What Are The Clinical Signs Of Diabetes Mellitus
The most common clinical signs seen in diabetic patients are an increase in water consumption and urination. Weight loss is also a common feature, and an increase in appetite may be noticed in some cats. Poor coat condition and weakness in the legs,more commonly the hind limbs, are other possible signs. Recognition of these signs is variable though, particularly because of the life-style of some cats. If a cat spends a lot of time outdoors, it may drink from ponds or pools of water outside rather than appearing to drink excessively from what is provided indoors. Sick cats, just like people, may act in ways we would refer to as cranky, easily agitated, or aggressive towards people, especially children, and/or other animals. Discomfort from any source/cause often causes cats to act out of their ordinary routine. They may hide,be less social, have different eating habits as described above, and/or different elimination habits which often means not using their litterbox to urinate and/or defecate. Sick cats are not being spiteful or acting out of anger, just out of distress/illness. It is their natural instinct to behave this way. In the wild, a sick cat is a weak cat and a weak cat is a potential victim. Changing their normal routine and/or demeanor may ward off a potential predator. So you see, what seems abnormal to the untrained human eye is actually normal to the feline survival instinct.
How Long Can A Type 1 Go Without Insulin
Hey folks, I was actually just wondering.
How long can a type 1 diabetic go without any insulin at all?
I got diagnosed like 6 weeks ago, and have been taking my insulin ever day since then.
But I been a little depressed lately, and just havenât taken any insulin at all today.
And this got me wondering, how long could one last without insulin??
I know before I was diagnosed, I think I was diabetic for a while, until I eventually went into ketoacidosis and found out Iâm a type 1. but does that mean before I DKAed my pancreas was dying?? and it finally quit on me when I went to the hospital. or was it straight up dead a while ago, and I just went into DKA??
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Hey Johnny I was Diagnosed in March of this year T1 in honeymoon stage ,I was taking shots but now on the pump. They told me that the longest I can go with out insulin is two hours.
Good luck welcome to the family
DMurray
If you dont eat anything and only drink water you might make it a week but that would about it. If you eat anything a couple days and you will be out cold.
It took me about 32 hours to go into and through DKA and into a Coma. Bad way to go. I forgot my Insilin except I had basal in me from the night before.
JohnnyPlease dont go without your insulinsyou dont want to find out what could happen to you. You are worth taking care of yourself and LIVING!!! You live near mecan I help in anyway? Robyn
So lesson is, dont skip a dose
Primary Cause Of Diabetes In Cats
The primary cause of diabetes in cats is that the insulin that their body produces is either insufficient or ineffective. This means that insulin is either not helping glucose get into the cells to supply energy or that there is not enough insulin to do its job efficiently.
There are a few different ways that cats can contract diabetes.
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You Can Buy Insulin Without A Prescription But Should You
âYou have to pay the $7,600 out of pocket before your insurance is even going to kick in,â she remembers telling him. Alec decided going uninsured would be more manageable. Although there might have been cheaper alternatives for his insulin supply that Alec could have worked out with his doctor, he never made it that far.
He died less than one month after going off of his motherâs insurance. His family thinks he was rationing his insulin using less than he needed to try to make it last until he could afford to buy more. He died alone in his apartment three days before payday. The insulin pen he used to give himself shots was empty.
The price of insulin in the U.S.from leading manufacturers has more than doubled since 2012. Thatâs put the life-saving hormone out of reach for some people like Smith-Holtâs son Alec. Bram Sable-Smith for NPRhide caption
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The price of insulin in the U.S.from leading manufacturers has more than doubled since 2012. Thatâs put the life-saving hormone out of reach for some people like Smith-Holtâs son Alec.
âItâs just not even enough time to really test whether was working or not,â Smith-Holt says.
A miracle discovery
Insulin is an unlikely symbol of Americaâs problem with rising prescription costs.
For patients, it was nothing short of a miracle. The patent for the discovery was sold to the University of Toronto for only $1 so that live-saving insulin would be available to everyone who needed it.
Situations When Type 2 Diabetics Must Go On Insulin
Few things are more worrisome for diabetics than when type 2diabetes needs insulin. Some doctors even use insulin as a scare tactic.
But the truth is, sometimes insulin therapy is really theonly way to go. Most of the time insulin is associated with worsened diabetesor the end of the road. But hopefully after you finish reading, youll feelmore confident that insulin is not the end and you can still regain yourhealth.
Insulin is indicated when blood sugar control cant beachieved with diet, exercise, and oral drugs for people with type 2 diabetes.
There are 3 main situations when insulin is usually used forpeople with type 2 diabetes. They are as follows:
Early Initiation ofInsulin in Type 2 Diabetes
For most newly diagnosed or people who havent had diabetesfor very long, their doctor will put them on oral medications and a diet andexercise regimen. The goal is to get these three to work in getting blood sugarlevels under control.
But when a type 2 diabetic presents with weight loss, moresevere symptoms and blood sugar levels greater than 250 mg/dL patients arestarted early on insulin therapy.
Late-Stage InsulinTherapy in Type 2 Diabetes
When MedicalSituations in Type 2 Diabetes Require Insulin
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What Medication Will My Cat Need To Control Diabetes
Most cats with diabetes will need insulin injections, normally twice a day, about 12 hours apart and after a meal. The injection is usually given in the scruff of the neck and should be painless for your cat. You may also need to test your cats blood glucose levels by taking a small swab of blood with a tiny pin prick.
Your vet will show you how to give insulin injections and carry out any urine or glucose tests. Many pet owners are understandably concerned about giving injections at first, but soon get the hang of it with practise. You may find you need another pair of hands to help hold your cat still for the injections, especially in the early stages.
Its very important to follow your vets instructions precisely and stick to a regular daily routine to make sure your cats insulin levels are kept at safe levels. Always double check you have the right concentrations of insulin on any syringes and ensure you store it properly, in the fridge at all times.
Why Do Cats Get Diabetes
Cats arent so different from people when it comes to diabetes.
The disease affects insulin — a hormone that helps the body move sugar from the bloodstream into the cells. Feline diabetes tends to more closely resemble type 2 diabetes in humans, in which the body makes insulin but becomes less sensitive to the hormone. Sugar builds up in the bloodstream, leading to symptoms like increased urination and thirst. If its left untreated, eventually diabetes can lead to life-threatening complications.
Although the exact cause of feline diabetes isnt known, its more likely to affect overweight cats, because obesity makes the cats body less sensitive to the effects of insulin. Diabetes is also more common in older cats.
Diseases like chronic pancreatitis and hyperthyroidism, as well as medications such as corticosteroids, may also make cats more prone to develop diabetes.
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Can I Treat My Diabetic Cat Without Insulin
Diabetic remission occurs when a cat maintains a normal glucose level for more than four weeks without insulin injections or oral glucose regulating medications. The primary goal of treating diabetes is to regulate blood glucose quickly and reach a point where the cat no longer needs insulin therapy.
Does Type 2 Diabetes Shorten Life Span
Estimating the impact of diabetes on longevity, the researchers determined that a diagnosis of type 2 diabetes at roughly 15 years of age led to a loss of approximately 12 years of life. A diagnosis at 45 years lessened the lifespan by roughly 6 years, while a diagnosis at 65 years shaved off 2 years of life.
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Continuous Blood Glucose Monitoring
Blood glucose concentration is best measured either with a portable glucose meter calibrated for feline blood, and measured from the ear or paw pad, or with a continuous glucose meter which is internally calibrated and has a long sensor life. Continuous blood glucose monitors measure glucose concentration in the interstitial fluid, mostly using an electrochemical sensor attached to a small monitor or transmitter implanted subcutaneously in the flank, lateral thorax, interscapular space, or dorsal neck in cats. The Min-iMed Gold , Guardian Real-Time , GlucoDay , iPro , and FreeStyle Libre have been reported for use in cats and dogs., However, many models still require calibration three times a day with blood glucose measurements obtained by traditional methods, most sensors need replacing every 37 days, and the glucose recording range can be limited. The FreeStyle Libre is a newer model that is calibrated in the factory and does not require additional blood glucose measurements to calibrate at home, and the sensor is suitable for 14 days of use.
Diet Change And Weight Loss
The other mainstay of diabetes treatment is diet change, an important part of possibly getting a cat to go into remission. Feeding a high-protein, low-carbohydrate diet allows the insulin to work better and helps the cat to lose weight. Canned food is better than dry food, since it is lower in carbohydrates, is not as calorie-dense and contains more fluid.
In conjunction with a change in diet, weight loss is a vital part of diabetes management. Weight loss is often achieved by feeding the cat a high-protein, low-carbohydrate diet, but it is also achieved by only feeding a certain amount of food at designated meal times. Feeding at select times also makes it easier to ensure that the cat will eat, which then allows insulin to be administered.
Exercise programs also help with weight loss and management in cats. Exercise can include taking the cat for walks using a harness and leash, having the cat chase toys or even encouraging the cat to hunt for his food if kibble is still being fed.
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Causes Of Type 2 Diabetes
Type 2 diabetes occurs when the body doesnt produce enough insulin to function properly, or the bodys cells dont react to insulin. This means glucose stays in the blood and isnt used as fuel for energy.
Type 2 diabetes is often associated with obesity and tends to be diagnosed in older people. Due to increased obesity, type 2 diabetes is now being seen in young people and all ages. Its far more common than type 1 diabetes.
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What Happens When You Run Out Of Insulin
First, lets talk about the physical process that sets in when a person with diabetes does not get enough insulin into their body.
Very quickly, severe hyperglycemia sets in. That is high blood sugar that leads to a state called DKA, short for diabetic ketoacidosis, which untreated leads to death.
Basically whats doing on is this: insulin helps sugar enter the cells, which use it for fuel. Without insulin, the body cannot access enough sugar to function properly, so your liver begins to turns some of the body fat into acids called ketones. These build up in the bloodstream and spill over into the urine. When these excess ketones get into the blood, the blood becomes acidic, causing DKA: a combination of very high blood sugar, dehydration and shock, and exhaustion.
Symptoms are vomiting and hyperventilation, and eventually passing out and going into a coma. Without treatment, this leads to death.
Generally, the first signs of DKA show up once the blood glucose level has been north of 300 mg/dL for about four hours, but how quickly things get out of hand at that point is highly variable. Some people with diabetes feel ill immediately, while others can wander around in a daze for days.
If you have any residual insulin at all in your system, it can help hold off DKA even when your blood sugar level is high, according to Dr. Silvio Inzucchi, clinical director of the Yale Diabetes Center.
Hospitalizations for DKA are unfortunately on the rise in the United States.
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Symptoms Of Diabetes Include The Following:
1. Weight loss as fats are mobilized for energy instead of glucose2. Increased appetite as the body tries to increase its energy supplies3. Increased drinking and urination the glucose in the blood overwhelms the kidneys and spills into the urine drawing excessive amounts of water with it4. Untreated diabetics can develop diabetic ketoacidosis. If this happens, the cat will show signs of severe illness including loss of appetite, lethargy and vomiting.
Diagnosing diabetes is generally straightforward. Most diabetic patients have significantly elevated glucose levels in their blood as well as in their urine. In many cats we recommend a fructosamine test to confirm the diagnosis and make sure the elevated glucose was not due to stress.
Most diabetic cats do very well with treatment and can live for many years with the disease. In addition to treating the diabetes, it is important to closely monitor all aspects of your cats health, since diabetes can make cats more susceptible to other problems such as infections. Dental health is especially important!
Obligations That Come With Insulin
Insulin needs to be administered twice a day.
After your dog is diagnosed with diabetes, it will take some time until the vet is able to prescribe an adequate dosage of insulin, and there’s going to be some trial and error.
You or your vet will run tests on the dog’s glucose level several times a day or a week in order to see the reaction of your dogs organism to a particular dosage. The positive thing is that once a good dosage is established, the dog wont need the check-ups as often.
Insulin needs to be administered around the same time.
This means creating a schedule around your dogs injections. If you have frequent business trips, irregular working hours, or stay overtime often, you would need to think about the alternatives for keeping up with the schedule. You can ask a friend, family member or a pet sitter to administer it to your dog when you are unable.
Some dog owners feel anxious about giving a shot to their dog, especially because the dog is not thrilled about it either. But giving injections to dogs is fairly simple, and most people get used to it very quickly it becomes a regular routine for them and their pet.
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Diagnosing Diabetes In Cats
After a physical exam and discussion of your cats symptoms, your veterinarian will take blood and urine samples for testing.
In addition to checking the glucose levels in your cats blood and urine, your vet will be checking for evidence of other diseases that have symptoms similar to diabetes, like kidney disease and hyperthyroidism.
They will also check for conditions that can complicate the treatment of diabetes, like infections and diabetic ketoacidosis, which require hospitalization.
What If Diabetes Isnt Treated
Diabetes is a disease that is treatable and if treated correctly will not shorten your cats lifespan or the quality of their life. However, it is a life-threatening illness if you dont treat it. When it is untreated for longer periods of time, it can lead to weak legs, malnutrition, ketoacidosis, and eventually death. You may notice your cat is not using its vertical cat scratching post as before. Thats because your cat cant climb well.
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If You Dont Get The Results You Expected With Your Diabetic Feline Patients Youre Not Alone
Originally published in the November 2014 issue of Veterinary Practice News
Fourteen diplomates from the American Board of Veterinary Practitioners met at the American Association of Feline Practitioners meeting in Indianapolis to discuss the clinical management of diabetes in the cat.
Elaine Wexler-Mitchell, DVM, of The Cat Care Clinic in Orange, Calif., invited all ABVP feline diplomates to participate and to discuss the apparent disparity in the results of academic recommendations for managing diabetic cats and the clinical outcome that we, as in-the-trenches practitioners, have experienced.
The main expectation in question is that most, if not all, diabetic cats will go into remission if treated properly and that home glucose testing and the use of glargine insulin are essential parts of this.
Those answering Dr. Wexler-Mitchells call responded with the following statements:
The diplomates observed that remission rates and overall management results were not as good as promised. The premise of the roundtable discussion was: The approach to the feline diabetic that is recommended in veterinary schools and by academic speakers does not consistently produce the promised results when applied to a primary care practice setting.
Data from cats that were alive at the end of the three-year study were also examined with emphasis on the four practices with the highest number of cats in the study.