Diabetes: what does it
mean for my cat and me?
The incidence of
feline diabetes is
on the increase,
with a recent
UK survey
suggesting that
nearly 1 in
200 cats are
diabetic.
This article,
from FAB’s
feline expert
panel, addresses
the practicalities
of dealing with
a diabetic cat.
It is designed
to be read in
conjunction
with FAB’s
information
sheet on
‘managing the
diabetic cat’
(available at
www.fabcats.org
/owners/diabetes/
info.html), which
discusses how
the disease is
diagnosed and
treated.
It will also be explained to
you how to store insulin, how
to draw up an accurate dose
and how to give the injection.
You will find out what to monitor your cat for – in particular,
signs of an insulin overdose.
You may be asked to collect
some urine samples from
your cat (and advised how to
do this!), and, if necessary,
given advice on what diet to
feed, how much food to give
and when to give it.
Another appointment will
be arranged for fairly soon
afterwards to assess how you
and your cat are getting on.
Despite being such a
common disease, feline
diabetes is often surrounded by much confusion. The disease has many
differences when compared
with diabetes mellitus in
people (and in dogs), and it
can be difficult to manage.
However, with the right information and support, and
by working closely with their
veterinary practice, owners
of diabetic cats usually
cope well. Indeed, as an
owner, you play a vital role
in maximising the chance of
successful treatment.
What to expect
Common questions and concerns
If your cat is diagnosed with diabetes, your
vet or veterinary nurse will first want to ensure
that you fully understand what the disease is,
and what the implications are of having a diabetic cat. Any additional concerns that need
to be addressed in order to successfully treat
the diabetes in your cat (eg, obesity) will be
discussed.
Did you know?
● Obesity is a common cause of
diabetes, so preventing obesity can
prevent diabetes in some cats
● Early in the course of the disease
you may not notice anything is wrong
with your cat. Routine health checks
at your veterinary surgery, including
urine checks, can help pick up early
signs of diabetes
● If diabetic cats are treated and monitored intensively early on, as many as
50–60% of them may recover (ie, their
diabetes will be transient, meaning
they won’t necessarily need insulin for
the rest of their lives). Unfortunately, it
is not possible to predict which cats
will fall into this category – other cats
will require lifelong treatment
My
cat is only 7 years
old, so surely can’t
have diabetes?
Although often thought of as a disease of older age, diabetes in cats
actually occurs most commonly
in the ‘mature’ life stage – that
is, in cats aged 7–10 years.
Diabetes is caused by many different factors.
My
The disease has been seen in sibling cats
cat has just
but there is no firm evidence that genetbeen diagnosed with
ics plays a role. It is extremely unlikely
diabetes – is his
that the brother will also get diabetes,
brother also at
but he should be monitored for early
risk?
signs of the disease through routine veterinary health checks, as your cats may share
lifestyle risk factors for the condition that should be addressed,
rather than a genetic link. FAB’s ‘WellCat for Life’ programme
(see page 2) provides a ‘gold standard’ for what routine monitoring checks are advisable and when these should be performed throughout life, encouraging owners and veterinary
practices to work together to form a partnership of care for the
benefit of cats.
The one exception, however, would be if your cat is a
Burmese – the risk in some lines of this breed is 1 in 10, and
there have been many cases where siblings have been affected.
Will my cat need
insulin injections for
the rest of her life?
Many cats will need lifelong insulin
treatment. However, when diabetes is detected early in the
course of the disease, and optimal
c a t owner
p o
i
n t e r s
cat health updates and advice from the Feline Advisory Bureau www.fabcats.org
p o i n t e r s 3
2 p o i n t e r s
WellCat for life
www.fabcats.org/wellcat/for_life
The WellCat for Life programme has been
developed by FAB’s feline expert panel to help
veterinary practices and cat owners to work in
partnership to ensure cats can enjoy long,
happy, healthy lives. It sets out the health
and care requirements of cats at all life
stages and warns owners of disease
risks, and the associated signs, to
be vigilant for.
given at about the same time every day, 12 hours apart if twicedaily insulin is being used, it will not be too detrimental if, for example, on some days insulin is only given once, or there is a
slightly longer gap between injections. Ultimately, the treatment
has to be practical for you, and having a slightly different regime
is going to be better for your cat than not being treated at all. The
only thing to be careful about is not giving the insulin too soon –
injections should not be given more frequently than every 10
hours. Work out with your vet a treatment regime that will be most
optimal while still being achievable for you.
Obviously you should aim to follow your vet’s
instructions as closely as possible, but if you
What happens if I
do miss giving your cat a dose, don’t panic.
miss giving a dose
As long as it does not happen regularly,
of insulin?
missing the odd dose of insulin will not be
detrimental.
Research has shown that feeding a high
protein and low carbohydrate diet in
combination with insulin treatment will
improve the control of diabetes and
increase the chance of remission from diabetes. There are prescription diets available that are ideally
formulated – discuss these with your vet. If for any reason you
are unable to feed a prescription diet, then look for the supermarket feline diet with the lowest carbohydrate and highest protein levels, ensuring that you choose a complete diet. ‘Wet’ diets
will be lower in carbohydrate than dry diets, and so are generally
preferable. Usually higher protein diets are also more palatable.
However, if your cat is especially fussy and won’t eat a recommended diet, then don’t worry – it is better that your cat eats
normal amounts of a diet that it likes, than ends up not eating
enough of the chosen diet.
Do I need to feed
my cat a special
diet?
treatment (ie, twice-daily insulin injections) is started promptly,
with close monitoring, then in up to 50–60% of cats, the need
for insulin may actually resolve, often within the first few months
of treatment. So being extra vigilant early on can really pay off!
There are tablets that in occasional
cases will reduce blood sugar a
I just don’t think I am
little, but generally they aren’t
going to manage to give my
cat injections daily. Aren’t there very effective in cats. They may
be worth a try if there really is no
any other options such as
possibility of you being able to
tablets?
give insulin daily at home. However,
if at all possible, give insulin a go. Most
owners find it daunting at first (you are certainly not alone!), but
you may be surprised to find that it isn’t that difficult once you get
used to it. The needles are very fine so your cat will hardly feel the
injection – in practice most people find giving injections easier
than giving tablets! Also, if you start insulin early on there is a
good chance that the diabetes may be transient, and your cat
will not need lifelong treatment. Conversely, if there is a delay in
starting insulin treatment, then it is much more likely that the only
treatment option for your cat will be insulin for life. So you really
have nothing to lose and everything to gain by giving it a go!
Your vet will instruct you on how often the
insulin needs to be given as it will partly
Is one injection a
depend on the type of insulin being
day of insulin enough,
used, and your cat’s individual response
or does it have to be
to the treatment. However, if you can
injected twice daily?
really only manage one injection a day then
this is going to be better than not treating the
diabetes at all, and you may still be able to achieve good resolution of your cat’s signs. However, twice-daily injections will increase the chance that your cat’s diabetes may only be transient
and that insulin will not be required for life. So, although treatment may be more difficult to manage in the short term, it may
well be worth it in the long term.
Don’t worry, you can
work around this.
Although the absolute
ideal is for insulin to be
I work shifts, which means I
can’t be around to give insulin
every 12 hours every day. What
should I do?
Generally, you can continue feeding your cat at the same times
that you fed it before it became
diabetic. So, if your cat grazes
food throughout the day, it is fine for
this to continue. The only exception is if your cat is on a weight
loss or calorie-restricted diet and would eat the whole ration all at
once! If this is the case, the food needs to be divided into separate meals. The precise feeding times can be tailored to you and
your cat – discuss a feeding regime with your vet.
Do
I have to feed my cat
at certain times?
If your cat is on a calorierestricted diet then any
Can I still give my cat treats?
treats need to be
‘counted’ in his/her daily
ration (discuss this with your vet). However, in principle, it is fine
to still feed treats. Just avoid treats that are high in carbohydrates
and instead choose ones that are high in protein, such as
chicken, fish or prawns.
Yes, there are plenty of
I have an overweight cat but I
things you can try!
just can’t get him to lose weight.
● Have your cat’s weight
Any tips?
checked regularly at a pet
slimmers’ clinic or by a veterinary
nurse. Regular contact with the pet slimmers’ nurse can dramatically help with your pet’s weight loss. Feeding quantities
may need adjusting in order to find the correct amount for
your cat.
● Weigh out your cat’s daily food allowance in the morning,
and place it in a container to divide between the allocated
meals. This way you are less likely to overfeed your cat. You
can take out a few kibbles to give as treats throughout the
day.
● It is important that no ‘extras’ are added to your cat’s daily
allocated allowance. This includes milk and cat milk!
● Increase your cat’s exercise levels gently in collaboration
with the pet slimmers’ nurse, who can help to design an
exercise programme. Cats can exercise by use of toys, light
torches, etc. Remember, ‘little and often’ is generally more
beneficial for weight loss.
● Trying placing the food in
different areas or hide kibbles around the house/room
to encourage your cat to
exercise more. A food ball or
‘puzzle’ feeder is also ideal
– making your cat work a
little to get its food.
● If you have more than one
cat, it important to feed them
separately and to watch over
them when they eat. If just
one of the cats is obese, try
feeding the others on a high
surface that the obese cat
cannot jump on to, or perhaps feed them in a box with
only a small entry hole that the
obese cat cannot squeeze
through!
● It is a good idea to inform
your neighbours that your
cat is going on a weight loss
programme, so they are not tempted to feed it.
● For the weight loss programme to be successful, you will
need to make sure that everyone involved in caring for your
cat, and who may feed it, is ‘on side’.
Unfortunately, this is very
variable and so your vet
How long will it take for the
will not be able to give
treatment to control my cat’s
you a precise answer.
diabetes?
Cats
can
be
very
unpredictable in their response to
treatment – both in terms of the type of insulin and the dose that
they need. While some cats will become stable very quickly,
others can take months to stabilise. This can undoubtedly be frustrating, but it is vital not to get impatient. Increasing the dose of insulin too quickly or too frequently can lead to serious problems,
and it can end up taking even longer to stabilise the diabetes. A
very low dose of insulin is always used to begin with. Then, depending on your cat’s response, this is increased by a very small
amount, and no more frequently than every 3–5 days. Try not to
get frustrated if it is taking months to stabilise your cat – this
is normal and you will get there in the end. Patience definitely
pays off!
This will depend on
your individual cat,
but generally you
may need to visit
the vet at least weekly in
the early stages of treatment. This will be tailored, as far as possible, to suit you. If a weekly visit is not workable for you, a schedule with less frequent veterinary visits can be discussed. It is
important to be open with your vet about how often you can bring
your cat in for a check-up so that the treatment can be tailored
accordingly. Closer monitoring (ie, frequent check-ups) in the
early stages will increase the
chance of your cat’s requirements for insulin actually
resolving, but this is not
possible for all owners. Good
control, with resolution of the
signs of diabetes, is still possible with less frequent
check-ups. Once your cat’s
diabetes is stable, then veterinary check-ups every 3–6
months are recommended.
How often will I have to take my cat
to the vet?
Parameters
What
that
are
is involved in
useful for
monitoring my cat,
you
to
and what do I need
monitor in
to do at home?
your
cat
are detailed
on the ‘owner instruction sheet’ on the next page.
Ideally, the more of this information that you can give your vet, the more help it will be in treating your cat’s diabetes. However, monitoring requirements will
depend on your individual cat, and a realistic schedule of what
you can monitor can be discussed and decided with your vet, to
take into account your lifestyle and your cat’s needs. For example, some owners may choose to take on measuring their cat’s
blood sugar levels at home; others will feel happier simply monitoring whether their cat’s appetite and thirst is increasing or decreasing. In addition to home monitoring, regular check-ups with
your vet will be required, as discussed above.
Don’t be afraid . . .
. . . to ask your veterinary surgeon or
veterinary nurse for further information or explanation if there is anything
you don’t understand at any stage.
They will be well aware that owning a
diabetic cat can be fairly daunting to
begin with, and that there is a lot of
information to take in.
Acknowledgements: The diabetes prevalence data quoted on page 1 was provided by pet insurer, Pet Protect.
www.fabcats.org
FAB is the leading charity dedicated to feline wellbeing through improved feline knowledge
FAB, Taeselbury, High Street, Tisbury, Wiltshire SP3 6LD, UK, telephone 0870 742 2278, [email protected]
Registered Charity No: 1117342 © Feline Advisory Bureau
diabetic cats
7
OWNER INSTRUCTION SHEET
cat:
Name
Date diabetes diagnosed
Weight at time of diagnosis
Estimated ideal weight
diet:
Food
Amount to be fed
Frequency/timing of feeding
insulin:
Insulin type
Dose
storage instructions The insulin bottle should be kept in the door of the fridge at all times. It is important that it is
not frozen or left out at any time, as this will damage the insulin.
administering the insulin When the insulin bottle is taken out of the fridge it should be gently turned up and down to
mix the contents (do not shake the bottle vigorously as this will damage the insulin). The correct amount of insulin should
be drawn up in the appropriate syringe provided by your vet, and injected under the skin on the scruff of your cat’s neck,
as demonstrated by your vet. More than one type of insulin syringe is available, and it is very important to use the correct
type. The wrong syringe might mean your cat receives an incorrect amount of insulin, which can be dangerous.
additional medication:
monitoring your cat for signs of inadequate control of diabetes:
Please keep a diary for your cat, recording the following observations:
● Bodyweight
Take recordings at least every 2 weeks if your cat is on a weight loss programme. A subjective
assessment of body condition should also be made regularly
● Demeanour
eg, Bright and active, or lethargic and weak
● Appetite
Amount eaten daily; eg, normal amount, less than normal (approximately how much less?) or cat
more hungry than normal?
● Thirst
Amount drunk daily; volume (either measured or approximate) or normal/increased/decreased?
● Coat
General condition
● Urination
Frequency/volume of urination; if cat uses a litter tray, normal/increased/decreased frequency and/or
volume of urination (eg, more or larger ‘clumps’ of litter). Weighing tray daily (at the same time) can
also give a measure of any change in volume of urine being produced
● Urine ketones
Measured periodically using a dipstick, as directed by your vet
monitoring your cat for signs of insulin overdosage (hypoglycaemia):
Signs of hypoglycaemia (low blood sugar) can occur at any time but are most likely at the time of maximal insulin action, which
is usually around 4–8 hours after giving insulin, depending on the type of insulin your cat is receiving. The lower the blood sugar
levels go, and the more rapidly they drop, the more severe the signs will be. In order of increasing severity these include:
Wanting to hide, lethargy, weakness
Hunger
Disorientation and/or apparent blindness
Shaking, wobbliness
Collapse
Seizures
Hypoglycaemia can be life threatening if left untreated so it is very important that early signs are recognised and treated
what to do if you notice any of these signs:
If signs are mild and your cat will eat, offering food may be enough to relieve the signs. If signs are more severe, or if your cat will
not eat, glucose syrup, honey, jam or sugar water can be rubbed on the gums. Your veterinary surgeon should then be contacted
for further advice. If signs have progressed to collapse or seizures, an emergency vet should be contacted immediately.