The number of cats diagnosed with diabetes mellitus appears to be increasing. This rise is thought to be associated with an increase in known risk factors such as obesity, age (older than 8 years), sedentary lifestyle, high carbohydrate diets, gender (male neutered), breed (Burmese in the UK), medications such as corticosteroids, and any concurrent condition(s) such as infection, hyperthyroidism, and/or chronic renal insufficiency.
What is Diabetes Mellitus?
Diabetes mellitus refers to a
condition in which the cat’s pancreatic cells do not secrete enough
insulin or the cat’s cells lose their ability to respond to the action of
insulin. Insulin acts to facilitate the movement of the glucose (sugar)
from the cat’s blood stream into the cells. Diabetes mellitus is divided into two types:
·
Type 1 – This type is
very uncommon in cats and is due to a lack of insulin.
·
Type 2 – This is the
most common type seen in cats, and generally occurs because the cat’s cells
become resistant to the action of insulin. Eventually this also leads to
a lack of insulin as this disease process progresses.
Clinical Signs
The diagnosis of diabetes in the cat can be challenging. Unlike dogs,
cats can have abnormally high blood glucose levels just from stress. In
addition, the common clinical signs such as polydipsia (increased drinking) and
polyuria (increased urinating) can be seen with other conditions affecting
older cats such as chronic kidney disease or hyperthyroidism. Other signs such as polyphagia (increased appetite)
or anorexia (lack of appetite), weight loss, and/or a “plantigrade” stance
(this stance looks like the cat is walking on his/her rear hocks instead of the
toes) may also be seen.
Diagnosis
The diagnosis of diabetes
mellitus in the cat is obtained by the demonstration of repeated abnormally
high levels of blood glucose referred to as hyperglycemia
and the presence of glucose in the urine which is referred to as
glycosuria. In addition, the veterinarian may choose to run a
fructosamine blood test. The serum fructosamine level can often times
indicate what the average blood glucose level has been over the past week.
The cat’s “stress-response” typically does not affect this measurement.
The diagnosis of diabetes is
typically made by evaluating the cat’s history, physical examination findings,
and laboratory test results.
Treatment
Successful management of the diabetic
cat depends upon regular communication between the owner and the veterinary
team with the overall goal of achieving diabetic remission. It is
important to recognize that it is okay for the blood glucose to be slightly
elevated above the normal range at some time during the day which differs from
people.
·
For the majority of
cats, insulin still remains the mainstay of a treatment plan.
o
There are several
insulin formulations available for cats. Most cats require twice daily
injections. Many owners find with practice that they are able to
administer the insulin to their cats quite easily.
·
Dietary Management is
also extremely important.
o
Several recent
studies have found that cats fed a high protein and low carbohydrate diet have
a better chance of obtaining remission of the diabetes as compared to high
fiber diets. There are several available prescription diets that allow
the “cat” to choose which one he or she likes best.
o
Studies have also
shown that insulin resistance is directly related to the cat being
overweight. Therefore, if needed, the veterinarian will prescribe a
controlled weight loss plan.
·
Oral glycemic agents
such as Glipizide promote the secretion of insulin from the pancreas.
These agents are mainly reserved for those cats whose owners are unable to
administer the insulin injections. One major disadvantage of these agents
is that the owner has to “pill” their cat everyday which can be very stressful
for both the cat and the owner.
Monitoring
The periodic checking of the
cat’s blood glucose level is necessary especially in the newly diagnosed
diabetic to make sure there are no changes needed in the cat’s treatment plan.
Home monitoring
·
Blood – There are
glucometers now available that can be used in cats. It is very important
to have the glucometer calibrated with the veterinary hospital’s blood
chemistry analyzer or in-house glucometer to make sure readings are accurate.
o
The veterinarian will
provide a blood glucose monitoring schedule. These results will then be
reviewed with the owner and any needed treatment changes will be implemented at
this time.
·
Urine – The following are two examples of
ways to monitor whether the cat has glucose or ketones in their urine by
replacing the litter in the cat box with a nonabsorbent litter and then either
placing the test strip or granules in the urine. If there is glucose
and/or ketones present, there will be a distinct color change.
o
The Multistix is an
example of a test strip.
o
The Glucotest is an
example of the granule form.
·
Body weight weekly
log – a more accurate weight can be obtained with the use of a pediatric scale.
·
Appetite/drinking –
The owner should assess such things as:
o
Is the cat eating a
normal amount?
o
How is the cat
drinking (more or less than usual)?
o
Is the cat’s behavior
typical?
Online Resources
Cornell Feline Health Center
This site has many videos on caring for your diabetic cat, treatment, how to give an insulin injection, nutritional therapy, monitoring and recognizing and treating hypoglycemia by Jodi Korich, DVM and James Richard, DVM. This article discusses getting the diagnosis, treatment including how to give an insulin injection and dietary management, and knowing what signs to look for that would indicate whether the cat’s blood glucose level is too low (hypoglycemia).
This site has many videos on caring for your diabetic cat, treatment, how to give an insulin injection, nutritional therapy, monitoring and recognizing and treating hypoglycemia by Jodi Korich, DVM and James Richard, DVM. This article discusses getting the diagnosis, treatment including how to give an insulin injection and dietary management, and knowing what signs to look for that would indicate whether the cat’s blood glucose level is too low (hypoglycemia).
International Cat Care
Formally the Feline Advisory Bureau, International Cat Care is a charity passionate about improving the care of all cats. Their site contains much information on cat health information including a diabetes fact sheet. Information sheets can still be found on the FAB site on manageing the diabetic cat, what does it mean for my cat and me, and supporting the diabetic cat and its owner.
Formally the Feline Advisory Bureau, International Cat Care is a charity passionate about improving the care of all cats. Their site contains much information on cat health information including a diabetes fact sheet. Information sheets can still be found on the FAB site on manageing the diabetic cat, what does it mean for my cat and me, and supporting the diabetic cat and its owner.
My Cat Has Diabetes
This Boehringer Ingelheim site, which was endorsed by the AAFP, contains information on what is feline diabetes, risk factors, diagnosis, FAQs about treatment, and links to other related websites.
This Boehringer Ingelheim site, which was endorsed by the AAFP, contains information on what is feline diabetes, risk factors, diagnosis, FAQs about treatment, and links to other related websites.
Feline Diabetes
This site has information on feline diabetes, message boards, and cat diabetes information for beginners.
This site has information on feline diabetes, message boards, and cat diabetes information for beginners.
Submitted by Susan Gogolski, DVM, DABVP
(Canine/Feline)
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