food selection for possible diabetes case

Discussion in 'Feline Health - (Welcome & Main Forum)' started by kalypso, May 23, 2019.

  1. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Hello to all!
    I am helping my friend choose some high quality low carb wet food for her cat Lisa, a 7 yo siamese, who may have diabetes (her blood glucose was measured 631 mg/dl). I am writing to you bc she is not fluent in english and there's not much info or support in greek! She switched to RC dry and Hills wet for diabetics, and saw some improvement on skin and polyuria. However, she is looking for some better quality (and lower carb) wet food. If I understand correctly, it is better for her to switch foods before she performs a glucose curve and possibly gets an insulin prescription. Is this true? If so, how many days should she be on the new diet before performing the curve? Also, should she stick on a particular food with a specific carb percentage? I mean, I understand that she shouldn't like swich to a lower carb food after an insulin dose is prescribed, but is this true also for picking a lower carb food within the 10% maximum, like swiching from a 6% to a 1% carb food like listed in here: https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml ?
     
  2. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi which country is your friend living in?
    Yes it would be easier to swap to a low carb, below 10% carb wet food before starting insulin. However with a BSL of 631 you will need to be careful that Lisa does not develop ketones, which can develop in cats with untreated diabetes.
    I would get your friend to buy a bottle of Ketostix from the pharmacy and test Lisa’s urine each day for ketones until the insulin is started. It is not hard but it is really important to make sure the ketones don’t develop.
    Any wet food 10% or less is fine. Depending on how long it takes to swap over to full wet low carb, you could do a curve a couple of times to see how things are going and it is good practise for when insulin is given.
    Always test before every shot to see it is safe to give the insulin and test again at about +4 to +6 to see how low the insulin is taking Lisa.
    Keep asking questions
     
  3. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Thank you very much for the reply!
    What should she do if ketones are found in the urine? Does it mean she should go to the vet asap?
     
  4. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Anything above a trace needs vet attention.
    She needs to make sure that Lisa is eating well and drinking well ( I know cats don't drink much, but if Lisa is eating wet food, that will help) , and if Lisa has any infection or inflammation anywhere, that needs to be treated..
    If you are unsure about anything just ask and we will try and help.
     
  5. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Hello all and thanks for your replies !
    So, we are researching this UK food list https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml, looking for food available in Greece!
    And there's couple of choices that cought our eyes, namely Gourmet and Sheba!
    I guess Gourmet is not a good choice, as it is commented it contains "various sougars".
    But again, these brands are so widely available, how is this true that they are better for diabetics than prescription food?
    Seeing the numbers, Hills md is 13% Kcals from carbs (https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf) whereas Sheba classics rabit is 3.1% (previous uk food list).
    How is this even possible?
    Anyway... Do you think Sheba is a good choice?
    Other brands I have found in greece from the list are lily's kitchen, canagan, carnilove, leonardo, animonda vom feinsten and little big paw.
    Do you think we should stick with Sheba or are there differences in quality of ingredients with the other choices?
     
  6. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    @Gill & George ma be able to help you with food choices in Greece
     
  7. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Thank you a lot for your reply!!
    Anyone familiar with these brands could be of great help!
     
  8. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    What do you think between these three ?
    - meowing heads
    - nature's menu country hunter
    - bozita tins

    Meowing heads seems to contain more carbs than the others (around 8% Kcals from carbs) and 25% of content is broth, which I don't know if it is good!
    Nature's menu seems to have good quality ingredients, but is more expensive than Bozita. Is it worth though?
     
  9. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    I can't speak for all of these but I feed my cat Natures Menu / Country Hunter and yes, they are good quality... you get what you pay for I guess.
     
  10. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Thanks for your reply!
    My friend bought both country hunter and bozita and is thinking to give it interchangably, because country hunter was a bit expensive!
    Is it ok if the cat finally has to take insulin? I mean that she eats something different each day or every couple of days or so?
    Both country hunter and bozita have similar Klcal percentage from carbs.
     
  11. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes it should be ok to feed more than one type of food as long as carb values are similar. The only proviso might be if a cat was allergic to something in one of the foods (it's not uncommon for a cat to be allergic to beef, for example) and that might mess up bg to some extent. You don't know until you try and you have to start somewhere!
     
  12. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Thanks so much!
    So I guess it is important to measure glucose at home every day, even if you change flavors of the same brand!
     
  13. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    If you're giving insulin, yes it is important to check bg, to make sure you actually need to give insulin. A low carb diet may well reduce the need for as much insulin so you have to be careful.
     
  14. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    We are not giving insulin yet. We are currently switching to a lower carb food (from hills m/d to bozita and country hunter).
    For how many days does the cat need to be fully on the low carb food before she does a glucose curbe to see if and how much insulin she needs?
     
  15. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    A couple of days should be enough see if insulin is needed. If bg is high you also need to be checking for ketones. Don't delay on these things.
     
  16. billysmom (GA)

    billysmom (GA) Member

    Joined:
    Feb 26, 2015
    The majority of the BG drop due to going to a low carb diet was 3 days for my cat. It dropped a bit more after that, but the first 3 days were large drops. Every cat is different (ECID) though.
     
  17. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Thank you all for your replies. Lisa was finally bought to a new vet on Friday. Her bg was now much lower, 344 mg/dl, and urine strip tests showed negative ketones but positive glucose. That was almost 50% lower bg though! Full blood and urine test results are awaited. She is now on mac's and bozita cans. Does urine glucose mean she will need insuline? I will post analytical results when I have them.
     
  18. AliceMeowliss&Cassandra

    AliceMeowliss&Cassandra Well-Known Member

    Joined:
    Jan 8, 2019
    A cat can have elevated glucose just from the stress of going to the vet but we don’t know for sure if that is what happened, it is possible she may still need insulin. I am glad to see the change in food helped her so much, however. That is always a good start. If your friend can learn to test blood glucose at home, they will get a lot more info on what the cat needs. Good job on making that food switch though! :D
    With the right treatment, some cats go into remission from diabetes, so it is important to take care of the next steps sooner than later. Beginning testing blood glucose now would be very helpful even if insulin has not been started yet. Your friend can use a human glucose meter, the only difference is the goal or safe range is slightly different. We have all that info on this website and someone can help you find the extra links if you need help to find. :)
     
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  19. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Some blood test results came out:

    Potassium 4.84 nmol/L (3.90 - 5.30)
    Sodium 155 nmol/L (147 - 156)
    FT4 1.44 ng/dL (1.00 - 4.00)
    fructosamine 437 μmol/L (174 - 204)
    cortisol 6.53 μg/dL (1.00 - 5.50)

    Does it make sense for fructosamine to be this higher than blood glucose?
    Do you have any insights? May Lisa have diabetes or both diabetes and cushings?
    We are waiting for more results (blood and urine as well)
     
  20. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Because the BG and fructosamine values are not directly comparable. Here is one comparison:
    Measure blood glucose (BG) and serum fructosamine (FR) and use the numbers together to determine control of diabetes:



    FR<400
    BG<180 Excellent control

    FR>400
    BG<180 Owner non-compliance

    FR<400
    BG<60 Over regulation

    FR<400
    BG>180 Stress induced hyperglycemia

    FR>400
    BG>180 Poor control
    Above from: http://www.felinediabetes.com/beyondBGcurve.htm

    Also see: http://www.caninsulin.co.uk/fructosamine.asp?context=management_cats
     
  21. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    So here is all the results!

    blood smear:
    clear of any pathological signs, infection agents or atypical cells

    blood test:
    Potassium 4.84 nmol/L (3.90 - 5.30)
    Sodium 155 nmol/L (147 - 156)
    FT4 1.44 ng/dL (1.00 - 4.00)
    fructosamine 437 μmol/L (174 - 204)
    cortisol 6.53 μg/dL (1.00 - 5.50)

    urine test:
    hue: yellow
    view: blurry
    s.g: 1005
    ph: 6.0
    total proteins: traces
    white blood cells: +
    glucose: 1000 mg/dL
    macroscopical exam: sediment traces
    microscopical exam:
    few squamus epithelial cells,
    few neutrophils,
    no pathological concentration of cylindres and crystals
    glucose concentration may be due to medication

    Do you have any insights?
    Do you think she will need insuline or a blood curve?
    Or some more tests?
     
  22. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    That is very low and if true indicates severe kidney degradation. I can't tell if the SG value is based on the urine dipstick value or refractometer. SG as determined by urine dipstick are nit accurate.
    This urine dipstick value tents to indicate diabetes together with the
    I do not know what the high cortisol value means
     
  23. kalypso

    kalypso Member

    Joined:
    May 22, 2019
    Hello!
    It took me a while, but I just wanted to update you on Lisa! She is on remission since October!
    Turns out, she was sneaking on the dry food for the stray cats, which caused her bg to rise high and her fluctuations to make no sense to us! It also caused diarhea.
    Since my friend figured this out and prevented it, so Lisa only eats low carb wet food, her bg is in the normal range and she also gained weight and looks very beautiful and healthy!
    So she didn't take any insulin and is controlled on diet. But does this seem that she is diabetic in remission? Will she always be considered diabetic or is there a cure?
    I wish the best for all kitties!!
     

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