So many questions ...

Our Trixie is a senior cat (13.5 yo) that was diagnosed on 12/18/17 with diabetes and chronic kidney disease. Currently, we are only focusing on the diabetes and will address the kidney issues once we get the diabetes under control. She receive 2 units of Vetsulin twice a day. When we are successful at testing her BG (she hates it), we are using a ReliOn Prime meter. Her food has been all over the place and is my main concern at the moment. She has been a dry food, free-feed, kitty her whole life, up until this point.

At the vets advice, we started her on Purina DM savory selects. I thought she would LOVE getting canned food, but she was just licking the gravy and not eating the meat. In an effort to make sure she was getting enough calories, the vet switched her to Royal Canin Glycobalance dry food on Friday, 12/22 (the other food she had readily available). The first few meals, she ate it right up, but then when we had company over on Christmas Eve, she was feeling shy and would not come out to eat. I mixed 1/3 can on Beyond, grain free, with the kibble bits and that was enticing enough for her to come eat. Now, if we try to go back to just the dry food, she isn't very interested in it.

My vet seems to only be interested in feeding her Vet prescription food. From everything I have read, this does not seem necessary or even in her best interest. Do I try to change her mind or just ignore her dietary directives?

How do I know what to feed her? If I am going to go against the advice of the professional on this, I'd really like to feel confident in what I am choosing, but I am so confused, it is ridiculous. I see a lot of comments about fancy feast classics ... is that much better for Trixie than the Purina DM or just less costly? Is the Beyond canned food also a good choice or inferior to the FF classic? The only reason we had the Beyond food available is because I wanted to test the texture of the pate type wet food before switching to the Purina DM original pate (which was the vets 1st choice, but unavailable in her office at the time).

How do I know how much to feed her? The vet gave us a print out at her diagnosis appointment that said she needed to eat 315 calories a day to maintain her weight (11.6 lbs.), but then advised to only feed her 1 can of the Purina DM savory selects per day (171 calories). When I questioned the calorie deficit, she said we wanted Trixie to lose weight. When I asked what her ideal weight would be, she said 10.5 - 11.5 pounds. Feeding her only 54% of her required calorie intake seems like an extreme weight loss program to lose 1 lb.

How often should we be trying to test her BG? So far, we haven't gotten any guidance on this from the vet other than to say we would do a glucose curve (at home) at some point.

Trixie is NOT a social kitty. Her favorite place to be is upstairs and left alone. All of this pricking and poking and extra attention between the pricks and pokes, so she doesn't expect pain at every encounter, is causing her to spend more time under my son's bed than anywhere else... making it harder to do everything.

Finally, I have seen some very fancy spreadsheets in the signatures of members here. Where so I find that? The one place I thought I had found it, only had broken links.

Sorry for the long vent ... just a newbie feeling very overwhelmed with all of this new information and the niggling annoyance in the back of my head knowing that I will have to readjust everything eventually for her kidney issues.

 

Vet's always push the 'prescription' foods, but those are not the best option. They are too high in carbs, and some of the other ingredients are not ideal either. A lot of people do feed Fancy Feast Classic pates, but watch the phosphorous in them. I think they tend to run a little higher than is ideal for a cat with kidney issues. There is a cat food database that is very helpful when looking for foods to try. You can filter the results based on your desired criteria. The vet who created it, Dr Lisa Pierson, suggests, "I usually like to start with protein minimum of 40, fat maximum of 50, carb max of 10, and for cats with kidney issues....phos less than 300." Keep the carbs at least under 10%, but lower is better (I try to stay under 5%). Of course, finding choices your cat will actually eat is always the fun part. Wet food is absolutely the best option. If you need a dry food, check out Young Again Zero Mature. It does not have the carbs the other dry foods do. ** Important note: if you are going to change your cat's food to one that is much lower in carbs, you will want to monitor her glucose very carefully since the change in diet alone can reduce her glucose levels.**

There are formulas available for how many calories to feed based on the cat's ideal weight. I think you are right that the vet's approach sounds extreme. I do not know the formula's off the top of my head, but others may provide that for you. I do know that the AAHA guidelines say that it is ideal to feed four times per day (using an auto-feeder, if needed). I am not sure if your vet told you you can only feed twice a day or not, a lot of them say that.

You will want to do a glucose test before every insulin shot to make sure her level is high enough to warrant the insulin dose. Make sure Trixie does not have access to food two hours before the pre-shot test so that her results will be impacted by food. Once you do the test, you will want to feed her then give the insulin shot. It is also important to get mid-cycle tests when you can since those tell you what impact the insulin dose is having.

Here is a link to instructions for setting up the 'fancy spreadsheet': http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

I hope this helps. Others will jump in with more.

 

That's not a vent, sounds rational to me. Why does your vet want her to lose weight? Is she obese? I find gaining weight back is just as hard as losing it.

 

One more thing I wanted to comment on but forgot.. if possible, try to develop a steady testing routine that has positive elements to it. For example, try to always do it in the same spot and to always give her a special treat. Giving lots of love and sweet talk can help, too. Some people even sing through it (I think that is more to calm themselves than the cat). As you become better at it and can do it more efficiently (and with less stress), it will be less stressful for her. When I first started testing, it was a nightmare, but it quickly became routine. Now, Mia goes and jumps up in her tower (our testing spot) and sticks her little ear toward me to let me do the test, then gobbles up her treat.

 

Weruva bff canned food (not the Pouches ) is both low in carb and low in phosphorus for the CKD.

 

I was in the same boat as you a few weeks ago. I knew nothing and my vet wasn't too knowledgeable about FD. This forum has saved my cat's and my life. Listen to the people on this forum. They know more about FD than a vet. I changed my cat to wet canned food and his numbers went down drastically. I can't say it enough, please get your cat on wet food. My cat still is having a hard time transitioning from dry to wet. Do not listen to the vet and food. Mine tried to get me to get the prescription but it is too high in carbs.