Rocky Mountain High: How sweet it is!

On a recent four day break away from the clinic, I had the amazing opportunity to experience the leaf changes of the aspen trees in the Steamboat Springs area of Colorado. Although threats of storms were in the forecasts, the weather was perfect with low humidity and clear blue skies. Evening dining along the Yampa River that meanders through town were finished with wonderful desserts.  In addition, exploring art galleries, long walks, and beautiful sunsets completed the picture perfect vacation. 

Although pets by nature do not crave treats, they certainly can experience dysregulation of their blood sugar. As in people this is called Diabetes Mellitus. A recent survey projects anywhere from one to five percent of the pet population is diabetic. Some feel this number has tripled in the last 30 years. In this blog I will focus on cats with this disease.

What are the signs of diabetes in cats?
Weight loss, increase in thirst, increase in appetite, increase in volume of urine in the litter box, and inappropriate urination are the most common findings. Some cats will have a change in the way they walk (walk on their ankles) and vomiting. Many owners note their cats seem more depressed and are not grooming themselves.

What are the more common ways diabetes Mellitus is diagnosed in cats?
Cats will have clinical signs along with a rise in their blood glucose level and sugar in their urine.

Are there other diseases that can have similar signs in cats?
Yes thyroid tumors (hyperthyroidism) and kidney disease will have similar signs and may be a concurrent illness.

What disease do both cats and "Jaws" in the James Bond movies share?
Acromegaly is a tumor (adenoma) of the pituitary gland that presents as insulin resistant, Type 2 diabetes often with exaggerated, distorted growth of the head and body. It is common in middle aged or older male cats due to excessive growth hormone production. A new study suggests up to 1/3rd of diabetic cats may silently have acromegaly without any outward changes. Richard Kiel, the giant figure in the James Bond series, recently passed away.


What is the goal in diabetes mellitus in cats versus dogs?
In cats, veterinarians seek remission while in dogs they seek control. In both, proper diet choice and insulin are recommended.

What is the diet choice for cats recently diagnosed with diabetes?
Low carbohydrate diets, especially canned ones.

There are so many choices in insulin: short, intermediate, and long acting. How does a veterinarian pick one?
Since cats are unpredictable in their response, most start with longer acting insulins such as Prozinc or Glargine injections twice a day, if low carbohydrate diets for a month have not lowered blood glucose levels after a month.

Are insulins interchangeable between brands?
No!!! It is dangerous to switch manufacturers without consulting your vet!

There is extreme variation in cost of insulin in human and veterinary brands. Also I see U-100 and U-40 insulin. I am confused and what does it mean?
U-40 insulin has 40 units of insulin and U-100 insulin as 100 units of insulin per cc (ml). It is very important to use U-40 syringes with U-40 insulin (and also U-100 syringes with U-100 insulin). To compare cost figure the cost per unit of insulin. For example, a U-100 insulin typically has 10 mls in a vial and thus 1000 units a vial. If the vial costs $200 divided by 1000 units= $.20 per unit

What is the biggest surprise for most owners purchasing insulin and syringes at a human pharmacy?Most pharmacies in North Carolina do not require a prescription for a normal number of syringes or older brands of insulin.

What is the statistics of a diabetic cat going into remission and off insulin?
Up to 50 percent of cats started on low carbohydrate diets will go into remission in 1 to 4 months.

What is new in diabetes for cats?
Exenatide,( Byetta,TMLilly) excreted from the salivary gland of the Gila monster when given sub-cutaneously to cats increases insulin production by the pancreas and increases insulin receptivity by the tissues. However, it only works when blood sugar high so no adverse effects if the blood sugar is low. For now, cost curtails its use in cats. In recent studies in Zurich, an extended release version of Byetta is being studied to see ways a once a week injection could help control diabetes in cats. Stay tuned!

My thanks to Theresa Vonder Harr for sharing pictures of her precious Twix and Maxwell

Betsy Sigmon DVM,Diplomate ABVP Canine and Feline

Creature Comforts Animal Hospital