Asthmatic/Diabetic Cat Health Help!

[pennydreadful]

Hi everyone,

After plumbing the depths of the interwebs in search of answers regarding feline health, I found this site and am hoping that someone out there could give me some insight into my baby's diagnoses.

A little background info on my cat: Kismet is a healthy, active 3 year old short hair I found when he was 2 months old. He is an only pet and lives exclusively indoors.

Case History:

In Late July, I took him to the emergency vet when I spotted a little bit of bright red blood in his vomit. Earlier that day, he'd had a serious coughing fit, what I'd thought was a hairball.He was acting normal, but thought I should get him checked out. The vet gave him a thorough physical exam, but didn't take any blood or do any x-rays because she didn't think it was necessary and was trying to spare me the exorbitant costs of such services. She said the blood was most likely the result of an irritated esophagus or stomach from hairballs. She prescribed Kismet Laxatone and sent him on his way.

I did a little bit of research on hairballs, and decided to switch him from science diet dry food to Wellness brand wet food. His retching episodes increased to between 3-4 xs a day and he wasn't producing any hairballs, but was eating and defecating normally. I was dosing him with Laxatone after every episode, up to 4xs a day. He started drinking excessive amounts of water and urinating a lot as well.

Fast forward to August. Alarmed at the amount of fluid input and output, I stopped giving him Laxatone since it wasn't reducing what I thought were attempts to expel hariballs, and was concerned that the high amounts of corn syrup was making him diabetic. His thirst and urination returned to normal. He continued to cough at unprecedented rates.

After a few weeks elapsed and I did some more independent research, it occurred to me that he was perhaps having asthma attacks. I read that asthma could be the result of allergies. The only thing different in his lifestyle was his food. I discontinued feeding him wellness right away and switched him back to his old food and scheduled an appt with the vet the next day.

They did an x-ray and couldn't find any evidence of severe asthma.
At any rate, they prescribed a nebulizer with a mixture, oral prednizone, 50 mg of theophylline 1x a day, and an antibiotic to give to him. His asthma attacks didn't decrease at all and additionally, he started drinking and urinating a lot and became withdrawn and very scared of me. He hated taking his meds almost as much as I hated giving them to him.

The next week when they got his lab results back, they told me he was diabetic and needed to stop taking the prednizone right away. (Goes to explain the frequent urination.) He now gets an injection of 3 units of insulin 2x a day and was prescribed flovent 220mcg 1x120. We stopped all other treatments since they were so traumatic for him. We haven't received the Flovent yet as it was ordered from Canada and will take a few weeks to arrive. The vet instructed me to give the bronchiodilator pills if needed, but they haven't made any difference and only make his life (and mine) miserable.

I am hoping that both his asthma and diabetes are situational. I'm very suspicious that his glucose levels were high as a result of the Laxatone. I mentioned this to the vet and she told me it was unlikely that he developed diabetes in a month, but it was her group that prescribed the Laxatone and she may just be trying to cover her a**. Kismet is a big cat, but not obese according to his docs. He is a tall, long cat and weighs in at around 15 lbs.

I've read a lot of conflicting information on what to feed cats, especially diabetic/asthmatic ones. My vet insists organic, canned wet foods are just a fad, and says that he should stay on the Hills w/d dry. I will not be going back to Wellness since I suspect that may be what triggered the allergic asthma attacks, but was wondering if perhaps there is a better alternative out there. Should I stay with Hills? I read that dry foods are bad for diabetic cats because they are rich in carbohydrates, even those that claim to be low-fat, low-carb. As far as treating his asthma, I've switched his litter to Feline Pine (a low dust, all natural litter.)

Overall, he seems to be doing much better now, more energetic and cuddly. He is still having asthma attacks, though. We go back in 4 weeks for a check up. This is another thing that concerns me. She told us we don't need to do at home glucose testing, but some of the literature I've read recommends ear pricks. What should I do?

Does anyone have any tips or suggestions regarding Kismet's specific situation and/or treating asthmatic/diabetic cats in general? I love my cat as though he were my child and would do anything for him. I want to give him the best treatment possible. I am especially concerned because he is so young and Ivwant to ensure that he lives a long, healthy life.

Thanks for any insight any of you can share,

Courtney

[sugarcatmom]

Hi Courtney, sorry to hear about Kismet's health issues.

Originally Posted by pennydreadful

My vet insists organic, canned wet foods are just a fad, and says that he should stay on the Hills w/d dry.

Your vet is seriously out of touch with recent feline diabetes treatment protocols. W/D is about as old school as it gets and was even losing favour way back when my cat was diagnosed, almost 10 years ago. I guarantee that if I'd been feeding it, Aztec would not still be alive. So absolutely disregard anything your vet has to say about diet because they clearly haven't kept up with any reading on the subject.
https://www.aahanet.org/library/diabetesmgmt.aspx

Diet therapy goals and management

Optimize body weight with appropriate protein and carbohydrate levels, fat restriction, and calorie control.

Weigh at least monthly and adjust intake to maintain optimal weight.
Management goal of weight loss in obese cats: 1% to 2% loss per week13 or a maximum of 4% to 8% per month (hepatic lipidosis risk is minimized with the recommended high-protein diet).
Minimize postprandial hyperglycemia by managing protein and carbohydrate intake.

Feed a high-protein diet (defined as >45% protein metabolizable energy [ME]) to maximize metabolic rate, improve satiety, and prevent lean muscle-mass loss.14-17

This is necessary to prevent protein malnutrition and loss of lean body mass.
Protein normalizes fat metabolism and provides a consistent energy source.
Arginine stimulates insulin secretion.

Limit carbohydrate intake.18-21

Dietary carbohydrate may contribute to hyperglycemia and glucose toxicity in cats.
Provide the lowest amount of carbohydrate levels in the diet that the cat will eat.
Carbohydrate levels can be loosely classified as ultralow (<5% ME), low (5% to 25% ME), moderate (26% to 50% ME), and high (>50% ME).22

http://www.veterinarypracticenews.co...onfidence.aspx

Scherk and other veterinarians say that in the past five years, there have been a number of changes in the way feline diabetes is managed. For instance, these days there’s a greater emphasis on diets lower in carbohydrates rather than higher in fiber.

“We recommend a high-protein, low-carb diet,” says Brianceau. “It’s important to understand that as obligate carnivores, cats have very different needs from those of dogs.”
.....
“Diet in conjunction with earlier insulin treatment has resulted in more cats being better controlled than was previously the case,” Scherk notes.

http://feline-nutrition.org/health/w...a-diabetic-cat
http://petdiabetes.wikia.com/wiki/Low-carb_diet
http://www.catinfo.org/?link=felinediabetes

Originally Posted by pennydreadful

I will not be going back to Wellness since I suspect that may be what triggered the allergic asthma attacks, but was wondering if perhaps there is a better alternative out there.

A much better alternative would be a raw diet. You'd have significantly more control over ingredients and it would be ideal for both the asthma and the diabetes. If that's not an option, look for a canned food without chicken or fish, grain-free, and maybe a novel protein like rabbit, duck, or venison. Nature's Variety, some of the newer Wellness flavours, Ziwipeak, are a few suggestions off the top of my head.

Originally Posted by pennydreadful

I've switched his litter to Feline Pine (a low dust, all natural litter.)

Some cats have problem with pine litters. Not saying that's the case with Kismet, but you might want to experiment with other non-scented litters like Blue Buffalo's walnut-based one, or something paper-based.

Originally Posted by pennydreadful

He is still having asthma attacks, though.

http://feline-nutrition.org/health/a...-feline-asthma

Originally Posted by pennydreadful

She told us we don't need to do at home glucose testing, but some of the literature I've read recommends ear pricks. What should I do?

You should check out these links and teach yourself how to home test Kismet:
http://petdiabetes.wikia.com/wiki/Ho..._blood_glucose
http://www.felinediabetes.com/bg-test.htm

You don't need the vet's permission. Just another thing she's out to lunch on. Given that 3 units twice a day (what kind of insulin?) is actually quite a large dose to start out with, I would start home-testing ASAP, and for sure before you make any diet changes.

[pennydreadful]

Hi Sugarcatmom,

Thank you so much for your response and all of the great links! The info you've provided is very informative. I will be getting a home test asap. There are a lot of recommendations out there... which one do you use/recommend?

Unfortunately, a raw diet is not very feasible. My husband and I are both professors and have night classes so we have no time to prepare meals for Kis, let alone ourselves! I found a great chart that breaks down the nutritional facts of various wet foods http://binkyspage.tripod.com/CanFoodNew.html I am reviewing them closely and will try a few out on him and see how he does. As aforementioned, he had a strong allergic reaction to Wellness so this will be a process of trial and error. As if having a MD cat isn't difficult enough, we also have the asthma to contend with.

I've located a Veterinary Specialist in my area and plan on taking him in. Hopefully they are more up-to-date in regards to diabetes treatment and management than my vet is! In the meantime, I have a lot of reading to do. I won't change his diet until I either consult with the specialist or when he goes back to his regular vet for a check-up in a few weeks. I don't care if she insists he should eat dry food, I am going to print out some of the articles written by DVMs who specialize in diabetes and bring them along and tell her I am switching him over. Do you recommend a specific brand? Kismet is not a very picky eater, fortunately. He prefers dry food, but will pretty much eat anything put in front of him. And not put in front of him, for that matter! We have to keep all food out of reach because he has been known to eat through packaging! Some foods he has helped himself to in the past are an unopened bag of cheetos he chewed a hole through, a wrapped brownie, and an unopened bag of bagel chips. He is also cuckoo for cantaloupe and will seriously stalk anyone eating any. My crazy little furball.

Thanks again!

[sugarcatmom]

Originally Posted by pennydreadful

There are a lot of recommendations out there... which one do you use/recommend?

I've heard a lot of people like one of the various Freestyle meters, but I've never used it myself so can't comment. I think as long as the meter uses test strips that "sip" (I don't even know if they make any other kind these days, but there used to be ones that required you to "place" the blood drop on the strip, a rather challenging endeavour when the blood donor is a cat), and only requires a small drop of blood, the only other thing to consider is the price of the test strips. Walmart carries a meter called Relion that supposedly is one of the cheapest. I personally have used the Precision Xtra (the only meter that also tests for blood ketones), Bayer, and now the iTest (I think called WaveSense in the U.S.).

Originally Posted by pennydreadful

Unfortunately, a raw diet is not very feasible. My husband and I are both professors and have night classes so we have no time to prepare meals for Kis, let alone ourselves!

Oh I totally hear ya! I can't make home-made raw diets for my cats either because of the time issue, along with the fact that my husband and I are vegan . So instead, I buy premade frozen raw from the higher end pet food stores and just thaw-n-serve. Easy peasy, but also a tad more expensive. They also get canned food that I leave out for free-feeding.

Originally Posted by pennydreadful

I found a great chart that breaks down the nutritional facts of various wet foods http://binkyspage.tripod.com/CanFoodNew.html I am reviewing them closely and will try a few out on him and see how he does.

The famous Janet & Binky charts! Yes, a great starting place. There are lots of newer options these days that aren't on that list but if you read ingredients carefully and weed out the ones with grains and a high vegetable content, you should be okay.

Originally Posted by pennydreadful

I am going to print out some of the articles written by DVMs who specialize in diabetes and bring them along and tell her I am switching him over.

Great idea! It's hard for vets to keep current on every issue related to every animal, especially if they don't often encounter patients with that particular condition. A good vet is open to learning things from their clients. One who gets defensive or dismissive when presented with new info is someone I would avoid.

Originally Posted by pennydreadful

Do you recommend a specific brand?

Hard to say really. For canned, I feed my cats a rather huge variety, everything from Nature's Variety, Weruva, ZiwiPeak, and Precise, to Wellness, Blue Buffalo, Evanger's and Nature's Logic. I think some rotation is important to avoid nutritional excesses and deficiencies, minimize the chance of addiction, as well as lessen the harm that might occur if one of the foods became toxic for some reason.

Originally Posted by pennydreadful

Some foods he has helped himself to in the past are an unopened bag of cheetos he chewed a hole through, a wrapped brownie, and an unopened bag of bagel chips.

Junk food junkie! My MIL's cat also loves cantaloupe, what is with that? Not very carnivore of them.

[pennydreadful]

How funny that Mil's likes cantaloupe, too! I thought Kismet was the only one. It is hands down his favorite treat. I've avoiding eating any since his diagnosis because it would be such a torture. Doesn't matter where he is in the house, as soon as he smells it he is right there by my side marauding for it haha! I've since wondered if the craving for cantaloupe doesn't have something to do with his diabetes. He definitely has a sweet tooth; perhaps they crave sweeter foods when their insulin levels are off?

Thank you for the food recommendations. I like your logic in providing a variety of food. I'm worried that it will be difficult to do that for Kis until we can get him regulated. I would love to switch him now but will wait until I consult with a vet to make sure we can do so safely.

I really appreciate you taking the time to chat with me. I've been so emotional the past few days and overwhelmed by the amount of information out there. I just desperately want to be well-informed and provide Kismet with the very best treatment available!