Don't sugarcoat it: the facts about diabetes in cats

Diabetes is a common and increasingly frequent health problem in cats.

Estimates vary, but right now, it looks like as many as one out of every hundred cats may develop diabetes over their lifetime.

Read on to learn all about this serious disease and what you can do to prevent and manage it.

Types of Diabetes in Cats

Diabetes in cats (officially called "Diabetes Mellitus") breaks down into two main types: Type 1 and Type 2.

Type 1 Diabetes

An animal’s immune system attacks and destroys the pancreatic cells that make insulin. Eventually, the pancreas produces little to no insulin. Type 1 diabetes is rare in cats but is the most common form of diabetes in dogs.

Type 2 Diabetes

The pancreas is still making insulin (at reduced, normal, or even increased levels), but the cat’s cells aren’t responding well to it. Type 2 diabetes is responsible for around 90% of cases of diabetes in cats.

Cats may also develop diabetes after being treated with certain medications (corticosteroids, for example) or in association with other diseases, including severe pancreatitis or acromegaly.

Cat Diabetes Symptoms

Insulin helps move glucose (a type of sugar) out of the bloodstream and into cells, where it is used as a primary source of energy. When this doesn’t occur as it should, cats develop symptoms like:

Increased Urination

Extra glucose in the blood ends up in the urine, pulling water along with it. This makes diabetic cats pee more frequently, in larger amounts, and sometimes outside the litter box.

Increased Thirst

Because diabetic cats are losing water in their urine, they try to compensate by drinking more.

Weight Loss (Despite a Good or Even Increased Appetite)

Glucose can’t make it into cells where it’s needed for energy. The body responds by trying to take in more food, but since it can’t be used normally, diabetic cats still lose weight.

Cats with diabetes are also prone to getting infections (urinary tract infections, for example) and, in advanced stages of the disease, may have nerve problems that make them stand and walk with the bottom part of their hind legs on or near the ground.

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Signs of Cat Diabetic Ketoacidosis (DKA)

They can also develop something called diabetic ketoacidosis (DKA), which results in severe dehydration and electrolyte imbalances. Signs of DKA in cats include:

• Poor appetite

• Low energy levels

• Weakness

• Vomiting

• Diarrhea

• Seizures

• Rapid breathing

• Unsteadiness 

DKA is a true emergency!

Get your cat to a veterinarian immediately if there is any chance they could be suffering from this life-threatening condition.

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What Puts a Cat at Risk of Diabetes?

Most cats who develop diabetes are overweight and around 10–13 years old. Male cats are at higher risk than females. The symptoms associated with diabetes are also seen in other cat diseases, so a veterinary evaluation is essential.

How to Test a Cat for Diabetes

Your vet will start by asking you some questions about what you have been noticing at home and then perform a thorough physical exam. They will then likely take blood and urine samples, looking for abnormally high sugar (glucose) levels.

A high blood sugar level combined with sugar in the urine is almost always caused by diabetes. Normal blood glucose levels for cats can vary a bit, but they usually range between 80 mg/dl and 120 mg/dl. Since stress (like being at the vet’s office) can make a cat’s blood sugar levels a little high, a veterinarian may want to run some additional tests before diagnosing diabetes.

The vet may also want to send a fructosamine test for cats to a lab. This will give the veterinarian an idea of what the cat’s blood glucose levels have been like over the last week or two, rather than just at a single moment.

Caring for a Diabetic Cat

Treatment for cat diabetes usually focuses on two things: insulin injections and diet.

Insulin Injections

Most diabetic cats should receive insulin injections, at least in the early stages of treatment. If they lose weight and eat an appropriate diet, it is possible that they can be weaned off insulin once their metabolism has normalized. If giving a cat insulin injections is impossible, oral medications, particularly a new product called Bexacat™, can be considered.

Diet and Weight Loss

Cats with diabetes need to eat a high-protein, low-carbohydrate diet. This can help them lose weight, maintain more stable blood sugar levels, and perhaps go into diabetic remission.

Most cats will be hospitalized for at least a day so their condition can be stabilized and the veterinarian can start to determine what an appropriate dose of insulin might be—every cat is a unique individual! Frequently monitoring blood glucose levels is essential during this time.

But fine-tuning a cat’s insulin dose is best done at home. A cat’s need for insulin is based on their activity level and food intake, neither of which is normal when they are hospitalized. Your veterinarian will send you home with detailed instructions, including what to feed your cat and how to give a cat an insulin shot—it isn’t as hard as it sounds!

Monitoring Your Cat's Insulin Levels

Cats should be reevaluated after a week or two of treatment with insulin. A glucose curve (blood glucose measurements taken every few hours) provides the most information about how high and how low a cat’s blood glucose levels are throughout the day.

Glucose measurements taken at home are always best, so if you’re willing, you can purchase a cat blood sugar monitor (like the Alphatrak) and send the data to your vet when you’re done. If you can’t do this, your veterinarian can do the glucose curve in the hospital or recommend other options, like fructosamine tests (which give less information) or a continuous blood glucose monitor.

Once an appropriate insulin dose is found, most cats can be monitored with a glucose curve every three to four months. Insulin needs usually change over time, so it’s important to keep a close eye out for signs that the cat is getting too little insulin (increasing thirst, urination, and appetite) and, even more importantly, signs of too much insulin in cats, including:

• Low energy levels

• Weakness

• Tremors

• Seizures

• Vomiting

If you notice any of these signs of hypoglycemia in cats (low blood sugar levels), rub a high-sugar solution like honey or corn syrup on your cat’s gums, DO NOT give them any more insulin, and get them to a veterinarian immediately.

How Long Do Cats Live with Diabetes?

Treating a diabetic cat can be very rewarding. Many cats enjoy an excellent quality of life for years. One study showed that although the median survival time for cats was around 1 ½ years, some individuals can live for much longer, which is impressive considering most cats are diagnosed when they are already around 10–13 years old. One cat in the study even lived for 9 ½ years after diagnosis!

Preventing Diabetes in Cats

Even though diabetes can be treated and may even go into remission if caught early enough, prevention is still best. Promoting physical exercise and keeping your cat slim by feeding the right amount of a nutritious diet will prevent most cases of diabetes. A quality wet food that is high in protein is usually best, but ask your veterinarian for an individualized food recommendation, particularly if your cat needs to lose some weight.

How Much Does Cat Diabetes Treatment Cost?

Finally, we need to address one more important issue: cost. Cat diabetes treatment is expensive. For example, a Lantus SoloStar glargine insulin pen is $108.49 at a major pet supply company, and one pen will last most cats for a month or two.

Other types of insulin are cheaper, but many veterinarians recommend glargine to give cats the best chance of going into remission. Then there are the expenses associated withspecial foods,insulin needles, sharps containers,blood glucose monitoring devices and supplies, and all the rechecks and monitoring tests that are a part of managing diabetes in cats.

How Cat Insurance Can Help

Specific costs will vary from patient to patient and may fluctuate over time, but what doesn’t change is the financial help that good cat insurance can provide.

Purchasing a policy when your cat is young and healthy is the best way to ensure that a chronic condition, like diabetes, will be covered and not excluded as a pre-existing condition.