Sarka - new member, introduction

Hello,
My name is Sarka and I am a new member on this forum, so am following advice and introducing myself and more importantly my cat. I have been having some troubles with him and am hoping to find some advice on this forum. Apologies that this inital story is going to be a bit long, but am going to try to give all relevant information.

Kuula is an 11 years old neutered male cat (age is estimated, I got him from a shelter 7 years ago). His name means "ball" in Finnish, because he was fat - partly due to the fact that soon after him I rescued a badly starved kitten who needed to have lots and lots of food, to which everyone else was helping themselves So, obesity. In autumn 2007, he was treated for crystals in his urine, after which the vet recommended urinary diet food (dry Royal Canine Urinary). For the next year or so, I kept him on strict diet to reduce his weight, but was not very successful (we managed some weight reduction, but not as much as was needed). Then in April 2009 he was diagnosed with diabetes. (Under horrible circumstances. He had a scab on his forehead which would not heal. I thought it was an infected wound from one of his fights with my other cat. The vet quickly assessed it as an allergic reaction and gave him a shot of cortisone, followed by the most horrible 24 hours, during which he first went quiet, then started vomiting incontrollably, and eventually stopped responding to any kind of stimulus, just lay with his head in the water bowl. He also lost one kilo of weight. The cause was the cortisone, which apparently is incompatible with diabetes. Then he spent a week at the vet's who would not commit for full five days to saying whether he was going to survive.) He had some signs before which I was ignorant of: he urinated too much (which I put down to a bad quality of cat litter, as I had recently changed brands), he could no longer jump to the table (weak hind legs, but I put it down to his obesity).

He's been diabetic for a year now, but I still didn't manage to get him stable. I discovered this forum already back then (the old forum still) and followed some advice from there on testing blood sugar and feeding. The beginnings were difficult. Kuula's eating habits changed dramatically - he would refuse his usual food (which I wanted to continue as I read that other conditions should determine the diet, and I was worried about another blocked urethrea episode), and it was generally very difficult to get him to eat anything at all. He also started scavenging in the rubbish bin and developed some taste for cheese, butter, meat and meat products, which he had always ignored. Together with my vet, we were trying for months to find the right dose of insulin (he's been on Caninsulin from the beginning), but that just was not and is not happening. In the summer, we had several dramatic hypoglycemic episodes (including the meter informing me that the level is too low to measure, which on the meter I use OneTouch Vita means less than 20 mg/dl). His hypoglycemia is difficult to spot, he's usually just sleeping, and on several occasion I found out because he was napping in the wrong spot at the wrong time (I am sure many owners will know that at 11 am, the cat is to be found in the southern corner of the sofa, and if not, something is wrong). I suspect he must have these episodes more often, but I am a working person... In the first months he was allowed to eat as much as he liked and whatever he liked (to make up for the severe loss of weight due to dehydration and also because of his sudden pickiness), but once we learned to live with his condition and he was more responsive to what I chose to put in his bowl, I started keeping him on a regular feeding regime. He gets food twice a day right after his shot at regular intervals of 12h, he gets 30g of urinary dry food (which slightly varies, I bought all known kinds when he wouldn't eat, so am using up the supplies, currently it's Purina for sterile cats) in the morning and 45g of Purina Mousse (wet food) in the evening. (He is an indoor cat; his body weight is stable and according to the vet, it's his ideal weight.) Occasionally, I will give him a few pellets of dry food for snacks (around 3g). He has no clinical symptoms - when awake, is cheerful, likes his food, fights with my other cat, cuddles and purrs. Yet, his blood sugar levels are very uneven. Even on regular food, he may have 300 one day and 550 the next day. I have seen some of the spreadsheets on this forum, and am envious, mine would be very often in the black numbers (I will make one, but need to ask where to find the template). A couple of months ago, I did a curve measurement for him (which I will try to attach if I manage) taken at 2h intervals over 48 hours. The troubling finding was that even if his evening sugal level was at say 420, he experienced a dip to 45 at his lowest point. (He had a consistent lowest point 6h after shooting.) It was also uneven - during the day, he wouldn't go as low, but during the night he had hypoglycemia. Petrified of those low levels, I have pretty much resorted to keeping him in permanent hyperglycemic state. I have adjusted his insulin to a higher dose in the morning and a lower dose in the evening (currently 2.5u AM and 1u PM), but didn't have a chance to make another curve. I feel at a loss as what to do. My vet was baffled that he is so unstable and that his values (the regular evening blood tests) range so much with no apparent reason. I am worried about Kuula's long term health and about that one hypoglycemic episode which I will not spot in time. I do not know about his ketones (never heard of them until I read about them a couple of hours ago on this forum), but did previously try to check his urine - an impossible task, I only managed to get there in time to catch a urine sample. I would be very grateful if I could find some advice here.

Some specific questions I have:
- Could I have a blank template of the spreadsheet?
- I have also read Dr. Lisa's web on cat nutrition and am wondering whether the big differences in the day and night values could be due to the food: dry food in the morning, wet food in the evening. Should I try to switch to wet food only? Or try a different feeding regime? (I am somewhat limited in times of day I think; I feed my two cats in separate rooms to have some control over their intake, my other cat can eat her food and his food in a nick of time, which also makes me hesitant about getting a cat feeder - I think she would eat it all before he even got to the bowl)
- Can I stop with the urinary food without running a high risk of crystals again? (He doesn't like the wet urinary food.)
- I am resident in Belgium. Is any other member of the forum from here, who may have experience with availability of other types of food/insulin?
- Can anyone give any advice on how to get him more stable and, importantly, keep his blood sugar values within a reasonable range?

I really appreciate your help.
Sarka

 

Hi, you can find info on spreadsheets in Tech support.
:smile:

 

The template and instructions are here: viewtopic.php?f=6&t=16

It is recommended that you feed only canned food. Dry food just keeps blood glucose levels too high. Most people here free fed canned food. Unregulated diabetic cats are always hungry so they should have access to food all day. You can use a timed feeder or freeze canned food into cubes/chunks.

Go slow with changing over to 100% canned food. Some cats will have a big drop in blood glucose levels once dry food is gone from the diet. You should closely monitor the blood glucose levels during the food change.

I think so. Most prescription foods are worthless junk that doesn't do much. Dr. Lisa's web site explains why a good water intake can help prevent urinary problems. Canned food will provide much needed water than dry food can. You can even add extra water to canned food.

I know there is a member in Germany. She may be able to help. I'll send her a PM.

Test the blood glucose levels daily, feed low carb canned food, use a good insulin.

Are you still on Caninsulin? If the Cainsulin hasn't been doing much since your cat was diagnosed, you should consider another insulin. Lantus is the insulin of choice for many vets now. ProZinc is a new one that some people here use. Levemir is similar to Lantus.

 

I can answer a few questions for you:

1st: Vetsulin/Canninsulin has been recalled due to instability and inconsistency between batches. This could be part of your problem with variable numbers. I am not sure what is available in Europe, but try to see if you can get Lantus, Levemir, or ProZinc. Also, chronically going low can result in rebound numbers from the body trying to protect itself - which could also explain your ultra high numbers sometimes.

2nd: dry food, no matter the kind, is high in carbohydrates, which is needed in order to produce the kibble shape. Wet food, in general, is lower in carbs. By feeding dry during the day - the numbers will be higher because there are more simple sugars in the system. Once fed only wet food at night, there is less simple sugars for the insulin to break down, so there is a higher insulin to sugar ratio in the blood, which results in lower numbers. What you are doing right now (2.5u in day, 1u evening) could help your situation, but I would try to work on feeding the same type of food all day long, if possible, and giving an even dose. Kitty's bodies like regularity and work best with a predictable input of food and insulin.

3rd: as for type of food - check out Janet & Binky's food charts in the diet section on the main page. There should be a chart for non US pet foods. Many people on here feed the Fancy Feast grain free flavors, but I don't know how available it is in Europe.

I know I haven't answered all of your questions, but I hope I helped a bit cat_pet_icon

 

you are getting great advice so far.

We have a couple members in Germany, who can help give you specific food ideas - they are

Monique & Spooky
Kate & Lucky

You may want to send them a PM and see what they recommend.

I also recall seeing recently a new member in Belgium (not sure where) and will see if I can remember the name.

Where in Belgium are you?

 

Hi there and Welcome!

I'm Monique (&Spooky) the sort-of International assistance person around here :lol:

I can help you to find foods that are availble and acceptable for diabetic kittys. Recently Maria & Suzie joined the board here and she is also from Belgium and I was able to help her find foods. Maria also may be able to give you the name of her vet who although is not a specialist for diabetes has been very open to the information Maria has recieved here and is interested in learning more (afterall how can she not be impressed with Suzie's recent progress!)

There are several foods availble and need not be the most expensive ones. I suggest reading Dr. Lisa's site for the basics about feline nutrition and ideas for how to deal with urinary problems.

Many people here from the USA and Canda feed Fancy Feast (as someone below recommended), well that is availble here too, you will find it many frociery stores or per food stores. It sold under the name Gormet Gold (Purina) and comes in little 85g cans. The low carbohydrate ones are generally the pate (pastete) styles that don't have sauce or Jelly. A good site for ordering foods is http://www.zooplus.be/

Here is the list of foods that many people here in Germany have had good results with

* Amadeus
* Amora Fleisch pur (enth. Distelöl)
* Amora Vom Besten
* Animonda Carny Kitten
* Animonda Carny Adult
* Animonda Carny Ocean
* Animonda Carny Fisch Menü
* Animonda vom Feinsten Classic
* Animonda vom Feinsten Grandis
* Animonda vom Feinsten Kitten
* Animonda vom Feinsten für kastrierte Katzen
* Animonda Vom Feinsten Pure
* Animonda vom Feinsten Senior
* Bozita Dose
* Bozita Paté (enth. Macrogard)
* Cat&Clean Foodline
* Forza10 Bio
* Leonardo Premium
* LogoCat
* Miamor Bio
* Miamor Pastete
* Miamor Milde Mahlzeit
* Porta 21
* RopoCat Adult
* Ropocat Feinstes Fleisch
* Schesir Natural
* Schesir Pur
* ShinyCat
* Smilla Geflügeltöpfchen
* Tiger Adult
* Tiger Adult Spezial

Supermarkt oder Discounter-Sorten die auch sehr kohlenhydratarm sind, aber manchmal mit geringerem Fleischanteil:

* AS Premium Menü (Schlecker)
* AS Paté (Schlecker)
* Dein Bestes (DM)
* Felix Paté
* OptiCat (Lidl)
* Lux (Aldi Nord)
* Shah (Aldi Süd)
* Sheba Essence Paté
* Sheba Menü (nur die Sorten Geflügelcocktail, Huhn & Kalb, Lamm)

I personally feed foods from Aldi (Shah, Cachet) and from Lidl (Opticat) as well as the Gormet Gold, Miamor, and occasionally Almo Nature (somewhat pricey). In general I try to find foods that have No artifical flavors, colors, or preservatives. SUGAR should not be an ingredient in any cat food! I try to avoid ones that contain grains or "plant-by-products". Foods with sauce or jelly (aspik) often contain sugar or caramel as well as thickeners (starch) which make them high carbohydrate. Generally speaking the pate foods are most likely to be lower carbohydrate.

Other foods (not on this list) which i have used:

Whiskas Mmmmmm! (pouches) 85g
Felix as good as it looks (So gut wie es aussieht) pouches 100g

 

That's Maria & Suzie (they post on Lantus) wherever you are in Beligum I'm sure Maria is close (Belgium isn't that big)

 

Silly Monique - I've been to Belgium a couple of times, love the food, the one girlie beer and of course the chocolate!

Thanks for knowing who the other Belgian is.....

 

Hello Sarka !

Monique flagged to me that there was someone living in Belgium who was looking for food advice. Many of the foods Monique mentions for Germany are the same for Belgium, except for the Aldi & Lidl ones.

Here is a list of foods from the Netherlands on the link below, most of which are available here in Belgium, or from http://www.zooplus.be (like Monique said).

http://spreadsheets.google.com/ccc?key= ... l=nl#gid=0

It is in Dutch, I don't know if you live in the Dutch or French speaking part of Belgium, but in any case, name of catfood is name of catfood pretty much. koolhydraten = carbohydrates.

Sarka, see if you can to get Lantus for your cat instead of Caninsuline. It is quite new over here and not all vets are familiar with it, if your vet isn't familiar with it, I suggest you try to find one who is. It is more stable and long-acting than caninsuline and is much more suited to a cat's metabolism, which is faster than a dog's or humans (cats are carnivores, dogs & humans are omnivores, seems obvious once you think about it). Your cat will be far more stable on Lantus and far less chance of any scary hypoglycemic episodes.

My regular vet in Belgium missed Suzie's diagnosis of diabetes, a bit more than a month ago she weighed 3.2kg and was dying. I went for a second opinion and happened to end up with a vet who has a diabetic cat, spotted what it was, put Suzie on Lantus. Now, a bit more than a month later, Suzie weighs 4kg and is doing great. She wasn't 15 & old, she was 15 with diabetes. I don't think vets here are so well-versed in feline diabetes + Lantus seems new to many.

Follow the good advice here about wet food (and all the other good advice too!)

I understand your stress, we all do, we'll all do what we can to help.

Send me a private message if you want, to talk about where you live in Belgium, Lantus, vets and so on... With the different languages here in Belgium, I may have a solution for you. If your cat has a Finnish name, are you Finnish too? (don't mean to pry)

I am Swedish, but have lived here in Belgium a very long time and speak Dutch. I know of a Forum that can offer advice about caninsuline, but it is in Dutch (odds are they speak English though, they are based in the Netherlands). I also know of some other people in Belgium with diabetic cats, they may be on caninsuline, or know of others.

Let us know how we can help !!!

Maria & Suzie (we live in Belgium)

 

Dear all,

It's been a long time since I posted to this forum. I wanted to thank you all for your replies and advice! My apparent inactivity was just an absence from the web (very busy at work etc. right now), but that does not mean inactivity in general!

THANK YOU ALL SO MUCH FOR YOUR FANTASTIC ADVICE!
I have made the first steps and transitioned Kuula to wet food only diet. The effect has been absolutely remarkable! After a year of struggle to (unsuccessfully) regulate him, I am finally making progress. His blood sugar levels have changed dramatically with the new diet. For more than a month, he hasn't had a value over 500, and as I continue to make adjustments, also the values over 400 are becoming rarer.

We had a visit to the vet two weeks ago, who was pleased with Kuula's new blood sugar curve - the values were still high, but the huge spikes from 450+ at shooting down to 50 at low points have disappeared, and I can now work on adjusting the amount of food and insulin without living in fear that I am sending him to a hypo. All that thanks to the advice I found here

We had a small setback a few days ago when Kuula developed a bladder problem - difficulty with peeing and lots of blood. A visit to the vet did not confirm crystals in his urine, and at the moment it's not clear whether it's just an infection or possible danger of crystals. That would be very unfortunate because it would mean changing back to urinary food again (of which he only eats dry). I am really really hoping it is just an infection and I can continue with the new food which seems to have done such wonders for his sugar levels. The vet suggested Hill's diabetes diet, so I am playing around with that a bit now, but sadly, sugar values are starting to be more erratic again. I am not sure if it's just a matter of adjustment or a sign that this food is not good for him.

Maria, I am not really sure how to send a PM. Can you perhaps send me one so I can reply to it? I live in Antwerp but am moving to Leuven in a few weeks' time.

Thank you all again, I will now start exploring the forum for more advice and next steps (it's overwhelming when you're new!). I will probably post more questions related to crystals/bladder issues, now I am just waiting how this one pans out.
In any case, Kuula looks lovely, he's lively and happy, and thanks to the weight he lost (due to diabetes), he looks better than ever.

Sarka

 

Blood in the urine is often a sign of cystitis and pain meds should be given. Please do not give antibiotics until you have the results of a c & S test where a culture is grown and identified. We have seen many cats dosed with antibiotics wen all they needed was something mild for pain.

 

Dear Gia,
Thank you very much for that piece of advice, but unfortunately, it's too late. The vet has injected Kuula with a week-lasting shot of antibiotics. She did mention cystitis and gave us food supplements that should hep restore his bladder lining (I think). I must say it did help though, the bleeding and peeing problems stopped within 12 hours. Perhaps I should mention I live in Belgium, THE kingdom of antibiotics, offered as a solution to most health problems in humans as well.
I will keep it in mind for the future though.
Sarka

 

Hi Sarka,

If you do a search here for posts on cystitis by lisadvm you'll get a ton of information about all the urinary tract stuff. We are overdosing our cats (and ourselves) on antibiotics and we are seeing resistant strains of all kinds of nasties popping up because of it. Also look for Dr. Lisa's posts on Convenia. If that's what your cat was given there are risks you should know about.

I've been around here since my cat was diagnosed ten years ago and have picked up more information than any layperson should have. If you have questions about any of this I'll be happy to take a shot at them.

 

Hi Sarka,

Have you read www.catinfo.org? This has excellent info about Feline Nutrition, written by a veterinarian.

It discusses appropriate diet for treating urinary problems amongst other dietary topics.

An important aspect is getting adequate hydration. Many people here add some water to the canned food to increase hydration.

 

Dear Gia and Pheobe,
Thank you both for the information. I have read the catinfo website, that's what i took as a starting point for transitioning Kuula to wet food. Thanks also for the offer to answer questions. The forum is fantastic in the wealth of information it offers, but sometimes it's just too much to take it all in. I spend several days here (literally!), but there's so much here. My first and most immediate problem was the regulation, so I started with food. Now that we are more or less getting the hang of it, I am going to move on to other issues, like proper regulation (so far I am just managing to avoid the hypo's, but still need to lower the sugar levels) and bladder issues.
I will be back with more questions and I am very grateful for all the help and support I am getting here.
Sarka

 

just in case you didn't know, lantus is also called glargine.
really recommend the switch. without calling it an actual "recall", it is recommended that people switch to a different insulin than caninsulin/vetsulin. there have been problems with batches of the stuff.

many cats develop urinary problems from dry food. the cystitis could be helped greatly by stopping all dry food. dry food has its uses, particularly for very sick cats who will not eat otherwise, but it causes/aggravates many health problems.

glad sarka is doing so much better, and totally understand about the overwhelming amount of info here. it's a blessing but does take some time to digest/put into practice particularly when one is stressed about one's cat's health issues.

 

welcome I am sure many people can help you with all the questions you have. I can't help you with insulin since Greylie is diet controiled. Re the urinary question. Greylie had a lot of problems he was on dry urinary food/he hated the wet/ when he became diabetic. I changed him to diabetic wet food and he has not had a problem since then. Maybe it is the fact that he got more water with the wet food. I wish you the best. I know it is not easy but you can come here anytime and ask... mainthing you are not alone. I have found so much help here when my Sophia became diabetic in 2005 any question I had was answered. I am glad you are here.