Low fat cat food, Diabetic Cat with 14,000 triglycerides

Long time lurker reaching out not sure if anyone here is able to help but running out of options...

My cat got really sick and is having breathing issues, took him in and got xray/ultra to check for fluid or other issues and a blood panel.

His triglycerides were 14,000 from 8,000 8 months ago last time which we were working to get down (hense 7.5% food) but wasn't a main focus because we got him regulated a year ago with diabetes.

I am using this cat food for the last year https://www.amazon.com/gp/product/B005HUVYBW and pick out the whole peas and carrots and it has regulated him very well with insulin.

It says 7.5% fat on his current food and the prescription foods are 3.0% fat does anyone know of a guaranteed low fat / low carb wet food?

My vet is making me get Chitosan today to block fat I welcome any feedback since lots of these low fat foods have high carbs.

I do tight regulation he runs about 100-110 glucose but right now I'm running him at 145 just because my vet tells me while he's having breathing problems going low isn't a option. It's bouncing a lot while he's sick.

Talking to 2 vets and the internal blood specialist and no one has any real answers other than cutting fat.

 

So is he having breathing issues because of heart disease? Off the bat I can't recommend low fat/low carb food but I'm sure you know of Dr. Pierson's food list here, should be able to find something: http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

Maybe @Marje and Gracie can help with this. She is great with path results.

 

The heart disease test showed slightly elevated but nothing crazy. His blood is more a pink because his triglycerides are crazy high and I learned that no foods have a Max fat so the fat level can be anywhere above the min fat

 

I have never heard of triglycerides being that high in a cat. Can you post the entire lab report?

 

Here you go they said with a value so off the charts it could skew everything and to see a catio specialist is A LOT of money not even in the couple hundred range. They told me changing food to lower fat, using the fat blocker is the first step. He is also sick (virus flareup or URI with congested nose) which he's on meds for. His breathing is high but not super high 22 bpm but he's doing abdomen breathing which is bad and said if it gets high they are going to put him on a trial of heart meds but it wouldn't make the tri go down. Did ultra and xrays looking for fluid and issues with organs and found none, two different doctors listened for a murmur and didn't hear one.

https://drive.google.com/file/d/1xeIaDcVUr0GoPDkcxBDe3yxCwbc1-Bey

He's always been high on tri and has seen 5 different vets even at different places and everyone just said lets wait till his diabetes is controlled I just learned that even if it says min 7.5%, etc.. fat if they don't have a max it can really range and be much higher then what's posted on the can.

Looking to do custom food but It's not something I can get done in one night while taking care of him and working more than full time.

Finding low fat and low carb food has been a battle in itself.

My vet is convinced that it's the food since the only thing that has changed is his food and instead of going down (the trend before) it went way up.

 

Changed the 911 but still fighting, he doesn't want to eat and tonight he's showing trace keytones. Still trying to find a super low fat food he can eat, had to do the emergency chicken breast tonight.

 

Try and give him extra fluids if you can to flush out the Ketones. Eating is very important also to fight ketones

 

This is the link to Dr. Lisa's recipe for homemade food is really not so hard, especially if you program yourself to make big batches then you can actually control what you put in the food

https://catinfo.org/making-cat-food/

Also consider Dr. Lisa's list (https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf) is made based on as fed basis not guaranteed analysis, so the numbers she shows in her list are very much closer to what your cat is really eating

 

By the way you may want to change the prefix on your thread because GA is usually used for Guardian Angel (kitties that have gone ahead)

 

You could look at Tiki Cat. They do give good nutritional data, as does weruva. Note, both of these foods are expensive and relatively low calorie, so you may need to feed more. Also if you don't want to feed fish, you have to have to check the lables since some have fish even if they're called chicken in the name. The chart listed above breaks out the fish and non fish selections.

 

@Redbehrend Looking at the results you've got, there's a lot that's out of range, not just the triglycerides. It looks to me as though there's liver involvement at some level, but not any of the typical types - his ALT is crazy low and there aren't any of the usual disease processes that would cause that. I do wonder, rare though it is, if he might be a case of true hypothyroidism, which can cause elevated triglycerides in dogs (naturally occurring hypothyroidism is very rare in cats, so there isn't much data at all on how it usually affects them). It might be worth running a full thyroid panel on him to check. I would also like to ask you if it would be OK for me to show your blood work to a friend of mine who is a feline specialist to see if she's seen anything like this before or has any ideas on what may be causing the issues?

 

@Veronica & Babu-chiri Thanks changed
@manxcat419 go for it!

I want to make my own food but haven't had the time yet.

I got him eating Fancy feast grilled turkey and giblet yesterday. That's what he's on right now and taking chitosan fat blocker.

He's still has a stiff or weak issue with one back leg which I reasearched happens with lots of the stuff he's got going on but strength is coming back.

I talked to two internal specialists and they told me get the tris down so he doesn't have limpo or whatever it's called then they want to redo them all again to see more true values.

Now his gluecose is showing 300 (normally 110 to 158), try to slowly up his does but the FF does have more carbs and cornstarch but he's eating so I'll work on that long term.

Has a watery eye and stuffy nose too which he's had for a week vets say probably virus but I think it's his high tris.

 

Thank you. I've shared them, but it might not be until much later or tomorrow that I can get back to you as she's in the UK so it's night-time for her now.

 

@billysmom (GA) It's really chewy I think it's a little much for him though I plan on trying it in like a week again maybe cut it up some. I like that it looks like what it says instead of processed chunks.

 

You could try putting it in a blender.

 

OK. So I shared the results with 2 friends, both of whom are very well qualified to know what they're looking at. So far, I've heard back from one who confirmed my suspicions that you really want to run a full thyroid panel because you could be looking at a rare case of hypothyroidism. The other suggestion was to do an echo (heart ultrasound) if you haven't already done one. I'll let you know when I hear back from my other friend too.

 

@manxcat419 Thanks I'll do that when I go back in, they did a heart ultrasound and said they didn't see anything abnormal or see any issues and the only way to know for sure was to see a specialist which would be at least $500+ for him to look at it again. Also did Xrays that didn't show any growths or extra large size.

 

If you've already done an echo, then it would just be the thyroid panel. The suggestion for an echo was to rule out that heart and thyroid were kind of bouncing off each other and aggravating the entire situation. But the main feeling was that hypothyroidism just might be the underlying answer.

 

Thanks for all the help he goes in tomorrow for a hail marry blood checks like thyroid. His breath is slowly getting worse and he's about to cross into uncomfortable, suffering stages in a matter of days. Nothing is turning blue but he either has fluid build up, not getting enough oxygen or even on a almost zero fat diet his tris are still going higher. Several vets are going to check listen tomorrow to his heart and breathing.

 

UPDATE:
Here are his xrays if anyone is interested. I've been doing research for hours all month long and can only come up with heart, liver, kidney disease.

Even learned how to somewhat read the xrays and can't see anything crazy.

https://imgur.com/K1Zj8dG
https://imgur.com/xUAPl5c
https://imgur.com/q9Y0rsu

Barely keeping his diabetes under control but something is off there too he's on lower carb food then before but requiring more insulin.

 

Al I see is a fll bladder and food in stomach and in intestines. What is consistency and color of feces?

 

@Larry and Kitties Normal color round like balls.

They just did another ultrasound and found fluid in the lungs, around the heart and in the stomach that wasn't there a week ago they are calling it congestive heart failure and said he'll be in distress and needs to be put down in the next couple days. . They said not to do the T4 test because it's so rapid it wouldn't help. They said there is so much fluid from a week that even if they drain it it'll be back in a week.

 

Sorry to hear that but still maybe I would ask them to give it a try on controlling the fluids and see how he responds to the treatment for the congestive heart failure before any other decision, cats do sometimes recover sending you lots of

 

@Veronica & Babu-chiri I'm doing that today. I was going to put him down today until I read stories online of people with 3 simple meds making it up to 8 months with no real extra maintenance. So I called in and am rushing a Diuretic right now.

The DR made it sound like the chance is slim but some of these cats were in way worse shape. Seems it's really based on the quality of his liver kidney because they usually start to give which make it stop working. I figured worse case he has side effects or gets a bad blood clot and I take him in to put him down. Lots of them said the heart just quit while sleeping which doesn't sound as bad.

Blood clot stories are scary though I'd consider that the worst case scenario.

If this works I'll have to find a low sodium food on top of low carbs and low fat... Man food options suck.

 

Sending you lots of prayers and keep us posted on how he's doing, and you may have to go with a home made diet, in order to cover all as I had but it is not as hard as it seems

 

I disagree on the T4 test - hypothyroidism could be the underlying cause of the heart issue. Treat the cause and you're a long way to controlling the effects. If you and your vet are worried about clots, make sure he's prescribed Plavix (clopidogrel). And yes, you can definitely buy time with diuretics to keep the fluids down. They should start by draining if there's a lot of fluid - diuretics can keep the level down but aren't great at clearing any large volume of fluids fast enough.

 

@manxcat419 His T4 levels have always been slightly low and showed low but within range 8 months ago. I'm picking and choosing my treatments because I already spent a ton if you really think it's worth it I'll talk to them again about it. They said it was $600 a pop for them to remove the fluids because he doesn't stay still and he could be back in after a week. That's why I'm trying to get rid of it the diuretics way I called another vet and they were within $20 dollars of that price so it seems to be the going rate in my area.

I'm open to ideas I'll ask them if there is any kind of T4 self test or home kit I can buy or maybe call around and see if there is a vet where it's cheaper and bring the results into them.

Diuretics
He started on diuretics Sat 2/2/19 so it's been 4 days he hasn't lost much weight I would say .2 lbs but he's peeing more and his breathing has gone 2 BPM so he's around 26-28 BPM instead of 30-32 BPM. Most of the fluid is in his stomach and not in his chest they are telling me. They did free ultrasounds really quick for me to help me out which is the only reason I knew he started to get fluid as it wasn't there a week or so ago when he got the xrays.

Plavix
We tried Plavix a week ago which was a few days before the diuretics and for some reason he lost his appetite 48 hours after we started it to the point a appetite stim wouldn't even get him to eat, the next day after we took him off it it came completely back. Weird huh since even with extreme pancreatitis where he just wants to die appetite stim worked.


Thanks for the feedback everyone I know most of you aren't vets but I'm already happy with the diuretics even if it's only a temporary fix.
Since I was going to put him down because I didn't see any choices I know when the time comes I won't fight it because I was lucky enough to get all this extra time.

 

I really do think the T4 would be worth exploring. Thyroid dysfunction in either direction is a major cause of heart disease in cats. So that might actually find the cause of his other issues for you. I do completely understand how much it all costs - we seem to have spent the last 3 years losing one cat to an expensive illness only to have another one get sick. We haven't dared add up how much we've actually spent on both the regular vet and the ER.

Can I ask what diuretic you're using? Furosemide (lasix) is the most commonly prescribed one and does work well for fluid in the chest and lungs, but for fluid in the abdomen, spironolactone often works better. Because he has fluid in both areas, you may get a better response using lower doses of both than from using either on its own.

If he can't tolerate the Plavix, so be it. Not all cats can take all meds, and I think at the moment the risk of a clot is less than the risk of the fluid build up at least in an immediate sense. Sometimes you just have to treat what you can - my Regan had heart disease, but couldn't tolerate enalapril which is one of the core meds for the condition she had. We just had to use everything else and leave that one out as BP meds simply crashed her BP dangerously low. It meant our treatment wasn't perfect, but it was the only way we could treat at all.

 

@manxcat419
I'll look into the T4 more then see what I can find out.
He's 11 pounds normal and 12 right now with fluid, they have him on 5mg of Furosemide (lasix) no heart meds yet because they told me everything seems to be fluid related at the moment and they want to make sure he takes it ok since the extreme reaction of the Plavix.
I'll ask them about trying both with spironolactone. His stomach seems to have shrunk a little but still is big, waiting to hear back tomorrow and how fast they expect it to show real signs in the stomach. He also has hanging skin now and a couple pockets of liquid under his skin on one of his back legs. It looks like when you put sub fluids above their shoulders but on the leg. I couldn't find anything online about it unless it's how the Furosemide extracts the water or something. I'll know tomorrow.
It's not a blister on the skin or under the muscle as I can move it around just like when you put a water in their back for hydration.

 

It's likely that the fluid is settling, in the same way that sub-q can give them a "fat leg" when it slides down due to gravity. I would definitely see if you can get some spironolactone in the mix if his stomach isn't going down - it's not overly expensive, and it may allow you to taper the furosemide dose earlier than you would otherwise be able to. I will say, that's a very low furosemide dose for the amount of fluid it sounds as though he has - you can go up to 4 mg/kg every 8 hours to remove fluid faster, so your vet actually has him on the low end of the dosing scale. If he has as much fluid as you say, I don't really see it working fast enough at that level. My Regan, at 10 lbs, had to be on 18.75 mg TID for fluid in her chest cavity only.

 

@manxcat419 I asked about upping the meds and the pockets and they told me the meds won't remove the fluid inside, upping it won't do anything and the pockets were it leaking through the muscle or out from somewhere. I looked online and the general dosage for cats is 1-2mg per pound so I'm not sure why they won't help me up it ... Thinking about upping it myself or going to another vet. Not sure why online is says it helps remove it slowly but they are telling me it doesn't...

 

If you can get to another vet, I would do. Of course increasing the diuretic increases the amount of fluid removed...that's basic logic. They are correct in that oral lasix doesn't necessarily remove fluid as fast as injected, and often a physical removal of some fluid is needed to allow the lasix to keep control of the situation.

 

Update for watchers
Went to a new vet and they doubled the dose or furosemide to 12.6 (one vet size pill) and put him on vetmedin (said it takes a week to see effects from it.)
With the new dose he stopped gaining liquid weight and his system flushed 1 and 2 on day one. He's been a little low on energy but everything I read and the vet told me 48-72 hours before his body gets more use to it.
Since he just hit 24 hours if he starts to lose liquid weight in the next couple days we are moving in a positive direction if he doesn't gain it means his dosage is maintain and he'll see if he change meds around.
Honestly even if he died tomorrow I feel way better that I tried something instead of following the orders of my old vet to sit around and wait for him to get bad.

 

Your furosemide dose, when given orally, can go as high as 4 mg/kg (it actually can go higher, but you don't get an increased benefit at higher doses than that). I'm really glad the new vet is working with you to get the fluid down - I agree completely, no matter what happens you know that you're doing something positive now instead of sitting around and waiting for things to get worse.

 

His BPM went up to 40 today for the first time ever (it was maxing out at 30 BPM a day ago im wonderingif it's the vetmedin which would mean he probably has HCM where the muscle is too think andaits making it worse chasing itito pump stronger. He's just progressing too fast I'll ask tomorrow.

 

I would just keep an eye on things for tonight. If he goes higher, then you do have the option of giving an extra dose of lasix to take down any additional fluid that might be building. And often that extra dose gives you the time to get them to the vet for assessment.

 

@manxcat419 Thanks for all the help I feel like I'm understanding it better now.
Just curious if you knew how fast does lasix rid of fluid in those spaces not in the lungs like the stomach?

Its hard to find info not related to liquid in the lungs and my vet sounded like he wasn't sure. He told me around the lungs and heart was slow, in the lungs was fast and then had no idea for the stomach. Been asking around but everyone wants appointments just to answer .

 

I'm glad that at least he's moving on the right direction for now, is good to hear that the new vet is more proactive , paws crossed and we are sending you lots of

 

Difficult to know for sure - there's a certain amount of individuality to it (we are dealing with cats after all). I've always been told that you do lasix only for fluid in the lungs, but for significant amounts around the lungs or in the abdomen, you tap first and then follow up with diuretics because lasix on its own often doesn't work fast enough. With that said, I do know of cats that have done fine with just lasix for all kinds of fluid, so if you and your vet feel its working, I would just carry on as you are.

 

Thanks! I would love to tap but they wanted like $500-$600 to verify then put them on a seditive with IV since he's a mover / fighter. Even though it only takes like a minute to do .

 

I would want a mild sedative on board anyway. My CHF girl was tapped twice using butorphanol (pain relief and mild sedative) and a touch of acepromazine (for a little additional sedation). I would be too worried about even a well-behaved cat being over-stressed by being tapped with no help to keep them calm. It is expensive though - if you can't afford it, just bear in mind that you can take the lasix dose higher at this point if you need to, even if it's temporary.

 

Going to try raising it a little today, called the vet and asked for a ace inhibitor enalapril as it can help stop fluids and help the lasix. Talked to a ER vet and they said for temp relief I can up lasix and as soon as they verified the results I had they would have put him on an ace inhibitor. They also told me if the issue is LVOTO the heart med he's on would make it worse

Update: vet said no ACE Inhibitors wait a week which he said is how long it takes for heart med to work if it doesn't then he'll be ok with switching them around and adding a ACE Inhibitor. Hopefully his breathing stays stabilized for a week.

 

Update2: Upping his dosage didn't show any drastic difference on his liquid (still only peed once) and talking to a cardio specialist they want me to use a lower dose and do it 3 times a day since high dose didn't make him go more than once. They will not give him any specialized meds without doing an echo which is like $500 so I accepted that Vets are punks not willing to try meds even if a cat is going to have to be put down I tried calling 7 of them. I'd rather try them but it seems without a echo no one will prescribe any heart meds or any ACE Inhibitors or Spironolactone.

Cardio specialist cost is $100-$150 to tell me what they want to do which is echo (I pulled info out of one over the phone) and approx $500 for echo and treatment plan.

Thanks for the help it seems the vet locked money system wins this fight I'll keep asking around but I haven't found a vet yet that will try anything without the cardio specialist telling them exact dosage and what to give.
Which is funny because online there are vet manuals, vet training presentations and vet journals with treatment plans and what they have seen to work the best but I cannot try anything without getting the prescription.

I'll update if anything changes based on his average raise of BPM he has approx 2-5 days till he's uncomfortable to the point of putting him down hopefully 3 times a day helps with his liquid and breathing.

 

I'm sorry you haven't been able to get more help from the vets. I do know that an echo is important in finding the cause of the CHF and that some forms of heart disease don't do as well with one or more of the treatment options. At the same time, when you're out of other options, you'd think someone would at least be prepared to try something to help. The 3 times a day lasix may well make a difference - it's only active in the system for 6 hours, so increasing the frequency definitely can help. I'll be thinking of you over the next few days and hoping for a better outcome than you expect for your boy.

 

Update: I got him to do a 360 figuring out dosage myself which the vet oked.. I upped him to 12mg furosemide with 6mg spironolactone, 1.25mg vetmedin and 2.5 enalapril. Also feeding him 300 calories a day instead of the 250 he was on before.

He is now doing much better and lost 3 pounds of liquid buildup weight he is now at 10.6 ( his normal weight is 10.2). He has ups and downs (but no labored breathing anymorea is acting normal though I've seen resting breathing still be around 30 BPM sometimes. He's jumping, climbing etc..

Insulin dosage has gone up but I'm told it's expected with the meds he want from .25 to 1 which randomly dips on days but I haven't seen lower than 130 yet. When I know it's not gonna flex anymore I'll fine tune it.

His body creating fluids has seem to go down also as his weight drop started to excel forwards the end to his normal weight.

My next step is finding the cheapest place to get all the meds I also discovered getting higher dose tabs and cutting is WAY cheaper.

I will also be reducing both lasix slightly to when I notice water gain. Then I'll know what is maintenance dosage is vs fast acting reduction dosage.

I learned a lot after finding a vet that will give them to me and now I'm trying to avoid a blood test for every refill or get longer than 25 day refills. Then he should be set till things turn for the worse. Which will happen could be today or a year from now but at least the biggest factor against him (fluid) is taken care of.

Tiki cat is killing me price wise though the company was super nice and gave me any value I asked for.

If anyone knows a budget diabetic, low carb, low fat, low sodium wet food lemme know haha

 

I'm glad to hear he's better and holding on, that's great news. Sending you both

 

Update for anyone that follows in the future or searches and finds this.

Overall
Cat is doing great now that all the water weight is off he lost a bunch of weight and pretty much doesn't have much or any fat left. Now down to 8.8-9lbs from 10.2lbs and his fur is turning it's normal color prob because he's overgrooming less.
We are looking to do a T4 test soon just in case his low T4 over several years is a super rare Thyroid condition that is not common in cats.
He is restless a little and full of energy, he sleeps fine that we know and gets in a few hours during the day when no one is home and most of the night.
He'll randomly become starving about an hour before food time and we are feeding him extra calories since his metabolism is higher, not sure if it's from the meds or the fact his body i pushing out all water and flushing more.

Glucose
His blood glucose does some crazy stuff it'll run about 150 a day then after about 5 days it'll crash to almost 60 so I'll have to skip a shot, this seems like clockwork If I lower his insulin by .25 the crash doesn't happen but he goes to more like 170-200.

The Future
He pretty much wants to play 24/7 while he is awake which is why we are thinking to test for ultra rare thyroid conditions since he hasn't been this active since he was kitten.
Feel like he's burning the candle at both ends and will crash one day (which we are told happens in the late stages of CHF.)
Still working at food I upped his fat content a little and feed weruva now which 2 cans a day, this brought his projected food cost from 200 a month to about 120ish.

Discounts Learned
Also learned there is a plan called petplus which seems to pay for itself if you use life meds, 65 a year and cuts off a bunch from his heart meds so after 3 months it pays for itself.
Seems Canada is cheaper but his heart meds have a California restriction from Canada

 

This is all really good news at this point. I would agree with checking his thyroid - if it's low it's most likely euthyroid sick syndrome resulting from his other conditions...but it's never good to assume that without being 100% certain. True hypothyroid in cats is very rare, but that never makes me want to rule anything out without making sure - possibly because all of our cats seem to come up with diseases that cats "don't get".

It sounds as though you've got his glucose as good as is going to be possible at this point. Unfortunately, once there are other things in the mix, it can be much more difficult to maintain tight regulation. If you can keep him at around 150 or so as a maximum, then his levels aren't high enough to cause organ damage. And being able to do that with just an occasional skipped shot to allow for lower numbers is actually still good regulation - I'm really impressed that you're able to keep his numbers that good with everything else going on and the effects of the heart medications.

Usually with heart disease cats, the recommendation is to let them set their own activity levels. If he's happy playing a lot of the time at the moment, and it doesn't cause symptoms such as open-mouth breathing, it would probably be more stressful for him to be stopped from doing what he wants. At some point, yes, heart disease cats tend to crash pretty fast. And, unfortunately, there's really no way of predicting when that's likely to happen. All we can ever really do is enjoy the times when things are going well - and at the moment, it certainly sounds as though they are.

With the number of meds that are needed for heart disease and diabetes, the plan you've found sounds like a good option. Anything that can reduce the ongoing costs really helps - and if getting his meds from Canada isn't an option, then finding something that reduces the higher cost locally is definitely the way to go.