Feline Diabetes
DIABETES MELLITUS IN THE CAT
Diabetes
mellitus can affect any cat, but it most often occurs in older, obese cats.
Male cats are more commonly afflicted than females. The exact cause of the
disease in cats is not known, although obesity (the major predisposing
condition), chronic pancreatitis, other hormonal diseases (e.g.,hyperthyroidism,
Cushing's disease, and acromegaly), and certain medications (e.g., megestrol
acetate and corticosteroids like prednisolone) have all been linked to the
disease.
In
people, diabetes is classified into Type I and Type II forms. The Type I human
diabetic is unable to secrete insulin and is totally insulin dependent. In Type II diabetes, the person develops
diabetes later in life and only has a partially secrete insulin. In cats, diabetes mellitus is generally
divided into two different types: insulin-dependent diabetes mellitus (similar
to type I diabetes in people), and non-insulin-dependent diabetes mellitus
(similar to Type II in people). Approximately one-half to three-quarters of
diabetic cats have the insulin-dependent type.
All cats are started on insulin shortly after they are diagnosed, since
the type will not be know. Some cats –
about 1/3 - go into diabetic remission when using a particular insulin and on a
specific type of diet. These may be the non insulin dependent cats.
Diagnosis
Diabetes
Mellitus is diagnosed by clinical signs and laboratory findings. The clinical
signs are typically increased drinking, increased urination (in extreme
amounts, typically) and weight loss.
Sometime an increase in appetite is seen. Less commonly, a cat can present very sick,
with decreased appetite and extreme lethargy. The bloodwork and urinalysis
demonstrate high levels of glucose (sugar) in the blood and urine. The sick diabetic cat may also have high
levels of ketones in the urine.
Treatment
Left untreated,
diabetes will shorten a cat's lifespan. A dangerous, sometimes fatal condition
called ketoacidosis may develop, indicated by loss of appetite, vomiting, diarrhea,
lethargy, weakness, dehydration, and breathing abnormalities. A diabetes-related disorder called diabetic
neuropathy may cause cats to become progressively weaker, especially in the
hind legs, impairing their ability to jump and causing them to walk with their
hocks touching the ground. Diabetes treatment is based on the severity of the
disease. Cats with ketoacidosis require prompt intensive care, which usually
includes fluid therapy and short-acting insulin injections. Treatment consists
of dietary management and insulin injections
Diet
In
cats, one of the most important aspects of the management of diabetes mellitus
is the use of the low-carbohydrate diets. Most experts feel that this change
alone is extremely significant in regulating the feline diabetic. High carbohydrate diets predispose cats to
obesity, and, in some cats, can then lead to the development of diabetes. Most,
but not all canned foods for cats are made to be adequately high in protein/low
in carbohydrate. A canned prescription diet can be used, but there are others available
if your cat will not eat the therapeutic diets.
A “Protein/Fat/Carbohydrate” chart is available on
the website: www.catinfo.org. Most experts recommend a canned diet with 7%
or less carbohydrate content as “calorie %” or metabolizable energy (ME). Compare foods on the list for high protein
content and low carbohydrate content.
Dry
alternatives to the therapeutic diets are very difficult to find. There are a few that are low in carbohydrate
content, but none that are less than 7% carbohydrates. And, since water as part of the food is
extremely important in cats, dry alternatives, in the long term, are not
recommended.
It
is important for obese cats to lose weight to better attain regulation. The
high protein, low carbohydrate diets work very well for this. Feeding 2 meals a day prior to giving insulin
is recommended and can help with weight loss, but 2-4 meals can be offered when
using Lantus if your cat will not eat a larger amount at once.
Your
veterinarian will usually start by putting your cat on an all canned, high
protein, moderate fat and low carbohydrate diet. Some cats will take some time to get used to
this change in diet, especially if they have been on an all dry food diet. It is very important to make sure your cat is
eating something, so slowly changing the diet in cats that don’t initially like
canned food is extremely important.
Skinny
diabetic cats can have more food with increased frequency.
Insulin
Your
cat will be prescribed insulin and your veterinarian will show you how to administer the insulin injections to
your cat. Cats are initially started on
Lantus (glargine) insulin because most respond best to this type of insulin. The
combination of a low carbohydrate, high protein diet with lantus insulin can
put your cat into remission (not needing insulin), sometimes very quickly. It is therefore important to check glucose
levels early on and frequently. Your
veterinarian will ask you to make appointments periodically to check glucose
(blood sugar) curves. These will tell
how well the insulin dose is working in your cat throughout the day and allow
for changes in these doses for better regulation.
Home Blood Glucose Testing
Human glucose meters can be obtained from any drugstore but ideally the AlphaTrak glucometer should be used as it is designed for pets. The AlphaTrak is more accurate in cats and dogs than the human equipment, although there are a few of the human products that have been used that seem to work sufficiently. If you would like to get an AlphaTrak meter, contact your veterinarian.
References:
Veterinary
Information Network, The Diabetes Mellitus Center, Wendy Brooks, July 23, 2010 (revised)
Feline
Diabetes Website (felinediabetes.com)
Cat Info.org
website, Lisa A. Pierson, DVM
Cornell
Feline Health Center (http://www.vet.cornell.edu/FHC
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