| Diabetes in cats |
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Diabetes mellitus occurs when there is too much glucose in the blood - caused either by an absolute deficiency of insulin, or resistance of the body's cells to insulin. The most common clinical signs seen in diabetic patients are an increase in the volume of urine that is produced and, to compensate for this, an increase in the amount of water that is drunk. Weight loss is also a common feature, and an increase in appetite may be noticed in some cats. Recognition of these signs is variable though, particularly because of the life-style of some cats. If a cat spends a lot of time outdoors for example, it may drink from ponds or pools of water outside rather than appearing to drink excessively from what is provided indoors. The presence of clinical signs and a high blood glucose on blood sampling suggest a diagnosis of diabetes. However, a diagnosis of diabetes cannot usually be made on a single blood sample as other conditions, and in particular stress, may also cause a transient rise in glucose levels. Confirmation of diabetes may therefore require a further blood sample for fructosamine levels to be sent off to the lab. Diabetes mellitus is a treatable condition. Although long-term treatment does require commitment, it can be very rewarding to manage this condition successfully. Initial steps in treating a diabetic cat may involve removal of any predisposing causes for the diabetes. For example, obese cats are more prone to develop diabetes and reduction in bodyweight can lead to resolution of the signs in some individuals. If there are no predisposing causes, or if correction of the predisposing causes does not lead to resolution of the diabetes, specific treatment is required. Most cats will require lifelong insulin supplementation in the form of injections to control the diabetes, although a few may go into remission. A special diet may also be prescribed. Once your cat has been diagnosed with diabetes, we will give you an information pack containing a cd-rom, so that you can get up to speed with what will be involved in treatment. Although the thought of giving injections is frightening, almost everybody learns how to do it and continues to do it very successfully. You will then be shown how to administer the injections, which will usually be required twice daily. The starting dose of insulin will be worked out for you and your cat will stay on this dose for 7-14 days; you will then need to bring him back for a check up and blood test. Depending on the result of this, and his clinical signs, the insulin dose will probably need adjusting. This ‘stabilisation phase’ can last several weeks until the blood glucose level is under control, and he may at some stage need a ‘blood glucose curve’ carrying out – this is where your cat needs to stay with us for a day and have serial blood samples taken to see what happens to the blood glucose over the course of 12 hours. Insulin must be kept in the fridge between 4 and 8 degrees C. Vials must be stored upright and rotated gently prior to withdrawing insulin, not shaken. An important part of longterm management is monitoring your cat’s appetite, drinking and general demeanour. If these change, we will need to see him.(See below for signs of ‘hypos’). We also recommend a check up 4 times a year (every 3 months) in order that we can weigh him and take a fructosamine test which will tell us how well the blood sugar is being controlled. If a cat receives too much insulin, it is possible for the blood sugar level to drop dangerously low. (Hypoglycaemia or ‘hypo’). For this reason it is important to be very careful in ensuring the cat receives the correct dose of insulin. Hypos can also occur if your cat does not eat his food; for this reason we advise giving the insulin after or during feeding. If he will not eat you will need to contact the surgery, and similarly if he vomits after feeding. The typical signs displayed by a cat with a very low blood sugar level are severe weakness and lethargy, shaking, unsteadiness and even convulsions. If a diabetic cat shows any of these signs it is important to seek urgent veterinary attention. If the more severe signs are displayed (ataxia or unsteadiness during walking, and/or convulsions) rub a little glucose powder onto his gums, or syringe a few mls of glucose solution into his mouth, carefully. Further information Help is also available at www.diabeticpets.co.uk, and Cats Protection have a support and advice network which can be contacted on 08707 708631. Please feel free to contact us at any time if you have any questions regarding your pet’s treatment.
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