Diabetes in Cats

Since my cat Dandelion has recently been diagnosed as diabetic, I thought I’d write a quick blog post about diabetes in cats.

This particular type of diabetes is called diabetes mellitus or ‘sugar diabetes’ and actually affects around 1 in 500 cats, making it much more common than you may have imagined.

Diabetes mellitus is caused by the body having insufficient access to the hormone insulin. This can be either because the pancreas does not produce enough, or because the cells in the body are unable to respond to the insulin that is present.

Why Is This A Problem?

The cells of the body must have insulin present in order to absorb glucose. Without it the cells do not get any energy from the glucose, and in Dandelion we saw a dramatic loss in weight as her body began burning fat and protein to replace the energy it was no longer getting from the glucose.

Another problem results from the concentration of glucose in the blood getting too high. This leads to hyperglycaemia, which has a number of long term health risks.

What Are Possible Signs Of Diabetes?

Weight loss, even with an increased appetite. Increased thirst and urination. In diabetic cats there will be glucose present in the urine, which would not be there at all normally. This is one of the ways that diabetes can be tested for, and although Dandelion’s blood sugar levels were inconclusive, the glucose levels in her urine confirmed diabetes. Other signs of diabetes may be lethargy and poor coat condition.

I Think My Cat May Be Diabetic – What Happens Next?

Book an appointment with your vet as soon as possible. Although the symptoms above are indicative of diabetes, there are other diseases which can present in the same way. We started off with blood tests as the vet was considering a number of options for Dandelion; diabetes, liver disease, hyperthyroidism or even just stress.

The second lot of blood tests we did helped the vet rule out hyperthyroidism, and so we were given a week’s course of medication which would have been relevant for liver disease and we had to get three urine samples. If you have to do this, it’s not as daunting as you may think; your vet can provide you with special kitty litter and a pipette and test tube. You simply keep the cat confined alone, with access to food, water and the special litter tray and wait for nature to call.

Dandelion’s urine samples all gave a very strong result for the presence of glucose, so although she’s a young cat – 6 years old, which is younger than normal for diabetes to present – that was conclusive evidence for the vet.

Treatment of Diabetes

Diabetes cannot be cured, but it can be treated very easily. With careful management cats with diabetes can live a completely normal life. Some cats’ diabetes even goes into remission after a few months – or even just weeks – of treatment. This happens because once the abnormally high levels of blood sugar (glucose) have been brought back into a normal range, the pancreas can produce enough insulin itself to deal with the glucose that comes from a healthy diet.

Treatment usually consists of insulin injections on a regular schedule. My vet mentioned an oral treatment, but doesn’t believe it has proven very effective, so get used to the idea of working with needles.

The first step in treatment for Dandelion is a test (or series of tests) to get a glucose curve. This involves giving a small injection of insulin – below the amount that the cat will probably require for daily treatments – first thing in the morning with food, and then monitoring the blood glucose levels by taking samples at regular periods through the day. This will show how effective that dose of insulin is, allowing the vet to tailor the dosage to your particular pet’s needs. My vet emphasised the fact that there are no two identical cases of diabetes. Even when an optimal level of insulin dosage has been found, you must keep monitoring your cat’s health. This is because the amount of insulin needed can change over time due to weight loss or gain, disease or infection, or a range of other factors.

Once a level has been settled on by your vet, you will need to give your cat an injection either once or twice a day on a regular schedule. This means that, in Danni’s case for example, she will need an injection every twelve hours – say, 8am and 8pm – and will need to be fed at the same time as well for the insulin to work most efficiently. In other words, it is best to have the levels of insulin in the body rising (from the injected dose) at the same time as the glucose levels are rising (from the ingested food). Now, Dandelion is a bit of a grazer; she’s always preferred to eat little and often, and the vet has said to give the feeding routine a go, but if she won’t eat on schedule then we won’t try and force her to.

Dangers And Warnings

As well as making sure that you’re keeping a check on your cat’s general health, one of the major thing to look out for is hypoglycaemia. This is extremely low blood sugar levels (as opposed to hyperglycaemia, high sugar levels noticed in untreated diabetic cats). This can be very serious; symptoms range from unrest or lethargy, to shivering or muscle twitching, right up to fits and unconsciousness.

Hypoglycaemia can be caused by your cat refusing to eat and thus not taking in more glucose, or by an overdose of insulin being given. If you notice signs of hypoglycaemia, try and get your cat to eat food immediately. If it refuses food you can syringe a glucose solution into the mouth or rub glucose powder into the gums and under the tongue. You can buy these from a pharmacy and you should aim to give 1 gram of glucose per kilogram bodyweight.

Other dangers are diabetic ketoacidosis and hyperglycaemic hyperosmotic non-ketotic (HHNK) syndrome, both of which are caused by extremely high blood sugar levels.

As a general precaution you should contact your vet immediately if you notice any usual behaviour or symptoms. These can include the hypoglycaemia signs mentioned earlier, excessive drinking or urination, constipation, diarrhoea, vomiting, blood in the urine or swelling of the face and/or neck.

Some general warnings for insulin are as follows; firstly and most importantly – never change your cat’s dosage without conferring with your vet. Always store the bottle upright, as substances on the rubber seal may affect the insulin. Store between 2°C and 8°C, out of direct sunlight – for most people this means in the fridge. Do not allow insulin to freeze – even touching the back wall of the fridge may be enough to affect the bottle. Gently roll the bottle end over end several times before drawing any insulin – this ensures that any material that has settled on the bottom is mixed back in to the solution. Do not shake the bottle however, as this may actually damage the insulin.

How Do I Inject My Cat?

So long as your cat is reasonably happy being handled, this is not as scary as it sounds. Luckily Dannicat is a little gem and will take shots and pills without a fuss. First, take your sterile syringe and uncap both ends. Get your bottle of insulin and, after ensuring any settled material is gently mixed back in, hold it upside down. Use the syringe needle to piece the inner circle in the bottle cap. Draw back the syringe plunger and fill the chamber with slightly more insulin than you need to use. Tap the syringe to ensure any air bubbles have floated to the surface, and then depress the plunger to pass the air back into the bottle, leaving you with the correct amount of insulin in the chamber. Pull the skin at the scruff of your cat’s neck upwards, and form a depression with your forefinger. Insert the needle through the depression you have just formed. Pull back on the plunger slightly – if any blood appears remove the needle and start again with a fresh syringe. If no blood is visible you can gently depress the plunger to deliver the insulin dose.

How Much Will This Cost?

I’m not going to lie to you; my bank balance is under serious strain right now. First consultation along with blood tests and flea/wormer for all three animals (which obviously bumped the price up but isn’t relevant to diabetes) came to £170. Second round of blood tests, £35. Week’s worth of meds and special litter another £35. Second consultation and urine testing, £33. Glucose curve tests, £75 a time. Insulin and other equipment is going to be about £15 a time. You’re looking at a couple of hundred quid up front and then a commitment to hundreds more in the long run. I’m just thankful that we can afford it right now, even with my impending unemployment, and that I have offers of support from my family as well. But at the end of it, even though Danni now has the nickname “mummy’s little money drain”, the alternative – not spending it – is simply not an alternative.

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