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Diabetes in cats

Feline diabetes mellitus (DM) is a metabolic disorder that affects a cat’s ability to regulate its blood sugar levels, resulting in high blood sugar levels (hyperglycemia). DM is considered the second most common endocrine disease in cats. It occurs when the pancreas is not able to produce enough insulin (the hormone in charge of regulating glucose levels) or when the organs become resistant to it. In cats, this condition is similar to DM type II seen in humans, where the main problem is insulin resistance. While type I DM (lower insulin production) can also occur in cats, it is a less frequent condition in this species.

PREDISPOSITION
Any cat can potentially develop DM during its life, but there are some risk factors that contribute to the development of this disease. These include:

  • Obesity → Overweight cats have a higher risk of developing DM due to the impact of excess body fat on insulin production and sensitivity.
  • Age → Middle-aged and older cats are more prone to DM, with the average age of diagnosis around 7 to 10 years old.
  • Gender → Male neutered indoor cats are also more prone to DM.
  • – Genetics → Some cat breeds, such as the Burmese and Siamese, have a higher predisposition to DM.
  • Other factors → Certain medical conditions such as pancreatitis or acromegaly, or steroid medications can increase the likelihood of DM.

SYMPTOMS
Common symptoms of diabetes in cats include:

  • Increased thirst and urination
  • Weight loss despite having a good appetite, increased hunger, lethargy, and fatigue due to the body’s inability to use glucose for energy.
  • Vomiting
  • Muscle wasting
  • Plantigrade stance (cats walking with their whole foot almost fully touching the ground). This sign is observed less frequently in cats.

DIAGNOSIS
Regardless of the type, in all cases of DM, there is an increased amount of glucose in the blood. As a result, DM is diagnosed by the presence of typical clinical signs along with persistent elevated blood glucose (BG) and glucosuria (glucose found in urine). This can be diagnosed by performing full bloodwork and a urinalysis. Your veterinarian may also use the blood sample to perform a serum fructosamine test, which provides information about the average BG levels over the last couple of weeks.

BLOOD GLUCOSE CURVE
There are a variety of insulin preparations available for cats; however, each cat responds to insulin differently. In order to find the right insulin dose and frequency that works best for your cat, your veterinarian will need to perform a BG curve. This is a series of BG measurements taken over the course of a day at regular intervals. This procedure is usually performed in the hospital, but eventually, cat owners can learn to perform blood glucose curves at home. This method can provide more accurate results as it helps to avoid stress hyperglycemia and inappetence experienced by many cats in the veterinary clinic. Blood can be collected at home from an ear vein or paw pad, and should be read on a monitor validated for cats.

Alternatively, a small monitor used for continuous BG monitoring can be implanted on the cat’s skin. This device records BG readings every few minutes for up to two weeks without repeated needle pricks. It is very important that owners who monitor BG at home shouldn’t change their cat’s insulin dose without first consulting with their veterinarian. It is also crucial to understand that even in a stable cat, regular monitoring will be required, as insulin needs can change over time. If performing a BG curve is not possible, a fructosamine concentration can be used to get an estimate of the BG levels over the last two weeks with a single blood sample. However, this method only measures the average, rather than the BG highs and lows throughout the day, crucial for the success of the treatment.

HYPOGLYCEMIA
One of the most serious complications of managing a diabetic cat is the risk of hypoglycemia (low blood sugar). Hypoglycemia can happen to any pet if they receive too much insulin and it should be treated as an emergency as it is potentially life-threatening. Typical signs of hypoglycemia that you should be aware of are:

  • Dull mentation or disorientation
  • Profound weakness or lethargy
  • Gastrointestinal signs (vomiting, diarrhea, not eating)
  • Trembling/seizures
  • Coma

TREATMENT
Once your cat has been diagnosed with DM, treatment is essential to control this condition.

  • If unwell at the time of diagnosis, your cat may need to be hospitalized for several days until its glucose level is controlled and it is feeling well.
  • Insulin therapy: Most diabetic cats require daily insulin injections. Your vet will determine the appropriate dosage for them and will teach you how to administer the injections at home. After your cat has been receiving insulin at home for about a week, they will need to have a glucose curve performed. Based on your cat’s symptoms and the test results, the insulin dose might need to be adjusted, in which case the glucose curve will need to be repeated. This cycle continues until your cat’s symptoms are well controlled and their BG levels are within an acceptable range. Regular BG monitoring is essential to assess the effectiveness of treatment.
  • Diet and weight management: A controlled and consistent diet is vital for diabetic cats. Feeding them a high-protein, low-carbohydrate diet can help regulate blood sugar levels. Consult your vet for suitable dietary options. If your cat is overweight, a weight loss plan might be suggested to increase insulin sensitivity.

GOALS OF THE THERAPY
The main goals of the treatment of feline diabetes are centered on:

  • Restoring normal blood-glucose levels
  • Reducing or eliminating the clinical signs
  • Normalizing weight and appetite

PROGNOSIS AND REMISSION
With early, aggressive treatment of diabetes, some cats might enter a state of diabetic remission, meaning they are able to maintain normal blood sugar levels without insulin injections. Cats who have achieved diabetic remission should continue to be fed a low-carbohydrate diet and receive close monitoring, as some will eventually require insulin therapy again. While there is no cure for feline DM, the prognosis is usually considered good with adequate management at home.

By recognizing the signs, seeking timely veterinary assistance, and implementing appropriate management strategies, we can help our cats live happy lives despite their diabetes diagnosis. If you are worried your cat might be showing possible signs of diabetes, please don’t hesitate to contact us.