Veterinary Topics : Living with a Diabetic Cat

Once a diagnosis of diabetes has been made, a series of recommendations will be made to help you manage this condition on an ongoing basis at home.

Treatment and Monitoring: At the Hospital and at Home

Cats are unfortunately, a tougher species to treat than dogs or people!

Cats with Ketosis Complications

Cats with ketoacidosis will need to be hospitalized. Initial treatment will consist of intravenous fluid therapy and insulin injections in an intensive care ward. The patient’s vital signs, blood, and urine need to be monitored very closely during the initial stages of treatment.

Uncomplicated Diabetes

Once hospitalized ketotic cats become stable, and for those who are stable at the time of diagnosis, a long-term treatment plan can be instituted. The primary goal of therapy for any type of diabetes is to have a satisfied owner with a healthy, interactive pet and to maintain the blood glucose concentration reasonably close to normal. Tight control is not practical in most cats. Most cats with diabetes are not euthanized due to a poor response to treatment, but rather over the owner’s frustration with the ongoing treatment and monitoring required. The key to managing diabetes successfully is to find a workable schedule that can be sustained by the caregiver, and will be tolerated by the cat.

Insulin Therapy

It is not difficult to give the injections, the needles are super-small and pain during injection is not a problem. If kitty is praised and treated during administration, most cats will soon come when called for the treatment! There are many types of insulin available for use. The choice of insulin revolves around the use of human recombinant versus animal origin (beef, pork), and how long the effects of insulin lasts (there are ultra-short or Regular, medium or NPH, long (Lente) and extra long (Ultra-Lente) lasting preparations.

Your veterinarian may need to try a few different types and doses before finding the perfect solution for your cat. Insulin injections are either administered on a once, twice, or sometimes three times a day basis and are given in the skin above the neck, the side of the body, or along the chest. It may be better to avoid the neck region due to the lower blood flow found in that area. Insulin therapy will be combined with dietary therapy. It is very important to keep a close eye on patients receiving insulin, because many cats revert to a normal status (become non-diabetic) and if this is missed, low blood sugar may result, leading to seizures and weakness. Have some Karo or Corn syrup on hand at home to rub on the gums if needed, and do not give any more insulin if these signs occur—instead call your veterinarian promptly so that the cat may be admitted for testing and low blood sugar therapy.

Oral Medications

A combination of dietary therapy and oral hypoglycemics can be used. Oral hypoglycemics are drugs given by mouth whose net effect is to reduce blood sugar levels. Candidates for treatment with oral hypoglycemics and dietary therapy alone are cats that are stable, are at their optimum body weight, and have no complicating diseases. Certain drugs can cause problems when combined with oral hypoglycemics, so do not give any other medications to cats on these drugs. Oral hypoglycemics are used in diabetic therapy because they improve insulin sensitivity, increase insulin response to glucose, and decrease the liver’s glucose production. The oral hypoglycemics do not provide immediate control of diabetes—often weeks are needed before beneficial effects are evident. A good portion of cats do not respond to oral medication, so if it is not effective, and the diabetes continues to progress, don’t hesitate to go to insulin therapy on your veterinarian’s recommendation!

Diet and Weight Management

Cats with diabetes may be obese, normal in weight, or very thin.

It is extremely important that cats are fed only the diet prescribed by the treating veterinarian for two reasons. One is the need to obtain and maintain an ideal body weight and the other is to reduce the size of the swing in the blood glucose concentrations that occurs with eating. High fiber diets and fiber supplements have been traditionally prescribed. Currently, high-protein, low carbohydrate diets are the food of choice, and fiber supplements such as pumpkin may also be suggested for certain cats. Traditionally, two meals were fed in order to synchronize with the blood insulin levels as it was absorbed after injection. This is still a system used today, but in some cats, free choice feeding offers an advantage because small meals lead to small swings in blood sugar, and if they are unwilling to eat a larger meal at once, one does not have to worry about excessive blood sugar swings.

Nutritional Supplements

Some compounds containing the transition metals vanadium and chromium have been shown to help decrease the blood glucose concentrations and alleviate the clinical signs in cats associated with early NIDDM, and may be prescribed in addition to other therapies in some cats.

Getting Ready for Home Treatment

Once a cat is diagnosed with diabetes mellitus, the veterinarian will schedule an appointment with the owner to discuss the disease, the treatment plan, and the home management strategies. The caregiver will be instructed on how to administer the insulin, how to store the insulin, how to mix the insulin, what type of food will be fed and how often, and how to monitor the cat at home for any signs of low blood sugar, and how to monitor water intake and urine production. Once the cat is regulated at home, glucose testing at the veterinary hospital will be scheduled periodically. Sometimes ear prick sampling at home is used to help keep tabs on the blood sugar levels, or urine sampling with sticks done at the box, or fructosamine will be periodically assessed by the veterinary hospital.

Although a diagnosis of diabetes can seem overwhelming, once the caregiver better understands the disease and develops the routine of daily treatment, most cats can be managed at home successfully and can go on to live healthy lives.