A Pet Owner’s Guide to Diabetes in Cats

by | May 28, 2024

Liza Cahn, DVM

Chances are you’ve heard of diabetes. In fact, most people have a friend or family member dealing with this common medical condition. But did you know that this could include your cat? Many pet parents find a diabetes diagnosis to be stressful and overwhelming, especially since it involves learning to give their pet insulin injections. Let’s explore how to spot the common signs of diabetes in cats and how this condition can be diagnosed and managed so that your feline friend can go on to live a happy, healthy life. 

What is Diabetes in Cats? 

Diabetes mellitus (aka sugar diabetes) is a disease of the pancreas in which the body can’t properly control blood sugar (glucose) levels. Glucose is a vital energy source, but in diabetics, it builds up in the bloodstream instead of fueling the body. 

Think of your cat’s body needing a key to unlock cells and let glucose in to be used for energy. This “key” is a hormone called insulin, made by the pancreas. In diabetics, either the pancreas doesn’t produce enough insulin or the body doesn’t respond to it properly. Without enough working insulin, glucose stays “locked out,” leading to high blood sugar and starving cells.

It is most common for cats to develop diabetes associated with insulin resistance. In this case, their body still continues to produce insulin, but their cells don’t respond to it appropriately. This is similar to Type II diabetes. Dogs, on the other hand, generally develop Type I diabetes, in which their pancreas does not produce enough insulin. 

Whichever type of diabetes your pet develops, the end result is the same – the cells cannot access the nutrients they need despite increased glucose in the blood. This elevated blood sugar is know as hyperglycemia.  

Symptoms of Feline Diabetes

It’s important to be aware of the common symptoms of cat diabetes. If you are concerned that your cat is diabetic, contact your veterinarian as soon as possible. 

Increased Thirst and Urination

One of the earliest and most common signs of diabetes in cats is an increase in thirst and urination, known as polyuria and polydipsia. In diabetic cats, excess glucose overflows into the urine, drawing more water with it. You may notice that your cat’s litter box needs to be cleaned more frequently, or they may even have accidents in the house. You will also see your cat drinking more than usual to try to make up for this fluid loss and associated state of dehydration. 

Weight Loss Despite a Good Appetite

Diabetic cats lose weight even though they eat normally or more than usual. Even though there is excess glucose in the bloodstream, the cells are not able to utilize it for energy, therefore essentially putting your cat into starvation mode. To compensate, their body begins to break down fat and protein stores, resulting in weight loss and muscle wasting. At the same time, they  continue to eat more to try to fuel their body. 

Other Symptoms 

  • Recurrent infections: High blood sugar levels can make diabetic pets more susceptible to infections, particularly urinary tract infections.
  • Poor coat quality: Sick cats may be less likely to groom themselves, resulting in an unkempt or greasy appearance. 
  • Plantigrade stance: In severe or uncontrolled cases of diabetes, some cats may adopt an unusual posture where they stand flat on their heels due to a complication called diabetic neuropathy.
  • Lethargy, vomiting, diarrhea, loss of appetite, and depression can be signs of a life-threatening complication of diabetes known as diabetic ketoacidosis (DKA). 
  • While most dogs with diabetes end up developing cataracts, this is not common in diabetic cats. 

What Causes Diabetes? 

Diabetes occurs in one out of every 100 to 500 cats. Several things can contribute to a cat developing diabetes. Some of the most common risk factors include:

  • Obesity: Obese cats are up to four times more likely to develop diabetes than those at an ideal body condition. Overweight cats and those who do not live an active lifestyle are also at increased risk. 
  • Age: Diabetes is more common in older cats.
  • Gender: Males are diagnosed with diabetes more often than females.  
  • Breed: Certain breeds, like Burmese cats, have a higher risk.
  • Medications: Long-term use of certain medications, like steroids, can sometimes trigger diabetes. Steroids may be used to treat other common feline medical conditions, such as asthma, allergies, and inflammatory bowel disease, among other things. 
  • Chronic illness: Underlying conditions like pancreatitis can increase the risk.

How Vets Diagnose Feline Diabetes

Diabetes is diagnosed when blood sugar levels are persistently elevated in your cat’s blood and urine. Your vet will begin by getting a thorough medical history and performing a nose-to-tail physical exam, followed by several important diagnostic tests. 

Blood tests focus on detecting elevated blood glucose levels. A single high blood sugar reading could be caused by stress or other disease, so your vet may recommend retesting or running an additional test called a fructosamine test, which reflects average blood sugar levels over the past couple of weeks.  

Urine samples get analyzed for the presence of glucose, which shouldn’t be found in the urine of healthy cats. A urine culture is also recommended to check for urinary tract infection, which is often present in diabetic animals. 

In some cases, additional testing might be needed to rule out other conditions that mimic diabetes symptoms or to identify any underlying health issues contributing to the diabetes.

Treatment of Diabetes in Cats

Thankfully, with proper management, most diabetic cats can live long and happy lives. Some cats even reach a state of remission, in which insulin therapy is no longer needed. Treatment aims to keep blood glucose near a normal level, alleviating symptoms and the risk of complications. Here’s what cat diabetes treatment usually involves:

  • Insulin injections: Most diabetic cats require regular insulin injections to control their blood sugar. There are several different types of insulin available for cats. While this may feel overwhelming for many pet parents, these twice-daily injections involve a very tiny needle and generally don’t bother your cat! Your veterinary team will teach you how to administer injections at home and provide detailed instructions about the dosage and timing of injections. 
  • Dietary changes: Your vet will recommend a diet specifically formulated for diabetic cats that is high in protein and low in carbohydrates. 
  • Oral medications: Oral medications known as SGLT2 (sodium-glucose cotransporter 2) inhibitors may be used in certain cases to help manage elevated blood sugar and associated symptoms of diabetes, but are less common and effective than insulin injections at this time. 
  • Weight management: If your cat is overweight, reaching a healthy weight is crucial.
  • Regular monitoring: You may need to learn to monitor your cat’s blood sugar levels at home or have them checked by your veterinarian regularly. Monitoring blood sugar levels is especially important for newly diabetic cats just starting insulin as it helps determine the appropriate dosage. This is generally accomplished through a blood glucose curve (a series of blood glucose measurements throughout the day). Your vet may also be able to place a continuous glucose monitoring device to help monitor glucose levels. Keeping track of your cat’s weight and symptoms is another important part of determining their response to treatment. 

Living With a Diabetic Cat 

Caring for a diabetic cat requires dedication and commitment for the rest of your cat’s life, but it’s incredibly rewarding. This not only involves following your vet’s treatment recommendations regarding insulin injections and diet, but providing your cat with plenty of exercise to keep them at a healthy weight, watching out for potential complications, and carefully monitoring their symptoms and blood sugar levels. 

Complications of Diabetes

It’s important to manage diabetes carefully to avoid complications such as:

  • Hypoglycemia: This refers to dangerously low blood sugar levels. It can occur if a cat receives too much insulin or doesn’t eat enough. Signs include weakness, unsteadiness, disorientation, seizures, or coma.
  • Diabetic ketoacidosis: This is a life-threatening condition that occurs due to severe or uncontrolled diabetes. The body starts breaking down fat rapidly for energy, producing byproducts called ketones. High ketone levels make the blood dangerously acidic, and leading to symptoms of illness such as vomiting, diarrhea, and lethargy. DKA requires urgent veterinary care.
  • Increased susceptibility to infections: Diabetic cats are more prone to infections, especially urinary tract infections. 
  • Diabetic neuropathy: Long-term, uncontrolled diabetes can contribute to diabetic neuropathy (nerve damage often affecting the hind legs).

Prognosis and Remission of Feline Diabetes 

It’s encouraging to know that some cats with diabetes can achieve remission. This means they no longer require insulin injections to maintain normal blood sugar levels. Remission is more likely with early diagnosis and excellent management, including weight loss, diet change, and insulin injections. However, even cats in remission require ongoing monitoring, as diabetes can potentially return. 

Even if your cat needs long-term insulin therapy to manage their condition, they can still live a happy and fulfilling life. The specific prognosis varies from cat to cat depending on how well the diabetes is controlled, whether any complications develop, and the cat’s overall health, but in general diabetes doesn’t shorten a ca’t life expectancy. 

You can help decrease your cat’s risk of developing diabetes by keeping them at an ideal body weight, providing plenty of opportunities for physical activity, feeding a complete and balanced WSAVA-compliant commercial cat food, and keeping up-to-date on routine wellness care.

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