Description
Diabetes mellitus is a common problem in cats – especially in middle aged, overweight, under-active cats. Feline diabetes is a potentially reversible condition, and remission appears most likely if diabetes is recognised and treated early, and effectively
Good control of the diabetes is most likely if:
The cat is fed a low carbohydrate diet in multiple small meals
A long-acting insulin is injected twice daily
Insulin dose is increased slowly
The International Society of Feline Medicine (ISFM) has recently published a set of Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats. These guidelines are free to access at http://jfm.sagepub.com/site/Guidelines/Guidelines.xhtml Aims of Treatment
To limit or eliminate the cat’s clinical signs
Aim to keep blood glucose < 14 mmol/L most of the time
To use a treatment regime that is affordable and fits into the owner’s daily routines
To avoid insulin-induced hypoglycaemia
Aim to maintain the blood glucose £5 mmol/L at all times
Dietary Considerations Cats are obligate carnivores with limited ability to handle carbohydrates. They hunt and eat small prey animals, so their metabolism is adapted for small frequent meals rather than infrequent larger meals. They also show no significant post-prandial hyperglycaemia, so the timing of feeding in relationship to insulin injections is less important. Insulin Treatment in Diabetic Cats The ISFM Consensus Guidelines recommend starting treatment with longer acting insulin preparation injected twice daily:
Starting dose 0.25 iu/kg twice daily based on the estimated ideal weight of the cat and then rounded down to the nearest whole unit
Rigid adherence to a 12 hourly injection schedule is impractical for many owners - injections given within a range of 10-14 hours apart is acceptable, and that the occasional missed dose will do no harm.
Monitoring the Response to Insulin Glucose curves are an invaluable tool in the management of feline diabetes, and home monitoring is a practical, cost effective option which, with good initial support, the majority of owners can learn to do. Martha Cannon is an RCVS Recognised Specialist in Feline Medicine and co-director at the Oxford Cat Clinic, a first opinion and medical referral cat-only clinic in Oxford (www.oxfordcatclinic.co.uk). She is also a trustee-director of International Cat Care (formerly Feline Advisory Bureau) and the International Society of Feline Medicine (ISFM), and is a frequent speaker at international and national veterinary meetings. She has been voted Central Vet Society Speaker of the year for 2014 and Webinar Vet Best Speaker of 2013 for her delivery of presentations that combine up to date insights into common feline medical problems with practical advice that can be readily applied in practice.