Feline Diabetes Quick Reference Guide

Insulin

Some cats can be successfully managed through diet change alone and do not require supplemental insulin. Hopefully that will be the case with your kitty. If not, there are three insulins that have been found to be most effective for cats: Lantus/glargine, Levemir/detemir, and PZI/ProZinc.

You never want to give oral insulin medications to a cat as they've been shown to damage the pancreas further, usually permanently, making remission a lot less likely. Remission, or going "Off The Juice" (OTJ) means that your cat no longer requires insulin injections and is a "diet-controlled" diabetic, aka a "broken" diabetic. You have the highest chance of getting your cat into remission within the first 6 months of diagnosis, so that's what we're aiming for here first.

Diet

Getting them switched to a low carb, wet food is your best bet. Dry food is usually too high in carbs (it's what holds it together) and is taxing on a cat's liver and kidneys due to water-depletion and can lead to UTIs and blockages. The Cat Info.org website has a nutritional information list on most of the commercial canned food available (you want anything less than 10% carbs, the lower the better). I created a sorted version of this list for Michelangelo's unique dietary restrictions (he's allergic to red meat and does best on anything over 50% protein). You do not need to feed any expensive "prescription" diets. In fact, most of those diets are too high in carbs for our diabetics, including the Hills m/d and Royal Canin Diabetic. Purina DM is not too bad, but it's still overpriced and is mostly pork liver. If you've already purchased the prescription foods, they all have a guarantee and you can return them for a refund and tell them your cat won't eat it. You also want to try not to feed too much seafood since it's high in contaminants.

There are also low carb treat options available for our sugar cats. You can also make your own treats by using any pure protein source (like a chicken breast) and plainly cooking it or even feeding them a bit of it raw. Raw gizzards are especially great for teeth. Try to stay away from deli meats as these usually contain sugar.

Hold off on making any diet changes if you are already giving insulin and are NOT home-testing yet. A change in diet can drop a cat's blood glucose levels significantly (100-200 points or more), requiring a decrease in insulin. If you do not drop the insulin dose with the diet change, you increase the risk of causing hypogylcemia.

Another thing that is common is that some vets will tell you to feed only a certain amount of food twice a day (usually at shot time). Depending on the insulin, this rule can be ignored...for the most part. Newly diagnosed diabetics are often ravenous because they're literally starving to death and need a bit more food since their body can't process nutrients properly so you will need to be feeding them a bit more food (some people report up to 50% more) to keep them from losing too much weight. There is a great discussion on just how much to feed Kitty (within reason) when first starting out that is worth reading up on. The catinfo.org page on feline obesity is also worth a read-through to help you know just how much Kitty should be eating to maintain his ideal weight and how to help him gain or lose weight in a healthy manner.

Home Testing

Yes, we test our cats much like human diabetics test themselves, except we use their ears (which are actually less sensitive than our own fingertips). We've taught many people how to test their cats and it becomes fairly routine and even easier than feeding them. When starting out, however, you might run into a few problems, so here's a great link on Ear Testing Tips to help get you started. The other great benefit of home testing is that you do not need to take your cat into the vet to get tested or for expensive curves since you can do it at home. My vet has only seen Michelangelo once since diagnosis and that was for his one-year checkup and not even diabetes related. Some cats may prove more difficult to test when first starting out, but with a bit of time and patience, they'll eventually catch on and start seeking you out for tests. It happens all the time, so don't give up!

Most of us use human glucometers since they're so much less expensive for the test strips than the pet meters, but are just as accurate (with a difference akin to Celsius vs. Fahrenheit). If you're in the US, Walmart carries the ReliOn brand that has the cheapest strips around, which is where the cost can easily add up. Even if your cat is not yet on insulin, I would still highly recommend getting a meter so you can see how the diet change might be affecting the numbers and if your kitty needs to go on insulin.

In order to figure out what numbers you're looking for, I simply reference Wikipedia's Blood Sugar Guidelines Chart. There is also this chart to help you interpret what the numbers mean as you go along.

Getting Started Shopping List:

1. Glucometer (i.e. a Walmart ReliOn Confirm/Micro or Prime)

2. Matching Strips

3. Lancing device if you prefer

4. Matching lancets if you're using a lancing device. If not, then look for the "alternate testing site" lancets, which are great to use for when first starting out.

5. Ketostix for testing the urine for ketones (a potentially dangerous condition that can develop from hyperglycemia)

6. Freeze-dried meat treats (essential when first starting out testing)

The AAHA Guidelines for Diabetes is a great resource for much of the information I provided above and is worth a read-through and perhaps even passing along to your vet.

Here is another great resource with lots of helpful links.

Disclaimer: I am not a vet so everything mentioned here are suggestions based on extensive research into and experience with feline diabetes management. It is not my intention to represent or replace medical advice you might have received from your vet; only to offer knowledge and assistance for you to work with your vet on the best management for your cat.