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Cat health

Diabetes Mellitus

Diabetes mellitus is a condition where there is an absolute or relative deficiency of the hormone insulin. Insulin is produced by the pancreas in response to a meal and its main actions are to help the body's cells uptake and use substances such as glucose (sugar).

Diabetes mellitus is a condition where there is an absolute or relative deficiency of the hormone insulin. Insulin is produced by the pancreas in response to a meal and its main actions are to help the body'scells uptake and use substances such as glucose (sugar). If the pancreas cannot produce enough insulin the sugar levels in the blood stream rise and spill over into the urine. This causes excess water to be secreted by the kidneys, which produces the classic diabetic signs of increased urination and subsequently, thirst as the body tries to replace the lost water. Because the body cannot effectively utilise building-blocks such as glucose, weight loss and hunger are also common signs of diabetes.

The type of diabetes that most cats get is similar to type 2 diabetes in humans. This is characterised by a loss of sensitivity to insulin by the body's tissues (insulin resistance). As a consequence, the pancreas must produce more and more insulin, until it eventually gets 'burnt-out'.

Why does my cat have diabetes?
The reason why a particular individual becomes diabetic is not completely known. Uncommonly, the pancreas may become destroyed by disease processes. More likely, diabetes is due to a combination of genetic susceptibility, inactivity, obesity and/or a high carbohydrate diet producing insulin resistance.

How is diabetes diagnosed?
In some circumstances diabetes is difficult to diagnose because normal cats may have transiently high blood sugar due to the stress caused by a visit to the vet. Usually, a diagnosis of diabetes is based on the presence of appropriate clinical signs (weight loss, increased hunger, thirst and urination), as well as persistently high levels of sugar in the blood or urine. A fructosamine test can also assess whether the cat's blood sugars have been persistently high.

How is diabetes treated?
Generally, diabetes is treated with a combination of twice daily insulin injections and a change to a high-protein diet. Stopping any drugs that may enhance insulin resistance (such as cortisone or progesterone-like steroids) is advocated, as well as the treatment of any other disease conditions, for example, infections. If the cat is overweight a careful weight loss program is advised as this will often reduce the insulin resistance.

For cats that will not take injections, a small number may respond to oral hypoglycaemic drugs, however these are only really suitable for mildly affected diabetics.

How is the treatment monitored?
The best indication of successful treatment is a reduction of the clinical signs (thirst, urination and hunger). Blood and urine tests can also give an indication of blood sugar levels. You own vet will tailor the appropriate monitoring program for your cat, as every diabetic is different.

Remember, it is important not to increase the dose of your cat's insulin without consulting your veterinarian first.

Can diabetes be cured?
The genetic predisposition to diabetes will always remain, however when other factors such as obesity or drug treatment are removed some diabetic cats may recover after 1-3 months of insulin treatment. This recovery period may last for an extended time, or may only be transient.

What are the long-term consequences of diabetes for my cat?
Left untreated, diabetes mellitus is eventually fatal as the cat becomes progressively dehydrated and energy-starved. Generally, a well-controlled diabetic cat can enjoy a long and happy life.

Diabetic animals are more prone to infections and other conditions such as pancreatitis. They may become very ill if the body starts to metabolise fat, which produces chemicals called ketones. These ketones lead to a condition called diabetic ketoacidosis which can be life threatening if not treated intensively.

Another life-threatening condition that diabetics sometimes face is hypoglycaemia. This occurs when the insulin dose is too high for the body'srequirements and the blood sugar level becomes dangerously low. Signs of this occurrence are: weakness, wobbly gait, disorientation, behavioural changes or seizures. If these signs are mild, offering the cat something to eat is a good idea. Glucose syrup can be applied to the gums if the signs are more severe. Under no circumstances should you attempt to open your cat's mouth if it is having a seizure, as you may get bitten. If you suspect that your cat may be having a hypoglycaemic episode, you should seek urgent veterinary attention.

The most important aspect of your diabetic cat's care is for you to have a good relationship with your regular veterinarian, so that you can readily seek his or her advice if required.

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