Diabetes mellitus is a condition in which the body cannot properly produce or respond to the hormone insulin. Insulin regulates the amount of glucose (sugar) in the bloodstream and delivers glucose to the tissues of the body to use as energy. Diabetes results in elevated levels of glucose in the blood. The most common form of diabetes in cats is type 2 diabetes. In type 2 diabetes, glucose levels are high because cells in the body do not respond appropriately to insulin.
Diabetes is the second most common endocrine disease in cats. (The body’s endocrine system consists of several glands—in the case of diabetes, that gland is the pancreas—that make hormones, which are chemical messengers to control organs throughout the body.)
Cats are typically diagnosed with diabetes between the ages of 10 and 13 years. More cats are acquiring diabetes as the number of overweight or obese cats grows. The average cat that weighs 13 pounds or more has about four times the risk of developing diabetes as a smaller cat. Signs of diabetes can include increased thirst, increased urination, weight loss, and increased appetite.
When a cat is suspected of having diabetes, a veterinarian will perform blood and urine testing. Diabetes is indicated if blood testing shows an elevated glucose level (hyperglycemia) and urine testing shows evidence of glucose in the urine (glucosuria).
Because stress in cats can lead to both hyperglycemia and glucosuria, another confirmation test called fructosamine is usually done. Fructosamine concentration reflects the average glucose concentration for the past 1 to 2 weeks and is not impacted by stress. If this test comes back as elevated, the diagnosis of diabetes is confirmed.
Insulin is the treatment of choice for cats with diabetes. This typically requires twice daily administration. In addition, dietary management can be an important component of managing diabetes in cats. A high-protein/low-carbohydrate diet is recommended. Weight loss is also an important component of diabetic management in overweight cats. Weight loss, if attempted, should ideally be gradual, one-half percent to 1% of total body weight lost per week.
The goals of treatment are to maintain a healthy blood glucose, stop or control unintended weight loss, stop or control increased thirst and urination, and avoid hypoglycemia (low blood glucose).
Unlike dogs, cats can reach diabetic remission; these cats have near-normal blood glucose levels without receiving insulin or other blood-sugar–lowering medication. However, cats in diabetic remission require close monitoring to ensure that they do not relapse. Remission is not achievable in every diabetic cat.
Blood glucose curves are used to monitor response to insulin dosing. If a blood glucose curve is performed at home, pet owners measure the first blood glucose reading before the insulin injection. Then, they test every 2 to 4 hours until the next dose of insulin, depending on the type of insulin used. Performing curves at home eliminates the stress of coming to the clinic, which can affect the accuracy of the testing. Owners may need to perform a blood glucose curve several times to find the right dose for their cat.
One method of measuring glucose is by using a glucose meter calibrated for feline blood, such as a AlphaTRAK3. Another way is by using a continuous glucose monitor, such as a FreeStyle Libre. These monitors can be picked up at a human pharmacy and installed by a veterinarian or veterinary technician. Other important monitoring tests include serial bloodwork and urine testing. Your veterinarian will help determine the frequency at which these tests should be performed.
Monitoring your cat’s level of thirst and urination, weight, and appetite are important throughout treatment. These measures can give clues as to how well the diabetes is being managed. Unfortunately, monitoring response to treatment in diabetic cats can be frequent and expensive.
Complications of Diabetes
One complication of diabetes is diabetic ketoacidosis (DKA). This problem occurs when there is not enough insulin in the body to control the amount of glucose in the blood. DKA happens in uncontrolled diabetics. Without the proper amount of insulin in the body, glucose cannot be used as an energy source. Instead, the body breaks down fat, which produces ketone bodies. With high levels of ketones, the body becomes more acidic, which disrupts fluid and electrolyte balance. Left untreated, the resulting abnormal electrolyte balance may lead to abnormal heart rhythms and muscle function and death. Signs of DKA can include increased thirst or urination, lethargy, weakness, vomiting, increased respiratory rate, decreased appetite, and weight loss.
The other complication is hypoglycemia, or low blood sugar, which may arise when insulin therapy lowers the blood sugar significantly. Signs of hypoglycemia include weakness, lethargy, vomiting, lack of coordination, seizures, and coma. Hypoglycemia can be fatal if left untreated. A diabetic cat that shows any of these signs should be offered its regular food immediately. If the cat does not eat voluntarily, it should be given oral glucose in the form of honey, corn syrup, or dextrose gels and brought to a veterinarian immediately. However, if a cat is seizing or comatose, oral glucose methods should not be attempted.
If you’ve noticed changes to your cat’s eating and drinking habits as well as weight, please have them seen by a veterinarian for additional testing to be done as soon as possible.
By Jeanette Barragan, DVM
Osteoarthritis in pets is often thought of as a geriatric pet disease that warrants treatment when our pets are obviously painful and experiencing lameness. However, osteoarthritis often starts younger than you might expect, and pain may be present even before lameness is apparent.
Let’s start with what osteoarthritis is: it’s the most common form of arthritis and it is characterized by painful inflammation and degeneration of one or more joints. Over time, it can lead to bone-on-bone contact.
Many factors contribute to the disease process, including overweight or obesity, abnormal joint development, past injury or orthopedic surgery, and how a pet is built.
In dogs, early signs of this disease can include:
- restlessness or irritability,
- frequent position changes during rest,
- not as fast getting up or sitting down,
- weight shifting while standing,
- less interest in activity or play, and
- hesitation before walking, sitting, or climbing stairs.
Eventually, a dog may begin to limp, to experience stiffness when walking, and to have difficulty going up or down stairs and jumping up or down.
In cats, osteoarthritis may look like a reduction in play, grooming, socializing, and appetite, with increases in hiding and sleeping and changes in urination/defecation habits. Cats can also have trouble jumping up/down, climbing up or down stairs, running, and chasing objects.
Because this disease is painful and progressive, early diagnosis and treatment are important for long-term pain management and slowing the progression of the disease. Treatment includes a combination of pain medication, weight loss or maintenance, dietary changes, environmental modification, and exercise.
If you feel your pet may be showing signs of osteoarthritis, our clinic can share additional resources on how to know if your pet has this disease and talk with you about treatment options.
– Dr. Jeanette Barragan
This is a question and a discussion that I have with clients daily. And to be honest, it’s a very difficult question to answer. I am going to give you a few tips on how to pick out a food that is best suited for your dog or cat.
I recommend feeding a food based on the life stage of your pet. The four life stages include growth, young adult, mature adult and senior. The below picture helps illustrate the life stages of cats. Canine life stages are pretty similar, but with more variation due to the vast size difference we see in the canine species. The growth life stage is typically done by 6-12 months of age. For cats the growth phase is typically finished by 6-10 months of age and I recommend transitioning to adult food around that time. If you have a puppy or kitten it is very important for proper growth and development to feed a puppy or kitten food. In the same manner as your pet is aging feeding a senior diet is important as they have different nutrient profiles.
You may ask what about an “All Life Stages” dog or cat food. For a company to market their food as “All Life Stages” the food must meet the nutritional requirements for all life stages. Therefore, most of these foods are formulated as a puppy/kitten food because puppies and kittens have the highest nutritional requirements of the four life stages. These foods can be good foods and well balanced, but they typically have a high caloric density. Therefore, in my experience, dogs are more likely to become overweight than if they were fed some other diets.
Does your pet have any health conditions that require a special diet? Prescription diets can play a vital role in management of many health conditions, including kidney disease, diabetes, obesity, allergies, and feline lower urinary tract disease.
If your pet suffers from a medical condition, diet can manage and help many conditions, so I always recommend considering a prescription diet if you pet has one of the above conditions.
More Expensive Does Not Mean Better
Many pet food companies are great at marketing but might not be as good at formulating diets. You can always look for the Nutritional Advocacy AFFCO (Association of American Feed Control Officials) Statement on each bag or can of food. These statements will tell you if the food has been through a food trial or formulated to meet particular feeding guidelines. The ingredient list should also list all ingredients in decreasing amounts by weight.
Labels are very confusing and often misleading to consumers. For example, if I made up a food with the following labels, the variation in ingredients can be drastic.
- If the term “All” is used, then the ingredient must make up 100% of product minus preservatives and water. So, this treat would be 100% beef
- If the listed ingredient is used, then the ingredient must make up 95% of product minus water. So, this Beef Dog Chow would be 95% beef on a dry matter basis.
- If the term “dinner,” “platter,” or “recipe” is used, then the ingredient must make up only 25% of product. So, this Beef Dinner is likely only 25% beef.
- If the term “with” is used, then the ingredient must make up only 5% of product. So, this Dog Chow with Beef is likely only 5% beef.
I hope this illustration helps demonstrate how confusing pet food labels can be to both consumers and veterinarians. I recommend visiting the AAFCO website if you want to be better educated about what’s in your pet’s food.
Say No to ‘Grain Free’
Does my pet need grain-free food? The answer is NO. There little to no research showing the true benefit of grain-free food. In fact, grain-free food has been shown to cause heart disease in some dogs. The exact cause is still being researched. Visit this site for more information. https://www.fda.gov/animal-veterinary/animal-health-literacy/questions-answers-fdas-work-potential-causes-non-hereditary-dcm-dogs
What About Raw Food?
Some dogs do really well on raw food, but I do not recommend it. That’s because I see too many owners who try to feed raw but who are not feeding a balanced diet because they are solely feeding raw meat and limited other nutrients.
In the wild canines and felines will consume entire animals. Eating meat, skin, ingesta, organs, and bone makes up a balanced diet.
Raw can be balanced and can be a good diet for some animals, but there is also a public health risk with feeding these diets. This is a statement from the CDC:
“Germs like Salmonella and Listeria bacteria have been found in raw pet food, even packaged ones in stores. These germs can make your pet sick. Your family can also get sick by handling the food or by taking care of your pet.”Centers for Disease Control and Prevention
Therefore, if there are young children or anyone who is immune-compromised in your house, I highly advise against feed raw pet foods.
Each Pet Is Different
I hope this information has been helpful and informative. I recommend discussing your pet’s daily calorie needs with your veterinarian as each pet is different, just like people. Two people that have ideal weights of 180 pounds may be able to eat very different diets to maintain their weight, and the same goes for cats and dogs. All 10-pound cats do not need the same daily calories.
The recommendations on the bag or can of food should only be a guide. Some animals may need more calories, but most will need less than the recommended amount to maintain an ideal weight. And always remember to factor in all treats and table scraps into their daily calories. Most pets are overweight these days.
—Dr. Drew Sullivan
Now that the end of the pandemic seems to be in sight, we are starting to think about returning to normal activities, our pets included. Getting out more and stretching out legs, we may notice that there’s a little more of our pets than there was in 2019, in a very physical sense.
At the Medical District Veterinary Clinic, we have seen a lot of pets gain weight over the last year as routines and activities changed. I know my dog, Emmie, has definitely got a little thicker. (Having a toddler in the house hasn’t helped Emmie’s weight, either.)
When it comes to pets’ weight loss and healthy weight maintenance, you should know that exercise helps, but what they consume is often more important. That doesn’t mean you shouldn’t get out there and go for walks, hikes, or trips to the beach with your dog. It’s just that how much you put in their food bowl will help more.
Also remember not to discount the little things. Small snacks add up, especially when you weigh only 11 pounds and need only 225 calories a day. That’s a healthy serving of peanut butter! That little extra snack may not seem like much, but it’s a lot for your pet. Remember that the recommendations on your pet’s food bag assumes that they are getting no other calories.
If you feel like you’re really calorie counting and the scale is going nowhere for your little fluffy, let us know. Some animals need a little extra help in the form of a prescription diet. In the same way that some people have a harder time losing weight, so can pets, and a special diet may help.
Finally, if your dog or cat is losing weight and you haven’t changed their diet or exercise, let us know. Weight loss isn’t always a good thing, and we will make sure they are okay.
Enjoy the rest of summer!
Alyssa Kritzman, DVM