? Why is my cat's "remission" inconsistent?

[impossibledreamer]

My 15 year old cat was diagnosed with diabetes 6 months ago, right after her brother died suddenly. We had her on insulin for a few months, but her blood sugar became too low so we were able to stop. I went from testing her multiple times a day to now testing her a few times a week.

About once or twice a month, her glucose will go above normal and I have to give her a low dose of insulin. I can usually tell because she'll get agitated and walk around howling. But she never needs more than a small dose and things go back to normal the next day.

She's always been a picky eater and doesn't eat the diabetic wet food consistently. Sometimes she's happy with it, but sometimes she almost seems disgusted by it. She will eat the diabetic dry food without problem, but I worry about her relying on a dry food diet. I do wonder if her erratic eating is causing the random glucose spikes.

Has anyone dealt with this kind of inconsistent remission? Is she not really in remission?

 

[Bron and Sheba (GA)]

What is the name of the diabetic dry food? If it is higher that 10% carbs, it could possibly be raising the BG.
Do you have some BG data you can share with us so we can see what the BG numbers are doing?

 

[impossibledreamer]

Her glucose is consistently around 150, but when she has these peaks it can to to 250-300. I’ll give her .5ml of insulin and that’s enough to bring it down.

What I have been giving her:
Royal Canin Veterinary Feline Diabetic Dry
raw protein 46.0 %
raw fat 12.0 %
raw fiber 3.8 %
raw ash 6.4 %
starch 19.0 %
EPA / DHA 2.88 %
total sugar 1.5 %

Royal Canin Veterinary Feline Diabetic Wet
raw protein 8.9 %
raw fat 3.2 %
raw fiber 1.1 %
raw ash 1.7 %
moisture 82.5
starch 1.2 % Total
total sugar 1.3 %

What I’m trying to give her, but she won’t eat the dry and the wet she’ll only eat a couple times a week:
Vet Concept Cat Low Carb Wet
raw protein 10.8%
raw fat 3.6%
crude fiber 1.6%
raw ash 2.0%
moisture 78.0%
starch 1.1%
total sugar 0.1 %
calcium 0.31%
phosphorus 0.25%
sodium 0 .15%
magnesium 0.02%
0otassium 0.18%
linoleic acid 0.40%
omega-3 fatty acids 0.15%
metabolizable energy (calculated) 369 kJ/100g

Vet Concept Cat Low Carb Dry
raw protein 44.6%
raw fat 10.8% crude fiber
6.0% crude ash
7.5%
starch 15.0%
total sugar 0.9%
calcium 1.25%
phosphorus 0.90%
sodium 0.30%
magnesium 0.08%
potassium 0.70%
linoleic acid 2.00%
omega 3 fatty acids 0.50%
metabolizable energy (calculated) 1,520 kJ/100g

When she doesn’t eat the others, I will give her this. The protein is low so maybe that is triggering her?
Almo Nature HFC Natural 12 x 280 g
raw protein 14.0 %
raw fat 0.5 %
raw fiber 0.1 %
raw ash 1.0 %
moisture 80.0 %
metabolizable energy 463.0 kcal

My vet did tell me to keep dry food out for her all the time, but she can overeat that, especially if she’s stressed. She's become more anxious since her brother died and I think she also has some mild dementia that makes her confused/stressed.

She consistently drinks and urinates a lot, even when her glucose is at a more normal level. She’s had an ultrasound and the only thing they found was inflammation in her pancreas, but her bloodwork didn’t indicate pancreatitis. She gets UTIs frequently (always has), but the ultrasound and the bloodwork didn’t indicate any issues with her kidneys.

 

[Bron and Sheba (GA)]

The Royal Canin diabetic dry is 19% carbs so is high carb. This will put stress in the pancreas and will raise the BGs.
If you want to feed dry food there are a couple of dry foods that are low carb
There is Young again Zero carbs (5% carbs) and Dr Elseys Clean Protein.
Another alternative is Stella and Chewys freeze dried food and Ziwi Peaks dried food, both low carb.
Alternatives to expensive prescription foods are here in is this FOOD CHART
look for foods that are 10% or under

Would you like to set up a spread sheet so we can see what is going on?
HELP US HELP YOU has the information how to set up the spreadsheet and the signature.
.

 

[Hendrick Cuddleclaw]

Regardless of what your vet says, I would recommend you eliminate the dry food entirely if you want your cat to be in the best health. Feed low carb canned or raw only if possible. Not always possible for everyone, of course.

 

[impossibledreamer]

The Royal Canin diabetic dry is 19% carbs so is high carb. This will put stress in the pancreas and will raise the BGs.
If you want to feed dry food there are a couple of dry foods that are low carb
There is Young again Zero carbs (5% carbs) and Dr Elseys Clean Protein.
Another alternative is Stella and Chewys freeze dried food and Ziwi Peaks dried food, both low carb.
Alternatives to expensive prescription foods are here in is this FOOD CHART
look for foods that are 10% or under

Would you like to set up a spread sheet so we can see what is going on?
HELP US HELP YOU has the information how to set up the spreadsheet and the signature.
.

I'm in Germany and the only one I was able to find is Ziwi Peaks, but I'll give it a try.

Thanks for the link with the instructions for the chart. I set one up and will start filling it out with her info.

 

[impossibledreamer]

Regardless of what your vet says, I would recommend you eliminate the dry food entirely if you want your cat to be in the best health. Feed low carb canned or raw only if possible. Not always possible for everyone, of course.

I'm willing to try, but I'm not sure how easy it will be with an elderly cat who has always had access to dry food. She's eating more now because she doesn't like the diabetic wet food, so maybe it'll be easier if I can find a wet food that she'll tolerate more.

 

[Noah & me (GA)]

Vets all over the world have wildly different protocols for diabetic cats. The dry food has got to go.
One reason for her numbers is that she may simply not be in remission. This is everybody's dream but the older the cat the less likely of remission being possible. Other websites call remission a cure, it's not and never has been. I don't mean to sound negative, just realistic. If this is your first remember that cats don't die of diabetes, it's just an inconvenience. Best of luck and keep posting.

 

[Red & Rover (GA)]

I'm in Germany and the only one I was able to find is Ziwi Peaks, but I'll give it a try.

Have you checked out the UK Food List? There are some EU-specific foods at the bottom.
UK Cat Food List

 

[impossibledreamer]

Vets all over the world have wildly different protocols for diabetic cats. The dry food has got to go.
One reason for her numbers is that she may simply not be in remission. This is everybody's dream but the older the cat the less likely of remission being possible. Other websites call remission a cure, it's not and never has been. I don't mean to sound negative, just realistic. If this is your first remember that cats don't die of diabetes, it's just an inconvenience. Best of luck and keep posting.

The thing that worries me is sometimes her blood sugar gets low, which is why the vet recommended keeping her food out. She's very finicky with food. Sometimes she barely touches her wet food and in that case I'd be worried her glucose will drop too much.

 

[impossibledreamer]

Have you checked out the UK Food List? There are some EU-specific foods at the bottom.
UK Cat Food List

This is very helpful, thank you!

 

[impossibledreamer]

Thanks everyone who offered advice. I went through her blood sugar measurements and entered them into her spreadsheet. If anyone has a chance to look at that, I would really appreciate it. Most of the readings are from after the vet had me stop twice daily insulin, but there are a few instances after that where her blood sugar went up and I had to give her a dose.

She also struggles with joint pain and has had a bone spur on her spine for years. When her pain is worse, she seems to eat more and I wonder if that throws her glucose off. We've recently started her on a biologic and it does seem to help, but I'm still struggling to get her diet right...especially because she's so picky and finicky with food.

 

[Larry and Kitties]

We've recently started her on a biologic

What biologic specifically? Any other treatment for the joints being given?

 

[impossibledreamer]

What biologic specifically? Any other treatment for the joints being given?

She’s on Solensia. She started a month ago and we’ve noticed she’s much less stiff and and she’s stretching and rolling around and asking to play more. I think the spur still causes pain because she meows when she uses the litter box and the vet said that the position of the spur likely causes pain when she’s squatting. We’ve had her on various temporary pain medications and CBD oil but not since she started Solensia. Nothing else for her joints. And I did have her on some “mobility” cat food but not since the diabetes diagnosis.

 

[Larry and Kitties]

She’s on Solensia.

Since you have not seen any adverse side effects I would stay with the Solensia.

 

[Sienne and Gabby (GA)]

We likely use a different set of values for what constitutes "low" numbers or remission. We generally look to see numbers consistently in normal blood glucose range, 50 - 120 mg/dL, for a period of at least 2 weeks for a cat to be in remission. (The spreadsheet would show mostly "green" numbers.)

Episodes of pain could easily be a cause for higher numbers. Likewise, the foods you're giving your cat are high in carbohydrates. ZiwiPeak is a good brand of cat food. The food chart that Bron linked has the carb values for ZiwiPeak included.

 

[impossibledreamer]

We likely use a different set of values for what constitutes "low" numbers or remission. We generally look to see numbers consistently in normal blood glucose range, 50 - 120 mg/dL, for a period of at least 2 weeks for a cat to be in remission. (The spreadsheet would show mostly "green" numbers.)

Episodes of pain could easily be a cause for higher numbers. Likewise, the foods you're giving your cat are high in carbohydrates. ZiwiPeak is a good brand of cat food. The food chart that Bron linked has the carb values for ZiwiPeak included.

I'll have to double check the values of my meter. We're in Germany so maybe it's measured differently. The chart our vet gave us has the normal range between 100-200. Her behavior is definitely the most normal when she's around 150. She got to 80 at one point and she was showing signs of hypoglycemia.

 

[Sienne and Gabby (GA)]

Some cats can be more sensitive to lower numbers. Depending on how long your cat was diabetic prior to being diagnosed, it may take a while for her to become acclimated to normal numbers. If you're using mg/dL as the unit of measurement, the information re. normal numbers being 100 - 200 is not what we use. I'd be curious what is considered normal range for humans in Germany (or according to your vet).

 

[impossibledreamer]

Some cats can be more sensitive to lower numbers. Depending on how long your cat was diabetic prior to being diagnosed, it may take a while for her to become acclimated to normal numbers. If you're using mg/dL as the unit of measurement, the information re. normal numbers being 100 - 200 is not what we use. I'd be curious what is considered normal range for humans in Germany (or according to your vet).

I’m thinking of taking her to a different vet for a second opinion. I did a quick google search and there seems to be a lot of variation in what is recommended here. We’re new to Germany so we don’t have a lot of experience with vets here, but at least with our own medical care we’ve found German doctors to be conservative with treatment compared to the US. I just can’t imagine they’d have wildly different recommendations for glucose levels. But maybe my current vet is just giving me the wrong information.

 

[Bron and Sheba (GA)]

This forum is a world wide forum. It is based in the US but we have people from all over the world. I am from Australia. We also have members from India, England, Canada, Spain, New Zealand just to mention a few.
Normal BG numbers for a cat are 50-120 (2.8-6.6). If you are using a pet meter which vets mostly do now the BG numbers will be a bit higher 68 (3.7) to approximately 150 (8.3) although these numbers are only estimates as no studies have been done to compare the results of the pet meters to the human meters.
We are very consistent with what are normal BG numbers here. It is the vets who all have a different idea of what they consider is normal and acceptable for diabetics cats. I would be asking a vet how many diabetic cats they have treated and how many they have got into remission.
What information are you hoping to get with a second opinion?
You have the diagnosis of FD and a good insulin.
Pain can certainly affect BG numbers. My Sheba’s BG numbers reduced after I got a pain medication for her spinal arthritis.
On a housekeeping note, it would be helpful if you could set up your signature so we can see information about Tuesday.
Information how to do this is in this link HELP US HELP YOU

 

[Sienne and Gabby (GA)]

If you speak German, there is a Lantus forum there. It actually predates this message board. If nothing else, they may be able to recommend a vet in your area.