Diabetes mellitus, or in everyday speech diabetes, is a hormonal disease that occurs in both animals and humans.
There are several different causes of diabetes in cats, but the end result is that the patient lacks insulin or responds poorly or not at all to insulin. Insulin is produced by specific cells in the so-called Langerhans cell islands in the pancreas. Insulin is needed for glucose (sugar) to be absorbed into the cells from the blood. In diabetes, this does not work. Glucose, which can be said to be the cells’ fuel, then remains in the blood. When the concentration of glucose in the blood becomes too high, glucose begins to leak through the kidneys. The sugar in the urine absorbs fluid, the animal urinates more and starts drinking a lot to compensate for the fluid loss.
Diabetes is usually divided into two different forms, called type 1 and type 2 diabetes. In type 1 diabetes, the insulin-producing cells in the pancreas are destroyed and an absolute insulin deficiency occurs in the body. In type 2 diabetes, there is a so-called insulin resistance in the body. Ie. the insulin-producing cells can still produce insulin but the body’s cells do not normally respond to the insulin. If this continues untreated, insulin production risks being damaged in the long run. Type 2 diabetes is the most common in cats. There are several possible causes of insulin resistance, where obesity and physical inactivity are two important causes. Furthermore, treatment with certain medical preparations such as cortisone can cause insulin resistance as well as excess of certain hormones. There is also a genetic predisposition to diabetes in certain breeds, including Burma.
Symptoms of feline diabetes
Symptoms of diabetes in cats are the same as in humans, ie:
- increased thirst
- increased urination
- and often a weight loss despite an increased appetite
The weight loss is due to the body’s cells not being able to assimilate the glucose that is in the blood, ie. the cells starve even though there is plenty of glucose. If diabetes remains untreated, many cats eventually develop movement disorders caused by muscle weakness and nerve damage.
This can be shown by the cat no longer being able to jump up on benches or furniture or by stepping on its hind legs and walking on its hind legs. Cats that develop diabetes are usually middle-aged to older and it is twice as common in male cats as in female cats.
Diseases that can cause similar symptoms as diabetes are, for example, kidney disease, liver disease and hyperthyroidism (overproduction of thyroid hormone).
A serious complication of untreated or poorly controlled diabetes is diabetic ketoacidosis (DKA). Since the cat’s cells are in a state of starvation, a divergent metabolism is seen where the formation of acidic ketone bodies (including acetone) takes place. The blood then has a low pH value which has major negative effects on the whole body.
The body’s enzymes do not work as usual and other effects are disturbances in the salt balance. Symptoms of DKA are lethargy, vomiting, refusal to eat, drowsiness / increased respiratory rate and in very severe cases collapse and unconsciousness.
When should a veterinarian be consulted?
If your cat has symptoms that could be compatible with diabetes, you should contact your veterinarian for an examination. The longer a cat goes with an untreated diabetes, the greater the risk of complications that can be life-threatening. An early treatment also increases the chances for the cat to respond well to the treatment, and some cats may even manage without insulin treatment in the long run.
In the case of ketoacidosis, this is an acute condition that quickly becomes life-threatening. If you have a cat with suspicious symptoms, a veterinarian should therefore be consulted as soon as possible.
The diagnosis is made by detecting elevated blood sugar levels together with an elevated fructosamine, a protein that shows how the blood sugar level has been over time. Elevated blood fat levels are also common. Cats have a special tendency to have elevated blood sugar levels in stressful situations, which is why a single blood test that shows elevated blood sugar is not enough to make the diagnosis. The test is often supplemented with a urine culture to rule out urinary tract infection, which is common in diabetes as the bacteria thrive in the sugary urine. Sometimes additional blood samples are also taken to investigate hormonal diseases that may be the underlying cause of the developed diabetes. If the veterinarian suspects other concomitant diseases, the examination is extended with, for example, an ultrasound examination or X-ray.
When the diagnosis of diabetes is made, both veterinarians and pet owners should ask themselves the question: why does the cat get diabetes now? If it depends on the lifestyle and that the cat is, for example, an overweight indoor cat, it must be included in the treatment plan for the cat. Has the cat been medicated with cortisone? Is the cat suspected of having another underlying disease that triggered the diabetes?
Before starting treatment, you must think through your life situation. The treatment for diabetes is insulin injections that are given under the skin twice a day and one must reckon with the fact that it can be a matter of lifelong treatment. Is there anyone who can take care of the cat when I travel? What do my working hours look like, is there anyone else who can help in everyday life? These questions are very important to reflect on before starting a treatment, both for your own sake and the cat’s.
When a decision has been made to start treatment, the veterinarian or nurse will go through how the injections should be given. As an animal owner, you can try injecting saline solution, which is completely harmless to the cat, a few times to feel safe before the real treatment with insulin continues at home. You will also receive important advice on the appropriate diet for your cat. In diabetes, low-carbohydrate foods are an important part of the treatment. During the review, you will also be informed about the symptoms that you should be aware of at home, for example if the cat should end up in a condition with low blood sugar values. Many of AniCura’s animal hospitals and clinics have nurses who work closely with veterinarians and who have specialist knowledge of diabetes. These can serve as an important support during future treatment.
At the beginning of the treatment, return visits occur frequently, when weight, symptoms and blood sugar are followed up. If there are specific causes for the disease, it is also followed up at the return visits.
It is also possible to learn to measure blood sugar at home with a glucose meter, so-called glucometer. This can be a good way to monitor blood sugar, as the cat usually experiences significantly less stress during this sampling than during visits and sampling at the clinic. Together with the treating veterinarian, it is decided whether this is suitable for your particular cat.
Some cats that start insulin treatment may go into remission, ie may recover either permanently or temporarily. These cases usually manifest themselves so that the insulin dose must be gradually lowered and finally stopped. In the event of a remission, the cat should continue to eat the special diet. You as a pet owner should also keep a close eye on the cat’s weight to reduce the risk of relapse. If a cat that has gone into remission needs cortisone treatment, you as an animal owner should inform the veterinarian that it is a cat in diabetes remission. Then the risk of an initiated treatment must be weighed against the benefit of the same. Maybe there are other possible treatments so that cortisone can be avoided.