Cat Diabetes

Overview of Diabetes Mellitus in Cats

In short, diabetes mellitus is a lack of insulin production by the body. It is unknown exactly what causes diabetes, but is thought to be a combination of genetics and bad luck.
Certain factors can increase the chance of diabetes: obesity, chronic pancreatitis or GI problems, or long term use of corticosteroids. Treatment of Diabetes in Cats All cats diagnosed with diabetes will require insulin injections, sometimes permanently, and some cats will revert away from the need for insulin with initial therapy and appropriate diet changes (which is one of the challenging aspects of diabetes management in cats, as one cannot predict which cats will require lifelong insulin and which will require for a short period). Cats require specific diet changes. The key to diabetes control is consistency of feeding, insulin injections, and monitoring of blood glucose readings.

Treatment of diabetes is not a cheap endeavor with costs of food, insulin, and monitoring. Additionally, dental care is even more important in diabetic patients, as the bacteria from poor dental health and higher blood sugars can create more difficulty in controlling the diabetes.

Insulin: We recommend Lantus or Glargine insulin in cats, as research has shown it to be the most effective product in cats with the highest rate of remission. The initial cost of the Glargine is expensive, ranging from 180-200$ / bottle, however the product will keep in refrigerator for up to 6 months (in the human world, they recommend replacing the bottle every 30 days, however it has been shown that the product maintains effectiveness when refrigerated for 6 months). The syringes for Glargine are human U-100 syringes, 1/3 ml syringes (smallest) to make the small doses of insulin needed for cats easier to administer. DO NOT use any other insulin syringes.

Monitoring: All cats will require blood sugar checks to determine how well the blood sugars are being controlled, in general home glucose testing is better as the patient is less stressed, the costs to the owner are lower, and excellent control can be obtained. We recommend the use of Alpha Trak glucometers, as they are specifically designed for use on pets. The glucometers are available through VCA River City for at home testing. The values can be called into the clinic for a doctor to review and recommendations made. Each phone consultation will be charged at $19.30. Some owners and some patients are not willing or able to pursue at home blood glucose testing, and will require in hospital monitoring of blood sugars. There is a link to a video on the River City web site of how to obtain blood glucose readings on your own, and our technicians are happy to help you/show you as well.

1. After the first week of insulin treatment, the patient will need to have blood sugars obtained just prior to food and insulin administration, and then 6 hours later. If the sugars are still significantly out of range, adjustment may be made to the insulin dose.
2. Generally, 2 weeks later (3 weeks from diagnosis), a full glucose curve will need to be performed. A glucose reading is obtained just before insulin as above, and then generally every two hours through the course of the day to allow full evaluation of how well the sugars are regulated, to see the high and low points of blood sugars, as well as how long the insulin is working.
3. In most cases with cats, 2-3 curves are required to get a diabetic cat fully controlled. Once a patient is regulated, approximately twice monthly a blood sugar should be obtained before food and insulin to assure that control has not changed. If the value is under 100 mg/dl or over 200 mg/dl you should contact the doctor. This step is especially important in feline diabetics, as they can go into remission and not need insulin at any time, without warning.
4. Insulin shock: if a patient gets too much insulin, or does not eat enough food, the blood sugar can get dangerously low. If your cat appears drunk or wobbly, weak, but is still alert, try to get the patient to eat or administer sugar water by mouth to increase blood sugars. In severe cases, low blood sugar can cause seizures or coma and the pet should be taken to a vet or emergency clinic immediately.

Diet: The most appropriate diets for cats that have diabetes are very high in protein and low in carbohydrates. Almost all dry foods for cats are very high in carbohydrates, as to make the nuggets "stick" together they have to be. Where possible, diabetic cats should be placed on an entirely canned diet. We recommend Science Diet MID canned diet as the initial diet, however, not all cats will eat it. There is also a list of alternative foods below that are also appropriate. If your pet will not eat the new food, return to the normal diet (as it is important for your cat to eat), and make a gradual change to the new diet, adding approximately 10% of the new food daily until the food can be fully changed to the new diet.

Generally, feeding should be performed in the following way: the patient should be fed twice daily approximately 12 hours apart. The food should be offered and the pet should eat, and then 15-30 minutes later the insulin should be administered.

• If no food is eaten, DON'T GIVE INSULIN, unless a blood sugar has been checked.
• If half the food is eaten, administer ha/f the normal dose of insulin.

Snacks: Control of diabetes can be challenging in some patients, and we generally recommend not giving snacks to diabetic cats particularly high sugar, over the counter snacks. If you must give snacks to your cat, good treat options include meat, freeze dried meats, and only in limited quantities.

While some cats can be challenging to regulate, most cats will have an excellent quality of life with diabetes. It is not uncommon for all diabetic cats to require some adjustment to insulin from time to time. If your cat shows any of the following signs:

• Seems to feel ill, goes off of food, generally not feeling well, or shows significant changes in urination or water consumption.
• Is losing weight despite good appetite.

Please schedule a follow up consultation with the doctor.

We’re here to help! Visit VCApetdiabetes.com to watch a video on how to give an insulin injection, monitor blood glucose with our eDiary, find expert advice and get support from our interactive community to help manage your cat’s diabetes.