Treatment for diabetes may include one or more of the following:
On the other hand, Type II DM, in which the tissues are merely resistant to the effects of insulin, can sometimes be controlled through weight management, diet changes and/or pills to lower blood glucose. Some cats can be maintained well on a special diet such as Purina’s DM. Patients with uncomplicated diabetes are generally managed on an outpatient basis, but those experiencing complications such as diabetic ketoacidosis will require initial in-hospital stabilization.
Insulin comes from several sources and in many formulations. The most commonly available source is recombinant insulin, produced by genetically engineered bacteria to mimic human insulin. Other sources are from processed beef or pork pancreas.
Insulin formulations vary in the time they require to reach peak action and duration of action. Commonly prescribed formulations include glargine insulin (brand name is Lantus), protamine zinc (PZI), humulin NPH and Humulin U. Many of these insulin come on and go off the market frequently. Currently, PZI and Humulin U are both off the market. Another formulation, “regular” insulin, is very short acting and is primarily used in the hospital setting for complicated diabetics.
A low carbohydrate and high protein diet and regular exercise can aid in control of DM. Ideally, 15% or less of metabolizable energy should be carbohydrates. Diets may include prescription diet DM or high quality kitten foods.
Ideally, meals should be divided into twice daily servings and offered prior to/with the insulin injections.
Animals with complications such as diabetic ketoacidosis will require in-hospital therapy, including insulin administration with frequent dose adjustment, intravenous fluids, administration of electrolytes (blood chemicals) and antibiotics.
Be prepared for frequent adjustments to therapy early in the course of treatment. Veterinarians prefer to start with a low dose of insulin initially and adjust upwards slowly to avoid overdose.
Too much insulin can be worse than not enough; insulin overdose can cause low blood glucose. When blood glucose is too low, the brain does not get adequate energy. The result can be disorientation, lethargy, seizures, coma or even death. If you notice disorientation in your alert diabetic cat, offer food immediately. If the cat is unconscious, you can apply a sugary solution like Karo® syrup to the gums. In either case, call your veterinarian immediately.
DM requires dedicated follow-up care on the part of the pet owner. With a commitment of time, education and careful observation, most diabetic cats can have a good, quality life.
Home Care of Cats with Diabetes
Familiarize yourself with insulin handling. This bottled hormone is not perfectly soluble or stable. It needs to be kept cool and out of direct light, and it must be gently mixed thoroughly before use (rolled in the hands), but not shaken hard.
Familiarize yourself with insulin syringes and administration. Insulin is given as “units” rather than as the standard cubic centimeter (cc) or milliliters (ml); special insulin syringes come in a variety of unit sizes. Insulin is usually administered just under the skin. Your veterinarian can spend time teaching you how to do this with a minimum of protest from your cat.
NOTE: A well-regulated diabetic pet should look and behave the same as a pet in good health.