Asthmatic Sugarcat with Polyuria

Discussion in 'Feline Health - (The Main Forum)' started by scienceofcats, Mar 1, 2018.

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  1. scienceofcats

    scienceofcats Member

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    Feb 28, 2018
    Hi guys. Okay, so Lola has been getting insulin for 5 days now, and I’ve noticed a new thing - this morning, as well as yesterday morning, she peed on my shoe tray near my front door. Is this a sign of polyuria? Her litter is clean.

    What can I do to resolve this?
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Yes, it might well be. The problem can clear up when the BG is better regulated. It can also be a sign of a brewing UTI and FD cats are very prone to these.

    As a scientist (read your other thread) you understand the importance of data in decision-making. As challenging as it might be right now I strongly recommend that you try the basic BG testing routine:
    1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
    2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
    3. do extra tests on days off to fill in the response picture
    4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
    5. post here for advice whenever you're confused or unsure of what to do.
    I also see that you have your own version of a spreadsheet. There's no reason why you can't keep that one for your personal use but also set up the one we're more familiar with here. We're all accustomed to looking at it and we can take in a lot of information about trends at a glance.
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
    It could save valuable time if you're in a tense situation with Lola and need advice quickly because we wouldn't have to shift mental gears to understand your version, as comprehensive as it is.

    Have you checked the %carbs as fed in the wet food you're giving her? http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
    Grain free doesn't necessarily translate into low carb if other plant based carbs are included. Most of us also feed more than twice a day. It can help with better regulation of BG level through a cycle. An automatic feeder can be great if you're away from home a long time.

    Here's my take on things for now:
    • new FD diagnosis and new to insulin = erratic responses
    • need for more BG data to visualize the ProZinc dose's action profile: onset/nadir/duration
    • suggested investigation of carb level in wet food - best to keep it under 10%
    • complicating factor - asthma and its steroid treatment, both oral and inhaled.
    I hope this helps. :)
     
  3. scienceofcats

    scienceofcats Member

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    Feb 28, 2018
    That's quite possible; she had some pain last Thursday night when the vet pressed into her kidney area, so they suspected a UTI. They found some bacteria when they did the urinalysis on Friday, so they sent samples for culture & sensitivity, but no cultures grew. She's on a course of amoxicillin/clavulanic acid just in case.

    That makes sense - thank you for the advice. In your opinion, what should the sliding scale thresholds look like?

    Fair enough - please check the link again, I have migrated the data to the accepted format.

    Yes, I have - I calculate it at approximately 9% dry matter or less. Here is the guaranteed analysis:

    Crude Protein (Min.) 12.5%
    Crude Fat (Min.) 6.5%
    Crude Fibre (Max.) 1.0%
    Moisture (Max.) 78.0%
    Ash (Max.) 3.5%
    Taurine (Min.) 0.07%

    I figured out dry matter basis by calculating Dry Matter = 100% - 78.0% moisture = 22.0%, and then figuring out that (22.0% - 12.5% protein - 6.5% fat - 1% fibre)/(22.0%) = 9.1%. I realize that the fibre is a maximum, so it might be less, but I figured the variance is probably accounted for by the ash. Does this make sense? What do you think about this food? I can't find actual carbohydrate information - I will request it from the manufacturer.

    That makes sense; my husband is now actually feeding her in the middle of the day, so that's good. I will have to eventually get an automatic feeder. Thankfully, my other cats don't like Lola's wet food, so I don't think they'll steal it.

    That makes sense. I will do more spot checks on the weekend, and am also going to do a glucose curve next weekend, as my vet said she had to be on consistent insulin every 12 hours for at least 7 days before the curve would be reliable. Does that make sense?

    Once she is stable on insulin and I have a feel for her numbers, we are going to try scaling the prednisolone back and using inhaled steroids plus bronchodilators, as this is probably better than oral steroids. Crossing my fingers she doesn't need to be on the prednisolone at this dosage at least.
     
  4. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Thanks for accommodating us wrt SS format. :)

    Re food: I pulled these passages from Dr. Lisa Pierson's food chart that might help:

    The data used to calculate the values on this chart are from Typical Nutrient Analysis (TNA) data - not the Guaranteed Analysis (GA) data which is listed on the product’s package (can/pouch/bag). GA values are reported as minimums and maximums and are, by definition, inaccurate since there is no ceiling or floor, respectively.

    Users of the old chart will notice that dry matter values (the weight of a nutrient) have been removed in order to streamline the chart and to make it look less overwhelming. The other reason is because, nutritionally-speaking, looking at the composition (the distribution of protein, fat, and carbohydrate) of food is best done on a calorie (energy) basis not a ‘weight’ basis.

    If you are interested in obtaining TNA data on a product not found on this chart, you will need to call the company. See Commercial Canned Cat Food for some help with the dialog to use.


    Re time on dose before curve: Yes, your vet's recommendation makes sense. It can take some time for kitty to adjust to exogenous insulin. I recommend, though, that you get some of the data outlined in the testing routine. A curve is a snapshot of a single cycle in Lola and if it happens on a day when she's not responding typically or is in rebound from having gone lower it can lead to less that ideal dosing decisions. The scattering of tests we recommend is a better picture of how a dose works overall. It's rather like building up a picture in a jigsaw puzzle by working across many areas instead of just along an edge.

    Re steroids: Her asthma needs treatment. Eliminating oral steroids is ideal but good asthma control is important. There are other people here who have to dose insulin around other meds.
     
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  5. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Sorry I missed this. The general approach here is to save sliding scale dosing for later when you're fine tuning what seems to be the good dose range. Done too early on an unregulated cat it can result in erratic numbers. It's usually best to start at a reasonable dose (1 u BID is a good starting dose), log data over time to learn how your kitty responds to that, raise or lower carefully in small increments of 0.25 u (eyeballed on the syringe - get ones with half unit marks) until you hone in on a dose that seems to be working fairly well. At that point your SS patterns will show you whether you can adjust dose based on the pre shot BG, tendency to run lower at night, etc. Those SS patterns are very important in guiding decisions.
     
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  6. JeffJ

    JeffJ Well-Known Member

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    Jul 7, 2016
    Some great advice from Kris. Kudos to you for getting the spreadsheet going and posting the numbers. As some time goes by, the patterns will help. It's important to get some nadir values at the +6 or +7 hr mark. Maybe on the weekend.
     
    Last edited: Mar 3, 2018
    Kris & Teasel likes this.
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