Diabetes in Cats

Breeds: Burmese predisposed – Devon and Scottish Rex are not predisposed,

Cats when  stressed can get high glucose levels, and  we need to differentiate =  Diabetic felines,   from feline stress hyperglycemia

Typically signs of Cat Diabetus:

1. Excessive thirst and urine production.
2. Increased apatite
3. Weight loss,
4. High fasting blood glucose.

If a cat is anorexic and not ketotic probably not feline diabetus..

Treatments of canine and feline diabetes

• Lots of owner patient interaction , and lot of owner effort
• Anxious owners  need to chill !!
• About 12.5% of dog and cat patients are euthanized once the diagnosis is made
• About 30% of diabetic dogs and cate are euthanized in the first year.
• Impact of the therapies on the owner’s quality of life – and a lot of effort
• Vets need to manage owner’s expectations –
• WE do not use oral; hypoglycemic agents in dogs !

Treatments of Canine and feline Diabetes Mellitus

• Insulin and Diet
• Caninsulin,  or Lente Insulin or  a porcine Zinc suspension – insulin glargine
• All insulin last about 8 -16 hours in the dog or cat
• They last for shorter times in cats than dogs than inpeople
• We use twice daily injections – for good control
• Start of treatments for Canine Diabetes : Start with : 0.5 – 0.75 iu/kg/ 12hours  of insulin for  the dog
• Start of treatments for Feline Diabetes 2-3 iu / cat /12h  for a cat (protamine zinc a good first choice for cats)
• Feed a standardized diet fed 12  hourly or at the time of injection or about 1  hour after the injection.
• Send pet’s home as soon as possible.
• Inject in flank on opposite sides morning and night – more reliable absorption than in neck

Feeding the diabetic Cat

• Must be matched with injections
• Insulin lowers blood glucose – the meal raises the blood glucose – we need to match the two!
• A balance for stable blood glucose
• The stomach takes about 45 minutes to empty – most of calories are being absorbed within 45 minutes meal 45 – 90 minutes = don’t feed at the same time
• Caninsulin start working maximally 2-3 hours later
• Feed 60 – 90 minutes after the insulin injection!! For the best effect in getting good diabetic control.
• Feed standardized caloric content and standardized diet – to body weight and metabolism.  The Fiber in diet? Does not necessarily improve diabetic control.

What if they don’t eat?  Usually do eat – must be something wrong

• Illness or  Insulin resistance – call your vet to review the case.
• How close to normal range do we want out Diabetic pet to be?  8 – 12 mmol/l
• Well controlled –may have a  blood fructosamine within 15 % of top normal range,
• Cats diet _>lower carbohydrate diet – chicken wings, hills MD
  Dogs diet -> what you like consistently, fibre not important

Monitoring the diabetic veterinary patient,

• Blood Glucose curves ideally being done at home – differences between hospital and home glucose curves in about 50% of cases.  Stab ear at side. Look at the average blood glucose – and lowest and highest.
• Fructosamine – glucose binding irreversibly to albumin depends on albumin stable concentration and glucose concentration.
• Attaching a glucose reader to the diabetic patient is becoming more common.

Summary

• Twice daily insulin injections
• Diet feed about 1 hour after injections
• Consistent diet
• Home glucose monitoring
• Besides insulin – in a cat – oral hypoglycemic like glipizide 5 mg tabs, may be trialed,  twice daily 1 hour before meal takes about 2 weeks to work.   Does not work in dogs.