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Lane&Biddy

Lane&Biddy

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Hello there!

My Biddy was diagnosed with IBD and then Triaditis (treated with Prednisolone, which of course caused his diabetes). We started with Bexacat but due to elevated liver values, discontinued and started Prozinc. I work for the vet clinic and have 100% confidence in the doctors here. That being said, I have been told by members of the fb group that we are increasing his dose too aggressively. How do you know when to trust the professionals and when to listen to others trying to help keep your kitty safe? I just want the best for him but I am being given conflicting advice.
 
LPerry said:
Hello there!

My Biddy was diagnosed with IBD and then Triaditis (treated with Prednisolone, which of course caused his diabetes). We started with Bexacat but due to elevated liver values, discontinued and started Prozinc. I work for the vet clinic and have 100% confidence in the doctors here. That being said, I have been told by members of the fb group that we are increasing his dose too aggressively. How do you know when to trust the professionals and when to listen to others trying to help keep your kitty safe? I just want the best for him but I am being given conflicting advice.
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Welcome to the Forum, you have an amazing advantage working in a vet clinic, we are here to give you support as well, my Corky is also on ProZinc, after 2 years his BG numbers are incredibly stable and low, his pancreas are healing magnificently, thanks to the help of the member is this Forum, I have followed the procedures of ProZinc methods here in this forum, any concerns you may have we are here to help you, one thing I can advise is that as you know diabetic cats need to have a diet between 0-10% carbs, below is a Drs list with many brands to choose from, the third column contains the % of carbs per food, stay away from kibble and treats, even" prescribed kibbles" they contain approximately from 20-30% carbs, here in this forum most of us members enjoy Fancy Feast Pates, it is US regulated, so no waste goes into our precious Fur babies, Is important to home test especially before AMPS/PMPS (shooting time) also I am sending you a carb calculator that can be helpful when you choose the food you are comfortable feeding, I will tag a ProZinc member that can help you with dosing and advise and again Welcome:bighug::cat::cat:
@Suzanne & Darcy
@Bron and Sheba (GA)
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
Cat Food Nutrition Calculator | Elizabeth C Scheyder
 
Hi Lane and Biddy and welcome to the forum.
I am very glad you stopped bexacat when you ran into issues. We have had several cats who have run into problems with the new oral treatments for cats (mostly ketones) and a couple have died.
Yes it can be difficult when you get conflicting advice.
What I would say is it is best to increase in small amounts, not 1 unit amounts. We recommend increasing in 1/4 units, or if the BGs are consistently over 300 then you can go up in 1/2 unit amounts. And we follow dosing methods we have here on the forum.
Well done hometesting the BGs. It can be challenging having an IBD kitty and finding the right food for him.
Have you thought about a home made raw food diet?
Do you give a probiotic?. I use visbiome for cats which is really good for cats with gut issues.

Are you able to get a test in every cycle during the cycles? This tells us how low the dose is taking Biddy and that determines the dose. And the pm cycles are just as important as the am cycles.
Where you have put no shot in the am column for 12/25, can you change that to fur shot please?

I am going to tag @Suzanne & Darcy as she is a ProZinc user and I am not.
 
Thank you for response! I updated my spread sheet, sorry I am new with all the lingo/abbreviations used here! And I will work on getting more mid cycle tests done now that he is comfortable with the process.

Biddy is on Proviable DC capsules for a probiotic and Hill's z/d for his diet. I am very hesitant to switch his food because any changes really upsets his stomach and this is the only food that has not given him explosive diarrhea and anal gland issues. He is actually having solid stools for the first time since 2021!

He's been on 3 units for over a week now and I am now understanding this is pretty high for being newly diagnosed. How should I proceed with dosing? Stick with 3 units or taper back down?
 
Communication and a good relationship with the vet is key. You'll get different opinions and advice from any cat diabetes group and board online. Discuss the online info with your vet to come up with a plan on how to proceed with your cat and his particular needs. I'm in contact with my vet daily via his secretary for my cat's various issues and any issue I have with the rest of the zoo. My vet trusts my judgement on adjusting insulin dose and treating minor issues at home.

Have you seen this web site for IBD? https://www.ibdkitties.net/ There's lots of good info there.
 
LPerry said:
updated my spread sheet, sorry I am new with all the lingo/abbreviations used here
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Don’t be sorry. We were all new once. We rely on the spreadsheet and data a lot, so seeing a ‘no shot’ in a column is different to a ‘fur shot’. When I first looked at it I wondered why you didn’t give a shot, then I saw in the remarks column you had given a fur shot. So it made sense. And you would be surprised at how much of a fur shot actually gets in sometimes.

Please try the visbiome probiotic. It made a huge difference to one of my cats with gut issues.

LPerry said:
Hill's z/d for his diet. I am very hesitant to switch his food because any changes really upsets his stomach and this is the only food that has not given him explosive diarrhea and anal gland issues. He is actually having solid stools for the first time since 2021!
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Are you feeding wet or dry food? Both are high carb. The Hills Z/D is 40% carbs for both wet and dry according to the site I looked up, so you are going to need a higher dose of insulin than if you were feeding a low carb diet. But you will need to reach that gradually and safely.
Have you joined the IBD Facebook page? They are very good and may have some ideas how to help with diet.
LPerry said:
He's been on 3 units for over a week now and I am now understanding this is pretty high for being newly diagnosed. How should I proceed with dosing? Stick with 3 units or taper back down?
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You would definitely not taper back down. A cat needs as much insulin as it needs. Some cats only need a tiny amount and others need a lot more. Every cat is different. And we know you are feeding a high carb diet so Biddy is going to need more insulin than he would need if he was on a lower carb diet.
I would wait until Suzanne comes along to help you with dosing. The 3 unit is getting him down in to blue BGs so that is good so he is progressing.
 
Welcome to FDMB.

In looking at Biddy's spreadsheet, I don't think you are increasing the dose too frequently. Based on how we approach dosing, like Bron noted, we increase in smaller amounts. The rationale for the small (0.25u) increases is so you don't sail past what would be an effective dose for your cat. Just out of curiosity, are you dosing using a pen or are you using a syringe?

I think those of us who have IBD cats all have a favorite website. My favorite is Raw Feeding for IBD Cats. They have great information on supplements to address problems like diarrhea and vomiting that are common with IBD. Had you ever tried a novel protein diet for Biddy? I think it could be difficult to get Biddy into better blood glucose values if you're feeding her a diet that is high in carbs. It may be a topic to discuss with your vet. There are clearly trade offs. I'll own my bias in that vets are often "educated" about nutrition by the pet food manufacturer's marketing representatives. Not all that long ago, the manufacturers lost a class action lawsuit over calling their food "prescription." The majority of the prescription foods have nothing prescriptive about them. For example, the dry diabetic foods are often very high in carbs. Regardless of what you decide, you are clearly weighing the options. The good news is that diet may interfere with remission but the insulin dose can be increased in order to get your cat into better numbers.

I'm linking the information on our dosing guidelines for Prozinc. This will give you a starting point so you have information on how we approach dosing.

Please let us know if you have questions. We're here to help.
 
Hi there. You certainly are dealing with some problems. I also have a cat with IBD (surgical biopsy performed) here and I haven’t yet found a diet to help him. Every time I try to reduce his Prednisolone dose as I am supposed to, he starts vomiting again. I haven’t tried the Z/D yet, although it was recommended by my vet. I didn’t like the ingredients. He is FIV+ so I do not feed raw. He isn’t diabetic, but he is still on a high dose of prednisolone so I am feeding low carb. Anyway, this isn’t about me… I just wanted you to know that I understand the food issues. I do not think you should reduce the insulin dose at this time. You have held the dose long enough for us to see if he were being overdosed and he is not. I would not have recommended increasing by whole units at this point in his journey, but don’t go back down unless he drops low enough to earn a reduction. I actually think you could increase by .25 units at this point. You have seen some blue numbers and that is very good. You have held the 3 unit dose long enough and you have gotten some curve data that is very informative. What will your schedule be like for the next few days/over the weekend? Will you be able to test some in the mid-cycle?
 
Suzanne & Darcy said:
Hi there. You certainly are dealing with some problems. I also have a cat with IBD (surgical biopsy performed) here and I haven’t yet found a diet to help him. Every time I try to reduce his Prednisolone dose as I am supposed to, he starts vomiting again. I haven’t tried the Z/D yet, although it was recommended by my vet. I didn’t like the ingredients. He is FIV+ so I do not feed raw. He isn’t diabetic, but he is still on a high dose of prednisolone so I am feeding low carb. Anyway, this isn’t about me… I just wanted you to know that I understand the food issues. I do not think you should reduce the insulin dose at this time. You have held the dose long enough for us to see if he were being overdosed and he is not. I would not have recommended increasing by whole units at this point in his journey, but don’t go back down unless he drops low enough to earn a reduction. I actually think you could increase by .25 units at this point. You have seen some blue numbers and that is very good. You have held the 3 unit dose long enough and you have gotten some curve data that is very informative. What will your schedule be like for the next few days/over the weekend? Will you be able to test some in the mid-cycle?
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Thank you for your support. I appreciate knowing someone is going through similar issues. I will work on getting more mid cycle testing done this weekend.
 
LPerry said:
Thank you for your response! I am dosing with a syringe and will do some research on a raw diet.
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Just to confirm, you are using U-40 syringes, correct? And do they have half unit markings to make it easier to do the doses that fall between the half and full unit marks?
 
Suzanne & Darcy said:
Just to confirm, you are using U-40 syringes, correct? And do they have half unit markings to make it easier to do the doses that fall between the half and full unit marks?
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I believe a here are the ones Suzanne is talking about, these are the ones I use for ProZinc

upload_2024-12-27_19-38-25.png
 

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LPerry said:
Yes I use U-40 syringes but they do not have half unit markings.
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The 1/2 unit markings are important for .25 units or small doses you want to make sure you give the correct one without having to guess at it, no more no less as you can see on the photo the markings are quite precise :bighug::bighug::cat::cat:
 
Perhaps you missed this - what I wrote above in post #12?


I’m glad you have been getting some blue nadirs! That’s good. I think you can increase to 3.25 units.
 
Oh. Your signature doesn’t mention prednisolone. Your signature should list any medications and dose and frequency given. That way when we look at your situation and spreadsheet to make recommendations, we are fully informed.

How much pred does he take (mg) and how frequently does he take it? What is he taking it for? The Triaditis?

And yes, if you are actually cutting his dose down now (today ?) that could lower BG so it’s best to make the transition to a lower dose and not raise the dose of insulin at the same time. Hopefully it is successful and his BG will go down some and insulin dosing decisions can be made then.
 
Suzanne & Darcy said:
Oh. Your signature doesn’t mention prednisolone. Your signature should list any medications and dose and frequency given. That way when we look at your situation and spreadsheet to make recommendations, we are fully informed.

How much pred does he take (mg) and how frequently does he take it? What is he taking it for? The Triaditis?

And yes, if you are actually cutting his dose down now (today ?) that could lower BG so it’s best to make the transition to a lower dose and not raise the dose of insulin at the same time. Hopefully it is successful and his BG will go down some and insulin dosing decisions can be made then.
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Oh I will get my signature updated! He is on pred for his triaditis. 10mg BID but Monday will cut back to 10mg AM and 5mg PM. Tried to taper to 5mg BID but that did not work out for us.
 
LPerry said:
Oh I will get my signature updated! He is on pred for his triaditis. 10mg BID but Monday will cut back to 10mg AM and 5mg PM. Tried to taper to 5mg BID but that did not work out for us.
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I am sure you want your Biddy to get better and healthy as soon as possible, my suggestion, is to let go, step back breath in and breath out, trust is the main thing:bighug::bighug::cat::cat:
 
LPerry said:
Oh I will get my signature updated! He is on pred for his triaditis. 10mg BID but Monday will cut back to 10mg AM and 5mg PM. Tried to taper to 5mg BID but that did not work out for us.
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It sometimes takes a long time before you can taper the Pred. My one IBD boy who had the biopsy September 23 was on 10 mg BID for one month and we tried to decrease it to 10 mg once a day after the 30 days. No way. He started vomiting again every single day. Back we went to 10 mg. BID for a couple more weeks. Tried once a day again and he started vomiting all his food again. Back up to 10 mg twice daily again. So after two full months on the 20 mg per day split a.m. and p.m. I cut his dose of Pred back to 10 mg daily. So far he is doing all right (knock on wood.). I hope to eventually be able to cut it down to 5 mg/day and then maybe 5 mg. every other day! I can hope. I have another cat with IBD who does all right on the 5 mg per EOD dose, although I was not able to reduce it that much until he started on Visbiome Vet and was on it for about 4-6 weeks.
 
Lane&Biddy said:
Yes 1 1/2 cans z/d and 1/4 cup HP
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What is HP? Sorry.

Anyway, even with the Prednisolone reduction, you have plenty of room to increase the dose. You should go ahead and increase to 3.25 units.

How is he now with the reduced pred? How are his clinical signs and behavior?
 
Suzanne & Darcy said:
What is HP? Sorry.

Anyway, even with the Prednisolone reduction, you have plenty of room to increase the dose. You should go ahead and increase to 3.25 units.

How is he now with the reduced pred? How are his clinical signs and behavior?
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Royal canin hydrolized protein. Will do thank you!
 
Lane&Biddy said:
Royal canin hydrolized protein. Will do thank you!
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Oh right. That’s a dry, right? Because I was told by my vet that Z/D was the only one that made a wet food. Although I looked at the ingredients and was disgusted by them (the wet z/d) so I have never fed it to him. Chicken liver is the only animal protein in there for one thing. And if it’s really that high carb I won’t feed it to him anyway. Between the food and hisPred, I would be afraid of diabetes.
 
Suzanne & Darcy said:
Oh right. That’s a dry, right? Because I was told by my vet that Z/D was the only one that made a wet food. Although I looked at the ingredients and was disgusted by them (the wet z/d) so I have never fed it to him. Chicken liver is the only animal protein in there for one thing. And if it’s really that high carb I won’t feed it to him anyway. Between the food and hisPred, I would be afraid of diabetes.
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I know you recommend Visbiome but I had a Probiable KP kit from before he was diabetic and I’m afraid that is the culprit!

Gelatin, fructooligosaccharide, gum arabic, dried Enterococcus faecium fermentation product, maltodextrin, dried Bifidobacterium bifidumfermentation product, dried Streptococcus thermophilus fermentation product, dried Lactobacillus helveticus fermentation product, dried Lactobacillus delbrueckii fermentation product, dried Lactobacillus casei fermentation product, dried Lactobacillus plantarum fermentation product, magnesium stearate, titanium dioxide, and ascorbic acid.
 
I have used Proviable before in my cats. Are you thinking it’s caused the BG to go higher? I tried to find some information on this and this is what I found.
Abstract
Purpose: To identify the current status of scientific knowledge in fructo-oligosaccharides (FOS), non-conventional sugars that play an important role in glycemia control.

Methods: We performed a search for scientific articles in MEDLINE and LILACS databases, from January 1962 to December 2011, using English/Portuguese key words: "blood glucose/glicemia", "prebiotics/prebióticos" and "dietary fiber/fibras na dieta". From an initial number of 434 references, some repeated, 43 references published from 1962 to 2011 were included in this study. The selected texts were distributed in three topics: (1) metabolism of FOS, (2) FOS and experimental studies involving glucose and (3) human studies involving glucose and FOS.

Results: Five studies have shown that the use of FOS reduces the fecal content and increases intestinal transit time. Experimental studies have shown that dietary supplementation with high doses (60 g/Kg) of propionate, a short-chain fatty acid decreased glycemia. The use of lower doses (3 g/kg) did not produce the same results. Study in subjects with diabetes type II showed that the addition of 8 grams of FOS in the diet for 14 days, caused a reduction in serum glucose. In another study with healthy subjects, there were no changes in glycemic control.

Conclusions: This review demonstrates that consumption of FOS has a beneficial influence on glucose metabolism. The controversies appear to be due to inadequate methodological designs and/or the small number of individuals included in some studies.

PubMed Disclaimer
 
Suzanne & Darcy said:
I have used Proviable before in my cats. Are you thinking it’s caused the BG to go higher? I tried to find some information on this and this is what I found.
Abstract
Purpose: To identify the current status of scientific knowledge in fructo-oligosaccharides (FOS), non-conventional sugars that play an important role in glycemia control.

Methods: We performed a search for scientific articles in MEDLINE and LILACS databases, from January 1962 to December 2011, using English/Portuguese key words: "blood glucose/glicemia", "prebiotics/prebióticos" and "dietary fiber/fibras na dieta". From an initial number of 434 references, some repeated, 43 references published from 1962 to 2011 were included in this study. The selected texts were distributed in three topics: (1) metabolism of FOS, (2) FOS and experimental studies involving glucose and (3) human studies involving glucose and FOS.

Results: Five studies have shown that the use of FOS reduces the fecal content and increases intestinal transit time. Experimental studies have shown that dietary supplementation with high doses (60 g/Kg) of propionate, a short-chain fatty acid decreased glycemia. The use of lower doses (3 g/kg) did not produce the same results. Study in subjects with diabetes type II showed that the addition of 8 grams of FOS in the diet for 14 days, caused a reduction in serum glucose. In another study with healthy subjects, there were no changes in glycemic control.

Conclusions: This review demonstrates that consumption of FOS has a beneficial influence on glucose metabolism. The controversies appear to be due to inadequate methodological designs and/or the small number of individuals included in some studies.

PubMed Disclaimer
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Oh thank you. I was so convinced I had done something wrong and gave him something harmful!
 
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