Not gaining weight

Chuck isn't gaining weight. I thought he was but my scale says different. I feed him 4 oz 9Lives meaty pate twice a day. He was 9.3 pounds last time he was at the vet. I weighed him a while back and thought he gained .4 oz but I think my math was off!
We are really just now getting some good numbers, under 250... Should I hold off increasing his food or give him the extra 1.5 oz to raise him to two cans a day?
I would love to give him the extra 1.5 oz as a treat throughout the day but he spikes or surfs at the number he's at if he eats anything with carbs.
Any ideas or suggestions?

 

It is possible that by feeding a little extra carbs and adjusting insulin to compensate for the additional carb intake it might help Chuck to regain the weight he needs. Have a chat with your vet about this.


Mogs
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He goes to his new Vet on the 18th. I will ask her.

 

What is Chuck's ideal weight? You can use the formula below to determine how many calories Chuck needs per day according to his ideal weight and then determine how much food to feed him.

13.6 X Chuck's ideal weight in lbs +70

Unregulated diabetics can't get all the nutrition they need from the food they take in, so until they are regulated, you may need to up his intake a bit over what he needs for his ideal weight. I don't know how many calories are in a can of 9 Lives but that info may be available on their website.

 

He should be 12ish pounds. He's only 9 right now. Weighed 3 times and took the average. So he should be getting about 8oz a day for 12 pounds. He was 13 pounds in May of this year and his old vet thought that was a normal weight. He's always been around 12-13 pounds. Just worried that he hasn't gained at all.

 

With the diabetes not being regulated, Satan's body is not able to use all of the food properly, so if you need to you could feed some extra low carb mini meals during the day. What you need is a food with more calories to a serving. Some of the kitten foods have more calories than the adult food. If I remember correctly the Evo wet kitten food is low enough in carbs, but has extra calories that will help with weight gain. If you add something like "need suggestions on higher calorie foods safe for diabetic" then others may have some other suggestions for you.

 

Here's a body condition chart for you to help assess Chuck's weight:

Body condition chart


Mogs
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I did not know this, @Tuxedo Mom! Thanks for the input. Hannah also has low weight and eating issues, so this may be worth a try for her, too. Who knows... maybe she'll actually like the stuff. That certainly would be progress for us.

 

Well, I've been trying to find Evo wet kitten food, and so far, no luck. Anyone know where we can find it? Is it possible that it's been discontinued or not available in the US? Are there other brands of low-carb wet kitten food that would also supply those extra calories? Suggestions would be welcome.

 

Thank you for the info. Yes, Chuck is about a 2 on that scale. I will look for the kitten food. I will look to see if there's a thread for low carb kitten food and if not maybe start one.
This picture is from 9/12/16. He is down another 0.3 oz according to my scale. (Don't mind my dirty table. We clean it before eating.)

 

Might be an idea to post a new thread to ask this question, Carole; might get more eyes on it.




Mogs
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Oh, Steph! You must be so worried.

I strongly recommend you go back to the thread title and edit it to read: "Help ASAP: Very underweight kitty - Feeding and Dosing Advice Needed"

Set the question mark icon in the title to attract more attention to the thread.

Test every day for urine ketones (as a precaution because Chuck is so underweight).

I'm tagging @Meya14 and @Sue and Oliver (GA) to see whether they may be able to give you some specialist advice on how to help Chuck start regaining weight safely and how to manage his insulin properly.

Can you let us know in the meantime whether Chuck actually wants to eat more (and how hungry he is) or whether his appetite is small (i.e. you can't get him to eat enough under his own steam). If he were mine I would be looking to do all possible to get him back to a healthy weight ASAP. I don't have enough experience to suggest how you might go about that safely.

I strongly recommend you get a vet to check Chuck over tomorrow, Steph, for safety.


Mogs
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Mogs, Steph posts daily in PZI for dosing advice. Steph, there are also higher calorie foods on Dr. Lisa's chart. There are some that have 240+ calories per serving vs 48. Maybe go down the chart and find some that are low carb, higher calorie. Calories are the last column over.

http://catinfo.org/docs/FoodChartPublic9-22-12.pdf

 

Agree - what Chuck needs is more calories, and more calories doesn't necessarily mean more carbs, are you able to give additional food during the day if he needs it? Does he still act hungry after feeding?

 

Should I just make sure I stay under 10% carbs? He reacts so strongly to carbs I thought about getting the pro plan max cal and feeding that once a day to see if it helps him gain weight. It's got 10% carbs I believe and I'm not sure if I'll be able to afford it twice a day but will budget for as much as I can to go towards his food. I will see the vet next Tuesday.

He ABSOLUTELY will eat more. His appetite is never ending and he FREAKS out over food. He would eat 3 cans or more a day if I let him- I'm sure! He licks his dish clean and then goes back to make sure he didn't miss a speck. I increased his food to 4.5 oz each feeding. I didn't want to spike him too quick with much more each feeding.

He's been this skinny since the beginning of August. He lost another pound in about 3 weeks when we were trying diet controlled... so I took him back and got him on insulin early. Vet wanted to wait 4-6 weeks. I refused. I will test for ketones again as soon as I catch him in the box again.

He's acting very normal. Always hungry. Every time we walk through the dining room he runs and jumps on the table to yell at us to feed him. No puking. Diarrhea is almost gone. He's almost back to his normal soft stool with the half ounce pumpkin every evening.

 

Music to my ears! Things would be far more difficult if it were a case of Chuck not wanting to eat enough. For starters, you should have a wider range of options of what to feed, you just need to be careful about how much to feed. Cats that need to lose weight need to do it slowly and gradually so as not to disrupt their metabolism so I would be fairly sure a similar approach needs to be adopted when trying to help an underweight cat gain weight in a controlled and safe manner; it's not a case of simply plonking kitty in front of an all-you-can-eat buffet and Bob's yer uncle.

I just had a look online and found this article which may give you some pointers:

https://www.cuteness.com/article/make-cat-gain-weight

With the diabetes in the mix you've got the added complication of Chuck not getting the same benefit from a given amount of food as would a non-diabetic. I think you definitely need to seek veterinary input on this.

If it were my cat I would be focusing on helping to get it back to a healthy weight as my first priority. I would seek advice from my vet about the best way to do this and what type of food to offer. I would manage insulin needs around whichever food was right to help my cat regain weight.

I'm sorry I can't suggest anything better; I've never had to deal with a situation like this. I hope other members may be able to give you more concrete suggestions. I really think you need to consult your vet about this ASAP.


Mogs
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After seeing Steph's picture of Chuck and comparing it to the body condition chart, I totally agree with @Critter Mom. Asking the vet about this would be the first place to start. If the vet is in agreement, it makes good sense to make weight gain a priority, adjusting insulin to accommodate food choice. Then, when Chuck has gotten back to a healthier weight, work on re-introducing lower carb food and adjusting his insulin accordingly. I'm glad to know Chuck wants to eat and he's acting like a normal kitty. That's a big plus right there!

 

I will call the new Vet in the morning and try to get him in tomorrow or Tuesday. Or at least this week instead of next. He "only" lost 0.3 ounces in 4 weeks but I expected a gain. I will get on this ASAP. The old vet made it seem like he would gain as soon as he started on insulin. He was an awful vet for feline diabetes. That's why we are going to a new one.

 

Your blood sugars are all over the place with the PZI insulin. I work with a lot of human diabetics and sometimes with the "in and out" types of insulin (ie NPH, regular in humans) there is a tendency to have a reactionary approach to dosing. This used to be what we taught, BS sliding scales to deal with high levels. However what happens is that often reactionary dosing based on BS scales leads to very unstable sugars. In humans, the new view is to use a scale based on food intake + base dose + correction dose for high BS. This ensures that you have enough insulin on board to -PREVENT- hyperglycemia, not react after the fact. A scale such as this might be difficult to develop for a kitty, and would be different for each cat.

Because your cat is so unregulated, when he is high it's an indicator that his body is unable to use all those calories to gain weight. Once BS reaches a certain level, the sugar gets eliminated by the kidneys. That can sometimes be a lot of calories lost in the urine. Also, being thin as well as unregulated, your cat is at risk for kidney damage as well as ketones. I would seriously consider switching to a long acting insulin that is not based on a sliding scale, such as lantus or levemir. If you don't want to switch, I would try stable doses with the PZI, giving the same dose every day and slowly increasing until the blood sugars start to even out - at least a few weeks. From there, you can tweak the dose here and there to correct, but you'll be much more stable.

Once the blood sugars stabilize, your cat will gain weight. Also, maybe find a higher calorie food and increase the food. Wellness pate foods, EVO cat and kitten, and iams kitten foods are high cal.

 

He should have advised you about feeding Chuck a little bit extra as well as starting him on insulin to help Chuck get back to ideal weight again. (The normal recommendation on FDMB for cats who have lost a little bit of weight by time of Dx is to feed a little extra until back to ideal weight and then gradually move to feeding a maintenance allowance of food.) Unfortunately with Chuck so underweight now he really needs specialised input on a weight gain plan.

Wishing you much better experiences with the new vet, Steph. I hope you'll post an update to let us know how you get on.




Mogs
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@Meya14 - Thank you!


Mogs
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Ok so your saying that I should give like 2.5 units morning and night no matter what his bg reading is?
3.5 seems like a magical dose to get him into the blues and then the next morning I'm afraid giving him too much because I gave him 1.5 units on a 155 and he bottomed out so fast.

 

I think you are doing a great job figuring out his doses, Steph. It certainly makes sense to give more insulin on high numbers and low doses on numbers near your no shoot number. Shooting a steady dose sometimes works if your kitty doesn't bounce.

 

Actually, this at first -seems- to make sense, but research in humans have shown that sliding scale alone doesn't work. This has to do with the onset and duration of insulin. For example, most zinc-based insulins will have an onset of about 1-2 hours, peak 4-6 hours and duration 8-12+ hours. When you are shooting, you should be giving a shot based on what the sugar will be in 4-6 hours, not where it currently is. So when you undershoot the low numbers, you are not taking into account the food consumed later in the day. This leads to the next BS being really high, then you overshoot, and next one is low - so on and so forth. You can actually see this happening in the spreadsheet on 10/6, 10/8, and 10/9.

I would keep the dose stable, say start at 2 units each shot, and wait a couple days. If no bottoming out occurs, and numbers are still high in general, then increase by a little bit and wait another couple days. If you get a low number, say under 150 as a preshot, only give half the current dose, and continue. Once you have most of your numbers in the yellow and stable, this can be your "base dose". From there, you can add maybe 0.5U to that base dose when the preshot numbers go higher than yellow. But establish a base dose first.

 

Guess we need to agree to disagree.

 

I tried that on 9/30... He was 155 and almost every time I wait 2 hours to give insulin he spikes 300-350 points from eating. So I was almost certain he would spike 300 ending up at 355-405 after 2 hours, when the insulin seems to start lowering his numbers. Instead it dropped almost 40 points in 2 hours and got down into the 70's after 2 snacks.

I don't like that he goes up and down and try to keep him at least out of the black and red. But he seems to react so strongly to carbs and when I thought I would keep him steady he plummets or goes up. I've only been at it for a month now. I will talk to my new vet about our options... I try to do what is best for him. Btw, I believe his diabetes is Depo-medrol steroid induced. I just didn't catch it soon enough. He had the shot in the beginning of May 2016 and I didn't notice his symptoms (weight loss being the #1 symptom which I thought was because he switched to wet food in April 2016) once I could start to feel his bones I made the appt. Which was August 18, 2016. In that 4 months he lost 3 pounds. Then another pound in the next 3 weeks. He started ProZinc on 9/7/16. Almost killed him with 7 units that night, 3 units next morning, then 7 units the next night. It was a rough start.

 

(((Steph)))




Mogs
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Oh, wow! In my opinion, his starting dose was way too high! The vet should have known to start out low and work the amount up, little by little, as needed. I'm so glad you were testing and keeping an eye on those numbers. It's a good idea to touch base with another vet. Glad you are doing so. It looks like you're figuring out his insulin, as his recent numbers show an improvement. Keep in mind that it takes time, sometimes it takes a lot of time. It doesn't happen overnight. Now, if we can also fatten the old boy up a bit, life will be better. Hugs and good luck to you and Chuck.

 

Yes, we are done with that vet! That is how I ended up here. I googled prozinc and found this forum. And I've been here every day since then. haha. This forum and the wonderful people here saved my baby boy! I am certain of that. Calling the vet this morning to try to get him in this week.

 

New Vet appt is Thursday 10:45am!

 

Great!!

 

Fingers and paws crossed for a productive consult. (Maybe print out this thread to bring with you to help with your discussion.)




Mogs
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Chuck has gained 0.5 pounds!!!!!!! He's up to 9.5 pounds. The vet is AWESOME. Cuddled him the whole time and said she is confident in the way I am treating him. She said it's considered "tight control" and once he gains more weight I have the option to try a different method (sorry I can't remember what she called it) that doesn't require such close monitoring at home. She said there's no reason to do an in office curve or blood test unless I request it. She even joked I just needed her to weigh him and prescribe the insulin (she even gave me refills and said I don't have to go in every time I need more). haha. I told her I'll be switching my other critters over to her too. She was very impressed with the spreadsheet- kudos to whoever designed it! I'm very happy about the weight gain. On paper it's only a 0.2 gain because his last official weight was 9.3 on 9/7/16.

 

This is really great news, Steph! I'm very pleased for you and Chuck. It sounds like your new vet will let you be hands on with Chuck but is available when you need her advice. My vet is that way and I know how lucky I am.

Half a pound is a good gain for a kitty. You might consider buying yourself a digital baby scale so you can weigh him at home. They aren't that expensive and work well at the lower weight ranges of babies and cats. A few treats and I'm sure you could train Chuck to sit on the pan.

 

Super happy to hear Chuck is gaining and that your new vet worked out so well. She sounds like a dream come true...a real keeper!

 

What GREAT news and what a GREAT vet!!!

 

I have been looking around for them. I found a cheap one on craigslist near me but I think I'm going to go with digital because those little lines are hard to see! She said I could stop by any time to get a weight on him. I might take him once a month if I don't get a baby scale before then. I'd like one for my fat cat Kitty too. He's losing weight since being on wet food only and I'm a bit concerned as to how fast he seems to be losing it but he's picky and only eats an ounce or so at a time and if I'm not home for 6 hours he goes without until I get home. Some days he doesn't eat as much as he should so I think that is the only reason he's losing so quick- the amount of food he's getting is much less than the dry grain free stuff. He will go in November to see our new vet. I've checked his BG and it's perfect. 50-60 every time. (he's not a diabetic)

 

I also use my digital baby scale to monitor Teasel's brother who is a bit "husky". I've had to tempt him onto it with treats because he's a very cautious kitty but it worked. Teasel just gets right on and hunkers down. Some people have said that they've found digital scales on Amazon for a reasonable price.

 

So pleased to hear that Chuck has regained some weight. Fingers and paws crossed for Chuck to steadily and safely return to his ideal weight. Great news about your new vet too, Steph!




Mogs
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So pleased to hear that Chuck has gained a little weight and that you have found a vet who will be supportive and easy to work with. Confidence in your vet is so very important. Looking forward to hearing more good news from you and Chuck.