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 >>
Preventing And Handling Diabetic Emergencies
Caring for a pet with diabetes can be daunting. Fortunately, the key to successful diabetes management is simple: a consistent, established daily routine. A healthy diet is essential, and feeding your pet the same amount of food at the same time every day will help make blood sugar easiest to control. Your pet will usually also need twice-daily insulin injections, which should be given at the same time every day. (The easiest way to do this is to coordinate shots with mealtimes.) Routine daily exercise and regular at-home monitoring of urine and/or blood sugar round out a plan for good diabetic regulation. Even if you are following a consistent routine, a diabetic pet may occasionally experience an emergency. A number of different things can cause an emergency, but the most common is hypoglycemia, or low blood sugar. In this case, it is important that you be prepared in order to avoid a life-threatening situation. Hypoglycemia: Why It Happens Hypoglycemia most often results from accidental overdosage of insulin, but it can also occur if a pet is not eating well, misses a meal or vomits after eating, or if the type and amount of food he is being fed changes. Hypoglycemia may become a problem with very vigorous exercise; for this reason, regular daily controlled exercise is best. Hypoglycemia can also result if the body’s need for insulin changes. This scenario is particularly common in cats who often return to a non-diabetic state once an appropriate diet and insulin therapy start. Vet Tips Avoid “double-dosing” insulin. Only one person in a household should have the responsibility of giving insulin. A daily log should be kept of the time/amount of food and insulin that is given to avoid errors. Proper daily monitoring of blood and/or urine glucose can help identif Continue reading >>
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 >>
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 >>
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 >>
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 >>
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 >>
4 Signs Of An Impending Diabetic Pet Emergency
Caring for a diabetic pet can be challenging, but there are certain precautions pet owners can take to prevent a diabetic emergency like hypoglycemia. Preventing a health crisis in a dog or cat with diabetes involves employing a consistent daily routine involving diet, exercise, insulin therapy, and supplementation. It also involves avoiding any and all unnecessary vaccinations. Even the most diligent pet parent can find himself facing a diabetic emergency with a dog or cat. Hypoglycemia is the most common health crisis, and is usually the result of an inadvertent overdose of insulin. Symptoms of hypoglycemia can appear suddenly and include lethargy or restlessness, anxiety or other behavioral changes, muscle weakness or twitching, seizures, coma, and death. At-home treatment for a diabetic pet with hypoglycemia is determined by whether or not the animal is alert. Signs of other potential impending diabetic emergencies include ketones in the urine; straining to urinate or bloody urine; vomiting or diarrhea; or a complete loss of appetite or reduced appetite for several days. By Dr. Becker Caring for a diabetic pet can be quite complex and time consuming. It involves regular monitoring of blood glucose levels, making necessary dietary adjustments, giving insulin injections or oral medications, and keeping a careful eye on your pet at all times. Frequent veterinary visits are the norm for dogs and cats with diabetes, as are the costs associated with checkups, tests, medical procedures, and insulin therapy. And unlike humans with the disease, our pets can’t tell us how they’re feeling or help in their own treatment and recovery. Preventing Diabetic Emergencies The key to preventing diabetic emergencies with a pet involves implementing a consistent daily routine and sti Continue reading >>
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 >>
Your Cat And Diabetes: Everything You Need To Know
Diabetes is a very serious issue – and not just in people either. That’s right, this chronic and potentially debilitating condition also affects cats (and dogs). And while it’s difficult to know the exact incidence of diabetes in cats, best estimates put it somewhere in the range of 1 cat in every 100-200 cats will become diabetic. What’s even sadder is that this incidence seems to be on the increase. Fortunately, armed with some good information, important tips, and a good working relationship with your veterinarian, you can give your cats the best chance at avoiding this frustrating condition. And if they’ve already developed it, know that these same tools can help you best manage your cat’s diabetic state; avoiding the potential complications and perhaps even getting them into diabetic remission. What is diabetes? In the most basic sense, diabetes mellitus is a disorder where blood sugar, or glucose, cannot be effectively utilized and regulated within the body. There are several hormones within the body that play important roles in glucose metabolism. Insulin is one of the most important, if not the most important, and it’s the hormone most central to the development and control of the diabetic state. Glucose fuels the body and insulin is the hormone that helps to get it into most cells within the body. Diabetes is often easily diagnosed and controllable. However, when undiagnosed or poorly managed, diabetes can be devastating. Diabetes can absolutely be managed and your cat can still lead a long and happy life. Routine veterinary care and evaluation are important, as is achieving and maintaining an appropriate weight in your cat and feeding him an appropriate diet. There are two types of diabetes – Type I and Type II. In Type I diabetes, the pancreas Continue reading >>
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. Maintaining low carbohydrate density in the diet is important in controlling diabetes. 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, its 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 Continue reading >>
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 >>
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 >>
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 >>
Out Of Remission :( | Feline Diabetes Message Board - Fdmb
Blu started losing weight and was interested in water - home checked him and glucose was at 290. Brought him to the vet the next day. He had been OTJ for over a year and a half. Glucose during periodic home checks while OTJ were stable in the 80-90 range. Before that, he was diagnosed with glucose in the 500's, and was on Lantus for around 4 months then quickly went into remission. He's been food controlled eating only Fancy Feast Classics. We are back on the Lantus starting today. Upsetting of course, but less stressful than the first time this happened as I know more of what to expect and do. Is this usual to go out of remission when eating an approved diabetic food? I asked the vet if he could achieve remission again and she mentioned that she had one cat patient who was on insulin 5 times with long remission periods in between and she seemed hopeful that Blu could go into remission again, but I've read elsewhere a 2nd remission is much more difficult to achieve. Thoughts or experiences with 2nd remissions? He does have some oral issues, couple teeth need to be removed but not until his glucose is under control per the vet. Did the vet do any bloodwork on Blu? Any other signs of infection or illness? I'm asking because typically, the big things that cause a cat to come out of remission are Infection/Illness, Dental issues, Reintroduction of dry or high carb foods into the diet, and steroids. If none of the other three issues are on the table, then you can definitely point to the dental issues as your culprit. Many vets seem to want to wait to get the cat regulated or under control before doing the dental, but because the dental problems are what is causing the BG to be out of control, you really have to have the dental done ASAP. If your vet wants to wait a few week Continue reading >>
