Vet insists dry food the way to go

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Maximus

Member Since 2017
New patient's mom here. Max had BG of 462. Vet suggested Hill's w/d so I bought it then found this site. Decided to try canned food, which Max ate no problem. On a Friday his BG was 176 so vet didn't want to start insulin. Unfortunately By Saturday he was vomiting and had diarrhea. Sunday he stopped eating (still vomiting and diarrhea) and I thought he was a goner. Monday morning back to vet, BG 252 and Starts insulin. Vet does not feel a canned food diet is necessary and insists on the Hill's w/d. I have been mixing Dry with canned since he started eating again Tuesday. I am so confused on the right way to go with dry vs wet. I don't want to go back to the vomiting and diarrhea, but I also want to do what's best. Anyone have similar experience and advice?
 
Hi Max's mom, and welcome! I'm so sorry to hear that Max hasn't been feeling well! Did the vet think anything was wrong that was causing it? If not, then anytime you change a cat's food quickly, it can lead to stomach upset, diarrhea, and vomiting. It's likely that he just wasn't tolerating the sudden change very well.

If Max will eat a low-carb wet food, that really will be the best thing for him, both in terms of diabetes and for his health in general. Here is a website for a vet that has helped us out here a ton regarding food: http://catinfo.org/ There is more info than you'll ever need on there about nutrition and food choices for cats! It's a fantastic resource!

So you might try giving him some of his old food, and some of the canned food, and then slowly transitioning him more and more to the canned food. That might ease his tummy troubles a bit.

Now some questions for you: What insulin are you using? What dose did the vet prescribe? Are you home testing, or are you interested in learning?
 
If your confused about the w/d just look at the ingredients - Rice, corn, powdered cellulose (sawdust)... Like Djamila says, the low carb wet is best, just try transitioning slowly and be sure you are home testing during the transition.
 
Welcome Max and his mum!
Unfortunately, the Vet probably doesn't understand that wet food diets are better for kitties and even more so for diabetic kitties. In Veterinary school I think they have like one course for nutrition because they have to learn a little about everything. Forums like this are compiled of people with 24/7 experience. Something I believe is more valuable than any class :). I like Djamila's suggestion of re-introducing his old diet and slowly transitioning to new diet. There are also probiotics that might help, like FortiFlora. Your Vet should have it or be able to get it for you.

With regards to Djamila's last questions, will be helpful to setup your Signature so we don't ask you them again :smuggrin:: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

And I like to give this to new members: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Also, that initial BG of 462 down to 176 after switching to wet is a really good sign. That right there shows you the benefit of a wet food diet. May have gotten back up to 252 since he wasn't feeling well and stressing him. There is tons of information here and Catinfo.org has more! Dr. Lisa Pierson is the Vet on that site and she compiled a food chart many of us use here.

Hope we're not overwhelming you too much more :bighug:
 
Thank you for the information. I have been mixing dry with canned and will try to lessen the dry over time like you suggested. He's on 3 units of Novolin 2x a day. I have purchased a home meter but haven't tried it yet. Does that need to be done daily?
 
Testing the blood glucose (BG) before every shot is really important to make sure that the BG is high enough for the dose. If the dose is higher than the kitty needs, they can go hypoglycemic which is very dangerous. We recommend that new folks don't give any insulin if the Pre-shot BG number is below 200. It's also important to get a test around the cat's nadir (nadir = lowest BG point in the cycle). I'm not sure when Novolin typically has a nadir, but I'm sure someone else can chime in with that soon.

Which home meter did you get?

Here is a great video to help you learn how to home test, and please ask as many questions as you have about this! It can be a little tricky at first, but it's so so important to keep Max safe!

@Sieden's video


The cat in the video is super chill, although Sieden has shared that it wasn't always that way. Same with my kitty: he was not a fan at first, but now he's totally calm about it (he'll do anything for a treat!)
 
It's very important to test since you're transitioning to a lower carb food. How long has Max been on insulin? 3u is a fairly high dose and with the lower carb food he may need less insulin. Testing is the only way to know. Watch the video, and give it a try. If you have trouble/questions ask and we'll try our best to help you.
 
If your starting insulin BG diagnosis was that 252, I fear 3.0U is way too much. Novolin N is a faster acting insulin (can start working about an hour after shot, or +1). Nadir (lowest BG) occurring between +4 and +6 (hours after shot). Usual starting dose is 1.0U twice a day. Definitely pull out that glucometer and try to get a test; what kind/brand is it? Did he get a shot of 3.0U tonight? How many hours ago?

Just going to reiterate AMPS and PMPS are the minimum recommended testing of BG. Ideally, not eaten anything 2 hours prior to this time. For Novolin, you'd want to get BG test reading, if not below 200, feed, then 30 minutes after eating give shot. So about 45 minutes before shot is due, you'll do PS (pre-shot) test. Ask any questions, we'll try to help as best we can. This is a support group for Max and YOU :bighug:
 
It's very important to test since you're transitioning to a lower carb food. How long has Max been on insulin? 3u is a fairly high dose and with the lower carb food he may need less insulin. Testing is the only way to know. Watch the video, and give it a try. If you have trouble/questions ask and we'll try our best to help you.
On insulin Since Monday 5/8. Vet prescribed dose and was told about diet plan to go low carb.
 
If your starting insulin BG diagnosis was that 252, I fear 3.0U is way too much. Novolin N is a faster acting insulin (can start working about an hour after shot, or +1). Nadir (lowest BG) occurring between +4 and +6 (hours after shot). Usual starting dose is 1.0U twice a day. Definitely pull out that glucometer and try to get a test; what kind/brand is it? Did he get a shot of 3.0U tonight? How many hours ago?

Just going to reiterate AMPS and PMPS are the minimum recommended testing of BG. Ideally, not eaten anything 2 hours prior to this time. For Novolin, you'd want to get BG test reading, if not below 200, feed, then 30 minutes after eating give shot. So about 45 minutes before shot is due, you'll do PS (pre-shot) test. Ask any questions, we'll try to help as best we can. This is a support group for Max and YOU :bighug:
Yes he had his shot about 7:45 pm. His very first BG was 462. Even at 252 ( on a meter) the vet said if he ran the blood though a full panel test it would be over 400. That made no sense to me, but I'm not a vet.
 
Testing the blood glucose (BG) before every shot is really important to make sure that the BG is high enough for the dose. If the dose is higher than the kitty needs, they can go hypoglycemic which is very dangerous. We recommend that new folks don't give any insulin if the Pre-shot BG number is below 200. It's also important to get a test around the cat's nadir (nadir = lowest BG point in the cycle). I'm not sure when Novolin typically has a nadir, but I'm sure someone else can chime in with that soon.

Which home meter did you get?

Here is a great video to help you learn how to home test, and please ask as many questions as you have about this! It can be a little tricky at first, but it's so so important to keep Max safe!

@Sieden's video


The cat in the video is super chill, although Sieden has shared that it wasn't always that way. Same with my kitty: he was not a fan at first, but now he's totally calm about it (he'll do anything for a treat!)
That video looks really helpful. I need to find a sock. Thanks for posting.
 
If your starting insulin BG diagnosis was that 252, I fear 3.0U is way too much. Novolin N is a faster acting insulin (can start working about an hour after shot, or +1). Nadir (lowest BG) occurring between +4 and +6 (hours after shot). Usual starting dose is 1.0U twice a day. Definitely pull out that glucometer and try to get a test; what kind/brand is it? Did he get a shot of 3.0U tonight? How many hours ago?

Just going to reiterate AMPS and PMPS are the minimum recommended testing of BG. Ideally, not eaten anything 2 hours prior to this time. For Novolin, you'd want to get BG test reading, if not below 200, feed, then 30 minutes after eating give shot. So about 45 minutes before shot is due, you'll do PS (pre-shot) test. Ask any questions, we'll try to help as best we can. This is a support group for Max and YOU :bighug:
What if it's below 200? Feed with no shot?
 
Honestly, I agree with Yong that the 3u is a very high starting dose, especially considering how low his numbers were to begin with. The 462 is high, but the other two numbers are low enough to make me worry about giving him more than one unit. Hopefully you can get some home tests and have a better sense of if he really needs that much insulin. The vet was likely talking about the fructosamine test. That test gives an average of BG levels over time. It's helpful for diagnosing diabetes, but not at all helpful for determining a correct dose. So he was probably estimating the average between the 462 and the 252.

Please let us know if we can do anything to help with the testing. The rice sock really is amazing! When I first started I took a square from an old t-shirt and tied it off to make a little pouch.

If it's below 200 you have two choices:

1. Feed and don't give a shot.

OR

2. Stall for 20 minutes without giving food, test again and see if the number is high enough. If yes, then feed and shoot. If not, stall for another 20 minutes without feeding, and test again. repeat for up to an hour. If the number is still not high enough, then skip the shot.
 
just had my first, and hopefully last, hypoglycemic event. Struggled to get the
Lancet to work properly. Couldn't see through ear well enough to make the sock work. Kept poking and not getting any blood whatsoever. Got myself instead. Finally had to pull the lancet out and use a flashlight to see where to poke. BG 23. Nightmare! Not the best time to learn. Got some caro syrup in him, and he's eaten a tiny bit. Seems okay now, but I need to test again.
 
just had my first, and hopefully last, hypoglycemic event. Struggled to get the
Lancet to work properly. Couldn't see through ear well enough to make the sock work. Kept poking and not getting any blood whatsoever. Got myself instead. Finally had to pull the lancet out and use a flashlight to see where to poke. BG 23. Nightmare! Not the best time to learn. Got some caro syrup in him, and he's eaten a tiny bit. Seems okay now, but I need to test again.

Have you tested again? Karo wears off quickly. 23 is very low. Do you have any high carb food? If you need help edit your title or start a new thread with the 911 prefix so people will know you are dealing with a hypo.
 
How long ago was his shot? Novolin is a very harsh insulin and 3 units is a lot. I dont know why vets even prescribe it for cats, dogs I guess do well on it, but it's not the best for cats. Keep testing........
 
Shot was given at 7:45 central time, so 6 hours ago. Just tested a 99
You did awesome at keeping him safe. Please today so no more than 1 unit and if you can, test at +4 hours after. If it's under 200 skip the shot completely until evening.
 
Can you add to your signature what type of meter it is? It makes a difference of its a pet meter or human meter.
 
Wow! You did a great job of getting through that!!! I'm so sorry you had to build your home testing skills during a hypo though! Thank goodness you went ahead and tried it last night and were able to keep Max safe and get his numbers back up before something bad happened.

After you've had some rest, setting up the spreadsheet Kris just gave you will be really helpful. If you have any trouble with it, just post here and we have some folks who can help you with it.

And of course, keep posting any other questions you have about how all of this works. Many of us end up here exactly like you did: the vet prescribes too much insulin, our cats go hypo, and we have to learn very quickly how to take control of this whole thing. You did a great job last night!
 
Max is better this morning. Tested 136. Called Vet who wants me to cut back insulin to 2 units and not test him so much. He says it may stress him out (as it's painful to him) and cause his BG to go up. Max doesn't like it, I struggle to get him to hold still but after last night I think it's important.
 
Please don't give 2u. That is just too much right now. And imagine if you didn't test last night! Once cats get used to the testing, it doesn't stress them out at all. My cat will even ask for tests (he jumps up in the testing place and paws at the meter) because he knows he'll get extra treats. Definitely not a stress! (He gets treats fairly often anyway, so it's not like that's the only way he can ask for them). Did you give him any insulin this morning? Or was the 136 without insulin?
 
136 without insulin. I told vet I'd check him again tonight before giving him anything else. He agreed. So cat treats are ok? I had been giving him treats regularly once a day before all this started, but stopped thinking they weren't helping. But the were he only thing I could really get him to eat last night.
 
It depends on the treats whether they're okay or not. High carb treats are a no-no, but they are great to have in your hypo kit because most cats will eat them no matter how woozy they feel, and they can raise the BG which is what you need during a hypo. High carb canned foods with gravy are also great for hypos (not for regular food) because the carbs from the gravy get into their blood faster than dry food.

Low carb treats are totally fine. Below are a few that I use. I buy them from my local pet store because they are sometimes a little cheaper than Amazon, but here are links to see some healthy options:

https://www.amazon.com/Cat-Man-Doo-...iner/dp/B000IW71BQ/?tag=felinediabetesfdmb-20

https://www.amazon.com/CATMANDOO-Dried-Chicken-Pet-Treat/dp/B00II6TGV2/?tag=felinediabetesfdmb-20

https://www.amazon.com/WildSide-Salmon-Treats-Cats-Pack/dp/B008B9TOYA/?tag=felinediabetesfdmb-20

https://www.amazon.com/Vital-Essent...lets/dp/B01B78M736/?tag=felinediabetesfdmb-20

The last one (Vital Essentials) has a lot of different flavors. Some are just meat (those are good), others have ingredients that add carbs (not good), so be careful to check ingredients before you get those.
 
I will check into those. I only had friskies brand available. Probably high carb. I also didn't have gravy canned food, thought that was a no-no also so I didn't buy any. It's funny, exactly what they don't need is what I actually DID need last night.
 
I will check into those. I only had friskies brand available. Probably high carb. I also didn't have gravy canned food, thought that was a no-no also so I didn't buy any. It's funny, exactly what they don't need is what I actually DID need last night.

Lol! You're right that the gravy foods are no-no's.....at least until there is a hypo! And those high carb treats were exactly what you needed last night, so good job! There is so much to learn about all of this, but you're doing great. That's also why vets have such a hard time with feline diabetes: they get very little training about diabetes at all, and a lot of what they learn is about dogs who are easy - you figure out the dose, and pretty much just give it to them. Cats are complex and varied and it's not one-size-fits-all. Our vets do the best they can, but they don't have the time to invest in learning about this the way we all have since we live with it every day!
 
I did contact another area vet who was very interested in more information about the Carb-less diet recommendations. He typically recommends the w/d stuff and all dry due to dental issues they see associated with wet food. I was very happy he was willing to take some time to review the information I sent and maybe it will make a difference for his future patients, and maybe even my Max. My Love to all of you who got me through last night. I seriously appreciate it!!!
 
Here's something I wrote up for others that needed help with testing...maybe it'll help you too!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him
...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.

When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

As for the myth about dry food being better for teeth than wet, that's hogwash too....that's like saying that if we eat lots of crackers, our teeth would be clean!!

Here's a good article explaining why kibble is actually bad for teeth....and another article HERE
 
As for the myth about dry food being better for teeth than wet, that's hogwash too....that's like saying that if we eat lots of crackers, our teeth would be clean!!
Oh that is the perfect use of the term "hogwash". I'm embarrassed to say I used to be the "Wet food will make your cat's teeth will fall out" guy. I don't see a lot of kibble in nature, I see food that is WET. Don't forget that coffee, red wine, butter is good/bad/good/bad for you either. I didn't believe in the gluten myth either until my wife's health improved to the point there was no other explanation. And people that think migraines are just headaches, bite me!
 
Max received no insulin this morning. Just tested him and got 249. Insulin or no? He hasn't eaten much, but he did eat a little bit ago.
 
Did you already give a shot?

If not, did he eat before or after the test? If before, how long before?
 
No shot. He hasn't eaten much today, so I wasn't sure what to do. Kind of waited for him to tell me when he's hungry. Test was done shortly after eating a small amount of canned food. About an hour ago now.
 
Can you find a new vet? This guy sounds like a tool, lol.

Also, for the diarrhea, some ppl use a 1/4 tsp of PLAIN canned 100% pumpkin. I use Purina's Fortiflora, it's a probiotic, and it works like magic. Within days my cats poop was normal again and if she won't eat her food, I sprinkle the probiotics on it and she gobbled it up. Good luck. And I agree with everyone, one unit for now. :)
 
Probably a good choice for tonight. When you do the pre-shot test, you want to test before he's eaten. It's best if there can be a two hour gap (or more) between his last food and the pre-shot test. In diabetic cats (and humans too!), the BG will rise after eating. So if you test after, you might see the food-inflated number and give too much insulin. That's why it's best to withhold food just for those two hours. If he's over 200, you can probably give him one unit of insulin.

You might try to get another BG test in this evening even though he didn't have insulin. First it will give you and Max more practice with testing, but it will also give you an idea of his BG now that it's been a few hours since he's had food.

Also, getting a spreadsheet going will really help. Seeing the numbers helps us to figure out how Max is responding to things so we can give better advice and help you keep him safe! You need a google account, and then you just have to follow the directions to get it connected and shared - the color coding happens automatically :)

Here's the link, but if you need any help just ask -- we have people who can help get it set up for you. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
I withheld his shot last night. Test this morning (without food since last night) was 214. This morning he's good and hungry. Like his normal self.
 
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