Making the jump to wet lower carb food

Discussion in 'Feline Health - (The Main Forum)' started by Adam Flowers, Oct 17, 2017.

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  1. Adam Flowers

    Adam Flowers Member

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    I am finally ready to get Mogee off the Royal Canin Glycobalance. I am convinced this is what I need to do as his numbers aren't going anywhere and my vet will want to up his dose again...

    I finally found a vet in Lincoln, Nebraska that goes with everything I have learned and read here.

    Please give me recommendations on what food I should buy and what you believe I should reduce his insulin dose to when I do change his food. I know/hope he will not need to be at 4 units when I change his food.

    Also, if anyone has time to look through Mogee's spreadsheet and can give me any advice, I always appreciate that!

    Thanks again for all the help everyone!
     
  2. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

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    This is the link to Dr Lisa's food list there you will surely find one that suits you and Mogee ( you may need to try different ones before you can find the one he likes), ideally you want one that has 10% or less carbs, a lot of people here use Fancy Feast , I used to feed Babu Instinct but since he developed CKD I'm home cooking

    http://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
     
  3. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Yay! I knew you would come to it in your own time. :) And, I am so glad you found a vet that apparently knows a little more about this.

    As Veronica said, you may need to try different ones before you find what Mogee likes. Dr Pierson's food chart is VERY helpful (here is the direct link to the one with filters: http://catinfo.org/chart/index.php). She recommends starting with these filters:
    Protein - min 40%
    Fat - max 50%
    Carbs - max 10%
    Phos - less than 300 (this is primarily for cats w/kidney issues, but I figure if this is better for the kidneys, it has to be better for all cats)

    I wanted the carbs a little lower and protein a little higher, so I used 5% on the carbs (which automatically did away with all the lower protein foods) and used her recommendations on the others. Since it is not a good idea to feed a cat fish regularly, I looked through the remaining list for foods that were not fish (which brings the list down a lot). I also have a cat, Willow, who is allergic to turkey, so I had to rule those out, too. Then, I started buying/trying the few foods that remained. In my case, it was hard to find anything they would eat enough of. Of course, they also had the difficult transition of going from all dry food their entire lives to all wet. As much as I wanted them to like things like Weruva's Paw Lickin Chicken or Tiki Cat Puka Puka Luau, they just did not. So, I had to go back to the list and change the criteria slightly until I finally found something they will eat enough of consistently which is Fancy Feast Classic Chicken Feast. So, I guess what I am saying is start out with the 'ideal' selections, but you may have to dial it back some to actually land on something he will eat.

    As far as the dose decrease, that depends on several factors including how fast you are going to change his food. If you are going to slowly transition, the dose increase probably does not need to be as much as if you are switching him all at once. You could read what Dr. Pierson says about this (catinfo.org) . There is one quote on her site that says, "High-protein, low-carbohydrate diets and low-fiber diets are highly beneficial in the management of cats with diabetes, resulting in a reduction of > 50% in the amount of insulin required in 8 of 9 cats in one study." So, if I was having to 'guess' at what to do, I might go with 2 units instead of 4 if you are switching completely to low carb right away. You can always go back up some after a few days, if needed.

    Whatever you decide, the most important thing is that you do this at a time when you can be there to monitor him, just in case. Let us know how things go.
     
  4. Adam Flowers

    Adam Flowers Member

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    If I go with the fancy feast classic, which I believe I will try that first... Is it safe to go down from 4 units twice a day to 2 units twice a day? Or does it need to be done gradually. I am afraid to change food and give 4 units, twice a day. Don't want him to hypo.
     

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  5. AlphaCat

    AlphaCat Member

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    Now that you've decided on a food, the dosing question might be best answered in the Prozinc forum. As the answer for my insulin wouldn't be the same for yours.
    Either way, when you make the switch make sure it's on a time where you can constantly monitor. I have Fabby on Friskies under 5% carbs and early on eating would help her manage her glucose better meaning if she eats regularly she lowers her glucose on her own. So the food by itself lowers her numbers too...

    But I'm sorry I don't know anything about the protocol on prozinc to help with dosing advice.
     
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  6. FurBabiesMama

    FurBabiesMama Well-Known Member

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    If you are going to be giving him some old food and some of the new and gradually transitioning him, if it was me, I would probably leave the dose as is, at least for the early part of the transition, and just monitor carefully. He does not have a history of dropping anywhere near too low. But, if you do not feel comfortable doing that, it is fine to drop his dose. Prozinc is an 'in and out' insulin. You can drop to 3 or 2 for a few days then stair step him back up if you need to.
     
  7. Adam Flowers

    Adam Flowers Member

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    Sep 23, 2017
    I guess another MAJOR thing is this, I have not 100% decided to go with the new vet yet and this is why:

    - new vet wants to switch to Vetsulin

    I know, after talking to her that she knows what she is doing and is fine with me home testing and using the fancy feast. In fact, this was the lady who recommended this message board when I posted that Mogee had diabetes on Facebook. So I would have never found any of you or learned all of this without that guidance.

    I know I need to get rid of my current vet but will it affect Mogee if we up and switch his insulin? I planned on just telling my current vet that Mogee stopped eating the Glycobalance and that I was going to try wet just so that I could still get the prescription for his insulin.

    I guess, with everything going on, it has been hard to make a definite decision on what to do. I know what vet I need to be with but am worried about a food and insulin change.
     
  8. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Why in the world does she want you to change to Vetsulin??
     
  9. Adam Flowers

    Adam Flowers Member

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    Sep 23, 2017
    She does not have experience with Prozinc. I believe that is why.

    But, it does sound like she will work with me! I am just so happy right now that I found a vet that goes with everything you all have been telling me!

    I have not slept or really even ate since Mogee has been diagnosed. I know this is because I have learned from you guys what I NEED to do and have been told differently by my vet.

    I have been told that I am hurting him, shouldn't be testing him, and that I don't know what I'm talking about when I questioned the Glycobalance and was told that Glycobalance "was made for diabetic cats specifically."

    In am just so grateful for all of your help and just relieved that Mogee may have someone he can see that knows what they're doing.
     

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  10. Adam Flowers

    Adam Flowers Member

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    ...
     

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  11. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Yeah, she sounds great in those posts, though I do not get the Vetsulin part. I may end up having to change Mia's insulin, so this is something I have done some reading on and talked to the specialist about, and that one just hasn't even made it on the radar as an option. There are some folks using it though, although the numbers are much lower than the other insulins (just look at the forums list and compare the number of discussions under each).

    Here is an article you might want to read: https://endocrinevet.blogspot.com/2013/05/whats-best-insulin-for-diabetic-cats.html Dr. Peterson is very well known in the world of animal endocrinology.

    All of us here have the goal (that sometimes feels more like a dream) of remission. Sometimes, the vets are satisfied with just getting the cats regulated. That may be a factor here. I wonder what the % is of cats that go into remission on Vetsulin. I wonder if that vet has had any herself. Just food for thought... :)
     
  12. AlphaCat

    AlphaCat Member

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    May 9, 2017
    We're on Vetsulin. I like it as an insulin. It feels very predictable for how it affects Fabby. Also, my human needs means I'm not always entirely 100%in compliance with dosing times. Vetsulin offers flexibility that I'm told the others don't.
    One of the folks I get dosing advice from in the Vetsulin forum got her kitty to remission at one point. I'm happy she's still on the forums even when her kitty went into remission.
    So don't be scared to switch to Vetsulin, it's about $60 a vial and we go through a vial every couple of months right now, so it's affordable, and I can watch Fabby's reaction through testing.
    Vetsulin is on a 12 hour schedule so you'll be at two shots per day.
    Come lurk around in the Vetsulin forum to get a feel for others on it.
    We've only been on Vetsulin, so you can take a peak at our spreadsheet to see how it works on Fabby. Just remember every cat is different which also means they respond differently to each insulin. The Vetsulin starting dose is 1 unit twice a day, most vet's will increase you in one unit insulin - but we Vetsulin folks will recommend only increasing in .25 increases with the max jump of a .5 dose. It's easy to skip the optimal dose and too much insulin can look the same as not enough. For example Fabby starts bouncing at 1 unit. If we had done as instructed the vet would have just continued to over dose her on insulin, when we really needed to lower the dose. She has a good consistent drop at the .5 dose. I am SO thankful for the people that were able to advise me from this board in the beginning.

    Having a good vet on your side is really worth everything, for your cat's care and your piece of mind. I'm glad you found a good one.
     
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  13. Adam Flowers

    Adam Flowers Member

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    Thank you for the information and advice. All of you are so kind in taking time to help me out. I meet with the new vet Saturday morning. I am excited to see what route we go. I know she is more familiar and comfortable with the Vetsulin but by the sounds of it she is not fully opposed to me staying on Prozinc. I know Prozinc is more expensive but in all honesty I could care less how much the insulin costs, I just want Mogee to feel better. I will update you on how my visit goes and what we decide to do about insulin choice. Again, I appreciate it. Have a good night.
     
    Last edited: Oct 18, 2017
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  14. Adam Flowers

    Adam Flowers Member

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    Mogee goes to see his new vet Saturday morning! We are very excited and hopeful of what is to come! Mogee has been in the blue the last couple of nights, and I know not far into the blue but I feel his numbers are now playing mind games with me, so to speak.

    I am for sure still changing his diet to the wet. I just hope he really likes it and will eat it. I know he needs off the Glycobalance, I've just never seen him so happy to eat. But I know I will see even better numbers when I do change his diet.

    Once again thank you for all the help and I will update what the vet decides to do about dosing and insulin. You all are so great!
     

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  15. rawia

    rawia Member

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    Aug 24, 2017
    FF classic chicken is no more low carb, they changed the formula. If you have just buy new canes, check the ingredients. Old one is ok but new one is no more low carb, i read that in other fourms and chicked what i have and when i make the calculation they were right it is high in carbs now.

    I guess the classic chicken and seafood are no longer low carb, please be careful.
     
  16. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    We use FF Chicken in our rotation....it hasn't caused any problems with China's numbers.

    They did change the formula quite some time ago and some cats had some problems with diarrhea, but it's still OK for most cats
     
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  17. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Could you please provide the source for this info? If the carb % has changed, I would very much like to know! Thanks.
     
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  18. FurBabiesMama

    FurBabiesMama Well-Known Member

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    Mogee is such a pretty boy! :cat:
     
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  19. Adam Flowers

    Adam Flowers Member

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    Mogee just gave his lowest bg ever since diagnosis. He's been in the blue the last three nights from when I've been able to test him (+3-+4). I am going to try and get some +5-+7 readings through the weekend.

    I guess my question is what number should we be aiming for at +4-+7? Mogee seems to always be high and never in the blue and has been in the blue lately at night early. But by +7 in the AM he is over 300.

    I have that appointment in the morning but do I want to change his diet and insulin now when he seems to be coming around? I want to meet a new vet regardless but more concerned about what the change will do to Mogee.

    Also what should we be aiming for for AMPS and PMPS? He seems to always be above 300 for both. And seeing that these numbers are on a human meter, he's probably a but higher than these readings?

    Appreciate any advice. Thanks guys!
     

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  20. AlphaCat

    AlphaCat Member

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    I checked out your spreadsheet and you are getting good drops from your insulin. The AMPS and the PMPS tests are what your cats glucose is on their own after your injected insulin wears off (which is why you inject more). So when you're looking at goals to focus on you want to slowly move those numbers lower. You do that by lowering the mid numbers through insulin. When you get more of the later numbers you'll be able to see the curve of the insulin as it dips. It looks like you already caught numbers going back up. Where you get your lowest number is your nadir. The goal is to get the nadir to drop about 30%-40% of your Preshot number, and then your preshot number to hopefully not go as high as the time it was before. It doesn't always work like that because a lot of things factor into glucose numbers, food, stress, schedule, activity level, but that's the goal.

    When you show this spreadsheet to the new vet, she may feel the same as you, that you're seeing successful drops, and to only transition to changing the food. Since food/feeding times can impact the schedule, the current schedule is Mogee just allowed to graze on the dry and gets the once a day wet? Or what is the current feeding schedule?
     
  21. FurBabiesMama

    FurBabiesMama Well-Known Member

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    My opinion... I would still transition to lower carb food. You do not want to have to be giving more insulin just to make up for the carbs in his food. I would not change the insulin yet, you have not been at this that long, give it a chance. The insulin is having an impact, so it is not like it is not working at all. (If you end up changing, I don't see where changing from a long-lasting insulin (Prozinc) to an intermediate-lasting insulin (Vetsulin) would be the way to go. If I end up having to change, it will be to a very-long-lasting insulin (Lantus or Levemir).)

    Would you at some point be able to do a full curve? That means testing every two hours for 12 (or even better 24) hours. Based on the morning mid-cycle testing you have done, it looks like nadir occurs at +4 to +6, but a full curve would give a clearer picture of the full cycle.

    The pre-shot numbers are his BG without insulin (and if he has had no food for at least two hours, it should not be impacted by food either). So, they are going to be higher. You want the insulin to 'smoothly' bring him down then gradually he will come back up to the next pre-shot number. (Forming a 'curve'.) If the drop between pre-shot and nadir is too extreme, that can cause issues like bouncing. So, you do not really want to see drops of 50%+. Over time, hopefully, the numbers, both pre-shot and nadir, will gradually come down as his system starts to 'kick in' and do more of the work.

    Believe me when I tell you that I know and understand that you want to see this 'fixed' ASAP. In the beginning, I was exactly that way, but I had to chill a bit and learn that, as you will see people on here say, 'this is a marathon, not a sprint'. I was not doing myself or Mia any good being so totally stressed out about it or so driven to just see low numbers. I had to focus on learning her and how she responds to the insulin and on trying to work with her system. I would love for her to be in remission already or at least to have per BG never go over 250, but that is just not our reality. It is also important not to forget to watch the clinical symptoms. Mia does not drink a lot of water and pee enough to fill the box anymore, her coat is silky and soft, and she just feels better overall. So, even though her numbers do not thrill me, I know she is doing okay, and we are going in the right direction.
     
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  22. FurBabiesMama

    FurBabiesMama Well-Known Member

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    I had reached out to Purina after seeing this, and I finally heard back from them. From what they tell me, the info for Classic Chicken Feast is still the same as what is in the cat food database. It is still low carb.

    "Thank you for contacting Nestlé Purina PetCare Company. We apologize for the delayed response.


    The actual percentage of calories that come from protein, fat and carbohydrates for the (metabolizable energy (ME) profile) in the Fancy Feast Classic Chicken is as follows.

    Fancy Feast Classic Chicken

    M.E. from Protein 40%

    M.E. from Fat 56.9%

    M.E. from Carbohydrates 3.1%

    Phosphorus 429 mg/100kcal

    Again, thank you for contacting Nestlé Purina PetCare Company."

    I wanted to post this for anyone else who was concerned.
     
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  23. Adam Flowers

    Adam Flowers Member

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    Sep 23, 2017
    The chicken feast is Mogee's favorite, along with the turkey and giblets! Good to know!
     
  24. Adam Flowers

    Adam Flowers Member

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    Sep 23, 2017
    Mogee has been on FF classics for exactly two weeks now. My main concern is his poop. Or should I say diarrhea.

    He eats the rotation of Chicken Feast, Turkey and Giblets, Tender Beef Feast, and Tender and Beef Feast.

    He had always been on dry and free fed before.

    He has been acting great, is active, his water input/output has been great (not drinking nor peeing nearly as much - seems back to normal).

    His numbers have been eh..

    Should I be concerned? It was really runny to start, has gotten less runny, but is barely formed when scooped.

    @FurBabiesMama I know you have used pumpkin, I've gave that a thought.
     
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