diabetestalk.net

Signs Of Diabetic Remission In Cats

How To Keep A Cat In Diabetic Remission

How To Keep A Cat In Diabetic Remission

Expert Reviewed If your cat suffers from feline diabetes, it is still possible for your kitty to return to an insulin-free life with the proper treatment. After your cat receives a diabetes diagnosis from your veterinarian, you must start treating the condition immediately. With the right insulin doses and a healthy diet, your cat may enter diabetic remission. To keep your cat in remission, you should help your cat stay healthy and fit through proper diet and exercise. You also need to always be wary of returning symptoms of feline diabetes. 1 Consult your veterinarian. Feline diabetes is a serious condition that must be treated with the supervision of a medical professional. You need to get a diagnosis from your vet and advice on a recommended plan for treatment.[1] If you think your cat has diabetes, or if your cat’s existing diabetes has changed, you need to schedule an appointment to see the veterinarian. 2 Prepare an insulin injection. Insert the end of the sterilized syringe into the vial of insulin and pull back on the dropper until you reach the proper dosage. You should push the plunger all the way down to release the insulin back into the vial, and redraw the insulin again. This will help you safely get the right dosage, as insulin can stick to the inside of the plastic syringe or create an air bubble inside.[2] Don’t shake the insulin bottle unless directed to do so by your vet. 3 Administer insulin to your cat. This is usually given to cats by injection twice daily, but sometimes can be administered differently depending on the formulation. Follow your vet’s advice on how to give your cat the insulin. Typically, insulin shots are given in the back, in the skin between the cat’s shoulder blades.[3] Pull on this loose skin so that it pulls up and away Continue reading >>

What To Expect When Your Cat Goes Into Diabetic Remission

What To Expect When Your Cat Goes Into Diabetic Remission

This week I received an email from one of our readers asking what to expect as her cat seems to be going into diabetic remission. So I got out my crystal ball and… Wait! I don’t have a crystal ball. How it plays out varies from pet to pet. I suppose what I can share with you is what I have seen over the years with some of my feline patients who have gone into remission. And I can offer some pointers to help keep the kitty in remission. Cats are usually type 2 diabetics, meaning they may yet produce insulin but don’t react to it as well as they should. This is called insulin resistance. Factors that commonly cause insulin resistance include obesity, high carbohydrate diets (such as cat kibble), infections (such as dental disease) and lack of exercise (rampant with indoor kitties). If we address these issues and provide them with supplemental insulin, a good portion of cats can go back into a non-diabetic state. This is called remission. How amazing is it that we can turn the situation around and actually “cure” these cats! Now, how this plays out varies. If you are very attuned to your diabetic feline and monitor the blood glucose at home, you will have a better outcome. As much as we hope for diabetic remission, if we fail to notice signs of diabetic resolution, the typical dose of insulin that had been working just fine for months might result in hypoglycemia. Mild hypoglycemia may not be noticed. Moderate hypoglycemia may look like a drunken cat. If the blood glucose gets below 20 or 30 mg/dl, the pet could seizure. If no one is home, this could be life threatening. To avoid tragic events like this one, I want all my clients with a diabetic to have a glucose meter at home. I keep close contact with them. If the pet is acting odd or goofy in any way, I have t Continue reading >>

Diabetic Remission In Cats

Diabetic Remission In Cats

To grasp diabetic remission in cats, it helps to have an understanding of feline diabetes, so here is a quick review. Diabetes is a complex disease involving a hormone called insulin. When a cat does not make enough insulin or cannot properly use the insulin it does make, diabetes results. Why is insulin important? Insulin keeps the body’s engine working properly. The body is like a well-tuned machine and needs fuel to run properly. The fuel for a cat is food that contains fats, carbohydrates, and proteins. But this fuel needs to be broken down into smaller parts that the body can utilize. One of these usable fuel components is glucose. Without glucose, the body’s engine stalls. Glucose must enter the body’s individual cells to keep the engine running. That is where insulin comes in to play. Insulin regulates the flow of glucose from the blood stream into the cells where it is needed to sustain life. When there is not enough insulin produced by the pancreas, or the cat does not use it effectively, glucose cannot enter the cells and high levels of glucose build up in the bloodstream. This condition is called diabetes. "The common signs of diabetes include increases in appetite, water consumption, and urination, along with weight loss." Without insulin to steer glucose into the cells, the cat's body looks for alternative sources of fuel and breaks down reserves of fat and protein stored in the body. Fueling the body is not efficient without the insulin/glucose team, so the cat loses weight despite eating more. Meanwhile, the accumulation of glucose in the blood stream is eliminated in the urine. The cat urinates more which makes him thirsty and he drinks more water. The common signs of diabetes include increases in appetite, water consumption, and urination, along w Continue reading >>

Glycemic Status And Predictors Of Relapse For Diabetic Cats In Remission

Glycemic Status And Predictors Of Relapse For Diabetic Cats In Remission

Go to: Abstract It is unknown if diabetic cats in remission have persistent abnormalities of glucose metabolism and should be considered prediabetic, or have normal glucose tolerance. Objective To characterize glycemic status of diabetic cats in remission and to determine predictors of relapse. At a median of 107 days after remission, screening blood glucose concentration was measured on entry to the clinic. After a 24‐hour fast in hospital, fasting blood glucose, fructosamine and feline pancreatic lipase concentrations were measured, and 3 hours later, a simplified IV glucose tolerance test (1 g glucose/kg) performed. Twenty cats were monitored for relapse for at least 9 months. Of the 21 cats in remission, 19% (4/21) had impaired fasting glucose concentration and 76% (16/21) had impaired glucose tolerance. Of cats followed up for 9 months after testing, 30% (6/20) had relapsed and required insulin treatment. Fasting blood glucose concentration ≥7.5 mmol/L (≥135 mg/dL) (odds ratio [OR] = 12.8) and severely impaired glucose tolerance (≥5 hours to return to <6.5 mmol/L or <117 mg/dL; OR = 15.2) were significantly associated with relapse. Blood glucose concentration >14 mmol/L; 252 mg/dL at 3 hours was significantly associated with relapse (OR = 10.1). Most cats in diabetic remission have impaired glucose tolerance and a minority have impaired fasting glucose concentration and should be considered prediabetic. More severe glucose intolerance and impaired fasting glucose concentration are predictors of relapse. Ongoing glucose monitoring of diabetic cats in remission is recommended. Keywords: Diabetes mellitus, Glucose tolerance test, Impaired fasting glucose concentration, Impaired glucose tolerance, Prediabetic, Screening glucose Continue reading >>

Diabetes Mellitus In Cats

Diabetes Mellitus In Cats

What is diabetes mellitus? Diabetes mellitus is a disease caused by failure of the pancreas to produce adequate amounts of insulin or of the body to respond to the insulin that is produced. Why is insulin so important? The role of insulin is much like that of a gatekeeper: It stands at the surface of body cells and opens the door, allowing glucose to leave the blood stream and pass inside the cells. Glucose, or blood sugar, is a vital substance that provides much of the energy needed for life and it must work inside the cells. Without an adequate amount of insulin, glucose is unable to get into the cells. It accumulates in the blood, setting in motion a series of events which can ultimately prove fatal. When insulin is deficient, the cells become starved for a source of energy. In response to this, the body starts breaking down stores of fat and protein to use as alternative energy sources. This causes the cat to eat more, but ultimately results in weight loss. The body tries to eliminate the excess glucose by excreting it in the urine. However, glucose attracts water, so the urine glucose that is excreted also contains large quantities of the body's fluids. This causes the cat to produce a large amount of urine. To avoid dehydration, the cat drinks more and more water. Not all of these signs are readily seen in every diabetic cat, but we expect that you will have seen at least two of them. How is diabetes mellitus diagnosed? Because the four classical signs of diabetes are also present in other feline diseases, clinical signs alone are not sufficient to make a diagnosis. We also look for a high level of glucose in the blood stream and the presence of glucose in the urine using laboratory tests. The normal blood glucose level for cats is 80 to 120 mg/dL, while diabetic Continue reading >>

Managing Diabetes Mellitus In Cats

Managing Diabetes Mellitus In Cats

You can successfully manage your diabetic cat with insulin therapy, a suitable diet and a healthy lifestyle. Can diabetes be cured? Diabetic cats usually require lifelong treatment with an insulin preparation. Clinical Remission of Diabetes Mellitus in Cats Some diabetic cats no longer need insulin after a few weeks or months of treatment. This is known as clinical remission. Diabetic cats that go into diabetic clinical remission have remaining functional cells in the pancreas which are able to produce sufficient insulin once persistently high blood glucose concentrations are treated adequately with insulin. The time to remission is variable and likely depends on how long the the diabetes was untreated and if there are still functional insulin producing cells in the pancreas. Remission may be seen may be shortly after the start of treatment (e.g. around 2 weeks) or take up to 3-4 months or longer. It is important to remember that remission does not mean cure and care must still be taken with your cat’s diet and lifestyle. Aim of Treatment of the Diabetic Cat The aim of treatment is to restore your cat’s quality of life to normal by stopping the signs of diabetes mellitus (drinking lots of water, urinating frequently, increased hunger and weight loss) without causing hypoglycaemia. Untreated diabetes mellitus may result in a serious condition known as diabetic ketoacidosis. Read more in Emergencies Insulin therapy in diabetic cats will also help minimise the long-term complications of diabetes mellitus such as hind limb weakness. How are Diabetic Cats Treated? A regular routine is vital for successful management of diabetes. Effective treatment of diabetes is very rewarding. You can help restore your cat's quality of life. Continue reading >>

Predictors Of Clinical Remission In Cats With Diabetes Mellitus

Predictors Of Clinical Remission In Cats With Diabetes Mellitus

Corresponding author: Dr Eric Zini, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland; email: [email protected] . The study was performed at the Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland. Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Background: Clinical remission is frequent in cats with wellcontrolled diabetes mellitus, but few studies explored predictors of this phenomenon. Hypothesis: Data retrieved from medical records at admission might be valuable to identify likelihood of remission and its duration in diabetic cats. Animals: Ninety cats with newly diagnosed diabetes, followedup until death or remission. Methods: Retrospective cohort study. Data were collected from records at admission, including history, signalment, physical examination, haematology, and biochemical profile, and the occurrence and duration of remission, defined as normoglycemia without insulin for 4 weeks. Predictors of remission were studied with univariate and multivariate logistic regression. Factors associated with remission duration were analyzed with KaplanMeier and Cox proportional hazard models. Results: Fortyfive (50%) cats achieved remission, after a median time of 48 days (range: 8216). By study end, median remission duration was 114 days (range: 303,370) in cats that died and 151 days (range: 281,180) in alive cats. Remission was more likely with higher age (OR: 1.23, 95% CI: 1.041.46; P= .01) and le Continue reading >>

About Glucose Curves

About Glucose Curves

Go to site For Pet Owners The glucose curve is a great tool to differentiate between an insufficient insulin dose and the Somogyi effect. It helps to determine insulin effectiveness and the maximum and minimum levels of glycemia, which ideally should be between 120–300 mg/dL (5.6–16.7mmol/L) for cats for most of the day.8 Try our online glucose curve generator. Veterinarians commonly adjust the insulin dose based on a blood glucose curve. When creating a glucose curve, remember that stress can affect the reliability of results, and the glucose curve is only one tool among others that can help diagnose and monitor diabetes mellitus. Take clinical signs (or lack thereof) into account when contemplating any change in the insulin therapy. The ultimate goal in regulating the diabetic cat is to control the clinical signs adequately so that the patient enjoys a good quality of life. How to complete a glucose curve The procedure is as follows: shortly after the animal has been given its first meal (preferably at home), the first blood sample is taken just prior to the insulin injection in the morning. Thereafter, blood samples are collected every 2 hours throughout the day for 12 hours, if possible. These data are then plotted on a graph to generate a curve. Veterinarians can determine based on the nadir whether the dose needs to be increased or decreased (or remain as is). How to interpret a glucose curve The aim of treatment is to alleviate clinical signs of diabetes. To achieve this goal, keep blood glucose concentrations below the renal threshold and avoid hypoglycemia. Thus, the goal is to maintain blood glucose concentrations roughly between 120 to 300 mg/dL in cats for the majority of the day.8 The duration of insulin action is measured from the time of Vetsulin® (p Continue reading >>

Cvc Highlight: What Influences Diabetic Remission In Cats

Cvc Highlight: What Influences Diabetic Remission In Cats

A look at which factors might make spontaneous normalization of glycemic control more likely in one of your feline patients. A unique feature of diabetes mellitus in cats is that some cats become non-insulin-dependent after treatment has been initiated. From 17% to 67% of cats with diabetes mellitus have been reported to go into spontaneous clinical remission after insulin treatment is initiated.1-4 Diabetic remission is usually defined as normoglycemia that persists for more than four weeks without the use of exogenous insulin,2 although some studies have defined it as euglycemia for only two weeks.5,6 The duration of remission varies, with some cats requiring insulin treatment again within a few weeks to months and other cats remaining in remission for months to years. Factors that have been hypothesized to influence the likelihood of diabetic remission include the duration of diabetes mellitus, whether the cat initially presented in a ketoacidotic crisis, the carbohydrate content of the diet, the type of insulin used for treatment, the cat’s breed, the presence of underlying disease, and how closely the blood glucose concentration is maintained within the normal range with insulin treatment. Stimulation tests with secretagogues such as glucagon and arginine have also been investigated to identify cats that have residual insulin secretion from the pancreas, but the presence of glucose toxicosis in cats complicates the interpretation of these tests, and they have not proved useful in predicting the likelihood of remission.7,8 In a study of factors influencing diabetic remission in cats, remission was found to be more likely with increasing age and increasing cholesterol concentration.2 Overall, 21 cats treated with insulin glargine and 23 cats treated with Lente insu Continue reading >>

Signs Of Cat Diabetes Remission

Signs Of Cat Diabetes Remission

Cat diabetes is an incurable disease, but in some cases, periods of remission are possible. However, for remission, the cat needs to have a change in diet, possibly lose some weight and get regular insulin treatment. The signs of cat diabetes remission may be difficult to detect, as these are often subtle or don’t appear. Testing the glycemic index is a safe way to detect if the cat is in remission. Cat Diabetes Remission Cat diabetes may be of 4 types. If the cat is affected by type 1 diabetes, the chances of remission are very low, as the cat may require insulin for life. If the cat has type 2 diabetes (often caused by obesity, a diet that is high in carbohydrates and a sedentary lifestyle), remission is possible and highly likely. However, in order to get to a remission phase, the cat needs to: Get regular insulin shots, with the doses required by the body to assimilate the glucose in the blood Have a change in the cat’s diet, reducing the amount of carbohydrates and increasing the proteins and fibers Lose weight, as obesity may have caused the diabetes in the first place Get plenty of exercise Type 3 diabetes is caused by an underlying condition such as pancreatitis or a hormonal disorder in the cat’s body. Total remission is possible in this case, provided that the underlying condition is properly treated. Type 4 diabetes is inherited and the cat has the disease from the day he is born. In this case, the cat won’t be able to have a remission phase and he will have to get insulin shots for life. Cat Diabetes Remission Symptoms Remission is possible if the cat has type 2 and 3 diabetes. The symptoms of remission are often too subtle to be recognized. However, you may notice some signs such as: Increased thirst Sleepiness and lack of energy alternating with no Continue reading >>

Clinical Remission Of Diabetes Mellitus In Cats

Clinical Remission Of Diabetes Mellitus In Cats

Clinical Remission of Diabetes mellitus in Cats Diabetic cats that go into diabetic clinical remission have remaining functional beta cells in the pancreatic islets which are able to produce sufficient insulin once persistent hyperglycemia, which results in glucose toxicity, is treated adequately with insulin. The time to remission is variable and likely depends on how long the hyperglycemia and glucose toxicity have been present and if there are remaining functional beta cells in the pancreatic islets. In diabetic cats it may be shortly after the start of treatment (e.g. around 2 weeks) or take up to 3-4 months or longer. It is important to remember that remission does not mean cure. Care with diet and exercise and avoidance of aggravating factors (progesterone, progestogens, corticosteroids, obesity, etc.) are important. In diabetic cats the remission rate may be as much as 60-70% if treatment is started early and you control diet and administer insulin appropriately. Continue reading >>

Feline Diabetes Mellitus: Keys To Remission

Feline Diabetes Mellitus: Keys To Remission

Diabetes mellitus is a common endocrinopathy for middle age and geriatric cats. The majority of feline diabetics develop hyperglycemia due to a combination of both decreased insulin secretion from pancreatic beta cell dysfunction and insulin resistance in peripheral tissues.1 As a result, the presence of remaining beta cell function in most feline patients allows for potential remission if the disease is promptly diagnosed and effective glycemic control is achieved. As the concept of diabetic remission has become more obtainable in many patients, the focus on insulin therapy, appropriate diet, and monitoring have become a mainstay of feline diabetic management. Diabetic remission is euglycemia achieved in a diabetic patient without the need for exogenous insulin. Persistent hyperglycemia results in glucotoxicity to pancreatic beta cells, resulting in continuing dysfunction.2 If hyperglycemia is controlled with long-acting exogenous insulin administration, Beta cells may recover function in some feline patients, allowing for adequate insulin production and secretion endogenously. Clinicians should focus on insulin, diet, and monitoring to optimize the chance of diabetic remission. Insulin Twice daily administration of an insulin with a duration of effect lasting 10-14 hours in cats, such as protamine zinc insulin (Prozinc, Boehringer Ingelheim), glargine (Lantus, sanofi-aventis) or detemir (Levemir, Novo Nordisk) results in improved remission compared to intermediate acting insulin (e.g., lente insulin).3 Bennett et al found that protamine zinc insulin (PZI, Boehringer Ingelheim) treatment in combination with a low carbohydrate-low fiber diet resulted in a 68% remission rate.4 Multiple investigations of glargine on remission rates in feline diabetes have resulted in vari Continue reading >>

Inducing Diabetic Remission In Cats

Inducing Diabetic Remission In Cats

This clinical review compiled information from human and veterinary studies regarding newer long-acting insulin in cats with diabetes mellitus. Diabetes mellitus affects up to 1.24% of cats; Maine coon, Russian blue, and Siamese breeds are overrepresented in the U.S. Most diabetic cats suffer from type-2 diabetes, which includes insulin resistance and a progressive reduction in insulin production resulting from β-cell dysfunction. Resolution of glucose toxicity because of tight glycemic control in newly diagnosed diabetic cats is thought to enhance probability of remission. Remission is likely with the use of newer, long-acting insulin such as glargine and detemir, low-carbohydrate diet, rapid initiation of therapy, intensive in-hospital or at-home glucose monitoring, and adjustment of insulin dose to achieve normal or near-normal blood glucose concentration. Clinical studies suggest twice-daily glargine administration is more likely to increase the probability of remission than once-daily glargine, twice-daily PZI, and twice-daily porcine lente insulin, especially when used in newly diagnosed diabetic cats. Detemir remission rates were also promising in newly diagnosed diabetic cats fed a low-carbohydrate diet. When using long-acting insulin, the goal is to achieve normal or near-normal blood glucose with a nadir of 65–117 mg/dL at home or 72–160 mg/dL in the hospital. Although data are limited, studies suggest that remission is achievable in 80%–90% of diabetic cats when rapid and intensive blood glucose control is achieved using detemir or glargine. Cats are not small dogs. Never has this statement been more accurate than when addressing diabetes. Most cats suffer from type-2 diabetes in contrast to dogs, which suffer from type-1 or type-3 diabetes. Unlike dog Continue reading >>

Many Cats With Diabetes Can Achieve Remission

Many Cats With Diabetes Can Achieve Remission

If your cat seems to be thirstier than usual, is urinating frequently, is hungry all the time but also losing weight, you should have him checked by your veterinarian for feline diabetes. Other signs to watch for include urinating outside the litter box, sweet-smelling breath, lethargy, dehydration, poor coat condition, and urinary tract infections. Left untreated, diabetes can cause your kitty to lose his appetite and a significant amount of weight, and develop muscle weakness. Uncontrolled, the disease can ultimately result in diabetic neuropathy, a condition in which there is profound rear limb weakness and a plantigrade walk, meaning the ankles are actually on the ground as the cat walks. Feline Diabetes Mellitus Diabetes mellitus is a common disease in older cats, and is especially prevalent in kitties fed dry food diets. In fact, a study published in the Journal of Feline Medicine and Surgery concluded that high-protein, low-carb diets are as or more effective than insulin at causing remission of diabetes in cats. The pancreas produces insulin based on the level of glucose in the blood. Insulin is necessary in order for glucose to enter the cells of the body. When glucose levels are high (which normally occurs after a meal), insulin is released. When there is not enough insulin being released from the pancreas, or there is an abnormal release of insulin coupled with an inadequate response of the body’s cells to the insulin, diabetes mellitus is the result. Sugar in the bloodstream cannot get into the cells of the body, so the body starts breaking down fat and protein stores to use as energy. As a result, no matter how much the cat eats, she loses weight. In addition, the glucose builds up in the bloodstream and is eliminated through urination. This leads to exce Continue reading >>

Feline Diabetes | Cornell University College Of Veterinary Medicine

Feline Diabetes | Cornell University College Of Veterinary Medicine

Avoiding inducing inappropriately low blood glucose levels with therapy Cats with diabetes are most often treated with injectable insulin. Oral drugs for humans (hypoglycemic medications) such as glipizide rarely work in controlling diabetes in cats. Insulin injection (see Figure 1) can be taught to most owners and, with a bit of experience, both owners and cats usually adapt to these injections very well. There are a variety of insulin preparations available, and each works for a different duration and has different effects on the ups and downs of blood glucose. Ideally, your veterinarian will perform a 12-24 hour glucose curve, during which insulin is administered intermittently and blood glucose is measured to establish the type of insulin and dosing frequency that best controls blood glucose while avoiding inappropriately low blood glucose levels (hypoglycemia). Your veterinarian may recommend feeding your cat a diet restricted in carbohydrates, which has been shown to improve control of blood glucose levels. When it comes to diet, its important to help your cat combat the weight loss that often occurs as a result of this disease. In diabetic cats that are underweight, this often means feeding multiple meals per day or allowing access to food at all times. If your cat is overweight, however, work with your veterinarian to institute a weight loss program, as managed weight loss in overweight diabetic cats will likely help the cat maintain steadier glucose levels. The optimal timing of meals for diabetic cats is controversial. Many veterinarians recommend feeding at the time of insulin injection to avoid a dangerous drop in blood glucose levels. However, there is no definitive evidence that the timing or frequency of meals in diabetic cats protects them from insulin- Continue reading >>

More in diabetes