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Old May 20th, 2010, 10:53 AM
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Diet for diabetic cat

This post may not end up mattering much since my mother has chosen not to take my advice with her cats up until now but, under the circumstances, it's worth another try.

She took her cat Jessie (14) to the vet Saturday. He'd been throwing up for two or three days and had lost an enormous amount of weight (he's at 11 pounds down from 25 a few months ago - yes, he is/was extremely overweight).

The vet diagnosed him with a liver infection and diabetes (I don't have a copy of the bloodwork, unfortunately). She said that he'd also lost a ton of muscle tissue. She prescribed a couple of meds to calm his stomach (which worked nearly immediately - he was OBVIOUSLY feeliing much, MUCH better within a couple of hours) and an antibiotic.

The vet put him on insulin so mom will be giving him shots twice daily. She (the vet) also recommended that she (mom) change his feeding to twice a day (she's (mom again) in the habit of leaving food for him 24 hours a day).

Now, when I say she hasn't heeded my advice up until now, I say this because she is currently feeding him Purina Indoor Cat dry food (left down all day) and a half can of Friskies canned food twice a day. She's been quite stubborn about my attempts to get her to switch them over to a canned-food diet. Since Jesse likes dry food, she hasn't been willing to force him to make the switch.

Now that he's been diagnosed with diabetes, I'm thinking diet is more important than ever. The vet told her to put him on "any senior cat food" but (and don't get me wrong, I totally my vet), she was very, very resistant to me putting Oscar on anything but Science Diet so she's not a feline dietician.

The thing is, I don't know what proper feeding for a diebetic cat is. I know it should be high fiber and low protein and I imagine that it would still be a really good idea to get him off kibble but I'm not sure what the result of that analysis is though.

Any thoughts on what food would be good? I also could seriously use some arguing material - I know why canned food beats dry food generally but any specifics regarding diabetes?
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Old May 20th, 2010, 11:02 AM
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Could you print the following page(s) off for your mom to read? Let her know how serious diabetes really is?

http://www.catinfo.org/felinediabetes.htm
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Old May 20th, 2010, 11:18 AM
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Quote:
Originally Posted by rjesak View Post
The vet put him on insulin so mom will be giving him shots twice daily.
Do you know what type of insulin it is and how much?

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Originally Posted by rjesak View Post
She (the vet) also recommended that she (mom) change his feeding to twice a day (she's (mom again) in the habit of leaving food for him 24 hours a day).
Depends on the type of insulin. My cat is on a slow onset, long-acting insulin and does fine with free-feeding wet food. If a fast acting insulin like Humulin N or Caninsulin is being used, it's more important to get a good meal in first and free-feeding isn't always a good idea.

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she is currently feeding him Purina Indoor Cat dry food (left down all day)
And that's why he now has diabetes, unfortunately. Kibble is absolutely the main cause well above and beyond any other factor.

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Originally Posted by rjesak View Post
The vet told her to put him on "any senior cat food"
Ugh. Not a good idea at all.

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Originally Posted by rjesak View Post
I know it should be high fiber and low protein
Quite the opposite. You want high protein, low carb. High fibre diets tend to be high in carb, so not a good choice. (and cats don't need much fibre anyway - the notion that it slows down glucose absorption may apply to doggies and hoomins, but cats - not so much).

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Originally Posted by rjesak View Post
and I imagine that it would still be a really good idea to get him off kibble
That's probably the most important factor in treating feline diabetes. There are some lower carb kibbles around like Evo and Core that would at least be better than Purina anything, but because those are so high in calories, it can actually make regulation more difficult than feeding strictly wet food. Many cats even go into remission when switched to wet and given an appropriate amount of insulin.

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Originally Posted by rjesak View Post
Any thoughts on what food would be good? I also could seriously use some arguing material - I know why canned food beats dry food generally but any specifics regarding diabetes?
Any of the grain-free wet foods, like Wellness, Evo, Nature's Variety, and yes, even Fancy Feast (but only the plant-free varieties - some are too high in carbs). The reason you want low-carb is because carbs are basically sugar. The feline pancreas wasn't designed to handle large amounts of sugar over long periods of time, and can eventually "burn out" from having to produce so much insulin to deal with it. The best way to help the pancreas recover is to stop stressing it out with all the sugar. So wet food it is!

One very important thing to know, however, is that if your mom does change her cat's food to wet, his insulin requirements may drop dramatically and it would be a really good idea if she either dropped his dose (depending on how much it is), or learned to home-test his blood glucose herself. Hypoglycemia can result otherwise. Does she know how to recognize a hypo event, and what to do in case it happens?

Gotta go back to work, but in the meantime here is some info for you and your mom to read on feline diabetes: http://www.catinfo.org/felinediabetes.htm

ETA - Doh, 14+ beat me with the link! Good job.
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Last edited by sugarcatmom; May 20th, 2010 at 11:22 AM.
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Old May 20th, 2010, 08:24 PM
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Thank you both! I've gotta start working on her. Because he lost weight, she's worried about changing his diet right now. I see her point to an extent (he looks dreadful - you can see the bones in his spine but he still has his big belly! Weird!), I remember feeling the same about Oscar but I think she ought to start moving him over anyway since it could take a while.

Anyway, this is good information and exactly what I need. Thanks again!

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Old May 20th, 2010, 08:37 PM
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Because he lost weight, she's worried about changing his diet right now.
He'll start gaining weight once he's better able to utilize the calories in the food, and the best way to get there is with small doses of insulin and a quality wet food. Can you find out what insulin she's using, and how much?
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Old May 21st, 2010, 01:31 AM
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I'm just going to second a few of the things sugarmom posted, because I've myself dealt with a diabetic kitty.

No no no on the "any senior food" thing. The vet is WRONG, and I cannot emphasize that more. Senior foods tend to be loaded with carbs, and this is BAD.
The pate formulas by fancy feast are actually pretty good for diabetic cats as far as storebought food goes. Many of the people on the forum dedicated to diabetic cats I used to read used them. You want to stay away from the formulas that are chopped up and with gravy, and the ones that that contain fish. I will post the website later in my post and they have a list of food that are acceptable.

Calories are also important for diabetic cats. Do NOT overfeed because an overweight cat will have more issues processing insulin, and you also do not want to feed a whole ton at once as it can cause a spike in blood sugar. Many people with diabetic cats feed 3 times a day so the meals are smaller, and also so that during the day the blood sugar does not drop too low due to the insulin shot.

Do please find out what kind of insulin has been recommended by the vet. Many vets mistakenly prescribe caninsulin, which is actually for dogs, or even humalin, which is for treatment of people, because they believe there isn't a difference or is not anything else available. Caninsulin is actually indicated for treatment of cats by the manufacturer, but it is NOT the best treatment.
I was going to recommend PZI, but I see from an article that it's being discontinued . That is quite unfortunate since many people had great success with it.
There's an article here on insulin http://www.felinediabetes.com/starttreatment.htm

Quote:
The vet put him on insulin so mom will be giving him shots twice daily. She (the vet) also recommended that she (mom) change his feeding to twice a day (she's (mom again) in the habit of leaving food for him 24 hours a day).
Please find out how much and what type of insulin the vet has recommended. And did the vet recommend testing the blood sugar before dosing? This MUST be done. Blind dosing insulin is DANGEROUS, and I say this from personal experience. Our former vet recommended to my mother in law (who had care of the cat at the time) to give a certain dosage of insulin twice daily. He did not even mention that you CAN test a cats blood sugar with a simple human blood sugar testing device. Due to this the cat had dangerous drops in blood sugar, several times, resulting in him passing out and having to be taken to the vet for treatment. I do believe this mistreatment of him after being diagnosed lead to his premature death, because if he'd been given proper treatment from the start his body wouldn't have been put under nearly so much stress.

This website, http://www.felinediabetes.com/ , is a great source of information and has a message board with a licensed veterinarian that has extensive experience with feline diabetes. I would suggest your friend go to it and do plenty of reading if she wants her kitties treatment to go smoothly.
A cat with diabetes can live a long time with the right treatment. My aunt had a siamese who lived until 19 years old taking pills for his diabetes most of his life.
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Old May 21st, 2010, 11:26 AM
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I forgot to mention one very crucial thing: testing for ketones. If your mom isn't doing this already, she needs to pick up some Keto-stix or Keto-diastix from the pharmacy. They're test strips that you dip in the kitty's urine which indicate whether ketones are present. Trust me, you don't want ketones. They can quickly develop into a life-threatening condition called ketoacidosis, and treatment is very expensive (24hr emergency care for several days). Unregulated diabetics are more prone to this. Here is more info:

http://petdiabetes.wikia.com/wiki/Ketoacidosis

And along with the felinediabetes.com website that MBIE mentioned, here is another one that is a wealth of very up-to-date info: http://petdiabetes.wikia.com/wiki/Main_Page
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Old May 21st, 2010, 02:34 PM
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They can quickly develop into a life-threatening condition called ketoacidosis, and treatment is very expensive (24hr emergency care for several days). Unregulated diabetics are more prone to this.
I know this from experience

My mom was on a med that caused her to develop diabetes without her realizing it. Undiagnosed and untreated she developed ketoacidosis and was in a diabetic coma for about 2 weeks. It was very scary.
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Old May 21st, 2010, 03:46 PM
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WHEN MY NICKY WAS ILL WITH DIABETES THE VET DID NOT GIVE HER MUCH TIME, AS SHE WAS VERY ILL. I WAS TO GIVE HER SHOTS TWICE A DAY. SO WENT ON LINE TO FIND OUT AS MUCH AS I COULD ABOUT THE ILLNESS. I THEN EXPERIMENTED AND FOUND THIS WORKED FOR HER. I GAVE HER LAMS ORGINAL 24/7 BUT WHEN SHE GOT HER SHOT I WOULD GIVE HER A SPOONFUL OF CAN FOOD. SHE THOUGHT THIS WAS HER TREAT FOR BEING GOOD GETTING HER SHOT. LOL THEN WENT TO VET AND GOT CAN FOOD CALLED a/d FELINE FOOD. HAS LOTS OF GOOD STUFF IN IT FOR CATS, YOU CAN NOT FEED THIS TO CAT ON A FULL TIME BASES, THEY JUST LOVE THIS STUFF AND WILL GAIN WEIGHT VERY FAST. I FOUND SOME VETS ON LINE FOUND VITIMEINS DID A LOT OF GOOD FOR CATS THAT HAVE DIABETES. NICKY LOST HER FIGHT FOR LIFE LAST YEAR BUT I HAD HER FOR FIVE WONDERFUL EXTRA YEARS. I WISH YOU THE VERY BEST IN FINDING THE RIGHT BALANCE FOR THE CATS
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Old May 21st, 2010, 11:38 PM
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py144 , Please turn your caps off as it's considered bad etiquette on forums. Makes it seem like you're yelling and makes the post hard to read. Just a friendly heads up

Sorry to hear about your girl passing away.
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Old May 24th, 2010, 10:23 AM
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Sorry for the delayed response. Because I was viewing this in the other forum, it showed me as the last poster. I only just noticed it had gotten moved and came to find the live thread!

Anyway, here's what I've got. According to the vet, she's put Jessie on a very low dose (1 1/2 units twice daily) of ProZinc insulin. She does NOT recommend checking the blood sugar - she says it's usually unnecessary...

She said to put down food in the morning. If Jessie eats, then give him the full dose (1 1/2 units). If he doesn't eat, give him 1 unit. Give him 1 1/2 units in the evening regardless. Mom is supposed to bring him back in for a full blood workup in a few weeks.

This seems like a pretty lazy way to deal with an actual diabetes diagnosis. Is it really unnecessary to check blood sugar? How on earth can you know how his blood sugar is doing if you check it every few weeks? I'm very confused...

I'll talk to mom about the ketone test strips - the vet didn't mention anything about this. I don't know how the food thing is going to go. Mom is like I was (only more stubborn) and is sure that the vet knows best.
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Old May 24th, 2010, 02:34 PM
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Quote:
Originally Posted by rjesak View Post
According to the vet, she's put Jessie on a very low dose (1 1/2 units twice daily) of ProZinc insulin.
ProZinc is a good choice. It's fairly new and was set to replace the discontinued Idexx PZI, which many cats have done well on.

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Originally Posted by rjesak View Post
She does NOT recommend checking the blood sugar - she says it's usually unnecessary...
Vets usually say this for one or more of the following reasons:

1) they don't want to lose the income of the client having to bring their pet in for testing,

2) they don't actually know anything about home-testing, like how to do it or how essential a tool it is in the management of diabetes,

3) they have a patronizing attitude towards their clients and don't want them taking control of their pet's care, or making dosing decisions without their input.

4) the vet doesn't want to overwhelm the owner of a newly diagnosed pet with too much information and risk the owner euthanizing the animal instead of treating it.

The fact is that diabetes is a home-managed condition. There is no better tool, whether for humans or pets, in managing diabetes than to be able to test what the bg levels are at any given time. To know if it's safe to give the insulin in the first place is crucial, especially given that cats can go into remission at any time. Would your mom give a diabetic child a shot without knowing what it's bg was first? Why would that be any different for her cat? In fact I would argue that it's even more important, because the cat can't tell anyone if they're feeling weird or sleepy or whatever. All we have to go on to decide if it's safe to give that insulin shot is what the bg levels are at.

Your mom does not need the vet's permission to test her cat. There's lots of info on the internet on how to do it, and while the learning curve can be a tad steep in some cases, it's absolutely doable. 1000's of us have learned how to do it without help from our vets. Please print this out for your mom to read: http://www.catinfo.org/felinediabete...ose_Monitoring

And some more info worth reading: http://www.felinediabetes.com/phorum...182#msg-779182
http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=287


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If Jessie eats, then give him the full dose (1 1/2 units). If he doesn't eat, give him 1 unit. Give him 1 1/2 units in the evening regardless.
That is crazy! There is no way she should be giving her cat insulin when it doesn't eat if she doesn't know what the blood glucose value is. That's a recipe for hypoglycemia. You might want to print out this info for her as well while you're at it, cause if she insists on following the advice of this vet, she's going to need it: http://felinediabetes.com/FDMB/viewt...hp?f=14&t=1122

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Mom is supposed to bring him back in for a full blood workup in a few weeks.
Does that include a curve? A fructosamine? How does the vet plan to monitor whether the dose of insulin is appropriate or not? One single blood glucose test at the vet, when the cat is possibly experiencing stress-induced hyperglycemia, is useless in the big picture.

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Mom is like I was (only more stubborn) and is sure that the vet knows best.
Not this vet. Sure, if your mom wants to give her cat 2 shots a day, every day, for the rest of her cat's life (however long that may or may not be if she isn't going to home-test), then by all means, tell her not to change a thing. But if she wants to have any hope at all of her cat being diet-controlled and not needing exogenous insulin, then she really must change to a low-carb wet food. There is no other way. Can you print this out and give it to her: http://www.catinfo.org/felinediabetes.htm Maybe the fact that it's written by a vet (one with more experience than her own vet clearly has) might make a difference.
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Old May 25th, 2010, 08:42 AM
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It sounded nuts to me. I don't think Mom would euthanize Jessie (she's been a dog person her whole life but this cat picked her and she adores him) but I think she's hesitant to learn a lot of new stuff. Maybe I can make it into some kind of computer game - that she'll do for hours!

In any case, I had told her that maybe we could control the diabetes with food and she asked the vet about it. The vet said it wasn't necessary!! Right, so we can keep giving him the crap food that caused the condition in the first place and medicate (regardless of the fact that we have no idea how much we should actually be medicating) to try to correct the problem that food caused (and will continue to cause)! It sounds pretty insane spelled out like this too.

I'll print out this whole thread, I think, along with the info you pointed me to SCM, and see if I can convince her. Much as I don't want to (I'm the only one in the house with a full-time job and a two-hour commute each way on top of it), maybe I can learn all this and do it myself. I really hope I can convince her though...

Quote:
Does that include a curve? A fructosamine? How does the vet plan to monitor whether the dose of insulin is appropriate or not? One single blood glucose test at the vet, when the cat is possibly experiencing stress-induced hyperglycemia, is useless in the big picture.
I'm not sure. She said they'd be taking Jessie in at 7 and he'd stay there all day so my guess was that they would be monitoring his blood sugar throughout the day.

Either way, it sounds like food is the first point to work with her on. Jessie won't like not having his kibble so she may have to spend some time working him over. Perhaps, if I can convince her changing his diet might change his condition, I can get her to consider it. I know my friend's cat no longer needed shots when they changed his diet (although she's actually not helping the case - they changed his diet to SD diabetic kibble).

You know I was raised by mom and I grew up letting cats in and out (even though one of our cats came back spray painted, one came back having fallen, or been thrown into, a vat of black crude oil, one came back with an abscess on his shoulder that was reopened no less than three times, etc.), and providing care for them, but mostly the easy kind - take them to the vet, maybe give them a pill. We certainly never spent that much time thinking about their care. Now I have nightmares about my cats getting out of the house. I worry about their food, their health, whether or not they're getting along... It's a whole different world and I sometimes wonder where I got it from!

Anyway, time to start printing. again!!
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Old May 26th, 2010, 04:48 AM
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I'm not even kidding here, a vet that would actually recommend AGAINST testing a diabetic cats blood sugar, would cause me to switch vets. That just shows a serious lack of knowledge on the subject.

It would be akin to a doctor recommending that a diabetic person just ignore their blood sugar because it's not necessary. It's actually DANGEROUS blind dose insulin. What if the cats blood sugar is already fairly low when you dose? Then you end up with HYPOglycemia. Blood sugar drops drastically and the cat ends up passed out and needs a trip to the vet. I've seen this with both animals and humans. It's why you see diabetics carry around candy with sugar just in case their blood sugar drops too low. A friend of my dad had a son who was diabetic from a very young age, and hypoglycemia was always a strong concern. Blood testing was constant and necessary and carrying something with a high sugar content to offset that issue was a must.

The fact that the vet sees no link between food and managing diabetes is also worrisome. Even with diabetic people a diet low in simple carbohydrates and sugars is recommended. It's the same with cats.

I would definitely try to find another vet that's will be willing to work with the owner more closely and knows more about managing diabetes. It sounds like this vet is just going to be working AGAINST you guys, which at best is going to cause frustration between owner and vet, and not good for everyone's mental state, not to mention not helpful with managing the cats condition.
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Old May 27th, 2010, 10:23 AM
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I gave mom this whole thread and talked to her about the food (for starters). She agreed that diabetic people have special diets so cats should as well. I think she's going to consider changing his diet. With any luck, that may be enough to keep him off insulin but we'll have to see.

As to testing his blood sugar, I'm not sure how she feels about that yet. Keep in mind that I'm speaking from a place of little experience (although with backup from people who have much) in comparison to my friend who is living in the house with us. Her cat was diagnosed with diabetes many years ago. She never did a single blood test at home. Eventually, she moved him over to Hill's diabetic cat kibble and took him off insulin. He lived for quite a few years after that and his death didn't appear to have anything to do with the diabetes (I don't actually remember the cause of death but he was 19 so he wasn't exactly a baby). Needless to say, I recognize that this was probably just good luck on her part (or on Kitty's) but she feels differently.

It's kind of one of those things - you don't want to do the extra work so you listen to the person who says the extra work is unnecessary.

In any case, I'm not sure if that's the route my mother will choose (or if I'll get involved and do it myself). I have to say that (and I feel horrible about this) but I really don't want to have to. I already have six cats of my own one of whom is pretty high-maintenance and I don't really want another one that will require the time and energy on top of the time and energy of my job, commute, foster son, and other responsibilities. On the other hand, how do I NOT get involved? You're making too much sense to just ignore (I think SCM asked who would give a child an insulin shot without checking the blood-sugar?) so am I sentencing the cat because I'm too lazy to get involved...
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Old May 27th, 2010, 11:50 AM
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Her cat was diagnosed with diabetes many years ago. She never did a single blood test at home. Eventually, she moved him over to Hill's diabetic cat kibble and took him off insulin. He lived for quite a few years after that and his death didn't appear to have anything to do with the diabetes (I don't actually remember the cause of death but he was 19 so he wasn't exactly a baby). Needless to say, I recognize that this was probably just good luck on her part (or on Kitty's) but she feels differently.
This is what's called antecdotal. There are always stories where someone was lax with treatment and survived a disease just fine.

But then you have someone like me who saw firsthand a cat pass out and nearly die from low blood sugar by being dosed blindly with insulin several times, and the cat died prematurely after the blood sugar became hard to manage due to poor treatment in the first place.

So taking antecdotal evidence from one source is just bad news. Scientific research and antecdotal accounts from MANY sources show that testing is necessary to manage diabetes in most cases and it can be dangerous to blind dose insulin. So there you go.

There are diabetic people for that matter that manage their diabetes poorly and don't always test, and live to a ripe old age, but you don't see doctors recommending others do this because some people did fine being irresponsible with their treatment.
Not all diabetics have the same blood sugar numbers, nor does their blood sugar respond the same to insulin dosing, or respond the same to the same amounts of insulin. The body just doesn't work that way, and we're talking about an organ (the pancreas) which is producing insulin at erratic levels, which will vary from diabetic to diabetic.
One diabetic may have high blood sugar that stays pretty consistent, so blind dosing works just fine for them, even if not recommended. Other diabetics may have blood sugar that goes all over the place, and while blind dosing insulin worked one day, the next day it caused them to become hypoglycemic. You just CAN'T blind dose and assume you will have good results.
Then there's the fact that after treatment is started the pancreas will often respond by pumping out different levels than it was previously. So while dosing with a certain amount of insulin worked for a long time, suddenly you have a hypoglycemia situation.
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Old May 27th, 2010, 04:34 PM
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Originally Posted by rjesak View Post
I think she's going to consider changing his diet.
That would be fantastic. At least she's considering it.

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Originally Posted by rjesak View Post
As to testing his blood sugar, I'm not sure how she feels about that yet.
Totally understandable. Maybe in time, as she becomes comfortable with Jessie's treatment, she'll be more open to the idea. It can be a bit of a shock to the system to find out you have a diabetic cat and all of the aspects that go along with it, so it's actually quite natural for her not to jump whole hog into learning to home-test right away. But it truly is the most accurate and safest way to monitor Jessie's treatment. Here is one last link for you that maybe she could pass on to her vet to hopefully change her opinion that testing isn't necessary: Convert a Vet

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Originally Posted by rjesak View Post
Eventually, she moved him over to Hill's diabetic cat kibble and took him off insulin.
The irony is that Hill's M/D was specifically developed to be lower in carbohydrates than most other dry foods, acknowledging the fact that it's the excess carbs that are the problem for cats. Except it doesn't go far enough (14% calories are from carbs, when cats need less than 5%) and it accomplishes this using lousy ingredients at an exhorbitant price. So while yes, a borderline diabetic that had previously been eating a very high carb kibble might benefit from a switch to M/D (or Purina DM, which is similar), enough to even go off of insulin in some cases, we can do much better!
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  #18  
Old May 10th, 2012, 07:21 PM
jmurray7 jmurray7 is offline
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Join Date: May 2012
Location: Windsor, ON
Posts: 10
My cat (15) has been diabetic for 4 years, I check her insulin with a human tester (her ear) to check her insulin level, and give her a shot of insulin twice a day. She also went from a heavy weight of 22 lbs, down to 11lbs. and I thought she was dying. I went to the vet, after feeding the food they recommended I did research and switched to Natures Variety and probably saved her life. It is a challenge to have a diabetic animal, but they can live a long life as long as they are monitored.
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