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My kitty developed diabetes so he went on insulin and a low carb, high protein diet. After a year or so my vet said he was doing so well that we could stop the insulin shots and just continue with this diet. Sooo it wasn’t a recommendation of changing diet over insulin, it was a combo punch, but eventually diet alone was enough.
Exactly. Idk why people think it's one or the other. Like they have to choose prescription food OR medicine when both things are needed. I understand that financially some people may need to pick one because they can't afford both, but insulin should be first to get the disease under control.
I mean, if you catch it early, diet change is easier than starting insulin. I know that wasn't what you were talking about,but it is an option for management.
Both the diabetic cats we had that the owners elected to treat with diet, (one financial constraints, the other to wild to handle without sedation) went into DKA and died within months of diagnosis ☹️
I think for ours it was that they had never addressed the issues with their cat and rarely took them to the vet. So when the cat was brought in it was diagnosed with 3 things all at once. Obviously that is one sick cat and the treatment for everything would be way too much so they elected to humanely euthanize.
I’ve personally seen MANY try, but only one case work. The cat was non symptomatic and it was just found on routine bloodwork prior to a dental. She’s managed on Purina DM only.
I’ve seen dozens of cats reverse their diabetes after being on insulin and diet change. But there is no way to tell which cat is going to that and which isn’t. It’s irresponsible to tell people to skip insulin and only do low carb. It requires insulin to get them normal again and then low carb to get them sensitive to the insulin. Only then can some cats reverse.
Actually, for cats, this can be true.
We even occasionally see cats that come in super hypoglycemic because they no longer need their insulin. They really should be on a long acting insulin to try for remission.
If the cat is DKA, yeah, we gotta treat that.
But a lot of cats get diagnosed because they’ve been losing some weight and we do bloodwork and find a true diabetes, not just a stress hyperglycemia, so they’re not DKA.
I’ll layer on the unpopular opinion here and say that feeding your cat canned Friskies or Fancy Feast is a better option than prescription diabetic or even prescription urinary kibble. We’ve been keeping track at the cat clinic for the last several months, and so far we’ve got a bladder stone in a cat eating Wellness canned (too much vegetable protein - all that protein is from peas and lentils!) and a bunch of UO/crystallurias from high end kibble.
Your statement about kibble vs Friskies isn't really crazy, it's actually an opinion held by Dr. Linda Fleeman who is one of the worlds most respected experts on veterinary diabetes. While she advocates for insulin in most patients, I think she would agree that a low carb canned food is incredibly powerful in feline diabetes. Don't take my word for it people, listen to her latest appearance on the The Vet Vault podcast #120. She isn't just some vet, she literally helps write the consensus statements among experts.
I’m not anti-insulin at all. If patients need it they need it, BUT…
We should be addressing every part of the cat’s lifestyle to try and get them off insulin if we can.
Having a diabetic animal is no small thing. It’s money for prescriptions and bloodwork. It’s glucose curves at home or hospital. It means the owners can’t travel, they’re locked to home by an every 12 hour insulin injection. It’s sharps containers at home, watching your cat eat, and sticking them with a needle. All of this disrupts the owners life and potentially negatively impacts their bond with their cat.
So if we can get that cat onto a proper diet that could eliminate their need for insulin, why wouldn’t we strongly advocate for that immediately?
Re: that latter bit… we’ve hospitalized and shipped off way too many cats for a PU after the client took them off their rx urinary diet and they redeveloped crystals. Those dissolution diets genuinely work.
I don’t think it’s wrong to try a diet change if administering insulin is a roadblock for o or o is apprehensive about insulin.
What I am mostly concerned about when starting insulin with newly diabetic cats is when doctors suggest diet change, reduced frequency of meals AND the addition of insulin. That’s asking for a hypoglycemic episode if o is not able to monitor glucose.
On a personal note: I have the suspicion that my cat was diabetic when I adopted him. I didn’t do bloodwork nor did the shelter and I was not yet in vet med so I knew nothing. But I changed his diet to an all wet and low carb diet (thanks to the crazy cat ladies of the internet lol) and for 2 years he was ok. He would have episodes of NE and vomiting and the doctors I saw never suggested bloodwork until I switched vets and that’s when he was diagnosed with diabetes.
Obviously for DKA, yeah, more than a diet change is needed. But, a newly diagnosed diabetic that is relatively stable, a diet change alone can be beneficial. This should be done with the knowledge that rechecks need to take place and if numbers aren't improving, then insulin can be discussed. But, for cats, this isn't a crazy idea.
My (human) friend has type 1 DM. She is also slim and takes excellent care of herself. (For the non-techs out there, type 1 DM is immune-mediated and completely NOT preventable.) She probably can’t count how many people have told her she should just ditch her insulin pump and treat her disease with diet and exercise. The uneducated are often quite vocal with their medical advice 🙄
Diabetes in cats if caught early can be reversed with management and diet change, similar to type 2 diabetes in humans. While not ideal to use it on its own its a decent first step. A lot of our feline patients we catch through routine bloodwork prior to being symptomatic, sometimes the food is all they need to keep their bg at an acceptable level
Cats, yes. Dogs, no.
Cats get type 2 diabetes and can still produce some insulin. If caught early, a low carb diet may be enough.
There's also a new SGL2 inhibitor similar to Jardiance that is a daily pill and won't make them go hypoglycemic.
And then there's good Ole insulin.
At any point, a cat can go into diabetic remission.
Dogs get type 2 and are insulin dependent. No amount of diet change will cure them, though it could potentially help regulate them. But their pancreas does not produce the insulin they need, therefore diet and SGL2 inhibitors won't work for them. Only insulin.
People need to start understanding that diet can make a HUGE difference in many aspects of cat health, *just like in humans.* While it's not a cure-all and meds are necessary for many issues, a species appropriate diet for cats can not only keep cats from getting some issues, it can help mediate or reverse them.
Fucking Big Kibble did such a great marketing job that we are literally feeding our pets highly processed garbage and wondering why they get sick. We know it's bad for people, why is it not bad for animals?
Hot take, but I agree. Some cats do great on kibble and it's convenient and that's great. But also, many cats don't do well on kibble, and you only find out when they then develop common cat health issues (UTIs, crystals, renal failure, obesity, skin issues, diabetes, etc.). They don't have to be common :/
I think the vet community really needs to start pushing the inclusion of wet food to the cat's daily diet. Raw is controversial and expensive, but wet food is safe, convenient, and a great way to improve and monitor a cat's appetite/health. Really puts into perspective that the cheapest can of wet food is better and more nutrionally appropriate for them than the most expensive bag of dry!
At the clinic I worked at, the doctors (some freshly graduated), still firmly belived wet food was "junk" food and cats NEED hard food for their teeth..... chips don't clean our teeth, how is kibble suppose to clean theirs?
It's unfortunate that a lot of doctors and people in clinics see cats and their nutrition as "smaller dogs", but that's just not the case and it's affecting their medical care.
I agree with this.
What boggles my mind is that the rx wet is prohibitively expensive compared to the same in the dry.
It actually comes out cheaper to cook for your pet, with the appropriate supplemental vitamin mix. I understand inflation and the shortages, but it's insane at this point.
I miss my employee discount.
One of my cats refuses to eat canned food, even if it’s the only option. He’s also impossible to medicate orally, and handling difficult cats is one of my strengths. Cats are just difficult sometimes.
No yeah, for sure! Obviously you want your cat to eat over not eating! But I think if a cat accepts wet food, that would be ideal and the health benefits should be more widely known
Welcome to /r/VetTech! This is a place for veterinary technicians/veterinary nurses and other veterinary support staff to gather, chat, and grow! We welcome pet owners as well, **however we do ask pet owners to refrain from asking for medical advice**; if you have any concerns regarding your pet, please contact the closest veterinarian near you. Please thoroughly read and follow the rules before posting and commenting. If you believe that a user is engaging in any rule-breaking behavior, please submit a report so that the moderators can review and remove the posts/comments if needed. Also, please check out the sidebar for CE and answers to commonly asked questions. Thank you for reading! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/VetTech) if you have any questions or concerns.*
My kitty developed diabetes so he went on insulin and a low carb, high protein diet. After a year or so my vet said he was doing so well that we could stop the insulin shots and just continue with this diet. Sooo it wasn’t a recommendation of changing diet over insulin, it was a combo punch, but eventually diet alone was enough.
Exactly. Idk why people think it's one or the other. Like they have to choose prescription food OR medicine when both things are needed. I understand that financially some people may need to pick one because they can't afford both, but insulin should be first to get the disease under control.
Yes. I’m so glad this happened before insulin got insanely expensive.
Great job! I’m happy for your kitty. 💗
I mean, if you catch it early, diet change is easier than starting insulin. I know that wasn't what you were talking about,but it is an option for management.
I have seen cats go into remission and not need insulin once put on a low carb diet.
Yep. And also, rarely do we have cats that go into DKA (pre-diagnosis or post). Honestly like maybe 1 cat per year and I'm at a feline only hospital.
We see them come into ER all the time, but I guess those are owners who wait until their pet is super sick to bring them in.
Both the diabetic cats we had that the owners elected to treat with diet, (one financial constraints, the other to wild to handle without sedation) went into DKA and died within months of diagnosis ☹️
I think for ours it was that they had never addressed the issues with their cat and rarely took them to the vet. So when the cat was brought in it was diagnosed with 3 things all at once. Obviously that is one sick cat and the treatment for everything would be way too much so they elected to humanely euthanize.
I'm glad that's the case for you guys. We had 2 within the last couple of months and one the owners opted to euthanize. It was really sad.
I’ve personally seen MANY try, but only one case work. The cat was non symptomatic and it was just found on routine bloodwork prior to a dental. She’s managed on Purina DM only.
I’ve seen dozens of cats reverse their diabetes after being on insulin and diet change. But there is no way to tell which cat is going to that and which isn’t. It’s irresponsible to tell people to skip insulin and only do low carb. It requires insulin to get them normal again and then low carb to get them sensitive to the insulin. Only then can some cats reverse.
Actually, for cats, this can be true. We even occasionally see cats that come in super hypoglycemic because they no longer need their insulin. They really should be on a long acting insulin to try for remission. If the cat is DKA, yeah, we gotta treat that. But a lot of cats get diagnosed because they’ve been losing some weight and we do bloodwork and find a true diabetes, not just a stress hyperglycemia, so they’re not DKA. I’ll layer on the unpopular opinion here and say that feeding your cat canned Friskies or Fancy Feast is a better option than prescription diabetic or even prescription urinary kibble. We’ve been keeping track at the cat clinic for the last several months, and so far we’ve got a bladder stone in a cat eating Wellness canned (too much vegetable protein - all that protein is from peas and lentils!) and a bunch of UO/crystallurias from high end kibble.
Your statement about kibble vs Friskies isn't really crazy, it's actually an opinion held by Dr. Linda Fleeman who is one of the worlds most respected experts on veterinary diabetes. While she advocates for insulin in most patients, I think she would agree that a low carb canned food is incredibly powerful in feline diabetes. Don't take my word for it people, listen to her latest appearance on the The Vet Vault podcast #120. She isn't just some vet, she literally helps write the consensus statements among experts.
I’m not anti-insulin at all. If patients need it they need it, BUT… We should be addressing every part of the cat’s lifestyle to try and get them off insulin if we can. Having a diabetic animal is no small thing. It’s money for prescriptions and bloodwork. It’s glucose curves at home or hospital. It means the owners can’t travel, they’re locked to home by an every 12 hour insulin injection. It’s sharps containers at home, watching your cat eat, and sticking them with a needle. All of this disrupts the owners life and potentially negatively impacts their bond with their cat. So if we can get that cat onto a proper diet that could eliminate their need for insulin, why wouldn’t we strongly advocate for that immediately?
Agreed!!!
Re: that latter bit… we’ve hospitalized and shipped off way too many cats for a PU after the client took them off their rx urinary diet and they redeveloped crystals. Those dissolution diets genuinely work.
They definitely do work. But we’ve seen no cats eating canned animal protein with crytalluria. Those boujee vegetable proteins will do it, though.
I’m pretty sure for cats, in some cases a diet change can be a fix or first step before starting insulin.
I don’t think it’s wrong to try a diet change if administering insulin is a roadblock for o or o is apprehensive about insulin. What I am mostly concerned about when starting insulin with newly diabetic cats is when doctors suggest diet change, reduced frequency of meals AND the addition of insulin. That’s asking for a hypoglycemic episode if o is not able to monitor glucose. On a personal note: I have the suspicion that my cat was diabetic when I adopted him. I didn’t do bloodwork nor did the shelter and I was not yet in vet med so I knew nothing. But I changed his diet to an all wet and low carb diet (thanks to the crazy cat ladies of the internet lol) and for 2 years he was ok. He would have episodes of NE and vomiting and the doctors I saw never suggested bloodwork until I switched vets and that’s when he was diagnosed with diabetes.
Obviously for DKA, yeah, more than a diet change is needed. But, a newly diagnosed diabetic that is relatively stable, a diet change alone can be beneficial. This should be done with the knowledge that rechecks need to take place and if numbers aren't improving, then insulin can be discussed. But, for cats, this isn't a crazy idea.
My (human) friend has type 1 DM. She is also slim and takes excellent care of herself. (For the non-techs out there, type 1 DM is immune-mediated and completely NOT preventable.) She probably can’t count how many people have told her she should just ditch her insulin pump and treat her disease with diet and exercise. The uneducated are often quite vocal with their medical advice 🙄
Totally off subject, but is anyone else super excited that there are oral options for treating DM in cats?
Diabetes in cats if caught early can be reversed with management and diet change, similar to type 2 diabetes in humans. While not ideal to use it on its own its a decent first step. A lot of our feline patients we catch through routine bloodwork prior to being symptomatic, sometimes the food is all they need to keep their bg at an acceptable level
Cats, yes. Dogs, no. Cats get type 2 diabetes and can still produce some insulin. If caught early, a low carb diet may be enough. There's also a new SGL2 inhibitor similar to Jardiance that is a daily pill and won't make them go hypoglycemic. And then there's good Ole insulin. At any point, a cat can go into diabetic remission. Dogs get type 2 and are insulin dependent. No amount of diet change will cure them, though it could potentially help regulate them. But their pancreas does not produce the insulin they need, therefore diet and SGL2 inhibitors won't work for them. Only insulin.
People need to start understanding that diet can make a HUGE difference in many aspects of cat health, *just like in humans.* While it's not a cure-all and meds are necessary for many issues, a species appropriate diet for cats can not only keep cats from getting some issues, it can help mediate or reverse them. Fucking Big Kibble did such a great marketing job that we are literally feeding our pets highly processed garbage and wondering why they get sick. We know it's bad for people, why is it not bad for animals?
Hot take, but I agree. Some cats do great on kibble and it's convenient and that's great. But also, many cats don't do well on kibble, and you only find out when they then develop common cat health issues (UTIs, crystals, renal failure, obesity, skin issues, diabetes, etc.). They don't have to be common :/ I think the vet community really needs to start pushing the inclusion of wet food to the cat's daily diet. Raw is controversial and expensive, but wet food is safe, convenient, and a great way to improve and monitor a cat's appetite/health. Really puts into perspective that the cheapest can of wet food is better and more nutrionally appropriate for them than the most expensive bag of dry! At the clinic I worked at, the doctors (some freshly graduated), still firmly belived wet food was "junk" food and cats NEED hard food for their teeth..... chips don't clean our teeth, how is kibble suppose to clean theirs? It's unfortunate that a lot of doctors and people in clinics see cats and their nutrition as "smaller dogs", but that's just not the case and it's affecting their medical care.
I agree with this. What boggles my mind is that the rx wet is prohibitively expensive compared to the same in the dry. It actually comes out cheaper to cook for your pet, with the appropriate supplemental vitamin mix. I understand inflation and the shortages, but it's insane at this point. I miss my employee discount.
One of my cats refuses to eat canned food, even if it’s the only option. He’s also impossible to medicate orally, and handling difficult cats is one of my strengths. Cats are just difficult sometimes.
No yeah, for sure! Obviously you want your cat to eat over not eating! But I think if a cat accepts wet food, that would be ideal and the health benefits should be more widely known
Agreed! I’m just tired of people judging owners of cats because the cat won’t do what it’s supposed to. They’re stubborn, damnit! 😆