Managing Feline Diabetes at Home

Diabetic cats are much harder to monitor than diabetic dogs.  When a dog's blood glucose is low, he does not want to chase the ball or go for a walk.  Your cat will be relaxing on the sofa whether his blood glucose is high or low!  And your cat is not going to give you a urine sample every time you walk him out on a leash.  But you know your cat, and knowing what is normal for him will help you regulate his diabetes.  We encourage you to keep a kitty diary and carefully record your observations.  Check out http://logfrogapp.com/ for an online tracking log.

CLINICAL SIGNS

  • Diabetic cats urinate large volumes, because the sugar in the urine pulls extra fluid along with it.  These cats have to drink extra amounts in order to replace that lost fluid.  As the diabetes becomes controlled, the excessive drinking and urinating should decrease, so it is important to be aware of how much water your cat is taking in and how much he is urinating out (frequency and volume).
  • A good appetite is crucial.  Cats that feel good are eating well, and your cat must be eating in order to get insulin injections, so you need to know exactly how much your cat is eating.
  • Your cat's attitude says a lot about how he feels.  He should be out and about, not hiding.  He should be interactive with other members of the family.  He should not be grumpy or act painful when handled.
  • Healthy cats are always grooming, so watch your cat's coat for spikey, oily hair or matting that would suggest that he is not cleaning himself.  Also watch for loss of skin elasticity, which might mean dehydration.
  • Poorly controlled diabetic cats can get weak, "rubber legs", especially in the rear limbs.  This is a reversible symptom, but it tells us that the cat is not regulated.

MONITORING URINE GLUCOSE

  • When your cat's blood glucose levels are above 180 mg/dl, glucose will spill over into the urine.  The amount of sugar in the urine is not a measure of the blood glucose at that moment, but rather an average of the blood glucose over the several hours during which the urine was being produced.  Typically, the higher the blood glucose, the higher the concentration of glucose in the urine.
  • Glucotests are small confetti-like paper chips that can be sprinkled in the litter box.  The chips change color in the presence of glucose, so they can be used to determine whether or not your cat is still spilling sugar into the urine.
  • If your cat is receiving insulin and you see negative glucotests twice in a row, contact your veterinarian for advice.  If you cannot reach your veterinarian immediately, reduce your insulin dose by 50% pending the veterinary consultation.  Negative chips may mean that your cat's blood glucose is going too low, or that he is becoming non-diabetic.
  • If you see dark purple chips (600mg/dl) for a week in a row, contact your veterinarian.  This may indicate that the insulin dose needs to be increased, but this is not an adjustment that needs to be done immediately.
  • Feline diabetes cannot be regulated using glucotests alone, and we do not make insulin adjustments based on a single glucotest reading.  There can be false positives and false negatives.  However, glucotests allow you to see trends in your cat's glucose levels, which can be very useful in regulating.
  • Hints for using glucotests:
  • The directions say to use a full package every five days.  If you are very careful to fold and seal your foil package with a paper clip, then seal it in a ziplock bag to protect the chips from moisture, you can use the chips 15-25 at a time and make the package last much longer.  There are approximately 400 chips in a bag.
  • Do not touch the chips with your fingers, as oils on your skin can affect results.  Disregard results of chips that came in contact with fecal material.  Do not clean your litter box with bleach or ammonia or add extra baking soda to your litter, as that could affect results.
  •  Color must be present on both sides of the chip to be significant.  If there is more than one color on the chips, record the lower glucose level.  Occasionally chips will be flooded with urine and the color will wash out, leaving a white chip that cannot be interpreted.  Color remains stable for approximately eight hours, so record and scoop out reacted chips frequently.
  • Newly diagnosed diabetics should be monitored continually with glucotests.  Once your cat is well regulated, weekly monitoring will allow you to follow trends.  The chips are especially useful in detecting cats that are becoming non-diabetic.
  • Be sure to record all of your glucotests results.  Include date and time in your records.

MONITORING BLOOD GLUCOSE

  1. Sometimes it is necessary for the owners of diabetic cats to be able to check the cat's blood glucose at home in order to closely monitor those cats whose glucose levels tend to fluctuate.  This is especially useful in detecting episodes of hypoglycemia (low blood glucose) and in performing glucose curves.
  2. Our veterinary staff members can teach you how to obtain a blood sample from your cat and show you how to use glucometers that are calibrated for use in cats.  
  3. Normally we ask owners to check blood glucose levels before each insulin dose when we are trying to get the cat regulated.  Sometimes we ask for more frequent tests, or for a glucose curve.  As your cat becomes well regulated, it should not be necessary to test so frequently. 
  4. Record the date and time and results of all blood glucose tests, as well as the date, time and dose of insulin given.  In newly diagnosed diabetics, we want those results faxed or emailed to Cat Clinic of Cobb weekly so that our veterinarians can review the results and make necessary adjustments in dosages.  In stable diabetics, we want to see the records every month.
  5. It can be very dangerous to change insulin doses without consulting with your veterinarian.  The insulin dose is based on many factors, including blood glucose levels, glucose curves, fructosamine levels, urine glucose levels, diet, appetite and clinical signs.  There are only two situations in which we advise owners to change insulin doses without first consulting with their veterinarian, and both of those involve hypoglycemia.

*         If you test blood glucose prior to giving insulin and the glucose level is 200 or lower, do not give insulin!  Skip that dose and contact your veterinarian for further advice.

*         If you test blood glucose at any time and the glucose level is 50 or lower, do not give insulin!  Give your cat approximately one tablespoon of Karo syrup or honey and retest blood glucose levels in one hour. Repeat the oral sugar dosing if the blood glucose level is still 50 or lower.  Contact you veterinarian for further advice.

PERFORMING BLOOD GLUCOSE CURVES

  1. If a diabetic cat is proving difficult to regulate, we sometimes need to perform a glucose curve, checking the glucose levels several times throughout the day.  Often these curves are run in the hospital, but if the owner can do them at home, we prefer those results as they do not have the "white coat" fear factor associated with the veterinary hospital.
  2. The purpose of the glucose curve is to determine how low the cat's glucose levels go between insulin doses, and to see when that lowest point occurs.
  3. The first reading of a glucose curve should be taken in the morning just before the cat eats breakfast and receives the morning dose of insulin.
  4. Subsequent tests should be performed every 2-3 hours throughout the day for a total of twelve hours, right up until the evening dose of insulin is given.
  5. Feed your cat as you would normally throughout the curve.  Try to avoid any extra treats that you would not normally give.  Keep exercise and activity as normal as possible.
  6. Any episode of hypoglycemia (blood glucose levels of 50 or lower) should be treated with oral sugar as directed above, and the remainder of the curve should be discontinued.
  7. Record all test results and fax or email them to Cat Clinic of Cobb for our veterinarians to review.  Check out http://logfrogapp.com/ for an online diabetic tracking log. 

The well regulated diabetic cat can have a good quality of life for many years.  The best regulation occurs through a partnership of cat, owner and veterinarian.  Please feel free to call us with any questions or concerns that you might have.  We will work with you and your cat to regulate the diabetes at home as much as possible, but we require physical examinations and blood work in the hospital every six months in order to maintain the doctor-patient relationship needed for monitoring a serious disease.

Cat Clinic of Cobb

2440 Sandy Plains Road

Marietta, Georgia  30066

 

Phone:  (770) 973-6369    Fax:  (770) 973-5772      catclinicofcobb@aol.com