New Member and multiple ailments

Hi,

Not sure how long the threads are here. We are members of the Tanya CRF group and had a recent diagnosis of diabetes. So members suggested I come here. My girl is 7.4 kgs or 16 pounds. Diagnosed with CKD in July of this year. We are in Canada. Shortly thereafter she lost her vision, not blind, but significant loss. She has hypertension (on Amlodipine, just increased to 1.5 ml per day - compounded liquid), has proteinuria, had glucose in her urine 3 of 4 urine tests. Recently diagnosed with diabetes and pancreatitis by blood tests. Fructosamine test was 393 umol/l, Spec FPL was 14.4 ug/l.. She also has HCT of .20 down from .25 in July when she had an infection, so she is bordering on anemia. Her bun is 29, crea is 373 (international values) and phos is 2.0 (high end of normal). We have started her on B12 injectable, doing B12 oral at 500 mcg daily, along with Amino BPlex, Restoralax at 1/16 tsp twice daily and D-Mannose 1/16 tsp daily. We had been feeding Hill KD Mobiity canned, with a bit of KD dry. We started insulin at 1 unit a day, and have readings of 13.8, 21.1 and 21.9 from the Alpha Trak. The 21.1 and 21.9 (mmol/l) are for the last two days when we are learning how to do this...

My main question is on food, what do I feed her? She is a former dry food junkie, she is 16, and we adopted her when she was 12. I am scared to give up on her kidneys, and scared to ignore her diabetes, and I am lost on the correct protocol. She is a grazer of food, so it will be a learning curve for her to do a tight regulation. We both work, and I worry about her during the day and not having food.

If anyone has any idea's, that would be great. I have been browsing for a few days looking for CKD posts. On the CKD site they say to treat diabetes first, here I have heard to also watch the kidneys, so I am lost and confused in Canada.

 

Wow you have a lot on your plate! Generally for a kitty with both diabetes and CKD it is suggested to feed a low carb, low phosphorus wet food with added water. Most of us feed multiple times a day. You can use an auto feeder for when you’re not home and at night. What insulin is she on? Is that 1u twice a day?

 

We are using Lansulin. We had the 13.8 reading when my vet took the bg reading, and the other two readings are our own attempts. Our vet said 1 unit once a day for now given the first reading. I have looked at many of the food lists, and just cant feel good about any food, for all of her conditions, and I want and need her to continue to eat for her ckd and other ailments, and am very scared to throw her off eating. I dont think she was micro chipped when we adopted her, so if you are talking about those feeders, not sure if that is an option.

 

do you mean Lantus? Or Vetsulin?

there are feeders that are microchip activated, but there's also an autofeeder like the PetSafe5 that's digital and you just program it to open when you want it to.

We have LOTS of cats here that have multiple diagnosis, with diabetes and CKD being one that's most common.....The most important thing is to treat the diabetes because diabetes puts a lot of extra strain on the kidneys. By getting the blood glucose under control, you take the extra pressure off the kidneys.

CKD cats (unless they're in late stage 3 or 4) benefit the most from a low carb/low phosphorus diet. Old school thinking said to limit the protein, but the latest research says no....you want to limit the phosphorus and feed a high quality protein to help prevent muscle wasting.

 

My apologies. I meant Lantus. The diabetes is new to us. My understanding with my girls numbers are that she would be considered stage 3.

 

Hi. I'm in Canada too and my cat, Champagne also has CKD (stage 3 it seems) and diabetes (was on Lantus, been in remission for 5 months now) . He's also on Amlodipine for hypertension, Epakitin as phosphorus binder, occasional Mirtazapine for appetite, daily Omega-3 supplement and he started receiving 60 ml of Sub Q fluids daily. He was also on K/D when he was diagnosed. It was a bit of a nightmare for me to find the type of food that worked for both his conditions so I understand how you must be feeling right now.

I don't know if this can help you, but the foods I ended up settling on for Champagne are ; Weruva - Steak frites, Tiki Cat - Puka Puka Luau (chicken) & Koolina Luau (chicken and egg) and surprisingly, Royal Canin - Renal Support D, which is kind of RC's version of K/D. It's listed as 16% carbs but Champagne's case, he's been eating it for nearly 3 months now and his BG didn't move at all. Every cat is different though, so it might be too high in carbs for a more carb-sensitive cat.

For a while he also really liked some of the Wellness - CORE, but I discovered they were really high in phosphorus since they'd changed their recipe

 

Welcome!!

Since you are on Lantus you may find the information on this link useful http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/ , so that you can start getting familiar with all of this and decide what protocol suits you best.

Also I think is important to mention that Lantus works best if given the same dose twice a day every 12 hours.

 

Welcome!

Is she getting Benezapril for the proteinuria? if not she should be. I had a ckd cat who took 5 mg of amlodipine (2 2.5 tablets) and 2.5 benezapril a day. Hopefully you caught the high blood pressure early enough that the vision will be restored. I was really fortunate my Zimmy didn't go blind... he had blood pressure of 220!

What oral b 12 are you giving? Make sure it's a b 12 Methylcobalamin I would up that to 1000 mcg daily, 500 morning and night. your cat is not just borderline anemic at 20%, she's approaching severely anemic. You should ask about adding in an ESA such as Aranesp. http://www.felinecrf.org/esas.htm
What's she getting the D-Mannose for? Is she prone to UTI?

Tanya's CKD site is basically the BIBLE of feline kidney failure. really a labor of love putting that site together. http://www.felinecrf.org/index.htm


OK FOOD... you want to find a food LOW IN CARB for the diabetes, and LOW IN PHOSPHOROUS for the kidneys. One good brand that satisfies both is Weruva Cats in the Kitchen Line (there are a few that are 8% carb, but most flavors are 2-5%), and Weruva Truluxe line of food (All flavors except Mediterranean Harvest and Peking duck).

Here's the food chart. Pick foods less then 8% carb and about 200 or lower Phosphorus. http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

Hi, thankyou for the replies. I will look over the links, food and diet and regulation of her diet and trying to treat all of her conditions is our concern. She is on 1.5 ml of semintra in the am for the proteinuria. We are giving oral methylcolbamin at 500mcg a day and have started b12 shots. I started d mannose after her uti in July, and with ckd and now diabetes, these cats are prone to utis, plus with her size, she does not groom as much as required.

We did not regain her sight, started amlodipine to late, she is doing okay with that. Everything stays in the same spot in our house.

We are on the crf site and group and it is amazing for us.

My vet and I have discussed esa's for the anemia, but we got hit with the diabetes at the same time. We do blood again soon, so hopeful for improvement, and hopeful , the b12s are helping. On the crf group, anemia and heart problems are the big subjects for the last several weeks.

For those with ckd, diabetes etc, what was diagnosed first, just out of curiousity, as I wonder if something was missed for us, and if something was corrected before, would we be here?

Btw, my girls name is Charlie , and the love of my life. She is loving all the attention, but not so much the ear pricks. We are getting better at the pricks each day.

 

Well it certainly sounds like you are doing everything you can for her. You are a great cat mama.

There's a great ckd cat group on Facebook called Cats with Chronic Renal Failure that would be worth joining. Is she getting sub q fluids at home? I think that's the best way to prevent advancement of the ckd.

For the diabetes getting on the lower carb diet is essential.

When you get a chance set up a signature. It will make it easy to see all the info in a glance.

Just click on your name at the top right corner and choose signature. Add info such as your pets name, date diagnosed, insulin type and dose, food you're feeding, if you are home testing and which meter you are using, medications and her other health concerns.

 

Welcome to the group! Very knowledgeable people here that helped me very much!! My Baby’s bun & creatinine #s are fine & has diabetes. Each cat is different (ecid) so do not blame yourself. I know now - dry food (unless it is of specific type) is not good for any cats in general! That being said... I’ve had 2 cats on 1/2 dry food & 2 wet meals daily that passed with kidney failure at age 12. My most recent loss had thyroid disease (treated) & dx age 12; failing kidneys but was euthanised due to mamm cancer at age 17 1/2. Dry food was also half of her diet. And I’m saying the dry food they were given was Purina cat naturals that is high carb! Know better now. Moving forward. Just my story on kidney disease, diabetic cats etc. You are a great kitty momma! Good job good luck.
My Baby is blind due to eye disease. She gets along fine & recognizes my clicking- & voice command. She knows how to get there by the forward position whiskers!
She knows she can run outside & where the trees are!

 

In Babu's case HCM came first, diabetes second and CKD later on, he was actually already in remission when diagnosed with the CKD, but he's also 15 and a Hymalayan so no way of actually knowing if there was any influence between them, or breed related or age related or maybe all of them

Testing does get easier in time so be patient

 

So after a week of testing, things were still not good, had a high of 23.1 mmol on Friday night the 17th, gave our cat and us a break, saturday and sunday night and still gave the 1 unit both days. Sunday night she was restless, agitated, meowing, pacing, laying in a bed she has not used in months, and then restless again, this was within an hour and a half after her shot. Total panic for two newbies, gave some honey on the gums, tested her after a liile while and she was 8.7 mmol, gave more honey, food and she finally settled. We will never give insulin again without testing. Not sure if she was hypo, but close? We took Monday night off, she was 15.4, but we gave nothing, and she was back to 23.1 tonight and gave normal dose. Not sure what happened, we are going to check sugar in the urine to see if there is any. Vet sais maybe she was hwading for remission, or her pancreas started, or maybe it was a blood pressure spike. Very glad I had read the hypo page anyways.

 

I'm glad she's ok, and nothing happened.

Maybe I'm making the conversion wrong but I think 8.7 ( around 155 ) was not a terribly low number, lower that she was used to for sure and usually when they start getting lower numbers they do not feel well, is like their body was used to work in high numbers so it has to get used to lower numbers, having ups and downs is quite common especially in a newly diagnosed cat, it takes some time to get regulated months even

Glucose in urine usually shows when they are over 200 (11) for several hours, that's why it's not really a good mesure for control specially when injecting insulin.

It would be very good if you started using the spreasheet and add it to your signatur so that everyone can see how he's doing, it will help a lot to the very experienced people so that they can help you, this is the link with the instructions http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Sice you are using Lantus, I also suggest you start posting in the Lantus Fourm all your questions and how she's doing so that more experienced eyes can see http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/