Diabetes in Cats: Understanding and Managing the Condit

Diabetes is categorized into two types: Type 1 and Type 2. Type 1 diabetes is characterized by damage to the pancreas, which is unable to produce insulin. This type of diabetes requires the administration of exogenous insulin, hence it is also known as insulindependent diabetes:

Type 2 diabetes is primarily associated with insulin resistance, although it can also involve both impaired insulin secretion and resistance.

In the case of canine and feline diabetes, nearly 100% of dogs and 50% of cats are affected by Type 1 diabetes, while the remaining 50% of affected cats suffer from Type 2 diabetes.

When insulin is weakened for any reason, glucose that should enter the cells remains in the bloodstream, leading to an increase in blood sugar levels. This condition is known as hyperglycemia, and if it persists for an extended period, it can cause damage to various parts of the body.

The incidence rate of diabetes in dogs and cats ranges from 0.2% to 1%.

II. Common Symptoms of Feline Diabetes:

Increased thirst

Increased appetite

Weight loss, dehydration, and emaciation

Increased frequency and volume of urination

Abdominal swelling (liver enlargement)

Cataracts

Diabetic ketoacidosis

In the early stages of the disease, symptoms may not be apparent in cats, with the only noticeable signs being a voracious appetite, excessive water consumption, and a high urine output. However, these symptoms quickly progress to weight loss, dehydration, and further complications such as loss of appetite, lethargy, weakness, unsteady gait, and more severe symptoms like thinning skin, jaundice, coma, and acute inflammation. If you notice any of these symptoms, seek veterinary care immediately to prevent further complications and potential lifethreatening situations.

Regarding blood sugar levels, the line between healthy cats and those with diabetes can be ambiguous. The widely used reference value for diabetes is "diabetes = 171290 mg/dL." According to a 2017 survey by a team from the University of Queensland, if an 8yearold or older cat of normal weight has a blood sugar level of 189 mg/dL or higher upon admission to a veterinary hospital, and if the blood sugar level is 116 mg/dL or higher 3 to 4 hours after the stress has decreased, it is very likely that the cat has diabetes. It is recommended to fast the cat for 1824 hours before the examination and then check its fasting blood glucose and glucose tolerance.

In another study, if the fasting blood glucose level is between 135 and 151 mg/dL, there is a 75% chance of developing diabetes within 9 months, and a glucose tolerance test was conducted (0.5 g/kg glucose intravenous injection for fasting cats, and blood sugar levels were measured 2 hours later). If there is moderate glucose intolerance, there is a 38% chance of developing diabetes within 9 months. However, such blood sugar levels and glucose tolerance are only indicative of the diagnosis and should be considered along with clinical symptoms.

Causes of Feline Diabetes:

① Fast eating: If a cat is accustomed to eating quickly, it releases a large amount of insulin with each meal. Over time, cells become less responsive to insulin, and the ability to absorb blood sugar diminishes. As a result, blood sugar levels remain high, eventually leading to diabetes.

② Age: Diabetes typically affects cats over 10 years old. A largescale study conducted in the UK in 2016 confirmed that the incidence rate of diabetes sharply increased from the age of six. The following data from Anicom Sompo's 2012 financial year's statistics on feline diabetes further confirms the sudden increase in the incidence rate at the age of six. It is worth mentioning that when comparing the incidence rate by gender, male cats accounted for 70%, while female cats accounted for 30%, with males seemingly dominating females.

③ Underlying diseases: Pancreatitis and tumors can cause diabetes. Other diseases that can improve feline insulin resistance (poor response to insulin) include hyperthyroidism, acromegaly (90% in male cats), Cushing's syndrome (60% in female cats), kidney disease, liver disease, heart failure, and tumors.

④ Medications: Corticosteroids, luteinizing hormone, diuretics, heart medications, and anticonvulsants can weaken insulin and cause diabetes.

⑤ Obesity: A largescale study conducted in the UK in 2016 found a link between weight gain and the incidence of diabetes. Specifically, if the incidence rate is "1" for less than 3 kg, it jumps to "3.2 times" for 4.0 to 4.9 kg, to "5.1 times" for 5.0 to 5.9 kg, and to "20 times" for 8.0 kg or higher. The underlying mechanism behind this is believed to be "due to chronic inflammation of fat cells caused by obesity → increase/decrease of adipokines → change in insulin resistance → diabetes."

⑥ Breed/Genetics: Studies conducted in the UK, Europe, and Australia have shown that Burmese cats have a high incidence of diabetes. Another study conducted in Sweden reported that Norwegian Forest cats, Russian Blue cats, and Abyssinian cats have a higher incidence, while Persians have a lower incidence. Additionally, a largescale study conducted in the UK in 2016 found that Burmese cats (3 times the standard), Norwegian Forest cats (3.5 times), and these data seem to confirm that certain breeds are more prone to diabetes. Although the genes associated with the disease have not yet been identified, research on obese cats suggests that mutations in the melanocortin 4 receptor gene (SNP) may be related to the onset of diabetes. Moreover, since feline diabetes is mostly Type 2, it is believed that there is a commonality with approximately 70 gene mutations related to the 70type II development mechanism in humans, although the details are still unknown.

Treatment of Feline Diabetes:

① Insulin and hypoglycemic drug combination therapy: Subcutaneous injections of artificially produced insulin can be administered under veterinary guidance. Do not administer too much insulin. Follow the doctor's instructions for dosage; if the concentration is too high, it may cause hypoglycemia, leading to loss of consciousness or seizures; conversely, if the concentration is too low, blood sugar levels will not decrease sufficiently, and the significance of the injection will be weakened. The appropriate amount of insulin depends on the amount of daily exercise and calorie intake.

② Fluid therapy: Multivitamin balanced fluids to correct electrolytes and dehydration. Avoid lactated Ringer's and glucose as they can increase the burden on the liver, accelerate liver lipid precipitation, worsen glucose tolerance, and increase blood sugar levels. Potassium, phosphorus, and magnesium ions should be supplemented. Pay attention to the slow administration of ion supplementation.

③ Diet therapy: If a cat consumes too much food, the amount of sugar released into the bloodstream will increase. Therefore, it is necessary to consider the quality and quantity of the cat's diet. Set the number of calories consumed daily, meal times, and exercise routines.

Limit the intake of chemical carbohydrates and increase protein intake. For example, feed cats lean meats and eggs. Supplement necessary vitamins and minerals to increase appetite.

④ Exercise therapy: Exercise therapy can be used to reduce excess fat or consume excessive blood sugar. However, forcing a cat to exercise can cause stress, which may lead to hyperglycemia. If it is combined with insulin injections, the injection amount will vary depending on the amount of exercise on that day.

Treating diabetes is a longterm process, and cats may require insulin to control blood sugar levels for life. This requires the owner to take on a significant responsibility and show great love and care. The owner's perseverance and affection are the hope and motivation for the cat's recovery to health.