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Diabetes Mellitus

The Basics

Diabetes mellitus (commonly known as sugar diabetes) occurs due to inadequate production of insulin by the pancreas. Insulin is secreted directly into the circulation and acts upon cell membranes to allow sugar to enter cells. In the cells, the sugar can be metabolized to form energy. Without insulin the body can not use sugar. This results in elevated blood sugar levels - hyperglycaemia (hyperglycemia). The excess sugar is eliminated by the kidneys, causing frequent urination. If a cat has sugar in its urine (glucosuria) on a urine glucose test, diabetes should be suspected. The cat compensates for the increased urination by drinking increased amounts of water.

75% of affected cats are aged between 8 and 13 years.

Ketones (a type of acid) are formed in the blood of diabetics because of the inability to metabolize sugar. High levels of ketones lead to ketoacidosis. The cat will have an acetone smell to its breath (sweet odour like nailpolish remover), rapid laboured breathing and eventually diabetic coma.

In the early stages of diabetes, the cat compensates for the inability to use blood sugar by eating more food. Later, with the effects of malnourishment, there is a drop in appetite.

Early signs of diabetes include:

Frequent urination (polyuria)
Drinking increased amounts of water (polydipsia)
Large appetite (polyphagia)
Unexplained weight loss

Laboratory findings include sugar and acetone in the urine and high blood sugar levels.

In more advanced cases, clinical signs include:

Dehydration
Depression
Ketone breath
Laboured breathing
Lethargy
Loss of appetite (anorexia)
Oily coat with dandruff
Vomiting
Weakness
Coma

Dietary control and daily insulin injections can regulate most diabetic cats. The insulin dose must be established for each individual cat. The cat will need to be hospitalized initially to determine its daily insulin requirement.

Dietary Management

Obesity makes diabetes difficult to control. Overweight cats should be put on a diet until they reach their ideal body weight. Aim to reduce the cat's weight over 2 to 4 months. Feed the cat at 70% of the requirement for the cat's ideal body weight.

Daily caloric requirements are determined by weight and activity level of the cat. The quantity of food needed is calculated by dividing daily caloric requirements by the amount of calories per cup or can.

The daily ration should be divided into 2 smaller meals spaced evenly throughout the day to coincide with twice daily insulin injections. If the cat receives once daily insulin, feed half the food with the injection and the remainder in 8 to 10 hours.

Hyperglycaemia (hyperglycemia) is less likely to occur if a cat is fed a diet high in fibre and low in fat. Dry diets are preferable to canned. Soft moist food causes a severe postprandial hyperglycemia - blood glucose levels rise very quickly soon after eating moist food.

Keep the cats caloric requirement the same from day to day.

How to inject insulin will be explained and demonstrated by your vet.

Insulin Overdose

Overdose of insulin drops the blood sugar levels well below normal - hypoglycaemia (hypoglycemia). The cat appears confused, disoriented, drowsy, shivers, staggers about, collapses, falls into a coma and seizures.

If the cat is conscious and able to swallow, give a sugar solution (corn syrup or honey). If the cat is unable to swallow, rub the solution onto the cat's gums or inside of the cheeks. Recovery should occur within minutes, then immediately take the cat to the vet.

References

Carlson DG & Giffin JM, Cat Owners Home Veterinary Handbook, New York: Howell Book House, 1995

Tilley LP & Smith FWK, The Five Minute Veterinary Consult - Canine and Feline (2nd Edition), Philadelphia: Lippincott Williams and Wilkins, 2000

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