Understanding Cat Diabetes

Welcome to CodaPet! We’re here to help you better understand your pet’s health. This article is dedicated to providing you with comprehensive information on diabetes mellitus in cats. You will gain insights into the types of diabetes cats can get, the symptoms, and the risk factors. We will also guide you on when to seek veterinary support, the diagnostic process, and how your vet interprets the diagnostic tests. Additionally, we will provide general comments on diabetes management, available treatments, and how to administer insulin to your cat.

By reading this article, you will be better equipped to understand feline diabetes and how to help ensure diabetic cats continue to live happy, healthy lives. Please note that the content of this blog is not meant to be diagnostic nor a replacement for medical advice from your local veterinarian who has a relationship with your cat and is able to reassess them as things change.

What is Cat Diabetes?

Diabetes in cats, like in humans, occurs when the body is unable to respond to a hormone called insulin, resulting in the inability to metabolize glucose. Glucose is the body’s primary source of energy; this sugar results from the body breaking down food into smaller simpler compounds. Once glucose is detected in the bloodstream, a healthy cat’s body releases insulin which “unlocks” the cells ushering the glucose inside to provide the cell, and the body, with energy.

In diabetic patients, the body either does not produce adequate amounts of insulin or the insulin is unable to act upon the cells appropriately to give glucose entry to the cells. As a result, the glucose levels in the diabetic cat’s bloodstream increase and remain high for prolonged periods of time leading to various other health issues all the while the cells remain undernourished. Simply put, diabetes is a disease in which the body starves despite high levels of sugar remaining in the bloodstream, within reach but inaccessible.

Types of Diabetes in Cats

Cats can primarily be affected by two types of diabetes:

• Type I Diabetes: This condition, albeit rare in cats, occurs when the blood glucose is elevated because the pancreas does not produce enough insulin. It is also referred to as insulin-deficient diabetes (IDD).
• Type II Diabetes: This is the more common type of diabetes in cats. It occurs when the blood glucose is elevated because the cells in the cat's body respond poorly to the insulin it has produced. It is also referred to as insulin-resistant diabetes (IRD).

In either case, the cells cannot access the glucose in the blood, leading to prolonged hyperglycemia and cells depleted of glucose, their primary energy source. Approximately 0.2% - 1% of cats will suffer from feline diabetes. It is not a curable disease, but with your veterinarian's guidance it is possible to manage the condition and provide your cat with a good quality of life.

Symptoms of Cat Diabetes

Early detection and treatment of diabetes in cats is important. Here are the most common clinical signs and symptoms pet owners need to look out for:

• Excessive urination and drinking: Cats with diabetes have high levels of glucose in their blood to contend with, they are unable to drive the glucose into the cells so the body flushes it out in the urine. However, the body needs to use extra fluids to accomplish this task, leading to large volumes of urine (polyuria) and increased thirst and drinking (polydipsia) to compensate for the losses.
• Unexplained weight loss: Cats with diabetes may lose weight despite a hearty appetite. Remember the diabetic body is unable to use energy from food and must turn to other sources such as stored fats and proteins leading to weight loss, including loss of muscle mass.
• Other signs: Cats with diabetes may also display signs such as an unkempt coat, inappropriate urination, weakness, and a plantigrade stance (walking with the hocks touching the ground)

‍Is Your Cat at Risk?

As with any disease, there are some cats that are at a higher risk of developing diabetes. Factors contributing to an elevated risk include obesity, a sedentary lifestyle, middle to advanced age, being male, and the long-term use of steroid medications (such as may be used for the control of asthma or other conditions).

Some of these factors are completely out of our control, however obesity is a major contributing factor with obese cats being up to four times more likely to develop diabetes than their average-weight counterparts. This means by maintaining a healthy weight for our feline friends, we can significantly decrease their risk of developing diabetes.

If you're concerned about your cat's risk of developing diabetes or seeking guidance for how to manage their weight through a healthy diet and exercise, contact your veterinarian. They can provide valuable guidance on how to manage these risk factors and help your cat lead a healthier life.

When to See a Vet

In addition to seeking veterinary care for preventative advice, recognizing the signs of diabetes in cats can significantly help in knowing when to seek veterinary support for a possible diabetes diagnosis. As discussed above, the most common signs of diabetes in a cat include excessive thirst, excessive urination, and weight loss despite a healthy or increased appetite.

While these signs are not exclusive to diabetes, they are indicative of an underlying condition and warrant a veterinary exam to discover the cause. Remember, early detection can drastically improve your pet's chances of managing diabetes, and other diseases, and maintaining quality of life.

Diagnosis Process

Your veterinarian will typically begin the diagnostic process by conducting a thorough physical examination and asking your cat's medical history. This involves understanding the symptoms your cat has been showing, including any progression of signs and the time scale over which they have occurred. It's also important to discuss your cat's lifestyle, diet, and any recent changes in their behavior or environment. Next, the vet will perform screening laboratory tests, primarily examining the levels of glucose in the cat's blood and urine.

Other tests can also be useful to rule out similar conditions, complications due to diabetes, or comorbidities (separate diseases present at the same time). Such tests may include a urine culture to check for urinary tract infections; fructosamine test which helps estimate blood glucose values over the recent past; or additional screening blood chemistry tests to assess major organ function.

Understanding Test Results

Making sense of your cat's test results can seem overwhelming, but understanding them can assist you in taking an active role in your cat's health. Three primary results point to a diabetes diagnosis: sustained elevated glucose levels in the blood (hyperglycemia), the presence of glucose in the urine (glucosuria), and the presence of ketones in the cat's urine (ketonuria).

We’ve discussed how the diabetic cat comes to be persistently hyperglycemic (glucose can’t get into the cells) as well as why they exhibit glucosuria (glucose is flushed out into the urine). The third marker, ketonuria, occurs when the glucose starved cells break down the body's protein to use as an energy source. Ketones are a byproduct of protein metabolism and are excreted in the urine.

When this occurs the cat is in or reaching a dangerous state known as diabetic ketoacidosis, which we will discuss later on under coping with complications. Ketonuria doesn't only occur with uncontrolled diabetes, there are other serious conditions that can lead to ketones in the urine including pancreatitis, hepatic lipidosis, and some forms of cancer. Your veterinarian will gather and interpret all the information, clarifying what it means for your pet's condition, and how it affects the treatment strategy moving forward.

Important Follow-ups

Post-diagnosis, regular follow-ups with your veterinarian are essential for managing diabetes in cats. Your veterinarian may recommend additional tests like a blood glucose curve or fructosamine concentration test monitor how well your cat's diabetes is being controlled over time.

Glucose curves watch the glucose levels throughout the day while fructosamine tests provide a snapshot of your cat's average blood glucose levels over the past 2-3 weeks, providing valuable insight into the effectiveness of your cat's treatment plan. Regular follow-up appointments also allow your veterinarian to adjust treatment protocols as necessary, address any concerns you may have, and monitor your pet's overall health.

From Diagnosis to Management

Managing diabetes in your feline friend can be challenging but remember, you are not alone in this journey. The first step in managing cat diabetes starts with understanding the problem at hand. As stated above feline diabetes is a metabolic disorder that disrupts the body's ability to utilize glucose gained from food, leading to elevated blood glucose levels. It is a disease that can be managed and may even go into remission but does not have a cure.

Once the diagnosis is confirmed and the cat is stabilized, the focus shifts to management. Managing diabetes in cats involves a combination of dietary changes, weight management, insulin therapy, and regular monitoring. Developing a good relationship with your vet is paramount, as you'll be in regular contact for check-ups and adjustments to the treatment protocol.

The initial stages of management can be the toughest, as it involves getting you and your cat accustomed to the new routine, possibly including daily injections, a new diet, smaller portions, regular exercise and frequent vet visits. Your pet may initially resist the changes, but with patient persistence, most cats will eventually adapt. Remember, it's important to stay patient and consistent. Further modifications may need to be made along the way based on your cat's response to treatment.

Available Treatments for Cat Diabetes

Diet and Exercise for Diabetic Cats

An appropriate and well-balanced diet plays a significant role in managing diabetes in cats. Wet food diets low in carbohydrates and high in quality protein are often recommended for cats with diabetes. Consistency is important in feeding, meaning you should feed the same food, in the same portions, at the same times as much as possible.

In addition to a balanced diet, exercise is another essential aspect of managing diabetes. Regular play sessions can help maintain a healthy weight in your cat and contribute to overall wellness. If your cat is overweight, your vet might recommend implementing a specified routine geared toward weight loss.

With diabetes, it is important to keep meals and exercise routines as consistent as possible to avoid sudden changes in blood sugar levels and requirements. While diet and exercise may not feel like meaningful changes, be encouraged that cats can go into remission from diabetes with weight loss and specialized diet. Slow and steady change can absolutely pay off for your cat in time.

Insulin Injections for Diabetic Cats

For many cats, insulin injections are an important part of treatment, especially while waiting to reap the benefits of changes to diet and exercise. As you recall, feline diabetes stems from either not enough insulin production or, more often from insulin that is ineffective at transporting glucose into the cell.

Giving exogenous insulin (insulin produced outside of the body) can allow your cat to regulate their glucose levels, provide appropriate nutrition to their cells, and prevent the signs and complications that come from diabetes. It is important to note that there are several insulin types and doses will vary from cat to cat and even over time within the same cat.

Your cat’s glucose needs can change based on lifestyle, environmental stressors, or aging. Additionally, your cat’s insulin responsiveness may change over time. For all these reasons, close monitoring is a must.

Despite other effective diabetes treatments in the human world, insulin injections remain the most effective treatment for feline diabetes as cats do not seem to respond the same way to oral blood sugar medications. It is crucial to remember that all treatments should be guided by your veterinarian and assessed for necessary adjustments regularly.

How to Administer Insulin to Your Cat

Administering insulin to your cat may feel a bit daunting at first, but with a bit of practice, you and your cat will adjust to the routine. Here is a basic step-by-step guide so you know what to expect:

• Feed your cat according to the schedule determined by your vet to ensure they will have glucose available in their bloodstream and avoid hypoglycemia. Commonly, feeding is recommended to be done prior to injecting the insulin but your vet may have special instructions based on your cat’s history and the type and dose of insulin being used.
• Draw up the correct insulin dosage into the syringe. It's important that there are no air bubbles in the syringe to ensure an accurate dose is given (injecting a small air bubble under your cat's skin will not lead to a life threatening embolism like it can when injected into a vein).
• The next step involves finding the right spot for the injection. Often, the best place to inject insulin is into the loose skin between your cat's shoulder blades.
• As you get ready to give the injection, try to make the process as calming as possible. Speak to your cat soothingly and pet them gently; try to control your own nerves.
• Pick up a fold of your cat's skin using your thumb and forefinger of your nondominant hand and quickly insert the needle with the other hand. Push the syringe's plunger to release the insulin, and then remove the needle.
• Safely discard the needle according to your vet’s instructions.

Your veterinarian or veterinary nurse will guide you through this process before sending you home with the prescribed insulin. If you ever have any questions be sure to reach out for assistance.

Feline Diabetes Monitoring- Checking Glucose At Home

As discussed above, your cat's insulin needs may change over time. Determining their blood glucose level is helpful in monitoring for needed adjustments to insulin therapy. If you are able to test your cat’s blood glucose at home it can give more accurate results than testing in a clinic situation after the stress of travel. To do this you’ll need a glucose meter and test strips and most importantly directions on how to safely get a small blood sample. Speak with your cat’s vet if this is something you are interested in learning to do. It may take time to get used to this process, but it will become easier with practice.

Living with A Diabetic Cat

Daily Routine Adjustment

We’ve discussed the importance of establishing a new normal routine of diet and exercise, and insulin injections when prescribed. Consistently carrying out these activities at the same time each day will help orchestrate your cat’s glucose levels, avoiding high peaks or low valleys throughout the day.

Monitoring your Cat's Health

Early detection of irregularities can be crucial in managing diabetes in cats. Diabetic patients have an increased risk of other conditions such as urinary tract infection, skin infections, kidney disease, liver disease, and cataracts. In addition to causing discomfort and disease, these other conditions can throw your cat’s glucose needs out of alignment causing insulin treatments to be ineffective or potentially dangerous.

Observe your pet for any changes in behavior or physical condition. Simple things, such as noting changes in drinking, eating, and urination habits, can be vital clues for your vet to investigate.

Coping with Complications

Sometimes, diabetic cats might suffer from complications such as diabetic ketoacidosis or hypoglycemia.

Diabetic ketoacidosis (DKA) is an emergency condition resulting from uncontrolled diabetes. It is characterized by signs like not eating, vomiting, diarrhea, progressive weakness, and even depression or coma. DKA occurs when a diabetic cat’s glucose-starved cells use alternate sources of energy such as the body’s stored proteins and fats for an extended period of time.

This protein and fat catabolism makes ketones as a byproduct. As mentioned above, some of the ketones leave the body via the urine, but this is an unsustainable solution. As the ketones build up in the cat’s blood they lower the pH making it more acidic and requiring intensive veterinary care to correct.

Hypoglycemia is another emergency problem which lies at the other end of the diabetic spectrum. Hypoglycemia occurs when there is not enough glucose in the bloodstream. It is characterized by signs such as lethargy, disorientation, weakness, tremors, seizures, and vomiting. Applying honey or dextrose gel to the cat’s gums and immediately contacting the veterinarian are potentially life-saving measures for a hypoglycemic cat. Once your cat is stabilized your veterinarian will investigate the cause for the hypoglycemic event and adjust the insulin dose as needed.

Preventing Cat Diabetes

Living with a cat with diabetes can be a significant source of worry for pet parents. The good news is, it isn't entirely out of your control. Here, we outline some preventive measures you can take, highlighting healthy lifestyle tips, risk factors to avoid, the importance of regular health checks, and the benefits of early detection.

Healthy Lifestyle Tips

Achieving and maintaining your pet’s ideal weight is a key starting point for preventing diabetes in cats. Obesity significantly increases a cat's likelihood of developing diabetes.

• Encourage regular physical activity. It can be especially difficult for indoor cats to remain active (although there are decreases in other risk factors for indoor cats). Regular playing sessions and stimulation can help keep their weight in check.
• Consider a diet that's low in carbs but high in protein. Balanced nutrition is vital for cats at every life stage. Wet food may be preferable to dry food for its role in promoting urinary tract health and kidney health.
• As a rule of thumb, monitor your cat’s feeding habits. Don’t leave food out all day for your cat to graze on rather, feed measured portions.

Remember, every cat has different dietary requirements. Feel free to consult your vet or a feline nutrition expert to ensure your cat is getting the diet they need.

Regular Health Checks

Having your cat examined by a vet can help detect any early signs of diabetes. Regular health checks are essential to maintaining overall health and spotting any potential issues early. If your cat is at risk of developing diabetes (due to factors like obesity or advancing age), your vet may suggest spot glucose testing during your cat’s regular check-ups.

Benefits of Early Detection

We cannot emphasize enough the importance of early detection in managing diabetes. The earlier the disease is diagnosed, the better the chance your beloved pet has of avoiding comorbidities and leading an active, healthy, and happy life. Early detection can prevent more severe symptoms from developing, and gives more treatment options. Remember, careful monitoring and regular vet check-ups are essential.

Coping with a Diabetes Diagnosis

Hearing the diagnosis of diabetes for your beloved cat can be a shock. We understand that it can be overwhelming to see your feline friend struggle with a serious and incurable illness like diabetes. But remember that you're not alone in this journey. There are numerous cat owners who have traveled this path and successfully managed diabetic cats.

When you first learn about your cat's condition, you may feel a whirl of emotions. It's normal to feel apprehensive and worried. You'll have more responsibilities now, including keeping a regular schedule that revolves around your cat’s mealtimes. Figuring out the best routine for your cat can feel like an unending process of trial and error. But don’t lose hope. Cats who suffer from diabetes can lead long and happy lives with care and management of the disease. Some cats will even achieve remission, where insulin injections are no longer needed to manage blood glucose levels.

If you’re struggling with the changes this diagnosis has brought to your home, try connecting with others who also have a diabetic kitty. Online forums, social media groups and local pet communities can be great places to meet other cat owners dealing with feline diabetes. Sharing experiences and coping strategies can make the journey easier and less isolating.

Understanding and managing cat diabetes can seem daunting, but remember, you're not alone. We hope this comprehensive guide has equipped you with the knowledge you need to move ahead and work with your vet to manage the condition effectively, ensuring your cat continues living a happy, healthy life.

References

• Cornell University College of Veterinary Medicine (2017, Oct 10). Feline Diabetes
• Samantha Morici, DVM. Diabetes in Cats: Symptoms, Causes, Risk Factors, Treatment, and Life Expectancy‍