Can Feline Diabetes Be Prevented
Theres no way to absolutely prevent your cat from developing diabetes, according to Cohn. Keeping your cat at a healthy weight is the best thing you can do, she says. And if your cat needs to be on steroids, educating yourself about the signs of diabetes can help you catch the condition early.
Talk to your vet if you see any signs that your cat has developed diabetes. Your vet can diagnose the problem accurately and help you decide on an effective treatment plan for your precious pet.
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 I Get Insulin Into The Syringe
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Levels After Youve Eaten
Many foods have types of carbohydrates called starches and sugars. When you eat foods with these types of carbohydrates, your body breaks them down into glucose, which is a type of simple sugar, and releases the glucose into your bloodstream. Aside from glucose produced by your liver, food is the main source of plasma glucose.
Two hours after eating, your blood sugar levels rise. They rise more when you eat more carbohydrates, when you do not eat fiber, fat, or protein with your carbs, and when you eat certain types of carbohydrates, such as refined sugars and starches.
These are target values from The Joslin Diabetes Center, which include levels for people with diabetes:
| When Measured |
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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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What Is Low Blood Sugar
The body needs glucose to maintain its energy levels, which are necessary for the bodys organs, cells and various symptoms to carry out their daily functions. If a cats blood sugar levels drop, most cells can absorb fatty acids from the reserve located in the liver. However, the brain is a unique organ that cannot take glucose from anywhere else in the body, other than what is carried in by the blood. Therefore, when blood sugar levels drop, the brain quickly loses vital fuel and can no longer function at full capacity, resulting in weakness, sleepiness, disorientation as well as coma. Low blood sugar in cats is a life-threatening condition, especially to juvenile kittens, so immediate professional care by a licensed veterinarian is vital.
Low blood sugar in cats is a symptom of an underlying disease that is causing the felines blood sugar levels to drop dangerously low levels. Low blood sugar, also known as hypoglycemia, is commonly caused by diabetes, but can also be the result of other health conditions affecting the bodys blood glucose regulators.
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What Are The Symptoms Of Diabetes In Cats
The symptoms of feline diabetes can start gradually and get worse over time. Signs may also be subtle and hard to notice since sick cats tend to mask or hide their symptoms when they dont feel well. Initial signs of feline diabetes can include the following symptoms:
- Increased appetite
- Urinating in areas outside the litter box
- Unkempt fur
- Lethargy
As the disease progresses, cats can get very skinny and show signs of weakness in their back legs. Eventually, ketoacidosis can occur, which requires immediate medical attention.
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How Is Diabetes Diagnosed
The four clinical signs of diabetes are also present in other feline diseases. Therefore, clinical signs alone are not sufficient to make a diagnosis. The two most important laboratory tests are the blood glucose level and a urinalysis. The normal blood glucose level is 80-120 mg/dL . Diabetic cats often have levels over 400 , or even 600 mg/dL . Diabetic cats also have glucose present in the urine. The combination of these two findings in a cat with at least two of the clinical signs of diabetes is sufficient evidence to make a diagnosis of diabetes.
A cats blood glucose level can be influenced by excitement. Stress hyperglycemia can result from a ride in an automobile and a visit to the veterinary hospital, especially in an excitable cat. This can confuse the testing process for diabetes. When this is suspected, another test, the serum fructosamine, can be used. This test gives an average blood glucose reading for the last two weeks. It will be clearly elevated in diabetic cats.
Do I Need To Monitor My Diabetic Cats Health
Because feline diabetes can have some serious complications, it is very important that you keep track of your cats health.
Check their blood sugar levels, either at home or by regularly taking them to the vet. Watch their appetite, weight, and food and water consumption.
Also check the litter box to make sure they are urinating the same amount. Call your veterinarian about any changes in their normal routine.
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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.
Once My Cat Has Been Started On Insulin Therapy What Monitoring Tests Will Be Necessary
When insulin therapy is first started, monitoring your cat’s response to therapy by periodic blood glucose determinations is important. Ideally, this involves serial blood or serum glucose measurements in the form of a glucose curve. Because of the nature of most cats, hospitalization and serial blood sampling, no matter how gentle, may result in stress-related increases in blood glucose that will confound the results of a glucose curve. New technology has allowed the adoption of home glucose monitoring with the use of a simple device such as an AlphaTRAK®2 or OneTouch Ultra® glucometer. A newer method of home testing that uses a skin-mounted sensor is currently under investigation. Your veterinarian will let you know if they feel this is right for your cat. Additional home monitoring can involve the evaluation of urine for the presence of glucose, although this is not a very sensitive way to monitor glucose levels.
At home, other important things you can do for your cat include monitoring her appetite, water consumption, energy level, grooming habits , and urine output. Any changes may signify the need for additional testing and/or adjustments in the insulin dosage. It is very important that you do not make adjustments in insulin dosage without first consulting your veterinarian!
“Important things you can do for your cat include monitoring her appetite, water consumption, energy level, grooming habits, and urine output.”
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Levels In The Morning
The best time to check blood sugar levels in the morning is right when you wake up and before you eat anything. This gives you a glimpse of what may be happening overnight, and it gives you a baseline for the day.
These are goal levels, according to The Joslin Diabetes Center:
- Under 70 mg/dl if you do not have diabetes.
- 70 to 130 mg/dl if you have diabetes.
The dawn effect can often lead to a high morning measurement in diabetes. This is your bodys tendency to get ready for the day by raising blood sugar by increasing levels of counter-regulatory hormones the ones that counteract insulin as in normal blood sugar. For people with diabetes, you do not have the capacity to counterbalance this rise in blood sugar, so levels can be dangerously high.
Ways to lower your morning blood sugar value include:
- Eating dinner earlier
- Checking your medications making sure you are taking them properly and asking your doctor if they are correct
- Going for a walk after dinner
- Including protein with your dinner
Causes Of Low Blood Sugar In Cats
Low blood sugar in cats is caused by an underlying condition affecting the bodys ability to produce, release, or store insulin. The hormone, insulin, is a chemical messenger that is responsible for regulating the bodys blood glucose levels. The pancreas manufactures these metabolizing hormones and releases them when a cat eats a meal. As the meal is digested, the food glucose is absorbed by the blood. The rise in plasma glucose triggers the beta cells in the pancreas and insulin is secreted to keep a balanced blood sugar level. An interference of the production, balance, or distribution of this process can result in hypoglycemia including:
- Diabetes: Diabetic cats can also develop hypoglycemia upon overdose of insulin injection or if two doses overlap one another.
- Blood Infections
- Copious vomiting
- Excessive exercise
- Addisons Disease: A condition of the adrenal glands. The adrenal glands produce the cortisol hormone that balances the effects of insulin.
- Glycogen storage disease: A condition that prevents the muscles and liver from properly synthesizing stored glycogen. A rare disease seen primarily in Norwegian Forest Cats.
The following can cause blood sugar levels to drop due to a dysfunctional storage of glycogen:
- Hepatic lipidosis
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Will I Need To Start A Special Diet For A Diabetic Cat
Cats are, by nature, meat eaters. Because theyve evolved from the hunt to the food bowl, its now their owners job to ensure that their diet includes a lot of protein.
Also, cats bodies arent as good as peoples at breaking down carbohydrates, says Richard W. Nelson, DVM, DACVIM, professor of internal medicine at the University of California, Davis, School of Veterinary Medicine.
Continued
This is especially true for diabetic cats. The ideal diet for a diabetic cat is one that has increased protein and decreased carbohydrate content, Nelson says.
Most canned cat foods are already high in protein and low in carbs. But many dry cat foods are made with starch, which makes them higher in carbohydrates. Your vet may suggest that you switch to a specially formulated cat food or an all canned-food diet.
As you watch the type of food you give your cat, youll also need to keep an eye on their weight.
Although the tendency in feline diabetes is for cats to be overweight, some cats may actually be underweight if their diabetes went undiagnosed for a long time. At diagnosis, some cats need to put on some pounds, some need to lose some pounds, and some need to stay right where they are, says Thomas Schermerhorn, VMD, Dipl. ACVIM , associate professor of Small Animal Medicine at Kansas State University.
Diagnosis Of Low Blood Sugar In Cats
Your veterinarian will begin the diagnosis of low blood sugar in your cat by obtaining a full medical history. You will be asked to relay your cats current symptoms, diet, medications and past illnesses. As mentioned previously, diabetes is the common cause for low blood sugar in cats, but if your cat is not diabetic or has not been properly diagnosed, the veterinarian will continue with the following diagnostic tests:
Physical Examination
Jaundice or yellowing of the eyes can be an indication of liver failure that can lead to hypoglycemia.
Urinalysis
The current status of the cats kidney and liver function will be presented in the findings of a urine examination.
Biochemical Profile
A test to evaluate the level of organ secretions and hypothesize their function status.
Complete Blood Count
The number of white and red blood cells will help the vet determine if the presence of a possible blood infection.
ACTH Stimulation Test
Cortisol hormone, produced by the adrenal glands, is measured to determine the level of gland function.
Insulin Test
Cats that are diabetic but have not been properly diagnosed will benefit from an insulin test.
Radiograph or Ultrasound
Imaging may be used to detect tumors.
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Blood Testing As A Means Of Monitoring
There are two tests that are used to monitor the level of regulation of diabetic cats:
Ideally, blood glucose determinations should be made just before insulin is given and at the peak time . If both tests are not feasible, the same testing time should be used consistently. Although this test is typically performed at the hospital, rare cases exist in which the owner is able to get blood from the cat and perform the test at home. Cats that are unduly stressed by riding in the automobile or being at the veterinary hospital can be tested using the serum fructosamine test. This gives an average blood glucose reading for the last two weeks. It is also being used routinely by some veterinarians.
Blood testing should be performed any time the home monitoring methods reveal abnormalities. It should also be performed every 3-4 months on a routine basis.
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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How Should My Cat Be Cared For When I Am Out Of Town
The ideal way to care for your diabetic cat when you are out of town is to have a friend or neighbor come to your house twice daily to give your cat its insulin and to feed it. This approach keeps almost all things consistent. If a neighbor will feed your cat but will not consent to giving insulin injections, your cat will be fine without insulin for 2-3 days. If you will be gone longer than 3 days or if you cannot find in-home care, a boarding kennel or veterinary hospital can be used for boarding. However, be sure to choose a facility that has someone available who understands diabetic cats.
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.
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