Causes Symptoms and Treatment of Feline Diabetes

Feline diabetes (also called diabetes mellitus) is similar in nature to human diabetes and occurs in middle age or older cats. Diabetes is a disease in which the pancreas does not produce enough insulin (the hormone that controls how the body absorbs and uses sugar) or the insulin produced is not effective at controlling blood sugar levels..

Your cat needs insulin to metabolize or use sugar, fat and protein for energy. Without insulin, sugar builds up in the blood and spills into the urine. Sugar in the urine causes your cat to pass large amounts of urine and to drink lots of water. The level of sugar in the brain controls appetite. Without insulin, the brain becomes sugar deprived and your cat becomes constantly hungry, even though she is experiencing weight loss due to the improper use of nutrients from the diet. Untreated diabetic cats are more likely to develop infections and commonly get bladder, kidney, or skin infections.

There are two types of feline diabetes:

• Uncomplicated diabetes: your cat will not be extremely ill and show basic signs of the disease such as excessive drinking, frequent urination and susceptibility to kidney and bladder infections.
• Diabetes with ketoacidosis: your cat would be very ill and may be vomiting and depressed. Ketoacidosis happens when Ketosis and Acidosis occurs. Ketosis is the accumulation of substances called ketone bodies in the blood. Acidosis is increased acidity of the blood.

Cat with feline diabetes will sometimes regain the ability to produce their own insulin in the pancreas. Cats that developed diabetes after receiving long term glucocorticoids or hormones are more likely to stop needing insulin after a while compared to cats that developed diabetes without a known cause.

Your diabetic cat should be evaluated by a veterinarian at 2-4 month intervals or anytime another health problem develops. The development of other health problems will often interfere with insulin regulation.

Cats will sometimes regain the ability to produce their own insulin in the pancreas. Cats that developed diabetes after receiving long term glucocorticoids or hormones are more likely to stop needing insulin after a while compared to cats that developed diabetes without a known cause.

Cat Diabetes Symptoms

Cat owners need to be aware of four cat diabetes symptoms:

1. excessive thirst (your cat will drink more water than usual)
2. increased need to urinate (your cat will urinate more than normal and may urinate outside of the litter box)
3. weight loss
4. increased appetite (even though cat is losing weight - see next paragraph)

Other symptoms of cat diabetes are associated with a condition called ketoacidosis. When sugar isn't available to the body for energy, the body creates an acid that helps to break down fats for energy. This triggers symptoms such as anorexia (lack of appetite), lethargy, vomiting, and diarrhea.

Feline Diabetes
Seborrhea sicca associated with diabetes
Source: Washington State University

Diagnosis

Your veterinarian will do a blood test to check your cat’s blood sugar and will also test her urine. Your vet may want to do these tests when your cat has been fasting (not eating) for 12 hours or so.  Blood sugar levels are often 4x to 5x larger than normal levels.

Cats are sometimes stressed by having a blood sample drawn leading to a temporary increase in blood sugar even if there is no sugar found in the urine. A blood screen of other organs is taken to look for changes in the liver, kidney and pancreas. A urine sample may be cultured to look for infection of the kidneys or bladder.

Treatment of Diabetic Cats

The treatment is different for feline diabetes patients with uncomplicated diabetes and those with ketoacidosis. Ketoacidotic diabetics are treated with intravenous fluids and rapid acting insulin. This treatment is continued until your cat is no longer vomiting and is eating, then the treatment is the same as for uncomplicated diabetes.

Treatment involves daily insulin injections 1x to 2x a day.

There are also oral medications for diabetes in cats.

Your vet will show you how to give your cat insulin injections and tell you what type and when to inject them. The three types are:

• Short-acting insulin (regular or crystalline) is used in sick diabetic animals until they are eating again 
• NPH and Lente are intermediate- acting insulins
• Ultralente and PZI are long- acting insulins
  

Give her the medication at the same time every day. It may or may not be necessary for you to check your cat’s blood glucose levels at home. If it is necessary, your vet will show you how to do it as well.

Because insulin needs vary with the activity and lifestyle of your pet, you may want to keep a written daily log of:

•  the dose of insulin
•  location in which the insulin is injected
•  any changes in the pet’s activity or appetite

Your veterinarian may ask you to check your cat's urine for sugar using a test strip. If your cat is well regulated on insulin, the sugar readings in most urine samples will be negative or trace. The strips may have color pads only for glucose or for glucose and ketones.

Feline Dietary Guidelines

For a cat diabetes diet, feed your cat in regular intervals and consider a series of smaller meals. 2x a day is fine. This way the body can use the insulin it is producing to act against a smaller amount of food each time. Keep the portions about the same every day.

If you “free feed,” leaving food available all the time, keep an eye on the amount she eats, making sure she is eating about the same amount each day.

Feed your cat a canned commercial cat food since these have a higher concentration of protein and a lower percentage of carbohydrates, the correct proportion for cats with diabetes. Do not give her table scraps and use treats sparingly. Avoid foods that are loaded with preservatives and high amounts of sugar. Purina DM or Fancy Feast are good choices.

Most studies support a low calorie, low carbohydrate and high protein diabetic cat diet over a high fiber alternative.

If your cat is overweight it will be harder to control her blood sugar levels, so talk to your vet about how to help her lose weight if needed. As she loses weight her insulin needs may change, so work closely with your vet.

As an alternative to a high protein diet, you can also consider one that is high in fiber and complex carbohydrates. This type of diet slows the digestive process and helps to stabilize blood sugar levels. Your veterinarian may prescribe one of the Prescription diets such as Hill's Prescription Diet w/d.

You also might want to consider a dietary supplement that is made to support pancreatic health and insulin supply. There is a growing body of evidence that these type of approaches will help. One product to research is called GlucoEnsure. Research has demonstrated that the ingredients in GlucoBalance help to keep blood sugar levels within the normal range.

Exercise

Your cat needs regular exercise, and she should get about the same amount of exercise every day.  The amount of exercise she gets affects the amount of insulin her body requires. That means if she exercises a lot one day and not at all another day, she’ll need different amounts of insulin. Unless you are monitoring her blood glucose level and adjusting her insulin dose accordingly, this could be a problem. Spend time playing with your cat and encouraging her to be active every day, and monitor her activity level. Let your vet know if her activity level changes significantly.

Prognosis

Overall, the diabetic cat prognosis is good. If you can identify the cause, and then eliminate it, then the disease in many cases can be reversed. For example, if you cat is overweight, bringing the weight down will help. If the disease was triggered by medication, than changing the course of treatment will also help.

If the cause for the feline diabetes cannot be identified then the prognosis is still good if you follow your veterinarians instructions and follow the prescribed treatment method. By carefully watching for changes in your cat's health and through frequent visits to the vet (every 2 to 4 months) you can expect your cat to live a long and healthy life.

References for Feline Diabetes

Techniques for Monitoring Diabetes Mellitus in Dogs and Cats
Nelson, Richard W. DVM

Diabetes Mellitus
Washington State University
College of Veterinary Medicine

Author: Jeff Grill