Diabetes is a relatively common disease in older or overweight people and is being recognized more frequently in older and/or overweight pets, but when your pet is diagnosed it can feel overwhelming. If left untreated, the disease has serious effects and will ultimately result in the death of your pet. But the good news is that the majority of diabetic animals can be treated and can live normal, happy lives. Managing diabetic cats does require some investment of time and money, so it’s important to have a conversation with your veterinarian about what will be required and whether this is something you are able to undertake. Although diabetes involves a lot of learning and monitoring at the beginning of the condition, it will soon feel like a normal part of your routine and cats generally tolerate their treatment very well. Some diabetic cats can enter into remission, following treatment, and may no longer require specific treatment - sometimes for extended periods of time.

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Diabetes is a disease caused when there is not enough insulin in the body. Insulin is a hormone which keeps blood sugar (glucose) at an optimum level. When there is a lack of insulin or when something interferes with the action of the insulin, sugar from food builds up in the blood and eventually starts to appear in the urine. The most common cause in cats is obesity, but cats who have suffered from pancreatitis in the past are also more likely to develop diabetes. Some long-term treatment such as steroid therapy, can increase the risk of developing a diabetes.

Animals with diabetes have high blood sugar levels and lose sugar in their urine. They are more thirsty than normal and you may notice that they drink from unusual places such as puddles or a glass. They often keep drinking rather than having a small amount and walking away. Cats with diabetes often lose weight despite having a good appetite. They will urinate more often, they may have accidents around the house or you may notice that their litter tray needs to be changed more frequently. If the condition is untreated, liver disease, eye disorders and problems walking or other illness may develop. If the early signs of diabetes are missed, more serious signs such as vomiting, inappetence and depression may develop. If diabetes is left untreated for weeks or months your pet could go into a coma or become seriously unwell meaning they will need hospitalization. Untreated diabetes can be fatal.

If your cat has been diagnosed as a diabetic you may be wondering if you have done something wrong. Unfortunately some cats are just more likely to develop the disease than others. Male cats are most likely to get diabetes but any cat can be affected. Obese cats are more likely to develop the disease, but there are many obese cats who do not develop diabetes. Some other diseases or long-term medications can cause diabetes to develop and your veterinarian will check to make sure your cat is not suffering from anything else. In a few cases treating the other disease will make the diabetes go away for a while, but it is quite likely to come back again later. In order to reverse diabetes, treatment is usually required as soon as the condition starts, with humans we are able to notice changes to our bodies easily. With pets, this is much harder with pets hiding signs of illness for long periods of time and therefore reversing diabetes permanently in cats is uncommon.

Most often diabetic cats require regular insulin injections to control their blood sugar levels. Diabetes rarely goes away completely and so these injections must be given on a regular basis (usually once or twice a day), for the rest of your cat’s life. Your veterinarian will discuss a diet and management plan for your cat. Injections should be given at set times each day but this can be arranged so that it fits into your usual schedule. Once the whole treatment schedule has been set you will have to stick to it in the future. It is important that your cat tolerates these injections for a long time and it doesn’t cause your pet stress. You may wish to think about a way to distract your cat or make the experience positive for your cat. Often, it is advised to inject your cat as they finish their meal or using a low calorie treat. More recently, an oral treatment has been made available for management of cats with early diabetes with no current metabolic complication. Your vet may discuss this option if your cat fits all the criteria to receive this medication safely.

Most diabetic cats will need insulin injections to treat their diabetes at some stage. In some obese cats, weight loss may control their diabetes for a while. There are diets which can help ensure their weight loss and blood sugar is controlled. If a condition or a medication interfering with insulin action is identified, and these can be controlled or discontinued, this may increase the chance of avoiding injections. Some cats can be managed by careful weight control and by giving tablets which lower blood sugar (hypoglycemic drugs). Although you may be worried about having to give your cat injections – most owners find that, with practice, it is easier to give their cat an injection than a tablet.

Insulin is a protein and (as with any other protein) can be digested. If insulin were given as a tablet, the tablets would be digested by the acid in the stomach and the insulin would have no effect. Insulin injections are given under the skin and do not hurt. Vetpens, similar to the pens used in human diabetes, are now available for dogs and cats.

Most people are naturally concerned that they will be unable to give injections to their pet. Your veterinarian will teach you how to do this and within a few weeks most owners of diabetic pets are happy to give the injections at home. Until you are confident your veterinarian will probably see you every day at the veterinary surgery and help you give the injections. Some vet nurses provide home visits to teach owners or administer insulin for owners who are unable to give injections to their pets. This is often offered as a private service but your veterinarian may be able to recommend someone in your local area. Diabetic pets owners’ discussion groups can also provide useful advice. The use of preloaded insulin pens is often considered more practical and easy to use. If you are struggling, your veterinarian can discuss diets that are made to regulate cats blood sugar, these are often needed in conjunction with injections but may reduce the frequency of the injections. Some cats can also be treated with tablets (hypoglycemic drugs) but these are reserved for patients with no significant metabolic complications.

Although it is possible to support you remotely during the management of your cat’s diabetes, your pet should be regularly monitored to make sure it doesn’t gain or lose weight or develop others signs. Your veterinarian needs to examine your pet regularly and review their notes to see how your pet is progressing. They will probably ask you to monitor how much your cat drinks to help monitor progress. At other intervals your veterinarian may want to take blood samples or urine samples from your cat – and may need to keep your pet in hospital for a day to do this. If you have any concerns about any aspect of your pet’s treatment discuss them with your veterinarian.

There are two important complications to be aware of:

• Low blood sugar (hypoglycemia) – If this is untreated it may result in permanent brain damage. Symptoms come on quickly. The main ones are restlessness, confusion, tremors, twitches, convulsions or coma. Sugar (or better still glucose, which can be bought from your veterinarian or a chemist) should be given by mouth, dissolved in water or as lumps. If your pet is still awake you can offer glucose with food if they will eat voluntarily. Contact your veterinarian immediately if these signs develop. Hypoglycemia can develop from an overdose of insulin and therefore it maybe a good idea to have a tick chart or similar to track your pets injections. This is very important in busy houses where family members may not see or communicate to each other between work shifts etc.
• High blood sugar (hyperglycemia) – This usually develops more gradually and your pet may become unwell or start to be sick over several days. This uncontrolled diabetes also leads to disturbances of the metabolism and can affect different organs. As the disease progresses your pet may go into a coma, but will not get better if you give sugar solutions. Contact your veterinarian immediately if your pet is unwell and they will probably want to take them into hospital.