The information contained in this sticky is provided for educational purposes only and is not intended to replace veterinary advice. The intention of this sticky is to open doors to understanding about the specific medical condition or topic, allowing for educated and on-going discussion with your vet.

Diabetic Cat Care   UK Info

Food Choices

Finding appropriate low carb wet foods in the UK can be a challenge as manufacturers keep switching up ingredients, some even including sugar! Please visit the Food Info section of the TR College of Knowledge (COK) to help assist you when calculating carbs based on dry matter for wet foods appropriate for diabetic cats. The downloadable Carb Calculation tool is available here.

Wet cat food with a lower than 10% carbohydrate count based on dry matter (which is not indicated on the label) is best for cats with FD and is required when practicing TR. Avoid foods containing grains such as rice, wheat and corn, glutens, starches, sugars and syrups, gravies and those containing vegetables and fruits. Foods containing soy and/or ‘vegetable protein extract’ can raise the BG even if the percentage of calories from carbohydrates is below 10%. These species inappropriate ingredients can render the liver useless to do its job of protecting the brain in the event of low BG, potentially resulting in clinical hypo and are not at all recommended for cats when starting TR as explained in The Liver's Job sticky.

Your vet may have prescribed Purina DM (Diabetes Management) prescription food. While lower in carbs than most tinned cat foods (a reformulation of the recipe has brought the dry matter carb content under 8%) it contains corn starch and is very expensive; it is an acceptable canned food for an FD cat on TR.

Before switching a cat already receiving insulin to an all wet low carb diet, it is very important to read the Detox Process to make sure your cat is transitioned from both high carb wet food and /or dry kibble to low carb wet food safely, avoiding a potential clinical hypo. To save you the challenge of scrambling to identify low carb wet foods currently available in the UK, the following list is provided. Ingredients are always being changed by the manufacturers, so it is recommended to double check the dry matter carb content of foods periodically.

At the Supermarket or Zooplus

SUPERMARKET CAT FOODS…(tesco, asda, morrisons, & most pet stores) shows no veg or grains.

Sheeba Fine Flakes in Jelly:They have started listing natural sugar on the cns. or pouches which have always been in their foods. but they seem to have no affect on the BG.

Sheba Fine Flakes Chicken selection…DM Carbs 0.4%, Phos 1.3%
Sheeba Fine Flakes fish (Salmon) selection…DM Carbs 0.4%, Phos 1.3%
Sheeba Classic in Terrine Poultry Cocktail - Chicken & Turkey DM Carbs 0.7%, Phos 1.3%
Sheeba Classic in Terrine - Duck & Chicken…DM Carbs 0.7%, Phos 1.3%

Here are a couple more brands that are good.
These can be found here from Germany: https://www.fuettern-mit-spass.de/katzenfutter/nassfutter/ropocat/

Based on Analytical Constiuents

Ropocat - Complete grain free tinned food for cats. 100g & 300g

Online:

DCC has joined Zoo plus UK's Affiliate Program to help you save $$ and help DCC at the same time. By clicking through on the Zoo plus UK link below, a small percentage of commission from members purchases will be earned by DCC. To benefit DCC the click-thru MUST come from this link.

Bozita, Chicken, Beef, Salmon and Prawn flavors 400g tin...DM carbs 5.6% (blue label) ...(none of the Bozita "chunks" flavors are suitable for TR)

Feringa Menu Duo, DM carbs 2.5%
Rabbit & Turkey with Buckthorn and Catnip
Duck & Veal with Broccoli and Dandelion
Salmon & Turkey with Courgette and Watercress
Poultry with Baby Carrots & Dandelion
Lamb & Rabbit with Cranberries & Watercres

Feringa Meat Menu, DM carbs 4.1%
Chicken with Squash & Catmint

Feringa Menu Kitten 6 x Food: Feringa Kitten, DM carbs 2.9%
Turkey with Pumpkin & Catnip

AnimondaPouches-Exotic (these consist of a higher percentage of beef (48%) then buffalo, kangaroo and ostrich (20%)
Animonda Carny® Exotic with buffalo 85 g - DM carbs 3.7%
Animonda Carny® Exotic with kangaroo 85 g - DM carb 3.7%
Animonda Carny® Exotic with ostrich 85 g - DM carbs 3.7%  

Trays-Kitten
Animonda Vom Feinstein Kitten with Beef, chicken, pork 100g - DM carbs 3.5%
Animonda Vom Feinstein Kitten with Poultry, pork, beef 100g - DM carbs 3.5%
Animonda Vom Feinstein Baby pate with meat & fish 100g - DM carbs 3.7%

Animonda Integra Diabetic wet with beef, chicken, pork & poultry - DM carbs 7%

Macs (no fruits or gravy’s) 200g cans, 400g cans
Beef with Chicken Hearts - DM carbs 0.5%
Duck, Rabbit & Beef - DM carbs 1.5%
Duck, Turkey & Chicken - DM Carbs 0.4%
Calf & Turkey - DM carbs 0.3%

Miamor Pate pouches 6X 85g (avoid those with veg & milk)
Chicken & Goose DM carbs 1.02%
Turkey & Duck DM carbs 1.02%
Poultry & Salmon DM carbs 1.02%

Tins 85g
Rabbit - DM carbs 4.34%
Chicken - DM carbs 4.34%
Poultry & Liver - DM carbs 4.34%
Salmon - DM carbs 4.34%
Tuna - DM carbs 4.34%
Pheasant - DM carbs 4.34%

Lily's Kitchen Organic
Chicken Dinner for Cats - DM carbs 0%
Fish Dinner for Cats - DM carbs 0%
Lamb Casserole for Cats - DM carbs 0%
Hunter's Hotpot for Cats - DM carbs 0%
Whisker Licken' Chicken for Cats - DM carbs 0%
Poultry Pie for Cats - DM carbs 0%
Marvellously Mature Chicken Supper for Cats - DM carbs 0%
Curious Kitten Dinner - DM carbs 1.58%
Turkey Dinner for Cats - DM carbs 0%
Catch of the Day for Cats - DM carbs 0%

Thrive Complete 75g tins
Chicken Breast & Turkey- DM carb  2.1%
Chicken Breast - DM carbs  2.0% 
Chicken Breast & Chicken Liver - DM carbs .2.0%

Thrive cat treats can be bought in small or larger tubs (Purchased from zoo plus or other online pet stores
Thrive Cat Treats – Fish: 100% white fish (freeze-dried)
Thrive Cat Treats – Chicken: 100% chicken (freeze-dried)
Thrive Cat Treats - Beef: 100% Beef (freeze-dried)

Cosma Snackies can be bought in small or larger tubs (Purchased from zoo plus or other online pet stores

Chicken & Shrimps 75% chicken, 25% shrimps
Chicken & Tuna 26g: 75% chicken, 25% tuna
Chicken & Chicken Liver 75% chicken, 25% chicken liver

Raw meat suppliers
https://www.naturalinstinct.com/ - balanced raw food for cats, high quality - contains Brewers yeast and bilberry powder and sea kelp - this recipe MAY effect bg's
http://www.woldsway.co.uk/acatalog/index.html - Search- Raw rabbit etc
https://landywoods.co.uk/ - Raw chicken etc
UK Barf Clubs - Located in several areas.

For those who are interested in feeding a raw diet, please see the COK and/or use DCC's search tool for more information on the benefits and vet approved raw recipes.

Diabetic Supplies

Many diabetic supplies, such as insulin (with prescription), syringes, meters, test strips, lancets, etc., can be ordered online from Weldrick's.

Home Testing

Any blood glucose meter that ‘sips’ the blood up using capillary action and requires less than 1 micro-litre of blood makes testing much easier. Members on forum use brands such as the Bayer Contour, Glucomen LX (which also tests for blood ketones), Accu-Check Aviva or Compact Plus, Ascensia Contour, OTU, and Freestyle to name a few. Informal on-form testing has indicated that the very popular Freestyle meters tend to read lower at higher numbers which is a concern when first starting TR. The meter to choose should be based on which one takes the least amount of blood, and the cost of test strips. Most meters are available in Boots and and local chemists and/or can be found for a cheaper price on EBay, although this will delay starting both home testing and TR. Strips can also be obtained on EBay for approximately £13-15 pounds for 50 or from around £25 from chemists. Please make sure you purchase UK/European test strips and not ones used in the USA as they are calibrated differently. If you need assistance to determine which strips to buy, please post on Talking TR for assistance from UK members.

DCC is a global community and as a result, we request your BG test results are recorded in both metric (mmol/l) and imperial (mg/dl) numbers. When posting your cat’s test results please post both values as follows 13.5/243 which allows members from around the world to understand your numbers and be able to provide quick feedback. To convert mmol/l (metric - Europe, Canada, and everywhere else) to mg/dl (imperial - American) multiply the number by 18. To convert mg/dl (imperial) to mmol/l (metric) divide by 18. For your convenience, Test Log Templates (which automatically convert BG results from Metric to Imperial and vice versa), are located here.

Lancets are the little needle suspended in plastic which is inserted into a lancet pen and used to prick the ear to do a blood test. You should change lancets each time you test your cat’s BG. However, at a push you can re-use them a couple of times (we’ve all run out of supplies at one point or another!). Lancets vary in price, sometimes being cheaper on EBay compared to the high street. They are approximately £12.00 for 100 to 200 lancets. Check to see if your lancet pen comes with a clear cap as this will make things much easier when it comes to testing.

Insulin

At the end of 2010, Insuvet PZI was discontinued leaving FD cats from the UK with Caninsulin as the only approved insulin under the UK Cascade system. Caninsulin was originally manufactured for dogs (hence the name Canin-insulin) and was discontinued in North America due to quality issues. According to the manufacturer, there are no quality issues in Europe. Caninsulin is a U40 insulin that requires U40 syringes which generally are purchased from the vet, but can be bought online. If at all possible, it is recommended to purchase U100 3/10 cc syringes with half unit marks to make measuring small doses much easier. PLEASE NOTE: When using U100 syringes with U40 insulin, a "conversion" to deal with the volume/size difference of the syringes is required. Please post on forum for more information about the required conversion.

Alternative insulin types are available in the UK - Lantus (aka Gargline), Levemir are manufactured insulin types and as such are very stable. Many vets will still require Caninsulin to be used first, before agreeing to a switch. If this is the case for you and your cat, frequent home testing of BG will be your most valuable weapon should it happen that your cat does not respond well to it, and significant data from testing will be required when it comes to convincing your vet that you would like to try another insulin type. Many UK vets are reluctant to veer away from Caninsulin, and may be persuaded to do so when reminded that they do have the latitude to be flexible when it comes to their clinical judgement in regards to prescribing alternative life saving medications under the Cascade Scheme.

Levemir is more flexible than Lantus...but any insulin type can be used with TR.

Ketone Test Strips

When practicing TR, there is generally no need to check your cat's urine for ketones. That said, when most owners find DCC, their cats have been in very high numbers for a long time, and in some cases, their cats are in the process of recovering from DKA (diabetic ketoacidosis). Until your cat is better regulated on TR, it is wise for some owners to periodically check their cat for ketones. You will need to buy Ketostix (pot of 100 urine dip sticks for around £7) from most chemists or on EBay. There is no need to purchase urine sticks that measure both glucose and ketones as they cost a fortune and are not essential. The presence of ketones may indicate the beginning (or a recurrence) of diabetic ketoacidosis (DKA); a dangerous and sometimes fatal condition primarily caused by prolonged hyperglycaemia. Until the cat is consistently reaching BG below renal threshold (12.5/225), it is wise to check the urine at least once daily for ketones. This also has the additional bonus of making you aware of what is ‘normal’ when it comes to your cat’s urine – colour, smell and clarity - all of which can change when other health issues are in play.

Supplements

Cats with FD typically are susceptible to a number of health related issues where the use of supplements can be very helpful. Most stores selling quality vitamins and health foods stock the supplements needed to make raw cat food (Holland & Barrett, Boots etc.). Great care must be taken to insure that the supplements contain no additives such as sugars (any ingredient ending in 'ose is suspect) or rice flours which will raise the BG. A list of sources for supplements is provided, but as with all purchases, please double check the ingredients before giving them to your FD cat.

Upset stomach, nausea, vomiting

Pepcid AC or its generic equivalent is helpful when kitty isn't feeling very well, for example, when certain antibiotics are being used, or during a pancreatitis attack or flare up. For generic brands, the active ingredient is Famotidine, 10 mg. Do not use Pepcid Complete. The dose for Pepcid AC is - 1/4 tab BID, preferably 20-30 min before feeding or medications. Pepcid AC can be given in 1/2 tablet doses twice a day in cases of extreme nausea. Long-term use of Pepcid AC should be monitored by your veterinarian.

Famotidine aka Pepcid AC from Ebay or druggist.

Important Notice for Pepcid AC(Famotidine) users with CRD cats, or cats with heart rhythm problems - Famotidine Side Effects and Interactions.

Some cats, particularly those with high creatine levels( <5 USA/450 international) do not do well on famotidine, perhaps because their kidneys cannot excrete it efficiently. CRD cats may in fact exhibit increased vomiting and appetite loss when it is used. If your cat's vomiting and appetite loss do not improve after two days of using famotidine, ask your vet about switching to ranitidine, which is also used for cats with heart rhythm issues. When using ranitidine, please work closely with your vet.

For more info on Pepcid's side effects

Periactin aka Cyproheptidine from Weldricks

Methyl B12, for cats suffering from neuropathy (walking on the hocks):

Cytoplan.co.uk

https://www.amazon.co.uk/d/4f2/Vitamin-B12-Methylcobalamin-500mcg-90-capsules-Magnesium/B00BMQOXGS

Zobaline (Methyl B12 for FD cats) Lifelink


Milk Thistle Powder:
Jarrows from iHerb

Swansons:
https://www.ebay.co.uk/itm/Swanson-Milk-Thistle-Liquid-Extract-Alcohol-Sugar-Free-29-6ml/112290158585?hash=item1a2503d7f9:m:myzU4D1VEw8r2gVWy8IB8NA

https://www.swansonvitamins.com/natures-answer-milk-thistle-alcohol-free-1-fl-oz-liquid?SourceCode=INT999A

SamE - Denemarin Tablets, Vet UK

Slippery Elm Bark G, Baldwin & Company

L Carnitine (must be pure L Carnitine, not acytel or D variety ) Now Brand from iherb
Solaray Vitamin B Complex - 50 G, Baldwin & Company

Now B50 Complex,  JG Supplements

Taurine, My Protein Company

Salmon Oil Capsules, Holland & Barrett

Hyperthyroidism

HT (hyperthyroidism) is a very common disease which affects cats whether they are FD or not. Please see the HT 101 sticky for further information to help you understand this disease. While tablet form medications are typically used in the UK, Transdermal Gel (Methamazole) for Hyper-T Cats tends to work better with less complications and is now available through Summit Veterinary Pharmaceuticals - it is recommended to discuss this option with your vet.

Indoor/Outdoor Cats

Many owners of FD cats around the world allow their cats outside unsupervised on a daily basis, more so in the UK. When it comes to TR, the critical issue regarding whether or not your cat should be allowed outside without supervision is whether there is any remote possibility the cat will have access to either high carb wet food or even worse, dry kibble. Well-meaning neighbours may leave dry kibble out for visiting cats, not understanding (or willing to believe) the life of an FD cat receiving insulin while on TR is put in dire jeopardy when permitted access to what is no less than high carb "kitty crack". While some may believe a well regulated diabetic cat - no longer ravenous from hyperglycemic (high) BG - will not be interested in dry kibble, the truth is; most cats weaned from dry kibble will always be kitty crack "addicts".

We highly recommend you limit your cat's outdoor experience; either by ensuring your back yard is 100% escape proof, or by using a leash and harness while being closely supervised. Do NOT ever leave a cat on a leash unattended even briefly, as they will be powerless to defend themselves from other cats or predators. While many will feel these restrictive measures will severely compromise their cat's quality of life, the potential that your cat may die from having access to dry food (rendering the liver useless to protect in the event of a low BG and subsequently cause clinical hypo because there is no low carb wet food available to assist with low bg) should be weighed VERY carefully. Most cats, regardless of age, will adapt very quickly to supervised outdoor access only, not to mention, it is the complete and total avoidance from "kitty crack" which is critical when it comes to achieving diet controlled diabetic remission allowing for your cat to go OTJ - where they will never need insulin again.

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