Some advice, please?

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skybar22

Member Since 2010
Morgaine is diet controlled but lately her BGs are a little higher than they used to be. She used to run 90-120 and now she is more like 130-150 and once in a while 170. I have increased testing her and I have also been checking her urine for glucose because she was spilling glucose. Mostly she is neg-+1/2 on the diastix. She went to the vet last week and due to the stress her BG went up to 365. Her glucose urine was +2 on diastix. Her BP is normal.

The vet has been very concerned about Morgaine's triglycerides. They were 1600 after a 12 hour fast. Two weeks earluer they were 1200 without a fast. Besides possible pancreas issues other than Diabetes, the vet thinks she needs a low fat diet. I had to convince her that a prescription diet was out the question because of the high carbs. right now she eats very low carb Pro Plan. Carbs are 4 and under. I am going to have to increase to a food with 6-10% carb. or make her food and add Instincts mix. She won't eat raw food.

If anyone knows what the carb content of Instincts with chicken liver is I would appreciate that info.

My question right now is whether Morgaine should be getting a tiny amount of Lantus. I have not had to give her any insulin since her diagnosis over a year ago. It has been a week since she had the high BG from vet stress and it came down to 199 the next day after the 354 but she seems stuck in the 150 range and there is some urine glucose occasionally beyond the trace amounts.

Do I give it a little longer to see if she is still recovering from that high glucose? I did get a 127 the other day.

Also, her fructosamine tests have confused me. 3 weeks ago the vet did one and it was 424 and the vet said it was good control. Her BG at the time of the test was 191. Last week it was done again, different vet, and it came back really high in the 500 range. Her BG at the time was 365. BUT, whenever I test her at home she is always in that 130-150 with occasional 170 range. I test her at different times and all the tests 2-3 hours after she eats are not high. It is as if the fructosamine tests are coinciding with the vet stress numbers. Try telling a vet that. I don't get any of this because my blood tests are always pretty darn good and mostly within the normal range.

I have been driving myself crazy with it all. As I have mentioned before, I have had type 1 diabetes for almost 50 years so i know this disease and i know how to control it. I have no problem giving Morgaine a little insulin but my numbers indicate she doesn't really need it at this point. The vet thought that maybe she was spending more time hyperglycemic than not but the only times I don't test her is overnight and she gets no food so why would her numbers be high?

Anybody have any idea what may be going on with my girl. She is 13, has high triglycerides and all blood tests other than glucose and the lipids are perfectly normal.
 
Hi guys .. hmm .. gosh this is a toughy .. I don't really have the answers you are looking for, but I am sure as the morning rolls on others will be here to help decide what is best for Morgaine .. have a great weekend!
 
Hi
A fructosomine test is an average of bg over a couple of weeks which if you are hometesting it is really not neccesary to have it done. My vet says she will not do it since I am hometesting and can get my own average right from the meter.

What are Morgaine's numbers 2 to 3 hours after she eats? She very well may need a little insulin but it is hard to tell without seeing more data.
Do you have a spreadsheet? If not it might be a good idea to start one and for you to keep track of the numbers so you can see if there is a pattern of rising numbers.
What is Morgain's feeding schedule. Does she get small meals throughout the day?

I am sorry I do not know the carb content of Instincts.

Let's see if some other "wise" people can give you more info. :smile:
 
Morgaine eats 5 small meals throughout the day totaling 220 calories. she is in need of losing a pound or two. She is a large cat and currently weighs 14.8 pounds. The vet would like her to lose some weight.

Her BG's 2 and 3 hours after eating are always good, 137-150. The day after that vet stress 365 she was 170 2 hrs after a meal.

I have not done a SS yet because I am not giving insulin but I could do a table or if I can access the SS I will do that. I couldn't access it last week at all. I have been testing her 2 times a day and at different times. She is not going over 150 from what I can tell unless, for some reason she goes higher overnight but that makes no sense as she isn't eating anything and has no insulin injected at all. I started testing her urine for glucose because Dr. Lisa thought there may be another issue and that her kidneys were spilling glucose due to a tubular issue but she is often negative for urine glucose so that is now ruled out. She may have a low renal threshold and perhaps, after a meal, she might have a BG of 180 or so because she did have a urine glucose of +1/2 yesterday but the next test a few hours later was neg and her BG was 137. Seems she is struggling to keep those numbers in the normal range and I fear giving her a slightly higher carb food but I have to get the fats down to under 20% on a dry matter basis, according to the vet.

Please contimnue to advise. I will be back later today.
 
I would agree with Miriam that a little more data about Morgaine's numbers throughout the day may help you pinpoint her needs. While the fructosamine test is an average of the past two weeks, I do believe that the numbers are not directly translatable to BG#s.

I do have a couple suggestions. First, I'd look at Binky's food chart (and another food chart with some of the more expensive food brands) for foods that are lower in fat/calories. There are some out there that are low carb. For example, BG Turkey is (I believe) slightly lower in calories than other varieties and is MUCH lower in fat (and, interestingly, also much lower in phosphorus... bonus!). While not crazy lower in calories, the higher protein/muscle meat content may make it more filling for Morgaine so that he would eat a bit less per sitting. Plus, you'd be getting the lower fat count the vet is seeking while still maintaining the low carb diet you desire. We also feed Wilderness Duck, though I don't recall whether that one was just lower in phosphorus or lower in fat as well. The good news is, there are options, and the info is readily accessible!

Also, if you are able, I would look into a high-quality fish oil supplement. I would suggest a human one, not the stuff in the pump (it can go rancid very quickly!). You are looking for very high concentations of EPA/DHA (that is what is beneficial in fish oil). This is important, because a cheaper fish oil with lower concentrations will have lots of filler oil... little to no health benefit, more fat/calories... which is what you are trying to avoid!! A quality fish oil has all kinds of good health benefits for both beans and furkids, one of which is a decrease in triglycerides. Willie and I both take OmegaVia. It is made by an absolutely wonderful company that still believes in old fashioned customer service, and the cost per dose of EPA/DHA is very reasonable. You can check out the blog on their site, which is very informative... one of the things that I love about their company is that they provide lots of great health info that isn't just about pushing their product.

Best of luck... hopefully more folks come along with some thoughts and suggestions!!
 
Did your vet provide you with a means of calculating values in terms of dry matter? Most of the calculations are based either on percent of kcal or percent of as fed value. I agree with Christie that the Before the Grain Turkey has the best ratio of protein to fat and is lower in calories. Another option is to feed a raw diet.

If you're consulting with Dr. Lisa, did she have any suggestions? On her website, she advocates for a raw diet.
 
Sienne and Gabby said:
Did your vet provide you with a means of calculating values in terms of dry matter? Most of the calculations are based either on percent of kcal or percent of as fed value. I agree with Christie that the Before the Grain Turkey has the best ratio of protein to fat and is lower in calories. Another option is to feed a raw diet.

If you're consulting with Dr. Lisa, did she have any suggestions? On her website, she advocates for a raw diet.
Morgaine is a picky girl. I tried raw when she was diagnosed but she would have nothing to do with it. I also tried all of the high quality and lesser quality foods and all she would eat is the Pro Plan with low carbs. I am considering cooking chicken, grinding it up and mixing it with Instincts and then slowly transition from the old to that. It is hard to find food she likes but once I do she loves to eat. I am also considering cutting the fat with some of that home made chicken with Instincts and just combining the two. I have no idea if she will eat it.

FF has two roasted flavors but they are 10% carb. They have wheat gluten but she is not allergic as far as I know. I have compared the fat % from Janet's tables to the prescription food the vet suggested and those are the same in fats. I also use the method Dr. Lisa suggests to determine the dry matter basis based on the inaccurate info. of guarnateed analysis. It is the best I can do. My vet does not seem to know much about the nutritional stuff. she has tables and calls Purina.

I will be calling Dr. Lisa at the end of the month. I have to wait for some money to build up. I have spent a small fortune on 2 vets and two sets of blood draws in the past 3 weeks. Vet wants to do an ultrasound on her pancreas but I just can't afford another $450 right now. Morgaine is not acting ill. she is her usual sweet and loving self with a very hearty appetitie.
 
I tested Morgaine 1 hour after eating as her +2 and +3 hour post prandial numbers were normal and she was 131. I am still so perplexed by the fructosamine tests since they totally contradict what I am seeing on home tests at various times. Onviously I should not be giving Morgaine any Lantus since shen is holding her own on diet.

I'll ask again for any advise regarding what is happening here.
 
The fructosamine numbers are on a different scale than BG numbers. Gabby just had labs run and, much to my chagrin, the vet ran a fructosamine level. My vet sent the analysis out to Idexx labs and their ranges for fructosamine are: 300 - 350 Excellent, 350 - 400 Good, 400 - 450 Fair, >450 Poor, <250 Prolonged hypo. Other conversions are:
Fructosamine Average BG
200....................90
250...................120
288...................150
325...................180
363...................210
400...................240
438...................270
475...................300
513...................330

The conversions vary by lab so you need to know what the reference ranges are.

We generally consider under 120 to be "normal" BG.
 
Morgaine's fructosamine numbers were way higher than the BGs and i understand the conversions. Her BGs are always under 150 with a few exceptions after stress and her fructosamines were 424 and over 500 respectively. I have been testing her at home 2 times a day and I get nothing that could correspond to numbers over 200 let alone higher so something is way off. I have 4 glucometers as I am a type 1 myself and have tested all of them. They may vary by 10-20% but that is all.

Is it possible that a high vet stress BG could affect the fructosamine dramatically? I get a test called an HbA1c every 6 months and it measures my glucose control over a 3 month period. It is much more accurate and always corresponds with my own meter numbers.

This was the first time she had a fructosamine done but the one done 2 weeks earlier was so much lower, still higher than her home tests would indicate. At $100 a pop I just do not want to keep doing these since my numbers would seem more accurate.
I really do know what i am doing. As mentioned almost 50 years of type 1 D gives me some level of awareness on these numbers. The first said her 424 indicates good control and 2nd vet said the over 500 indicates she spends most of her time hyperglycemic but she doesn't unless our meters are useless and we know they are not.

I tried to set up a SS but i can't access it at all. I get a google error every time I try to use the insulin SS. Do i need to have excel to use it?
 
I think you'd mentioned you were diabetic. I forgot. Sorry!

The fructosamine average spans a shorter time frame than the HbA1c. It covers a few weeks so it's entirely possible that a stress spike at the vet's office could exert a greater influence on the fructosamine results.

You'd asked about the carb content of Instincts. One of the members here put the attached info together. It's not for Instincts with chicken liver. We were both adding fresh liver to the raw food but the numbers should be pretty close.


I'd suggest posting in the Tech Forum regarding the problems you're having with the spreadsheet. We've had a few new people join the forum and they haven't had the problems you're experience. It may be an issue of your computer's settings and I'm not sufficiently tech savvy to be helpful. In the meantime, if you need input on dose, you can always post the info in your condo.
 

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I just found this very interesting piece of info while doing a google search and i sent the info to my vet:

http://petdiabetes.wikia.com/wiki/Fructosamine

False fructosamine test result:
High levels of Vitamin C (ascorbic acid) or circulating fat in the blood (lipemia) can interfere with fructosamine testing. The breakdown of red blood cells (hemolysis) or hyperthyroidism can also[11].

It certainly explains the great difference between my home BG testing and the Fructosamine results.
 
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