Feline Diabetes: Diagnosis, Treatment, and Remission Demystified

By the time you’ve finished reading this guide, you’ll understand what feline diabetes is, how to treat it, and what to expect from the coming months and years as a diabetic cat guardian and caregiver. You’ll have the foundational knowledge and the vocabulary you need to ask your veterinarian the right questions and make sure your cat gets the care he needs.

What is diabetes?

The word diabetes originates from the Ancient Greek word for “siphon”—a reference to the excessive urination so common among diabetes patients. In 1675, the word “mellitus” was tacked onto the end of the name. As a derivative of mel, meaning “honey”, it gives the name a sugary-sweet flavor. Diabetes mellitus translates to, roughly, “sweet siphon”.

It’s an appropriate name. Diabetes causes sugar to fill the bloodstream. The body attempts to siphon the excessive glucose out through the urine, resulting in a flood of sticky-sweet urine.

It’s an endocrine condition that involves several dynamics, all of them related to the pancreas and glucose metabolism. The pancreas is an organ responsible for several tasks related to digestion and metabolism. One of its jobs is producing insulin.

Normally, each time your cat eats a meal, beta cells in his pancreas trigger the release of insulin, which streams into your cat’s blood and attaches to and unlocks cells, allowing them to absorb energy-giving sugar.

When a cat has diabetes, something’s gone wrong with either insulin production or insulin receptivity.

A small percentage of feline patients have type 1 diabetes, which occurs when the immune system destroys the pancreatic beta cells that trigger insulin production. This disease is usually genetic and, again, rare among cats.

Almost all feline diabetes patients exhibit metabolic peculiarities typical of type 2 diabetes, a name we give to chronically high blood sugar that’s not caused by an autoimmune disease (type 1 diabetes). Some doctors argue that calling it type 2 diabetes as if it’s a single pathology limits our understanding of the condition. Some think it’s more accurate to call it “idiopathic hyperglycemia”.

The situation is particularly blurry among cats, who usually have a combination of insulin resistance and poor insulin production.

To make things more interesting, prolonged insulin resistance and consequently high blood glucose damages the pancreas, so even if a type 2 diabetic produces plenty of insulin at the onset of the disease, their pancreas might wear out over time, making them both insulin-resistant and insulin-deficient.

Without insulin, glucose is incapable of converting to fat and energy in the body. If insulin is a key, glucose in a diabetic cat’s body is like a person locked out of their house. Unable to do anything useful, the sugar builds up in the blood. Molecules that should be creating energy instead weigh the body down, depressing the entire system.

The result is a lethargic, weak cat who drinks too much, pees too much, and doesn’t feel his best.

What are the symptoms of feline diabetes?

The two most distinctive symptoms of diabetes are called polydipsia (excessive urination) and polyuria (excessive drinking). Not sure how you’ll remember those words? Polydipsia involves a “D” like the word “drink”, but it refers to excessive urination. Polyuria sounds like it refers to urination, but this one is about drinking. Try these words out at your next vet visit!

Other symptoms of diabetes include sticky sugar-filled urine, a ravenous appetite, lethargy, and weight loss. Though obese cats are more likely to develop diabetes, they may lose weight as the disease wears them down.

What are the complications of feline diabetes?

cat

Unlike humans, who often suffer from diabetes complications including foot infections, diabetic glaucoma, and more, cats seldom develop such serious complications.

It’s not that diabetes is easier on cats—they just don’t live long enough for it to wreck their bodies. While a well-managed diabetic cat has a normal life expectancy, that’s still not a lot of time to have diabetes. A cat who develops diabetes at age eight will usually live with diabetes for no more than ten years. A human might be diagnosed at age 40 and have diabetes for 40 years, giving hyperglycemia multiple decades to slowly chip away at their health.

In cats, diabetic neuropathy is the most common complication of diabetes.

It affects about 10% of cats diagnosed with diabetes and usually develops after a few months of untreated diabetes.  Diabetic neuropathy typically affects the femoral nerve, causing weakness of the legs and something called a plantigrade gait. You and I have a plantigrade gait—we walk on the soles of our feet. Cats usually walk on their toes. When they have diabetic neuropathy, cats often walk on their hocks or heels. Cats with this type of gait look a bit like rabbits—they just don’t hop.

Diabetic neuropathy is usually reversible with glycemic control through insulin therapy, diet, and healthy lifestyle.

Ketoacidosis is the second complication you’ll need to think about.

Diabetic cats, particularly skinny ones, are at risk of developing ketoacidosis, which occurs when the body is starved of insulin, can’t metabolize glucose, and starts breaking down fat for fuel. Instead of doing this at a normal rate, the body breaks down fat too quickly, releasing a rush of ketones into the blood. The ketones overwhelm the blood, making it acidic and toxic.

Signs that your cat is in a state of ketoacidosis include fruity or acetone-scented breath,  lethargy, loss of appetite, and vomiting. Diabetic ketoacidosis may occur when you miss a dose of insulin, let your cat remain hyperglycemic (have high blood sugar) for too long, or when your cat has a serious illness or infection. Ketoacidosis is a serious, life-threatening complication that demands a rush visit to the veterinarian.

What causes feline diabetes?

Type 1 diabetes, which is, again, rare in cats, involves an inappropriate immune response to the pancreatic beta cells that initiate insulin release.

Type 2 diabetes or idiopathic hyperglycemia has a range of root causes.

These include obesity, a high-carbohydrate diet, inactivity, and genetic factors. Male cats, indoor cats, and those over the age of eight are also at increased risk of developing diabetes. Diabetes is more common among some populations of Burmese cats around the world.

Of these causes, diet and obesity are the easiest to control and the most related to treatment.

Diabetes is an endocrine condition and deeply connected to diet. Though we don’t know how much of an impact diet has on your cat’s chances of developing diabetes, several things are clear.

Cats are obligate carnivores with a metabolism optimized for meat, meat, and more meat. Every aspect of their physiology, from saliva to pupils to claws to intestines and stomach acid, is characteristic of an animal-eating machine. As an animal optimized for this type of high-protein, high-fat, low-carbohydrate diet, cats are capable of carbohydrate metabolism, but a less efficient form of carbohydrate metabolism than that found in omnivorous species.

Metabolically, cats are similar to diabetic humans. Even healthy cats exhibit some insulin resistance, and the gluconeogenic pathway is always open, allowing glucose to flood the bloodstream unhindered.

It’s speculated that a lifetime of eating high-carbohydrate food continually floods the body with glucose. Considering the feline’s naturally repressed insulin response, glucose isn’t utilized effectively and instead goes coursing around the body, wearing out the pancreas and eventually leading to diabetes.

Then there’s obesity. Excess body fat increases your cat’s chances of developing diabetes and it can make diabetes worse. Fat cells release hormones that inhibit the insulin response, making the condition even harder to control.

Diagnosing Diabetes – What to Expect at the Vet

My vet is recommending a therapeutic diet. Does my cat really need a special food

If your cat is tired, drinking all the time, and urinating more than he used to, it’s time to visit the veterinarian and find out if he has diabetes.

Your veterinarian will probably want your cat to stay in the animal hospital for a couple of days while they perform blood glucose profiles. These tests will tell your veterinarian whether or not there’s too much glucose in your cat’s blood.

Blood glucose values between 180 and 288 mg (milligrams) per dl (deciliter) are indicative of diabetes and values over 400 mg/dl are an undeniable sign that your cat is diabetic.

There are a few factors that can distort these values, so it’s important to control them. The vet will perform multiple tests to confirm that the elevated blood glucose isn’t caused by vet-associated stress. Because food consumption distorts blood sugar values, the vet will withhold meals to obtain your cat’s fasting blood sugar.

Caring for Your Diabetic Cat

cat food 1

“In general, the best glycemic control is obtained in the majority of cats by using PZI or glargine twice daily combined with a low carbohydrate-high protein diet.” – Therapeutic Goals for Otherwise Healthy Diabetic Cats

Your diabetes control strategy has several primary facets—glycemic control through insulin and diet combined with weight loss.

While diet and insulin management are both essential, weight loss isn’t. Although obesity is a major contributor to diabetes, not every diabetic cat is obese and, in some cases, weight loss is not a good idea. Note that weight loss is one of the symptoms of diabetes, so some cats may even become underweight.

Treatment begins with consistent blood glucose monitoring.

Some people opt to have their cat’s blood tested during regular vet visits, but this might not be the wisest approach. Your cat’s blood sugar soars when under stress, so the environment at the veterinarian’s office will cultivate unrealistically high blood sugar test results. You don’t want to give your cat too much insulin based on stress-induced high blood glucose, so control for stress by testing at home.

If you’re serious about reversing your cat’s diabetes rather than just controlling it, you can’t wait three or four months until your next vet appointment. You need to know how much glucose is in your cat’s blood all the time. Without close attention to changing blood glucose levels, you can’t adjust insulin to meet your cat’s changing needs. Administering too much insulin could lead to hypoglycemia.

But wait. What is an aggressive treatment plan?

An aggressive treatment plan involves strict glycemic control. Through insulin therapy and diet, strict glycemic control keeps your cat’s blood glucose within a normal range of around 72 to 180 mg/dl.

Without frequent blood glucose testing, this kind of glycemic control could easily result in hypoglycemia. With a good glucometer and a regular blood testing schedule, it’s the best way to bring your cat’s diabetes into remission.

In one report, cats on a strict glycemic control protocol experienced an 84% remission rate, compared to 35% remission rates among cats who weren’t tightly regulated.

As soon as you learn that your cat has diabetes, pick up a good glucometer. Cat and dog guardians have successfully used the MiniMed Gold, Guardian Real-Time, GlucoDay, iPro, and FreeStyle Libre, among others.

Here’s how to test your cat’s blood sugar.

After you’ve gotten your hands on a glucometer, learn how to test your cat’s blood sugar. Using the lancet that comes with your glucometer or a sterile hypodermic needle, prick your cat’s ear between the outside edge of the ear and the highly-visible vein that runs more or less parallel to the outer edge of your cat’s ear.

Dip your test strip into the droplet of blood that forms in the place where you pricked your cat’s ear. You may read the test strip according to a color-coded chart or insert it into the glucometer, which will provide a reading and, depending on the capabilities of your glucometer, potentially stream that reading to your smartphone or other device.

If your glucometer doesn’t do it for you, don’t forget to record your results. These results will start to show trends that allow you to evaluate your cat’s progress and changing requirements. You’ll also want to present this information to your veterinarian at your next visit.

Your cat’s blood sugar should be tested at least three times a day:

  1. Early in the morning before he’s received an insulin injection or eaten a meal.
  2. Late in the afternoon before he gets the second injection of the day.
  3. Right before bed.

What do your cat’s blood test results mean?

The normal level of glucose in the blood is 80-120 mg/dl, though it’s normal to dip into the 60-80 range. A normal cat’s blood sugar may rise to 250-300 mg/dl following a large or high-calorie meal, but unless a cat is diabetic, his blood sugar will never reach 400 mg/dl or higher. Some diabetic cats have glucose levels as high as 700-800 mg/dl, though this is relatively uncommon.

Injectable insulin therapy is the heart of managing your cat’s diabetes.

Feeding Cats with Diabetes

When your cat is diagnosed with diabetes, your veterinarian will likely offer you two treatment options—injectable insulin or oral hypoglycemic medications, the most common being Glipizide. If you’re needle-averse, you might be initially drawn to oral medications, but I’d like to encourage you to opt for insulin injection instead.

Hypoglycemic medications have a 5-30% success rate, which isn’t particularly impressive, especially considering that insulin injection isn’t just more effective than pills. It’s safer. In addition to potential hypoglycemia, Glipizide is associated with side effects including vomiting, loss of appetite, and jaundice. Insulin’s only side effect is hypoglycemia.

And as most people realize after a couple of weeks of trying to pill their diabetic cat twice a day, the reality of pilling a cat is more frightening than injecting your cat with a thin hypodermic needle.

Injectable insulin allows you to control your cat’s blood glucose, relieving diabetes symptoms and stopping the toxic effects of excessive sugar in the bloodstream. This type of glycemic control is a critical part of your diabetes treatment plan.

By injecting insulin on a regular basis, you mimic the normal function of the pancreas. Your veterinarian will help you to select the appropriate dose and may advise you on which insulin is best for your cat. Remember that your cat’s insulin dose will not necessarily remain the same forever. Since the goal is to stabilize your cat’s blood glucose levels within a normal range, you will ideally taper off insulin use until your cat no longer requires any injections at all.

What type of insulin should you use?

Insulin may be derived naturally from the pancreas of pigs (usually called porcine insulin) or cattle (usually called bovine insulin) or genetically engineered as a human insulin analogue.

Bovine, porcine, and human analogue insulin are all acceptable options for cats, but they’re not equal. Insulin preparations using bovine insulin are the closest match to your cat’s own insulin, making them theoretically the most readily-accepted type available.

Ultimately, however, the insulin’s origins aren’t as significant as they might initially seem. While it’s speculated that the wrong insulin could trigger a release of antibodies to fight against the foreign amino acids, clinical data suggests that this type of reaction is rare and harmless.

The more significant difference between different types of insulin is its release time.

Some types of insulin, referred to as fast-acting insulin, spike shortly after injection, necessitating multiple injections through the day. They work for about 5-8 hours.

Intermediate insulin is a combination of multiple types and also demands twice-daily injections.

Others, called long-acting insulin solutions, have a slow, even release and may require just one injection per day.

Because they metabolize insulin twice as fast as people or dogs and should be eating an extremely low carbohydrate diet, long-acting insulin is ideal for cats.

Popular Insulin Products Compared

  • Lantus or glargine is a long-acting human insulin analogue that appears to be safe and effective when given to cats. It lasts for 12 to 18 hours in the body. In one study on the effectiveness of glargine treatment, 84% of 55 cats achieved diabetic remission within 6 months.
  • Detemir is a long-acting synthetic analogue of human insulin. It’s administered one to two times daily and lasts for 18 to 21 hours. In a study on 11 newly-diagnosed cats treated with detemir, 81% went into remission.
  • Prozinc/PZI is a long-acting bovine insulin designed for cats. It lasts for 10-14 hours. In a study of 133 diabetic cats, 85% achieved diabetic control within 45 days. In another study, 38% of cats given PZI achieved remission within 112 days or just under 4 months.
  • Vetsulin or lente insulin is an intermediate-acting porcine insulin for dogs and cats. In a 12-month study of 25 cats given lente insulin, 84% had a good or excellent response and 28% reached diabetic remission within 4 months of treatment.

Though neither are formulated or marketed for cats, glargine and detemir have the best history of promoting feline diabetes remission.

How often do you have to give your cat insulin?

Your insulin dosage frequency depends on which type of insulin you’re giving your cat.

If you’re using short or intermediate-acting insulin, you’ll inject twice a day with each injection 12 hours apart. If you’re using long-acting insulin, you’ll only need to give your cat one dose per day—maybe two if your cat doesn’t respond well to the once-daily dosing pattern.

If you’re doing twice-daily dosing, look at your schedule and choose two times that you can commit to and follow consistently. This might be 8:00 in the morning and 8:00 at night.

The best time to give your cat his insulin injections is just after a meal when his blood sugar levels are the highest. If you’re concerned that your cat won’t stay still, some recommend administering insulin while your cat is in the middle of a meal.

If you’re busy and frazzled and always forget things like this, put an alarm on your phone, alarm clock, or watch that will remind you that it’s time to give your cat the juice. We’re trying to space injections by 11-12 hours, so you have a one hour window in which you can safely give your cat his shot. If you get caught up in a conversation with your dinner guests and don’t get a chance to give your cat his shot until 10 pm, skip the dose. It’s better to miss a shot of insulin than to give your cat one dose at 10 pm and another dose at 8 am the next day.

We’re weighing the negatives of high blood sugar from not getting enough insulin versus low blood sugar from too much insulin. Low blood sugar or hypoglycemia is a life-threatening condition, while hyperglycemia was everyday life for your cat the day before he was diagnosed with diabetes.

Theoretically, you could push your next dose out to 11-12 hours from the oopsie shot, but then you’re at risk of creating a dosing schedule that’s sliding further and further from your intentions and eventually would have you giving your cat insulin at 2 am. Routine is important for you and it’s even more valuable for your cat. It’s better to skip a shot.

If you’re giving your cat once-daily doses, the rules are the same.

Here’s how to give your cat injectable insulin.

Your vials of insulin should remain in the refrigerator at 36 to 46 degrees Fahrenheit (2 to 8 degrees Celsius). Insulin kept at room temperature will not last as long as that kept in a fridge. Take the insulin out of the refrigerator shortly before you’re ready to use it. Warming the insulin to your cat’s body temperature is not necessary and may reduce the insulin’s efficacy.

After you take the insulin vial out of the refrigerator, clean the rubber stopper with alcohol. This is where you’ll insert the needle, so it has to be sterile. Stick the needle into the syringe and draw up the liquid, paying close attention to the measurements on the syringe. If you draw up too much, push it out and adjust the amount.

Look at your cat from above and plan your approach. Aim for spots a few inches from the center of his back and near the shoulder blades or hip bones, but don’t sweat this. Ultimately, you’re just looking for a spot on your cat’s back where he has a lot of loose skin. So pet your cat, squeeze around a little bit, and find a baggy-saggy spot where you can easily pinch an inch or two. Cats often have a ring of loose skin right behind their neck wrapping around the shoulder blade area and down the sides of their ribcage.

Remember to vary your injection sites to avoid soreness. You can systematize this by drawing a circle with your injections or map out a little rectangle with four injection points on your cat’s back. It really doesn’t matter how many points you run through before you hit the same area again—just don’t poke the same spot over and over until you create a sore.

Hold the syringe with your thumb and middle finger, keeping your index finger free—that’s your plunger-pusher finger. Don’t touch the plunger just yet, though. Cat wrangling can be a challenging job and there’s a chance you could jerk and accidentally waste the insulin or even give yourself a shot. So repeat after me: “keep your finger off the plunger until you’re ready to inject.”

With your non-dominant hand, gently pinch a couple of inches of your cat’s skin into a tent. Doing this allows you to inject the insulin under the skin. While holding this tented shape with your other hand, swiftly but gently push the needle into the center of the fold. Aim for a thirty-to-forty-five-degree angle pointing slightly downward towards the muscle under the skin. Now you can put your finger on the plunger. Use your index finger to depress the plunger, administering a full dose of insulin. Withdraw the needle and massage the injection site.

When you’re done, you’ll need to safely dispose of the needle. Instead of dumping them straight into the trash, drop used needles into a sturdy container like the kind used for laundry detergent, shampoo, or shortening, then throw it away. Some landfills have designated areas for hazardous waste and you may be able to drop off your cat’s needles there.

After you’ve given your cat his dose of insulin, mark it off on the calendar or check it off of your to-do list. It’s important that you maintain a record of your insulin doses, especially if you’re living in a home with multiple people. Giving multiple people the chore of insulin dosing increases your risk of overlapping shots, so everyone needs to be extremely vigilant to avoid double-dosing.

If you can’t remember if you gave your cat insulin or don’t know if your spouse did it last night, just don’t do it. Skip a dose and try again next time. Again, high blood sugar is better than low blood sugar.

Diet is the second key to diabetes control. Here’s how to choose the right food for your cat.

Why doesn’t my cat want to eat

Cats who eat a high-carbohydrate diet are more likely to develop diabetes and they’re more likely to stay diabetic for the rest of their lives. If you want your cat to enter diabetic remission and no longer need insulin, don’t feed him the same high-carbohydrate diet that got him into this mess.

Diabetic cats should switch to a high-protein, low-carbohydrate diet. Remember that every time your cat eats carbohydrates from potatoes, corn, or tapioca, he’s hit by a blast of glucose rushing into his bloodstream.

What’s the best food for diabetic cats?

Diabetic cats need the same kind of food as every other cat. A diabetic cat should eat food with protein, fat, and carbohydrate levels that reflect his natural prey diet, which is about 52% protein, 46% fat, and 2% carbohydrate.

The easiest way to start feeding your cat the right diet is by switching from dry to wet food.

A species-appropriate nutrient distribution is all but unheard of among dry foods, which demand starchy ingredients like corn and wheat, or in grain-free foods, potatoes or lentils. These foods range from 20% to over 40% carbohydrate content—ten to twenty times higher than your cat’s natural intake. There’s no nutritional precedent for this carbohydrate content. There’s no such thing as a feline starch deficiency. High-carbohydrate ingredients aren’t there to make dry food healthy. They make it more economical and give it structure.

While low-carbohydrate dry foods are almost nonexistent, particularly at a reasonable price, store shelves are stuffed with low-carbohydrate wet food. Switching your cat to wet food is the easiest first step towards a diabetes-appropriate diet.

Look for wet foods containing at most 12%, and ideally, under 6% carbohydrates on a dry matter basis.

Any ordinary wet food will do, provided that it’s low in carbohydrates. Here’s a short list of brands and foods I recommend for cats with diabetes. All of them are low in carbohydrates, high in protein, and moisture-rich.

  • NomNomNow Flavorful Fish Feast
  • Tiki Cat Puka Puka Luau (and most other Tiki Cat wet recipes)
  • Hound & Gatos Turkey & Turkey Liver (plus all other Hound & Gatos foods)
  • Fancy Feast Classic Paté (almost all recipes)
  • Fancy Feast Flaked (select recipes)
  • 4Health Paté
  • Against the Grain

Resources to help you choose the right food for your diabetic cat:

Once you’ve found a diet that meets these standards, it’s time to make the switch.

When you reduce carbohydrates from 24% of your cat’s diet to 6% of that diet, you’re significantly reducing his blood sugar and, therefore, reducing his need for insulin.

The effects of switching to a low-carbohydrate diet kick in immediately, so it’s imperative that you closely monitor your cat’s blood glucose while changing his diet. You can’t wait days, weeks, or a month before reducing the insulin dosage to accommodate a low-glucose diet. You need to watch his blood glucose and change his insulin as soon as you make the switch. Some cats don’t need any insulin at all after switching to a species-appropriate diet.

Weight management is the third primary facet of your diabetes control strategy.

If you’ve established an appropriate diet and an insulin regimen and you haven’t noticed any change, weight loss may be the missing factor that could bring your cat into remission.

Instead of leaning on a weight loss diet, use a combination of calorie restriction and exercise. You’ll want to feed your cat smaller portions of his high-protein, low-carbohydrate wet food until he reaches an ideal weight. Note that as your cat loses weight, his insulin requirements will also change. This is another reason to closely monitor blood glucose.

When Blood Sugar Drops Too Low: Hypoglycemia and How to Treat It

While we begin treatment to reverse the effects of hyperglycemia, its polar opposite is even more dangerous. Though most cases are mild, serious hypoglycemia or low blood sugar can result in seizures, unconsciousness, and death.

Hypoglycemia, also known as insulin shock or an insulin reaction, occurs when there isn’t enough sugar in the blood. In cats, low blood sugar is usually defined as anything under 65 mg/dl, though some put the number closer to 54 mg/dl. Blood glucose levels under 18 mg/dl are life-threatening and often result in permanent brain damage.

A hypoglycemic episode usually occurs minutes to hours after an insulin injection. Hypoglycemia isn’t always obvious. Symptoms range from moderate to severe and they’re not always congruent with the severity of the hypoglycemia. A hypoglycemic cat may have very low numbers—under 40 mg/dl—but appear perfectly comfortable, at least temporarily. Likewise, a hypoglycemic cat might have relatively normal blood glucose close to 50 mg/dl and go into an intense hypoglycemic episode with seizures, poor coordination, and, eventually, unconsciousness.

How do you know your cat is having a hypoglycemic episode?

Mildly hypoglycemic cats will suddenly switch from normal to not-quite-normal. They’ll be ravenously hungry, weak, or start shivering. All of these symptoms will be relatively mild.

A moderate hypoglycemic episode triggers intense behavioral changes, including aggression and urgent meowing. Moderately hypoglycemic cats are disoriented, confused, uncoordinated, and restless. They might hold their head oddly or bump into furniture.

Click here to watch a video of a cat who appears to be moderately hypoglycemic. The cat is confused, disoriented, and stumbles around the house on his hocks. Near the end of the video, you’ll see that he’s panting. The person who uploaded the video also noted that the cat loses bladder function and doesn’t seem able to see his human guardian when in a hypoglycemic episode.

If your cat starts exhibiting severe hypoglycemic symptoms, it’s an emergency situation. Your cat might pass out or go limp. Convulsions or seizures are common among severely hypoglycemic cats. If this happens, you need to immediately get some sugar into your cat’s body before rushing him to the veterinarian.

If your cat shows symptoms of hypoglycemia or if you notice low numbers in your routine blood test, you need to closely monitor your cat’s blood glucose while trying to get some sugar into his bloodstream.

If your cat’s blood sugar is below 40 and he’s not exhibiting any symptoms, verify that it’s not a fluke by retesting with a larger blood sample. If you still get a very low number, feed your cat a teaspoon of corn syrup, honey, or liquid glucose along with food or treats. You can administer the sugar with a syringe or mix it into your cat’s food. Monitor your cat’s behavior and blood glucose until it rises to a normal level.

If your cat’s blood glucose is low, but not extremely low—think under 50 but over 40—give your cat a few treats and retest until his blood glucose level rises. If he refuses to eat, you can give him a little corn syrup or food with a syringe.

When you start noticing moderate symptoms like disorientation, confusion, and stumbling around, you’re going to want to give your cat a tablespoon of corn syrup, teaspoon of liquid glucose, tablespoon of honey, or a tablespoon of sugar syrup. It’s always important to follow the sugar with food to ensure a long-lasting effect.

If your cat’s exhibiting intense symptoms, you’ll still need to give him sugar, but you do not want to squirt it into his mouth. A limp, seizing cat is likely to choke, so you’ll have to rub a tablespoon of sugar syrup, honey, or corn syrup directly on your cat’s gums. You may also inject it rectally (make sure you know how to do this by consulting your veterinarian first).

Since it’s not safe to feed a severely hypoglycemic cat, you won’t follow with food. Instead, you’ll need to rush to the emergency vet immediately.

Can Diabetes be Cured?

It is possible for most diabetic cats to go into remission, provided that their blood glucose is tightly regulated through the right diet and a good insulin regimen. But most doesn’t mean all and some cats need to be on insulin for the rest of their lives.

Cats with blood glucose values of 190-270 mg/dl before treatment are great candidates for diabetic remission, as it’s unlikely that their pancreas has been poisoned out of commission. If the cat has higher blood glucose, remission is perhaps less likely, but possible. Remember that your cat’s initial blood glucose values may be unrealistically high due to vet-induced stress.

While some cats have temporary diabetes and go back to normal after a simple dietary change, some cats might take six months of aggressive dietary changes, weight management, and insulin therapy before they go into remission.

Even after your cat has healthy blood glucose levels without any need for insulin supplementation and appears to be cured of diabetes, the first time he eats a carbohydrate-laden dry food, he could go right back to full-on diabetes and you’ll have to start all over again.

An estimated 25% to 35% of cats in diabetic remission will relapse. A second remission is possible, but unlikely. That’s why it’s critical that you continue to control your cat’s insulin through an extremely low-carbohydrate diet and periodically test his blood glucose to ensure that he’s still in remission.

Looking Forward: Life with Feline Diabetes

Until your cat goes into remission, diabetes will become a way of life for both you and your cat.

Most cats are fine with getting a few pokes a day as long as they associate it with meal time and cuddles. By combining weight management with a species-appropriate diet, you’re giving your cat better food and a better body.

Diabetic cats have a unique daily routine. Each day, you’ll need to perform a series of care tasks to keep his blood sugar under control and ensure that he continues moving towards the goal of remission.

Here’s a checklist of things you need to do every single day:

  • Check your cat’s blood glucose at least three times a day. Those aggressively working towards diabetic remission may test blood glucose up to eight times a day. If your cat’s blood glucose has been stable for a while or if your cat appears to be in remission, you might cut blood testing back to once a week, month, or less.
  • Administer insulin once or twice every day. Insulin should be injected just after or while your cat is eating a meal.
  • Keep a consistent, detailed record of your cat’s activities and treatment each day.

Enter the following into your daily record:

  • Time(s) you injected insulin
  • How much insulin you injected
  • How many times your cat ate
  • How much he ate at each meal
  • Anything you did differently (dietary changes, type of insulin, activities)
  • Anything unusual—hypoglycemia, abnormal behavior, or symptoms of any kind

You’ll want to weigh your cat once every week. Enter his weight in a separate weekly log.

The future is bright for cats with diabetes.

Diabetes doesn’t necessarily mean your cat’s body is broken. It appears to be a normal reaction to a carbohydrate-loaded diet and a body weighed down by too much fat.

Indeed, you can look at diabetes as a gift. A wake-up call.

Feline diabetes is almost always the result of a species-inappropriate human-controlled lifestyle and you can turn it around by correcting those abnormalities. Diabetes just may be the punch in the gut you needed to improve your cat’s health.

This road could be challenging, but fortunately, you have a world of resources and support at your fingertips. Here’s a selection of resources to keep you sane in the months ahead.

Resources

About the author


Mallory Crusta is a writer and adventurecat enthusiast on a mission to make cats’ lives extraordinary. She’s one of the founders of Wildernesscat – a site for happy, healthy, and adventurous cats who are fueled by nature. Visit Wildernesscat for radically natural cat nutrition, home remedies, and lifestyle inspiration.

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