What is diabetes?

Diabetes mellitus (sugar diabetes) is a condition in which there is a problem with the production or response to insulin. Insulin is released from the pancreas, which is an organ that sits next to the stomach, and it tells the cells around the body to absorb sugar from the blood that they then use for energy. If there is a lack of insulin, or if the body doesn’t respond to it properly, then the cells are unable to absorb sugar from the blood and therefore they are starved of energy, while the blood sugar level remains high. The cells instead must use other sources of energy, such as fat and muscle protein, which can lead to toxic by-products that can make the cat extremely ill (diabetic ketoacidotic crisis).

What causes diabetes in cats?

Cats are prone to developing diabetes similar to Type 2 diabetes in humans, whereas dogs tend to suffer from Type 1 diabetes. As in humans, Type 2 diabetes in cats is linked to obesity; in fact, obese cats are four times more likely to develop diabetes than those of normal weight. In this form of diabetes, the body does not respond to insulin in the way it should – there is resistance to it, and so more needs to be released to have the same effect. This puts more pressure on the pancreas, leading to a spiral in which it eventually becomes exhausted and the insulin level then drops dramatically.

Other known risk factors include inactivity, older age (>7 years), other related hormone disorders or cats that have been treated with corticosteroids.

What are the symptoms of diabetes in cats?

The symptoms tend to be non-specific, but include:

• Increased drinking and urination
• Weight loss (often despite a good appetite)
• Lethargy and weakness
• Vomiting
• Increased tendency for skin and urinary tract infections
• Some cats become sunken on their ankles (hocks) due to nerve damage

If left undiagnosed or untreated cats can develop diabetic ketoacidosis (DKA) – this is an emergency, life-threatening crisis where the blood becomes acidic due to a build-up of toxins. The cat becomes extremely lethargic to the point of collapse and coma; they normally start vomiting and are completely of their food. They need immediate veterinary care otherwise this condition can be rapidly fatal.

How is diabetes in cats diagnosed?

The vet may be suspicious of diabetes based on the clinical history and physical examination. They will suggest taking blood and urine samples to confirm the diagnosis of diabetes mellitus. Further tests may be needed to rule out any conditions that may interfere with the treatment of the condition.

How is diabetes in cats treated?

The following treatments form part of the management plan for cats diagnosed with diabetes mellitus:

1. Insulin

• Your cat will be prescribed with insulin for daily injection(s). These are given under the skin either one or twice a day, and you will receive thorough training on how to give these injections. Most cats get very used to these injections and it soon becomes part of the daily routine.
• If treatment is started early in the course of the disease, then some cats can go into remission. It is important that cats are monitored very closely to ensure that they receive the correct dose of insulin, and this dose may decrease over time if their diabetes is improving.

2. Diet

• This is usually an important part of the treatment plan, as appropriate dietary management can dramatically increase the chances of achieving diabetic remission.
• For cats that are overweight, a weight loss diet will be recommended. It is important that the weight loss is planned and monitored closely, as continued excessive weight loss is normally a sign that the diabetes is not yet well controlled.
• Most diabetic cats will be recommended a diabetic diet such as Hills M/D or Royal Canin Diabetic - both available in our shop. These diets are higher in protein and lower in carbohydrate, thereby more closely mimicking the natural diet a cat should eat. As obligate carnivores they should be eating a mainly protein diet, and excessive carbohydrate is often linked to obesity and an increased risk of diabetes mellitus.

What is the prognosis for diabetes in cats?

The majority of cats can be stabilised on insulin and can go on to live a relatively normal life for years. However, some cats are much more difficult to stabilise, requiring very high doses of insulin - this can be due to an underlying hormonal imbalance due to a benign pituitary tumour in the brain (acromegaly).