Combating Diabetes and Pancreatitis

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Beanie071, Jan 23, 2021.

  1. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    Hi I am new to the board, and I have been through the ringer with my cat Hurley who is 8 years old. He was diagnosed with diabetes in september of 2020 and diagnosed with pancreatitis in november 2020. He has been up and down with his glucose levels and I have had multiple opinions that's he is not text book and just may be a cat that has higher glucose levels. Although his pancreatitis is making it hard to regulate him it's hard to maintain him on a diet that will work for him. He is been on Hills Science ID for the pancreatitis, but was just switched back to Hills Science MD for the diabetes which I think has flared up his pancreatitis again. Are there and diet options that help with both? He only eats wet food no dry at all. Please need some help. Thanks
     
  2. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Not knowing what information you have on pancreatitis, this is a Primer on Pancreatitis that one of our members put together.

    There really isn't a "recommended" diet for a cat with pancreatitis. The issues with diet were changed years ago. Idexx had put together a panel of vets who discussed pancreatitis and they noted that the diet restrictions were old school. As far as a canned food diet for feline diabetes (FD), the key issue is the amount of carbohydrates in the food. You want to keep the carbs below 10% although most of the people here use foods that are around 5%, This is a link to a website on feline nutrition that is authored by a vet (Lisa Pierson, DVM) who has put a great deal of time an energy into understanding what is beneficial to a cat's diet. It's great that you're already feeding your cat a canned food diet! There's also a chart of canned foods and their nutritional information, including the carb content, on her site (the link is on the menu on the right side of the page -- and I linked it).

    Most cats aren't happy with Science Diet. The ingredients are not the best. The "prescription" diets are really not prescription -- there's nothing in them that requires a prescription. It was a marketing gimmick. There are much better quality foods that are available at the same or lower price than the prescription stuff.

    If you're not already home testing, if you are going to switch to a lower carb food, you will want to home test.. The only way to keep a diabetic cat that's receiving insulin safe is to home test. You do not need your vet's permission to home test. Many of the members here purchase their glucometer at Walmart -- they use the Relion brand meter. It's strips are among the least expensive available. We have lots of resources on home testing.

    Please let us know how we can help.
     
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  3. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    Yes I am home testing. I learned how to apply the Libre Free Styles 14 day sensor so I use that and in between breaks of the sensor I use the alpha trak and I have another back up reader. While he goes through his crazy ups and downs I like to use the sensor cause he can go really high and then drop super low, so I like to keep a continuous monitor on him in case he needs a boost. I also administer him with lantus twice a day. I have been doing alot of research on high protein and low carb diets. I was trying to see if anyone else has had some actual experience with anything. I've been finding in alot of these high protein/low carb/grain free that they add supplements like glucosamine and gluconate which I am assuming would not be ideal for a diabetic cat.
     
  4. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    How are you treating the pancreatitis? Max had chronic pancreatitis for a few years before becoming diabetic. It’s very common unfortunately but I was able to get him tightly controlled. If you want a food without unnecessary additives a raw diet is good or you can make your own. It would be great if you would set up a spreadsheet and tell us what meds he’s taking.
     
  5. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    I was given instructions to do a diet change from the Hills Science ID to help settle his pancreas and to continue with a 3unit dose of Lantus. My second opinion vet has switched him back to Hills Science MD, but now his BG values are all over the place, he is not benefiting from either food at this point. So I'm trying to get some other input on what others have experienced with their own fur babies that have been battling with both diabetes and pancreatitis.
     
  6. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Hurley sure is a handsome boy! It looks like the Hill's M/D is what we'd consider high carb, their website has it as 15% dry matter basis. As Sienne mentioned, feeding canned food under 10% seems to work the best for most diabetic cats that we have here on the forum.

    If you'd like some help assessing Lantus dosing, and you'd like to share some of your test data, we would be happy to help take a look, just to give you perhaps a different perspective. 3u may or may not be a good dose, depending on what kind of numbers you are seeing. If I may ask, what is your feeding schedule like with Hurley currently?
     
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  7. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    Well he is now on 2.5 since he has been on back on the MD, it's not necessarily the insulin dosage that I'm concerned with right now. There is nothing consistent about his BG values, I feel like until we can get a good diet for him and his pancreas isn't all over the place the insulin dosage can be reevaluated. He is on a 12 hour schedule he eats at 5 am/pm and is finished by 5:30am/pm and I do a BG test and insulin dosage at 6 am/pm.
     
  8. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Ok, I asked about the feeding schedule because I found with my cat, who has used Lantus in the past and is now on Levemir, that feeding some smaller snacks during each cycle actually tends to keep him from dropping. This post gives some more info on how to use food to manipulate the curve: https://www.felinediabetes.com/FDMB/threads/8-10-tashie-pmps-high-questions.101989/#post-1087990

    With my cat, when he was on Lantus, if I saw a sharp drop by +1 or +2, I'd feed a small snack, depending on the drop, sometimes a little higher carb to try and flatten him out a little. And if the numbers continued to drop, I'd feed a little more, until he reached nadir (lowest point in the cycle). it is a bit of an experiment with food and when to feed, but might me worth trying if as you say, he is really getting inconsistent BG values.

    I appreciate your concern about pancreatitis, from what I understand it can be painful, has the vet prescribed any pain meds? Addressing the pain may help bring the BG levels down. Again, not sure what values you are getting, but the primer on pancreatitis that was shared in post #2 really has some good info.

    With Lantus we tend to test, feed, and shoot all within 10-15 minutes. The BG tests you are seeing after 1 hour and before shot, will be likely influenced by food.
     
  9. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
     
  10. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    I have consider small meals, but until I find the right diet choice I dont feel like that would be beneficial right now. I have gotten plenty of negative view on the hills science, but no real opinions on a another diet choice, and that is my main concern. He is not on any other medicine besides the insulin his values are literally all over the place one day he could range from 250-40 and the next day he is ranging from 600-350. I am specifically looking for recommendations on a diet that would help the pancreatitis but also be beneficial to a diabetic cat. Like I said previously I have been researching high protein low carb diets, but alot of those formulas have glucosamine and gluconate supplements in them. I dont wanna change to much at the same time and I think the first step is to find an appropriate diet.
     
  11. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    I didn't give you a negative review of Hills, I just mentioned that it was higher carb. In many cases, no matter what we want, choice of diet depends on the cat, and sometimes what he wants to eat. Good luck in your search, I hope you find something that works for Hurley. If he is currently having a pancreatitis flare up, you may want to ask your vet about pain meds.

    Just an observation, I noticed that you mentioned a day range of 250-40. 40 is getting down there if that was on your Libre, and very low if that was AT2. That would indicate too much insulin. If you want help with dosing, just let us know. I have to go and poke my cat now :)
     
  12. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    Well I didnt mean you were giving a negative review, but that it's being suggested it's not necessarily they best and that's why I was really hoping someone would give me some other diet suggestions.

    As for him dropping to 40s yes it was low and, but I tested him before his dose and he was in the 300s and he just plummeted with in a few hours and for no reason got him to drop that low. I solely think his pancreas is pumping and dumping insulin irregularly and until I can find the solution to make his pancreas happy he will never get regulated. Vets tend to push prescription diets and I was really hoping some one who has had a pet that's suffers from both would have some diet recommendations. I of course appreciate any other advice, but I feel like it first needs to start with a happy diet and then adjustments can be made to his insulin. The only factor that has change in his treatment has been his diet.
     
  13. Christie & Maverick

    Christie & Maverick Well-Known Member

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    Aug 1, 2017
    Yes, I see your point, it is possible that his pancreas is sputtering occasionally. He is still early in his diagnosis. I guess from my perspective, if there really isn't anything available in terms of a diet that is made solely to keep Mr. Pancreas happy, which by the sounds of it, there isn't. From what I understand, pancreatitis often has no known cause. I'd turn my attention to trying to manage what I could control, which is the diabetes, and the insulin.

    I do believe you can change that factor in his treatment. Lantus is a hormone, not a drug, so you have to expect that you may see variance in his BG levels, which may have nothing to do with whether his pancreas still has some reduced function. It may be that the fluctuations you are seeing are as a result of dropping too low ie . 40, which may cause his system to dump extra stored sugar, and that results in higher numbers for a few days. Just some more things for you to consider.
     
    Last edited: Jan 23, 2021
  14. tiffmaxee

    tiffmaxee Well-Known Member

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    Nov 15, 2013
    I never gave Max RX food except when he was on Hills CD because he blocked when he was 5. When he had pancreatitis flares he became inappetent. My vet said feed small amounts frequently as eating too much would be painful. I didn’t realize his being picky was nausea. He got ondansetron, a human drug for nausea. Other use cerenia if vomiting. I switched him for fancy feast pates, low carb, when diagnosed with diabetes. Have a look at our primer for pancreatitis.
     
  15. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    Thanks for the info. Yeah I checked out the primer for pancreatitis he doesnt really seem to have any of the regular symptoms of pancreatitis, but he had an ultra sound done and the specialist said it was inflamed and that it's the culprit for his drastic fluctuations in his BG values. He has all the blood tests and and ultrasound to rule out any other possibilities.
     
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  16. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    Yes that has been a thought and we are at lower dose of insulin for that reason , but nothing about his numbers are consistent even with a consistency of a diet and insulin dosage he is still all over the place and its changes drastically. I've even thought maybe changing his insulin to see if he responds differently, but they vets are unsure how beneficial that would be.
     
  17. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi,

    I'm sorry to hear that Hurley has pancreatitis.

    Just to share my experience of managing feline pancreatitis, I went through the best part of a year of trialling goodness knows how many low carb wet foods before I found one that Saoirse could eat reliably. There were some foods that she might eat once or twice but then refuse because they didn't agree with her. I learned to monitor her closely for signs of nausea and postprandial discomfort to help me better determine which foods suited her better. I found this resource invaluable:

    Nausea and appetite problems - symptoms and treatments

    I looked for foods with very simple ingredient lists. I also found that Saoirse did better on foods that seemed to be fairly bland and which didn't have a strong aroma. Even with that she needed ondansetron twice a day as a regular maintenance medication.

    All of the above said, even when I lighted on a food Saoirse got on pretty OK with (Sheba Fine Flakes in Jelly, chicken and turkey varieties only), how well it agreed with her could vary from batch to batch.

    I hope you find something that agrees with Hurley much, much faster.


    Mogs
    .
     
  18. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    Thanks that is helpful I think I will stick to chicken/ Turkey variety. Do you have experience with weruva paw lickin chicken, fancy feast natural, or nulo chicken and turkey?
     
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  19. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    I'm in the UK so 'fraid not.


    Mogs
    .
     
  20. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    BTW, I fed Saoirse mini meals once every three hours round the clock (using a timed feeder at night), as smaller feeds were easier on her system.


    Mogs
    .
     
  21. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    I'm not sure how he would do on that schedule I have two other cats, who also have to eat a certain food, so I have to monitor them all eating so they do not go wandering to each others food bowls haha. Well good news is I've narrowed it down to a new food I was gonna try the tiki cat, but I saw alot of reviews that sometimes the meat is grey in the chicken version, and that's just seems too suspicious to me. So I'm gonna try Weruva and I'm starting the transition process now and in incorporating probiotics and a lower dose of insulin since the drastic reduction in carbs. His numbers are still high but have dropped and are staying pretty consistent. He is also dealing with some diahrrea pre food change so I'm battling with that too and he may need medicine for that. Hopefully after the transition and diahrrea he will settle out and I can reconsider his insulin dosage. Hopefully a good update soon.
     
  22. Anna Magno

    Anna Magno New Member

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    Jul 5, 2019
    Hi all. I too have an IBD/Transient Diabetic kitty. Her name is Lily. She was first diagnosed with Diabetes in late June 2019 and was in remission within 6 weeks. Fast forward to this last Sept 2020. Complete panels and blood tests show IBD Triaditis/Pancreatitis, etc. As she is 12 and a tiny cat, my Vet and I both are not really on board with anesthesia at this point for exploratory, etc. The question we are continually pondering is "which came first?" Every cat is different. I've managed to get her on to Fancy Feast shredded chicken. Still at 5gm carbs!!!! And it has taken 4 months to get her on to that. We are now slowly migrating to Weruva paw licked chicken which is 3gm carbs. Trying to switch food is a real trial with an IBD kitty. She was on 2UN Glargine twice a day. After some real dips, she was switched to 1UN twice daily. And her numbers are always all over the place. Im actually reading her every 3 minutes while I type this. LOL. She is using a Libre Freestyle. These tend do be about 20-30 points above actual blood levels from ear tips. A great advantage in fighting hypo. Some days she doesn't drop out of the 300's-400's. Other days, she tanks and we feed. Other days, sweet harmony. Sweet harmony has now happened twice this week, and we are only on Wednesday. She's also been playful and running all over the house for the first time in 4 months. The Vet says it looks like her Pancreas may be trying to kick in. I'm making some organic bone broth for Lily, to help with the inflammation inside and help with nutrient absorption. She has lost about 1.5 pounds since August. She needed to, but still. And her fur is scratchy looking sometimes. We all know that 2020 was full of trials. But I thank God every day that things were shut down, as it has allowed me to treat her 24 hours a day. I'm working from home now, and will try to continue that. Any suggestions on brands of prebiotics, probiotics, food types and brands? Thank you guys.
     
  23. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    Hi there. I will have to say I am still on the food journey as well. The one thing with the weruva paw lickin chicken is that you may have to feed more it is a low calorie food. So for Lily to get the proper calorie in take she might have to eat more food. I struggled with that with Hurley and he isnt a small cat, he just wouldnt eat as much as he needed to. So if your are transitioning to that full time keep that in mind. I honestly went through the food chart provided and picked a few and then went to the ingredient list and narrowed stuff down that way, but I haven't found anything solid yet. For right now I have him on fancy feast and he seems to be managing alright. For probiotics I use the forti flora purina packets, but they can be a little pricey. I believe it is 30 for a month supply. I'm sure someone might have some other suggestions for that. Are you doing manual readings with the libre? I know that Hurley has dropped on the libre and his manual reading showed him low as well. Any time he drops low I always double check with a second meter just to be safe. What is Lily's feeding schedule like? I was suggested not to give home two big meals a day I've been breaking up to 4. I can not do a every 3 hour meals, but even with 4 it seems to be helping. One thing I know is that with pancreatitis it can be tricky, when it is inflamed and not happy it pumps and dumps insulin irregularly so my first priority is to make that happy and to play it safe I've lowered the insulin dosage to eliminate the low random events especially if he tends to plummet.
     
  24. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    I am wondering if you are chasing the right issue, and very sorry to say so, as I am no vet. Your worry about big changes in BG, are very common (as you described). Have a look at my own hercules spreadsheet, starting with last year. It is very strange to think about it this way, but quite often very high numbers are more the result of too much insulin. Hercules is a very bouncy cat, so everytime he went down, he bounced back up. This may, or may not be what is happening with your cat, because i cannot see your data, but I think is definetely something to consider. Pancreatitis does make it harder to control insulin. That makes biological sense because it is the pancreas that secretes insulin. However, it is less clear as Sienne pointed out whether food does anything to pancreatitis.

    I landed on your thread because I just receive a call 15 minutes ago with the blood results from the vet indicating that Hercs has pancreatitis. This was done by a SpecFPlc tests. I assume that you have done one of those?

    FWIW, my vet was just bending my ears about food. I will do my own research, but she said that once cats are doagnosed with pancreatitis you treat the pancreatitis, so she just want me to move into a hydrolysed diet. However, the reason for that is mostly the assumption that cat is also suffering from IBD. Does your cat suffer from diarhea or vomiting? Has low apetite?

    At any rate, I would stick with your first vet, who seems to be in agreement with most of the recent literature I've read ;)
     
  25. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    High BG is a concern, but my priority is his pancreas right now. He had an ultra sound which determined his pancreatitis diagnosis. He has no other symptoms of pancreatitis. He had a bit of diarrhea when I first posted the thread cause i knew his diet needed to change. He was on a Hills Science Gluco Support which is in the 14-15 carb percentage. With food change and antibiotics his diahrrea has cleared up. I also lowered his dosage with the low carb diet change and have started to see a difference in his BG values.
     
  26. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
  27. Beanie071

    Beanie071 New Member

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    Jan 23, 2021
    It is interesting, however Hurley does not vomit unless it's for a hairball. Nor has he lost any appetite. This is the first time he has had diahrrea and I really think he had a mild flare up of pancreatitis. Since the diet change and the full probiotics and antibiotics he has done alot better. I know it takes at least 14 days or more for the pancreas to heal itself. So I feel like the diet change has been the right change for him. Unfortunately I havnt quite found the food I'm happiest with, but that just part of the journey . But since the diet change and changing his meal amounts and being off the antibiotics his numbers have dropped so I feel like we are headed in the right direction, but things can always change so we will see. What hydrolyzed diet are you considering?
     
  28. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    The vet wanted me to change to hypoallergenic prescription food, because these diet food are usually hydrolized to break down the proteins (to reduce allergy reactions) and she thinks this is the best for the pancreas. I have been doing some research, and there is some mention that "low residue" food may help, but as far as I can tell any connection between food type and pancreatitis is very tenuous, and it mostly improve symptoms (which hercs is also not showing any). So, at the moment I think I will hold the pattern, because since changing to Lantus his BG numbers are much better and I'm hoping that would help the pancreas heal. I might try some B12 vitamin that has no side effect, and many people here rave about it. To be honest I am more tempted with trying antibiotics to reduce possible infection then trying the food....
     

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