Diabetes

Diabetes is a condition in which an individual is unable to regulate their blood sugar levels.  In a healthy pet, sugar is absorbed from the gastrointestinal tract after a meal. Even in cases where the meal did not contain obvious sources of sugar, the body can take calories from some of the proteins and fats and create sugars. This sugar is absorbed into the blood stream where it circulates for a short time after the meal is digested. The presence of sugar in the bloodstream triggers the pancreas to secrete a hormone called insulin into the blood. The insulin acts as a messenger that tells the body to take the sugar molecules and package them into units that can be stored in the liver and muscle tissue. During times of increased energy need, the pancreas senses a lack of sugar in the blood and secretes a different hormone called glucagon. This hormone tells the liver and muscle tissue to release their stored sugar into the bloodstream where it then circulates to organs and tissues that use it for energy.  

In a diabetic pet, one of two things has gone wrong. Either the pancreas is no longer capable of secreting insulin, or, the pancreas is secreting insulin appropriately and the body is just not “listening” to the message to store the blood sugar. This second mechanism is called insulin resistance, and is commonly a result of a pet being chronically overweight for a large portion of its life. Either way, sugar levels stay permanently and dangerously elevated because the body is not able to store the circulating blood sugar in the liver and muscle tissue. 

Because the nutrients that the pet eats and converts into blood sugar are not able to be packaged and used appropriately, the body “thinks” that it is in starvation mode, even if the pet is eating well. In an effort to find an energy source the body can use, it starts to break down its own muscle tissue to use for energy. This leads to significant muscle wasting and weight loss, especially along the backbone in diabetic cats. 

A perpetually high level of blood sugar is also toxic to the body. In an effort to rid the body of this toxic substance that cannot be packaged and used properly, the kidneys step in to try to urinate out the sugar. Because the blood sugar cannot be urinated out as solid sugar granules, water must be urinated with it. So much sugar is urinated out of the body that excessive quantities of water are lost during this process. This leads to the pet trying to replenish these fluid losses through excessive water consumption. Owners of diabetic pets often report that their pet is constantly at the water bowl and is urinating more than normal. 

Diabetes cannot be cured. In order to manage the diabetes, insulin must be supplied to supplement the insulin your cat is lacking. The only way to provide this insulin is through injection. Your veterinarian or animal health technologist will show you the correct way to administer your cat’s insulin. As well, your cat will benefit from a food that is very high in protein and very low in carbohydrates, such as Hill’s m/d. This will make the insulin’s job easier, because it won’t have to control the packaging of as much sugar. 

Your veterinarian has created a treatment plan for your cat. This treatment plan includes twice daily insulin injections for at least four months. In some cases, after four months of treatment the insulin dose can be decreased to once daily. Occasionally, a diabetic cat will go into remission and no longer require insulin at all. The best chance of achieving diabetic remission is to strictly control your cat’s diet, provide insulin as directed, and to ensure that your cat has no underlying infections (such as urinary tract infections or dental abscesses). Infections will further increase insulin resistance, and must be appropriately treated in order to maximize the benefits of insulin. 

In insulin-dependent diabetic humans, blood sugar is measured several times throughout the day in order to best determine the frequency and dose of insulin. With cats, blood sugar monitoring throughout the day can be quite challenging. More commonly, veterinarians will start the cat off on a moderate dose of insulin and check a 10-12 hour glucose curve after a few weeks of treatment. 

A glucose curve is a test whereby a tiny blood sample is collected from your cat every hour for a full day. The blood glucose is measured and plotted on a graph in order to gain an understanding of how the cat’s blood sugar fluctuates throughout the day in response to meals and insulin injections. This gives your veterinarian a good idea of how to make adjustments in your cat’s insulin dose. Unfortunately, it can take several weeks or even months to determine the best dose of insulin for your cat’s specific needs. 

It is much safer to start a cat at a low insulin dose and gradually increase it than to start at a high dose and have to decrease it. If an insulin dose is too high, it will result in catastrophically low blood sugar called hypoglycemia. Hypoglycemia can cause dizziness, disorientation, seizures, coma, and death. If an insulin dose is too low and the blood sugar levels remain high, it can result in symptoms that mimic hypoglycemia, but the long term results are not generally as dangerous. 

There may come a time when your cat is demonstrating the above symptoms. This can be very scary for a cat owner, because you may not know if the symptoms are a result of an accidental insulin overdose or an underdose (ie., are the symptoms because your cat’s blood sugar is too low or too high?). This situation must be treated as an emergency. Because the most dangerous of the two possibilities is low blood sugar, you must give a small quantity of Karo corn syrup orally (about ½ - 1 teaspoon). Transport your cat to the veterinarian immediately. If the cat’s symptoms were due to high blood sugar, you are not likely to have made the problem medically worse by administering the corn syrup, but you might save your cat’s life in the event that the problem was due to low blood sugar. 

For tips on handling insulin and syringes, a video demonstrating how to draw insulin into a syringe can be viewed at: http://www.prozinc.us/video.aspx#how. 

For a step-by-step guide to administering insulin to your cat, a helpful video can be viewed at: http://www.prozinc.us/video.aspx#easy.