Underweight Diabetic Cat

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Yvonne & Milo

Member Since 2022
I have a cat that is 2 years old and was diagnosed with diabetes on September 15th so I feel very lost. My vet instructed me to either feed him a full can of wet or 5/8 cup of dry prescription food a day, which I have both of, and wonder which one is better for him. My only concern is that he is very very skinny (his spine is easily felt and the area around his hips looks bony). Can I feed him more throughout the day to help him gain weight or will that affect his glucose levels too much? I am also just starting insulin today and am concerned with how much he eats before injection time, most of the time he eats about a fourth cup before he refuses to continue.
 
@Wendy&Neko @Sienne and Gabby (GA) would one of you mind moving this to Feline Health?

Can you tell us a little more about how he was diagnosed? Symptoms, tests/lab work, etc. Any other health issues?

Which prescription food is he on? Wet food is better from an overall health perspective, and more often than not they are lower carb than the kibble. But there is only one prescription diabetic food that is actually low enough in carbs for a diabetic cat.

We recommend feeding multiple smaller meals vs two large meals. Do you know his current and ideal weight? Or how many calories he needs to safely gain weight?

Is he currently on Vetsulin? What dose? Twice a day?

There are some other things we recommend doing, but I'll cover that once I get answers to questions above.
 
I had taken him in for a check up due to him breathing heavily on July 23 and he weighed 9.1lbs he was diagnosed with bronchitis and given meds about a month and a half went by and I noticed he was losing weight and drinking more water than usual so on September 15th I took him in and after a few questions and bloodwork he was diagnosed with Diabetes due to glucose levels of almost 600 with a weight of 6.90lbs.

He is on Hills Prescription GlucoSupport m/d I bought both the wet and dry. He was not put on insulin until today when he had another check up.

Today his weight was 6.44lbs which was even lower than last time and his glucose reading was 477. I am not sure what his calorie intake should be, I honestly blanked when I took him to the vet and totally forgot to ask that question.

He is on Vetsulin, 1 unit twice daily after eating. Thank you for your reply, I've felt so lost since his diagnosis and I just discovered this site so I am grateful for any tips you are able to provide.
 
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What was the bronchitis treatment? I'm guessing a steroid? Steroid induced diabetes is pretty common here unfortunately. And the bronchitis resolved?

Did they by chance run a fructosamine? Any other issues or infections?

Both of the Hills diabetic foods are too high in carbs. What country are you located in? I can provide a list of foods that are under 10% carbs, which is what we aim for.

I would call and ask them about ideal weight and calories for weight gain. Unregulated diabetic cats also do not fully process food, so he will need even more calories.

Do not change food right now, it can have a drastic effect on BG and we need BG data first - more on that below

So there's a few things we ask newcomers to do:
 
Bronchitis did resolve. They didn't mention the fructosamine exam, he is on Amoxicillin and Clavulanate Potassiumn due to a high fever of 103.1. I am located in the United States.

I was told that his prescribed medication was low in carbs, could that be harming him?

He is drinking and urinating a lot more that usual but he is also a bit active, he was playing with a toy earlier today.

He is really underweight right now and since we just started insulin today I feel so lost.
 
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Yvonne Cervantes said:
Bronchitis did resolve. They didn't mention the fructosamine exam, he is on Amoxicillin and Clavulanate Potassiumn due to a high fever of 103.1. I am located in the United States.

I was told that his prescribed medication was low in carbs, could that be harming him?
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Do they know the cause of the fever? How many days has he been on the medicine, and how many days left?

Was he on a steroid for bronchitis?

Theoretically if they remembered he's diabetic, they should have given you meds without sugars. But we've seen lots of mistakes made with that. Take a look at the label and see what it says.

I do apologize for the 25,000 questions, just trying to get the full picture.

Start with home testing both BG and ketones. Infections alone can raise BG, though not usually to the 600s. Once the infection resolves, you'll have a better idea as to baseline BGs. Once you have a few days' worth of data, then you can start a diet change to something much more low carb. That alone brings BG down, many times significantly. Then once a diet change is complete, you would start tweaking the insulin dose to get him more regulated.
 
The questions are okay, you are just trying to help and I appreciate that I am sorry if I don't have the answers like I said it's new to me and you are really the only one that's been helpful. I can't tell you how many times I've cried feeling like such a bad owner.

They do not know the cause, he was on a different medication for 2 weeks since he has had the fever and we just started the new one I mentioned which he will be on for 9 more days. He was on steroids for bronchitis but that was before his diagnosis when he weighed 9.1lbs.

How would I test ketones, I saw the strips but am confused on how to get a sample from him.

I feel to blame for the levels being so high, when I started noticing him losing weight, before his diagnosis, I bought canned food with gravy and I kept giving him treats.
 
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Some tips for getting a urine sample here (its a Google doc) - https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

He's pretty young to have diabetes, we don't often see them this young. It's likely the steroids caused the diabetes, but of course no way to know for sure. The infection isn't helping, but hopefully the meds knock it out.

Don't beat yourself up. Unless you have prior experience with it, diabetes isn't something most people think of when their cat is losing weight. And they're so fluffy that you don't often realize just how much theyve lost. Before my cat's diagnosis, I didn't even know cats could get diabetes!
 
Thank you for all of this amazing information, I can't tell you how happy I was when I saw this site. I've been reading all the links that you posted on this thread and I am feeling hopeful that my Milo will be fine. At first I was so confused but you guys are amazing at making it simple and easy to understand. I am working on getting my spreadsheet set up and will be going to Walmart once I know exactly what to look for!
 
Should I be worried about his weight? He measured 9.1lbs in July, he was given steroids for an infection, and on Sept 15th he measures 6.9lbs lastly he was 6.44lbs on Oct 1st. While he was diagnosed on the 15th of Sept the doctor didn't start insulin until Oct 1st, is that normal or did I drop the ball on that?
 
The weight loss is a little concerning, but also typical. My cat had lost 3-4 lbs by diagnosis as well, but he is larger.

As I mentioned, talk to the vet about ideal weight and calories to gain. Then with whatever the vet says, he will probably need more on top of that because he's currently unregulated and can't fully process the food.

For now, I would not limit food in the way your vet suggested. Since he is underweight - if he is hungry, let him eat. Keep the same dry amount/timing you currently have, but make any extra food the wet as it's lower carbs.

I usually use this as a baseline - https://www.petplace.com/article/cats/pet-health/how-to-calculate-your-cats-daily-calorie-intake/

So assuming 9lbs is his ideal weight (again check with vet) he needs about 360 calories a day. Since he is unregulated, he likely needs something above that even.

The GlucoSupoort dry is 463kcal/cup, so right now you are only giving about 290 calories (@5/8 cup). The wet is 173kcal per can. I should also add one of GlucoSupport's claims is "Clinical nutrition optimized to help cats lose weight" (straight from Hills website).

Since the vet gave you both and said feed either - what are you feeding, how much, and when?
 
Yes his ideal weight is 9lbs
I am feeding him the 5/8cup divided into 3 meals (2/8cup at 11:30, 3:30, and 1/4cup 11:30)
He only eats about half of the wet food, he prefers the dry so he eats 1/4 cup at before his insulin shots at 6:30 a.m. and 6:30 p.m.
I had been giving him some treats after dosing and measuring his glucose levels, it's freeze dried chicken the brand is Whole Life Just-One, but my doctor said that he shouldn't be eating any treats at all.
 
Oy. No, he needs more calories. The treats you are giving are perfectly fine! We encourage the treats to make testing and shooting more enjoyable/a good experience for them.
 
So should I give the whole can of wet food? He is a very picky eater, he tends to lick the wet food until its dry and then he won't want anymore.
 
You will want him transitioned to wet food eventually anyway. There are some tips and tricks here - https://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

Some common ones are to mash it up with a fork, top with parmesan cheese or crushed dried kibble or crushed freeze dried treats.

For now keep giving the same amount of dry until you have about a week of BG data. Then, you'll want to transition to low carb wet (I will help you to do that safely). Try to get him to eat more wet.

This is a list of cat foods and carb % - https://catinfo.org/chart/index.php

You want something under 10%, ideally in the 3-7% range. Most of us just feed the Friskies or Fancy Feast pate's.
 
Right now I would let him eat, as long as he isn't eating so much/fast he throws up. If he does that you'll have to pace it a little bit. I know I've read before that when underfed, increase the calories by 25% each day...so I suppose it's up to you. Definitely don't force anything on him.

If you have a bathroom scale at home, I would start weighing him weekly or every other week and writing it down. There's no point in doing it more often than that because he should only be gaining a few ounces a week, and home scales aren't sensitive enough to pick up such small differences. Some CGs buy baby scales for that purpose.
 
I do not have a bathroom scale, I probably wouldn't be able to get one until 3 weeks from now, I just paid my rent and the recent vet bills have put a dent in my available money.

I just kept adding a bit of food to his plate until he refused to continue eating, the tip about crushed freeze dried meat helped a lot!
 
Good!

Don't worry too much about scale. Most vets will actually just let.you come in and weigh them without charging, but they're all different
 
I wouldn't want to traumatize my Milo too much, he is always terrified when we go to the vet. When he sees his carrier he runs to his under my bed

I'll ask around my friends to see if I could borrow some cash
 
I fed him and will wait the 30 minutes to dose Vetsulin, since his dose will be an hour and a half late will the other need to be pushed back as well or can I keep it at the same time 7 a.m?
 
Thank you so much for the encouragement, I won't ever be able to thank you enough for all the help you've given me these last two days.

Would I be able to feed him before I go to bed or should I wake up in the middle of the night to give him a snack?
 
Yvonne Cervantes said:
Should I feed then test or test and then feed? If I feed then test how long should I wait in between the two?
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Doesn't matter. Sometimes testing while they eat is easiest lol only the preshot tests need to be fasting, the other tests we want to see them bring fed as they normally would.

Wet food takes about 20-30 minutes to take effect. Kibble usually takes longer than that.
 
Could I change the feeding amount to half a can of wet twice, one before each dosage, one fourth can at night and 5/8cup of kibble through out the day?
 
I would actually feed the kibble at shot time up to +3 ish, because Vetsulin hits pretty hard and will be better able to offset those extra carbs. Then I'd feed the wet at other times.
 
So would this be a good schedule to try and keep:
6:00 a.m.= BG test
6:30 a.m.=2/8cup of kibble
7:00 a.m. =1u of Vetsulin
12:30 p.m.=wet food
6:00 p.m.= BG test
6:30 p.m. = 3/8 cup of kibble
7 p.m.= 1u of Vetsulin
11:00 p.m.= wet food(BG test if needed)
 
FrostD said:
I would actually feed the kibble at shot time up to +3 ish, because Vetsulin hits pretty hard and will be better able to offset those extra carbs. Then I'd feed the wet at other times.
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when you write "up to +3 ish" does that mean from the time of the shot to 3 hours after it he could eat kibble? so if he gets a dose at 7 he can eat kibble until 10?
 
Yvonne & Milo said:
So would this be a good schedule to try and keep:
6:00 a.m.= BG test
6:30 a.m.=2/8cup of kibble
7:00 a.m. =1u of Vetsulin
12:30 p.m.=wet food
6:00 p.m.= BG test
6:30 p.m. = 3/8 cup of kibble
7 p.m.= 1u of Vetsulin
11:00 p.m.= wet food(BG test if needed)
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You can feed at the same time you do the preshot test, I'm sorry if I wasn't clear on that. So for example:
6am: BG test, then feed kibble. He can free feed on this til about 9am, then I'd switch to wet.
630a: insulin injection.
9a: pull dry food and leave wet food

(Then same with PM schedule).

This will change a little bit once we start to remove the dry food, but should work ok for now.
 
FrostD said:
You can feed at the same time you do the preshot test, I'm sorry if I wasn't clear on that. So for example:
6am: BG test, then feed kibble. He can free feed on this til about 9am, then I'd switch to wet.
630a: insulin injection.
9a: pull dry food and leave wet food

(Then same with PM schedule).

This will change a little bit once we start to remove the dry food, but should work ok for now.
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I appreciate all the help, you were perfectly clear on it but I second guessed myself so I just wanted to clear that up
 
When you say free feed on the kibble does that mean I can give him more that the 5/8cup a day?
He really enjoys the kibble so he would eat more if he is allowed to do so
 
Yvonne & Milo said:
When you say free feed on the kibble does that mean I can give him more that the 5/8cup a day?
He really enjoys the kibble so he would eat more if he is allowed to do so
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My preference would be he eats extra wet food, because eventually we need to phase out the dry.

That said he's pretty underweight, so I'd rather him eat what he'll eat to gain.
 
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