Diabetes in Cats

                                       Introduction

           Diabetes mellitus (DM) is the second most common endocrine disorder in cats, with an expected incidence of 0.5 % (1 in 200-250 cats).Its incidence appears to be increasing, perhaps due to an increase in obesity in the cat population. Risk factors for DM have been identified as age, obesity, neutering and gender. Age has been identified as the single most important risk factor.

           Diabetes occurs in a wide age range of cats but most cats are over six years of age when diagnosed. The average age at diagnosis is 10 years and the peak incidence is between 9 and 13 years .Diabetes in young cats is extremely rare. Obesity increases the risk of developing diabetes 3 to 5 fold. When treating a diabetic cat, the primary goals are to control clinical signs without causing hypoglycaemia and to maximize the chance of achieving diabetic remission.

           Identification and treatment of concurrent disease plays an integral role in the successful management of the diabetic cat. Concurrent disease such as urinary tract infection and pancreatitis can interfere with issue responsiveness to insulin, making glycaemic regulation difficult and predisposing to episodes of ketosis. Minimizing the impact of food type and feeding method on postprandial blood glucose concentration and correction of obesity are important dietary considerations in diabetic cats. A low carbohydrate, high protein diet is recommended but should not be given as the sole therapy in an overly diabetic cat.

                                        Diagnosis

          A diagnosis is done on the basis of clinical findings, urinalysis, signs of obesity, history of corticosteroids, laboratory tests such as CBC, biochemistry profile, urine culture and T4 level. Other diagnostic tests include fPLI (feline pancreatic lipase immunoreactivity), abdominal ultrasound/ radiography and blood pressure measurement.

                                       Prevention

          Minimizing circumstances for insulin resistance (e.g. Obesity, inactivity). Not all obese cats become diabetic, many diabetic cats are of normal size. Avoid irrational use of steroids and prevent inactivity of cats. Treatment can be done either by insulin therapy or oral hypoglycaemic drugs. 

                                     Clinical Signs

• Weight loss
• Initially increased thirst & appetite but in later stages it decreases.
• Increased urine production
• Hind limb weakness
• Decreased jumping ability
• Plantigrade posture
• Muscle atrophy
• Vomiting
• Depression
• Diarrhoea

                               Dietary recommendations

           Insulin resistance caused by obesity can be resolved as obesity is corrected. Following weight reduction, glycaemic control often improves and some diabetic cats revert to a subclinical diabetic state. Unfortunately, correction of obesity is difficult in cats because it requires restriction of daily caloric intake, ideally with some increase inn caloric expenditure (i.e. exercise).

                                    Nutritional Aspects

           Dietary therapy may minimize postprandial blood glucose fluctuations. Diets should be palatable to ensure predictable consumption. A consistent feeding schedule is more important than timing between insulin administrations. The ideal dietary composition is debatable as low carbohydrate /high protein and high fiber / low fat .Diets can result in good glycaemic control when used with insulin. Low carbohydrate diets result in higher remission rate. Overweight cats require a weight reduction program, as obesity is a reversible cause of insulin resistance. Compared with dry foods, canned foods are generally preferred, as they typically have lower carbohydrate content. 

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