Diabetes mellitus is a disease caused by a deficiency of insulin. Insulin is a hormone produce by certain cell ( beta cells) in the pancreas- the elongated gland just below the stomach- and is necessary for the body tissues to use to absorb blood sugar. An analogy, is that insulin is a key that unlocks the door to each cell that allows glucose to enter the cell. All food that we eat is broken down to sugar and then fed to each cell. Without insulin, sugar remains in the blood stream and eventually passes into the urine. This causes increased urine production and thirst. Hunger is increased because the body cannot use the sugar in the blood. As diabetes progresses, chemicals called ketones accumulate, resulting in vomiting and dehydration. Eventually coma and then death occur in untreated animals. Diabetes is not a curable disease, but with proper insulin administration, the disease can be controlled and the prognosis for a managed diabetic cat is very good.

Diabetes is a problem primarily of middle-aged and older cats. Male cats get the disease about twice as frequently as females, and the typical feline diabetes patient is overweight – although unchecked diabetes will cause weight loss over time.). Unfortunately, owners – especially owners with more than one cat – may not notice these signs. Instead, the reason many owners bring their cat in is because the animal is urinating outside the box. If you notice any change in your cat’s behavior that might indicate diabetes, take your cat to an animal hospital right away. Your veterinarian will need to measure the level of glucose in your cat’s blood and urine and check for other diseases that might be causing these signs. Even if your cat does have high blood sugar, it doesn’t necessarily indicate diabetes. Sometimes, animals under stress or on medication develop a temporary elevation of blood glucose (transient hyperglycemia). Your veterinarian may therefore suggest repeating the blood and urine tests in a few days.

The other thing to keep in mind is that there are different categories of diabetes. Cats with insulin-dependent diabetes mellitus “Type I” (IDDM) require daily insulin injections because they are unable to produce sufficient insulin. Cats with noninsulin dependent diabetes mellitus  “Type II”  (NIDDM) can produce insulin, but they don’t respond to insulin as readily as they should (insulin resistance). Cats with IDDM must have insulin injections, but animals with NIDDM may do well with only dietary management and oral hypoglycemic agents.

It has been published that the nutraceutical “Chromium Picolinate” is sometimes used as a supplement in obese cats that have Type II diabetes mellitus to improve glucose metabolism and enhance insulin sensitivity.  The feline dose is 200 micrograms daily.

To determine whether your cat needs insulin, your veterinarian will measure blood glucose. If the glucose level is only slightly above normal, your veterinarian may suggest dietary management and oral hypoglycemic agents before resorting to insulin injections. But cats with persistent and pronounced hyperglycemia usually require insulin. About 70 to 80 percent of feline diabetes patients fall into this latter category. If your cat does require insulin, you should be able to learn to give injections . The insulin needles are very tiny. For most cats giving a pill is more difficult then giving an injection. Nevertheless, remember to reward your cat with praise or playtime each time you give an injection.

The toughest thing about having a cat on insulin is finding the best type of insulin for the individual cat and balancing the dose. Veterinarians usually recommend running a glucose curve – a test that involves several measurements of a cat’s blood-glucose level over the course of 12 to 24 hours. For this test, the cat may need to stay overnight in the veterinary clinic.

Some veterinary offices have been much more successful using animal derived insulin rather than the biologically engineered human insulin. They use insulin derived from cows or pigs. Also, the feline metabolism is quite unpredictable. Some cats respond to insulin very quickly-others do not.

Some cats, for reasons still not completely known, cycle in and out of diabetic states. Even after a cat appears stable, the animal’s insulin requirements may shift. So stay alert to behavioral changes that signal too little insulin (excessive drinking, eating, and urination) or too much insulin (lethargy, vocalizing, lack of coordination). Because an insulin overdose can lead to life-threatening hypoglycemic shock, veterinarians prefer erring on the side of a lower-than perfect insulin dose. As long as your cat isn’t drinking huge amounts of water, is maintaining a normal weight, and seems to be feeling well, be satisfied. Cats with diabetes must eat regularly to guard against insulin overdose, but owners also need to control food intake so the animal doesn’t become obese. One strategy is to feed the daily food allotment in measured installments. Clinicians may recommend two or three meals per day.

Some diabetic cats benefit from special diets rich in fiber. Fiber tends to slow down digestion, thus preventing sudden spikes of blood glucose. High-fiber foods can also help obese cats lose weight – which can decrease the need for insulin in some cats. But never shift your cat’s diet without first consulting with your veterinarian. If a diabetic cat finds a new food unpalatable, it may eat less, throwing its blood glucose out of whack.

Managed diabetic cats can live full and happy lives, but they do need careful tending because of the dangers of an insulin overdose. To be safe, keep your diabetic cat indoors. Also, if your cat hasn’t yet stabilized on its insulin dose, stay alert for trouble during insulin peaks (about 4 to 8 hours after each injection, depending on the type of insulin).

If a diabetic cat gets too much insulin or doesn’t eat enough food, its blood sugar could dip to dangerously low levels (hypoglycemic shock), causing seizures and even death. To be safe, always make sure your cat is interested in food before you administer insulin. Also, keep careful track of injections so your cat doesn’t get double dose from two separate caretakers. When in doubt, no insulin is better than too much. If your cat is acting very sluggish, is having a seizure, or is unconscious, you must raise its blood-glucose level immediately. If possible, get your pet to eat something. But if the animal is unable to eat, dip a cotton ball or your finger in Karo syrup (or maple syrup, in a pinch) and swab it over your cat’s gums. The gums will absorb some of the sugar, which should help bring your cat out of shock. Once your cat begins to respond, immediately take the animal to your veterinarian.