These FAQs should answer most of your questions, but if there is something more you want to know you can always contact us or your veterinarian for more information.
Diabetes mellitus in Cats
Q. What is diabetes mellitus and what causes it?
A. Diabetes mellitus is caused by an absolute or relative deficiency of insulin. Animals with an absolute or relative deficiency of insulin are called diabetics.
Insulin deficiency can develop for different reasons:
- Disorders of the pancreas—the pancreas is unable to secrete enough insulin.
- Other diseases or the presence of other hormones—may be antagonistic to insulin or cause resistance to insulin. Insulin is unable to function normally in the body.
Q. What signs do cats with diabetes typically show?
A. The most common signs of diabetes mellitus in cats are:
- Excessive drinking
- Excessive urination
- Excessive appetite
- Weight loss despite good appetite
- Failure to groom; dry, dull fur
Q. What do the terms polyuria, polydipsia, and polyphagia mean?
A. Polyuria is the production of large amounts of urine in a given period (eg, per day). Polydipsia is chronic excessive thirst. Polyphagia is great hunger.
Q. My cat is having problems holding its urine; does that mean it has diabetes?
A. No, your cat could have a bladder or kidney infection, or some other medical problem. If your cat is having problems holding its urine, you should schedule a trip to your veterinarian as soon as possible.
Q. How is diabetes diagnosed?
A. Your veterinarian will measure your cat's blood glucose level and test your cat's urine for the presence of glucose and ketones. Persistently high blood glucose levels along with glucose in the urine usually means that your pet has diabetes mellitus.
Q. Are all cats susceptible to diabetes?
A. Cats of all ages can get diabetes. Diabetes typically occurs in middle- to older-aged cats and cats that are obese. Neutered male cats are more susceptible than females.
Q. What other problems can be associated with diabetes?
A. The most common chronic complication of diabetes in the cat is the development of peripheral neuropathy, which you'll notice as weakness in the hind legs. Diligent control of hyperglycemia (high blood sugar) can potentially reverse the clinical signs of neuropathy. A common problem in both canine and feline diabetics is recurrent infections.
Q. What other diseases have the same signs as diabetes?
A. Cats with diabetes mellitus drink and urinate a lot. They may also have a good or increased appetite but usually lose rather than gain weight. Other cat diseases that may cause some or all of these signs include:
- Exocrine pancreatic insufficiency
- Kidney disease/renal failure
To reach a definitive diagnosis of diabetes mellitus, your veterinarian will test your cat's blood glucose levels and its urine for the presence of glucose and ketones.
Q. Did I do something to cause diabetes?
A. No. Diabetes mellitus is due to a lack of insulin produced by the pancreas. It is not caused by a virus or infection.
Q. What is the difference between type 1 and type 2 diabetes?
A. Insulin is produced by the beta cells in the pancreas. Type 1 diabetes is due to the destruction of the beta cells with progressive and eventual complete loss of insulin secretion. This type always requires insulin therapy. Type 2 diabetes is characterized by dysfunctional beta cells (irregular insulin production) or the other cells of the body not responding to insulin properly. Type 2 diabetes may or may not require insulin therapy. In general, all diabetic dogs have type 1 diabetes and require insulin to control their disease. Unlike dogs, cats can fall under the type 1 or type 2 classifications.
Q. What is the expected lifespan for a diabetic cat?
A. It is only recently that cats were treated aggressively for diabetes. Sadly, not many years ago these animals would have automatically been euthanized. Today, studies suggest that, if a cat is kept well regulated and does not have any other health problems, he or she should be able to have a normal life expectancy. Unlike dogs, some cats may go into remission with the proper therapy and a controlled diet.
Is diabetes in animals similar to that of humans?
A. Yes, it is very similar. Your cat will be using similar medications, equipment, and monitoring methods as human diabetics use.
Vetsulin® (porcine insulin zinc suspension)
Q. Where on my cat's body should Vetsulin be injected?
A. Injections should be given subcutaneously (under the skin) about 1 to 2 inches below the spine or backbone. Constantly vary the injection location from behind the shoulder blade to just in front of the hip bone, and alternate injections between your pet's left and right sides. Your veterinarian can help guide you as to the recommended locations for injections. Download the Administration Sheet for instructions on how to administer Vetsulin to your cat.
Q. Can I still use a vial of Vetsulin if it freezes?
A. No, freezing will damage the insulin molecules and reduce the efficacy of the product. If a vial of insulin accidentally freezes in the refrigerator, it should be discarded and a new vial should be used.
Q. Can I still use a vial of Vetsulin if it was forgotten outside the refrigerator between doses?
A. Ideally, Vetsulin should be stored upright, protected from light, between 2°C and 8°C (35°F and 46°F). Vetsulin should always remain refrigerated. If you accidentally leave a vial out of the refrigerator, contact your veterinarian for instructions.
Q. What else should I know about Vetsulin?
- Always have a spare vial on hand
- Protect it from light
- Keep it refrigerated
- If it has gotten too hot, or frozen, discard it immediately
- Discard contents after 42 days of the first vial puncture
Q. How do I dispose of insulin syringes?
A. The guidelines for each community are different. You will need to check with your own. All syringes should be disposed of in an appropriate sharps/biohazard container.
Q. What makes VetPen unique?
A. While insulin pens have been commonly used in the management of human diabetes for some time, VetPen is the first such device designed exclusively for use in diabetic cats and dogs. Previously, the only approved way to give Caninsulin injections was to use vials and syringes, which some pet owners found inconvenient and overwhelming. While human insulin pens are used to administer insulin with a concentration of 100 IU per mL, VetPen works specifically with 40 IU per mL Caninsulin, which is tailor-made for use in pets.
Q. Is VetPen difficult to use?
A. VetPen is ergonomically designed to make handling easy and the dosing process simple. It also reduces the time it takes to prepare and give insulin injections. It’s easy enough to use even for pet owners with poor eyesight, arthritis, or any other condition that may cause unsteady hands.
Q. How do I measure insulin doses with VetPen?
A. The user-friendly instrumentation of VetPen enables you to provide a precise dose of Caninsulin to your pet at each injection. VetPen eliminates the need to draw up doses from a vial using an insulin syringe. After preparing the device, you simply turn the dial and it draws up the selected dose for you. You then insert the needle through the skin and inject the insulin into your pet with the push of a button. This simple process enables greater accuracy and reduces the chance of user error.
Q. Can I take VetPen with me when I travel?
A. The all-in-one construction of VetPen allows you to take it with you while away from home and makes it easy for you to give your pet its insulin nearly anywhere. The VetPen Starter Kit includes a handy travel pouch that holds the VetPen, needles, needle remover, and insulin, as well as the Dose Selector Adaptor and Release Button extensions.
Q. Is VetPen reusable?
A. VetPen contains a reusable insulin cartridge that allows you to provide Caninsulin doses with minimal preparation time. It is still necessary to prime VetPen before using a new cartridge and to mix Caninsulin prior to each injection to remove any air bubbles. When the cartridge is empty, you simply remove it and insert a new one. The warranty for VetPen covers at least 3,000 uses.
Q. Can VetPen be used with different insulins?
A. VetPen has been designed specifically for use with Caninsulin, the world’s most trusted veterinary insulin, proven safe and effective for almost 20 years in millions of diabetic pets. To avoid dosing errors, other types of insulin cartridges for other types of insulin should not be used with VetPen.
Q. Does VetPen offer any other benefits over traditional insulin vials and syringes?
A. VetPen helps enhance use by:
- Lowering the risk of accidental needle stick injuries
- Protecting the insulin cartridge from breakage thanks to its sturdy design
- Reducing the likelihood of insulin spills
- Reducing air bubbles that lead to inaccurate dosing
Q. What type of needle is used with VetPen?
A. VetPen uses 29 gauge, 12mm pen needles only, which are small, thin, and specially lubricated. These are the only needles that should be used with VetPen. Always use a new needle for each injection.
Q. Can VetPen needles be reused?
A. A new needle should be used with each injection. The needle should be removed with the needle remover and safely disposed of immediately after use. Reusing a needle may lead to insulin contamination, needle blockage, and/or inaccurate dosing.
Q. What if less than a whole dose is administered?
A. If the dose selector of VetPen stops before the start line returns to the arrow, this indicates that your pet has not received the full insulin dose. If only a partial dose is administered or your pet dislodges the needle before the count of 5, do not attempt to inject again. Wait for your pet’s next scheduled injection.
Q. How do I take care of VetPen?
A. VetPen should always be stored or carried with the needle removed and the cap on. To clean VetPen, simply wipe with a damp cloth. Do not immerse it in water. Keep Caninsulin cartridges refrigerated and protected from light prior to use. Do not freeze.
Management of diabetes mellitus in cats
Q. What must I do if I know that I missed a full dose or part of an injection?
A. If you missed a dose or part of a dose, it is best to wait until the next insulin dose is required and then continue as normal. A brief period of high blood sugar (hyperglycemia) due to too low an insulin dose is not as dangerous as the possibility of causing low blood sugar (hypoglycemia) by administering too much insulin.
Q. What should I do if I think I have given too much insulin?
A. Contact your veterinarian and explain the situation. Monitor your cat carefully for signs of low blood sugar (hypoglycemia):
- Very quiet or sleepy
If you see any of these signs, try to encourage your cat to eat a small meal or if this fails, rub some corn syrup on your cat's gums.
What should I do if I think that my cat has very low blood sugar (hypoglycemia)?
A. The following signs may indicate hypoglycemia:
- Trembling or shivering
- Unusual movements or behavior
- Unusual quietness or sleepiness
- Loss of consciousness (coma)
If your cat is conscious, you should immediately treat your cat by pouring a small amount of a sugar solution (eg, corn syrup) onto your finger and then rubbing it onto your cat's gums. The sugar is absorbed very quickly and your cat should respond in 1 to 2 minutes. The sugar solution should never be poured directly into your cat's mouth since there is a risk that the solution will be inhaled into the lungs. Once your cat has responded to the sugar administration and is sitting up, it can be fed a small meal. Once the cat has stabilized, it should be transported to your veterinarian for evaluation.
Q. How much water should I let my cat drink?
A. If your cat is diabetic, and drinking excessive amounts of water, give him/her all it can drink. Your cat's body is trying to combat the high blood glucose level by expelling the excess sugar out of its body through the urine. Once your cat is regulated, this will subside.
What is the importance of making sure my cat is regulated?
A. If diabetes is left untreated or unregulated, it could cause many complications. The most common chronic complication of diabetes in the cat is the development of peripheral neuropathy, which is exhibited by weakness in the hind legs. Diligent control of hyperglycemia (high blood sugar) can potentially reverse the clinical signs of neuropathy. Recurrent infections are a common problem in both canine and feline diabetics.
Q. How long does it take to regulate a diabetic animal?
A. Each case is different. There is no way to put a specific time on it. Sometimes the regulation process will require you to try different dosages, diets, or injection frequencies. Regulation can be achieved sometimes within a month, and in some cases, over a year from the time therapy first started. It is very important to work closely with your veterinarian during this process to avoid further complications. Even after your cat is regulated, frequent veterinarian visits will be necessary to maintain good health.
Q. My cat is ill and not eating. Should I still give him/her an insulin injection?
A. If your cat is not eating—do not give Vetsulin or any other insulin! If your cat has a reduced appetite, consult your veterinarian on how to proceed with insulin injections.
Q. What can I give my cat as a treat?
A. Your veterinarian will be the best person to determine your cat's diet, as he/she best knows its needs. Ask about appropriate treats your pet could still enjoy!
Q. What does the typical diet consist of?
A. To keep your pet's diet constant from day to day, it is best to use commercially produced rather than homemade foods. Cats are natural meat eaters and in general need high protein, low-carbohydrate diets. Canned foods are generally lower in carbohydrates and preferred over dry foods. Consult with your veterinarian for the best diet to meet your cat's specific needs.
Q. What is a blood glucose curve?
A. Your veterinarian will use the blood glucose curve as a tool to either validate or adjust your pet's insulin dose. The procedure is as follows: shortly after the animal has been given its first meal (preferably at home), the first blood sample is taken just prior to the insulin injection in the morning. Thereafter, blood samples are collected every 2 hours throughout the day for about 12 hours, if possible. These data are then plotted on a graph to generate a curve that is useful for veterinarians to determine how well the current insulin dose is working.
Q. What are some problems with blood glucose curves?
A. The results of the curve can be affected by several factors that may make the curve done at the veterinarian's office an inaccurate portrayal of what is occurring at home. Feeding and exercise patterns are different, and stress (especially in cats) can alter the glycemic response. Therefore, your veterinarian will take clinical signs (or lack thereof) into account when contemplating any change in the insulin therapy. In addition, it is not uncommon for curves to vary from day to day because many things can affect blood glucose levels such as appetite, digestion, metabolism, exercise, hormones, stress, etc.
Q. How often should a blood glucose curve be done?
A. Once regulated, probably minimally every 6 months, or more frequently if a problem is suspected. Your veterinarian will advise you on the frequency.
Q. What is stress hyperglycemia?
A. Stress hyperglycemia is caused when the animal is frightened or stressed. It is caused by the release of epinephrine (adrenaline). Glycosuria (glucose in the urine) is usually absent with stress hyperglycemia, because the blood glucose does not stay high for a significant period and therefore does not spill into the urine. Stress hyperglycemia may influence the diagnosis of diabetes, but usually is distinguishable by the lack of glucose in the urine.
Q. What is fructosamine?
A. Fructosamine is a type of protein in the blood that can be used to measure glycemic (glucose) control over a longer period. Unlike blood glucose measurements, fructosamine is not affected by stress or the timing of the insulin injection. Your veterinarian may recommend periodic measurements of fructosamine to evaluate how well your pet's blood glucose level has been controlled over the last few weeks.
Q. How often should my diabetic cat see the veterinarian?
A. If healthy and well regulated, most experts recommend every 3 months. Talk to your veterinarian about how often they would like to see your pet.
Q. Should my diabetic cat still receive vaccinations?
A. It is perfectly safe for your diabetic cat to receive its vaccinations. In fact, this annual visit also gives your veterinarian a good opportunity to give your cat a complete check-up. By keeping your diabetic cat healthy, there will be fewer fluctuations in its insulin requirements.
Q. Is it safe for a cat with diabetes mellitus to receive a general anesthetic?
A. Normally animals need to have an empty stomach before they are anesthetized. A diabetic cat that has not been fed needs far less insulin. Your veterinarian will advise you on how much insulin to give your cat before it is admitted or may wish to administer a reduced dose of insulin for you. Usually a diabetic cat is administered intravenous fluid therapy while under anesthesia. This hydrates the animal when it cannot drink on its own. Apart from needing a reduced amount of insulin and fluid therapy (which is also given to some non–diabetic animals undergoing anesthesia), your diabetic cat is not at any additional risk from anesthesia than a non–diabetic cat of the same age.