My cat was just diagnosed with diabetes mellitus. My veterinarian tells me that we must make some feeding changes, and I'd like to better understand what kind of changes she's talking about.
Diabetes mellitus (DM) is a complex disease in cats. Most cats have type II diabetes. This means that they produce insulin – the hormone that tells the cells to absorb glucose (sugar) from the bloodstream – but the cells no longer respond to insulin in the same way. The cells have become resistant to the insulin signal, so glucose does not enter the cells. This is why cats are often said to have “non-insulin-dependent diabetes mellitus.”
Nutrition is very important in managing cats with DM. The single most important lifestyle factor that contributes to the development of DM in cats is being overweight or obese. Excess body fat creates insulin resistance in the tissues, which stimulates the pancreas to secrete even more insulin. Conversely, cats that attain lean body weight can improve their insulin receptivity and may go into diabetic remission, where they don’t require insulin injections to manage their blood sugar.
The best way to deal with DM in cats is to do everything possible to prevent it, which means managing meal portions when feeding, starting when cats are still kittens.
How can I help my cat now that he has diabetes?
Once a cat has been diagnosed with DM, the most important long-term management strategy after beginning insulin injections is diet change. It is well established that a lean body condition sets the stage for better control over blood sugar, and controlling blood sugar is the key to managing DM.
Controlling blood sugar is the key to managing DM."
It is critical to work closely with your veterinarian to choose the most appropriate nutrient profile to achieve a normal body condition. If your cat is overweight, your veterinarian will recommend a diet formulated to promote weight loss while offering adequate levels of easily digestible protein. If your cat is underweight, a diet with a higher caloric density may be recommended.
The goal during weight loss is to preserve muscle while using fat selectively as an energy source. There is good scientific data to guide nutritional choices, and your veterinarian is the best partner to help make the best choice for your cat.
A higher percentage of lean body mass contributes to less insulin resistance in the tissues, and this can lead to a lower insulin dose or potentially remission. Cats with a more normal body mass and better body composition tend to feel better and often want to be more active as a result. Exercise can help the body use its energy sources more effectively.
What are other important considerations for my cat’s diet, now that he is diabetic?
- Water: As cats with DM often drink more and urinate more, they need easy access to clean fresh water all the time.
- Calorie density: The number of calories in a cup or can of food is an important consideration when selecting a diet for a cat with DM. A cat that needs to lose weight generally needs a less calorie-dense diet, but if your cat is underweight, they may need a diet with more calories per cup/can. Canned diets are often beneficial in cats with diabetes as they are less calorie-dense than dry kibble.
- Fiber: Fiber is an important part of every cat’s diet. Soluble fibers can improve the health of the colon and overall immune health, but insoluble fibers like cellulose benefit cats with DM. Insoluble fibers can slow the absorption of glucose from the diet.
- Protein: Protein is very important for a cat with DM, but the exact need will change depending on your cat’s body condition and muscle condition – another reason to communicate closely with your cat’s veterinarian.
- Carbohydrates: Glucose is a type of carbohydrate. Although low carbohydrate diets are often recommended, it is important to remember that not all low-carbohydrate diets are the same. Many diets low in carbohydrates are calorie dense and associated with obesity – something that is essential to avoid in a diabetic cat.
- Other complications: Many diabetic cats have other medical concerns like pancreatitis, inflammatory bowel disease (IBD), or chronic kidney disease (CKD). The best diet for these cats needs to address all their medical issues.
There is no best diet for all diabetic cats. It is essential to collaborate with your veterinary team i the best diet for your cat.
When should I feed my cat?
If your cat grazes on their food throughout the day, they may be able to continue this pattern if they use a diet appropriate for DM and their body condition. Some cats who eat meals or whose glucose isn’t regulating will need to have their meals timed along with their insulin injections.
Often, insulin is given right after the cat has eaten a meal. Ask your veterinarian what they recommend if your cat doesn’t eat their meal. A missed meal may mean hypoglycemia. Once you know the blood glucose level, call your veterinarian for guidance. If you do not have a home monitoring device, skip insulin and call your veterinarian as soon as possible.
Will my cat be able to stop getting insulin if I feed him as my veterinarian recommends?
If DM is diagnosed and addressed promptly with diet, insulin injections, and a healthy body condition, it will go into remission for some cats. Remission means the cat no longer needs insulin injections to control their blood glucose. Cats in remission are not cured. They still need careful attention to their diet to keep them in remission as long as possible. Eventually, most of these cats will need insulin injections again.
Can my cat get treats?
Treats can be given with caution and should be discussed with your veterinary team as part of your cat’s nutrition plan. Often, using a portion of the daily kibble ration is recommended, or giving carefully selected treats at the same time each day. No matter what, be sure to work closely with your veterinarian to achieve the best outcomes possible.
