Diet controlled diabetic with severe IBD diet advice needed

Hi all

Remi has been a diet controlled diabetic for the last two years thanks to this forum.

In this time his IBD has progressed and we have tried him with every novel protein foods available in the UK. They worked at first but eventually he had constant diarrhoea and lost a lot of weight. He has a low dose of steroid eod but because the dose remains low to prevent diabetic relapse it doesn't control the IBD. He has recently started chlorambucil as we have exhausted all other treatments and this is helping but still he has diarrhoea.

I am thinking of trying a wet hypoallergenic prescription diet that is easily digestible. Does anyone have any suggestions as to which ones are okay carb wise.

I am a little desperate as remi is refusing the ropocat rabbit that he always likes and I need to find something soon.

I have some hills Zd. I tried to work out the carb content using the calculator but it was already I dry matter so that confused me somewhat. Does that mean the carb content is 39%!!

http://www.hillspet.com/en/us/products/pd-feline-zd-canned

Any suggestions gratefully received.

Thanks
Sarah and remi

 

Hi Sarah! (Hugs, hugs and more hugs...! )

I think the only low carb 'prescription' food is the canned Purina DM...

Does Remi have to have a single protein food?
Are there proteins that he is known to be intolerant to?
Have you ever tried him on a raw diet...?

Eliz

 

Hi Elizabeth

I hope you well.

Yes remi has a single protein food rabbit.

So far we have tried single protein:
Chicken
Turkey
Lamb
Horse
Venison
Rabbit

Basically everything from happy kitty company.

He has had diarrhoea on all of them. The rabbit was the best but has now failed.

Before his diabetes his IBD was well controlled on a hypoallergenic food but it was high in carbs.

Years ago I tried raw food and he refused it. Plus I would be too nervous to try it now with his pancreatitis.

I looked at the purina PM but I don't think it would be good for his stomach. Am I right that the carb content of the hills is 39% ?

I am at a loss. I think remi finds the really high protein foods hard to digest.

 

One of mine is on Royal Canin Hypoallergenic prescription wet food which is duck-based. Likely too high in carbs ... You're trying to balance the needs of two serious health conditions, IBD and diabetes. Weight loss puts diabetic cats at risk of other complications like DKA, hepatic lipidosis, etc. It may be that you'll have to find a food/foods that Remi likes and tolerates and go back down the road of insulin control of his diabetes. I see you've been there before. I've read elsewhere on here that sometimes a cat has other more pressing health issues that require higher carb food and the insulin dosing has to work around that.

 

I also have a diet controlled diabetic that has IBD (not confirmed as we opted not to do a biopsy, but it's highly suspected). I'd say hers is moderate and her main symptom is vomiting, with occasional soft or loose stools (not full-blown diarrhea). She's also has slightly elevated numbers on her last few Spec fpL tests, suggesting chronic low grade pancreatitis.

Have you considered home-cooking (or perhaps you'd be willing to give raw another try)? Squeak has been on raw now for a month and, while it hasn't been an overnight miracle, I can see that she's getting better - she's more energetic, her coat is glossy and soft, her vomiting and nausea symptoms are decreasing, and her bowel movements have firmed up. I was in a similar situation to you earlier this year - I'd tried a few of the prescription diets, as well as most of the limited ingredient, low-carb commercial diets out there and nothing was making any difference. Squeak ended up having a bad flare up of IBD/pancreatitis over the summer and I thought for sure we were going to lose her - she was refusing to eat anything, meds were helping very little and, even if I could get her to eat, the only thing that was "safe" was plain, baked chicken breast. After much deliberation, I decided we had nothing left to lose and started her on raw. She was an easy transition, but I still did it slowly. I use a product called EZ Complete by Food Fur Life (www.foodfurlife.com) - I just add water and the supplement mix to raw meat (you can also use it with cooked meat) and that's it - quite simple. If your cat isn't on board at first, there are lots of tricks you can employ to get them going and proper transitioning is explained on the website.

If you're on Facebook at all, there's an excellent group called "Raw Feeding For IBD Cats" that has been invaluable for us on our journey so far. They also discuss home cooking if that's a route you'd rather follow - I know of several group members who are feeding cooked food. The owners of the group are the ones that started the Food Fur Life company.

Another thing you can look at is probiotics, if Remi isn't currently taking any. I've read that S. boulardii in particular is supposed to be helpful for diarrhea. There are instructions for getting started, as well as product recommendations on both www.rawfeedingforibdcats.org (files repository for the previously mentioned Facebook group) and ibdkitties.net. I have Squeak on a high quality human grade probiotic (L. acidophilus and other strains) and am seeing a difference since adding it to her routine.

As far as the prescription diets go, Dr. Pierson (www.catinfo.org) lists the Hill's z/d as 34% calories from carbs and 41% carbs on a dry matter basis. I'm not sure if the formula is different in the UK or if it has changed since Dr. Pierson's chart was made up, but it looks like your calculation is right in the ballpark. The other two I know of are both Hill's as well - d/d duck and d/d venison. They are also high in carbs, per Dr. Pierson's list and the dry matter analysis on Hill's site. Squeak tried both flavours of d/d and neither made any difference for her, unfortunately.

There are others here on FDMB dealing with IBD, but I don't know of anyone in the UK off the top of my head - hopefully someone with better knowledge of the food options available to you will be able to offer some more information to give some immediate help, since the home-cooked or raw diet may be more of a longer term plan, rather than an short term one.

 

Hi Sarah, sorry have had to add IBD on the list of things to manage. Which steroid is Remi on? My civie with IBD is on prednisilone but Neko is on budesonide. Budesonide is easier on the blood sugar and better for diabetics in that respect. Neko can't take pred due to her heart, but the budesonide is helping her. I get it compounded into liquid fish flavour. You should be able to try an every day dose of it.

I second trying raw or at least cooked with premix. There are a lot more protein options out there in raw, such as pork, goat, duck, pheasant, and Cornish game hen that you may be able to get. In Canada I add kangaroo, elk, buffalo, ostrich, and llama to the list. Thankfully after a six month cleanse, I was able to add chicken and turkey back I tot the civie's rotation. Before that, only the most expensive proteins worked.

My civie ended up on metronidazole for a while to help his vomitting. We also tried Tylan but it didn't work for him.