Your cat has been diagnosed with diabetes. This is a disease that occurs when the pancreas is no longer able to produce enough insulin to control blood sugar levels. The worst consequences of diabetes can be life-threatening, so treatment is important. Diabetes in most cats requires treatment and monitoring for the rest of their lives.
There are a few diseases that can occur in conjunction with diabetes. Your vet may recommend additional testing for these diseases, as their presence may cause your cat pain and/or make the diabetes more difficult to control.
- Urinary tract infection – diabetic cats have glucose (sugar) present in their urine. This sugar is a perfect food source for bacteria, which can multiply in the bladder and cause a UTI. Urinary tract infections are diagnosed by a urinary culture, and we recommend having a urinary culture done at least every 6 months in diabetic patients.
- Pancreatitis (inflammation in the pancreas) – a common and often painful condition occurring in cats with diabetes. In some cases pancreatitis may have been the initial cause of the diabetes. If present, pancreatitis requires longterm treatment in addition to the usual diabetes treatment.
Risks of Diabetes
As well as the concurrent diseases mentioned above, there are some other potential complications of diabetes. These include:
- Ketoacidosis – a life-threatening complication of diabetes. It occurs only rarely in cats with well controlled diabetes, and is something that we regularly check for with blood & urine tests. Symptoms include poor appetite and vomiting and requires immediate veterinary attention.
There are 3 components to treatment of diabetes:
- Insulin injections – done twice daily at home, we will teach you how to give these injections – it is easier than you think and will soon become a normal part of your daily routine
- Diet – it is best to feed your cat a prescription diet specifically formulated for cats with diabetes. These diets are designed to have a low GI index (slow energy release), to avoid blood sugar spikes throughout the day.
- Monitoring – initially your cat will have to come to the clinic every 1-2 weeks to spend the day with us while we measure blood sugar levels over the course of the day (called a blood glucose curve). These visits will become less frequent after we find your cat’s correct insulin dose. There will also be some monitoring to be done at home.
Other considerations – it is very important for diabetic patients to have CONSISTENCY in their lifestyle in order to keep their blood sugar levels stable. This means their daily regime should be the same every day whenever possible.
Also critical for diabetic patients is to maintain a healthy weight. So we will aim to adjust feeding amounts of over- or under-weight patients in order to slowly achieve a healthy weight.
- We will teach you how to give injections.
- Lantus glargine should be stored in the fridge.
- Do not use alcohol wipes or any sort of disinfectant on the skin.
- Injections should be given every 12 hours. If an injection cannot be given within 2 hours of the usual time (e.g. you are going out all evening), it is best to miss that dose completely. Occasionally missing a single injection does not cause problems.
- You should offer your cat’s food just prior to giving insulin to ensure that they eat. If they do not eat anything, only give half the usual insulin dose. If your cat misses 2 meals in a row, stop insulin injections and contact the clinic to book a blood sugar check
Things to monitor at home – please bring these records to every recheck at the clinic, as they form an important part of working out your cat’s insulin dose.
- Hypoglycaemia (low blood sugar) – this occurs when your cat’s blood sugar levels have got dangerously low. This can occur if your cat gets too much insulin, or doesn’t eat when they should, or exercises excessively. Signs to look out for include your cat looking wobbly or weak on their legs, disorientation and in the worst cases may lead to collapse or seizures. If you think your cat looks wobbly, please rub some honey or glucose syrup on their gums, offer them some food, and get them to a veterinary clinic ASAP. You should keep some honey or glucose syrup in the cupboard at home at all times for this purpose.
- Appetite – please keep a daily log of your cat’s appetite.
- Water intake – it is VERY useful to monitor your cat’s water intake at home twice weekly. This is most easily done by measuring the volume of water in your cat’s water bowl at the beginning and end of a 24 hour period and calculating the difference.
- Urine dipstick – most chemists will sell “ketostix” urine dipsticks. You can dip these strips into a sample of your cat’s urine once to twice weekly and keep a record of the results. Once your cat’s diabetes is controlled, the glucose in the urine should be 0-1+, and the ketones in the urine should be negative.
- Body weight – done every 1-2 weeks either at the clinic or at home if you have accurate scales.
- Blood glucose curves – in the future, we can teach you how to take blood sugar measurements at home, so you can do your own blood glucose curves. This is not for everyone, so we are more than happy to do blood glucose curves in the clinic for you.
Things we monitor at the clinic
- Blood glucose curves – The most important test for determining your cat’s insulin dose is a blood glucose curve. Initially we will do this every 1-2 weeks. It will probably take a couple of months for us to find the correct insulin dose, as this is not something that we can rush. Once the correct dose is found, blood glucose curves can be done less frequently and eventually every 3-6 months. For this test, you should give your cat breakfast and insulin in the morning as usual, and then bring your cat to the clinic as soon as possible afterwards.
- Urine culture – done every 6 months to check for urinary tract infections