November is National Pet Diabetes Awareness Month.
Diabetes Mellitus is a condition that affects the concentration of glucose (or sugar) in the blood; cats become diabetic when their bodies do not make enough insulin or if the body is unable to use (is resistant to) the insulin that is produced. Insulin is a hormone produced in the pancreas, which regulates the amount of glucose in the blood. There are two types of Diabetes; Type I Diabetes is usually caused by a loss or dysfunction of the cells of the pancreas, meaning that it cannot produce insulin properly and Type II Diabetes, where the body develops an abnormal resistance to the insulin
When an animal eats, the food is broken down into very small components that the body can use some of these components are converted into several types of sugars including glucose. Glucose is absorbed from the intestines into the bloodstream, it then travels to cells in the body where it can be absorbed and used as a source of energy. Insulin is responsible for converting the glucose to energy in the cells; without insulin the glucose cannot enter the cells and just builds up in the bloodstream, which may cause the cat to act hungry all the time and eat constantly, but still be malnourished because its cells can’t absorb glucose for use in the body.
Cats At Risk
Diabetes affects 1 in 500 cats and dogs. It has been diagnosed in cats of all ages, both sexes, neutered and unneutered, and all breeds. It is, however, seen more frequently in middle-aged to older male cats.
Whilst we do not know the exact cause of diabetes in cats, experts believe that it can be linked to several different factors including
- Lack of exercise
- Pre existing medical conditions; Pancreatitis and hyperthyroidism for example
- Genetic tendencies or predisposition; It has been noted that Burmese cats may have a higher predisposition than any other breed.
Symptoms Of Diabetes
If your cat shows any of the following signs speak with your veterinary surgeon about the possibility of diabetes:
- Drinking more water
- Urinating more frequently or has “accidents” in the house
- Always hungry or has changes in appetite with weight gain or weight loss
- Lethargy or sleeping more
- Thinning, dry or dull coat
Diagnosis Of Diabetes
To test for diabetes the vet will thoroughly examine your cat and then examine a urine sample which will show us if any abnormalities are present, such as glucose or ketones. If the urine test shows that there is glucose and/or ketones present, then the next step is to take a blood sample from your pet. A blood sample will show the vet how much glucose is present in your cat’s blood as well as how well the other organs in your cat’s body are working, in order to rule out any other diseases or problems. A diagnosis of diabetes only becomes definite when glucose is found in the urine and at a persistently high concentration in the blood.
Treatment Of Diabetes
Although we cannot cure diabetes, it can be treated successfully and many cats can lead long and happy lives providing their diabetes is kept under control. Treatment will take a lot of commitment from you as the owner, as well as regular check ups for your cat with your vet and veterinary nurse. A fixed routine for your cat is the key to successful management of diabetes and any sudden changes in diet should be avoided.
Medication – Your cat may need once or twice daily injections of insulin in order to help keep the diabetes under control. This is not as scary as it sounds and you can be shown how to do this properly and safely by a veterinary nurse. There are tablets available which control hypoglycaemia, but can have side effects and are not generally the first choice of treatment as they are not suitable for all cats with diabetes.
Some diabetic cats can go into ‘clinical remission’ and no longer need insulin after a few months of treatment, and they can often be managed on diet alone (It is important to remember that remission doesn’t mean that he or she is cured and care must still be taken with the cat’s diet and lifestyle)
Diet – What your cat eats is extremely important in the successful management of diabetes. Food has a massive effect on the amount of glucose in the body and how quickly it is utilised. Your cat will need to be fed exactly the same food at the same time every day. Titbits and treats can be given, but again they must be the same every day.
The ideal diabetic diet for cats will be a wet food that includes high quality, highly digestible protein and restricted carbohydrate. Sadly most dry diet foods are far too high in carbohydrates. There are specially made veterinary prescription diets available that are low carbohydrate-high protein and it is possible to find over-the-counter diets that are also fairly low in carbohydrate (ideally they should contain less than 5g/100 kcal), but you will need to check these with your vet and information will need to be obtained from the manufacturers on specific brands and flavors to ensure that the diet is going to be nutritionally balanced for the diabetic cat.
If the cat is overweight/obese, then the aim will be to provide a diet that will aid in weight loss as well as helping to maintain blood glucose levels. In some cats, losing weight can be enough to help them into diabetic remission and remove the need for daily medication.
Regular monitoring – Your cat will need regular monitoring by you and the veterinary team, to ensure that the diabetes is well controlled. As well as giving any medication, you will need to monitor your cat daily for any signs that he or she is unwell. You may also be asked to regularly test your cat’s urine using a dipstick, or shown how to take pinprick blood samples from your cat (usually from the ear) in order to monitor glucose levels.
Your vet will monitor your cat by giving them health checks and taking regular blood samples in order to make sure that he or she is receiving the correct treatment at the right dose. Occasionally your cat may need a test called a ‘glucose curve’; this usually means that he or she will need to stay at the veterinary practice for the day (and sometimes overnight) for a series of pin prick blood tests to check the glucose concentration in the blood every two hours; some owners may be able to do this at home, but not everyone is always keen on the idea of taking a blood sample, no matter how small. A glucose curve gives the veterinary team a really good indication of how well the insulin medication is working and helps them to change your cat’s dose if necessary.
Complications Of Diabetes
There can be complications if Diabetes is not carefully monitored and treated properly including
Hypoglycaemia (low blood sugar): This is usually caused by
- The cat receiving a normal dose of insulin but not eating its normal quantity of food (Not eating, vomiting the meal, or having diarrhoea).
- The cat being abnormally active or having more exercise than usual, leading to abnormally high energy (glucose) use.
- The cat accidentally being given too much insulin by injection (human error).
Hypoglycaemia can be fatal so it is extremely important that you are able to recognise these signs which may be some or all of the following
- Trembling or shivering
- Unusual movements or behaviour – some animals become very quiet and may stop eating.
- Muscle twitching
If your cat is showing any of the above signs, you need to act quickly and get some glucose into them. This can be achieved by feeding, syringing a glucose solution into the cat’s mouth or by rubbing glucose powder onto his or her gums.
Hind Leg Weakness: High concentrations of glucose in the blood may cause damage to nerves resulting in weakness and muscle wasting, usually of the hind legs.
Cataracts: These are rare in diabetic cats but are caused when high blood glucose levels lead to changes in the lens of the eye as water diffuses into the lens causing swelling and disruption of the lens structure. When the lens of the eye becomes opaque, blindness results in the affected eye or eyes.
Diabetic Ketoacidosis: In very severe cases, where diabetes has gone undiagnosed for a long period or if treatment is not working for a diabetic animal, the animal may develop diabetic ketoacidosis. Because of a lack of insulin the glucose in the body cannot be used as an energy source so the body starts to break down fat and muscle instead of using the glucose, this releases acids known as ketones into the bloodstream causing anorexia, lethargy, acetone-smelling breath, dehydration and nausea and may eventually lead to death. Ketoacidosis is a veterinary emergency and you need to get your pet to a vet immediately.
If your pet is showing any of the above symptoms and you are concerned about Diabetes then please contact your veterinary practice to book an appointment.