Diabetes mellitus in cats Causes, symptoms and treatment

Diabetes mellitus (or sugar diabetes) is caused by an absolute or relative lack of the hormone insulin

Insulin is produced by special cells in the pancreas and this hormone is essential for the control and utilization of blood glucose (sugar). Insulin helps maintain normal blood glucose levels.

If insulin is deficient, blood glucose levels will rise and the body will not be able to use glucose efficiently as an energy source, instead relying on other sources, such as the breakdown of fats.

Diabetes is one of the most common endocrine (hormonal) disorders in cats, but in most cases it can be successfully diagnosed and managed, although management options can be quite complex and treatment must be tailored to each cat.

Types of diabetes in cats

The most common diabetes in cats is very similar to type II diabetes in humans.

Essentially, there are three different classifications of diabetes mellitus:

  • Type I diabetes mellitus: Itis insulin dependent, which means that the pancreas of the sick cat can no longer produce adequate amounts of insulin, there is a delayed response to secrete it, or the tissues of the cat’s body are relatively resistant to insulin
  • Type II diabetes mellitus: Itis not insulin dependent and occurs when the body cannot use the insulin that is produced efficiently. In these cases, the pancreas can still make insulin.
  • Type III diabetes mellitus involves insulin interference from certain diseases, conditions, and / or medications. Examples include hyperadrenocorticism (Cushing’s disease), acromegaly, gestational diabetes, etc.

Causes of feline diabetes mellitus

Diabetes mellitus in cats can be caused by amyloidosis, pancreatitis, or by certain medications.  Amyloidosis is a disease in which amyloid, a starch-like protein, is deposited in the pancreas and sometimes in other body tissues. Pancreatitis is an inflammation of the pancreas. Medications that can cause diabetes include: corticosteroids, megestrol acetate.

Obesity is also an important factor in the development of diabetes mellitus in cats .


Symptoms of diabetes mellitus in cats

Diabetes is primarily a disease of middle-aged and older cats, and is more common in male than female cats. The disease is also more common in neutered cats and overweight cats.

The most common signs seen in diabetic cats are:

  • Increased urination and a greater volume of urine.
  • Increased thirst (polydipsia), to compensate for the water lost through increased urine output.
  • Increased appetite (polyphagia), this is not always present in all cats.
  • Enlargement of the liver (hepatomegaly), which may be evident on examination by your veterinarian.
  • Neglected coat of hair.
  • Weakness, especially in the hind legs.
  • In some cases, secondary bacterial cystitis may appear.


Diagnosis of feline diabetes

Tests to confirm a diagnosis are usually done in the form of blood and urine tests:

  • Analysis of a urine sample will reveal the presence of glucose. Ketones can also be present in urine.
  • A blood test should show the presence of a high concentration of glucose.

Although the presence of hyperglycemia (a high level of glucose in the blood) and glycosuria (glucose in the urine) are typical cases of diabetes, these changes can also occur in some cats simply as a result of stress. If there are doubts about the diagnosis, the vet may want to wait a bit and repeat the tests, or do some additional research such as testing for fructosamine or glycosylated hemoglobin.



Treatment of diabetes in cats

Diabetes mellitus is generally a treatable condition, but it is not a simple disease to manage and requires dedication and commitment on the part of the owners.

Four are the remedies that should be taken into account:

Management of factors that predispose to diabetes

Initially, it is important to identify any predisposing factors or complications, for example, if medications are given that may be causing diabetes, these should be gradually withdrawn.

Nutritional management of the diabetic cat

There are two main considerations to take into account when managing diabetic cats. First of all, if the cat is overweight or obese, it is very important to normalize its body weight. This in itself can end diabetes (because obesity interferes with the action of insulin). Weight loss can be achieved through a combination of reduced calorie intake and increased exercise, although the latter can be challenging for cats. 

As a routine, cats with diabetes often benefit from a low carbohydrate diet . In some cases, diabetes actually resolves itself simply by switching to a diet that is very low in carbohydrates. 

Oral medications to control diabetes

In humans with diabetes, there are a number of oral medications available that can help manage the condition. Many of these are toxic to cats (so they shouldn’t be used) or they just don’t work on cats. Some tablets (called oral hypoglycemic agents, tablets that lower blood glucose) may be valid in a small proportion of diabetic cats, but their long-term use is controversial. However, this can be an occasional option for cats who are difficult to inject insulin.

Using insulin injections

Most diabetic cats will need to control their diabetes with daily insulin injections. Although the prospect of having to inject your cat once or twice a day can be very daunting for most owners, it can actually be very easy to do with practice. The injection is given under the skin, usually in the neck area.

The vet will explain the entire procedure to you on how to administer insulin to your own cat. Sometimes practicing injecting water into something like an orange can help you get a feel for how to handle the syringe and needle and gain confidence. At first you can try injecting your cat when he is distracted by other things, and to begin with, it may be best to have a second person who can help hold your cat, although with practice this will not be necessary.

There are several different types of insulin available, generally insulins are divided into:

  • Short-acting preparations.
  • Intermediate action preparations.
  • Long-acting preparations.

Each cat may respond differently to each insulin, but most cats will require an injection twice a day of an intermediate or long-acting type of insulin, although in some cats an injection once a day may be sufficient.

Insulin storage and handling

It is important to store insulin properly to keep it effective. Insulin should be kept in a refrigerator at all times, and never frozen. Before injecting insulin into a syringe, the contents of the bottle should be mixed gently to obtain a uniform suspension, but you should not shake the bottle as this can damage the insulin.

  • Follow your vet’s instructions carefully when using insulin.
  • Be precise, draw the correct amount of insulin into the syringe. 
  • If you are not sure if the injection was given successfully,  never givea second injection. It is better to skip a dose rather than risk giving too much insulin.


Long-term management of the diabetic cat

Daily routines, diet, activity, and body weight should be kept as constant as possible, as this will help minimize fluctuations in insulin needs. Once a diabetic cat is stable, the insulin dose may still need to be adjusted occasionally.

The vet, from time to time, will want to:

  • Check blood samples for blood glucose and fructosamine and / or glycosylated hemoglobin concentrations.
  • Check the weight of your cat.
  • Check urine samples (for glucose and ketones)
  • Study the general health of your cat.

For your diabetes control, it is very helpful to keep a journal and record key things every day. Seeing trends and changes in these parameters over time can be very helpful in managing your cat’s disease.

Keep a daily record of:

  • The times of the injection and the amount of insulin injected.
  • The cat’s appetite and the amount of food consumed.
  • The general behavior of your cat, especially if he becomes lethargic or more sleepy than normal
  • The presence of any vomiting or diarrhea.
  • If possible, measure the amount of water your cat drinks every day. Measuring your water intake is one of the most helpful ways to manage diabetes. 

Some other useful things to journal:

  • As for the weight, keep a weekly note also put it in the journal. Bring the diary with you every time you go to the vet so that you and your vet can review what has been going on.
  • Your vet may suggest that you take a urine sample from your cat from time to time to be able to check for glucose in the urine.



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