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Feline Diabetes Treatment Fact Sheet

This fact sheet covers the general principles for the treatment of diabetes mellitus in cats.

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Introduction

Unlike in human Type II diabetes, in cats alterations in diet and lifestyle are not typically effective at reversing the disease process on their own, and as such all cats diagnosed with diabetes will require treatment with insulin.

Insulin is given by injection under the skin (in a similar manner to when your vet administers vaccinations), and is performed at home. Treatment with insulin is generally combined with a standardised dietary regime, with the main focus being on maintaining a consistent routine from one day to the next in order to allow the best possible stabilisation of the disease.

The aim of treatment in diabetes is to maintain a blood glucose level a little above that seen in a normal cat for as much of the day as possible in order that the signs of diabetes (drinking, urinating and weight loss) are eliminated. Blood sugar levels will vary widely throughout the day even in well managed cats, and so they are kept slightly above normal levels to reduce the risk that they will drop too low. As a result of this we would expect the blood sugar to be high on some occasions and, therefore, it is important to realise that this is not necessarily a sign of poor disease control.

For more detailed information on Insulin treatment – Click here to read our Insulin Therapy in cats fact sheet

How can diet be used to control feline diabetes?

Diets are available that are designed specifically for diabetic cats, and these may increase the chance that your cat’s diabetes goes into ‘remission’ (see below for more information on this). Diabetic diets for cats are designed to have a very low carbohydrate level, as this is thought to reduce the upward drive for blood glucose after eating, reducing any peaks in glucose levels and therefore reducing overall blood sugar. Ideally, all cats with diabetes would receive one of these diets, however, this is not practical in all cases. Some cats require specific diets for other diseases (for example kidney disease or pancreatic disease), which almost always take precedence, and so cannot be changed. Other cats are particularly fussy where food is concerned and will refuse to eat a new diet.

The absolute priority with diabetic cats is consistent food intake. Many will have lost weight due to diabetes and this process needs to be arrested as quickly as possible. As such, whilst diabetic diets are helpful, the overriding aim is to ensure food is being eaten. This means that in the first instance, the best diet to use is the one that they will eat! Stabilisation of a diabetic cat is possible on most complete diets, with the only difference being the likelihood of diabetic remission.

Much more important than the type of food is the amount of food they are given. This should be kept consistent each day as far as is possible – ideally the same volume of the same food every day, offered at the same time to allow them to develop a consistent routine. How quickly the food is eaten is not especially important in cats, and many cats refuse to meal feed, favouring an ad lib approach where they gradually work their way through the food as the day goes on. Both meal feeding and ad lib feeding are fine in feline diabetes as cats do not get the same blood sugar peaks after eating that dogs and humans do (which requires food and insulin to go in at the same time).

In some cats, regular diet change is required in order to keep them interested in eating. This makes stabilisation a little more difficult, but if your cat is one of these, it can help to have a list of 4 or 5 diets that you can rotate through. Working out the appropriate volume of each so that they have similar energy volumes is helpful for stability.

What other aspects of treatment of diabetes in cats do I need to be aware of?

Other important aspects of treatment in diabetics include:

  • Weight loss in overweight cats. This needs to be done in a controlled way but successful slow-and-steady weight loss as part of a calorie-controlled diet can vastly improve diabetic control and the likelihood of achieving resistance. It is very important that this is done in consultation with your local vet practice to avoid overly rapid weight loss and its consequences. We aim for loss of about 1% of body weight weekly.
  • Treatment of other underlying diseases that pre-dispose to diabetes.
  • Avoiding use of steroid drugs where possible. For cats being treated with steroids, transition to an alternative drug is highly desirable if possible.
  • In some cases where cats present very unwell (diabetic ketoacidosis), a period of hospitalisation for intensive management of blood glucose may be required to control the disease. This can take a number of days (sometimes longer), but once the ketoacidosis is resolved and the cat is eating, the treatment plan is the same as described above.

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