Five Minutes to Understanding Feline Diabetes: Symptoms, Diagnosis, and Therapeutic Measures

Why Is It Important to Understand Feline Diabetes?

Obese Cats Are Prone to Diabetes!

According to the Pet Obesity Prevention Association (APOP) in 2018, as much as 60% of domestic cats in the United States are overweight (at least 10% over the normal weight). Research indicates that the risk of diabetes in cats with excessive weight is 4.6 times higher than that in cats with a normal ideal body condition. This means that the more cats are found to be obese, the more will suffer from diabetes.

Symptoms That Are Not Easily Noticed Without Careful Observation!

The early symptoms of diabetes in cats are not apparent, and many owners may even think their cats are in good health until they notice something is wrong. By the time of diagnosis, it usually has led to a number of metabolic-related complications, increasing the risk of death.

Prone to Misdiagnosis and Incorrect Treatment!

The “diagnosis” and “treatment” of feline diabetes remain quite challenging to this day. Incorrect diagnosis and treatment can lead to serious consequences.

What Is Diabetes? Why Do Cats Get Diabetes?

Diabetes is primarily caused by excessively high blood sugar levels, which can trigger a series of the most severe, even fatal, complications. Symptoms include the presence of excessive sugar in the urine due to the blood sugar, attracting more water to be lost through urine, resulting in polyuria.

The reason for high blood sugar levels is the reduction in the secretion of “insulin” in cats, which is used to lower blood sugar, or a decreased response of the body to insulin.

Statistics show that the prevalence of feline diabetes is 0.25%-1%, meaning that out of every 100-400 cats, one cat suffers from diabetes. The physiological mechanism of diabetes in cats is very similar to that in humans, mostly due to a decreased response of peripheral tissues to insulin, known as Type 2 Diabetes.

Which cats are at risk of diabetes? Risk factors for diabetes include:

• Breed: Breeds such as the Burmese, Maine Coon, Siamese, and Russian Blue have a higher incidence rate.
• Age: The older the cat, the higher the risk of disease.
• Gender: Male cats are 1.5 times more likely to develop diabetes than female cats.
• Body Condition: The risk of diabetes in overweight cats is 4.6 times higher than in cats with an ideal body condition.
• Environment:
• Diet: High-calorie diets increase the chances of obesity, and diets high in carbohydrates also raise the index of postprandial hyperglycemia in cats.
• Less activity, indoor living
• Long-term use of long-acting corticosteroids or sex hormones
• Diseases: Pancreatitis, pancreatic tumors, hyperadrenocorticism, acromegaly

Are the Symptoms Obvious? How Do I Know If My Cat Has Diabetes?

The typical symptoms of feline diabetes are “polydipsia, polyuria, polyphagia, and weight loss.”

• Drinking a lot: Drinking more than weight in mL × 50 per day, for example, a 4 kg cat drinking more than 4 × 50 = 200 mL of water per day is considered polydipsia. Owners often say that they used to hardly drink water, but now they often see it drinking water.
• Urinating a lot: The total urine volume exceeding weight in g × 50 per day, for example, a 4 kg cat urinating more than 4 × 50 = 200 g of urine is considered polyuria. Many owners notice that the urine clumps in the litter box are larger or find that the cat frequently goes in and out of the litter box, urinating for a long time at once.
• Eating a lot but losing weight, owners may think they have succeeded in dieting or wonder why the cat is not gaining weight despite eating a lot.

It is worth noting that polydipsia, polyuria, polyphagia, and weight loss are not easily noticed unless deliberately observed or measured. Many owners often do not notice or mistakenly believe that a cat’s willingness to drink water actively and eat a lot but become thin is a good change, ignoring the possibility that it may be symptoms of diabetes.

In addition to the typical symptoms, cats with diabetes may also exhibit: lethargy, hiding, vomiting, diarrhea, weakness in the heels, and a decrease in skin luster.

If intervention is too late, symptoms such as extreme dehydration, jaundice, dehydration shock, and even coma and death may occur.

Can I Know Right Away If My Cat Has Diabetes If I Take It to a Veterinarian?

When visiting the clinic, the veterinarian will make a comprehensive diagnosis of whether the cat has diabetes and its complications based on: clinical symptoms + blood sugar levels + urine tests +/- fructosamine or glycated hemoglobin and other related tests.

The normal blood sugar level for a cat is between 70-150 mg/dL, but! Never forget! Exceeding this value does not necessarily mean the cat has diabetes that needs treatment!

• The most common cause of high blood sugar in cats is transient hyperglycemia caused by stress or fear, which can even lead to temporary glucosuria, but this does not require treatment! Therefore, to rule out stress factors, other tests may be required, or re-testing at different times may be necessary to confirm whether diabetes is truly present. Misdiagnosis and incorrect treatment can very likely trigger fatal hypoglycemia!
• In addition, if there are other serious diseases at the same time, temporary high blood sugar may also occur, which does not mean that diabetes needs immediate treatment!

How to Treat Feline Diabetes?

The key to successful treatment is close cooperation and communication with the attending veterinarian and other caregivers. Feline diabetes is a disease that requires close monitoring; if properly monitored and treatment plans are adjusted, the quality of life for diabetic cats can be as good as that of normal cats, and there is even a chance of cure!

Hospitalization / Home Care / Follow-up Visits

• After confirming diabetes, it is important to follow the veterinarian’s instructions and start treatment as soon as possible. The longer it is delayed, the higher the risk of complications, and severe complications can even lead to death.
• Cats diagnosed with diabetes may be hospitalized for 1-3 days after diagnosis to replenish dehydration, adjust ions, observe appetite, and monitor blood sugar changes after insulin injection (cats with more severe complications usually need to stay for at least a week or more).
• Once the appetite and blood sugar changes are confirmed to be safe for discharge, the brave cat parents will have to start helping the cat inject insulin (methods of insulin injection will be introduced in a separate article later, stay tuned!), adjust diet, and monitor. If even braver parents and cooperative cats can even monitor blood sugar at home.
• Regular follow-up visits for diabetes are very important! It is necessary to return to the clinic according to the veterinarian’s arrangement, mainly to confirm weight, hydration status, muscle mass, blood biochemical values tracking, and continuous blood sugar curve measurement, to know whether the dose and type of insulin need to be adjusted. Usually, it takes several months to achieve stable insulin dosage and good blood sugar control.

Administration of Exogenous Insulin

• There are three common types of insulin: short-acting, intermediate- and long-acting. Each type of insulin has its special storage and drawing methods.
• It depends on the veterinarian’s experience, habits, and assessment of the cat’s current blood sugar status, eating habits, and response to insulin to decide. During the treatment process, it may be necessary to change insulin according to the situation.
• Always follow the veterinarian’s instructions and never change the type and dosage on your own, as there is a significant difference in the efficacy of each insulin.

Proper Diet

• In principle, the daily caloric requirement for the cat’s ideal body condition should be calculated according to the veterinarian’s estimation, and it is essential to accurately calculate whether the cat’s actual daily intake of calories meets the target.
• It is generally recommended to use wet food or prescription feed with a low carbohydrate content (carbohydrate calories less than 12% of total calories), given in small amounts and more frequently. However, the cat’s palatability should still be the main consideration.

Will the Treatment Cost for Feline Diabetes Be High?

High costs mainly come from hospitalization intensive care when diabetes is first diagnosed or during the treatment process when severe complications occur, which may require at least 7-10 days of hospitalization fees, starting at tens of thousands of yuan.

Long-term cumulative costs: the cost of switching to wet food, home blood glucose test strips, insulin syringes, insulin, and regular follow-up visit fees.

Therefore, if diabetes can be detected and treated early, with good home care, there is a chance to avoid expensive high costs.

Will Cats with Diabetes Never Get Better?

Statistics from abroad show that 84% of newly diagnosed diabetic cats can achieve a cure within 6 months if blood sugar is well controlled.

Therefore, cats with diabetes can get better. Early detection of symptoms, treatment, and removal of risk factors that may cause diabetes can potentially allow cats to maintain constant blood sugar levels in the future without the need for insulin injections. However, cats that have recovered still have the chance of recurrence, so regular follow-up visits and diet monitoring are still recommended.

Is There a Way to Prevent Feline Diabetes?

• Avoid obesity and try to maintain the ideal weight for your cat at home. You can ask the veterinarian for the appropriate weight; if it is too heavy, a weight loss plan is needed.
• High-risk cats (the risk factors mentioned above, such as old age, obesity, use of corticosteroids) are advised to eat a low-carbohydrate diet (carbohydrate calories less than 12% of total calories), with the main food being canned food, which is easier to achieve this goal.
• Try to avoid long-term use or injection of corticosteroids (if special diseases must be given, regular tracking of blood sugar levels and attention to symptoms are required).

Conclusion

Cats are masters at hiding diseases, and it is necessary to rely on cat parents to closely observe for symptoms that may suggest diabetes (polydipsia, polyuria, polyphagia, weight loss). Early detection and treatment can potentially lead to a cure for diabetes and prevent severe complications that threaten life and generate high costs. Even if the cat does not get better, with close cooperation with the veterinarian and good blood sugar control, diabetic cats can still have a good quality of life and be able to accompany their owners for a long time!