Diabetes in cats, a growing problem
Integrative Pet Vet
As with dogs and humans, diabetes mellitus in cats is a common problem. The incidence has been increasing over the last 30 years. With an estimated seven of every 1,000 cats affected with diabetes, there are approximately 800,000 diabetic cats in the U.S. While all cats can be affected, diabetes is seen most often in middle-aged and older cats. Risk factors include obesity, genetics, dental disease, certain drugs and inactivity, especially with indoor cats.
Diabetes in cats shares similarities with diabetes in dogs, but has some notable differences. These differences are important because unlike diabetes in dogs, which is almost always type 1, 80-95 percent of diabetic cats have type 2. Type 2 diabetes occurs because insulin secretion from the pancreas is impaired. At the same time cell response to insulin becomes reduced (increasing resistance or lowered sensitivity).
Insulin is critical for control of the glucose level in blood by signaling cells to take in glucose where it is used for energy. In addition, when energy levels are sufficient, insulin signals the liver to take in glucose and store it. With type 2 diabetes, the insulin levels are low, often 80-90 percent below normal, and body cells become less responsive or insensitive to the insulin. This results in cells not being able to effectively take in glucose and liver production of glucose is not switched off contributing to the increased blood glucose. The body starts using fat as an energy source. Altered metabolism of carbohydrates, fats, and proteins occurs.
The altered carbohydrate metabolism contributes to elevated blood glucose and to glucose in the urine once the blood glucose rises high enough. It is this elevated glucose that results in increased urination and drinking. Altered fat metabolism can result in increased fat in the blood and liver changes. Cats with a reduced ability to use glucose, proteins and fats can become lethargic, lose weight, are hungrier, have a poor hair coat, experience reduced immunity and can have recurrent infections when the diabetes is not treated.
Diagnosis of diabetes in cats is based on a combination of the signs of excessive drinking, excessive urination, increased appetite and weight loss combined with persistently elevated blood glucose and glucose in urine. The presence of a persistent glucose elevation is important because cats have the ability to significantly increase their blood glucose in response to stress. Since this rise is temporary, it does not reflect the daily ongoing blood glucose levels. For some cats, repeating the blood glucose measurement is important to document a continuing high level. Another valuable test measures blood fructosamine. This provides information about what the blood glucose levels were two-four weeks before.
Diabetes in cats is treatable. The typical approach for treating diabetic cats is to rule out and treat diseases, such as an over-active thyroid, that can complicate management of diabetes. Drugs, like methylprednisolone, that have been linked to increased risk of diabetes should be eliminated if possible.
In the early stages of diabetes where the problem is subclinical, oral hypoglycemic drugs may be beneficial along with control of obesity and use of high protein, low carbohydrate canned foods. When the diabetes is more advanced and clinically evident, the administration of insulin is essential. Your veterinarian can provide guidance on the best approach for each individual cat. Monitoring of the blood glucose is important especially early in treatment. As the diabetes becomes controlled, some cats can have reduced need for insulin injections over time and some can go into remission. This makes ongoing monitoring vital for effective management.
In addition to oral hypoglycemic drugs and insulin, supportive care for the liver, pancreas and immune system using nutritional supplements may be beneficial. There are a number of herbs advocated for use in diabetic cats to aid in reduction of blood glucose levels. These include gymnema leaf, dandelion root, and burdock root. However, it is important to note that these herbs have not been fully evaluated to demonstrate their real value for diabetes management in cats. As a result, caution should be used to avoid potential negative complications including lowering the blood glucose too much. In addition, cats are less able to metabolize many substances compared to dogs and people, making them more susceptible to potential toxic reactions.
If you have concerns about your cat and diabetes, contact your veterinarian for guidance. Diabetes can be a complex problem to manage making regular interaction with your veterinarian valuable as you assist your cat companion with this common disease.
Ron Carsten, DVM, PhD, CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach. In addition to his Doctor of Veterinary Medicine, he holds a Ph.D. in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. A member the State Board of Veterinary Medicine, he practices integrative veterinary medicine in Glenwood Springs.
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