? Vet wants to change food to higher carbs, and not change insulin dose.

Mathilda and Maverick

Mathilda and Maverick

Member Since 2020
Maverick is experience several health issues (such as DKA, liver issues, pancreatitis, IBD) along with the diabetes that was diagnosed mid November. He has been very hard to regulate, and has been back to the ER one time with another DKA.

He is currently on PPP D/M. He has shown signs of allergy to food before, and now he seems to react bad to this food as well. He lost much weight these past 2 weeks so he is now getting 2 cans/24h which he eats with good appetite. His symptoms of allergy include diarrhea, and over grooming he has been on Cerenia since he was diagnosed except for a couple days (and he vomited then so we got him back on it). He's been on Metronidazole since Saturday, but it hasn't helped, but vet want him to stay on this until Monday. Yesterday we started Proviable also. We have Mirtazapine as needed, but haven't needed it much lately. He's been on Farmotidine since the Dec 17th and Denamarin since diagnosed.

Mavericks BG's has been very high lately, I just increased his Lantus dose to 1U AM/PM, but I'm afraid it's still not enough considering how much he eats throughout the day.

The vet want me to gradually switch food starting Monday. I researched some novel diets I'd like to try, but she is determined to have him on Prescription food, either RC Selected Protein or Hill's Z/D. These feed are both way higher in carbs (15%, 16%, 35%) and lower in calories than his current food. Hence, my understanding is that he'll need to eat much more of either these feed to reach the same calorie intake he has now- and that will be dangerously high carb intake unless the insulin is matched. Is that correct? However, the vet is determined to keep him on 1U for another 5 days, even though it doesn't seem to be enough already before changing food. The vets reasoning is to "choose the battles" and trying to treat the allergy and hoping for the BG's to go down when allergy stressors are controlled. I understand this reasoning, but not that one can't consider two issues at the same time and change insulin according to increased carb intake. Am I wrong?

I am very concerned, and each time I try to reach out to my vet, there is a technician that takes my message and I never get to talk to the vet directly unless it's during an appointment. I had a hard time finding a good vet that sincerely care and look into Mavericks history, so I do not want to get into a dispute with her either and having to change vet.

Any thoughts on this?
What should I do?
Does it look like Maverick needs to have a higher dosage now, and/or after changing feed?
Any experience with any of these prescribed food?
Any ideas and tips on how else to help with the diarrhea?
Any tips on how to better get him regulated?
 
How is the vet deciding this is allergy vs IBD? It's entirely possible what you're seeing is more the IBD which causes diarrhea and/or vomiting and not allergy. If this is allergy, has Maverick been tried on an antihistamine? Generally, the strategy with IBD is that your cat needs to be eating novel proteins. Usually flavors such as venison, rabbit, lamb or other proteins that have not been part of your cat's diet are encouraged. (My IBD cat ate a diet of chicken and turkey prior to being diagnosed. Now he eats pork. venison, and a lamb and rabbit combination). Often steroids (prednisolone) are used to help with the inflammation.

There is nothing magical about prescription foods. In fact, the FDA has taken issue with the cat food manufacturers for misleading the public by referring to pet foods as "prescription." Read the labels -- there's nothing different in the foods that warrant them being called prescription. The first several of the ingredients in the R/C Select Protein include: Water sufficient for processing, venison by-products, venison, pea flour, vegetable oil, natural flavors, powdered cellulose, carrageenan, fish oil, calcium sulfate, carob bean gum, taurine. The venison by-products are parts of the animal no one wants to eat. Peas are high in carbs so not good for a diabetic kitty. Carrageenan and the carob bean gum -- carrageenan and gums are really not good for a cat with IBD and have been associated with GI problems. And best yet, powdered cellulose is another name for saw dust. And, the RC is 24% carb. I would compare this with ZiwiPeak Venison: Venison, Water Sufficient for Processing, Venison Tripe, Venison Liver, Chickpeas, Venison Lung, Venison Heart, Venison Kidney, New Zealand Green Mussel, Venison Bone and it's 3% carb.

Many vets do not get good training in feline nutrition. They rely on the sales people from the pet food companies for information. You do not need to buy your cat food from the vet. All of these foods are commercially available. Or if you need to appease your vet, buy one can since Maverick can be fussy. If they will only sell you a case, tell them you want them to guarantee they will take the food back if Maverick won't eat it. (And then return all but one can.) Tell your vet he won't eat the food and give your cat a low carb food. For what you'd pay for a "prescription" food, you could be buying a much higher quality food that's low carb.

My go to probiotic for diarrhea is S. boulardii. Either ReNew or Jarrow's with MOS are both very good. I've used the ReNew product -- you start with about 1/4 of a capsule twice a day and increase if necessary. This site, Raw Feeding for IBD Cats, has great information on supplements and on how to manage diarrhea.

It looks like you just raised Maverick's dose. You may want to read over the sticky note on dosing methods. There are two approaches that we use. Depending on whether you opt for Tight Regulation (TR) vs Start Low Go Slow (SLGS) will dictate how long you hold the dose for. With TR, you hold a dose for 3 days and with SLGS you hold the dose for a week unless a reduction is indicated. Sticking with a dosing method will likely help with getting Maverick regulated.
 
Sienne and Gabby (GA) said:
How is the vet deciding this is allergy vs IBD? It's entirely possible what you're seeing is more the IBD which causes diarrhea and/or vomiting and not allergy. If this is allergy, has Maverick been tried on an antihistamine? Generally, the strategy with IBD is that your cat needs to be eating novel proteins. Usually flavors such as venison, rabbit, lamb or other proteins that have not been part of your cat's diet are encouraged. (My IBD cat ate a diet of chicken and turkey prior to being diagnosed. Now he eats pork. venison, and a lamb and rabbit combination). Often steroids (prednisolone) are used to help with the inflammation.

There is nothing magical about prescription foods. In fact, the FDA has taken issue with the cat food manufacturers for misleading the public by referring to pet foods as "prescription." Read the labels -- there's nothing different in the foods that warrant them being called prescription. The first several of the ingredients in the R/C Select Protein include: Water sufficient for processing, venison by-products, venison, pea flour, vegetable oil, natural flavors, powdered cellulose, carrageenan, fish oil, calcium sulfate, carob bean gum, taurine. The venison by-products are parts of the animal no one wants to eat. Peas are high in carbs so not good for a diabetic kitty. Carrageenan and the carob bean gum -- carrageenan and gums are really not good for a cat with IBD and have been associated with GI problems. And best yet, powdered cellulose is another name for saw dust. And, the RC is 24% carb. I would compare this with ZiwiPeak Venison: Venison, Water Sufficient for Processing, Venison Tripe, Venison Liver, Chickpeas, Venison Lung, Venison Heart, Venison Kidney, New Zealand Green Mussel, Venison Bone and it's 3% carb.

Many vets do not get good training in feline nutrition. They rely on the sales people from the pet food companies for information. You do not need to buy your cat food from the vet. All of these foods are commercially available. Or if you need to appease your vet, buy one can since Maverick can be fussy. If they will only sell you a case, tell them you want them to guarantee they will take the food back if Maverick won't eat it. (And then return all but one can.) Tell your vet he won't eat the food and give your cat a low carb food. For what you'd pay for a "prescription" food, you could be buying a much higher quality food that's low carb.

My go to probiotic for diarrhea is S. boulardii. Either ReNew or Jarrow's with MOS are both very good. I've used the ReNew product -- you start with about 1/4 of a capsule twice a day and increase if necessary. This site, Raw Feeding for IBD Cats, has great information on supplements and on how to manage diarrhea.

It looks like you just raised Maverick's dose. You may want to read over the sticky note on dosing methods. There are two approaches that we use. Depending on whether you opt for Tight Regulation (TR) vs Start Low Go Slow (SLGS) will dictate how long you hold the dose for. With TR, you hold a dose for 3 days and with SLGS you hold the dose for a week unless a reduction is indicated. Sticking with a dosing method will likely help with getting Maverick regulated.
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Hi!
Thank you so much for you response and all the great advice- I really appreciate it!
I think its a combination of allergy and IBD we are trying to battle with the diet change and we are going for the novel diet, and then she's hoping the BG's will follow suit and decrease as the other stressors in the body calms down. I can not remember if he's been on antihistamine before. I do know that he never been on a steroid though because of his previous liver failure, except for right before his liver went bad.

I really do want to find a food that we both agree on being good and stay away from the prescription food and I entertained the idea of just saying that he wouldn't eat what she suggested, because I do want us to stay on good terms and being able to have discussion to come up with plans. I tried some of the Instinct limited ingredients today, and the picky eater liked it, but I like the ingredients in the ZiwiPeak Venison you suggest better so I think I'll order that. Should I stick with one flavor to start with, or does that matter at all? Should I gradually change the feed on him?

I'll look into those probiotics and site, thanks! How would I measure 1/4 of a capsule the best way?

I am planning on going with the TR, but need to discuss this as well with the vet so she's on the same page. Maverick just had another DKA yesterday so that seem like the best option for him.
 
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