New to forum and at my wit's end!

My 14 y.o. cat Colby was diagnosed in May of 2013. He is a kibble addict and I still struggle with getting him to eat his wet food. It doesn't help that I have 4 other cats who get to eat kibble and he knows that. Anyway, he has been on Novolin since he was diagnosed. He started off doing pretty well. I'm sorry, but I don't have numbers right now, but he was on a reasonable dose of insulin. Colby is a big cat. His good weight now is 16 lbs, but at one time in his life he was over 25lbs (yes, I'm ashamed I let that happen to him).

So, the last 3 months or so, he hasn't been looking very good. He's always spent a lot of time around the water bowl, even when his BG numbers were lower. Long story short, he either has pancreatitis or exocrine pancreatic insufficiency. We did the tests for it and numbers were kind of inconclusive, but he has classic signs of EPI. So, the last month or so, I've really been struggling to get him to eat food w/ the enzyme on it and the Tylosin on it. I was about ready to break down and put the stuff in capsules and then he suddenly decided he would eat what I gave him. He was doing okay, gaining back some weight (he had dropped a pound or so). During this time, his BG numbers were getting higher. This last week, he stayed at the vets so he could be monitored more closely and get his insulin adjusted. He wasn't responding to higher dosages, he was up to 10 units, so the vet and I decided to try Prozinc. He just started it yesterday and is on 7 units of that. Oh, and his BUN numbers have gone up slightly, so we could now be looking at early kidney disease, btw. Dr. wants him on lower protein food.

What prompted me to write today is my frustration!!!! Colby ate the crappy Hills mature canned food all week long at the vet--they said he ate great! I get him home, put the same thing in front of him and he practically gives me the middle finger! Last night I finally got him to eat some of his Friskies pate, but this morning, again, he eats a little and wants something else. I'm pretty sure the something else is kibble. I don't know what to do and I know he can sense my frustration with him, and that makes it worse. Nothing makes me madder than a cat that won't eat! All the other cats would be scarfing down that wet food, but Colby wants the dry kibble. I've got to find something he will eat and I'm about to break down and give him the dry food again. But now, I've got to look for a food that is lower protein and lower carb! I'm picking up some Nature's Variety raw today, but I don't hold much hope for it.

I mostly just need to vent, but if anyone has some ideas about my food situation, I would appreciate the help. I'm sure I've left out some info, but I'm it's morning and I'm irritated right now.

Thank you,

Cindy and Colby

 

Hi cindy and colby

I wonder if the pickiness could be nausea? Does he go up to the food and act like he wants to eat but then walks away? Does he lick his lips a lot or grind his teeth? If so an anti nausea medication such as ondansetron can help.

If it is him being fussy how about some of the suggestions in this link may help
http://www.felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

http://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

But before you start swapping foods can I check they you are monitoring his blood glucose at home? And if you are can you start up a spreadsheet so members can give better advice.

With regards the prozinc that is a very big starting dose. When you say 7 units is that 7 units twice a day? The starting dose is normally 1 unit twice a day or even 0.5. When was his last shot and when is his next due? Are you able to monitor him today?what and when is he being given food. I think at that dose I would be okay giving him a little dry unless you can monitor his glucose and know he is safe

@Sue and Oliver (GA) is really experienced with this insulin. I think I would ask for her advice. Here is the protocol followed

http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/

Could I get you to start a new thread on the prozinc dose in the main forum. You can link it back to this thread but I think you need more people advising you on the dose.

 

Are you really giving 7 units of ProZinc? Are you drawing up 7 units on a U40 syringe? Those have a red needle cap. Drawing ProZinc up top the 7 unit marking on a human (U100 syringe, orange needle cap) would be 2.8 units of ProZinc

 

Yes, I'm using the U40. He had 7 units yesterday at the vet and was fine. I have been monitoring at home. I have a Walgreens True Track. I know that is a large dose, but he is showing signs of insulin resistance. I will be checking BG again shortly. His BG was over 500 this morning. He was running in the 400s all week long at the vets, that's when we decided to switch insulins. I don't believe he is nauseated... think he's just being picky. After I wrote my first post, I opened up three different cans of food and put them down for him. He went back and forth between 2, so he did finally get some food. He just really loves his kibble!

Thank you for your concern. I will give an update about his BG later.

 

okay, I gave his dose about 3 hours ago. Starting BG was 560, now it's 335. He's been grazing off and on all morning.

Sorry, but I can't seem to find info on starting a spreadsheet. Could someone please give me a link?

Thanks!

 

Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.

 

"True" meters are one of the few human meters not recommended. They read low.
The 560 to 335 drop in 3 hours is a good sign

 

I picked up a True b/c that was what my vet was using. I guess I'll read up on what's good and go get another one.

 

Here is a great link on hometesting.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Here is a link on meters
http://www.felinediabetes.com/FDMB/...best-blood-glucose-meters-august-2013.103511/

http://www.felinediabetes.com/FDMB/threads/feline-diabetes-home-testing-kits.60261/

A lot of people use he relion meter.

 

WalMart ReliOn Confirm, aka Arkray Glucocard 01 (available at ADW)

 

Hi Cindy and sugardude Colby and welcome to the FDMB.

I know you pain and frustration in getting your Colby to eat food that would be better for him and his medical issues. Colby, welcome to DFAA!!!

My Wink is a lifelong member of DFAA (Dry Food Addicts Anonymous). When I first got him from the shelter, I knew that getting him on a lower carb diet would help his diabetes immensely. In order to do this, I switched my other kitties to low carb wet food a couple of weeks before I brought Wink home. If there is no kibble in the house, then Colby won't be able to eat any and raise his BG (blood glucose) levels.

It took time to get my sugardude Wink to switch. It took patience, persistence and trying a lot of those tricks in the Transitioning Feline Dry Food Addicts to Canned Food article by vet Dr. Lisa Pierson, which someone else pointed out to you. I printed that document out and read and reread and read it again, and again to try other ideas.

The transition didn't happen overnight. It didn't happen in a week. It didn't happen in a month. Yes, it was very frustrating.

While not ideal because the dry is higher in carbs, during your time trying to transition Colby from dry to wet food, you could crush some of his dry food and sprinkle that on top of the Friskies pate food. That is one trick that helped me with Wink. Even better than crushing the dry food on top of the wet food, was to crush some Halo Liv-a-Little freeze dried chicken treats on top of the wet food. I might have to do that 3-4 times to get my kitty to eat a tiny 1.5 ounce serving of the wet food, but it did help us immensely.

Using your cat's natural hunger drive is immensely useful. If you free feed now, I suggest you take up the food and only put it down at certain times. For example, offer the wet food first for at least 15-20 minutes at a time first thing in the morning. If the food is not eaten in that time, take it away and bring back again in 15-20 minutes after your morning ablutions. Always offer the wet food first and only then a little bit of the dry food if needed.

Chip and Dip, smorgasbord, heating the food to increase the smell, elevating his dish, holding his dish in front of his nose again after he walked away, trying different flavors, were all some of the ways I used to get Wink to decide he liked wet food.

It's not the protein you need to watch out for in early kidney disease, but the amount of phosphorus in the foods. In fact, restricting protein in the early stages of kidney disease can lead to muscle wasting. See Tanya's CRF site for more info.

The Friskies Special Diet pate canned foods is low in phosphorus and low in carbs. Maybe your Colby would like one of those flavors.

 

Hello, I don't have time to address other issues right now, but I did want to report that I tested Colby with both my True Track and my mom's Bayer Contour Ascencia and the results were:
TrueTrack 432
Contour 244
So now I'm really confused after being told that the True line usually tests lower.....

 

I would try the comparison again.

 

All glucometers test within 20% of what a lab might get. They aren't perfect tools. You can see if the values overlap doing the following:

True Track 432 * 0.8 = 345
Contour 244 * 1.2 = 292.8
Nope. They don't overlap. I'd be inclined to stick with the Contour.

 

Deep breathing exercises. Really, when ever you feel yourself getting a bit overwhelmed, frazzled, stressed, sit down for 5 minutes and do some deep breathing exercises. It will help you to think clearer and help you to help your kitty Colby better.

Remember, taking care of yourself is important too so you can take care of Colby.

 

Deb thank you... I think I do need to take a step back and breathe! I'm just feeling very overwhelmed. I like your idea about crushing and sprinkling the kibble on his food-- I will give it a try. Ever since he was diagnosed with diabetes, I've had him on Friskies pate. It's only been recently that he's been refusing to eat much. Mainly b/c I've been having to add the Pancrezyme and Tylosin. I'm going to do as you said and check into the lower phosphorus Friskies varieties and try giving his meds via capsule. I may even try to find a lower carb dry kibble and supplement with that. I feel like he may not be with me much longer, and maybe he should enjoy his last months eating the dry food that he wants so bad.

I appreciate everyone and all the info they have offered. I'm going to just try to chill for now and get him back to the vet next week to strategize.

 

Young Again makes what they call a Zero Carb dry food. It's actually around 5% carbs. Only available by mail order. You may want to contact the company for a free sample first before springing for the cost of a bag.

Wysong Epigen 90 is another possible dry option. It's usually found at specialty pet stores. Not sure of the carb content, but think it's under 10% carbs.

There is a third dry option. EVO Cat and Kitten is about 8% carbs.

It would definitely be more difficult to get the enzymes into Colby if you are feeding dry. But better that he eat something and you can always fill capsules with the medications to get them into him.

 

Thanks, Deb. I requested a sample from young again and will pick up some other food tomorrow.

FYI- concerning the insulin I'm giving... It's not PROZINC, but Vetsulin! I mistakenly thought they were the same! Hopefully, that will relieve some fears about the high dose my vet started him on. 6 hours following this evenings dose and he's back in the 100s by my Truetrack meter.

 

Hi

That's still a high dose of caninsulin so you need to make sure you monitor him during the cycle as with caninsulin they can drop hard and fast. It is what is called an in and out insulin and so you might find it not much better than the Novolin. The possible problems with such a high dose is that when a cat drops that low in such a short time they can end up bouncing hard back up so you end up with high numbers again. I am probably not explaining it well but others will hopefully chime in.

On the forum we recommend the longer lasting insulin that can give you better blood glucose control over the whole cycle. These include lantus, levimer and prozinc

The current guidelines for treatment can be found in this link
http://www.felinediabetes.com/FDMB/...-from-aaha-convert-your-vet-if-needed.131187/

Sorry to give you more info I don't want to overwhelm you

 

Vetsulin is a different insulin and does work a bit differently than Prozinc. Some cats do get a long enough duration from the Vetsulin but many do not. You want good BG control for 12 hours if you can get it.

This is where some home testing will come in handy, to let you know how long the duration of the Vetsulin insulin is in your cat. ECID Every Cat is Different.

Vetsulin is known as Caninsulin in the UK and Canada. I see that one of our UK members has popped into your post and given you some information.

I see that you home test. What would be really helpful to us, is if you would set up our standardized google spreadsheet and link it into your signature. Directions for doing that are here.

That way, we can see what is going on and perhaps make some other suggestions on test times to see what the duration is on that insulin.

I'm also tagging @Wendy&Tiggy since one of her cats has EPI and she may be able to give you some ideas on what is working with the enzymes for her kitty, Bailey.

 

Thank you. I am picking up a Relion Prime (or do I want the confirm?) meter tomorrow and talking to the vet about different insulin. I've spent so much money on wasted insulin! But it will be worth it, if I can get better control.

Sorry, been too stressed to sit down and do a spreadsheet. I will try to get to that soon.

 

Go with the Confirm. It takes the smallest blood droplet.

It'll help us give you feedback if you add a few tidbits to your signature.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name,
cat's name,
date of Dx (diagnosis)
insulin
meter
any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.

 

We've been using the AlphaTrak 2 meter, the vet checked it against the machine they use to do their general blood work on, and it was only a little differnent. We've been feeding the Hills Prescription DM, but I found Evo cat food, 10% carbs and will start integrating it this weekend.

 

Hi Tammy,

Since the switch to a lower carb food may have a big impact on Goofus' BG level, have you spoken with your vet about any changes that might be needed with Goofus' insulin dosing yet? If not, please do before starting the crossover to the lower carb food, and remember to test regularly throughout the crossover period. It might also be a good idea to start a new thread on the main Feline Health forum to ask other members - particularly those who use Prozinc - to share their experience of diet changes/dosing with you. If you're prepared in advance any surprising BG numbers will be easier to deal with. Saoirse had to be transitioned to low carb very abruptly (appetite problems) and her BG dropped hugely because she had previously been on Hills w/d Dry which is stuffed with carbs. Thankfully I was home testing so I caught the low, but it still put the heart crossways in me.

Good luck with the food change, and give Goofus some scritches for me.

 

Unfortunately, I had just bought a new bag of Hills DM when I found the Evo 8% food, so he hasn't been switched yet. Maybe another 2 weeks before I start integrating the new food. I spoke to my vet and he did tell me that when I start, I'll have to go back to testing before each feeding. The vet looked at the guaranteed analysis and said its an excellent food. It's kind of like starting over but it'll be better for Goof in the long run.

 

I'd strongly recommend testing mid-cycle too, Tammy, to see how low the BG is going. Good luck to you both with the switch.