? pls advise on Food, Renal or Hill's m/d CKD cat with Diabetes

Hi All,

I'm Manon and my cat is called Joy, he's a 18 year old with thyroid problems, kidney faillure (both mild) and since last monday irregular heartbeat and diabetes.
Ruby&Baco helped me find this forum.

Basic info
weight 3kg
thyroid meds 2 a day 5mg Felimazole
Kidney meds Fortekor 1 a day 2,5mg
heartmeds Atenolol Actavis 2 a day 1/4 of 25mg

Diagnosed last monday, started Prozinc wednesday , first full day yesterday.
I give him Royal Canin Renal pouches but is that the right thing to do?
Does anyone in here have the same combo issues? What food do you use with these issues?
Please advise or share

 

I have some RC renal pouches here as one of my cats (non-diabetic) also has CKD. They are really high in carbs so not the best for a diabetic kitty.

There is a list of foods on this page somewhere that is suitable for a cat with both. I don't have it, but hopefully someone will be along soon who can find it.

 

Hi Joy and welcome.
Here is a list which may help.
Can you buy Weruva brand canned food in the Netherlands? Much of their canned foods are low carb and low phosphorus....which is what you want for kidney failure.
http://www.felinediabetes.com/FDMB/...for-europeans-and-international-buyers.64843/

Are you home testing at all. We would highly recommend it as it will keep your kitty safe.
If you have been giving high carb food and have started insulin, it is not safe to switch to low carb food until you are testing the blood to see how low the insulin it taking it. The reason you need to be testing is because the lower carb food will drop the blood sugar level by 100 points or more and if you have not adjusted the insulin, you could have your cat drop too low.
I will look for more links to suitable foods

 

Here is another list. Look for canned food under 10% carbs and 200 to 250 mgs/100 calories of phosphorus.
http://www.catinfo.org/docs/FoodChartPhosphorus9-22-12.pdf

 

Thank you so much. Im testing like crazy, the sheet is up to date, we've just started. We are from the netherlands, so getting food might be a problem, I havn't come a cross the brand you mentioned, but I'll see if I can find it.

 

I'm Manon and my kittykat is called Joy (his twin brother Pride died 5 years ago, Pride and Joy )

 

Sorry Manon!
Great..so it is safe to swap to a low carb food when you can find one. Just be aware that the blood sugar will probably drop lower than it has and you might have to reduce the dose.
Do you have a hypo kit?

 

Just Honey z'n sirup, right now, I still need to get high carb food he likes. He has trouble eating his RC renal atm, he doesnt eat that much

 

Exuse my dutch autocorrect please

 

Here is a link to managing low numbers and what you need in your hypo kit
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

Goedemorgen, Manon.

Have a look at the foods available from Zooplus on this UK food list to get some ideas of what you might be able to get from them:

https://docs.google.com/spreadsheets/d/19znI5E0x5asox0n_SdOUFaXaUDaA4C07EDPr-tH9rac/edit#gid=0


Mogs
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Oke I'll keep checking in on dose advices, I'm not doing anything right now without asking you guys on here tbh, no one has any experiance with Prozinc in the netherlands incl vets. I'm so happy I found you guys!

 

The hypo box
http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

 

I've checked the sheet, the weird thing is, I have a Zooplus account and have been ordering for years with them, but some of the brand are not available to me.

So you guys do not use Hill's m/d food, right?

 

Oh great hypo box tips! Ill try to get it together asap!

 

I see that 1 unit dropped the BSL to 65 with the high carb food. I will tag someone who uses or knows Prozinc to help you. I don't use that insulin and would not like to advise you on dosing.
@Elizabeth and Bertie

I used to use Hills MD and it got Sheba into remission the first time around but she acquired an allergy to it and I had to stop using it. A lot of people say it is too high in carbs and the dry one definitely is but I was told by the company that the carb level of the canned was less than 5 .....just can't remember the exact number off the top of my head. So not sure what to advise you re that. It is low phosphus.

 

That's a bit of a sprag, Manon. Do they offer Granatapet in the Netherlands Zooplus line? If yes, then the Granatapet Symphonie organic range is excellent food - with the caveat that not all cats get on with the salmon oil it contains; the quality of the food is excellent provided it suits the individual cat. It would be my first choice for Saoirse but the salmon markedly disagrees with her system. )

I don't know whether other zooplus country sites with a wider product range might be able to supply you in the Nederlands?


Mogs
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I see you have found your way over to the Prozinc forum and have received advise on dosing. That is great.

 

No Granatapet or caveat available in the netherlands or Zooplus

 

@Bron and Sheba @Elizabeth and Bertie

The past few days were a mess (diagnosed, hospitalized on fluids for 2 days, a vet who doesnt know any thing about Prozinc cuz it just came available 2 months ago in the netherlands), Joy always ate RC Renal and Kattovit Renal ( about 10 carbs but not sure about the quality of the protein so I used both, he doesnt always want to eat so I can try different things), thuesday afternoon he ate Hill m/d, wednesday morning he ate Hill's m/d, and from wednesday afternoon he ate RC Renal and Kattovit again. So it's really hard to interpet the sheet.

 

What sheet do you mean is hard to interpret?

 

I mean Joy's readings @Bron and Sheba

I did find the Prozinc forum and I ask there for dose advice, but no one there has my CKD diabetes combo and food intake is an important variable.
I'm still quiestioning if I should switch to Hill's m/d

On the dutch form they use a low carb sheet and Hill's m/d is listed at 15.5 carbs and RC Renal at 26 carbs and the Kattovit Renal at 13 carbs , but I question the quality of carbs and protein in Kattovit...

https://docs.google.com/spreadsheet...OpqbL4AcKnz83RXgqdC5gCh6c/edit#gid=1144498914

Here's the link to the dutch carbs list, " ruw eiwit" means protein (first purple collum) and "werkelijke KH%" (green collum) means Carb percentage , but it doesn't say anything about phospor levels

 

Do you mean you are concerned with Joy's numbers because they were low this morning and tonight they are high?
This would be because Joy went quite low this morning into low blue and a green number which she may not have done for a while. When this happens the body thinks it needs to rescue itself and it releases hormones to raise the blood sugar and the BSL 'bounces'. Many cats do this and it is normal. Bounces can last up to 6 cycles and there is nothing you can do except wait it out. You don't raise the insulin. So the >450 you are seeing tonight is most likely a bounce.

Re the M/D, I just looked up the letter I got from the company and they said the 'as fed' value of the carbs is 3.9%. The higher number you are seeing for the canned M/D is the 'dry matter' value of the carbs. When we talk about carbs being under 10% we are talking about the 'as fed' value of the carbs.
M/D is an expensive prescription food which is really no better than many of the canned cat foods that are available over the counter. However if you are having trouble finding a food right now for Joy which is low carb and low phosphorus for the kidneys M/D would be OK til you find something more suitable.
Another way to reduce the phosphorus level is to add an egg white ...cooked .....to the food...mashed up. Don't use the yoke it is too high in phosphorus. But the egg white is low in phosphorus and high in good quality protein.
Also make sure Joy is getting plenty of fluids for her kidneys. You can add some warm water to her food ...as tolerated to increase the amount.

Sheba has diabetes and kidney disease and I home prepare her food and use raw meat and cooked chicken. If you are interested in that I can show you a link

 

Yeah that's what I meant @Bron and Sheba , I keep thinking the bouncing is due to his food, thank you for explaining
Can I use different brands of food that have similar carbs? It's different for Prozinc users I guess...

The boild egg white is a great tip! I feel way better using kattovit foods now!

Can I reduce phospor levels in food somehow?

I've heard of home preparing and raw food, its something I'm going to look into in the future, I'll start a new thread when I do.

 

The Kattovit Renal is still quite high in carbs...10% but I would imagine the phosphorus level is good being a renal Food.
It is a good idea to try and have the same number of carbs in each cycle. This is so that the insulin has the same number of carbs to work with each cycle. If you had 10 carb food in one cycle and 3 carb food in another, the effect of the insulin would be quite different on the BSL. So yes you can use different brands of food that have similar number of carbs.

Re the egg white....it reduces the phosphorus levels in the food not the carbs. It is important to also check the phosphorus level of any food you use and try and keep it under 250 to 200 mgs / 100 calories.
Using a low phosphorus food and making sure Joy is getting enough fluids are two of the most important things you can do to help manage the kidney issue.

 

So the egg whites not only give good protein but also reduces phosphorus levels, that's great!
Joy's fluid intake has been great the past 2 years (diagnosed 2 years ago) he never had dry foods and he has a water fountain wich he loves. If I need to I'll add water to his food or force feed with a syringe, but I never had to do that yet. There's another brand that's called Integra 9% carbs, it's the only renal food that's lower than Kattovit, but both brands are not therapuetic diets, so I feel I have to add somethings like egg whites, maybe Vit B....

 

What do you mean by not therapeutic diets? Do you mean not prescription diets or not a complete meal diet with the correct supplements in it....ie calcium, taurine etc

 

I mean a complete meal (calcium taurine vit B omega 3) and quality carbs (the few that are in it)

BTW.
Joys reading at +4 was 337, but 30 mins after I measured he started walking like a drunk and almost falling over, he lay down on his bed for a while and gagged but didn'y throw-up... are these bounging sympthoms?
A drop to to low levels is not possible, right?

 

They are not symptoms of bouncing.
I would retest his BSL now because that sounds more like low blood sugar.

 

Pfffffff oh what an emo rollercoaster, the reading was 21.7mmol , so higher than +4, I dont know what is is in US levels but it shows on my sheet.

 

OK then it wasn't low blood sugar so that is good. I am not sure why that walking like a drunk and almost falling over means. If he continues to do it I would go to the vet. And also mention it anyway even if it doesn't happen again.

Re the food. I think you would be much better to try and find a suitable complete meal canned food/s for Joy than try and muck around with an incomplete meal and try and supplement it.
It would be OK to give the M/D canned until you can find something suitable. I fed Sheba Hills MD for 3 years ....2 1/2 of which were in remission and it was fine.

 

Joy is calm again now, he's laying in his bed and looks good, calm breathing aswell. I'm asking about his symtoms in different places right now incl vet.

Yeah mucking about with lower carbs renals and supplementing it sounds like a good plan, it would mean i would'nt have to change food much. And i can vary when he gets fussy with his food.

Thank you so much for your input Bron

 

You are very welcome Manon
Hope Joy is OK. Would be interested what the vet says.
When you think you might have found some suitable low carb and low phosphorus canned food, post here and we will be able to tell you if it is OK........and of course Joy has to like it!
11 pm here in Australia so I am off to bed

 

Be no harm to check Joy's urine for ketones to be on the safe side. Did your vet have any ideas as to possible cause?


Mogs
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I've continiued that conversation in the Prozinc form Mogs

 

Thanks for the heads-up, Manon. Will check other thread.


Mogs
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@Bron and Sheba Joy is stil losing weight, do you know of a supplement or an alternatieve food to help him gain some? He was 3kg on monday but i think he's lost some more, I'll weigh him when he feels a little better he just had his PMPS and he was high

 

It is possible that Joy could be using weight because until the BSL is more under control, he is not absorbing all the nutrients from the food.
Is he hungry? You could try free feeding him and letting him eat as much as he wants of a suitable food but make sure you pick up the food for the 2 hours before preshot so it is not influenced by food.
Plain steamed or poached chicken has few carbs but could provide some extra calories if he will eat it. I would use the leg or thigh part and only give it after he has eaten his normal food.
There are some foods that have higher calories per ounce than normal food that I see some people use when their kitties need more calories, but I have not used them so I do not know much about them, but I will tag someone who I think has used them. @Tricia Cinco(GA) & Harvey ...have you used these foods, thanks?
Otherwise he has complex health problems with his heart, thyroid, kidneys and diabetes and I would speak to the vet about his weight.

 

@Manon&Joy
Manon, I have just read through your thread on Prozinc where you are getting great advice on dosing and related issues, and I think you are managing this whole thing amazingly well, and you have the added problem of English being a second language...........which you speak as well as any of us!
It is a roller coaster ride for the first few weeks after a diagnosis of diabetes. It is quite normal to feel as you do at the moment, especially dealing with other health issues for you both. It is OK to cry....we all did!
And you need to look after yourself as well......if you get sick you will be no good to Joy.
It does take time for the insulin to start doing its job. Insulin is a hormone, not like a medication ( eg an antibiotic) that works straight away, so it takes time for the body to adjust to it.
I think you are been a wonderful mamabean to Joy. Keep asking questions and leaning on us for support.

 

Thank you so much Bron, everyone on here has been amazing. You all make me feel so supported

 

Hi Manon. I saw Bron tagged me about food. I have fed Hill's a/d, which I imagine you could get there, since you can get m/d. The a/d is lower in carbs than the m/d. The a/d is 12% and phos is 214. M/d is 14% carbs and phos is 171. I don't know where Bron got her carb numbers for m/d, but this is from Dr. Lisa's list. Can you get Iams there? Their MaxCal is 9% carbs, 159 phos and almost double the calories of the other two. A/d is actually about the same in calories as most commercial foods. I wish I knew more about what foods are available in The Netherlands so I could help you more, but as Bron said, if you find one you think will work, ask us about it and someone should be able to tell you if it's good or not. Typically you want to keep carbs under 10% and Phos under 250. That said, some cats are less sensitive to carbs than others and can do okay on a higher carb food. I suspect Bron's Sheba was one of those, since she went into remission on the m/d. Or maybe she just really didn't want to get shots anymore!

 

Hi @Tricia Cinco(GA) & Harvey
I could only see the M/D dry food composition in Lisa' list....but I know everyone says that the canned food is the same.
However I wrote to the company here is Sydney and received the following letter back. I then rang and spoke to the vet involved who assured me that the 'as fed' amount was 3.9% and the 'dry matter was 15 %
Here is the letter:
M/D Hills canned for diabetics. The following is correspondence I had with the company here in Australia. I was inquiring as to the percentage of carbs in the M/D in As Fed basis. I was surprised to be told it was 3.9%. The lady who wrote the email was the vet attached to the company here in Australia by the looks of it. The emails start with an inquiry from me.

· “Re: Hills prescription M/D canned cat food for diabetics. I have a diabetic cat and I feed her M/D canned food and she has insulin twice a day. I am concerned your food has 15 percentage of carbohydrates. It is given as dry matter. Could you tell me the percentage of carbohydrate when it is given as eg: percentage of water, percentage of protein, percentage of fat, percentage of carbohydrate please? I want to compare it with other canned cat food. I am not entirely happy with M/D - the texture and look of it changes, sometimes quite dry, and it is expensive. Thank you for your time.”

“Thank you for your enquiry. The percentage of carbohydrate on an As Fed basis- which is when water is included (I am assuming you are referring to the canned food?) is 3.9%. Since canned food is made mostly of meat, the water content will be high, around 75% - because this is the amount of water found naturally in meat. I am sorry to hear the texture is not favourable at times. Natural changes can occur as the product comes closer to shelf life. Fresher batches will generally be more moist. We can assure you that the product is clinically trialed and shown to be not only safe but effective up till the expiry date. If your cat ever dislikes the food because of the different texture, check with your clinic, they should be able to organise the 100% Money Back Guarantee on the remaining cans.
Kind Regards”

“Are you saying that M/D canned has 3.9% carbohydrate per can and 78% water (which all canned food has of course). If this is so, can you tell me the amount of protein and fat as a percentage as well please?”

“Yes, there would be approximately 6 grams (3.9% means 3.9g in 100 grams, so 3.9% of 156 gram can gives about 6g).
The m/d has been clinically trialed and shown to, in some cases, bring diabetic cats into remission, however this is based on it being the only thing fed. Even though chicken and kangaroo and bones are not high in carbohydrates, addition of any food can dilute the active ingredients and components of the food and render it less effective. It may be worth while trying to cut out these foods and see if that helps control her levels again. Even if you previously fed these treats, our bodies change with age, so she could be experiencing changes that mean she cannot handle the extra nutrients. The Fat content is 4.8% and Protein is 13.1% (as fed not dry matter). The products are displayed in Dry Matter because this is a commercial standard in pet food labelling, and is the most accurate way to compare two different products- including different brands” End of correspondence.

Sheba is actually quite sensitive to carbs....except when she is dropping fast and the only thing that stops her is honey......so I tend to believe the vet. I think we ought to check it out because I think it is quite a good food in a sense.....I don't particularly like the ingredients... and I think it is expensive....but I think it does the job for people who cannot get anything else.

I asked the vet why they marketed the canned food as 15% carbs and she said that they used the 'dry matter' value as it was the industry norm. I said it was very misleading to the general public and turning people away. She agreed and said she would bring it up with management.

I have put all this information into my list in the Food link in Think Tank.

Here are a few of the Wellness values I received from the Wellness company and you can see that the dry matter value is about 4 times the as fed value.
Wellness® Complete Health Wet Cat Foods
Complete Health Chicken Recipe
As Fed: 0.31%
Dry Matter: 1.15%
Complete Health Chicken & Herring
As Fed: 0.37%
Dry Matter: 1.48%
Complete Health Beef & Chicken
As Fed: 0.28%
Dry Matter: 1.17%
Complete Health Turkey
As Fed: 0.28%
Dry Matter: 1.04%
Complete Health Turkey & Salmon
As Fed: 0.35%
Dry Matter: 1.44%

Interested in you response Tricia

 

The 3.9% as fed, with 78% moisture works out to just over 17% carbs on a dry matter basis. But the important thing for our cats is the % of calories from carbs, which isn't exactly the same as either of the other 2 values. The 15.7, from the Hills site looks as though it might be the dry matter Guaranteed Analysis, which is different again! Putting the percentages given on the website into a calculator returns a value of 17.67% of calories from carbs, which makes the D/M a high carb food.

 

Thanks, @manxcat419. @Bron and Sheba, I'm in the car, on my phone right now, so can't paste the place in Dr. Lisa's list where it shows the 14%. It's near the end where she lists the prescription foods. April explained it better than I could have. It appears we have been talking about two different things. . Sorry if I sounded critical. I didn't mean it that way.

 

Thanks @manxcat419
We need to write to the company again and pose all those questions.
I just don't understand why all the cat food companies can't just be truthful and publish their readings.
I guess it is because all they are interested in is the bottom line

@Tricia Cinco(GA) & Harvey
I didn't think you were being critical at all. Discussion is what this forum is all about
I think we all need to talk about it and get it sorted out.......because we are getting mixed messages from the company.

 

A couple of things - first, the information on catinfo.org is most likely the more accurate unless the formulation has changed recently. I was using the dry matter guaranteed analysis figures really to show the difference in the numbers we get depending on what we need the value for. The catinfo.org information is based on actual as-fed values so is always going to be more accurate than anything we pull from a guaranteed analysis basis.

With that said, Bron, Sheba may be a case of ECID. I was talking with someone on the CKD forum a day or two ago who said that her cat has been in diabetic remission for some time on Wellness Core food. I assumed she must be feeding the wet food, but she's actually feeding the dry at over 19% of calories from carbs! Apparently, her cat's numbers spike on various other foods so who knows but that there's maybe an intolerance at play that hasn't been identified because it doesn't cause any other issues! If you've got something that's working for you, that's the most important thing.

I would love to see the information on pet food regulated in the same way that information on human food is. I just don't see it happening - the FDA even released a statement about prescription foods for cats that pretty much says that they're not prescription because of any of the ingredients and that vets and pet owners must be aware of what they're feeding their pets. The link is here for you to take a look at for yourself - they even compared Friskies to a prescription food...the results are interesting to say the least! http://truthaboutpetfood.com/consumers-and-veterinarians-should-take-note-of-new-fda-decision/

 

@manxcat419
That article is very interesting! Thanks for posting it.
Would love to get to the bottom of the MD carb issue.

Sheba is no longer on M/D. I had to stop it about 2 1/2 years ago when she developed an allergy to it which gave her chronic diarrhoea which ultimately tipped her out of remission.

 

I got it from someone on the CKD forum who found it and posted it there, so I can't take any credit at all for that! But I figure the information should be shared, especially as so many people start off here with a vet recommendation for an rx diet!

It would be great to get a definite answer on the carb issue for MD, but as Hills seem to be sparing with their information, it would probably require a very probing email to them with some very direct questions. I'll try and do just that in the next few days and see what information they can and will actually give on it.

Unfortunately, cats seem to be prone to developing food allergies. I'm sorry Sheba became allergic to something she'd been doing so well on and that it took her out of remission but glad that she has you to take such good care of her.

 

My cat had diabetes for a year. injection, blood smaples - was my everyday routine, until i started looking into the subject with my eyes wide open. it was when I decided to give RAW food a try and my cat was back to normal in just 1 month! Been feeding raw now for about 4 years and my 2 cats are completeley healthy!

 

Hills M/D canned is on Dr. Lisa's canned food list, and it is 14% carbs. The formula has not changed since the list was compiled. It contains corn starch, which is why it's higher than other foods with similar ingredients. I would not feed it to a diabetic cat.

I also would not trust any information that Hills gives you. I've seen them outright lie to people about real or imagined "studies" that they say supports whatever ridiculous claim about their food they're making that week, only to refuse to produce said studies when asked for them. If you asked the rep you spoke to for the study that showed diabetic cats eating only M/D were brought into remission they would not produce it for you. They stay in business by convincing people and vets not to trust real studies (that support feeding a species appropriate diet), and it seriously infuriates me that they are allowed to do so. If they were a human food company, they'd have been sued or shut down a long time ago.

 

Neither would I. Prescription foods overall have done my cats more harm than good.

Case in point: a couple of months ago I was quite horrified to hear the words of a vet nurse at our practice singing the praises of Hill's foods; she was raving about how much better their products were than regular commercial foods because "the quality of the ingredients in Hill's foods is so much better quality than in [regular cat foods]." In other respects I have a great deal of time for the vet nurse in question but ye gods! she has drank deep of the Hill's Kool-aid; she was talking about the alleged virtues of their foods with what I can only describe as the zeal of someone indoctrinated into a cult. My civvie had recently been put on Hill's i/d for a major diarrhoea problem but the problem only resolved when I switched her back to a fairly average commercial food. She hit a bump on the way to recovery and again I tried the i/d but it made the diarrhoea worse. I subsequently cut one of the varieties out of her commercial food diet and things improved again. I didn't bother telling the vet nurse about this because I knew that she would not want to hear about it, nor did I try to argue the case for species-appropriate diets nor point her to the work of Drs Pierson and Zoran because, much to my sorrow and frustration, I knew in my heart of hearts I would have been completely wasting my breath.

I have yet to meet a cat who would queue up to eat corn or soy.



Mogs
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