Diabetes Mellitus In Cats
What is diabetes mellitus?Why is insulin so important?
- Weight loss
- Ravenous appetite
- Increased urination
How is diabetes mellitus diagnosed?laboratory testsWhat does a diagnosis of diabetes mean for my cat ?What does a diagnosis of diabetes mean for me?How is diabetes treated?Understanding Diabetes About Insulin Clinical Signs of Diabetes Blood Testing as a Means of MonitoringWhat causes hypoglycemia, how do I recognize it and what should I do about it?
- A dose of insulin that is too high
- A double dose of insulin
- Too little food intake or vomiting of food
- Too much exercise or activity
- Spontaneous remission of diabetes
seizureTell me more about spontaneous remission of diabetes.What do I need to know about handling insulin?
Because insulin comes in a glass bottle, we recommend that you store it in a small plastic container in the refrigerator to prevent breakage. Lay a thick towel on the countertop where you are working just in case the bottle slips out of your hand. Be sure to replace the bottle in the refrigerator immediately after drawing up the dose.
How do I make a proper injection?How should my cat be cared for when I am out of town?boarding
What Is High Blood Sugar
High blood sugar is caused by the body’s inability to make its own insulin or use it effectively. When your cat eats he digests fats, proteins and carbohydrates for his body to use. Sugar, or glucose, is an important substance because it provides him with the energy he needs to live. His body should also produce insulin to regulate the flow of glucose. If he isn’t producing insulin, his body will use other sources for energy and his blood sugar will be high.
Keeping your cat healthy requires being in tune with his body. It is important to learn his behavior, so you will know if he isn’t at his best. While most cats are generally healthy, some develop medical conditions similar to humans, including hyperglycemia, or high blood sugar. Diabetes mellitus is a condition that occurs in cats which is characterized by high blood sugar.
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Poorly Controlled Diabetic Cats
Some diabetic cats will prove difficult to control, often requiring high doses of insulin administration. This may be due to owner noncompliance, insulin choice, inappropriate dosing, or underlying diseases contributing to insulin resistance.
Inappropriate storage of insulin leading to loss of potency, incorrect administration , and irregular dosing can all contribute to poorly controlled diabetes and should be ruled out as much as possible by discussing with the client and watching their injection technique. Dosing errors occur when one type of syringe is changed for another without proper education. Porcine lente insulin and Prozinc use 40 U/mL syringes , whereas other insulins use 0.3 mL, 100 U/mL syringes . Duration of action of intermediate-acting insulins may not be sufficient with twice-daily dosing to maintain a prolonged decrease in blood glucose concentrations., In these cats, a change to longer acting insulin such as glargine or detemir typically resolves the poor control.
Underlying diseases can contribute to insulin resistance and poor control, despite good client compliance and appropriate insulin selection and dosing. Further testing should be offered if insulin doses exceed 1.01.5 IU/kg q 12 hours, and blood glucose control remains poor .
Hyperthyroidism has been associated with impaired glucose tolerance however, it does not appear to cause clinically appreciable insulin resistance in most diabetic cats.
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Hyperglycemia And The Sick Cat
In hospitalized sick cats, it can be unclear whether stress or diabetes is causing an elevated blood glucose concentration. If hyperglycemia persists for longer than 46 hours, low-dose insulin therapy should be given. Exogenous insulin lowers blood glucose and helps overcome deleterious effects of hyperglycemia on -cell function. Glucose concentrations should be monitored closely and insulin adjusted accordingly.
How Do You Check A Cat For Diabetes
The first test your veterinarian will do is check your cats urine for the presence of glucose and ketones. If indicated, the next step is to measure your cats blood glucose concentration. The diagnosis only becomes definite when glucose is persistently found both in the urine and at a high level in the blood.
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Client Education: Its More Than Injection Instruction
The appointment to go over how to administer the insulin may be one of the most important visits your staff ever has with a client. Did you catch that? Your team members can be empowered to help your clients understand the entire diabetic situation. Administering the insulin is the tip of the iceberg. It is crucial to make sure that the client understands how insulin works, what hypoglycemia is and what it looks like, how to monitor water intake and urine output, and most of all, what to do if a problem is identified. Many people are taught to administer insulin without being told how it works. Because of that, when they think the cat is having a diabetic problem, their instinct is to give more insulin. We all know where this can lead. Leverage your staff members and allow them to teach your clients in simple terms. Our clients dont care about the pathophysiology of ketosis they need to know that insulin lowers blood sugar.
The three main insulin choices for cats are insulin glargine, protamine zinc insulin,and porcine zinc insulin.
To help your staff become more comfortable, consider having them take the AAHA Diabetes Educator Certificate Course. Its a great investment in your staff and can help improve their confidence levels.
Preparing Your Cat For The Blood Test
When drawing blood from diabetic cats, sugar test strips and the remaining equipment must be nearby. By completing the test quickly, your cat remains calm and stress free. Stress causes blood sugar levels to rise, so it is important to soothe your pet throughout the process.
Place diabetic testing supplies within easy reach and have a few pieces of all natural cat food handy. You can give them as treats when the test is complete.
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Oral Diabetes Drugs For Cats
Oral diabetes medication, such as Glipizide, can be used, but most veterinarians prefer that cats be treated with injectable insulins. The oral medications do not work as well in cats, and its often easier for people to give a cat injections rather than pills. However, there are some circumstances in which oral medication may be used. Some people are very uncomfortable around needles, and some cats will not allow injections, but will eat the oral medication in food.
Insulin Injections Are The Preferred Method Of Managing Diabetes In Cats
Figure 1: To administer an injection, pull the loose skin between the shoulder blades with one hand. With the other hand, insert the needle directly into the indentation made by holding up the skin, draw back on the plunger slightly, and if no blood appears in the syringe, inject gently.
Tips for Treatment
Possible Complications
Diabetic cats with uncontrolled diabetes may develop a condition known as ketoacidosis. This occurs when cells starved for glucose begin to break down fats for energy, a process that creates chemicals called ketones, which make the blood more acidic. Ketoacidosis is considered a medical emergency, and cats diagnosed with this complication require hospitalization for ideal management.
Monitoring Your Cat At Home
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Timing Of Glucose Curves
According to AAHA and ISFM recommendations, performing blood glucose curves often serves 2 important purposes.2,6 First, they can reveal subclinical hypoglycemia, so that adjustments can be made to the insulin dose before clinical signs or critical situations develop. Second, in patients whose diabetes is not well controlled, it can be challenging to determine whether the reason is too high or too low of an insulin dose.2 Detailed blood glucose curves provide information that can be used in making treatment decisions and dose adjustments.2,6
The timing of glucose curves varies slightly among patients depending on the type of insulin and dosing regimen used. Detailed recommendations are described in the AAHA guidelines.2
In general, when acquiring a blood glucose curve, glucose is measured every 2 to 4 hours for 12 to 24 hours. If the blood glucose concentration is below 150 mg/dL, measurements should be taken hourly.2
AAHA and ISFM offer similar but slightly different guidelines for when to perform blood glucose curves, but both recommend that they be performed at home. According to the AAHA guidelines, blood glucose curves should be done after the first dose of a new type of insulin is administered, 7 to 14 days after a dose adjustment, if clinical signs recur in a patient whose disease was controlled previously, any time hypoglycemia is suspected, and then regularly at 3-month intervals.2
What Does Insulin Do In My Cats Body
Insulin has been called the cells gatekeeper. It attaches to the surface of cells and permits glucose to enter the cells from the blood. When insulin is absent or present in insufficient amounts, glucose builds up in the blood resulting in high blood glucose levels.
Glucose is one of the bodys primary energy sources. When insufficient amounts of glucose are available to the cells, the body looks for alternate sources of energy . Eventually, these energy demands lead to weight loss. This weight loss causes the cat to eat more in an attempt to make up for the energy drain. Also, the body attempts to remove excess blood glucose by spilling it into the urine. Since glucose attracts water, tremendous amounts of water follow this glucose into the urine. This loss of water causes dehydration and the cat must drink more to counteract it.
Therefore, high blood glucose levels result in the four typical signs of diabetes:
Not all of these signs are readily seen in every diabetic cat, but we expect that you will have seen at least two of them.
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What Causes Cats To Develop Diabetes
While the actual origin of feline diabetes is unknown, fat cats are the ones who are most at risk of having the condition. Besides chronic pancreatitis, there are other risk factors to consider, such as hormonal abnormalities such as hyperthyroidism and Cushings disease. In addition to certain drugs, such as corticosteroids , diabetes has been related to certain medications. Male cats are also more susceptible to this illness than female cats, according to research.
Treatment Of Low Blood Sugar In Cats
Treatment of low blood sugar in cats ultimately begins with identifying the underlying cause, as hypoglycemia is a symptom and not a disease. Low blood sugar can be the result of diabetes, a pancreatic tumor, a disease of the adrenal gland, a blood infection, or a result of toxicity. Talk to your veterinarian about the appropriate treatment plan for your cat and his/her low blood sugar.
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What Causes High Glucose Levels In Cats
Increased Glucose Causes and Symptoms. A cat that has increased glucose levels in the blood may have diabetes, or may have just consumed a meal. Some cats may have an increased level of glucose due to stress or excitement. Diabetes can be caused by an increased production of glucose and an insufficiency of insulin to assimilate the glucose.
When Should I Test My Blood Sugar
You may need to check your blood sugar several times a day, such as before meals or exercise, at bedtime, before driving, and when you think your blood sugar levels are low.
Everyone is different, so ask your doctor when and how often you should check your blood sugar. If you’re sick, you’ll probably need to test your blood sugar more often.
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How To Complete A Glucose Curve
Feed and inject the cat with Vetsulin® as it is done at home. This may be done by the owner and then verified by the veterinarian. If the cat exercises at home during the day, the same exercise routine should be adhered to while the cat is in the hospital.
Blood sampling:
- Just prior to insulin administration .
- Then, in at least 60 to 120 minute intervals. Glucose monitoring should occur hourly if glucose is in a range where hypoglycemia is a concern.
- Over a period of 12 hours, if product administered every 12 hours. This should ideally be done for 24 hours, particularly if product administered once daily.
What Is Diabetic Remission And How Does It Work
The primary goal of treating diabetes in cats is to get blood glucose levels under control as quickly as possible and to the point where the cat no longer requires insulin therapy. Having an average glucose level for more than four weeks without insulin injections or oral glucose-regulating drugs is considered in diabetic remission in cats with type 1 diabetes.
Not all cats will go into remission, but those who do may be able to maintain their condition for months or even years. According to one estimate, insulin therapy results in remission in anywhere between 17 and 67 percent of cats. Under other estimations, remission is possible in 90 percent of felines.
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Regulation In 12 Simple Steps
I. FIND A VETERINARIAN THAT YOU TRUST
You need to feel comfortable with your veterinarian. Find out if she has very many diabetic cats in her practice. Ask your friends for references. Make sure your vet knows your philosophy of treating feline diabetes, e.g. if you plan to do home testing. If you ever feel that your veterinarian is not responsive to your needs and the needs of your cat, dont hesitate to change vets. There are plenty of wonderful veterinarians out there.
II. LEARN ABOUT INSULIN TYPES
If your cat is started on insulin, know what type of insulin it is and be sure to use the right syringe. All human insulins in the United States are a concentration called U-100. PZI is often U-40. I am ignorant of insulin in non-U.S. countries. Regardless, the syringe must match the concentration of the insulin. To be sure you get the right syringe, take your insulin into your pharmacist when you go to buy syringes and the pharmacist will make sure you get the right syringes. When you buy the next batch of syringes, take the syringe packaging with you to make sure you buy the right type.
You also need to know the activity of your cats insulin so you can know when to expect peaks of insulin action that correspond to nadirs of blood sugar. This will be very important when watching for hypoglycemia . Knowing how insulin acts will help you interpret blood glucose results you get. Many insulin manufacturers, such as Eli Lilly, have excellent information about insulin activity.
Natural Options To Help Manage Diabetes In Cats
While insulin may be necessary to ensure effectiveness in managing diabetes in cats, pet parents can also take a natural approach to diet and lifestyle changes following a diabetes diagnosis.
Raines recommends a low-carb diet without the addition of grains, sweet potatoes, potatoes, and green peas. If you are feeding raw or home cooking your cats diet, definitely make sure that it is balanced appropriately, she says, This can be done by purchasing a supplement designed to balance a home prepared diet, or by purchasing commercially prepared complete raw diets.
In addition to natural dietary changes, Raines says diabetic cats may also benefit from a cranberry-based urinary supplement since diabetic cats can be at a higher risk for bladder infections.
When searching for a natural urinary supplement, look for companies that perform independent testing and for products that have the GMP label. Its best to work directly with your veterinarian to ensure safe and proper supplementation for your diabetic cat.
Most importantly, never change your cats insulin dose or diet without first talking to your veterinarian. Oftentimes, a cats insulin needs will change when they start eating a different food. A mismatch between diet and insulin can result in serious and even fatal complications.
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What Might A Cbc Indicate If My Cat Has Diabetes Mellitus
The complete blood count evaluates the red blood cells, the white blood cells, and the platelet components of a blood sample.
With uncomplicated diabetes mellitus, these components are often within the normal range, but changes may occasionally be seen in the red or white cell values.
Despite drinking large quantities of water, diabetic cats lose body water because they produce such dilute urine. Therefore, your cat may actually be dehydrated. Dehydration can be indicated on the CBC by increases in the packed cell volume , as well as increases in the total red blood cell count.
In some severe diabetic states, lysis of red blood cells within the blood stream may occur because of the loss of electrolytes resulting in reduced red blood cell numbers .
Infections, particularly urinary tract infections, are common in diabetic patients. Increased numbers of white blood cells typically indicate the presence of infection or other inflammatory diseases such as pancreatitis.