Diabetes (Feline)

by Petside Team

Feline diabetes is a common endocrine disease of cats. Common signs of diabetes include increased thirst, increased urination and weight loss in spite of an increase in appetite. These signs are the result of an inability of the cat's body to use glucose.

This condition leads to a gradual decline in the cat's state of health that, if untreated, will eventually result in death. Proper treatment and care for a diabetic cat can keep the disease under control and give the cat a good quality of life.

Common name: Diabetes
Scientific name: Diabetes mellitus

Diagnosis

Signalment
Feline diabetes is usually seen in cats over 8 years of age, with a peak incidence in cats from 10 to 13 years old. Diabetes can affect any breed of cat. Neutered males are more likely to be affected than females.

Incidence/prevalence
The incidence of feline diabetes varies from 1 in 100 to 1 in 500 cats affected. Diagnosis of feline diabetes is increasing most likely due to increasing obesity in cats, a known risk factor.

Geographic distribution
There is no known geographic distribution or predilection to feline diabetes.

Clinical signs (primary)
Increased thirst and increased urination, Increased appetite with weight loss.

Clinical signs (secondary)
Poor hair coat due to lack of grooming, Peripheral neuropathy (hind-limb weakness with plantigrade posture ‚Äî the cat will walk with his hocks touching the ground).

Cause
The pancreas is unable to secrete insulin and/or the tissues are unable to respond to insulin properly.

Organ system affected
Feline diabetes is a systemic disease.

Diagnostic tests
Patient history, Clinical signs, Blood chemistry, Urinalysis.

Differential Diagnosis
Stress, Hyperadrenocorticism (Cushing's disease), Acromegaly (excess growth hormone yielding enlarged bones in hands and feet), Pancreatic cancer, Drug therapy (glucocorticoids).

Overview

Feline diabetes is a common endocrine disease in cats. Diabetes usually affects cats over 8 years of age and is more common in obese, neutered males. It is caused by either a failure of cells in the pancreas to secrete insulin or from an impaired ability of the body's tissues to utilize insulin. Insulin is a hormone that helps cells absorb glucose. The signs of illness in a diabetic cat result from this inability of the cells and tissues to use glucose.

Common signs of diabetes are increased thirst, increased urine output and increased appetite with a paradoxical weight loss. Many owners notice that they have to empty their cat's litter box more frequently or the used litter is heavier due to the larger amount of urine in the box.

Diabetes can affect the nervous system of some cats. These cats often have hind-limb weakness and walk with a plantigrade posture. A plantigrade posture means the cat will walk with his hocks touching the ground. Cats with diabetes often fail to properly groom themselves. Their hair coat may contain flaking skin and have an oily, unkempt appearance.

Diabetes is diagnosed based on several factors. These include the cat's history, clinical signs and physical examination, and various laboratory tests. Standard laboratory tests for diabetes are a blood chemistry and urinalysis. The blood chemistry looks for elevations in liver enzymes, cholesterol and triglycerides, and most especially blood glucose. The urinalysis checks for the presence of glucose in the urine. An appropriate history, clinical signs, and consistently high blood glucose and urinary glucose are often enough to establish a diagnosis of diabetes. A blood fructosamine test can also be used to help confirm a diagnosis.

Treatment

Home Care
Appropriate home care of diabetic cats consists of a diet change and daily administration of some form of insulin. Diets that are high in protein and contain lower amounts of carbohydrates are recommended for cats with diabetes. These diets help control the cat's blood sugar and promote weight loss in obese cats.

Insulin is used to keep the cat's blood glucose under control. There are several different types of insulin used for diabetic cats. They vary based on the duration of effect. Because it is difficult to establish an appropriate dose of insulin, which can vary, it is important to monitor the cat's response to treatment at home.

It is helpful to keep a daily journal of the cat's clinical signs. This journal should record the cat's general demeanor, appetite and amount of water consumed over 24 hours. Activity level (for example, the ability to jump) and body weight should be recorded weekly. If the owner of the cat is willing and able, monitoring for glucose in the urine and serial blood glucose measurements at home can help care for the cat.

Professional Care
After diabetes is diagnosed via appropriate tests, the veterinarian will prescribe insulin and a change in diet. The cat will need to be reevaluated by the veterinarian once a week for approximately one month after starting insulin.

At each visit the cat will stay at the hospital for the day to obtain serial measurements of the blood glucose. This is done to evaluate the cat's response to insulin. The dose and even type of insulin given to treat diabetes may be changed by the cat's veterinarian based on the glucose measurements in the hospital and the response to treatment that the cat's owner notices at home.

Action
If a cat is showing signs of diabetes, he needs to be examined and evaluated by a veterinarian. The pet parent and the veterinarian will need to work closely together to give the cat appropriate treatment and care.

Outcome
The prognosis for a diabetic cat depends on the owner's commitment to treat the disease, good communication between the cat's owner and veterinarian, and good control of the blood glucose with appropriate diet and dose and type of insulin. Proper care can give a diabetic cat a relatively normal life.

References/Additional Readings

Fleeman, Linda M. Options for Monitoring Diabetic Cats. In: August, John R., ed. Consultations in Feline Internal Medicine. St. Louis: Elsevier Saunders, 2006; 183-190.

Marshall, Rhett D. and Jacquie S. Rand. Diabetes Mellitus in Cats. In: Richards, James R., ed. Veterinary Clinics of North America Small Animal Practice Advances in Feline Medicine. New York: Elsevier Saunders, 2005; 211-224.

Nelson, Richard W. Diabetes Mellitus. In: Ettinger, Stephen J. and Edward C. Feldman, eds. Textbook of Veterinary Internal Medicine. Philadelphia: W.B. Saunders, 2000; 1438-1460.

Author

Leigh K. Gass, DVM

Editor

Steven Hansen, DVM, MS, MBA

DABVT, DABT