'Re'-Introduction & Seeking Advice on Bambi’s Diabetes & Kidney Issues

[Caglar and Bambi]

Hello everyone,

It’s been quite a while since I was active here, over 1.5 years, but I wanted to reach out again for advice. My cat, Bambi, was diagnosed with diabetes in early 2023, and thanks to the support and knowledge from this forum, I was able to get her diabetes under control.

In June 2023, although I hadn’t fully completed the TR protocol (I was very close), I made the decision to take her OTJ slightly earlier than recommended. The main reason was that I was unable to consistently find wet food below 7% carbs, which made it difficult to strictly follow the protocol. The best options available to me were in the 8–10% range, and while this resulted in slightly higher but stable BG levels, I reasoned that it was due to the slightly higher carb content rather than an underlying issue. Since then, I have continued monitoring her BG levels daily—twice a day before meals—though I haven’t done full-spectrum curves every two weeks.

Now, I’m facing a new challenge. Although her BG levels have remained stable for the past year, recent bloodwork from a vet visit has revealed signs of kidney problems, along with other concerning issues. While I’ve become quite familiar with feline diabetes over my time in this forum, I have little to no knowledge about kidney disease and what this means for her care.

I explained Bambi’s full history to my vet, including how I managed her diabetes. As expected, the vet has a different perspective on nutrition, believing that the brands I’ve been using lack essential nutrients and could have contributed to her health issues. My primary low-carb food source (a boutique brand, ~10% carbs) unfortunately shut down six months ago, leaving me with Purina Felix (Cow & Chicken in Gel, ~8% carbs) as her main food since then. Based on what he knows to be best for kidney health, he recommended switching to a kidney-support diet and suggested this food: Virbac Cat Advanced Kidney & Joint Support KJ3

I tried calculating the carbs (though I’m unsure due to missing ash content) and estimated them to be around 25–35%. The product page also states "Energy from Carbohydrate: 29%," which I assume means the same thing.

I’m completely unsure of what to do next. From what I understand, kidney diets tend to be high in carbs, and I worry that switching Bambi to this food would mean needing to restart insulin. However, I don’t know what alternatives I have. It also seems that kidney-support foods are mostly prescription-based and difficult to find commercially, further limiting my options. Should I start her on this food and resume insulin? Are there better dietary options that balance both kidney and diabetes management? What should I be focusing on in her bloodwork, and are there any other critical factors I should be aware of?

You can see her recent bloodwork and updated spreadsheet here:

• Bloodwork
• Spreadsheet (Also in signature)

Since I had to input 1.5 years' worth of data in just two days, there may be slight inaccuracies in earlier entries, but I made sure the last six months are as precise as possible. I also have handwritten notes on food and other details, which I can provide if needed. Additionally, she recently had an infected, loose tooth extracted, which has healed well. For her dental care, I’ve been giving her malt paste, taurine paste, and a dental spray as per my vet’s advice.

I really appreciate any help or guidance you can provide. It’s already been nearly a week since the test results came back, and I don’t want to delay the necessary treatment any longer.

Thank you in advance!

 

[Bron and Sheba (GA)]

It looks like you are not giving any insulin at the moment. Is that correct?
Some of those BGs are creeping up a bit and you may need a drop of insulin to get them back down to green BGs.

I couldn’t see the phosphorus level in the results unless I am missing seeing them.
What stage CRD did the vet say Bambi was?

I disagree with your vet who says prescription food has more nutrients than ordinary canned cat food. There is nothing special about prescription food and I would not feed it to my cats. And the carb content is high and the protein level is low for their foods for CRD cats, which is now thought to be not a good thing for CRD cats except in advanced cases. Most likely the best food for your kitty would be a low phosphorus food which still has a high protein content. Have a look in the FOOD CHART and under phosphorus levels have a look for foods that have 250 or 200 mg/100kcals of phosphorus or less.
Weruva brand has a range of low phosphorus foods which are suitable

You may find this thread interesting https://www.felinediabetes.com/FDMB/threads/home-prepared-diet-of-crd-cats.150441/

And have you read this TANYA’s guide to CRD cats

 

[Diane Tyler's Mom GA]

@Caglar and Bambi
I don't know if you can get Weruva wet food in Turkey but if you can
low carb/ low phosphorus for diabetic cats
if you tap on this link and look at post #32 I listed some Weruva pates for another member that's low carb/ low phosphorus.
https://felinediabetes.com/FDMB/threads/new-member-11-8-and-i-am-tired.283363/#post-3124085

 

[Caglar and Bambi]

It looks like you are not giving any insulin at the moment. Is that correct?
Some of those BGs are creeping up a bit and you may need a drop of insulin to get them back down to green BGs.

That’s correct, but please take a quick look at her 2024 sheet as well - this has been the case for about 1.5 years without insulin. Her BG levels are slightly higher than the ideal for the TR protocol, but they have remained stable. As I mentioned, I believe this is due to the slightly higher carb content (8–10%) of the wet food I’ve been able to source, as sustainable options below 7% have been hard to find.
The vet says that determining whether a cat is diabetic should be based on Fructosamine levels rather than individual BG readings. Since this requires an external lab test, I haven’t had it done yet.

I couldn’t see the phosphorus level in the results unless I am missing seeing them.
What stage CRD did the vet say Bambi was?

I’m not very familiar with bloodwork values, but I’ll ask the vet and follow up. He didn’t specify the stage, but the food he prescribed seems to be for Stage 3 (Advanced).

I disagree with your vet who says prescription food has more nutrients than ordinary canned cat food. There is nothing special about prescription food and I would not feed it to my cats. And the carb content is high and the protein level is low for their foods for CRD cats, which is now thought to be not a good thing for CRD cats except in advanced cases. Most likely the best food for your kitty would be a low phosphorus food which still has a high protein content. Have a look in the FOOD CHART and under phosphorus levels have a look for foods that have 250 or 200 mg/100kcals of phosphorus or less.
Weruva brand has a range of low phosphorus foods which are suitable

As I mentioned, I also believe in a fully low-carb wet food diet, both from my experience with Bambi’s recovery and the knowledge I’ve gained from this forum. However, as you can imagine, my vet and I have different perspectives on this. Nearly every vet I’ve spoken to has a different stance, which makes these discussions difficult.
I’ve strictly followed a low-carb diet for Bambi since joining the forum, and I even transitioned my other healthy cat to a 50/50 wet and dry diet. However, kidney disease is entirely new territory for me, and I’m struggling with what steps to take.
I’ve already gone through the food chart extensively in the past, but unfortunately, most of the listed brands aren’t available where I am. We don’t have Weruva here, and I’ve even been waiting a long time for Fancy Feast to become available. I had to put together my own list of possible options, which you can find here: https://docs.google.com/spreadsheets/d/1XrUc__zYmbGhJIiKa60oP66WsGVQioGBrZeFgube09U/edit?gid=0#gid=0

You may find this thread interesting https://www.felinediabetes.com/FDMB/threads/home-prepared-diet-of-crd-cats.150441/

Yes, I’ll look into home-prepared diets, but it’s not something I can implement quickly. It would take a lot of research, preparation, and adjustments before I could fully transition her. For now, I need a more immediate solution.

And have you read this TANYA’s guide to CRD cats

Yes, I became a member about four months ago, just before I lost my other (third) cat. I’ve started reading through the resources, but it’s a lot to take in, and I still need time to fully understand everything. I’ll definitely continue learning from it.

 

[Caglar and Bambi]

I don't know if you can get Weruva wet food in Turkey but if you can
low carb/ low phosphorus for diabetic cats
if you tap on this link and look at post #32 I listed some Weruva pates for another member that's low carb/ low phosphorus.
https://felinediabetes.com/FDMB/threads/new-member-11-8-and-i-am-tired.283363/#post-3124085

Thanks for the suggestion, @Diane Tyler's Mom GA. Unfortunately, Weruva isn’t available here. We have very few options, and finding suitable alternatives has been a challenge. I’ll keep searching, but the choices remain quite limited.

 

[Caglar and Bambi]

Update: Just to clear up any misunderstanding, my vet confirmed that she doesn’t have CKD, but her values are higher than they should be and require attention and intervention. He didn’t check phosphorus levels, as that would need to be sent to an external lab. Apologies if I misrepresented anything - it’s simply because I’m still getting familiar with all of this.
Btw, I’ve seen quite a few vets before, and this one is the most knowledgeable and reliable—I trust him a lot. On a positive note, he’s also looking into options for high-protein, low-phosphorus wet food.
I truly appreciate all the help so far and would be grateful for any further suggestions. @Diane Tyler's Mom GA @Bron and Sheba (GA)

 

[Bron and Sheba (GA)]

The vet says that determining whether a cat is diabetic should be based on Fructosamine levels rather than individual BG readings. Since this requires an external lab test, I haven’t had it done yet.

The fructosamine test is a good test to do at diagnosis to see if your cat has diabetes, but once you are hometesting the fructosamine test becomes redundant. The fructosamine test is an average of the past couple of weeks BGs. Doesn’t show the highs and lows, just the average.
Once a cat has been diagnosed with diabetes, it is always a diabetic. If it goes into remission it is a diet controlled diabetic…that is still a diabetic.

 

[Caglar and Bambi]

The fructosamine test is a good test to do at diagnosis to see if your cat has diabetes, but once you are hometesting the fructosamine test becomes redundant. The fructosamine test is an average of the past couple of weeks BGs. Doesn’t show the highs and lows, just the average.
Once a cat has been diagnosed with diabetes, it is always a diabetic. If it goes into remission it is a diet controlled diabetic…that is still a diabetic.

Got it, that’s what I also recalled, just needed confirmation. My last vet - well, actually his new vet partner - was likely just making a general point since she doesn’t know Bambi’s full history (though I did explain it to her). In my conversation today, I made sure to emphasize that Bambi is diabetic and that if she were to get too many carbs, she’d end up back on insulin. He’ll take that into account while researching treatment and feeding options. Thanks for your input @Bron and Sheba (GA)