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Symptoms & Treatment of Cat Diabetes: A Comprehensive G

20. December 2024
Understanding the Disease Mechanism: In the pancreas of cats, there is a substance called amyloid be

Understanding the Disease Mechanism: In the pancreas of cats, there is a substance called amyloid beta peptide, abbreviated as IAPP. This peptide is secreted alongside insulin by the beta cells within the islets of Langerhans. The issue lies in the fact that while cats can utilize insulin, they cannot process IAPP effectively. Over time, this imbalance leads to a transformation of IAPP into islet amyloid protein, which physically damages the beta cells. Additionally, the biological activity of IAPP can affect beta cells, leading to a negative feedback loop that disrupts the normal secretion of insulin by the islets. This disruption affects the transport of insulin and glucose, causing glucose toxicity, rendering the body unable to recognize glucose levels, and ultimately leading to the cessation of insulin production. A highprotein, lowcarbohydrate diet can reverse this process. Therefore, with proper treatment within the first six months, most cats with diabetes can recover completely. Beyond that, cats may require lifelong insulin injections, which can be a nightmare for pet owners. Feeding older cats a highcarbohydrate dry kibble can increase the incidence of diabetic ketoacidosis (DKA).

Diagnosis of DKA in Cats: If a cat's blood glucose levels are above the threshold during a test, it does not necessarily mean they have DKA. Symptoms like excessive drinking and urination should be considered, and fructosamine levels should be tested for a definitive diagnosis. Once diabetes is confirmed, it's important not to panic. With timely treatment, cats have a very high chance of returning to a completely normal state. Unfortunately, many cat owners discover diabetes when their pets are already experiencing diabetic ketoacidosis, which is a critical condition.

Treatment for Diabetic Cats: A combination of a highprotein, lowcarbohydrate diet and insulin injections is crucial.

HighProtein, LowCarbohydrate Diet: Avoid all dry kibble, and even diabetesspecific formulas may not be recommended. Opt for wet food, freezedried options, or homemade meals that are low in plant ingredients. However, transitioning cats from a lifelong dry kibble diet can be challenging, as they may be resistant to other foods. Owners often compromise, which can significantly hinder diabetes treatment. Diet plays a significant role in the management of diabetes, and poor control or nonrecovery can be largely attributed to dietary habits.

In insulin selection, cats should primarily consider glargine insulin (Lantus) due to its lack of peak and long duration, making it a suitable choice for maintaining blood glucose control until complete recovery.

After finding the correct insulin dosage, adjustments should be made based on stable blood glucose levels over a week:

1. If preadministration blood glucose is above 360 mg/dl or postmeal 4hour concentration is above 180 mg/dl, increase the insulin dosage by 0.5 to 1 unit, twice daily.

2. If preadministration blood glucose is between 270360 mg/dl or postmeal 4hour concentration is between 90180 mg/dl, maintain the current dosage. This could indicate that the cat is recovering insulin secretion.

3. If preadministration blood glucose is between 190270 mg/dl or postmeal 4hour concentration is between 5490 mg/dl, assess clinical symptoms and subsequent measurements to determine whether to reduce or maintain the current dosage. If symptoms improve, reduce by 0.51 unit. If symptoms persist, maintain the current dosage and reassess after a week.

4. If preadministration blood glucose is below 180 mg/dl or postmeal 4hour concentration is below 54 mg/dl, decrease the insulin dosage to 2 units. If this continues the following week, reduce by 0.51 unit. If the cat's blood glucose is within normal limits during fasting, it may no longer need insulin. However, this is contingent on avoiding highcarbohydrate diets, as recurrence is possible. Repeated episodes of diabetes can significantly reduce the chances of recovery, with each recurrence lowering the likelihood of successful treatment.

Complications during Treatment: Initial diabetes treatment may lead to hypokalemia, causing neurological symptoms and possibly hemolytic anemia due to low phosphorus. In cases of fatty liver, consider preemptive phosphorus potassium supplementation and blood transfusions. However, excessive potassium supplementation can lead to cardiac arrest, especially in cats with preexisting heart conditions. Pancreatitis is common in diabetic cats and should be treated to prevent insulin resistance and acute pancreatitis. Immediate medical attention is required for diabetic ketoacidosis, including correcting blood gases and inhibiting ketones. Poorly controlled diabetes can lead to acromegaly, particularly in larger breeds like Maine Coons and Norwegian Forest Cats, possibly due to pituitary lesions. Liver enzymes should be monitored, and fatty liver treated concurrently. The importance of maintaining a healthy diet, regular exercise, and not valuing obesity as an aesthetic cannot be overstated.

Diabetes can be a challenging condition, but DKA is not as terrifying as many believe. It is not a life sentence of insulin injections. By providing cats with a good diet, especially in highrisk breeds, encouraging regular exercise, and avoiding obesity, we can help prevent diabetes and its complications. This article aims to reassure pet owners that with proper care and treatment, their cats can lead healthy lives despite diabetes.

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