Feline Diabetes Explaned

Feline Diabetes Explaned

If your cat has been diagnosed with diabetes, you may be feeling a little overwhelmed.  Hopefully these pages will help you to understand a bit more about the road ahead. 

So what actually is diabetes in cats?  Diabetes mellitus (also known as ‘sugar diabetes’) is a condition caused by either a lack of the hormone insulin, or the inability of the body to process insulin.  Insulin is produced by the pancreas and regulates the levels of glucose (sugar) in the blood.  When insulin is insufficient, blood sugar levels will rise, causing your cat to become unwell and, if left untreated, can be fatal.   

Diabetes is a common disorder of cats, normally affecting middle-aged to older cats and is more common in males than females. 

The most common signs of diabetes is an increase in thirst and urination.  Your cat would most likely be really thirsty and need to urinate more often.  You may have noticed your cat can’t hold their pee through the night so they are waking you to go outside or they’re urinating in the house.  Your cat may have lost weight and may be eating more.  These can all be signs of other common diseases too so it’s important to get a diagnosis from your vet as soon as possible if your cat is showing any of these symptoms.

Most diabetic cats may appear relatively well in themselves but prolonged diabetes may lead to a complication known as diabetic ketoacidosis.  Your cat may become extremely lethargic with signs such as vomiting, diarrhoea, not eating and eventually collapse.  These signs warrant an emergency trip to your vet. 

Diagnosis of diabetes mellitus usually requires a urine sample and a blood test.  The long-term prognosis for cats with diabetes varies depending on how early the disease has been caught, how old your cat is, how easy it is to stabilise their diabetes and whether they have any other diseases.  Most cats respond well to treatment and, once stabilised can live quite happily for the remainder of their lives. 

Unfortunately, some cats don’t respond well to treatment and can’t be stabilised easily.  This brings us to the question of whether euthanasia is an option for a newly diagnosed diabetic cat.  There is no definitive answer to this but you should feel comfortable discussing this with your vet.  You should look at the whole picture – your cat’s age, other diseases they may have and your financial situation.  I would always suggest giving your cat a chance at successfully being treated but the reality is that everyone’s circumstances are different.   To read more about when the time is right for euthanasia click here.

 

 

 

 

 

 

 

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Treatment of Feline Diabetes

Treatment of Feline Diabetes

vet If your cat has been diagnosed with diabetes mellitus, it’s easy to become overwhelmed by the information, costs and responsibility of the disease.  However, successfully managing this disease can be extremely rewarding for a cat owner.

It’s important to know that diabetes is not a cheap disease to treat, nor is it the most expensive.  However, costs can vary greatly from vet clinic to vet clinic and from patient to patient.  I would strongly recommend that you ask your vet for an approximate ballpark figure of costs involved including blood and urine tests, insulin and syringes.  Please remember this will be an idea of costs only as it would be impossible for your vet to give you a specific quote as it will very much depend on how your cat responds to treatment which, in turn, will affect how often they need tests and how much insulin they will need.

Treatment of diabetes basically entails keeping glucose levels in the blood down to normal levels  by giving insulin via an injection.  Remembering that insulin is the hormone that is insufficient in your cat, so we are injecting insulin to bring the high blood sugar levels down to a normal range.

The idea of injecting your cat can be a terrifying thought for some but please be assured that it’s a learning process and once you, and your cat, have done it a few times, it will get easier.  The highlight for your cat is that they will always get food immediately before the injection so they tend to learn this positive relationship pretty quickly.

As well as giving insulin injections, which we’ll talk about in more detail here, the other important factor is food.  Daily changes in the content and frequency of your cat’s food can really affect their blood glucose levels regardless of the insulin injections.  Your vet will probably recommend a low-carbohydrate food specifically made for diabetic cats which can help minimise these fluctuations.  You can find out more about these foods here. 

More important than the food itself is the feeding routine of your cat.  It’s vital that they eat at the time they have their insulin injection so if they are used to grazing on biscuits during the day, this may need to change as you will want them to be hungry at their injection times (either twice a day or once a day).   

Diabetic cats are often overweight at the time of diagnosis and we know that obesity is a cause of diabetes.  Getting your cat to a healthy weight is vital in giving your cat the best chance of successful treatment and even possible remission from the disease.  Read more about how to get your cat to lose weight here.

The other thing to consider is making sure that your cat has plenty of access to fresh water.  Diabetes causes your cat to lose a lot of fluid through urination so it’s vital they have access to plenty of fresh water.   Find out the best way to get your cat to drink well here.

Your cat will most likely need to stay in the vet hospital for a day, sometimes longer, when they are initially being stabilised.  During this process your vet will give your cat insulin and then take very small blood samples throughout the day to monitor the effect of the insulin.  This is a vital part of the initial treatment as it will indicate to your vet how much they need to adjust the insulin dose to get good control of the diabetes.

This process may need to be repeated a few times in the first few weeks of treatment until your vet is happy that your cat is getting the right amount of insulin (i.e. stabilised).  If your cat is given too much insulin, their blood sugar will drop too low and they may have a hypoglycaemic episode which is life threatening (more on this here).  

At the end of the first day in hospital the vet will hand over the treatment to you.  They should run through it all with you, however, if you are feeling anxious about giving injections to your cat for the first time, this is the time to ask for help from your vet and nurses.  It’s perfectly normal to feel apprehensive about injecting your cat and your vet will understand this.  The way to beat this feeling is to get confident.  Take extra syringes so you can practice at home on a soft toy or piece of fruit and ask the vet nurses for guidance until you feel more comfortable.

 

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Monitoring the disease

Monitoring the disease

Hypoglycaemic To give your cat the best chance of success as a diabetic, it all comes down to monitoring.  If you can record information in a diary, it will be invaluable to your vet when your cat goes for their regular check up. 

Monitoring at home

Your cat’s weight.  Just a weekly weight will be fine.  See my post on how to do this at home here.

Your cat’s urine.  Again, just weekly or even fortnightly or monthly will be fine unless your vet tells you differently.  If your vet asks you to do this, they will give you a simple glucose strip to test it with.  To find out how to collect your cat’s urine for a urine sample, see my video here.

How much your cat is drinking.  This can be vital information for your vet but can be tricky if you have more than one cat or other animals at home.  You will need to measure out their water in the morning from a measuring jug and pour it into their empty bowl.  Then 24 hours later, measure the amount left over.  Subtract the second measurement from the first and you will know how much they’ve had to drink over the last 24 hours. 

How much your cat is eating.  This is important in terms of appetite – are they losing their appetite or is it normal?  Also note if there has been any vomiting or diarrhoea.  This will all be helpful to your vet. 

There is also a newer technology called FreeStyle Libre sensors.  This allows for blood glucose readings to be taken at home.  It’s a human product but many cats will tolerate the sensor.  The cat’s owner downloads an app and scans the sensor to get a reading.  This gives really accurate information as it’s done at home so stress doesn’t interfere with the blood sugar levels as it would in a vet hospital situation.  Speak to your vet about whether this is an option for your cat.

Monitoring at the Vet

Your vet will want to take blood tests from your cat on a fairly regular basis.  In the early stages of treatment, or following any dose changes, this may require fortnightly visits to your vet, possibly with a day in hospital for your cat to be assessed throughout the day – this is called a “blood glucose curve”.  The vet will take a small sample of your cat’s blood every 1-2 hours throughout the day and see how the blood glucose level sits at these intervals.  If you were to pinpoint this data on a line graph, it would show a ‘curve’ hence the name. 

If your cat is stable and has been for some time, your vet may do a blood test called a ‘Fructosamine’.  This doesn’t require a stay in hospital and is normally done during a consultation.  This blood test shows more of a historical indication of how the blood glucose levels have been over the previous weeks and indicates whether any adjustments are needed.  

 

Signs of a life-threatening hypoglycaemic episode

There is always risk when giving insulin that your cat may have a hypoglycaemic episode.  This is a life-threatening condition and needs immediate emergency treatment at your nearest vet so it’s important to know the signs to look for.

Hypoglycaemic episodes are more likely to occur when increasing an insulin dose for the first time or if your cat has lost their appetite and isn’t eating well.  The signs of hypoglycaemia are weakness, disorientation, walking like they are drunk, they may collapse and this can progress to seizures.  It is frightening for a pet owner to witness their beloved cat going through this so it’s important to be aware of these signs so you can take early action. 

Contact your vets or your nearest emergency vet immediately and then, before bundling your cat into the car, put some glucose syrup, glucose powder or honey in their mouth.  Remember, their blood sugar levels have fallen too low so you need to add sugar quickly by giving them glucose or honey.  Be careful if they are seizuring – use a spoon as you may get bitten inadvertently.  It is worth having glucose powder on hand at home in case this emergency were ever to occur. Once you have done this, take your cat straight to the nearest available vets. 

 

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Veterinary Foods for Diabetic Cats

Veterinary Foods for Diabetic Cats

 Your vet may have already mentioned special diabetic foods to you already.  So what is the big difference between diabetic food and normal cat food, and is it worth it?  Most importantly, diabetic food is high in protein and very low in carbohydrates.  Studies have shown that feeding a diabetic cat a diet that is low in carbohydrates require less insulin, are easier to manage and in some cases may go into remission completely. 

When treating diabetes, it’s ideal to avoid foods that are high in fats and salts which commercial foods often are as this will cause the glucose levels to rise.  By giving them a diet made to support their diabetes you are helping to gain more controlled blood glucose levels and, ultimately, a better opportunity for successful treatment.  Diabetic cats are often overweight (but not always) and the diabetic food can also assist in weight loss.

See more about diabetic diets and the options available here, as well as tips on how best to change your cat onto this food and how to get a fussy cat to eat it.

The most important thing to remember is that it’s by far more important at this stage to keep your cat eating.  So if they don’t like the food and are refusing to eat it, please offer them their usual food and follow this link for tips on getting them to eat the special diabetic diet.

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How to give an insulin injection

How to give an insulin injection

Most diabetic cats will need to have their insulin injections given once or twice daily.  It can be a daunting prospect having to do this for the first time but you’ll quickly find that you’re a dab-hand at it.  It’s important to note that insulin needles are really small so cats often don’t feel the injection. 

Your vet should have provided you with: a vial of insulin, a packet or box of insulin syringes and a sharps container.  If your vet hasn’t provided you with a sharps container, you can purchase these from your local pharmacy.   Insulin should always be stored in the fridge, upright and the syringes should be kept out of the reach of children. 

 

Practice

The injection is given under the skin behind the neck or slightly further down between the shoulder blades.  Your vet or vet nurse will have spent some time showing you how to do this, and ideally, been with you while you practice.  A good idea, to help you get the feel of the syringe in your hand is to practice injecting water into a piece of fruit or a soft toy – it doesn’t really matter what, as long as you are gaining confidence with it.  

 

Prepare

To begin with, it’s a good idea to have someone there ready to help hold your cat.  This only needs to be a gentle hold.  This is a really important point.  Cats are very perceptive animals and if they feel like they are being ‘pinned down’ or ‘held down’ they will get very disgruntled.  They only need a very gentle hold and to be distracted with stroking and talking to.   Before your friend or relative, holds your cat, get everything ready.  You don’t want your cat being held when you’re still unpacking the syringe. 

Close all doors and windows so that your cat can’t run off, especially the first few times.  You want them to eat immediately beforehand– firstly to help maintain good blood glucose levels, and secondly, so that your cat learns there is a reward associated with this.  

 

drawing up the insulin into the syringe

You want to gently mix the contents of the insulin vial – don’t shake the bottle as this could damage the insulin – but a gentle swirling is good.  Then get your syringe ready, turn the vial upside down and pierce the rubber top with the syringe needle.  If it’s a brand new vial, it will have a hard plastic lid which can be pulled off and discarded.  Once you have pierced the rubber top with the needle , draw down on the syringe plunger.  The insulin will then start filling the vial.  You can go up and down on here until you get the right amount.  If bubbles appear, then let go of the syringe – it will still stay inside the vial – and ‘flick’ the syringe.  This will release the bubbles to the top.  You may need to do this a few times. 

Your vet should have showed you how much insulin you need to draw up into the syringe and it should also be on the veterinary label on the box or vial.   This is usually given in the measurements of units known as I.U. (insulin units) rather than ml or cc.  If you are in any doubt of the amount you need, contact your vet and ask them to confirm. 

Ensure you replace the cap on the needle now until you are ready to inject your cat.  It’s important that the needle remains sterile. 

Occasionally, insulin ‘pens’ are used instead to give insulin.  This may help when giving very small amounts and your vet will show you how to use this.

 

feed your cat

You should always feed your cat immediately before giving their insulin injection.  This helps to prevent their blood sugar levels falling too low after the insulin has been given.  This is why it’s important for them not to graze during the day as we want to make sure they eat at ‘insulin’ time so they will need to have set meal times and be hungry enough to reliably eat those meals.  If they do not eat, do not give them their injection until they have done so.  For tips on getting a fussy cat to eat, see my post here. 

Wait until your cat has finished their meal and eaten at least half of it before giving their injection.  Although it may seem tempting, please don’t give it to them while they are eating as they may come to associate eating with something they don’t enjoy very much and this can disrupt their eating habits.

While they are eating, move away to the other side of the room and leave them to eat their meal in peace.  They will sense it if you are waiting to ‘grab’ them as soon as they are finished.

Giving the injection

Once your cat has eaten, you can give the nod to the person helping that you are ready for them to hold your cat. 

You want to lift the skin on the back of the neck, or between the shoulder blades.  Make a tent with the skin and then point the needle towards the ‘tent opening’ (if it had one).  Keeping the needle and syringe parallel to your cat’s back but pointing very slightly downwards. When you enter the skin, you want to do this quickly and confidently.  Once you are sure the needle is in – press down on the plunger of the syringe.  Once it has been given you can pull the syringe out and give the skin a gentle rub.

Make sure that you put the insulin vial straight back into the fridge and discard the used syringe and needle into the sharps container. 

If you aren’t sure that an insulin injection was given successfully, never give another dose.  It’s always best to just wait until the next dose that’s due rather than risk giving too much insulin. If your cat’s fur is wet to touch afterwards, it may be that they still got some of the insulin so it is still best to wait until the next dose.

If it doesn’t go well the first time, please don’t be disheartened.  You AND your cat will get used to it and you will find the ways that work for you both and it will get easier.

 

 

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