Diagnosing feline diabetes can be challenging due to their propensity to develop stress-induced hyperglycemia. Cats presenting persistent classic clinical signs of diabetes, such as polydipsia (PD), polyuria (PU), and weight loss despite good appetite should be further monitored for corroborative laboratory test results showing hyperglycemia and glucosuria.
Also, conduct blood serum and urinalysis testing to rule out infections and other underlying medical conditions. Plantigrade stance presents as a characteristic clinical sign of advanced feline diabetes.
Confirm a preliminary diagnosis of diabetes mellitus based on clinical signs with blood and urine tests. Glucosuria combined with hyperglycemia (>16.7 mmol/L (300 mg/dL)) indicates diabetes mellitus. Although it is common for cats without diabetes to develop transient hyperglycemia in times of stress, such as during blood sample collection, the urine glucose should be negative in a cat without diabetes.
Because stress-induced hyperglycemia can result in blood glucose concentrations of 16.7-22.2 mmol/L (300-400 mg/dL), it can confound the interpretation of blood glucose results. Persistent hyperglycemia and glucosuria should therefore be present to definitively establish diabetes diagnosis. It’s useful to measure serum fructosamine concentrations because they remain normal in stress-induced hyperglycemia and elevated in sustained hyperglycemia.
Evaluating glucose accumulation in urine is a useful diagnostic tool in helping to make a definitive diagnosis of diabetes in cats. Since it takes several hours of stress for detectable glucose to accumulate in the urine, glucosuria will not be present in cats with stress-induced hyperglycemia. In addition to the absence of glucosuria, none of the typical clinical signs of diabetes are present in cats with stress-induced hyperglycemia.
When a diagnosis of diabetes has been confirmed, consider beginning management with Caninsulin® (porcine insulin zinc suspension). A diet appropriate for cats with diabetes should be started as well.
The goals in managing diabetes mellitus are to minimize the clinical signs of diabetes, the risk of hypoglycemia, and the development of long-term complications. Accomplishing these 3 goals requires that pet owners understand all aspects of diabetes management. It pays to invest sufficient time to carefully explain all aspects of diabetes therapy to your clients.
Managing diabetes can be an exercise in frustration until stabilization occurs; however, this website offers help to veterinary professionals as they evaluate the disease and its management. It also provides tools and resources (see additional support).
Management of diabetes mellitus in cats includes medications (e.g., Caninsulin®) and diet. For intact females, spaying is required because of the hormonal changes during the estrous cycle. In particular, the elevated progesterone level is antagonistic to the action of insulin.
Monitoring blood glucose is a good way to evaluate regulation of cats with diabetes that are being treated with insulin. It’s accurate, quick, and requires only a drop of blood. However, in certain conditions, it may not be reliable because blood glucose concentration is influenced by many factors and may not show an accurate result of insulin management.
Various factors such as economics, logistics, and clinical situations can force veterinarians to limit diagnostic procedures. When it’s not possible to perform a complete glucose curve (clinic or home), punctual blood samples combined with assessment of clinical signs, general observations and other complementary laboratory tests can provide an overview of the health of the animal with diabetes.
Food intake, cat and owner cooperation, use of a drug (e.g., prednisolone, progestogens, megestrol acetate), concurrent disease conditions (e.g.,hyperadrenocorticism, acromegaly), or stress can affect blood glucose levels. In these cases, blood glucose measurements will need to be interpreted in combination with other methods of evaluation.
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