This Glossary was written by Dr Audrey Harvey BVSc (Hons) for Cats and Diabetes. Can’t find what you’re looking for?
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This is an oral treatment for diabetes which slows down the digestion of starches. The result is a more steady release of glucose into the bloodstream and therefore a more stable blood glucose level, which may be easier to manage.
Acromegaly results from an excess of growth hormone in the body, associated with a tumor of the pituitary gland in the brain. This results in a larger-than-normal body size and a large head. Less obvious signs are big paws and a long jaw with increased space between teeth. Growth hormone has an anti-insulin effect, causing increased blood glucose and diabetes mellitus that doesn’t respond to insulin.
Hills a/d is a prescription food designed for animals that are recovering from injury or serious illness. It tastes good and has extra energy and nutrients that promote recovery. Because it is soft and easily blended with water, it can be given by syringe or spoon to those animals that have trouble eating on their own.
An ataxic cat is unable to coordinate their muscle movements, leading to wobbliness and a staggering gait. It tends to be associated with central nervous system disease or injury, rather than a problem with the muscles themselves. There are many causes of ataxia including infection, trauma and cancers, but it can also occur secondary to low blood sugar.
These cells are found in certain areas of the pancreas known as the islets of Langerhans. They are responsible for the storage and release of insulin.
Please see Blood glucose.
This acronym means ‘bis in die’, which is Latin for ‘twice a day’. Medications that are prescribed to be given BID are therefore given twice a day, ideally 12 hours apart.
Glucose is a sugar, and is a source of energy for all the cells in a cat’s body. It comes from the carbohydrates in their diet. The term ‘blood glucose’ refers to the amount of glucose in a cat’s blood.
Blood glucose curve
A blood glucose curve is a graph created from a series of blood glucose tests. These tests are done two hourly over a 12-hour period, usually from 8am to 8pm. The results are used to calculate how much insulin a cat should be prescribed, and when it should be administered.
Blood glucose level
The blood glucose level is the amount of glucose in a cat’s blood. It is expressed as either mmol/L or mg/dL (depending on what part of the world you live in) and it is kept at a fairly constant level by the actions of hormones. Normal blood glucose levels for the cat are between 4–8 mmol/L or 60–120 mg/dL.
Blood glucose meter
A blood glucose meter is a small handheld device that is used to measure the amount of glucose in a cat’s blood. Typically, a small plastic strip with an absorbent area is pushed into a slot on the glucose meter, and a drop of blood is placed on the absorbent area. The meter then reads the amount of glucose in the blood.
Blood glucose monitoring
Blood glucose monitoring means checking the blood at regular intervals to make sure it stays within acceptable limits. Please see the blood glucose level definition for those limits. Regular monitoring allows you to make sure your cat’s insulin dose is still appropriate for how much and how often they eat.
This is a score given to cats that indicates their body condition. Scores from 1 to 4 indicate that your cat is underweight, and this is characterized by prominent ribs and a marked abdominal tuck. Scores from 7 to 9 mean that a cat is too fat; you can’t feel their ribs, and they have a round abdomen with an obvious layer of fat on their abdomen. The ideal score is 6; your cat will have very little fat on their tummy, you’ll be able to feel their ribs under a thin layer of fat, and you’ll notice an obvious waist just after their ribs.
This insulin is commonly used by vets to treat diabetes in cats. It is a lente insulin, which means it has an intermediate duration. Caninsulin is purified pig insulin, and lasts 8–12 hours in cats. This means that treatment usually involves giving two injections of Caninsulin each day, 6–8 hours apart. In the United States, this product is known as Vetsulin.
A capillary is the smallest blood vessel in the body, being only big enough to allow one cell to pass through it at a time. At-home blood glucose testing involves using a lancet to pierce the skin and capillaries to produce a drop of blood large enough for testing.
The word carbohydrate usually refers to a food that contains starch (a complex carbohydrate) or sugar (a simple carbohydrate). The carbohydrate content of a food is important to diabetic cats because it influences how much insulin they need. Some cats have gone into diabetic remission when they are fed a low carbohydrate, wet food diet.
Clomicalm is a brand name for the drug clomipramine. This is a tricyclic anti-depressant which, in animals, is used to treat anxiety and mood disorders in dogs, and urine spraying in cats. It increases the amount of available neurotransmitters in the animal’s brain, resulting in an improvement in mood and behavior.
Combur 9 test strip
This is a test strip that is dipped in a urine sample, and it gives quite a lot of information. Color changes in the little test panel indicate the presence of white blood cells, protein, glucose, ketone bodies, nitrite, bile pigments and blood in the urine. The combur 9 test strip also tells you the urine’s pH, or acidity.
Please see Blood glucose curve.
An important part of diagnosing disease in animals is examining a sample of urine. Our pets don’t urinate on demand, so veterinarians use cystocentesis to obtain a urine sample. In this procedure, a needle is passed through the skin and directly into the bladder, and a syringe attached to the needle is used to collect the sample. The advantage of this procedure is that the urine sample is uncontaminated. There are very few risks associated with cystocentesis.
Dehydration occurs when there is an excessive loss of water from the body. It can occur in many medical conditions, including diabetes. To check if your cat is dehydrated, look at their gums and tongue. If they are dry and tacky to the touch, and the saliva is thick and stringy, it’s likely that they need more fluids.
If your cat is given too much insulin, their blood glucose will drop to below normal levels. They will appear sleepy and confused before losing consciousness. You can handle this emergency by rubbing corn syrup or honey on your cat’s gums, and the glucose will be absorbed through the mucus membranes of their mouth.
Up to 30% of diabetic cats will show signs of gastrointestinal upset, including diarrhea. There is no specific cause for this. One theory is that there is an underlying pancreatitis or gastroenteritis which may have triggered the diabetes in the first place. Another thought is that a high carbohydrate diet can upset the natural gut flora of the cat, which is a carnivore and not designed to eat carbohydrates. Any diabetic cat that develops diarrhea needs a thorough evaluation and possibly a change to a low carbohydrate/high protein canned food or fresh raw meat.
Diabetic ketoacidosis (DKA)
Diabetic ketoacidosis, or DKA, is a serious condition that needs emergency veterinary care. It occurs when your cat’s body can’t utilize the glucose in its blood, and starts to metabolize fats for energy instead. The result is severe metabolic imbalances, loss of appetite, vomiting and coma. Ketones (which smell like nail polish remover) can be smelled on your cat’s breath, and can be detected in their urine.
Diabetic remission occurs in cats when they no longer need insulin injections and their blood glucose levels are within normal levels. If you have a cat that enters diabetic remission, it is recommended that you still monitor them, and periodically conduct blood tests.
Retinopathy means an abnormality of the retina at the back of the eye, and often results in vision loss. Diabetic retinopathy is, as the name suggests, retinal disease that occurs in cats with diabetes. High levels of blood glucose may lead to with an increase in acidification of the retina, and this has been thought to be associated with diabetic retinopathy.
A hormone known as anti-diuretic hormone is responsible for absorbing water in the kidneys, and making the urine more concentrated. If the brain doesn’t produce enough of this hormone, or if the kidneys can’t respond to it, the water isn’t resorbed. This results in the production of a lot of clear dilute urine, and is known as diabetes insipidus.
This is the type of diabetes we are most familiar with, and is caused by insufficient insulin production. There are high levels of glucose in the blood and urine. Symptoms are extreme thirst, increased appetite and weight loss.
This term refers to anything that causes diabetes. In cats, such things can include pancreatitis and the use of medroxyprogesterone acetate medications.
This term refers to someone with a special interest and expertise in managing diabetes. In the veterinary field, difficult to manage diabetic cats are referred to endocrinologists, who are specialists in dealing with all manner of hormonal diseases.
These test strips are dipped into your cat’s fresh urine and will give you an indication of how much glucose is present in the urine.
This acronym represents the word ‘diagnosis’.
This is a human or veterinary specialist that is an expert in hormonal diseases, including diabetes.
Fasting blood glucose test
A fasting blood glucose test is a blood glucose measurement taken first thing in the morning before your cat has eaten. It is best interpreted as part of a blood glucose curve.
The flank is the side of your cat, between their ribs and their pelvis. It is a useful site for insulin injections.
Feline Lower Urinary Tract Disease is a syndrome characterized by blood in the urine, straining to pass urine and often urinary obstruction. Affected cats can also urinate in odd places and lick their urethral opening excessively.
The cause of FLUTD varies depending on the age of the cat. In senior cats aged 10 years or older, over three-quarters of affected cats will have a bladder infection, bladder stones or both. In young animals, half of the cats with this condition will undergo any number of tests, and no specific cause will be found. Another 40% will have bladder stones, a bladder obstruction or a bladder infection.
Fructosamine is a chemical that is produced when glucose reacts with proteins.
The fructosamine test measures the amount of fructosamine in a cat’s blood. Blood fructosamine levels are used to indicate how stable a cat’s blood glucose has been over the previous two weeks. So, it is useful in assessing how well a diabetic cat is being regulated.
It isn’t necessary to aim for a normal fructosamine level, but is a useful tool to monitor your cat’s diabetes. If the test suggests that your cat’s condition isn’t being managed well, then the next step is a blood glucose curve, which will give much more useful information.
Fructose is the natural sugar found in fruit. It was once thought to be a healthier option for diabetic people, but that’s not the case. Cats tend not to eat a lot of fructose in their diets.
This term refers to inflammation of the gastrointestinal tract. Causes include infection, allergies and toxins. The most frequent symptoms of gastroenteritis are vomiting, diarrhea and loss of appetite.
Glargine insulin, also known as Lantus insulin, is long acting insulin that is commonly used in managing diabetes in cats. It has the best chance of causing remission in diabetic cats, especially if it is used when they are first diagnosed. However, it doesn’t work well in every cat. It is usually administered every 12 hours.
Glipizide (brand name – Glucotrol)
This is the most commonly used oral hypoglycemic medication used to treat diabetic cats.
This is another name for a blood glucose meter.
Glucose is a simple sugar that is used as an energy source by cells in the body.
This is a way to express the effects of a food’s carbohydrates on blood glucose levels. Those foods that break down quickly and release glucose rapidly are considered high glycemic index whereas those that have a slower release of glucose are known as low glycemic index.
This relates the glycemic index of a food to the amount of carbohydrate in that food. It gives an indication of how much glucose is released into the bloodstream and how quickly when a specific amount of that food is eaten. It is a much more accurate way to assess the effect of a particular food on blood sugar levels.
Glycosylated hemoglobin test
This test works out how much glucose is attached to the hemoglobin inside the red blood cells. Like the fructosamine test, it is a more general long-term measure of how well diabetes is being managed. There have been no studies on its use in cats, and the blood glucose curve is still the best way of checking how well a cat’s diabetes is being controlled.
See Hyperosmolar hyperglycemic nonketotic syndrome.
The hock on a cat is the equivalent of our heel or ankle. When a diabetic cat has neuropathy, they often walk on their hocks, known as a plantigrade stance.
Home glucose monitor
Home glucose monitors for diabetic cats are small hand held devices which can be easily used to check their blood glucose levels. A test strip is placed in the machine and a drop of blood is applied. The monitor will measure the blood glucose; this can take up to 60 seconds, depending on the machine.
Home testing is an important part of monitoring your diabetic cat. Blood glucose measurements can be taken, which often gives a more accurate result than in-clinic testing because it is less stressful for them (stress can lead to an inflated glucose reading). It’s also a good idea to check your cat’s urine by using Diastix or Ketodiastix to check for the presence of glucose or ketones.
Some testing strips can also indicate whether or not there are white blood cells or blood in the urine which can indicate infection. These strips can easily be used at home. Your vet can do more extensive testing, including checking for crystals in the urine and measuring how concentrated the urine is.
Hyperglycemia is a higher than normal level of glucose in the blood.
Hyperinsulinemia is a higher than normal level of insulin in the blood. It can be associated with a tumor in the pancreas that is secreting excess amounts of hormone, which leads to low blood glucose.
However, in diabetic cats, it is related to obesity. Excess weight can cause insulin resistance where the cat’s body doesn’t respond to the insulin, so the pancreas keeps producing more in the hope that it will be effective.
Hyperosmolar hyperglycemic nonketotic syndrome (HHNS)
This is a disease characterized by very high blood glucose levels (over 600 mg/dL or 33 mmol/L) and dehydration, but without any real ketosis. It is usually associated with another disease, such as pancreatitis or severe infection, and isn’t easy to treat. The prognosis is poor.
This condition is an ongoing increase in metabolism due to an increase in thyroid hormones. It is the most common hormonal disease in cats, and it tends to affect mature to elderly cats. Because of the increased metabolic rate, affected cats have a rapid heart rate and are always hungry. They drink a lot of water and urinate more than usual. They also tend to lose weight. Symptoms are very similar to those of diabetes mellitus.
Hypoglycemia is a lower than normal level of glucose in the blood. It occurs with an insulin producing tumor of the pancreas, or with an overdose of insulin in diabetic cats.
The lack of thyroid hormones causes a reduced metabolic rate. This condition doesn’t occur very often in cats. It may result from treatment for hyperthyroidism where too much of the thyroid gland is removed, resulting in lower levels of thyroid hormone. Some cats are born with congenital hypothyroidism. Affected cats tend to be small, and not very alert. Treatment is to supplement them with thyroid hormones.
Impaired fasting glucose (IFG)
Impaired fasting glucose occurs when a cat’s blood glucose levels after a fast (for example first thing in the morning) are slightly higher than normal, but aren’t high enough to be considered diabetic. This level of fasting blood glucose is considered to be part of the pre-diabetic state in cats and if their diet is changed and they are encouraged to lose weight, then it’s possible that they won’t develop full blown diabetes.
Impaired glucose tolerance (IGT)
This phrase means a lower than normal ability to metabolize glucose. Some diabetic cats that are in remission can have a slightly higher than normal fasting blood glucose. Also, when these cats are given glucose, it takes longer for their blood glucose to return to normal than a cat that has never had diabetes.
Implantable insulin pump
An insulin pump implanted under the skin is an excellent alternative to regular insulin injections for administering insulin to diabetic people. This technology hasn’t been adopted in veterinary medicine, but in early 2012, researchers at the University of Zurich started investigating its use in cats.
The injection site is the part of the body where an injection of insulin is given. There are several places where insulin can be injected in a diabetic cat. The most obvious is under the loose skin between the shoulder blades. However, some veterinarians feel that this area has too much fat and therefore insulin absorption isn’t consistent, leading to a less dependable response. They recommend injecting under the skin of the flank.
Injection site rotation
It is important that you change the site where you inject your cat’s insulin each time. This rotation of injection sites means that one part of the body isn’t at risk of developing fat abnormalities due to being injected repeatedly in the one location. These abnormalities can make insulin absorption unreliable. The best site for insulin injection in cats is the flanks and you can alternate sides and even choose a site that is an inch or two away from the last injection.
Insulin is a hormone produced by the pancreas, and is vitally important in the regulation of blood glucose. Reduced insulin production leads to diabetes mellitus.
Diabetic cats need insulin injections. The injectable insulin is either derived from beef or pork pancreas, or it is produced by splicing the gene responsible for insulin creation into a bacterium. This bacterium then produces human insulin, which is then tested thoroughly to make sure it is pure. There are several human insulins used to treat diabetes in cats.
This is a cartridge containing multiple doses of insulin, which can be calibrated to deliver an exact dose of medication. It is used with disposable needles. It isn’t used in veterinary medicine because firstly, it can be hard to get the needle through the fur under the skin, and secondly it can take a few seconds for the insulin to inject. If your cat doesn’t enjoy their insulin injections, it may be even harder to hold them still if their injection took a few seconds to complete.
In humans, an insulin reaction is a period of hypoglycemia after an insulin injection. Some cats do appear a little lethargic after their injection, and a blood glucose curve should be done to make sure their glucose stays within acceptable limits. Another type of reaction is a skin swelling at the injection site. Some cats can become allergic to the beef or pork in the insulin and develop a skin reaction.
An insulin receptor is a receptor on a cell wall that binds to insulin in the blood. Its purpose is to initiate glucose uptake by the cell.
Insulin resistance occurs when a diabetic cat doesn’t seem to respond to their insulin injections, and their blood glucose stays high. This is usually caused by concurrent disease such as pancreatitis, liver disease or gastroenteritis. It can usually be managed by treating the underlying disease. If that doesn’t work, then giving higher than normal doses of insulin helps. This should be done with guidance from your veterinarian.
Insulin shock is another word for hypoglycemia, particularly where treatment for high blood glucose has been too successful and the blood glucose levels have dropped below normal.
This type of insulin has a relatively slow onset of action and a long duration of activity. NPH insulins, such as Humulin N fall into this category. They are inexpensive, but their duration of action may not be long enough for feline diabetics.
Ketogenesis is the process by which ketones are produced from fatty acids. Insulin deficiency results in increased fatty acids in the blood, which are converted to ketones in the liver. The result is diabetic ketoacidosis.
Ketones, also known as ketone bodies, are compounds that are produced when fatty acids are metabolized in the liver. They are acetoacetic acid, acetone and beta-hydroxybutyric acid.
Ketonuria is the appearance of ketones in the urine.
Ketosis occurs when an abnormally high amount of ketones accumulate in a cat’s body.
Ketostix or Ketodiastix
These are small test strips which are used to detect ketones (Ketostix) or ketones and glucose (Ketodiastix) in the urine of your diabetic cat. If there are ketones only occasionally, then it’s not a problem, but if they appear for more than three days in a row, it’s time to visit your veterinarian.
This is a deep, labored type of breathing that is associated with acidosis. It can occur in cats with diabetic ketoacidosis.
A lancet is a small needle, used in a lancing device, to pierce a cat’s skin and obtain a drop of blood for glucose testing.
A lancing device is a spring activated pen that securely holds a lancet. The device has multiple settings used for different depths depending on the amount of blood required for a test.
Lantus insulin is the brand name for Glargine insulin.
The thorax is the part of the body commonly known as the chest. It contains the heart and lungs. The term lateral refers to the side, so the lateral thorax is the side of the chest. It is a frequently used injection site for cats.
Lente insulin has an intermediate duration and lasts around 6-8 hours. It needs to be given to cats every 8–12 hours. Brand names are Caninsulin and Vetsulin.
This insulin appears to have a similar effect to Glargine in cats, in that it doesn’t have a peak activity but instead maintains a stable blood concentration. It may work better in those cats who don’t respond to Glargine.
This is very quick acting insulin, and there have been few studies done in cats; however, it appears to work the same as it does in humans. It has its effect within 15 minutes and lasts no more than five hours.
The liver is a very important organ that sits in the abdomen and is involved in digestion and detoxification. Liver disease is a broad term for any condition that causes the liver to work less effectively. Some examples include toxins, cancer and diabetes.
Long-acting insulin, known as ultralente insulin, has its peak activity around 12 hours after administration. One brand name is Humulin It isn’t used much in cats because Glargine is usually the first line of treatment of diabetic cats.
Hills m/d dry and canned food is a nutritionally balanced calorie controlled food for cats that is designed to help them lose weight. It has also been shown to help regulate insulin levels in diabetic animals. For managing diabetes in cats, the canned variety is preferred by veterinarians.
A measure of blood glucose used predominantly in the United States, but also in some other countries. It refers to the number of milligrams of glucose per deciliter (100mls) of blood.
A measure of blood glucose used in predominantly Australia, New Zealand, the United Kingdom and Canada, but also in some other countries. It refers to the number of millimoles of glucose per litre of blood. The mole is a unit of measure commonly used in chemistry and biology.
The nadir is the lowest glucose level in a cat’s blood glucose curve. It coincides with the peak activity of the injected insulin.
This is the diameter of the needle used to give an injection. Insulin is usually given through a 28 or 31 gauge needle. Needle gauge is also relevant to lancets, and a 30 gauge lancet is commonly used. The higher the gauge number, the finer the needle.
This is an uncommon condition where diabetes affects the nerves, leading to hind leg weakness. Affected cats usually walk on their hocks.
Non-insulin dependent diabetes
Up to 30% of diabetic cats can do well without injections of insulin, and will be well regulated with oral medications and dietary modifications. These cats could be considered to have non-insulin dependent diabetes. However, it is important that they are still monitored frequently just in case their condition worsens and they need to start insulin injections.
This is another brand of NPH insulin.
Also known as Humulin this is an intermediate acting insulin which has an 8–12 hour duration of action.
A body score with a range from 1 to 9 is used to determine if your cat weighs too much. If you can’t feel their ribs, they haven’t got an obvious waist and there is a large abdominal fat pad, they are too heavy. A body score of 6 or above indicates your cat is overweight. Your veterinarian can determine the body score of your cat.
Oral hypoglycemic agents
These are drugs given by mouth to reduce blood glucose in diabetic cats. They cause the pancreas to release insulin more effectively and make their cells more sensitive to insulin. This means that small amounts of insulin have a greater effect.
The pancreas is an organ in your cat’s abdomen that has two important roles. It produces lipase and amylase, two enzymes that are important in fat and carbohydrate digestion. It also produces insulin, the hormone that regulates blood glucose.
Pancreatitis is inflammation of the pancreas. It is characterized by high temperatures, vomiting and abdominal pain. It can cause diabetes in cats, or it may cause previously well-managed diabetes to become unregulated.
This is when the insulin effect is at its greatest. This can be confusing, as the peak insulin effect results in the lowest blood glucose level.
Periodontal disease is infection and inflammation of the tissues around the teeth, including the gums and ligaments holding the teeth in the sockets. It is a common condition in cats, and it can make it difficult to regulate blood sugar. Cats with diabetes need to have good dental care.
When a cat has a plantigrade stance, they stand and walk on the part of their leg from the foot to the hock. It is seen in cats with diabetic neuropathy.
Polydipsia is an increase in water intake, exceeding 100ml per kg body weight per day. How much water your cat drinks is also influenced by his food – wet food contains more water than dry kibble – and again, you need to look at this value in relation to what’s normal for your cat. Often the first indicator that your cat’s water intake has increased is that you notice him drinking at his water bowl more frequently.
Polyuria is an increase in urine output, exceeding 50ml per kg body weight per day. It’s not easy to accurately measure this at home, and it’s not absolute because there can be some individual variation between cats. If your cat appears to be urinating more than usual and the litter in the tray is wetter than usual, then that’s enough to warrant investigation.
Prednisone is an anti-inflammatory drug. Sometimes inflammation makes animals more uncomfortable or more unwell, and it’s good to be able to reduce that inflammation. One example is skin allergies – prednisone will reduce any skin redness and itching. It is known as a glucocorticoid because it has an effect on the body’s glucose metabolism. Side effects of prednisone use resemble the symptoms of diabetes – increased thirst, urination and weight loss. Long term use of prednisone can lead to diabetes mellitus, and this drug should be used with caution in diabetic animals.
Protein is a nutrient in food. Diabetic cats do best on a diet that is high in protein and low in carbohydrates.
PZI (brand name – Prozinc)
This is a synthetic insulin that has been specifically manufactured for veterinary use. It isn’t a human drug. However, Glargine insulin is still preferred by most veterinarians.
Rapid acting insulins act within 15 minutes and last for 3–5 hours. They aren’t often used to manage diabetic cats.
Also known as the Somogyi effect, this occurs when the body reacts to low blood glucose by compensating and producing more glucose.
The term ‘renal’ refers to the kidneys. These organs work hard to filter waste products from blood while retaining water. They are essential for keeping animals alive. When the kidneys fail, excess water is lost from the body, leading to increased thirst and urination. The buildup of waste products in the blood, including urea, causes depression, vomiting and lethargy.
The scruff of a cat is the loose skin over the back of the neck. It is a common site for injections, but is not suitable for insulin injections because absorption can be variable.
Secondary diabetes is caused by a drug or disease, unlike primary diabetes which has no obvious cause. Prednisolone and medroxyprogesterone acetate can cause diabetes in cats, while those animals that develop pancreatitis often develop secondary diabetes.
A sharps container is a special container that is designed to safely hold needles used to give injections. It is usually made of a very hard plastic so there is no risk of the needle penetrating the container.
Short acting insulin doesn’t have a very long duration of effect. It isn’t commonly used in cats; because its effect doesn’t last as long, it needs to be administered more frequently. This isn’t often convenient for an owner or enjoyable for their cat. It can be used in hospital to quickly drop a cat’s blood glucose. Humulin R is one brand of short acting insulin.
This is another name for rebound hyperglycaemia.
Sucrose is common white sugar. It consists of glucose molecules and fructose molecules.
This is a generic term for a simple carbohydrate such as glucose or fructose. It usually refers to the white table sugar that is added to food.
An old name for diabetes mellitus.
This is a hollow tube with a plunger and measures marked on the side. A needle is attached and it can then be used to draw up insulin and inject it into the diabetic patient.
This acronym comes from the Latin phrase ‘ter in die’, which means three times a day. It is usually used when referring to how often to give medication.
This is a protocol for treating diabetic cats that involves testing their blood glucose several times a day, and, based on the results of that test, giving a dose of insulin at that time. The aim is to keep your cat’s blood glucose within normal limits, which is thought to allow their body to re-start insulin production. The less time a cat spends with high blood glucose, the more likely they are to go into remission.
Many veterinarians don’t think this degree of micro-management is necessary, because spot checks of blood glucose can be hard to interpret. Also, glucose levels can fluctuate naturally from day to day. It can be very difficult for an owner to test their cat up to four times a day.
Cats with transient diabetes initially need insulin to keep their blood glucose levels within normal levels. Over time, their body re-regulates, and they are able to stop their insulin injections. This is most likely to occur if their diet is changed to a low carbohydrate, high protein food.
These cats may relapse and need further insulin treatment in the future.
Type 1 diabetes
This type of diabetes is characterized by an absolute lack of insulin, leading to high blood glucose levels. It is most likely to occur with immune mediated damage to the pancreas or chronic pancreatitis. Type 1 diabetic cats are always insulin dependent. This type of diabetes is less common in cats, but more prevalent in dogs. Diabetic remission is not possible with Type 1 diabetes.
Type 2 diabetes
In cats, this type of diabetes is caused by a reduced ability to secrete insulin, as well as insulin resistance. Risk factors are genetics, obesity and diet. In some cases, affected cats don’t need insulin but can be managed with oral hypoglycemic agents, weight loss and an appropriate diet. Most diabetic cats have this type of diabetes. Diabetic remission is possible with Type 2 diabetes.
This is very-long-acting insulin. It has a peak effect in 3–8 hours, and can last up to 20 hours. There are no ultralente insulins recommended for use in cats, because much better control is achieved with shorter acting insulins.
Urinary Tract Infection (UTI)
UTI, or urinary tract infection, is an infection anywhere along the urinary tract. Cats with diabetes are at increased risk of UTI, in particular a bladder infection, because of the increased glucose in the urine. Symptoms to look out for include increased water intake, frequent and strained urination, and urinating outside the litter box.
Unit of insulin
Insulin is measured in units, and your cat will be prescribed a specific number of units to be given as recommended by your vet.
This involves collecting your cat’s urine and having it tested for glucose levels, blood, protein, white blood cells and ketones. This can be done at a laboratory or it can be done at home using a test strip, such as Ketodiastix.
U-40 insulin contains 40 units of insulin per ml. U-40 needles have a red cap.
U-100 insulin contains 100 units of insulin per ml. U-100 needles have an orange cap.
A vein is a blood vessel that carries de-oxygenated blood from the organs back to the heart.
This type of insulin can have an effect for up to 20 hours. A well-known brand of very-long-acting insulin is Humulin. These products can be used in animals, but most veterinarians will still reach for the Lantus insulin first.
This is a lente insulin, which has an intermediate duration of action, approximately 6-8 hours. It needs to be given to cats every 8–12 hours. In Australia, this product is known as Caninsulin.