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Susie, Diabetic
Cat
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Management
of Feline Diabetes |
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Introduction | Tablets | Insulin | Diet | Monitoring | Cost
Introduction
There is no cure for diabetes, and once a cat has the condition, it is usually for life. Treatment is aimed at managing the condition. It is normally possible to manage diabetic cats and many cat owners have reported that their cats have continued to benefit from a normal quality of life. Life expectancy can also be normal, provided that the diabetes is stabilised properly and that treatment continues regularly, even if diagnosed in a young cat. The key message is that diabetes is not a death sentence and with a little extra care, it can be managed successfully.
The condition is very similar in people and in animals. It is therefore no surprise that there are also similarities in the approach to manage it. This usually takes the form of regular injections of insulin, often with dietary control and always accompanied by some sort of monitoring of key signs.
There are also some differences however. With people, the objective is to enable them to manage the condition themselves whilst continuing their normal lifestyle. This might involve regular monitoring of blood glucose and perhaps varying the insulin dosage accordingly, all done to a strict time table in relation to meal times and with the benefit of responding to their own symptoms.
With animals, it is impractical to monitor the condition so closely, so the objective is to manage the diabetes in such a way that the symptoms are removed (excessive thirst, etc) and quality of life is maintained. Depending upon the details of treatment and monitoring, this might leave the blood sugar or more specifically the blood glucose (BG) level slightly elevated, perhaps with just a trace of glucose in the urine, or perhaps an almost normal BG.
There are 2 key stages:
- Regulation or Stabilisation
Reducing the blood glucose (BG) from its very high level down to something approaching normal. If there are no other complications, the signs of diabetes should then disappear and the cat should return to apparently normal patterns.
- Maintenance
The stage when the cat has reached the appearance of being normal and healthy. The cat might stay in this phase for the rest of its life, although the needs of some cats do change over time.
Tablets
Sometimes, diabetes might respond to drugs given as pills or tablets, sometimes described as "oral hypoglycaemics" (i.e. drugs given through the mouth that reduce blood glucose). For example, my vet at that time suggested that I tried Susie on these for a couple of weeks first, before starting on insulin. Glipizide appears to be the most common. I am told that only a small proportion of cats respond to such treatments, although this might be related to the proportions of cats with type 1 and type 2 diabetes. Either way, if a cat becomes diabetic, it is likely to mean insulin injections.
I was never able to give Susie any tablets and Glipizide was no exception. The only way I could get her to take them was by crushing them into a little gravy from a sachet of catfood. She would lap this up, often enjoying the newly found extra attention - it was given before her meals, which were not provided until she had finished all of the tablet. From my experience, injections are far easier.
Insulin Injections
This is by far the most important method of managing diabetes in cats. Insulin has to be injected rather than being given orally, because it is a hormone. Hormones are protein based and would be destroyed by the digestive acids and enzymes. Insulin is injected "subcutaneously", i.e. under the skin. Once there, it is gradually absorbed into the cat's bloodstream.
Before I started giving Susie insulin injections, I found the whole idea very daunting, but it is very straightforward and far less invasive in my experience than trying to give a cat a tablet. Further information on insulin and on giving injections is available elsewhere in the Susie, Diabetic Cat pages.
Diet
Most of the popular brands of catfoods available in the high streets and supermarkets may have a variable composition and they can contain sugars that contribute to increases in the blood glucose level. Vets will normally suggest a more controlled feeding regime as part of the treatment or management of a cat with diabetes and this can sometimes be based on prescription foods. This will be based on the vet's assessment of the cat's individual circumstances. There are prescription foods available that are specifically made for diabetic cats, as well as foods intended to support controlled weight-loss.
The key dietary factors in managing diabetic cats appear to be:
| Minimal sugars | Sugars rapidly raise the blood sugar level. The ideal is for a lower rise that is sustained over a longer period. This can be achieved by complex carbohydrates in place of sugars. |
| Constant formula | Most sources including various vets that I have asked suggest that the diet should be as constant as possible. Changes in diet often result in a change to a cat's insulin requirement. Changes should therefore be as infrequent as possible and should be phased in over a few days. |
| Controlled calories | A common cause of diabetes is obesity and in this situation, the calorie content of the food needs to be restricted as part of a controlled weight reduction programme. For cats that aren't overweight, there are other foods with a higher but controlled calorie content. |
| Fibre | Major manufacturers of specialist and prescription catfoods appear to differ on the need for high fibre diets. Some suggest that fibre is not beneficial whilst others suggest that it is. They have all formulated their foods accordingly. The argument in favour is that fibre reduces the rate of absorption of nutrients from the intestine into the blood stream, producing a lower but more sustained rise in blood glucose that is more manageable. The argument against is that such benefits have been observed mainly in dogs and that the evidence for similar benefits in cats is much weaker. My experience is that vets also differ in their opinion, so my approach with Susie has been to use a specific mixture of high and low fibre foods. |
Monitoring
Diabetes is a condition which can potentially be managed successfully, but things can also go wrong. Some of the complications can be severe and life-threatening, but with careful monitoring as a routine part of the management of the condition, the risks of things going wrong can be minimised.
At its most basic level, but very important, monitoring is based on looking out for any changes in the cat - in habits (eating, drinking, litter tray) or in behaviour or manner.
There are also more specific monitoring techniques, on which vets will advise. These might include regular testing of the blood glucose level, testing urine samples for glucose and ketones, keeping a note of how much water the cat drinks, and other occasional tests which the vet can do every few months.
More details of monitoring and complications can be found elsewhere in the Susie, Diabetic Cat pages.
Cost
One of the fears if a cat becomes diabetic is what the cost might be. With veterinary supplies - insulin and syringes, special food, regular visits to the vets, possible expensive assessment when the cat is first diagnosed, it can all seem like a bit of a nightmare. Every case is different, so I can only speak about my experience with Susie, but it wasn't as expensive as I had feared.
Insurance taken out before the cat became diabetic should cover the costs of treatment and perhaps supplies, but this might only be for a limited period. I hadn't taken out insurance for Susie, so I had to pay for her treatment and supplies from day one.
Initial Regulation or Stabilisation Stage
It seems that the costs can be very different during the initial diagnosis and
regulation stage (i.e. when everything is first getting sorted out) compared
with the subsequent maintenance stage (when hopefully everything is going along
smoothly). Different vets seem to have widely differing approaches to the
initial regulation stage. Some vets will recommend that the cat stays at
the surgery for a few days so that they can sort out an appropriate insulin
injection regime. That option would certainly be expensive. My own
vet chose a different and far less expensive approach. It was to start
Susie on a very low dose, with me doing all the injections at home. I was
also closely monitoring Susie. It took several months to get her
stabilised, but it was much lower in cost to me, and it helped train me up on
doing the injections at a time when the risks were lower if I made a
mistake. I'm not in a position to say that either of these approaches are
better, but simply to say that as in most aspects of managing a diabetic cat,
there is normally more than one option available.
Ongoing Maintenance Stage
Once Susie was stabilised, I found it helpful to divide the costs into 3 distinct areas -
medical supplies, food and veterinary treatment. When I ordered
supplies from the vet, I would order several things at once,
so the bill always seemed expensive. However, it is possible to
work out how long a vial of insulin, a pot of Keto-Diastix or a
bag of prescription catfood should last, so the average cost per
week, month, or year can be calculated. Looking at it in this way, it
doesn't seem to be that expensive. The detail will vary according to the
way the cat is being managed, but when I compared it to what I was paying before
for tinned and sachet foods, it wasn't much more expensive.
Important note: All information and opinion in the Susie, Diabetic Cat pages is from personal experience. Nothing in these pages is intended to be a substitute for proper professional advice, which should always be sought from a qualified veterinary surgeon.
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