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Symptoms That Feline Diabetes Is In Remission

Feline Diabetes: Five Principles Breed Success

Feline Diabetes: Five Principles Breed Success

Feline Diabetes: Five Principles Breed Success Five principles to help any owner help manage feline diabetes in their cat. Diabetic cats and the challenges associated with their management intrigue me, which is why I have about 75 diabetic patients in my practice at any given time. Successful management of a diabetic cat requires a multifaceted approach that begins with five principles: Tight control is not essential and probably not even desirable. Cats tolerate hyperglycemia without significant consequences better than humans or dogs do. Hyperglycemia is always better than hypoglycemia. The latter can be fatal. As long as the cat is not ketoacidotic, it is not critically ill. You do not have to get the cat regulated in the first week, or even in the first month, after diagnosis. Consistency is extremely important in maintaining regulation. The more things you can keep the samediet, exercise, stressthe easier it is to regulate the diabetic cat. Monitoring clinical signs is vital in achieving and maintaining regulation. With few exceptions, if the clinical signs and the blood-glucose level conflict, believe the clinical signs. Based on these five principles, here are four treatment steps: Client education. You are the coach on the sidelines. Your job is to instruct the quarterback so the plays are run properly. I recommend a client information handout that details the treatment plan. Treat other diseases. The most commonly associated diseases are chronic pancreatitis (50 percent incidence in newly diagnosed diabetic cats) and periodontal disease. After the diagnosis of diabetes is made, I recommend a urine culture and feline PLI1 as minimum diagnostics after the MDB (CBC, chemistry profile with electrolytes, FeLV/FIV test, urinalysis). I usually put my newly diagnosed 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 >>

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 >>

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 >>

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 >>

Diabetic Cats Who Stop Being Diabetic

Diabetic Cats Who Stop Being Diabetic

Owners of diabetic cats need to be aware of a syndrome in which their cats are no longer diabetic. While that sounds like good news, it rarely is, for several reasons. First, this is not a predictable syndrome. One never knows when it is going to happen. It happens in but a small percentage of cats and there is no way to know which cats will be affected. Second, it’s not a permanent change, and reversion to diabetic status is just as unpredictable as the former switch was. Causes for this problem are not clearly defined. Endocrinologists agree that the first step is for the Beta cells in the Islets of Langerhans, embedded in the pancreas, to resume producing insulin. Perhaps a time period of our providing insulin gives them a rest. After all, it is widely believed that diabetes results when the Beta cells are exhausted. In some cases perhaps capacity for insulin production still exists; the cells are merely tired, not exhausted. A recuperating period then allows insulin to enter the bloodstream again, processing blood sugar (glucose) along with the insulin we have provided, dropping blood sugar levels to a dangerous, even deadly level. Observed, these patients will exhibit predictable signs in this order: lethargy, vomiting, loss of consciousness, seizures and death. If you are fortunate enough for the episode to occur when you can see your kitty entering it, you can administer highly concentrated sugar solutions, such as Karo syrup. Of course, this option is viable only in awake cats. If you find your cat comatose there is no time to lose. Take him to the nearest animal emergency hospital for intravenous glucose and fluids administration, along with other therapies. Be prepared that cats who survive this syndrome take several days to get back to normal. Once the emer 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 >>

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 >>

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 >>

Diabetic Remission

Diabetic Remission

How to recognise and approach diabetic remission Good glycemic control soon after diagnosis reverses glucose toxicity and many newly-diagnosed diabetic cats can have their insulin dose gradually reduced and many can have their insulin completely withdrawn. It is suggested that insulin not be withdrawn completely for at least two weeks after starting insulin therapy to ensure adequate time for beta cells to recover from glucose toxicity. Insulin dose can be reduced when indicated by low blood glucose parameters listed above. If pre-insulin glucose is below 10mmol/L and insulin dose has been reduced to 1U, insulin should be withheld and blood glucose measured for 12hrs (if the pre-insulin glucose is below 10mmol/L and insulin dose greater than 1U, insulin dose should be reduced to 1U rather than withheld and pre-insulin glucose measured again in 3-7 days). In most cases, if when insulin is withheld the blood glucose concentration rises rapidly or significantly over 10mmol/L cats should be discharged on 1U twice daily rises slowly towards or just above 10mmol/L, then cats should be discharged on 1U once daily remains below 10mmol/L for 12hrs with no insulin, they can be assumed to be non-insulin dependant and cats should be discharged without insulin with their blood glucose monitored every 2-3 days for several weeks. Confirmed non-insulin dependant diabetic cats should have their blood glucose checked weekly for 3 months and then monthly forever. Some cats may have a pre-insulin glucose concentration below 10mmol/L within 2 weeks, but insulin therapy should be maintained for at least 2 weeks to give beta cells adequate time to recover from glucose toxicity. Use 1U BID or SID until insulin is withdrawn. What to do with a diabetic cat in remission Once remission has occurre Continue reading >>

Remission

Remission

It is in many cases possible to induce remission (a temporary or permanent freedom from insulin-dependence) in diabetic cats. (This appears to be unique to cats, unfortunately for dogs and humans. Dogs may experience remissions if their diabetes has a transient or secondary cause.) There is growing agreement among experts[1][2] that a combination of low-carb healthy diet, well-chosen insulin, and well-chosen dosage plans can in many cases bring glucose levels and insulin requirements down to what the damaged pancreas can handle, and allow the cat's blood sugar to be controlled entirely by diet thereafter. (A low-carb diet is usually required for the remainder of the cat's life.) Remission has been claimed (by Dr. Rand and Dr. Hodgkins) to be a realistic goal for all cats who can be properly regulated quickly. Chances of success are highest in the first few months after initial diagnosis. This limited time window is probably caused by amyloidosis and glucose toxicity, and is a good reason to start with low-carb diet and very slow-acting insulins, the most successful known combination, right away. Dr. Elizabeth Hodgkins[3] and Dr. Jacquie Rand[4] both recommend regimes of Tight regulation to achieve remission. In cats whose diabetes has been recently caused by steroids or some other transient cause, remission seems particularly likely if regulation can be achieved early. Note that Glipizide and similar oral diabetic medicines have been shown to increase amyloid production, and amyloidosis when blood sugar is high, damaging the pancreas and therefore making remission less likely.[5] When a diabetic cat's pancreas begins again to produce insulin, that insulin production is seldom predictable or sufficient to immediately put the cat's blood glucose levels in a non-diabetic r 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 >>

Diabetes In Cats

Diabetes In Cats

This article is about diabetes mellitus in cats. For other uses, see Diabetes (disambiguation). Diabetes mellitus is a chronic disease in cats, whereby either insufficient insulin response or insulin resistance lead to persistently high blood glucose concentrations. Diabetes could affect up to 1 in 230 cats,[1] and may be becoming increasingly common. Diabetes mellitus is less common in cats than in dogs. 80-95% of diabetic cats experience something similar to type-2 diabetes, but are generally severely insulin-dependent by the time symptoms are diagnosed. The condition is treatable, and treated properly, the cat can experience a normal life expectancy. In type-2 cats, prompt effective treatment may lead to diabetic remission, in which the cat no longer needs injected insulin. Untreated, the condition leads to increasingly weak legs in cats, and eventually malnutrition, ketoacidosis and/or dehydration, and death. Symptoms[edit] Cats will generally show a gradual onset of the disease over a few weeks or months, and it may escape notice for even longer.[citation needed] The first outward symptoms are a sudden weight loss (or occasionally gain), accompanied by excessive drinking and urination; for example, cats can appear to develop an obsession with water and lurk around faucets or water bowls. Appetite is suddenly either ravenous (up to three-times normal) or absent. These symptoms arise from the body being unable to use glucose as an energy source. A fasting glucose blood test will normally be suggestive of diabetes at this point. The same home blood test monitors used in humans are used on cats, usually by obtaining blood from the ear edges or paw pads. As the disease progresses, ketone bodies will be present in the urine, which can be detected with the same urine stri 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 >>

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 >>

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