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 Diabetes mellitus is a condition where there is an excessive amount of blood sugar (glucose), caused by an inadequate production of insulin, or when the body's cells are unable to use available insulin to take glucose from the blood.
Insulin is a hormone produced and released by specialized cells in the pancreas, which permits the body's cells to take glucose from the blood and use it for their metabolism and other functions.
Type 1 diabetes (referred to as 'insulin dependent' diabetes) occurs when the pancreas doesn't make enough insulin. Type 2 diabetes, also referred to as 'relative insulin deficiency', occurs when the body’s cells develop 'insulin resistance', meaning that they are unable to effectively use available insulin, or when the pancreas is producing some insulin, but not enough to serve the body’s needs.
Most diabetic cats have type 2 diabetes. However, many of them still require insulin for adequate control of their illness.
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What are the signs of diabetes?
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Diabetes is more commonly seen in middle-aged to older cats, and in males. Obesity also predisposes to development of diabetes.
In the UK, Australia, and New Zealand it has been established that Burmese cats are more commonly affected than other breeds of cats. Risk factors for the development of diabetes in these Burmese cats include advancing age, chronic or recurring medical problems, dental disease, repeated corticosteroid treatment, confinement indoors, lower physical activity and greater body weight; male and female Burmese cats are equally likely to develop Diabetes Mellitus.
Clinical signs may vary depending on the stage of disease, but they can include the following:
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- Increased drinking and urination
- Urinating outside of the litterbox
- Weight loss
- Vomiting
- Dehydration
- Lethargy (tiredness)
- Increase or decrease in appetite
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How is diabetes diagnosed?
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Diagnosis of Diabetes depends on the finding of high blood sugar in the blood and the urine, together with the signs of disease above. This can be difficult in cats as blood sugar rises when cats are stressed, as often happens with visits to the veterinarian, and with blood sampling. In these cases, blood is sent to the laboratory for a specific test that measures the average level of blood glucose during the previous 2-3 weeks.
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How is diabetes treated?
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Some cats are in a subclinical state (that is, they have diabetes without the signs), and the presence of another disease causes them to become clinical. In these cases, diagnosis and treatment of the concurrent disease will be sufficient.
If a diabetic cat is untreated, he may develop severe illness called diabetic ketoacidosis due to derangements in metabolism. These cats can be very ill with vomiting, weakness, coma, and eventually death. Hospitalisation will be required to treat these secondary complications as well as controlling the diabetes.
A healthy diabetic cat will be treated with insulin injections. These are usually twice daily and are easy and painless to give. The type of food is important, as is the timing of feeding to correspond to the action of the insulin. Your cat may be hospitalised for a few days to establish the initial insulin dose, although this may be difficult if your cat is stressed by being in hospital thereby raising it's blood glucose levels, or if he won’t eat properly.
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What is the long-term outlook for my cat?
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After being discharged from hospital, your cat will need to return for a serial glucose curve to look at the levels of blood glucose and how they change during the day. Adjustments will be made in the amount of insulin given, and sometimes in the timing of feeding.
An obese cat will be required to lose weight under the guidance of your veterinarian. Most diabetic cats with normal bodyweight can continue to be fed their regular food, though diets high in simple sugars (semi-moist foods) should be avoided. There is continuing debate over the dietary management of feline diabetes. New evidence suggests that feeding a high protein diet is advantageous for diabetic cats. Your veterinarian will advise you of the most appropriate diet for your cat. It is important to give the prescribed amount at the prescribed time to correspond with the peak activity of the insulin injection.
Many cats live active, happy lives once their diabetes is well regulated. Since insulin requirements can change with time, sometimes even reducing to zero, diabetic cats need to be monitored closely. Watch for the return of the signs of illness, such as drinking excessively, and the level of appetite and activity. Report any changes to your veterinarian.
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Could my cat develop hypoglycaemia?
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If your cat receives too much insulin, blood sugar levels could become very low. Hypoglycaemia manifests as weakness and lethargy, unsteadiness, trembling, and sometimes seizures. Giving a glucose or sugar solution will help alleviate these signs. Obtain veterinary advice as soon as possible, and an adjustment in the insulin dose may be required.
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Dr Julia Adams BVSc
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