DIABETES MELLITUS
What is diabetes mellitus?
Diabetes mellitus refers to a medical condition where there is an excessive
quantity of sugar (glucose) in the blood. This is caused by a relative or absolute
deficiency of the hormone insulin, which is secreted by the pancreas.
The clinical signs seen in diabetes are largely a consequence of the raised
concentrations of glucose in the blood, and the inability of the body to use
glucose as an energy source (due to the deficiency of insulin).
Diabetes mellitus is an uncommon disease in cats, but is seen more frequently
in middle to old-age cats and more common in males than females.
What clinical signs do you see in diabetes mellitus?
The most common clinical signs seen in diabetic patients are an increase in
the volume of urine that is produced and, to compensate for this, an increase
in the amount of water that is drunk. Weight loss is also a common feature,
and an increase in appetite may be noticed in some cats. Recognition of these
signs is variable though, particularly because of the lifestyle of some cats.
If a cat spends a lot of time outdoors for example, it may drink from ponds
or pools of water outside rather than appearing to drink excessively from what
is provided indoors.
How is diabetes mellitus diagnosed?
The diagnosis of diabetes mellitus is made by finding appropriate clinical
signs, together with a persistently elevated blood glucose concentration and
the presence of glucose in the urine. However, a diagnosis of diabetes cannot
usually be made on a single blood and urine sample as other conditions, and
in particular stress, may also cause a transient rise in glucose levels. Confirmation
of diabetes may therefore require more than one blood sample collected over
a period of time (perhaps several days).
How is diabetes mellitus treated?
Diabetes mellitus is a treatable condition. Although long-term treatment does
require commitment, it can be very rewarding to successfully manage this condition.
Initial steps in treating a diabetic cat may involve removal of any predisposing
causes for the diabetes. For example, the administration of some drugs predisposes
cats to develop diabetes, and withdrawal of these drugs may lead to resolution
of the condition. Also obese cats are more prone to develop diabetes and again,
reduction in bodyweight can lead to resolution of the signs in some of these
individuals.
If there are no predisposing causes, or if correction of the predisposing
causes does not lead to resolution of the diabetes, specific treatment is required.
Although a small proportion of cats will respond to a form of tablet ('oral
hypoglycemic') designed to increase the amount of insulin produced by the pancreas
and increase its effectiveness, most cats will require insulin supplementation
in the form of injections to control the diabetes.
During the initial stages of treatment, it is common for a cat to be hospitalized
at a veterinary surgery so that appropriate monitoring can be carried out while
a suitable dosage and preparation of insulin is being determined. Once a cat
has been stabilized (which usually takes a few days to a week or so), treatment
can be continued at home. For most cats, this involves a single daily injection
of a small dose of insulin. Very small needles are available for this which
cause no pain to the cat, and within a short period of time the procedure becomes
very routine. Normally the insulin will be administered in the morning (usually
between 7.00 and 9.00) along with 1/4 to 1/3 of the daily food, with the remainder
of the food being given around 8 hours later. However, there is individual variation
in the response to insulin and you must follow closely any advice given to you
by your veterinary surgeon.
Do treated cats need to be monitored?
Yes, it is important to monitor treatment to make sure it is working properly,
and to determine if any adjustments are necessary to the dose of insulin given.
Monitoring can be done in part through collection of occasional blood samples
by your veterinary surgeon, but it is particularly valuable to keep accurate
records of the following information:
Daily records:
- Time of insulin injection
- Amount of insulin injected
- Amount of food fed and eaten (and time)
- Amount of water drunk
Weekly record:
In addition to these records, it can be valuable to monitor the quantity of
glucose passed in the urine as a guide to the effectiveness of the treatment.
This is best done on urine that is passed during the night or first thing in
the morning. To collect urine, it is usually easiest to replace the normal cat
litter with clean (washed) aquarium gravel at night which will not soak up any
urine passed. The urine collected can either be tested by your veterinary surgeon,
or they may supply you with a kit to test it yourself. If there is any marked
change in the amount of glucose in the urine, this may indicate the need
to alter the insulin dose, but you should never change the dose of insulin
without first discussing it with your veterinary surgeon. Changes in the
insulin dose are usually based on trends in urine glucose concentrations
as there is normally some day-to-day variation.
What happens if my cat receives too much insulin?
If a cat receives too much insulin, it is possible for the blood sugar level
to drop dangerously low. For this reason it is important to be very careful
in ensuring the cat receives the correct dose of insulin.
The typical signs displayed by a cat with a very low blood sugar level are
severe weakness and lethargy, shaking, unsteadiness and even convulsions. If
a diabetic cat shows any of these signs it is important to seek urgent veterinary
attention. If the more severe signs are displayed (ataxia or unsteadiness during
walking, and/or convulsions) a tablespoon of a saturated glucose or sugar solution
should be given by mouth immediately. As this is an emergency, it is useful
to have a small amount of a glucose solution stored in a refrigerator for any
cat receiving insulin.
Back
to Feline Information Index
|
