Initiating Treatment of the Diabetic Cat

Take your cat to the veterinarian for tests to confirm the diagnosis of diabetes. Just because your cat is drinking and peeing a lot and perhaps losing weight, the cause may not be feline diabetes. Even if you have tested your cat's blood sugar several times and found it high, only your veterinarian can make a definitive diagnosis.

Your veterinarian will probably suggest insulin shots and should also discuss dietary changes that will help your cat. If your veterinarian wants you to start your cat on a special DRY food for diabetics, please educate yourself about diet and diabetes and discuss your options with your veterinarian. Recent veterinary research has repeatedly confirmed that wet food low in carbohydrates and high in protein is best for all cats, especially diabetic cats. Do NOT buy any dry prescription food from your veterinarian.

Your vet may suggest that your cat be hospitalized for "regulation" and treatment. If your cat is very ill, specifically with a condition called ketosis, hospitalization is advised. Most cats do NOT need to be hospitalized to begin treatment for their diabetes and current veterinary practice guidelines indicate that iff your cat is alert, well-hydrated, eating and drinking without vomiting, your cat can be managed as an outpatient.

Your veterinarian should demonstrate the technique for giving insulin shots. Many excellent on-line guides are also available. Please note that many veterinarians still suggest giving the insulin shot in the scruff of the neck. Due to a poor blood supply in this area, the scruff is not the best place to give insulin shots so please use alternative injection sites such as along the cat's sides.

Insulin shots in the cat are started twice a day, usually at 1-2 units of insulin per shot. Cats should not be started at higher doses of insulin. At one time, a type of human insulin called NPH, or N, was the insulin of choice for the cat, due to lack of better choices. The molecular structure of NPH insulin is very different from that of cat insulin. Cats have unpredictable responses to NPH (N) insulin. If your veterinarian suggests this type of insulin, educate yourself and then your vet.

PZI insulin was often used until recently but is being discontinued. Vetsulin is pushed by pharmaceutical representatives and is good for dogs but is not the best choice for your cat. Newer insulins such as glargine (Lantus) and detemir (Levemir) show great promise. The effectiveness of glargine (Lantus) is well-documented, has a high rate of inducing remission of diabetes in cats diagnosed within 6 months of starting this insulin, and has published protocols (see Roomp and Rand, 2008, available on this site in Health Articles) for its use.

Once your cat is started on insulin, you should monitor your cat at home. Usually, you do not need to take your cat in to your vet for weekly blood tests. There are various methods of monitoring your cat at home and veterinarians disagree as to the best method although opinions among caretakers and vets are becoming strongly directed toward using a glucometer to test the cat's blood glucose levels, just as human diabetics do. The monitoring section of this website can give you more information. You are urged to monitor at home using either blood testing. Monitoring may seem intimidating but is easily tolerated by the cats and can be learned by the vast majority of caretakers. If you absolute cannot do glucometer testing, at least use urine test strips. Your only other alternative, a poor one due to stress on your cat and expense, is to take your cat in and let your vet do the testing.

To monitor, you can also simply observe your cat for the resolution of symptoms. If your cat starts drinking and peeing normal amounts and its weight normalizes, it can be considered regulated. This method only works if you keep insulin doses low and do not increase the dosage amount without using other monitoring methods. Urine testing is advocated by many veterinarians and you have various options for collecting urine, including the Smart Cat Box, a specialized litter box. Perhaps the most accurate method is to use a glucometer to test blood glucose levels just like human diabetics do. Blood testing sounds intimidating, but more than 90% of cat caretakers learn to do it successfully.

References and Links:

• The 5-minute Veterinary Consult, 3rd edition. Published 2004. Please note that the section on "Diabetes Mellitus Without Complications" contains outdated information on diet, monitoring and types of insulin.
  
  
• Insulin
  Types of insulin and their characteristics along with injection information.
  
  
• Home Monitoring
  Various techniques for monitoring your cat's diabetes at home.