Type II diabetes is a common disease in cats (1). It is an illness that occurs when the body loses its ability to manage sugar (glucose) levels in the blood properly. Decreased physical activity, increased carbohydrate intake, and obesity are all factors that predispose pet cats to diabetes.
When a cat eats, sugar from the food is transferred to the blood. When glucose levels in the blood increase, the hormone insulin is released by the pancreas. Insulin tells the cells of the body to absorb the glucose for use as an energy source. When the cells take up glucose, the blood sugar levels come back down.
When the pancreas does not produce enough insulin, or when the cells don’t respond appropriately to the insulin signal, the blood sugar levels remain high after a meal because the glucose is not getting moved into the cells. High blood sugar levels can be toxic, especially when sustained for a long time. On top of this, when cells do not absorb the glucose that they need for energy, they begin to starve. These impacts combine to give us the typical signs of diabetes: appetite changes, weight loss, and increases in drinking and urination.
Fortunately, diabetes can be treated in cats and may even be put into remission. Below are the primary tools for diabetes management in cats:
Fat is a hormone-producing organ that significantly impacts how cats process glucose and respond to insulin. Lean cats are far less likely to have diabetes compared to overweight cats. Weight loss makes diabetes easier to control in cats and can even reduce or eliminate their need for insulin injections.
Foods that are rich in simple carbohydrates create post-meal spikes in blood sugar. Exaggerated troughs follow blood sugar peaks. Dramatic fluctuations like this make diabetes harder to manage. Diets rich in protein, fat and complex carbohydrates promote more steady blood sugar levels throughout the day, making diabetes more manageable and appetite more stable.
Active, working muscle cells are among the few cells that can absorb glucose without insulin signalling. Exercise helps regulate blood sugar without putting demands on the pancreas to produce more insulin. Active pets are less likely to become diabetic and are more likely to achieve remission if they do. Exercise through play and hunting behaviours can be encouraged with environmental enrichment. Cat toys, lasers, treat balls, trees, and perches are examples of tools that get cats more active.
When the pancreas does not produce enough insulin on its own, this hormone can be given by injection. Diabetic cats usually require insulin injections twice a day. Giving injections at home can sound daunting, but your veterinary team can train you to administer this life-saving medication in a fast and safe manner. Injection pens are easier to handle than traditional needles, and they measure the dose automatically. Cats typically don’t mind the pokes, especially if they’re distracted by a tasty meal or a good petting session.
Glucose monitoring devices
Blood glucose levels can be dangerous when they are too high or too low. Low blood sugar is an emergency in the short term. It can cause weakness, confusion, seizures and even death. In contrast, high blood sugar is a problem in the long term, causing weight loss, nerve damage, and blood chemistry changes that can be fatal if present for an extended period. A typical, healthy cat has blood glucose ranging between 2.6 and 8.4 mmol/L (2). Insulin therapy drives blood sugar levels down. Because it is vital to avoid severe glucose lows, insulin dosing protocols are designed to keep a cat’s blood sugar slightly higher than usual, between 5 and 14 mmol/L throughout the day (2). Cats that are diligently kept in this range may go into diabetic remission. This means that their ability to produce and respond to their insulin normally is recovered, and there is no longer a need to give the injections. The key to achieving remission is adequate monitoring of blood glucose levels at home.
A variety of devices are available for sampling the blood sugar of a cat. The simplest of these are glucose meters identical to those available for human use and calibrated for a cat’s chemistry. They include a lancet for skin-prick blood collection, test strips, and a digital reading device. They are inexpensive and relatively easy to use with a cooperative cat. As always, training can be provided by your veterinary team. More sophisticated monitoring devices are also available that provide continuous monitoring for up to 14 days. These devices eliminate the need for owners to perform skin pricks. Blood glucose monitoring aims to determine the cat’s highest and lowest blood sugar levels during the day and when they happen in relation to insulin administration. This information allows insulin doses to be adjusted to increase safety and to improve the chance of achieving remission.
Bacterial infections, such as urinary tract infections, are more common in diabetic cats. The presence of a disease can make insulin less effective at managing blood sugar levels. Consequently, regular screening for common infections is necessary for good diabetes management.
The take-away message
Diabetes is a severe disease for cats, but effective treatment can help cats live long and healthy lives after a diagnosis. For more information about the latest technology for managing diabetes in your cat, reach out to your family veterinarian.