Update on Ritchie

JohnWNC

JohnWNC

Member Since 2021
It's been 8 days since he was hypoglycemic and I panicked. He has been to a animal hospital since then and I have lab results that I put onto his spreadsheet. The vet told me that he might have early stage kidney disease and that I need to change his food again. I asked her about a zero-carb dry food for early stage kidney disease and she said that she would have to ask the vendor about that and that she would let me know. She wanted to prescribe some science diet food and I was very nonplussed about that. That was the brand of food that I fed him for years that turned out to be 40% carbs and contributed to his diabetes..

She also gave me a potassium supplement, some weekly b12 shots, an appetite drug called Miratz, a bag of IV fluid because he's dehydrated and miralax to mix with broth. Since I started doing all of that he has taken a turn for the worse. He is back to sleeping all of the time. When he stands up he kind of shakes and he holds his head right next to the ground. He stumbles over to his food and water bowls and then back to a cushion on the ground. This is how he was behaving 7 weeks ago when this all started. I asked the new vet about this behavior and she doesn't seem concerned. She said that holding his head close to the ground might be because of the potassium deficiency.

She also told me to stop giving him insulin unless he tested above 250. That experiment seemed to be going well for a few days but it's been creeping up and this morning he was 287 so I guess he's not in remission.

He has been eating more and seems to like Dr. Elsey's food much more than Young again. He may have just been tired of it after 2 years. I haven't been giving him the Miratz since the first day because I thought it might be causing his drunken behavior. I did the IV fluids for a few days and then stopped that for the same reason. After all of the tests the new vet doesn't seem to be any more useful than my old vet so I'm just hoping that he recovers.

Thanks again Wendy for the advice last week. I will be very cautious about the insulin and stick to .5 unit twice a day for at least a week to see how it works. I don't want to ever have a reading of 31 again.
 
JohnWNC said:
It's been 8 days since he was hypoglycemic and I panicked. He has been to a animal hospital since then and I have lab results that I put onto his spreadsheet. The vet told me that he might have early stage kidney disease and that I need to change his food again. I asked her about a zero-carb dry food for early stage kidney disease and she said that she would have to ask the vendor about that and that she would let me know. She wanted to prescribe some science diet food and I was very nonplussed about that. That was the brand of food that I fed him for years that turned out to be 40% carbs and contributed to his diabetes..

She also gave me a potassium supplement, some weekly b12 shots, an appetite drug called Miratz, a bag of IV fluid because he's dehydrated and miralax to mix with broth. Since I started doing all of that he has taken a turn for the worse. He is back to sleeping all of the time. When he stands up he kind of shakes and he holds his head right next to the ground. He stumbles over to his food and water bowls and then back to a cushion on the ground. This is how he was behaving 7 weeks ago when this all started. I asked the new vet about this behavior and she doesn't seem concerned. She said that holding his head close to the ground might be because of the potassium deficiency.

She also told me to stop giving him insulin unless he tested above 250. That experiment seemed to be going well for a few days but it's been creeping up and this morning he was 287 so I guess he's not in remission.

He has been eating more and seems to like Dr. Elsey's food much more than Young again. He may have just been tired of it after 2 years. I haven't been giving him the Miratz since the first day because I thought it might be causing his drunken behavior. I did the IV fluids for a few days and then stopped that for the same reason. After all of the tests the new vet doesn't seem to be any more useful than my old vet so I'm just hoping that he recovers.

Thanks again Wendy for the advice last week. I will be very cautious about the insulin and stick to .5 unit twice a day for at least a week to see how it works. I don't want to ever have a reading of 31 again.
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Tagging Wendy for you
@Wendy&Neko
 
Rather than giving 0.5 units when over 250, I'd try giving 0.25 units on a more regular basis. Otherwise you end up with higher numbers like you saw today, and he's likely over renal threshold. That's the point where the kidneys output sugar in to the urine, and means those kidneys are working harder.

Early stage CKD (chronic kidney disease) does not need special food to treat. Ideally you would stick with wet low carb food. Kidneys kitties need more liquid, which dry doesn't give them. Choosing a food with lower phosphorus can also help. Lots more about kidney kitties, as well as a some food charts can be found here: http://www.felinecrf.org/ There is also a FB group associated with that site. Someone has also put together some food lists good for multiple conditions. Check out this one for diabetes and kidneys.

Did the vet mention anything about going back and getting the potassium tested again after a couple weeks of treatment? You do want to get potassium in range.

Mirataz is an appetite stimulant. If he's eating enough calories, he doesn't need it.
 
I gave him .5 again because he tested 324 tonight. He hasn't been that high in years. I'll keep it at .5 twice a day for a few days to see if he gets back into the normal range. The vet didn't mention anything about coming back but I will follow up with her. I'll try switching him to wet food again if he recovers from whatever is bothering him now.

He walks with his nose almost touching the ground, like he can't lift his head up. And he's not jumping up on any furniture. And sometimes he stands in one spot but still with his nose almost on the ground. But he's eating better and drinking plenty of water and visits the litter box so maybe he will recover eventually.
 
With a potassium value of 3, that’s low enough to match with what you’re describing for symptoms you are seeing. You want the potassium value up closer to 4.4 but solidly above 4. It’s been a really long while since I had a cat with low potassium but depending on the supplement and dose you were instructed to give, if you haven’t seen much improvement with symptoms after about 5 days, might be worth checking in with the vet. The link Wendy posted for Tanya’s CRF site has a separate updated page on potassium imbalances http://felinecrf.org/potassium.htm#symptoms_low

and some suggested dosing depending on the supplement.
 
I have been reading through the felinecrf site and the only dry food that I see with 0 carbs is the young again food that I have been feeding him up until last week. It meets the phosphorous requirement but is higher in protein at 68% than the 35% that she recommends. Also I see that the Dr. Elsey's food that I switched him to a week ago has 6% carbs, which is not that large compared to most of the others but is still larger than 0. I wonder if that is contributing to his greatly increasing glucose levels. The young again people caution against ever feeding anything that isn't zero carbs because it can cause the glucose levels to climb quickly because he still can't process carbs. I realize that they are saying that about their food brand so it's a little suspect but he had been doing very well on that food for two years until he stopped eating it. He tested 354 this morning which is getting worse but after what happened last week I'm sticking with .5 units twice a day at least for a few more days.

I've looked on their website and they sell a flavor enhancer product. I thought I might order that to add to the young again to see if that would entice hi to eat more of it.

You all were correct. His symptoms like holding his head low and staggering a bit sound exactly like low potassium levels and he's been drinking a lot of water which she says is typical of CKD. It's a relief to have a diagnosis and that it's not deadly serious... yet. It sounds like if I can find the right food and continue the potassium he might be greatly improved.

I'm willing to try anything at this point as far as the food goes. It just doesn't seem like there are many commercial options. Even most of the canned foods from her list are high in carbs. And of course, he won't eat them anyway. I'll try again when he's feeling better but we've had that battle many times before. I am reluctant to take the dry food away altogether to force him to eat the canned food. When I tried that a few years ago he drove me crazy meowing to be fed and he still didn't do much more than lick the canned food.
 
@JohnWNC
https://felinediabetes.com/FDMB/threads/new-member-11-8-and-i-am-tired.283363/#post-3124085

Take a look at this thread , post #32
There are some food suggestions for low carb/ low phosphorus pates for kitties that have CKD
Is there anyway you can get some more tests in during the day cycle ?, if you work test him when you get home. During the PMPS cycle you at least need to get another test in before you go to bed, if you can I would get a few more tests in other than a before beds test. You are only seeing half the picture by not testing after PMPS . You want to see how he's doing during the night cycle ,cats often drop lower during the night
Can you add SLGS to your signature also
You may want to re read about the SLGS method
https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/
 
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I was gone all day today but will be home all day tomorrow so I'll do lots of testing. I got in the habit of testing when I do the shots and I realize that was not the right thing to do. I'll pick up some weruva food later this week and give it another try. I'm concerned though that it's not 0 carbs. Thanks for the advice.
 
JohnWNC said:
I was gone all day today but will be home all day tomorrow so I'll do lots of testing. I got in the habit of testing when I do the shots and I realize that was not the right thing to do. I'll pick up some weruva food later this week and give it another try. I'm concerned though that it's not 0 carbs. Thanks for the advice.
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Weruva has a low phos/no carb/high liquid food... you might want to check it out > https://www.weruva.com/collections/wx-phos-focused
 

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JohnWNC said:
I was gone all day today but will be home all day tomorrow so I'll do lots of testing. I got in the habit of testing when I do the shots and I realize that was not the right thing to do. I'll pick up some weruva food later this week and give it another try. I'm concerned though that it's not 0 carbs. Thanks for the advice.
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Tiki cat wet foods are also 0%, plenty of flavors and textures to help with picky kitties
 
Thanks. I'll look for both of those at my favorite pet store tomorrow. If I could only get him to eat it..

He's doing a lot better today. He holds his head up as normal and is still eating a lot of the Dr. Elsey's food. Unfortunately his glucose is still testing in the 300's. I'm trying to follow the protocol this time and not increase the dose for 7 days but it's hard. I hate to see him above 300. He went for two years not going above 150 or rarely.
 
Jason - Kona's Dad said:
@kelcie @JohnWNC

https://www.felinediabetes.com/FDMB/threads/feeding-lowest-zero-carb-vs-lower-carb-foods.144220/

Please check out this thread when you get a chance regarding zero & low carb foods.... there's speculation that some cats actually do better with a little carbs over complete 0.0%.
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I believe 0% is actually indicative of no extra added carbs such as starches or gums. There are natural carbs in the meat organs and such that are typical to a carnivorous diet.
 
Jason - Kona's Dad said:
there's speculation that some cats actually do better with a little carbs over complete 0.0%.
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It is more than speculation. I've seen it be true more than once. For example, take a look at Babuchiri's spreadsheet, end of March 2017. He wasn't eating much so his caregiver had to give him A/D, which is 12%. Until then, he was a very bouncy boy. I've also seen it happen with higher LC too. This doesn't work for all cats, some cats are more or less carb sensitive than others. ECID. Learn how your cat reacts to food and carbs.

kelcie said:
I believe 0% is actually indicative of no extra added carbs such as starches or gums. There are natural carbs in the meat organs and such that are typical to a carnivorous diet.
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I've had the opportunity to see the lab analysis results from a local raw pet food manufacturer who sent their product out to an external lab. The analysis gave results "as fed" of all carbs present, which is what we are looking for when calculating the carbs % in food. Some proteins are higher carb than others. Strangely enough, kangaroo is higher carb, though still well within the LC category.
 
Well, it's not definitive but Dr. Elsey's is 6% carbs and his glucose has been much higher since I started him on that. But he's eating more so that may make it higher and he has a lot of other issues going on. I'm trying to actually follow the instructions for SLGS this time instead of jumping around based on his reading like I used to. But he's been testing high for the 2.5 days since I started him on insulin at .5 twice a day. I'm going to make more readings today and tonight but I'm considering raising him to .75u tomorrow. It doesn't seem like that would make him hypoglycemic but when I had that bad scare last weekend I had just raised him to 1u and he dropped to 31 that night.. But he wasn't eating much then. It's very complicated.

The good news is that he's moving around like normal today and not dragging his head or shaking any longer. It's reassuring to know that those were symptoms of the potassium deficiency and the kidney issue. felinecrf.org was very educational. I thought he was dying but he seems back to normal today.

I found two packages of the Weruva food. He hasn't tried that brand yet so maybe it will be acceptable though I have my doubts.
 
The depot needs to rebuild after stopping insulin. I would wait at least 5 days/10 cycles after you restarted the 0.5 unit before thinking of increasing.
 
Wendy&Neko said:
I've had the opportunity to see the lab analysis results from a local raw pet food manufacturer who sent their product out to an external lab. The analysis gave results "as fed" of all carbs present, which is what we are looking for when calculating the carbs % in food. Some proteins are higher carb than others. Strangely enough, kangaroo is higher carb, though still well within the LC category.
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Unfortunately there is no standardized way of testing for pet food and no requirements for how to report, we see that even in human products. I agree that protein carb values are different and since Tiki cat are all listed as 0 carb that’s where I’m drawing the conclusion it is only indicating added carbs. For example Weruva contains guar gum, a polysaccharide and could be the reason for the little carb boost.
 
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