How much do you know about diabetes in cats?
If your reaction is “Enough,” then this piece is especially for you. I like to think that by the end of the article you’ll understand why every cat guardian should be up to speed on the risk factors for diabetes.
What is Diabetes?
Let’s start at ground level by refreshing the memory about what diabetes is. Sugar diabetes (diabetes mellitus) is the inability of the body to properly control its blood glucose levels, which climb too high.
The hormone insulin is responsible for cells absorbing glucose, with the latter used as a fuel much like diesel powers a car engine. Without insulin the cells can’t soak up sugar (the car’s fuel cap has seized on) so it remains in the blood stream. When blood sugar levels reach critical, the sugar spills over (the fuel pump is running but not into the petrol tank) and overwhelms the kidney’s ability to cope and sugar appears in the cat’s urine.
Signs of Diabetes
Let’s fully set the scene by knowing what the signs of diabetes are, before moving onto the really interesting stuff.
To diagnose diabetes your vet needs to run a combination of urine and blood tests, but your suspicions should be raised if you notice:
- Increased thirst — Frequently refilling the water bowl and a constantly wet litter tray are clues not to miss.
- Weight loss — The cat eats well but loses weight.
- An unkempt coat — If the gloss has gone from your cat’s coat, then she may be unwell and diabetes is just one reason.
- Flat-footed gait — In well-established diabetes your cat may walk flat-footed on their back legs because of nerve damage
- Cataracts and blindness — Diabetic cataracts are a common complication of untreated advanced diabetes.
What Causes Diabetes in Cats?
Put your preconceptions away because this is where things get really interesting. Yes, it’s true that some cats are genetically predisposed to developing diabetes. But it’s also true that there are risk factors involved, and that we control some of those risk factors. So let’s take a look:
- Breed — Burmese, Maine Coon, and Siamese are more likely to develop diabetes than other breeds.
- Gender — Neutered males top the list.
- Age — This is a condition of middle age or older.
- Weight — Obesity is a major risk factor.
- Medications — Drugs such as steroids can increase the chances.
- Acromegaly — This is when the body produces too much growth hormone (more of this exciting discovery later).
- Prompt treatment — Whilst not strictly a risk factor, rapid treatment does give the insulin producing cells a rest and a chance to recover so the cat may go back to being non-diabetic.
Decreasing the Risk for your Cat
Don’t frown. I’m not about to suggest we should stop neutering male cats, but rather take some sensible steps to keep your cat fit and well. Let’s take a look at the role of weight control.
No one deliberately makes their cat fat, but be aware that feeding too much invites complications such as diabetes.
Those extra calories turn to fat which has to be deposited somewhere. Unfortunately one of the places the body stashes fat is in the beta cells in the pancreas which are responsible for producing insulin. Much like a spare room that’s so full of junk there’s no room for a guest to sleep, the beta cells can’t now fulfil their primary purpose of making insulin.
This creates a relative lack of insulin which allows the blood sugar levels climb too high. However, the good news is new diabetics stand a chance of reverting to being non-diabetic if they are put on a diet. Weight loss empties out those beta cells and lets them go back to producing insulin.
In fact, a combination of diet and exercise can go a long way towards helping your diabetic cat.
The Link between Acromegaly and Diabetes
Some diabetic cats are easier to stabilize than others. For a long time it’s been known that other illnesses, such as dental disease or an overactive thyroid, makes the body less responsive to insulin. In turn this leads to dangerous swings in blood sugar levels and the diabetic being unstable.
Now another major cause of diabetes has been identified, which is especially important for cats whose blood sugar trace is more erratic than a kitten chasing a ball.
Acromegaly is a condition where a tiny gland at the base of the brain, the pineal gland, produces too much growth hormone. The symptoms are not always obvious, of which the most noticeable is the cat with an unusually large, chunky face or paws. Now we vets know to look for the condition, we’re finding around one-third of all diabetic cats produce too much growth hormone.
This is significant because growth hormone interferes with how the body’s cells recognize and react to insulin. If the cell is a room and insulin is the key to the door, then growth hormone is like putting sticky tape over the keyhole so that the insulin can’t open the door and let glucose inside.
Your vet can diagnose acromegaly via a blood test sent to a specialist lab. Once confirmed, it forewarns the vet (and you) that your cat’s sugar control is liable to be unpredictable. In turn, this means it’s crucial to monitor it with a home blood glucose testing.
Alternatively, specialist surgeons are now operating to remove the overactive gland (brain surgery!) with excellent success. Indeed, many cats revert to being non-diabetic after surgery, a win-win situation.
Back down to earth, most cat guardians opt to control diabetes with a combination of diet and insulin injections.
Diabetes and Diet
There are a number of options when it comes to feeding diabetic cats. Most important is to safely diet the overweight cat back to a slim, trim waistline. This is best done under the guidance of your vet to avoid additional health issues.
There is a lot of debate over which type of diet is best for the diabetic cat. The main contenders are:
- High fibre foods which give a slow, sustained release of calories.
- High protein foods which are similar to the diet a feral cat living on mice consumes.
The idea is to provide a slow burn of calories so as to reduce the risk of see-sawing blood sugar levels.
For the majority of diabetic cats, daily insulin injections are key to control. These may be given once or twice a day, depending on the individual cat (refer to your own vet for guidance.)
However some cats have an erratic response (possibly due to infection, other disease, or acromegaly) which can leave them vulnerable to insulin overdose. The latter is very serious and can be life-threatening, and is where the cat receives too much insulin. The symptoms are:
- Extreme drowsiness
- Excessive twitching of ears or whiskers
- Poor co-ordination and walking as if drunk
If you see these symptoms in your diabetic cat, phone your vet immediately as untreated they can result in coma and at worst, death.
And finally, diabetes is nothing to fear as it can be treated. If your cat shows signs then seek a vet’s opinion as soon as possible. This is doubly important because prompt treatment in the early stages gives the cat’s pancreas a chance to rest and recuperate, and then there’s a chance your cat could revert back to being non-diabetic. Sweet!
Dr Pippa Elliott BVMS MRCVS is a veterinarian with 27-years’ experience in practice and a special interest in feline medicine and behaviour. Pippa is housekeeping staff to four highly individual cats that conspire to keep her busy opening doors on demand.