Added/Modified on August 26, 2013
Diabetes Mellitus (diabetes) is a disorder in which the body is unable to regulate blood sugar levels due to a lack of insulin or insulin action. Insulin is a hormone required to move sugar into body cells where it is used for energy. Without this energy, the cells of the body starve, shut down and eventually die, which leads to multiple complications.
There are two forms of diabetes which affect cats. In type 1 diabetes, the body does not produce insulin. In type 2 diabetes, insulin is produced but the body does not respond properly to it. Type 2 diabetes is also called “insulin resistance” and is the most common form of diabetes in cats and people.
Just as for people, there has been a tremendous increase in the incidence of type 2 diabetes in cats over the last 30 years. Diabetes now affects one out of every 100 cats—approximately 800,000 cats in the U.S. Pet Obesity often leads to Feline diabetes and results from indoor confinement, decreased physical activity and feeding high carbohydrate foods.
Unique Metabolism and Dietary Requirements
Cats have evolved as true carnivores, resulting in high dietary protein and fat requirements. These nutrients, not carbohydrates, are used to produce glucose (sugar) which is the energy source of the body. Feeding high-carbohydrate foods to cats causes abnormally high blood sugar levels. In attempts to lower this high blood sugar, by producing more insulin, a cat’s body enters a pre-diabetic state. Eventually the cat’s ability to produce more insulin is exhausted and at that point, actual diabetes develops.
Unfortunately, most commercial cat food is moderate to high in carbohydrates and in susceptible cats, long term feeding of these foods may lead to feline diabetes. Halo has recognized this problem and has created a holistic cat food diet that addresses cats’ need for lower carbohydrates.
Risk Factors for Development of Diabetes
Other than high carbohydrate foods, other risk factors for cat diabetes include increasing age, male gender, obesity, physical inactivity, concurrent illness and medication.
Physical inactivity in cats directly contributes to obesity. Fat cats are at high risk for diabetes. In these chubby, couch potatoes, insulin is unable to move sugar into the cells properly, which leads to persistently high blood sugar levels. As already discussed, these high blood sugar levels eventually exhaust the body’s ability to produce insulin and diabetes occurs.
Certain medical conditions can also lead to diabetes. Ask your veterinarian to check for the presence of inflammatory conditions (e.g. pancreatitis), infections (e.g. mouth, urinary tract, skin) or endocrine disorders (e.g. hyperthyroidism) to ensure your cat is not as risk for developing diabetes.
Certain medications, such as steroids, can also increase the likelihood of your cat becoming diabetic. If your cat is on these medications, talk to your veterinarian about how to monitor your cat properly.
Signs of Feline Diabetes
Keep in mind that the only signs of pre-diabetes are increased appetite and weight gain. Eventually this will be followed by increased drinking, excessive urination and weight loss as the development of diabetes occurs. Diabetic cats will often be lethargic and have a very scruffy appearance due to the lack of grooming. Their hind legs often become weak and wobbly as a result of sugar toxicity to the nerves.
If you detect any symptoms of diabetes or are concerned that your cat is gaining weight, please visit your veterinarian for a full medical checkup.
Diagnosis of Feline Diabetes
Your veterinarian makes a diagnosis of diabetes with confirmation of elevated blood sugar, elevated fructosamine level (sugar attached to blood proteins) and the presence of sugar in the urine.
After a full physical examination and blood panel, your veterinarian may also recommend a urine culture, x-rays or ultrasound to determine if your cat has underlying conditions leading to insulin resistance as a cause of diabetes.
Treating Feline Diabetes
Diet and Weight Loss
There is good news: A large percentage of cats with Type 2 diabetes can be managed, just like people, with dietary therapy, weight loss, and increased exercise…without insulin. With this treatment, cats often achieve remission, which means they revert back to a non-diabetic state.
I believe that cats have the best chance of achieving remission when fed a canned, high protein, low carbohydrate food twice daily. Only canned cat food should be fed to diabetics as it contains much lower carbohydrate levels than dry forms of the same diet. These foods should not contain rice or corn due to their negative effects on a cat’s blood sugar levels. Avoid “weight loss” diets as they too are high in carbohydrates and are inappropriate for use in diabetic cats.
Cats of ideal body weight have a better chance of achieving remission. For most cats, ideal weight is between 7.5 and 12 pounds. Your veterinarian can calculate daily calorie requirements for ideal body weight and get your cat started on a weight loss plan. The rate of weight loss should be approximately 1% per week. Monitor the weight every two weeks and adjust your cat’s calories 10-30% up or down for faster or slower weight loss.
If your cat continues to be diabetic despite the change to a canned, high protein, low carbohydrate diet, you will need to begin medical therapy to prevent complications from occurring. Insulin given twice daily is the preferred treatment, as it effectively lowers blood sugar and can help cats to revert to a non-diabetic state. There are many types of insulin available and studies done with cats reveal that glargine and PZI insulin are both very good choices for cats. Oral hypoglycemics are pills that help lower blood sugar; however, the chance of achieving remission is less with this medication and not all cats are candidates to receive it. Ask your veterinarian for more information.
Monitoring Diabetes in Cats
Using recommended methods of home urine and blood sugar monitoring, it has been reported that 70% of diabetic cats will go into remission! Your veterinarian can teach you how and when to perform these tests and how to keep a journal for best diabetic management. Blood sugar curves performed at your veterinarian’s office are no longer recommended as the stress of your cat visiting the veterinarian often creates inaccurate results.
Cats can revert to a non-diabetic state quickly or it can take one to four months to do so. Remember not all cats go into remission. If your cat remains diabetic, a routine recheck with your veterinarian is recommended every three to four months—even if he or she is doing well. This allows evaluation of weight, blood pressure and blood work necessary to monitor for complications of diabetes (high blood pressure, infection, liver damage, kidney damage, etc).
The prognosis is excellent if your cat goes into remission. The prognosis of feline diabetes is otherwise dependent on owner commitment, the ease with which your cat becomes regulated, the presence of other diseases and avoidance of complications. Historically, a guarded long term prognosis (average two years) was expected. This is changing now that better diet and insulin are available and remission is the goal of treatment. Diabetic cats, when managed properly, can easily maintain a good quality of life for years!
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