Feline Diabetes

Most people know some about diabetes. They may either know someone that has it or even have diabetes themselves! But did you know your pets can get diabetes also? They definitely can and this post will be about the most common diabetes that cats get. I will do another one about dogs due to the length of this topic.

endocrinology book
First, we have to start with a little background in endocrinology, or the study of hormones and how they influence the body. When we are talking about diabetes, there are two different categories it falls into: Diabetes Mellitus and Diabetes Insipidous. Diabetes basically means excessive urination, which is seen with both of these diseases. Diabetes Mellitus is the most common one that is seen and discussed. This is where there is too much glucose in the blood stream. Diabetes Insipidous is very rare. This disease causes the body to not retain water normally, so most of the water passes through the kidneys into the urine.

For this section, we will stick to Diabetes Mellitus. Diabetes Mellitus has 2 types.
Type 1- This is called “juvenile onset” diabetes in people. The main regulator of glucose in the body is insulin that comes from the pancreas. Insulin is released in response to glucose to help keep the glucose at a certain level. The insulin then helps the glucose to move into cells so we can turn it into energy. Type 1 Diabetes is when the pancreas just stops releasing insulin. This causes the glucose to go very high because the body can not use it properly. We can supplement the body’s insulin with injections, which we will discuss later.
Type 2- This is called “adult onset” in people. The pancreas is still trying to work, but the body is becoming immune to the insulin. The pancreas may not be releasing as much insulin, but what little it is, the body is not responding to it the way it should. This type can be reversed with proper diet and exercise as it is seen in overweight people and overweight cats.

Diabetes in cats is the most common form of diabetes I see. Cats will get Type 2 diabetes. This means it is usually the overweight cats that end up getting it. Their body gets immune to the insulin so it can no longer work to move the glucose into their cells.

cat drinking a lot, veterinarian lawrenceville
Signs that your cat may be diabetic include: ravenous appetite, drinking a lot, peeing a lot, weight loss and sometimes their back feet seem closer to the ground than normal. The most common complaint people come in for is peeing outside of the litter box or filling the litter box with so much urine. In the very early stages you will mainly notice the drinking and peeing a lot. This is because the high glucose is pulling water into the urine and dehydrating the cat.

blood work, veterinarian lawrenceville
What to do if you see these signs? A veterinarian needs to check out your cat and do some blood work. The signs of diabetes can be very similar to other diseases and only blood work will be able to tell the difference. The vet may want to check some urine as well because glucose in the urine is a very strong sign of diabetes. Checking the urine also helps to rule out ketones as being an issue, which we will discuss later.

Purina DM, veterinarian lawrenceville, cat diabetesVetsulin

Now that you have a diagnosis of diabetes, what are going to be the next steps? We manage diabetes in cats similar to people. The first part of the conversation is going to be diet and exercise. The diet is going to be a prescription diet. The main reason the prescription is best is because it is formulated specifically for a diabetic’s needs. Most of the prescription diets are going to be high in protein and low in carbohydrates. The high protein will feed the muscle and the low carbs will keep the glucose curve low. If we are feeding a regular diet higher in carbs, that could bump the glucose up high and make controlling the diabetes more difficult. Now, exercising a cat is not as easy as a dog. You can try putting them on a treadmill, but I wouldn’t advise it. The most important thing is trying to keep them moving. You can use a toy on a stick for them to chase, or a laser pointer. The more they move, the easier their weight control.
The next part of the control conversation is insulin. Insulin is given to make sure it is there for the body to use. Even though the body may be immune to its own insulin, the insulin we give could work to bring down the glucose. There are a couple different types of insulin out there, so your vet will decide which one they prefer. Before we move on, giving insulin is not as scary as it sounds. A lot of times we in the veterinary profession take it for granite because we do it all the time and some owners are very apprehensive about giving it. Will I give the right amount, will it hurt the cat, will he try to bite me? These are some of the most common questions we get. Giving insulin can be very simple and stress free. The animals tolerate it very well. Most of the time you can give the injection as your cat is eating. Before deciding against giving insulin, I would recommend giving it a try and seeing how easy it is. To help make it easier there is something called a “vetpen.” This is a tool to make giving insulin easier. It has a dial on it to make sure the correct amount is given and it is bigger so it’s easier to hold. This VetPen (click for instructions on how to use VetPen) would absolutely be something I recommend every owner of a diabetic pet has.
There is also a pill that can be used in cats. The medication is called Glipizide and helps the pancreas to secrete insulin. This helps some cats, but not all. I personally haven’t used it much and just stick with giving insulin.

Once medication is started, then we need to check to make sure that the therapy is working. The first thing to know is how the pet is doing at home. Good signs are if the cat is feeling great and peeing less! Once the pet’s diabetes is under control, it is very easy to know when the glucose starts getting too high as you will see them peeing much more. Some tests that we will want to do include a urinalysis, glucose check and maybe a glucose curve. A urinalysis is a simple way to tell whether the glucose is high or not. It does not give us an exact number. Anytime the glucose is over 250 mg/dl, we begin to see it spill over into the urine. This is an easy way to tell us the glucose is high, but doesn’t tell us how high. A glucose check is the quickest and easiest way to see where your pet is with the glucose levels and it gives us a good guess where we are with control. To me, it is very important WHEN we test the glucose. If we are giving the insulin every 12 hours, I like to test the glucose as close to 6 hours after the insulin as possible. This should give us our lowest point. If we check the glucose 2 hours after the insulin, I have no way of knowing how much the glucose will drop, if any. A 6 hour post insulin shot glucose check gives me a good idea of how we are doing. A glucose curve is the best way to see how we are controlling the diabetes. This is where we give the insulin and check the glucose every 2 hours until it stops decreasing and begins to increase again. These results tell us if we are giving enough insulin, too much insulin and how long the insulin lasts in your pet specifically. If you don’t want to drop your pet off at the hospital for this to be done, there are pet specific glucometers that you can purchase and you can do this yourself at home! You need to get a pet specific glucometer because it is specially built to read dog and cat blood. The difference between these and humans glucometers can be vast! You can check the glucose by pricking the ears or sides of the pads or the skin at the elbows. All of these can be shown to you by your vet, but know that it is possible for you to do at home. Once you have the results, you can call and discuss them to decide if there is good control or not.
It is very important to monitor therapy because cats can revert back to normal from daibetes. If the proper diet, exercise and insulin therapy is implemented to control the high glucose, cats can go back to normal and not need any more insulin. The main reason this is so important to remember is because if you continue to give the insulin when the pet no longer needs it, you can drastically drop the glucose, and that can lead to an emergency!

Diabetic related complications:
Giving too much insulin can be very risky. Many people will see the pet acting weird and think it needs more insulin, so they will give another dose. They may continue to do so until the pet has no more glucose storage and begins to have seizures. IF THERE IS EVER A QUESTION OF WHETHER TO GIVE INSULIN OR NOT: DO NOT! I can’t emphasize that enough. Too high of a glucose for one day is not an emergency, but too low is an emergency right then.
Also, not treating diabetes can lead to a major issue. Since the body is no longer able to use glucose for an energy source, it looks for another source, and makes ketones. Ketones are a different way to make energy, but they come at a price. The ketones are an acid, so they throw off the balance of the body towards more acidic. They body is structured to work at a certain pH. If that balance is skewed one way or another, systems begin to shut down. These pets are going to be very sick and going to need hospitalization and IV fluids until the ketones are washed out and the body begins using the glucose again with the help of insulin. Please do not think there won’t be major consequences for not treating a pet’s diabetes.

fat cat before and after
Diabetes in cats can be a scary thing when you’re in the exam room wondering how the next year will go with your beloved pet. Just know that it is manageable and you can do it! Just take a deep breath and relax. We or your vet can help you through it to make sure you give your pet the best possible chance at a healthy life!