Diabetes Mellitus in Cats – Owner Instructions

Your cat has been diagnosed with diabetes mellitus

Diabetes mellitus is a chronic condition that affects your cat’s ability to use the carbohydrates in food for energy. Normally, the cells of the body use insulin to take in the glucose and use it for energy. Cats with diabetes mellitus either are not producing adequate amounts of insulin, or their body can’t respond to the insulin they are making, or a combination of both.

To treat this, along with other changes discussed later in this summary, diabetic cats are given insulin injections.

Being given the diagnosis of diabetes mellitus is a life-changing moment for both you and your cat, but this doesn’t have to be a bad thing. Many owners find that the routine of giving insulin followed by a special treat or some brushing/petting time can really strengthen the bond with their cat.

Diabetics need time (often many days or even weeks) to adjust and respond after we begin giving them insulin or change the dose of insulin being given. Each cat has a unique need for insulin, so the dose that works best for one individual may not be effective for another. For this reason, a newly diabetic cat will be monitored to determine what the most helpful dose of insulin will be. Please do not make any changes with the insulin dosage at home without consulting your veterinarian. It may take at least one month to establish an adequate insulin dose. Although this initial period can be time consuming, once your cat’s diabetes is under better control, they will need to be rechecked much less frequently.

Always remember – our primary goal, like yours, is that your cat be clinically well (feel good, have a good energy level, drink and urinate less than they did before diagnosis, and not continue to lose unhealthy amounts of weight). At each recheck appointment or check-in conversation, we will ask you to tell us your observations about how much your cat is drinking, urinating, eating, and anything you notice about your cat’s overall health. We will also carefully monitor any changes in body weight.

DAILY ROUTINE
A predictable and stable routine (feeding and medication) are tremendously helpful in regulating a new diabetic and in keeping an established diabetic patient stable. We understand that life can be busy and unpredictable, so please let us know if establishing a routine is a challenge. We may be able to offer tips and tricks to help.

Feeding:
If your cat is used to meal feeding, please feed twice daily. If they prefer to eat throughout the day, allow them to graze. A high protein, low carbohydrate diet is ideal but not always critical – your veterinarian will recommend a diet for you to try. The most important thing about feeding and diet is that your kitty has a good appetite and eats regularly. If they are not eating the food we recommend, please let us know so we can find something your cat will enjoy more. Please offer food approximately 30 minutes before giving insulin. If your cat refuses food, give half the prescribed insulin dosage. If this should happen twice in a row, please consult us or your local veterinarian immediately. If you think your cat is sick, do not give the insulin and notify your veterinarian. It’s safer to miss one dose of insulin than to accidentally give too much.

Insulin:
The insulin bottle should remain refrigerated. When taken from the refrigerator, the insulin should be slowly rolled (~30 seconds) in the palm of your hand to mix. Do not shake the insulin bottle. Invert the bottle and withdraw the necessary units. Avoid any air bubbles.

Please let us know if you are having difficulty injecting the insulin. Check the fur for any moisture which may indicate that the insulin got on the skin as opposed to being injected. Use a new syringe for every injection to avoid infection. Place used syringes in a hard-sided plastic container or in an approved needle receptacle. Approved needle receptacles can be brought to the clinic for disposal; generic plastic containers will need to be brought to an appropriate needle disposal location, such as a police station.

WHAT TO WATCH OUT FOR
It is not unusual for a cat’s insulin needs to change over time. When this happens, you will notice signs similar to what you saw before your cat was diagnosed with diabetes, such as increased thirst or urination or weight loss. Again, please let us know if you notice any changes – we are here to help.

Insulin shock/hypoglycemia:
When a cat receives too much insulin, it is possible for their blood sugar to drop to a dangerously low level. If this happens, they will become groggy, listless, nauseous, and may act uncoordinated or “drunken.” If you suspect that this is happening, immediately offer your cat food. If your cat will not eat, you will need to give sugar. The easiest way to do this is to rub a small amount of corn syrup onto the gums. Your cat does not need to swallow the syrup – the sugar will absorb through their gums. Contact your veterinarian at once, as sometimes hospitalization is needed after such an episode. Your veterinarian will also need to determine why your pet developed hypoglycemia and adjust the insulin dose. DO NOT GIVE MORE INSULIN until your veterinarian tells you to.

GOING FORWARD
It is possible for some lucky cats to cycle out of diabetes, so there is a chance a cat may not need lifelong insulin. After about a month of treatment, if your veterinarian is not seeing the progress they hope for, they may recommend additional testing to look for other medical issues making it harder to control the diabetes.

The best long-term outcomes for diabetics depend on good observations and communication between you and your veterinary team. If you have any questions or problems, please feel free to check in with us.

Ilana Halperin, DVM
Updated: 05/2019