Diabetes is a commonly diagnosed disease in cats and is especially common in middle-aged to senior cats which are overweight or obese. Commonly seen symptoms of feline diabetes mellitus are:
- polyuria (an increase in urine volume),
- polydipsia (an increase in water consumption),
- weight loss, and
- sometimes an increased appetite, particularly early in the course of the disease.
The hallmark sign of diabetes mellitus is hyperglycemia (an increased blood glucose or blood sugar level). The primary goal of treating diabetes mellitus in cats is controlling the hyperglycemia. Diagnosing diabetes mellitus early in its course is preferable and diabetes can usually be easily diagnosed through routine periodic blood and urine screening. Evidence of hyperglycemia even in seemingly healthy cats may prompt the veterinarian to recommend additional testing to confirm the presence of diabetes.
Oral Hypoglycemic Agents in the Treatment of Feline Diabetes Mellitus
Some cats may suffer from a form of diabetes similar to Type 2 diabetes in people. These cats may have a relative insulin resistance. However, the beta cells in the pancreas may still be capable of producing insulin. These cats may respond to oral hypoglycemic agents, such as glipizide.
Cats diagnosed in the early stages of feline diabetes, when the blood glucose levels have not been elevated for a significant length of time, are more likely to respond successfully to oral hypoglycemic agents.
Treating Diabetes Mellitus in Cats with Insulin
Oral hypoglycemic agents may become ineffective if the pancreatic beta cells which are responsible for secreting insulin have been damaged by trying to combat elevated blood glucose levels for too long. Once the pancreatic beta cells have died and are no longer capable of secreting insulin, insulin injections will be necessary to treat the diabetic cat.
Several different types of insulin exist and include glargine (or Lantus®), Vetsulin® (or Caninsulin®), detemir (Levemir®), and NPH insulin. Twice daily insulin dosage is necessary for most cats. On rare occasions, once daily insulin administration may be adequate.
In diabetic cats in which the pancreatic beta cells still retain the ability to secrete insulin, rapid and adequate control of the blood glucose levels may make clinical remission of diabetes possible, at least for a time. For this reason, many veterinarians recommend the use of insulin instead of oral hypoglycemic agents as the initial treatment for feline diabetes, particularly for those cat owners who are willing and able to learn how to give insulin injections at home for their cats.
Proper Diet for Diabetic Cats
Recent research indicates that diabetic cats tend to respond better to diets containing high protein levels and low carbohydrate levels. This more closely approximates the needs of a species which is an obligate carnivore (a species which consumes only meat).
High fiber diets have not been found to help control the glucose levels in diabetic cats and are no longer considered to be the diet of choice for cats with diabetes.
Monitoring Feline Diabetes
Cats with diabetes must be monitored closely to insure adequate glycemic control. This is especially important in the early course of the disease and the early stages of treatment, where cats may actually enter a stage of remission and no longer require administration of insulin.
Methods of monitoring feline diabetes include blood fructosamine levels and blood glucose curves. Single blood glucose measurements are not a good method of monitoring glycemic control as they do not give enough information about the high and low glucose levels reached during the course of a day.
Blood glucose curves may be completed by cat owners at home and this method of monitoring diabetes is becoming increasingly more popular. Home measurement of glucose levels helps alleviate the stress hyperglycemia that so often becomes a factor when a cat is hospitalized. Most cat owners can be taught how to easily test their cat's blood glucose level at home. Blood glucose curves are normally easily performed by cat owners and the results obtained can be reported to the veterinarian who can evaluate the efficacy of the current insulin dose and suggest any changes in dosage needed.
Feline diabetes mellitus can be successfully treated with insulin administration, a proper diet and simple monitoring techniques. The main objectives to treating diabetes in cats are to control the elevated blood glucose levels normally found with this disease and to control the resulting clinical symptoms.
Sources:
Diabetes Mellitus in Cats, Jacquie Rand & Rhett Marshall, Veterinary Clinics of North America Small Animal Practicioner, January, 2005, Pg. 211-224.
Feline diabetes mellitus: low carbohydrates versus high fiber? Claudia Kirk, Veterinary Clinics of North America Small Animal Practitioner November, 2006, Pg. 1297-1306.
Home monitoring of the diabetic cat, Claudia Reusch et al. Journal of Feline Medicine and Surgery April, 2006, Pg. 119-127.
Use of glargine and lente insulins in cats with diabetes mellitus, Kelli Weaver et al. Journal of Veterinary Internal Medicine March-April, 2006, Pg. 234-238.
Control of diabetes mellitus in cats with porcine insulin zinc suspension, G Martin, J Rand, Veterinary Record July, 2007, Pg. 88-94.
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