ALISON LAURIE-CHALMERS: Diabetes is serious but treatable, so don’t ignore signs
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Bubba had always been an overweight cat. His owners were very aware of this and had been trying to work with weight management with him.
However, Bubba’s neighbours were guilty of giving him “two dinners”, so frustratingly his owners continued attempts over the years to get excess weight off him had been futile.
Bubba was brought into the clinic as his owners had noticed a weight loss, however, he was also lethargic and his appetite wasn’t as good, which was unusual for Bubba. His owners had noticed that he had a tremendous thirst, and he was always at the water bowl and had been licking at the bath taps.
Blood tests confirmed that Bubba had diabetes.
Feline diabetes is becoming increasingly common in the UK affecting up to one in every 230 cats. It is like Type-2 human diabetes; however, cats are often severely insulin dependent by the time their symptoms are diagnosed.
The condition is usually controllable with insulin injections, and if responsive to treatment the cat can experience a much longer life expectancy.
Diabetes is a chronic disease affecting blood sugar levels, where there is insufficient insulin, or an insulin resistance, leading to persistently high blood glucose levels. Overweight cats are four times as likely to develop diabetes, and older cats and male cats are at higher risk.
The clinical signs of diabetes mellitus are related to the elevated concentrations of blood glucose due to this insulin problem, and the inability of the body to use this glucose as an energy source.
In a healthy cat, food is digested and absorbed into the blood. Glucose, a form of sugar, is the result from this digestion and provides the body with energy. As the glucose level rises after a meal, the pancreas releases insulin. Insulin allows glucose to enter the cells where it is used as a source of energy.
In a diabetic cat, the pancreas either does not produce enough insulin, or the body does not respond to insulin properly. As the glucose then cannot be used, other substances, such as fat or muscle proteins, are used to provide energy.
Untreated diabetes can cause severe health problems, leading to coma and death. In the final stages, the cat starts wasting, with the body breaking down its own fat and muscle to survive, and ketoacidosis can occur. Lethargy, weakness, dehydration, and acetone-smelling breath are symptoms of ketoacidosis, which is an emergency.
Symptoms of diabetes include: an increased thirst and/or appetite; passing more urine; weight loss; lethargy; muscle weakness and a neuropathy, in which typically the hind legs become weakened. These signs and symptoms may often go unnoticed in the early stages of disease.
Being overweight greatly increases a cat’s risk of developing diabetes. Other diseases, such as chronic pancreatitis, and certain types of medications can also lead to diabetes in cats. It is possible for some cats to go into diabetic “remission” and be able to regulate its own blood glucose again, if insulin treatment is instituted before severe damage to the pancreas occurs. So regular blood checks are required.
To diagnose diabetes, bloods are taken from your cat to check their blood glucose levels. Further specific Blood and urine tests may then be performed to help with the final diagnosis.
This is a controllable condition if detected and treated in the early stages with insulin injections and diet control.
Most cats require insulin injections given under the skin twice a day to control it initially. Your cat may require initial inpatient and repeat visits until they are stabilised, and an appropriate insulin dosage is determined. A specific treatment plan will then be made for your cat, and counselling and demonstrations on the correct injection technique will be given.
Take your vet’s advice on diet, as this will assist, and may change as your cat becomes stabilised. If your cat is overweight, your vet will aim to help your cat slowly lose weight, using a specific diet protocol for diabetic cats. A good advised balanced diet, with no high calorie “treats”, high in protein and low in carbohydrates, can greatly improve your cat’s blood sugar levels. Your vet will advise you on and appropriate diet, and the best timing for meals and insulin injections. Controlling what and when the cat eats is essential for diabetes management.
For good control of the disease, a routine is also important, and daily injections and feeding regimes should be carried out at the same time each day. It is also valuable to keep accurate home diary and records of timings of insulin injections; the amount of insulin injected; the amount and time of food fed and eaten; the cat’s demeanour and the amount of water drunk.
New technology has now allowed the adoption of home glucose monitoring, as well as vet visit monitoring.
You should always let your vet know immediately though if you notice any changes to your cat’s appetite or thirst, or if they appear dull or wobbly or are sick at any time.
With treatment a cat can live a relatively normal and happy life. But a lack of treatment can be life-threatening. Bubba responded well to his injections and new diet, and the guilty neighbours were aware now that he should not be fed by them at all. His owners were vigilant with his injections and care and repeat check-ups for blood monitoring at the practice, and he stabilised well.
If your cat has symptoms, call your vet. The sooner they are diagnosed, the better the chance of stabilisation.
Alison Laurie-Chalmers is a senior consultant at Crown Vets in Inverness.
