducts, so if you have a senior kitty and you want to be proactive with the kidneys, I would opt for a low phosphorus, high quality protein food.

Did you see my response in your other thread on IBD?http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=74732. Several of the foods I recommended there are low carb, high quality protein, and low phosphorus. I think they would suit the health needs of all your cats.
 
They have learned a lot more about CKD in the last few years. Restricting protein is no longer thought to be a good response except in advanced cases. Restricting Phosphorus is helpful. Did you get a full blood workup done and a urine analysis when Gypsy was dx? Your vet should give you a copy if you ask at no charge. If the BUN, Creatinine and Phos are in the normal range and the urine test Urine Specific Gravity is also normal you should not need to worry. Getting Gypsy on a wet diet should actually help her kidneys, dry food leads to dehydration and adds stress to the kidneys.

My Tess has been dx w/ early stage CKD and a lowered Phos diet has helped a lot. It takes some research for foods good for both FD and CKD but there are a few, most of the lists are good for one or the other but not both. :? Take a look at my signature, in Tess's SS there is a tab for LC/Low Phos , it's a list of the foods I've found that are good for both.

Julia, thanks for the link, I hadn't seen that site before. :-D
 
I'm pretty sure the major low-carb dry options (Wellness and Evo) are really high in phosphorus too, as well as the lack of moisture inherent to any dry food, which as the others said is hard on the kidneys. The low-carb, low-phos wet options that have been mentioned should be a better option than the dry if you have concerns about CKD.
 
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