Care of diabetic cats
The optimum treatment of a diabetic cat consists of three main components:
- Diet (low in carbohydrates, preferably not dry)
- Home testing (testing of blood sugar levels using a glucometer)
- Insulin injections (using a long-lasting insulin)
Feeding your cat is key in properly managing his or her blood sugar levels. Carbohydrates cause rapid rises in blood glucose, followed by rapid declines. This roller coaster effect leaves the body craving more carbohydrates to stop the ill feeling of low blood sugar. (Think of how eating a candy bar may provide you with an immediate burst of energy, followed by a sluggish feeling and a craving for more sugar.)
Cats, as strict carnivores, are less equipped to deal with carbohydrates than humans are. The best diet for a diabetic cat (and non-diabetics, for that matter) is one low in carbohydrates. Fortunately, most readily available canned foods fit that bill nicely! Simply read the ingredients and look for a canned food that does not contain carbohydrates such as corn, rice, etc.
The "low carbohydrate" dry foods are much less effective at managing diabetes than wet foods like canned. The high heat processing necessary to produce kibble causes it to be highly glycemic. In addition, some form of starch (corn, rice, potatoes, etc.) is necessary in order to create dry food, so dry foods, even low-carbohydrate versions, are naturally higher in carbohydrates than wet food.
You can test your cat's blood sugar at home, using the same glucose meter human diabetics do. The meters are available over-the-counter at any drugstore. Simply use the lancet pen (or you can use the lancet without the pen, if you prefer) to poke your cat's ear to get a small droplet of blood.
Most cats don't mind this form of testing. It's generally less stressful than pilling or trimming claws. The test can give you a good picture of your cat's blood sugar levels at home, without the stress and expense of a vet visit.
Many diabetic cats require insulin injections, two or more times daily. Many only need them temporarily, and once a proper diet is fed and normal blood sugar levels achieved with insulin, their pancreas will resume activity on its own.
Cats metabolize very quickly, about twice as fast as humans or dogs, so a long-lasting insulin is best. PZI, Lantus (Glargine), or Levimer are all reasonable choices. Shorter-acting insulins such as Humulin N or Vetsulin (Caninsulin) generally don't provide enough duration for cats, and only manage their blood sugar for 6 to 8 hours.
There has been much research in the area of feline diabetes in the past few years. Several advances have been made, and some studies show success rates (cats off insulin entirely) of 60% to 80% on a low-carbohydrate canned diet and after temporary administration of insulin.
Brochure (printable version)
Our founders' cats, Meow Meow, Cheech, and Mrs. Hippy, were diabetic. Meow Meow and Mrs. Hippy went off insulin. Diet can go a long way toward "curing" diabetes (it can also go a long way toward inducing it). So if you're starving for more information after reading the following - head to the nutrition links! Other diabetic cats adopted by the board members have had reduced insulin needs or gone off insulin entirely on a low-carb wet diet.
Besides our own cats, we've fostered diabetic cats for area shelters. One stayed with Lynette two weeks and then went to a furever home with an angel of the feline diabetes message board. One went into remission after only ten days on a low-carbohydrate (grain-free canned) diet.
Lynette testing blood sugar of a diabetic foster cat - video demonstration
Diabetic neuropathy in a foster cat - video demonstration
Cost Saving Ideas
Many non-prescription canned foods are naturally low in carbohydrates, and are less expensive than prescription foods. We recommend canned foods with little-to-no grains, vegetables, or fruit. Avoid most canned foods in gravy, as they generally contain flour, starch, or syrup, which elevate blood sugar levels. Examples of low-carbohydrate canned foods include: 9-Lives "ground dinner" varieties, Fancy Feast "gourmet feast" varieties, Friskies dinner varieties, Wellness, SophistaCat, etc.
Not only does home-testing give a better picture of the cat's blood glucose levels at home (when not under the stress of a vet visit, as stress raises blood sugar levels), but it's also significantly less expensive. Using a blood glucose meter at home would generally cost $.40 to $1.00 per test. When choosing a meter, check the cost of test strips for that meter - as the ongoing cost of strips typically outweighs the one-time cost of the meter itself.
Often companies offer their meters for free - either with completion of a survey or a purchase of test strips. Note most of these meters are not manufactured for use specifically in animals, but many caregivers have found the results are not significantly different from more expensive meters and test strips designed specifically for dogs and cats.
Examples of free meter offers:
Idexx no longer manufactures PZI (protomine zinc insulin) as PZI-Vet. However compounded PZI is still available (BCP-PZI, PZI by Veterinary Pharmacies of America, etc.) Many caregivers report that the compounded insulins may vary a bit batch to batch, and may not remain effective as long
as the manufactured insulin. Manufactured insulin is generally considered effective until the expiration date on the vial. FelineDiabetes.com has a list of sources of PZI.
Click here to find out more about BCP PZI Insulin and receive a free trial vial.
Lantus (Glargine) insulin is more fragile than PZI. Although the Lantus (Glargine) manufacturer's insert recommends replacement after 28 days, many caregivers use a vial many months and note no loss of potency. To extend the life of the insulin, handle it carefully and gently - never shake the vial. Do not inject excess Lantus from the syringe back into the vial, as contact with the syringe can contaminate the insulin. Dr. Rand (feline diabetes specialist) states insulin Glargine has a shelf life of 4 weeks but can be stored
in the refrigerator opened and used up to 6 months as long as there is no discoloration or "snowflakes".
By home-testing, you can ensure the insulin is still working properly to bring down blood glucose levels. Another option is a 3 ml Lantus pen cartridge, which is more expensive upfront, but may last longer than a vial of insulin.
Syringes and other supplies may be available at a lower cost at local drugstores, large discount stores, or online (such as Walmart, Hocks.com and AmericanDiabetesWholesale.com. Always check your syringes (U-100, U-40, etc.) to make sure they match the concentration of your insulin. If they do not match, or if you
desire conversion for other reasons, you'll need to perform some conversion calculations when drawing up your insulin.
For futher information, visit:
Message Boards/Forums for Information and Support:
Feline Diabetes The original internet guide
and message forum for feline diabetes
dedicated to management of diabetes using Dr. Hodgkins' tight regulation protocol
Diabetic Cat Care Forum for care of diabetic cats using Dr. Hodgkins' tight regulation protocol
Yahoo! Feline CRF-FD group
Pet Diabetes Wiki
Feline Diabetes and Diet: The High Carbohydrate Culprit by Dr. Lisa Pierson, DVM
Diabetes and Obesity: The preventable epidemics by Dr. Elizabeth Hodgkins, DVM, Esq.
Diets for Diabetic Cats by Dr. Elizabeth Hodgkins, DVM, Esq.
Feline Diabetes: The Influence of Diet by Elisa Katz, DVM CVA
Dietary Recommendations for Cats with DM by Dr. Deborah Greco, DVM, PhD, DACVIM
Canned Cat Food Nutritional Information by Janet & Binky
Canned Cat Food Chart frequently asked questions
Diabetes Blood Glucose Testing Thanks to Carolyn from FelineDiabetes.com (FDMB) for compiling this information!
Evaluation of long-term home monitoring of blood glucose concentrations in cats with diabetes mellitus: 26 cases (19992002)
Evaluation of five portable blood glucose meters for use in dogs
Capillary blood collection valuable tool in at-home diabetes management
Home Testing of Blood Glucose for Diabetic Cats Slideshow and video demo of how to test blood glucose.
Blood Glucose Monitoring
Home Blood Glucose Testing for Diabetic Cats
Home Blood Glucose Testing for Diabetic Pets by Cheri & Louis
Protocol for Success in Managing Feline Diabetes by Dr. Elizabeth Hodgkins, DVM, Esq.
Treating Diabetes Holistically by Dr. Larry Siegler
Understanding feline diabetes mellitus Drs. Rand and Marshall
Update on Feline Diabetes Mellitus by Claudia E. Reusch, DECVIM-CA, Clinic for Small Animal Internal Medicine, University of Zuerich, Zuerich. World Small Animal Veterinary Congress (WSAVA) 2006.
The latest management recommendations for cats and dogs with nonketotic diabetes mellitus by Audrey K. Cook, BVM&S, MRCVS, DACVIM, DECVIM-CA
Feline Diabetes Mellitus by David Church. WSAVA 2006
Feline Diabetes: New ways of looking at an old enemy by Elizabeth Hodgkins, DVM, Esq.
Tilly Diabetes German site on treating diabetes with Lantus
Other Medical Issues Common to the Diabetic Cat:
Treatment of diabetic neuropathy with methylcobalamin - Jasper's page
Somogyi rebound mini-FAQ
Feline Hypertension: Risks, Diagnosis and Management Clarke E.
Atkins, DVM, DACVIM (Internal Medicine & Cardiology)
Acromegaly and other Hi-Dose conditionsThanks to the dedicated caregivers of cats with acromegaly that compiled this information!
Steroid-induced Sugarcat Research Project
Steroids - risks & benefits
Steroid side-effects--Skin tears & Diabetes Warning: Graphic pictures of skin tears
last updated: 1/5/2014
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