Feline diabetes


What is diabetes? Diabetes mellitus is a condition where a cat has high glucose levels (blood sugar) as a result of the pancreas either not producing enough insulin (type I diabetes) or because body cells do not properly respond to insulin (type IIdiabetes). Insulin is a hormone produced in the pancreas which enables body cells to absorb glucose to transform into energy. If the body cells do not absorb the glucose, it accumulates in the blood leading to various potential medical complications.

Clinical signs can include weight loss despite an increased appetite. An increase in thirst and urine production. A difficulty to climb due to weakness in the hind end caused by neuropathy. Some diabetic cats will develop diabetic ketoacidosis (DKA) which is a potentially life-threatening complication. When this occurs your cat could stop eating, become depressed, dehydrated and even die.

There are two ways to lower blood sugar and try to control diabetes. One involves giving insulin injections and the other is to give oral hypoglycemic agents. Insulin injections will supply what is naturally lacking and will enable glucose to enter the cells and give them the energy they need. Oral hypoglycemic agents are pills; they can be of some benefit to cats with type II diabetes but in a large majority of cases will not control blood sugar successfully. For this reason (and also because they can affect appetite, cause vomiting and affect liver) we recommend insulin injections as the primary treatment.

The main risk from insulin injection is hypoglycemia (low blood sugar). The signs associated with this could be depression, weakness, ataxia, blindness, stiffness and in more severe cases seizures, coma and death. If you see this and your cat can swallow, administer 1 tablespoon of maple or corn syrup in the mouth. If it can’t swallow, rub some of it on the gums. Measure blood glucose if possible and contact us as soon as possible.

There are different kinds of insulin. In most situations, it has to be given twice a day or every 12 hours.
It will also be very important to get your cat back to a healthy weight because obesity increases insulin resistance. We will recommend a special veterinary diet for diabetes; it is low in carbohydrates and rich in proteins. A canned version will be the preferred choice because it has half the carbohydrates than the dry. This diet will help for weight loss and glycemic control. We can custom make a weight loss program for your cat. Ideally, you should give two meals a day but if your cat is used to free choice feeding, more meals can be offered in restricted amounts.

As soon as therapy with insulin is started, we will need to know what your cat’s response to the insulin is. We will recommend serial blood glucose curves either performed in clinic or at home. For the first option, you have to leave your cat in the hospital for 12 hours and we will get blood samples every 2 to 4 hours after insulin injection. This is often stressful for cats and can affect the glucose readings. When possible, it is ideal to monitor blood glucose at home. The cat is in his own environment so less stress and the curves are more likely to reflect the real picture. To do this, we recommend you use the blood glucose monitoring system ALPHA TRACK because it was designed and calibrated for small animals. It only requires a tiny amount of blood. The kit includes an instructional DVD, a glucose meter, a box of 50 tests strips and a box of lancets to draw blood. Use the small vein on the outside of the ear, make a pin hole with the lancet and apply pressure to ear until a drop forms. Touch the drop with the test strip and insert in the glucose meter. We can teach you how to do this.

Enter these readings with times and insulin dosages in a diary and always report them to the veterinarian before altering the dose. In the beginning, it may take a few weeks before diabetes is under control. When diabetes appears well controlled, we recommend you come in for fructosamine levels every 3 months. This measurement gives us a hindsight of the glycemic control of the last 3 weeks, this is unaffected by stress.

Here are general guidelines regarding handling of the insulin vial:
-Keep the vial in the fridge.
-Before drawing the insulin, gently roll the bottle in your hands (do not shake).
-After the insulin is drawn from the inverted bottle and the needle is still in, make sure you get rid of the small air bubble that is in the syringe by flicking it with your finger.
-To give the insulin injection, lift the skin in the neck area to create a small tent. Insert the needle in the center and press the piston.
-Avoid injecting always in the same spot.

< Hyperthyroidism  Asthma >