, also known as
“sugar” diabetes for its reference to excess glucose in the bloodstream.
It is a complex, but common, disease similar to diabetes in humans, in
which the cat doesn’t produce sufficient insulin or doesn’t process the
insulin produced by its own body. Insulin is a hormone secreted by the
pancreas in small amounts and helps to properly balance the blood sugar
(glucose) levels in the blood. Glucose is the fuel that provides energy
needed by the cells of the body to sustain life.
Type
1 form of diabetes is defined as an absolute insulin deficiency. In
this form, the pancreas is not able to produce enough insulin to
regulate the glucose in the bloodstream, leading to persistent high
glucose levels in the blood. This type of diabetes is very rare in the
cat.
Type
2 diabetes, the most common form of diabetes in cats, occurs when the
cells in the cat's body don’t respond to the insulin that is being
provided. As a result, the cat becomes hyperglycemic (high blood sugar),
which may lead to having excess sugar in the urine.
Type
3 diabetes is also less common and may occur due to other conditions
(e.g., secondary to another primary disease which may damage the
pancreas).
While
diabetes can affect any cat, older, obese and neutered male cats are
more commonly associated with the disease. In addition, chronic
pancreatitis, hormonal diseases and certain medications have shown a
link to increased incidence of diabetes.
As
in humans, diabetes is often seen in overweight cats because fat cells
produce a substance that decreases the body's response to insulin (as
occurs in Type 2 diabetes).
In
addition, diet plays a major role in maintaining the cat's proper
weight and nutrition, both of which are key determining factors in
diabetic patients. Because cats are designed to consume mostly proteins
and fats for energy in their diets, high carbohydrate diets may lead to
weight gain and increased incidence of diabetes in many cats.
Further,
diabetes is more prevalent in older cats, neutered male cats and
felines with a history of pancreatic disease, hormonal imbalances and
use of certain medications
Your first vet visit: diagnosing feline diabetes
Your
veterinarian can diagnose diabetes with a simple, in-office physical
examination of the cat and laboratory tests, which will determine if
there is an abnormally high level of sugar in the bloodstream and urine.
Your veterinarian may ask if your cat has exhibited any of the following symptoms, indicating a possibility of feline diabetes:
- Increased thirst
- Sudden increase in appetite
- Sudden weight loss (despite an increase in appetite)
- Increased urination
- Increased lethargy
Understanding your cat's diagnosis
The
food your cat eats is broken down into glucose during the digestion
process. Glucose is the fuel that provides energy needed by the cells of
the body to sustain life. As glucose enters the bloodstream, the cat's
pancreas secretes insulin. Insulin is a hormone released in small
amounts to properly balance the blood sugar (glucose) levels in the
blood.
Feline
diabetes is similar to human diabetes, and occurs when your pet either
doesn't produce or is unable to process insulin, a hormone that helps
regulate glucose or sugar in the bloodstream.
Just
like humans, diabetic cats are diagnosed primarily with Type 2
diabetes.The types of diabetes in cats are based on the human
classification system.
Type 1 Diabetes
Type
1 form of diabetes is defined as an absolute insulin deficiency. In
this form, the pancreas is not able to produce enough insulin to
regulate the glucose in the bloodstream, leading to persistent high
glucose levels in the blood. This type of diabetes is very rare in the
cat.
Type 2 Diabetes
Type
2 diabetes, the most common form of diabetes in cats, occurs when the
cells in the cat's body don't respond to the insulin that is being
provided. As a result, the cat becomes hyperglycemic (high blood sugar),
which may lead to having excess sugar in the urine.
No test can differentiate between Type 1 or Type 2 diabetes in the cat.
Type 3 Diabetes
Type
3 diabetes is also less common and may occur due to other conditions
(e.g., secondary to another primary disease which may damage the
pancreas).
My cat has just been diagnosed with diabetes … now what?
Discovering
that your pet has diabetes can seem overwhelming and scary especially
since there is no cure. The good news is that feline diabetes is not a
fatal diagnosis and with proper attention, your cat can live a happy and
virtually normal life.
Learning
how to monitor your cat's blood sugar levels will be one of the most
important aspects of caring for your diabetic cat. Your veterinarian may
run these tests in the hospital or may demonstrate how to test your
cat's blood sugar levels at home, either through urine or blood sample
testing.
Additionally,
feeding your cat on a regular schedule will help prevent dips and
spikes in the cat's glucose levels. Again, your veterinarian will
discuss specific dietary changes and options to best fit your pet, your
family and your lifestyle.
Finally,
it's important to understand that you and your cat are not alone — the
more you know about this disease, the easier it can be to manage. Our
reference library provides links to additional resources and community
blogs about feline diabetes to help keep you connected.
Hypoglycemia vs. hyperglycemia
Hypoglycemia
Hypoglycemia is the medical term for low blood sugar. Diabetics have the opposite problem of hyperglycemia, or high blood sugar.
Diabetic
cats can develop hypoglycemia (low blood sugar) when their diet and
treatment is managed incorrectly. Symptoms of hypoglycemia include:
- Abnormal hunger or disinterest in food
- Restlessness
- Weakness or lethargy
- Shivering
- Staggering or uncoordinated movements
- Loss of eyesight
- Disorientation
If
your cat experiences symptoms of hypoglycemia it is recommended to
contact your veterinarian for advice. In the meantime, you can try
feeding the cat some of its normal food. If the cat is unwilling to eat,
try encouraging the cat by offering a small amount of corn syrup on the
food. In cases of extreme condition, contact your veterinarian and take
your cat in immediately.
Hyperglycemia
Hyperglycemia
is when your cat's blood sugar levels are too high, resulting in the
primary symptoms of feline diabetes, including:
- Increased thirst
- Sudden increase in appetite
- Sudden weight loss (despite an increase in appetite)
- Increased urination
- Increased lethargy
Generally,
hyperglycemia is not life-threatening and can be controlled through
administering insulin. Your veterinarian will work with you to develop a
regimen for testing and controlling your cat's blood sugar levels to
avoid hypo- and hyperglycemia.
Living with a diabetic cat
Each
diabetic cat responds differently to different therapies. Some cats are
easier to regulate; others require more complex types of treatment.
Some cats can be treated successfully through changes in diet and with
oral medications. In cats with more severe diabetes, insulin injections
may be required for the remainder of their lives.
In general, treatment for diabetes falls into three categories:
- Insulin injections
- Oral hypoglycemic medications
- Diet
Home monitoring & testing
Ongoing
and frequent home monitoring of your cat's glucose level is important
both for ensuring that diabetes is under control and the long-term
health maintenance of your pet. Home monitoring usually results in less
stress on the cat and allows for closer, more precise control of blood
glucose levels on a regular basis, which helps avoid the risk of
hypoglycemic episodes.
Home
testing of glucose levels can be done with a similar type of blood
glucose monitor used by humans. This method requires a small sample of
blood that is taken from the cat for testing and generally provides an
immediate reading of your cat's blood glucose level.
In
addition to monitoring glucose levels through the blood, caretakers can
use urine glucose monitoring. However, urine glucose monitoring is
generally not as accurate due to the lag time for glucose to go from the
blood to the urine in the cat's body.
It
is recommended to consult with your veterinarian on the best way to
monitor your cat's glucose. They can also provide valuable advice on
which type(s) of monitors work best in cats, as well as train you on how
to use and interpret the test results.
When
at home, you also should continually be aware of your cat's appetite,
water consumption and urine output to determine what is normal behavior.
Changes in your cat's eating and drinking habits, weight and urine
output can be a sign that there is a problem and veterinary attention is
needed.
Diet
Along
with insulin and oral medications, maintaining a proper diet for your
cat is important in a successful treatment program. Obesity is a major
risk factor for diabetes and insulin sensitivity in most cats. If your
cat is overweight, you and your veterinarian can tailor a safe weight
loss regimen. Some cats respond better to carbohydrate-restricted diets (
Catkins diet ) and some respond well to high-fiber, complex
carbohydrate rations. In fact, some cats have been able to get off
insulin after losing weight & staying on the low carb diet.
In
addition to the type of diet fed, the feeding routine also is
important, especially for cats receiving insulin injections. Ideally, a
cat should be fed half its daily food requirement at the time of each
injection, with the rest available throughout the day. When and how much
to feed your cat should be discussed with your veterinarian as other
factors may impact this process, (e.g., number of insulin injections/day
or living in a multi-cat household).
Insulin injections
Most
diabetic cats require insulin injections under the skin once or twice a
day, depending on the diabetic severity, type of insulin used, dose,
diet and other factors. Because each cat reacts differently to insulin,
your veterinarian will most likely perform a blood glucose profile at
various time points during the day to determine the proper insulin
dosage and treatment program. Insulin dosage may change over time as the
cat ages, and you may need to adjust the dosage based on new blood
glucose profiles, test results and how the cat responds to therapy. It
is very important to consult with a veterinarian before making any
changes to your cat's insulin dose. Many factors are involved with a
decision to increase or decrease dose and you want to avoid causing
hypoglycemia in your cat. There are reports of some cats reverting back
to being non-diabetic after being on certain insulins, as glargine.
There
are several different types of insulin available for use in managing
your cat's diabetes. Some of the most common include protamine zinc
(PZI) insulins, lente insulins, Humulin® and other human-type products.
Oral hypoglycemic medications
Some
healthy diabetic cats can be successfully treated with orally
administered hypoglycemic medications that lower blood glucose levels.
Often, the use of these medications requires frequent glucose monitoring
to ensure the best results, and many cats still require insulin
injections to achieve the highest level of control.
Ketones
Ketones
are waste products of fatty acids that may build up in the bloodstream
and urine of cats with diabetes. Ketones develop when the cat's body
burns fat, instead of glucose, to fuel its body.
If
your cat accumulates too many ketones in the body, diabetic
ketoacidosis (DKA) may occur. This is a serious condition altering the
pH and blood chemistry of your pet, and should be treated immediately.
Signs your cat may have diabetic ketoacidosis:
- Drinking excessive water or no water
- Excessive urination
- Diminished activity
- Not eating for 12 hours or more
- Vomiting
- Lethargy or depression
- Weakness
- Dehydration
- Ketone odor on the breath (may smell like nail-polish remover or fruit)
Simple
urine tests will alert you to the presence of ketones. If you discover
ketones in your cat's urine sample, check to see if your cat is
exhibiting any of the symptoms of diabetic ketoacidosis listed above. If
the cat is generally alert and well-hydrated, simply treat the cat with
your normal insulin regimen, provide the cat with continual access to
food and water, and monitor the cat for signs of diabetic ketoacidosis.
If the cat develops signs of DKA, contact your veterinarian immediately.
For more information on feline diabetes, please go to www.MyCatHasDiabetes.com
References
- Boehringer Ingelheim Vetmedica, Inc. What is Feline Diabetes?
www.MyCatHasDiabetes.com 2013.
- Nunn, Lyn. Feline Diabetes: Cat Diabetes Types and Causes
http://www.catbreedsjunction.com/feline-diabetes.html 2013.
Written by:
Charles Jameson, DVM
Lap of Love Veterinary Hospice:
Houston location
http://www.lapoflove.com
