Diet Change in a Diabetic Cat
It Started with Excessive Peeing Outside the Litterbox
When our 10 year old cat, Nibbler, first started peeing outside her litterbox, we thought it was a wake-up call for us to clean the litter more often. As it turned out, it was a wake-up call that she wasn't feeling well. We started cleaning the litterbox more often, even when there was only one scoop of waste it. Around this time, she also started losing the hair on her hind end, a little at first, then to the point where it was nearly bald within a few weeks. Our once obese cat was suddenly losing weight at a rapid pace. Then she started peeing in the bathtubs, even when her litterbox was completely clean. This was a good kitty who never peed anywhere other than her box. Worried about cat cancer and any number of other possible ailments, we took her to the vet. The vet did a blood test on her and called me the next day. Nibbler had diabetes.
Nibbler at Two Years Old
Getting the Diabetes Diagnosis
When the vet called with the diabetes diagnosis, I cried. I asked the vet, "What now?" She recommended getting Nibbler started on twice-daily insulin shots, and we made the arrangements for me to pick it up at Walmart and bring it to the vet to get trained on how to use it. That day, I went to Walmart and bought a Relion glucometer so I could test Nibbler's blood sugar at home. There are many resources online to show you how to test a cat's glucose. Simply google, "How to test a cat's glucose," and any number of amazing folks' videos or blogs will pop up.
The first time I tested her glucose, I was shaking and scared to death. Even though the people in the videos assured me she probably wouldn't mind getting the ear prick, it's never exactly comfortable getting poked by a needle. She took it like a champ, and didn't even flinch at the quick-as-a-flash poke. Her sugar tested at 410. The vet wanted it around 100.
Nibbler and Rocco Hanging Out
Google: A Vet's Worst Nightmare?
Like any average American who has just been presented with an unfamiliar ailment, I googled. I spent hours and hours browsing pet forums and pet blog comments, looking for information that might empower me to help my cat to the best of my knowledge--and budget. I found many people (not necessarily veterinarians, mind you) who had success in getting their cat's glucose levels down to normal range just by changing their diet to a low-carb, high protein diet. Aka, no more dry food. Unbeknownst to me at the time, not just any wet food works either, although any wet food would be better than most dry foods. The thing to look for is less than 5% carbs; the lower (=zero), the better. Check out the amazing list of resources at Janet and Binky's Cat Food Page! Diabetes is unheard of in the wild, because cats are carnivores, and carnivores eat high-protein, low-carb diets. Although expensive, I figured I'd give diet change a try before I started stressing Nibbler out about constant vet visits (she hated the vet) and daily insulin shots.
Nibbler Playing Peek-a-Boo in our Window
What to Feed a Diabetic Cat?
Having no previous experience with carbs--or diabetes--I figured there was no harm in trying the wet food diet first, then proceeding with insulin and giving her , I ordered a bunch of Fancy Feast varieties, and figured I'd let Nibbler pick and choose her favorites. Knowing what I know now, I would've stuck to ONLY the CLASSIC pate varieties. No "Grilled," no "Sliced," and definitely nothing "in gravy." The pate varieties; Tender Beef Feast, Chunky Chicken/Turkey Feast, have only 2-3% calorie carb count! Unfortunately, Nibbler preferred the Grilled variety (which I now has a much higher carb count, and probably didn't do her as much good as the Pate variety could have).
On the pate Fancy Feast Classic, Nibbler's glucose fell from over 400 to 300 within one week. At this point, I called the vet and cancelled our appointment for insulin trainging. The second week, it dropped another hundred. The following week, another. In four weeks time, our diabetic cat had normal readings. I patted myself on the back and declared her "cured."
Low-Carb Cat Food: Only the Classic Pate
The Wrong Diet
Since my cat's diet diet appeared to do the trick, I slacked off on testing Nibbler's glucose after getting several "normal" readings in a row. Months went by, and the peeing that had subsided and been confined to the tubs came back with a vengeance. Suddenly, it seemed, our potty-trained kitty was peeing anywhere and everywhere. Most often, she liked to go potty on clothes laying on the laundry room floor (vinegar helped with the clothes). We began testing the glucose again, and it was back in the 300's. I quickly hopped back on google to see why it was coming back after it had plummeted so nicely.
As it turns out, the "Grilled" and "Sliced" varieties of Fancy Feast had quite a bit of carbs in them. Not as many as our previous dry food, but in the 13-%-17% range, as opposed to the <5% range where I wanted to be. I hadn't realized only the classic Fancy Feast Pate varieties were the low-carb ones. So I quickly bought several packs of classic pate varieties, and I thought we were back in the clear. We weren't.
Can diet alone work when treating a diabetic cat if you by the right type of high-protein, low-carb food? Vets don't seem to agree on this. According to Dr. Lisa Pierson at catinfo.org, many cats have been able to "honeymoon" into remission (though often temporary) based on diet alone. Others, like my vet later told me, say it "never works." While it may be worth a shot, let your vet know if you intend to try it along with the insulin, because a drastic diet change plus starting insulin could lower a cat's sugar too much, and hypoglycemia could result!
The night before we took Nibbler back to vet, she had stopped eating. After she didn't come running to the sound of the cans of food opening, we found her laying at her water bowl, with her head hanging over it. Late that night, she appeared dazed and extremely lethargic. In that moment, I had the sinking feeling we'd waited a little too long.
The vet confirmed she had ketoacidosis, a dangerous complication of diabetes. Her blood sugar was in the 400's, she was dehydrated from the sickness, and she had a urinary tract infection. Before she went further with treatment, the vet presented my husband with the $1600 bill. As he was signing it, he asked her to be honest: was the cat going to be "OK?" The vet said that she was in bad shape, and her quality of life would continue to deteriorate from there. She said that diabetes often comes with complications: UTIs, kidney disease, hypoglycemia and ketoacidosis were some. The treatment would be hard on her--some cats with severe sickness don't make it, and if she did pull through, her arthritic joints would not make her quality of life worth it.
We. Were. Crushed.
"Like it or not, I'm a lap-kitty!"
Mourning the loss of an animal was surprisingly horrific, and I wouldn't wish it on my worst enemy. The first 48 hours after Nibbler went to kitty heaven were some of the worst hours in my life. I'd loved this cat longer than any animal I'd ever had, and it pains me that she got so sick towards the end. I cried until I thought my eyeballs would pop out, and then I cried some more. I didn't eat, barely slept, and couldn't hold a thought in my head except her. The "What-ifs" wouldn't stop. What if I had put her on insulin to begin with? What if we'd taken her to the vet sooner when the peeing and weight loss first started? What if we'd at least tried the treatment? In the end, it all came down to our vet's recommendation and the sick feeling in my gut that Nibbler wasn't going to have the active, happy kitty life she'd always had.
By the third day after her passing, the crying became more sporadic, and I knew I would be OK. By the grace of God, 72 hours later now, I am remembering her fondly and without tears. She was my sweet "Nibbie," and we did our best to give her a good home. Did we make mistakes...yes! But Nibbler did have a good kitty life, and I like to think most of it was filled with happiness from sun-basking, dog-swiping, and bug-chasing.
As the weather warms up, I like to imagine her all stretched out on a cloud in heaven now, basking in the sun, the way she always did on our back porch in the summer.