Diabetes Mellitus

Diabetes Mellitus is a condition that develops when the cat cannot use sugar (glucose) effectively, and control the sugar level in the blood.  Insulin is made in the pancreas and is essential for regulating the use and storage of blood glucose.  Insufficient insulin production is potentially life threatening.

There are two types of diabetes:

• insulin-dependent diabetes mellitus (IDDM)
  
• non-insulin-dependent diabetes mellitus (NIDDM) 

• Increased thirst
• Increased and frequent urination
• Weight loss
• Change in appetite - first increasing then decreasing
• Lethargy
• Weakness
• Vomiting - in severe cases

• Overweight cats are more likely to develop diabetes
• Cats can develop diabetes at any time, but the peak onset is at around the age of 8 years
• Some breeds, such as Burmese are more at risk than other breeds
• Hormonal changes or diseases such as hyperthyroidism, Cushing's disease, and acromegaly
• Certain drugs can reduce the effects of insulin such as megestrol acetate and corticosteroids like prednisolone
• Damage to the pancreas (e.g Chronic Pancreatitis)
  
• Male cats are more commonly affected than females

How is diabetes diagnosed? 

Diabetes mellitus is diagnosed based on the cat's signs, physical examination findings, laboratory test results, and the persistent presence of abnormally high levels of sugar in the blood and urine. Once diabetes has been diagnosed, immediate treatment is necessary.

Left untreated, diabetes will shorten a cat's lifespan. A dangerous, sometimes fatal condition called ketoacidosis may develop, indicated by loss of appetite, vomiting, diarrhea, lethargy, weakness, dehydration, and breathing abnormalities. Additionally, diabetes can lead to an unhealthy skin and coat, liver disease, and secondary bacterial infections. A diabetes-related disorder called diabetic neuropathy may cause cats to become progressively weaker, especially in the hind legs, impairing their ability to jump and causing them to walk with their hocks touching the ground.

Diabetes treatment is based on the severity of the disease. Cats with ketoacidosis require prompt intensive care, which usually includes fluid therapy and short-acting insulin injections. For cats that are not severely ill, your veterinarian may recommend a treatment plan that includes insulin injections or oral medications, along with dietary changes.

Each diabetic cat is an individual, and each responds differently to treatment. Some can be treated with oral medications, while others require insulin injections. . Different cats respond best to different types of insulin. Regardless of this variability, all diabetic cats do best with consistent medication, consistent feeding, and a stable, stress-free lifestyle.

• Insulin - Most diabetic cats require insulin injections administered under their skin twice daily. The injections can be given at home, preferably at the same time each day. Your veterinarian will show you how to give these injections, which are not painful-in fact, most cats are unaware that the injection is being given. Because each is different, the proper type of insulin, dose, and frequency of administration needs to be determined by your veterinarian. Ideally, this is based on an 18- to 24-hour blood glucose profile, obtained through a veterinarian-administered insulin injection and subsequent testing of blood sugar levels at regular intervals throughout the day. Insulin dosage may change with time and may need to be adjusted based on new blood glucose profiles, the results of intermittent blood tests and urine sugar measurements, and the cat's response to therapy.

• Oral Hypoglycemic Medications - Healthy diabetic cats can sometimes be successfully treated with an orally administered hypoglycemic medication that lowers blood glucose.
  

• Diet - In addition to medication, an important step in treating diabetes is to alter your cat's diet. Obesity is a major factor in insulin sensitivity, so if your cat is overweight, you will need to help him lose weight gradually. Your veterinarian can tailor a safe weight-loss program, in which your cat loses weight gradually. A high-fiber, high-complex carbohydrate diet not only can achieve weight loss if necessary, but is believed to help control blood sugar levels after eating.
  

• Feeding - Your cat's feeding routine is important. While many cats are "free-choice" feeders (i.e., food is left out for them to eat whenever they want), this may not be the ideal routine for a diabetic cat. Ideally, a cat receiving insulin should be fed half its daily food requirement at the time of each injection, with the unconsumed remainder available throughout the day. The timing of feedings is less critical for cats receiving glipizide; nevertheless, food intake should be closely monitored.