Diabetes is a disease of insulin deficiency, either because the pancreas is no longer able to make sufficient insulin or because the cells of the body are no longer sensitive enough to the insulin that is made. Insulin is used to help move glucose (sugar) into the cells where it is used as an energy source. As diabetes develops glucose levels in the blood begin to rise. At a certain level the kidneys are no longer able to recycle that glucose back into the blood and we begin to see it show up in urine samples as well. Glucose in the urine makes cats need to urinate more frequently and so they also drink more water to compensate for the increased water loss.
Symptoms of diabetes in cats include increased thirst, increase frequency and volume of urine, weight loss despite a good appetite, weakness or wobbliness of the rear legs and lethargy. If the diabetes goes untreated cats can become ketoacidotic. This is when levels of ketones, a breakdown product that increases in diabetes get too high. This can cause more severe symptoms including vomiting, total loss of appetite, rapid breathing and an acetone smell on the breath.
Diagnosis of diabetes is done by a combination of bloodwork and urinalysis. Both are important because together they can help distinguish the high glucose level we often see in stressed cats from true diabetics. Diabetic cats are also more prone to urinary tract (bladder) infections that can complicate treatment.
Treatment for most cats is insulin injections twice daily. Surprisingly, many cats do not mind the insulin injections. Most owners, once they get over their concern about poking their cat, find that injections are much easier to give than oral medications in a cat. The needle is very small and the injection can be moved to different parts of the body to minimize discomfort. Your vet may also recommend diet changes to help improved the effectiveness of the insulin treatment and to decrease the amount of insulin needed in each injections.
Cats diagnosed with diabetes will need to be treated for the rest of their lives. There are a small number of cats that are found early in their disease who may go into remission with quick, aggressive treatment. However, even these cats will likely need to go back onto insulin at some point. Regular glucose curves, multiple blood glucose checks throughout the day, are important in ensuring good control of insulin and glucose levels. We do not check glucose levels daily as diabetic humans need to. This is because we are not trying to control the glucose in as narrow a range as we do in humans. But glucose curves are still vital to appropriate and effective treatment.
Everyone always wants to know about risk factors for diabetes. There is probably a little bit of a genetic component since Burmese cats seem to be at increased risk. We also believe, as in humans, that obesity is a risk factor. And we know that most diabetic cats are senior cats(10+ years of age). Male cats also appear to be at increased risk. According to the recently released Banfield State of Pet Health 2010 there has been a 16% increase in diabetes diagnosis since 2006. And for all you dog owners who have stuck with me this far, your dog is not immune to developing diabetes. In fact, the same Banfield report found a 32% increase in diabetes diagnoses in the same time period, though cats still are more likely to develop diabetes. http://www.banfield.com/Pet-Owners/Pet-Health/Downloads/State-of-Pet-Health-2011-Report-vol--1
Bottom line? Keep your pets on the lean side which is better for their cardiovascular and joint health too. Have your pet checked at least yearly with a physical exam.; even if they aren't due for vaccines that year. And beginning by at least 10 years of age consider having baseline wellness bloodwork run to check for indications of diabetes or other metabolic diseases.
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