grovercentervetFeline Diabetes Mellitus: A Practical Guide for Cat Owners
When your cat begins drinking more water, making big lumps in the litter box, and then continues to lose weight even though he’s eating a lot, it’s time to consult with a veterinarian about cat diabetes. This chronic disease is more common among older cats and occurs in about 1 in every few hundred cats. The great thing about diabetes is that many diabetic cats live long, happy and comfortable lives with insulin and the right food, and some even enter into remission.
In other words, the answer is: A diabetes mellitus is a disease in which the blood sugar remains elevated in cats, due to a inability to produce or effectively use insulin. The classic symptoms include an excessive thirst, frequent urination, weight loss and the insatiable appetite. It can be treated with diet, insulin and regular monitoring.
Diabetes in Cats?
Insulin is a hormone responsible for transporting glucose from the blood to the cells inside the body to give the cells energy. Diabetes mellitus in cats occurs when the cat’s pancreas no longer produces enough insulin, or when the cat’s body no longer uses it normally. Subsequently, glucose accumulates in the blood, passes into the urine and is able to remove additional water from the body. While a cat’s cells are deprived of fuel, the body begins to use fat and muscle for fuel.
The majority of cats with diabetes have a similar type to type 2 diabetes in humans. Eventually the cells become insuline-resistant and the insulin-producing cells of the pancreas begin to deteriorate. Fewer cats get diabetes as a secondary disease, from another more primary disease (such as diabetes from pancreatitis or from chronic use of steroids).
Symptoms to Watch For
Early signs are hard to discern, as they are gradual. Symptoms of diabetes in cats include:
- Increasing water consumption beyond usual levels
- Urinating more frequently, in larger amounts in the litter box
- Weight loss with high appetites
- Sluggishness, decreased play or jump activity
- A dull, greasy or unkempt coat
In severe cases, vomiting or decreased appetite may occur.
Weak hind legs and heels on the ground (a flat-footed gait)
This final posture is referred to as plantigrade posture. This is due to damage to the nerves that results from high blood sugars for a prolonged period. This is a good reason to make a vet appointment ASAP since it will often improve when glucose is under control.
So, what causes diabetes in cats?
Often, there’s no single cause. Rather, multiple risk factors are compounded.
- Obesity: The greatest modifiable risk factor is excess body fat. Fat tissue makes cells less responsive to insulin, which increases the likelihood of disease in overweight cats by several times.
- Age: Most cats are diagnosed after 8 years of age.
- Sex and neutering: Males are at a greater risk than females.
- Breed: The condition is more common in Burmese cats, especially in Australia, the UK and NZ.
- Diet and inactivity: Cats that are kept indoors and fed dry high-carbohydrate food and do little exercise to get their energy needs are at a higher risk for weight gain.
- Other diseases and drugs: All of the following can contribute: pancreatitis, changes in the treatment of hyperthyroidism, acromegaly, and use of steroids.
Emergency Warning: Diabetic Ketoacidosis
Without enough insulin, a cat’s body will start to burn fat too fast, resulting in the accumulation of acids in the blood called ketones. This is a life-threatening complication that is called diabetic ketoacidosis – or DKA. Undiagnosed cats often present to the clinic initially like this.
If your cat:
Seek emergency veterinary attention immediately if your cat:
- Repeated vomiting or not eating at all
- Looks very weak, wobbly or doesn’t respond
- Is short of breath or gasps for air
- Produces sweet, or nail polish remover-like, smelling breath
- Has yellow gums or skin
DKA typically needs to be treated at a hospital, where one is given intravenous fluids, insulin and electrolyte support. Early treatment is best to increase the likelihood of recovery.
Vets Diagnose Feline Diabetes
More than one high glucose reading is necessary to diagnose as stressed cats may have a temporary spike referred to as ‘stress hyperglycemia’. Your veterinarian will check for elevated glucose levels in your blood, urinalysis for glucose, and associated clinical signs. Common tests include:
- Blood glucose: indicates the amount of sugar in the blood at a given moment
- Fructosamine: measures the average glucose levels in the blood over the last 2 to 3 weeks, and can be used to distinguish diabetes from stress.
- Urine tests – urinalysis and urine culture – check for glucose, ketones, and infection
- Blood chemistry and thyroid tests: check for kidney disease, pancreatitis and hyperthyroidism
Treatment Options
Diabetes treatment for cats is a joint effort between you and your veterinarian. Most plans include three components- insulin, diet and monitoring.
- Insulin therapy: Insulin is typically administered twice daily, under the skin, to most cats. Needles are very small and most cats don’t mind them at all – if they do, it’s best to offer them a meal or treat simultaneously. Your veterinarian will determine the type of insulin and initial dosage and adjust it over a period of several weeks, do not adjust the dose without your vet’s instructions.
- Oral/newer options: In some countries, an oral medication of the SGLT2 inhibitor class has been approved for cats who are stable and do not require insulin. Your veterinarian will be able to determine if it is right for your cat.
- Home monitoring: Many owners will learn to use a small glucose meter and/or wearable continuous glucose monitor, and maintain a very simple daily record of their pets’ appetite, water intake, and litter box output.
- Regular rechecks: Early on expect frequent visits, and then every few months once your cat’s stable.
Cat Diabetic Diet
One of the strongest weapons you can use is food. Cats are obligate carnivores and a diet rich in protein and low in carbohydrates helps to maintain stable blood sugar levels after eating. This is typically accomplished by feeding canned wet food, and there are also diabetic diets for prescription use.
Have a scheduled meal time, with insulin doses, and don’t leave food on the table all day. If your cat is overweight, gradually lose the weight with your vet’s advice; rapid weight loss can result in a serious liver issue. Always have fresh water available.
Low Blood Sugar: Become familiar with the signs and symptoms
Hypoglycemia occurs when a person’s blood sugar gets too low, typically after taking too much insulin or forgetting a meal. Symptoms are trembling, wobbliness, glassy eyes, weakness and seizures. Rub a tiny bit of honey, or corn syrup, on the gums, if your cat is awake and can swallow, and call your vet right away. Take your cat to an emergency clinic if he is unresponsive or is having a seizure. A cat should not be given insulin if it is not eating, unless your veterinarian approves.
Is it possible to have remissions of diabetes?
Yes. Remission is when a cat is able to maintain normal blood sugar without insulin. It is more likely if treatment is started early in the disease process, if the cat is on a low carbohydrate diet, and if blood sugar is kept well controlled during the first few months of treatment. The disease may recur, so always feed the appropriate diet and have regular veterinary checkups – remission is not a cure.
Guide your cat to reducing the risk
Help your cat to reduce the risk.
While not all cases are preventable, there are a few habits that decreases the likelihood of diabetes in cats:
- Feed your cat using measured amounts (not free-fed) to keep him lean.
- Eat a diet high in protein with fewer carbohydrates (wet food)
- Encourage playing with wand toys, climbing trees and puzzle feeders every day.
- Have regular check-ups at the veterinarian’s office year-round, and twice a year for cats over 10 years old.
- If taking steroids for a long time, please consult your vet first
Conclusion
In cats, diabetes is a serious, but manageable disease. If you notice any of these symptoms, such as increased thirst, frequent urination, and weight loss despite good appetite, watch for them and get them seen by your vet as soon as possible. On the other hand, there are many cats that live years on insulin, a low carbohydrate, high protein diet, and regular monitoring and many cats achieve remission. The most important thing you can do for your cat is to take action early on.
Frequently Asked Questions
- What are the first signs of feline diabetes?
The initial symptoms are thirst, increased urination and weight loss despite a normal diet. Some symptoms you might notice are that your cat is less active or has a dull coat.
- Can you cure diabetes in cats?
It’s not a disease that can be cured, but it can enter into remission. If a cat is in remission, his blood sugar remains normal without insulin and this is typically achieved through early treatment and using a low carbohydrate diet.
- What is the life span of a diabetic cat?
With proper management, the cat lives for several years after diagnosis and some do live to normal life span. Affects outcomes depending on age, other diseases, and adherence to treatment.
- Do insulin injections in cats cause problems?
Most owners find it to be less difficult than they anticipated. The needle is very fine, and usually cats will only minimally flinch, especially if injections are administered during feeding time. Your veterinarian or technician will demonstrate how to do this.
- What are the costs of treatment?
Depending on the country and clinic, costs will differ. The initial testing and stabilization costs will be the highest, followed by insulin, syringes, special food and periodic rechecks.
- Is dry food a cause of feline diabetes?
The disease is not caused directly by the dry food, but a high carbohydrate diet may lead to obesity, which is a significant risk factor. A lot of vets recommend a high protein food that is moist.
- Are treats safe for diabetics?
If the treats are low in carbohydrates and within the daily calorie limit, then, yes, occasionally. They are often given plain cooked meats or freeze dried meat treats, although it is essential to consult with your vet.
- When is it an emergency?
Take your cat to an emergency vet if he/she is dragging its feet, wobbly, seizing, has sweet smelling breath, vomiting and is very weak. They can indicate dangerously low blood sugar or tell of ketoacidosis.
