Feeding Diabetic and Non-Diabetic Cats - I need help!

Hi. I have been reading this forum for a long time and finally joined so I can post. I have four cats. Pumpkin is a 10-ish year old neutered male. He became very sick from pancreatitis about two years ago and became an insulin-dependent diabetic. My other three are all spayed/neutered as well. They are all indoor only. The two other boys (Simon and Charlie) are 12 and 3 and my girl (Adah) is 11-ish. Adah is very allergic to corn and wheat so I have been using corn- and wheat-free foods for several years. I vary the brands because they are picky and will stop eating if fed the same thing repeatedly. I use Halo, Evo, Taste of the Wild, Before Grain, Castor & Pollux, Weruva (canned only) and occasionally Wellness for both canned and dry foods. They free feed on dry food and get wet twice a day.

Pumpkin gets Humulin N twice a day. I don't understand the conversion charts for insulin. Humulin N is U-100. We use U-40 syringes. He takes three units from a U-40 syringe of U-100 insulin. This Pro Zinc was a failure for him and couldn't get below 300. We do not test daily. Our vet does not support daily testing. I take him for a glucose curve every 6-8 weeks at the vet's office.

My vet seriously pushes the Royal Canin Diabetic diet. Pumpkin loves it but only gets it when we let him into the bathroom. Adah can't breathe when she eats it and she tries like heck to sneak into the bathroom. My vet finds it perfectly okay to recommend that Pumpkin be in his own room all the time so he can't get to the other cats' food. I do not find this acceptable. Pumpkin loves playing and cuddling with the other cats and with us. She also pushes the Science Diet M/D canned food. Pumpkin is okay with it. Adah LOVES it. Charlie and Simon don't eat it.

I don't entirely understand carbs as a way of controlling diabetes. I understand the science behind it (I have a strong professional medical background) but I don't believe that my vet is right in saying that if he is only on diabetic prescription food that he won't need insulin when she previously said he had low or no insulin production. Diabetic prescription food is high in carbs and filled with a lot of things that I don't feed my cats.

I am willing to try using reduced carb food but it has to be something that EVERYONE can eat. I have called Royal Canine and Science Diet and neither offers a grain-free diabetic food. Further, both said that it was not a profitable market. I find it hard to believe that I am the only person with this problem.

I would rather not make my own food. I haven't eaten meat in 20 years and am not sure that I can handle raw meat.

I just need some ideas on food options. I have looked at the Janet & Binky page but the lowest carb stuff my cats don't really like, I don't like FF or other grocery store brands because they cause Simon to have a lot of stomach issues.

Any thoughts/opinions/advice would be most welcome. Thanks!!

 

Where to start!

First, please get yourself some U-100 syringes. Humulin N is NOT a U-40 concentration and you run the risk of making an error in dose if you mess up the math to convert between syringe types.

Humulin N tends not to work very well because it lasts only 6-8 hours in a cat, leaving you with several hours of skyrocketing blood glucose levels. If you went to dosing every 8 hours, you might get better control, but it can be very inconvenient, uses more syringes, and the resulting glucose levels drop quickly and rise back up quickly. If Prozinc wasn't helpful, I would encourage you to go to the Lantus and Levemir forums and read the sticky posts about each type of insulin. Both are dosed on a 12 hour schedule. Both have a duration for roughly all of that 12 hour period. Both have the dose adjusted by the lowest glucose level during the 12 hours (called the nadir, often around +6 hours, but may be earlier or later depending on the cat.) Both provide more level control of the blood glucose.

It doesn't matter if your vet supports home testing - it is YOUR cat and if you choose to test it, thats your business. If you had a diabetic child, would you give insulin without knowing what the glucose level was? Absolutely not, because you might accidently kill the child with an insulin overdose. The same principal is true of cats (and dogs!)

All of us here will encourage you to feed all of your cats the same food - low carb, canned or raw food. The prescription diets have too much carbohydrate, something a diabetic just doesn't handle well. If you must compromise on the carbohydrate levels (say 10-15% calories from carbs) to get everyone to eat without triggering digestive upsets, just understand it may result in a higher insulin requirement. You use what is going to work for you in managing the whole household.

Your vet is incorrect in stating that use of prescription diabetes food will eliminate the need for insulin.

 

Hi!

I don't have any true advice other than I have 4 cats who basically all like different food. We don't have any that are allergic to anything though so that sounds difficult. I agree with you that Adah should not be sequestered especially since she clearly loves all of you, that is just not fair. Hang in there! I'm sure someone will come along with additional advice to add to BJM's already helpful post.

Love to kitties,

tmjn

 

If I'm reading this correctly you're drawing the N up to the three unit mark on a U40 syringe so that would be giving 1.2 Units of N twice per day.

http://www.felinediabetes.com/insulin-conversions.htm

N is fast acting insulin that is metabolized quickly. For most of the day your cat is not getting any insulin. For Tucker he used it up by 5 hours. For 7 hours of the day he was basically getting nothing. I learned this through hometesting. After years at this, we have settled on Levemir insulin but we do use Lantus insulin, I have a few diabetic kitties that I've adopted.

Regarding food, the gluten free canned food would be best for all your cats and you are right, the script stuff is too high in carbs. Canned Wellness, Merrick, any of those that are grain free would be great for everyone. Carbs for cats is like sugar for a human diabetic. The more carbs the harder the diabetes is to control.

I would highly recommend you hometest, switch insulin to Lantus or Levemir and get away from the N, get some nice U100 short syringes so kitty will be more comfortable and feed everyone canned only and let your kitty be happy with the others.

 

I know someone in your area with lots of special kitty knowledge. I'll send her a message and point her your direction in case she has a vet recommendation if you find you need one or maybe can help with local food choices, etc....

 

I am in the same boat as you though I have 6 cats.

The bottom line for me is--

they all have to be on canned food eventually as I am not going to police the food dishes to keep Pinky out of food she can't eat. Nor am I locking Pinky up by herself away from the other cats. That would be cruel.

What gets me is that ALL of these fancy brands (and cheap ones too) go uneaten. They are not palatable at all compared to the dry. I put out several different types a day and throw most away but I don't see any other way around it until I find what varieties I need to put out to make sure everybody is eating something.

Some of mine will lick the gravy out of FF Florentines and eat a tiny bit of the 'meat' --they have done that for years. Have you tried the FLorentines on the cat with tummy issues? Maybe he/she would tolerate those. My diabetic one eats the classic ones as she is starving-- not because she likes them much.

Ditto on the home made food. I just don't want to get into that. Though never say never.

You might want to check out this thread and see Dr Pierson's links under her signature on food issues, diabetes, urinary tract problems, etc.

viewtopic.php?f=28&t=53580


Good luck.

 

Larry, thank you very much for catching my mistake. I love the peer review on the Board.

 

The conversion chart at http://www.felinediabetes.com/insulin-conversions.htm is ONLY to use U100 insulin syringes with U40 insulin.

Humulin N is a U100 insulin and requires the use of U100 insulin syringes. The U40 insulin syringes you are using are the wrong ones and you are actually underdosing your cat by following the chart. You can buy U100 insulin syringes online with no prescription. Hocks.com and AmericanDiabetesWholesale.com are two places. You want U100 3/10 cc with half unit markings. Needle length and gauge is your preference. 5/16 inch long needles that are 30 or 31 guage are popular.

Here's info about how Humulin N works for cats: http://www.felinediabetes.com/FDMB/viewtopic.php?f=19&t=303 It tends to be too short acting in cats even with twice a day dosing.

Where do you live? There may be a member who can suggest a good vet in your area. It doesn't sound like the current vet is willing to let you take control of how you want your cat's diabetes be managed.

Food - You can try the higher end brands if they are in your budget. Brands like Wellness, Innova EVO, Merrick, and Nature's Variety Instinct are low carb. You can feed commericially available raw pet food. Many come in 1 ounce nugget shapes. Nature's Variety's frozen raw is a good choice. There are others.

 

Just to clarify, using these syringes at this dosage is per the vet based on BG curve tests; I didn't just make it up. I had the needles from a U-40 insulin. They were shorter than the ones at the vet so I brought them with me when they did his third glucose curve after starting ProZinc. ProZinc didn't get him below 300, so the doc used my needles to start Humulin N. As they were finding the dosage, no one realized that they were U-40. But the dosage that he is on works for him (sort of). I give him insulin around 7am. The vet opens at 8:30 and the first BG is usually 280-290. It goes down slowly, then a big drop. His last one says 10:10 - 263, 11:15 - 222, 12:15 - 162, 2:00 - 151, 4:00 - 179. These numbers are pretty consistent for the last several months.

He has been off insulin for as much as 3 weeks because he was being very nasty about it and his neck was swollen and the doctor recommended a break to let the swelling go down. He lost 3/4 of a pound that time. He is currently not super great about taking shots like he used to be.

I really like my vet except for this issue. She saved Pumpkin's life when he pancreatitis, she saved Simon's life when he had a serious kidney infection, she gives me nice rates when I bring strays in for shots and speutering. They usually don't prescribe anything other than ProZinc or Humulin N.

I think Pumpkin needs BG testing. I worry about him constantly. I have been a paramedic for years and adopted a little boy that was ventilator dependent so I am not unaware of the medical issues surrounding diabetes.

@Cindy & Mousie - Your friend wrote to me. She is in the next town so I am hoping she can show me how to test his BG. And maybe some tips on giving the insulin because he is not real cooperative right now.

My cats are really into Halo's dry food but even their grain-free chicken is 29% carbs. I don't have a problem doing wet food only if I could find something that was low-carb AND no wheat, no corn AND wouldn't create health issues with the other three. I love my cats and I will spend what I need to spend but I am so lost as to what kind of food can accommodate all of them.

I appreciate the people that agreed with me that no kitty should have to be locked away! :smile: I can't imagine one kitty all alone. That would be so sad.

 

If you are loading a U-40 syringe with U-100 insulin to the "3" unit mark, then
your true dose is 7.5 units of insulin.

We do not recommend you use U-40 syringes for U-100 insulin.

Always state your dose as the TRUE dose, not the mark on the syringe. We
need true dose information to help you.

The mathematical formula for this (not recommended) conversion is:

Number of U-100 units times .4 equals the MARK on the U-40 syringe.

Thus, 7.5 units of U-100 times .4 = "3" mark on a U-40 syringe.

If you have some U-40 syringes and some U-100 syringes and you hold them up
next to each other, you will find that the "3" mark on the U-40 syringe lines up with the
"7.5" unit mark on the U-100 syringe.

7+ units is a lot of insulin !!!!

Please get some U-100 syringes. They are available in much smaller gauges, and will be
more comfortable for your kitty, also.

 

There's quite a few higher end foods that are affordable (especially if you have a local independently owned pet store). Here's a link to an updated chart of the premium foods:

https://docs.google.com/leaf?id=0B8...MzhkYTkxOGM4NThk&sort=name&layout=list&num=50

I feed Bandit Merricks because of the high protein, lower fat content. Anything grain free (and all of the merricks flavors below 10% are grain free) is going to be okay for your allergy kitty. If you have a cat with pancreatitis, you want something that's not ridiculously high in fat, so I would say Merricks or one of the commercial raw foods is you best way to go.

I pay $1.16 for a 5.5 oz can of Merrick's at my local pet food store, which is nearly the same as what I pay for the grain free flavors of Fancy Feast. If you go the Fancy Feast route, stick the the flavors that say "classic". The Elegant Medleys in the green cans usually have grain and higher carbs.

I definitely recommend getting all of the cats on a canned diet, and changing insulins to one of the longer lasting insulins like Lantus or Levemir. With the combination of home testing, diet, and one of those insulins, you'll be able to get your cat regulated, and possibly off insulin completely.

 

I'm surprised neither the vet nor a vet tech checked your insulin syringes or used their own U100 insulin syringes before they started dosing the Humulin N.

Your dose of "3 units" in the U40 insulin syringe is actually 7.5 units :shock: Very few cats need that much insulin and those that do have acromegaly or some other health condition. The dry food you are feeding is what's keeping your cat from constantly hypoing from all that insulin.

I agree about tossing those U40 insulin syringes and getting some U100 insulin syringes to use with Humulin N. Any Human pharmacy sells U100 insulin syringes and you can also buy them online. 3/10 cc (max 30 unit capacity) are the most ideal ones to use for cats.

However... if you do switch insulin syringes, I don't know if you should dose 3 units (as the vet expects you to) OR the 7.5 units that your cat is actually getting right now. Someone more experienced can suggest which would be the better way.

Sometimes it takes a bit of doing your own research and presenting all the info you find to the vet to change their mind about something. Many people here have convinced their vets about hometesting, using a different insulin, and low carb diets.

Look for grain-free canned foods. Many of the higher end foods are grain-free and low in carbs, like Wellness and Nature's Variety Instinct. Petco sells Wellness and is just starting to sell Nature's Variety Instinct now. A non-chain speciality pet store usually sells only the higher end brands of food. Most pet food companies have a store locator search on their web site that you can use. In general, any canned food can help prevent possible health issues.

Avoid gravy-based canned and pouched foods. These tend to be too high in carbs for a diabetic. Your non-diabetics can eat these with no problem but your diabetic may get jealous :smile: The only good thing about gravy-based foods it that it will raise blood glucose levels in a hypoing diabetic cat so keep a few cans or pouches in the house.

 

You mentioned his neck being swollen and him being nasty about getting his shots. Wondering if it is just swollen or if lumps have formed? (I am assuming he is getting his shots in the neck scruff??? If not, please disregard the following.)

I have read in more than one place that the neck scruff isn't the best place for injections because lumps can form that make shooting difficult and this in turns effects absorbtion of insulin.

This mentions the problem:
http://bd.com/us/diabetes/page.aspx?cat=7001&id=7374

etc etc

This is from this site:

 

Please make sure that you read the STOP sign section on my Diabetes page linked below BEFORE you change the diet....especially on that extremely high dosage of any insulin but especially N.

N is definitely not my first....or even second....choice of insulin for a cat.

Regarding the syringes.....I strongly agree with the others - please use the proper syringes.

Please also make your vet aware that a mistake was made so that the amount of insulin you are really giving is accurately recorded in your cat's records. We are all human and do make mistakes but this is one that could result in severe hypoglycemia - including seizures, blindness and death due to an overdose of insulin when appropriate syringes are not used.

 

I was shown shooting in the scruff by local vet tech. and the insulin hardly worked at all on Miss Maisey. When I switched to more muscular areas as shown from FD websites the insulin worked much better and Maisey was soon off insulin. Experiment with the foods. My kitties initially wanted soup with the switch from dry. Now I mix in good sized bites of chicken thigh and pinches of ground turkey in the meat flavors and chunks of canned salmon in the seafood flavors and they are quite happy - and have the most beautiful coats of fur - like silk.

 

I think looking for a new treatment plan, whether with your current vet or a new vet, is a good option since what has been done is not working and has caused pain to your cat.

7U (based on its accurate dosing, not the incorrect syringes) of any insulin in high. Very high. And its not working. That curve you shouldn't isn't that spectacular. Though it does show the BG coming down so it is does curve in the right direction, your cat never gets into non-diabetic numbers.

The scruff is not the best place to shoot and if yourr cat is getting lumps, the flanks or an alternating site routine may be beneificial.

You are absolutely correct to researcg the food. Your vet is correct that a cat can become diet controlled, but that will only happen if the pancreas is allowed to heal and until the insulin needs are met thats not going to happen. Switching to a low-carb wet food can help because the insulin needs are less, but you really really have to get that dose adjusted before changing diet because the drop in BG from diet change on 7U could be very dangerous.

All of your cats can eat a low carb wet food. We feed Fancy Feast, Wellness, ProPlan, Friskies, and a couple other organic lower carb ones to all of our cats. One of my younger ones won't eat enough wet so we have Innova Cat and Kitten out too.

 

I consider that Pumpkin's curve is pretty good, especially for N. However, changing to a low-carb food may result in Pumpkin dropping too low on 7.5 units BID.

I give him insulin around 7am. The vet opens at 8:30 and the first BG is usually 280-290. It goes down slowly, then a big drop. His last one says 10:10 - 263, 11:15 - 222, 12:15 - 162, 2:00 - 151, 4:00 - 179. These numbers are pretty consistent for the last several months.

AMPS: ?
+3 262
+4 222
+5 162
+7 151
+9 179

 

I'll chime in with another vote in support of Merrick canned food. I have two cats who develop breathing problems from food allergies - one pretty severely. The one with the most severe problems does fine on Merrick's Grammy's Pot Pie (which is a chicken food). It is grain-free and also low-carb, so I don't need to worry about whether my intermittent-diabetic kitty gets into it. In fact, I feed her the same flavor.

When somebody decides that their regular food isn't tasty enough, all I need to do is sprinkle some "chicken dust" from PureBites freeze-dried chicken on it, and suddenly it is delicious again. The PureBites are fine for all my kitties, and they all go crazy for them.