SYMPTOMS
Symptoms of diabetes include drinking excessive water, increased appetite and weight loss.  Advanced, untreated diabetics can become quite ill with severe vomiting, seizures, coma and death.  Medications as well as other diseases can aggravate diabetes, including steroids (prednisone and other cortisone like drugs) and diseases like Cushing’s and pancreatitis.  Symptoms are often mild in the early stages and may be unrecognized for months.  Obesity is often present prior to developing diabetes.

CAUSE
Food from the intestine is broken down into sugar, or glucose, and is transported into the blood.  The body requires a hormone, insulin, to move the glucose from the blood into the cells where it is needed to provide energy.  A diabetic either is deficient in insulin (type 1 diabetes) or cannot use the insulin it has (type 2 diabetes).  Dogs tend to be type 1 diabetics while cats can be either type (although usually type 1).  Because a diabetic cannot use the sugar in its diet it essentially will starve to death without treatment.  The classic symptom of sugar in the urine is due to the excessive glucose spilling through the kidneys into the bladder.

DIAGNOSIS
Identifying an animal as diabetic is based on the symptoms, a physical examination and tests on blood and urine.  Typically, the blood glucose is abnormally high with most other tests being normal.  The urine has excessive sugar in it and often is harboring a bacterial infection.  Other diseases that can accompany diabetes such as pancreatitis are also identified with these tests.

TREATMENT
The mainstay of treatment is insulin therapy.  A variety of types and doses are used depending on the animal and the veterinarian’s preference.  Most insulins used today are human products derived from sheep, although new insulins designed for animals are becoming common.  Insulin is given at home as an injection under the skin either once or twice daily.

Initially when starting therapy a dose and type is selected that is approximate for the animal.  This will likely change as treatment progresses.  At intervals blood sugars are checked to monitor the animal’s progress.  Often, a day long series of blood sugar tests are completed to create a graphical curve of the daily sugars.  This gives the most information to assess treatment effectiveness.  Using these tests adjustments are made in the dosage and type of insulin as well as the frequency at which it is given.  Ideally, sugars should be between 100 and 200 in the dog and between 100 and 300 in the cat.

Dietary therapy is also very important and animals are often fed specialized diabetic foods.  Small, frequent meals are best and water should be available at all times.

Cats that are thought to be type 2 diabetics may receive oral hypoglycemic drugs instead of insulin.

PROGNOSIS
Success in treatment varies greatly from animal to animal.  Most can be treated well and will live normal lives.  Others can be difficult and can suffer complications or be difficult to regulate properly.  Cats tend to be more difficult than dogs.  Complications include blindness from cataracts, recurrent infections, resistance to therapy and seizures or coma.  

Diabetics do best with regularity in their lives.  Owning a diabetic animal requires commitment to administering medication on time and with strict dependability.  We must perform recommended blood tests when needed and be prepared for complications.  With care, a diabetic can live long and well but much depends on our reliability as caregivers.

PROBLEMS
The most common complication of treatment is hypoglycemia or low blood sugar.  This can happen unexpectedly and can be very dramatic.  Sudden weakness or disorientation is most often seen.  We recommend that owners keep a source of sugar available such as Karo syrup to use in an emergency.  Place a spoonful of the syrup in your pet’s mouth.  A rapid response is usually seen giving you time to bring your pet in for evaluation. 

Another common problem is poor appetite.  If your pet does not eat well prior to giving the insulin, you should reduce the insulin dose by 50 % and monitor its appetite the remainder of the day.  If normal eating resumes, give the regular dosage of insulin.  If its appetite is still poor, call the hospital and discuss with the doctor.

Diabetic cats can present special problems.  Cats can either permanently or transiently resolve their diabetes.  This can occur suddenly and without much warning.  Owners must watch closely for symptoms such as loss of appetite and weakness.  Cats also become stressed when in the hospital for testing which can make results difficult to interpret.

TECHNIQUE
Feed your pet while preparing the injection, this enables you to monitor its appetite.  Sometimes giving an especially tasty snack or canned food will encourage eating.  Get the insulin vial out of the refrigerator and gently mix by rolling on your thigh for about 20-30 seconds.  Do not shake.   Draw the desired dosage of insulin into the syringe and replace insulin in the refrigerator.  Inject insulin subcutaneously.  Syringes can be reused 2-3 times if desired.  It is always best to use a new syringe if possible.  Always make sure that the insulin type and syringes match or dosing irregularities can result.

RESOURCES
If you would like to review additional material concerning diabetes in cats, a short video is available for loan. Please contact our office to request “Caring for Your Diabetic Cat”.

You may download a handout with this information by clicking here.