6 months for checkups.”
Feeding For Health
Although these diets can help with dental care, be sure the
diet itself is appropriate for your cat’s total health
requirements. The need for a therapeutic kidney diet may
override dental concerns, for example.
Eukanuba Dental Defense System (added to many
adult Eukanuba foods)
Friskies Dental Diet
Hil ’s Science Diet Oral Care
Hil ’s Prescription Diet Feline t/d (only available from
veterinarian)
Purina Veterinary Diets, DH Dental Health
ROYAL CANIN Veterinary Diet feline DENTAL DD™
27
DIABETES MELLITUS
When your cat eats, her body processes the food into
glucose (sugar). A hormone cal ed insulin moves glucose
from the blood into the cel s of the body where it is used as
fuel. The pancreas, located near the liver, manufactures
insulin and digestive enzymes. “In cats we see what’s cal ed
amyloid deposition in the pancreas, where you essential y
have gradual depletion of functional pancreatic tissue
because it’s being covered up by this amyloid deposition,”
says Dr. Davenport.
Diabetes mel itus is a metabolic disorder in which not
enough insulin is produced by the pancreas (Type 1, insulin-
dependent), or the body is unable to use the insulin that’s
present (Type 2, non-insulin-dependent). The latest evidence
suggests that Type 2 diabetes mel itus (DM) is the most
frequently occurring form of DM in cats and humans.
Type 2 DM in cats is characterized by an impaired
ability to secrete insulin fol owing a glucose stimulus and is
caused by both a defect in pancreatic beta cel s and by
peripheral insulin resistance. Diabetes renders the cat
unable to use glucose for energy, in effect starving the body.
Diabetes is one of the common endocrine (hormone)
disease in the cat affected one in every 200-300 cats seen
by veterinarians, says Sharon Center, DVM, an internist at
Cornel University.
“About 20 percent of them have an in-and-out phase of
diabetes,” says Richard Nelson, DVM, an internist at the
University of California-Davis. He notes that transient
diabetes is most commonly associated with pancreatitis.
“Those cats are ones that are amenable to just diet
sometimes, or diet and oral medicine.”
Another common cause is obesity. Fat suppresses the
insulin function so that even though the pancreas is making
insulin, the body can’t use it effectively. Diabetic cats are
very often overweight.
Senior Symptoms
Various signs of diabetes can be similar to symptoms of
other serious il nesses, such as kidney disease.
Increased thirst
Increased urination
Sticky ‘sugary’ urine
Missing the litter box
Increased appetite
Weight loss
Bad breath that smel s sweetish, like nail polish
“Plantigrade” stance—walking on her heels
Because cats are true carnivores and have evolved to
best use a diet consisting primarily of animal flesh, they’ve
lost the need for dietary carbohydrates. Some experts
suspect, therefore, that carbohydrate-based commercial dry
cat foods may be one part of the puzzle that causes some
cats to develop diabetes and obesity.
The unused glucose is eliminated via the bladder,
turning urine into a sugary liquid that pul s additional fluid out
of the body. Losing so much water prompts the cat to drink
more water, which creates a vicious circle when she then
needs to urinate more frequently. Often, the first signs you’l
notice is the cat urinating outside the litter box when she’s
not able to get to the facilities in time.
A smal percentage of diabetic cats develop diabetic
neuropathy, which causes a rear-leg plantigrade stance.
Instead of walking normal y on her toes, her stance drops
reversed once the diabetes is under good control, says Lisa
Klopp, DVM, a neurologist at University of Il inois. “Diabetes
is a very dynamic disease, it’s not static,” she says, and that
can make it difficult to treat effectively. The combination of
symptoms point to the disease, and diagnosis is confirmed
by testing the blood and urine.
“It’s an old animal diagnosis,” says Richard Nelson,
DVM, an internist at University of California-Davis. Most cats
are diagnosed at age 10 or older, and average survival time
after diagnosis is three years. “I’ve had diabetics that have
had it for 8 or 9 years,” he says. The key is getting the cat
regulated and maintaining them.
Nurse Alert!
In most cases, a diabetic cat wil require insulin
injections. Typical y these are given with tiny needles
that the cat tolerates quite wel . Most owners find that
giving injections is easier on al concerned than trying
to pil the cat—little restraint is required. Try rewarding
each injection with a treat so she associates the
medication with something pleasant.
How much your cat eats or exercises influences
glucose levels. Maintaining a regular routine is
important.
Too much insulin or too little can have devastating
consequences. Diabetic coma may result if the cat
gets the wrong amount of insulin. the insulin is too old,
if she doesn’t eat on schedule, or over-exercises. The
cat loses consciousness, and can’t be awakened. This
is a life-threatening emergency that requires
immediate veterinary help.
Too much insulin causes hypoglycemia—an insulin
reaction. The cat acts disoriented or drunk, drools,
shakes, acts weak and may develop a head tilt. Giving
her a glucose source such as honey or Karo syrup
should reverse these signs in five to 15 minutes.
Without intervention, the condition progresses to
convulsions, coma and death.
Treatment
Diabetic cats don’t tend to have the same severe
complications as diabetic people, says Dr. Nelson. A rigid
control of the human disease is required because people
live for decades and complications tend to develop twenty or
more years after diagnosis. Of course, cats don’t live that
long. The goal is to keep cats happy, active and interactive
with the owners. “It’s a quality of life issue,” says Dr. Nelson.
In the last few years researchers have begun taking a
closer look at the practice of feeding cats complete and
balanced commercial diets that are largely carbohydrate-
source ingredients. “Dietary feeding practices in the cat are
kind of mirrored after the dog, and in the dog they’ve been
mirrored after a person. But a cat is a pure carnivore, and
the dog is an omnivore just like a person,” says Dr. Nelson.
“One of the theories is that we would be better off feeding
cats a real high-protein, low-c
arbohydrate type of a diet
rather than the more standard omnivore diet that dogs tend
to get. DM diet by Purina goes after that approach.”
DM-Formula (diabetes management formula), a Purina
Veterinary Diet, comes in dry or canned forms and
combines extremely high protein with low carbohydrates. A
percentage of type 2 diabetic cats may be able to live
normal lives without insulin injections when fed this or a
similar diet. “Cats fed the high protein/low carbohydrate
diets are ten times more likely to lose their dependency on
insulin injections,” says Dr. Center.
Deborah S. Greco, DVM, PhD says the best
approach is dietary change alongside other medical
management, be that oral agents or insulin injections. A low
carbohydrate, high protein diet can be therapeutic products
designed for treatment of diabetes, or over the counter
canned food diets (such as Fancy Feast). Dry forms of
diabetic diets may be meal fed, but not free choice. Choose
t he lowest carbohydrate content based on a dry matter
basis.
Feeding For Health
A high fiber diet not only helps reduce overweight but also
helps regulate the rate at which food is digested and glucose
released into the cat’s system. Other therapeutic diets
increase the protein and reduce the carbohydrates. A
number of diets may be appropriate, including:
Eukanuba Adult Weight Control Formula
Iams Veterinary Diets, Nutritional Weight Loss
Formulas, Restricted-Calorie/Feline
Max Cat Lite
IVD (Royal Canin) Select Care Feline HiFactor
Formula
IVD (Royal Canin) Select Care Feline Mature Formula
IVD (Royal Canin) Select Care Feline Weight Formula
Nutro Complete Care Weight Management
Precise Feline Light Formula
Purina Veterinary Diets, DM Diabetes Management
Formula
Waltham Feline Calorie Control Diet
When the diabetic cat is fat, losing weight is an
important part of treatment. “If you can correct that, a lot of
times the diabetes wil go away,” says Rhonda L. Schulman,
DVM, an internist at University of Il inois. A weight-loss diet
combined with veterinary supervision and exercise—
encouraging the cat to play—is most effective. She says
about a third of al diabetic cats can be managed with the
diet, but that they typical y need some sort of oral medication
as wel .
“Twenty-five to 30 percent can be treated with oral
medication,” says Dr. Nelson. Obese male cats with type 2
diabetes are the best candidates for oral hypoglycemic
agents. Glipizide (Glucotrol) boosts the production of insulin
in the pancreas. Some of these cats do wel on oral
medication for a long time. Other times, this only works for a
few months and they end up having to go on insulin. Reversal
of glucose toxicity using a short course of insulin therapy
prior to or in combination with oral hypoglycemic agents may
improve the response to oral hypoglycemic agents, says Dr.
Greco.
Initial studies using a canned high protein/low
carbohydrate diet and the starch blocker acarbose have
shown that 58 percent of cats discontinue insulin injections
and those with continued insulin requirements could be
regulated on a much lower dosage (1U BID). Comparison of
canned high fiber versus low carbohydrate diets showed that
cats fed low carbohydrate diets were three times more likely
to discontinue insulin injections.
“About 50 to 60 percent of cats have an absolute
requirement for insulin at the time of diagnosis is made,”
says Dr. Nelson. They’l need insulin injections, usual y twice
a day. Various types of insulin are available, and different
ones may work better for individual cats. “The two best are
recombinant human lente and PZI insulin,” he says. There
are other kinds as wel , but they may have different durations
of effect and require more frequent injections. The amount
and frequency of insulin injections varies from cat to cat and
depends on activity level and metabolism. Usual y it takes
time and experimentation to find the right dose, best insulin,
and ideal schedule. Most owners become quite adept at
giving insulin injections.
Bottom Line
The initial testing and regulating is the most expensive part
and may run a couple hundred dol ars because typical y the
cat must be hospitalized for several days. Once that’s done,
though, managing diabetes with special food, oral
medicines and/or insulin can be quite reasonable. The cost
varies in different parts of the country but usual y is wel under
$20 a month.
Testing
Usual y, blood tests are monitored for blood sugar levels,
and the amount and frequency of insulin shots are adjusted
accordingly. “There’s a trend towards clients actual y
measuring blood sugars at home,” says Dr. Nelson. An
instrument cal ed a glucometer tests the blood, and a sample
is obtained by performing an ear prick. “In the kitty, you heat
the ear with a warm washcloth,” says Dr. Nelson. Put a damp
washcloth in a plastic baggy, warm it in the microwave for
about 5 to 10 seconds, and then massage the damp warm
cloth against the ear for about 30 seconds. “That brings the
circulation to the ear, and then you use the lancet to prick a
drop of blood just as a human diabetic does on their
fingertip. I have 10 or 12 clients now that routinely do blood
sugar measurements and send me the information,” he says.
Home monitoring can be a big advantage because stress
can affect the reading, and bringing the cat to the hospital
may mean the tests aren’t as accurate as when done by the
owner.
A newer in-hospital monitoring test examines the blood for
levels of fructosamine. “It’s a marker of average blood
sugars over a period of two to three weeks, and it’s not
affected by stress,” says Dr. Nelson.
Comfort Zone
Many owners of diabetic cats like the Ascensia Elite
XL glucometer (formerly the Bayer product cal ed
Glucometer Elite XL) because it requires a very smal
amount of blood to monitor the glucose level. The care
system is available at most pharmacies.
A cat box additive can turn conventional litter into a
glucose monitoring system. Glucotest Feline Urinary
Glucose
Detection
System
(Purina
Veterinary
Diagnostics) is thoroughly mixed with the cat’s usual
cat box fil er and reacts to urine with distinct color
changes to indicate the level of glucose in the urine.
The test is not intended for home diagnosis of
diabetes, but only for monitoring purposes. The
Glucotest packets are available from your veterinarian.
Golden Moments: A Second Kittenhood
When Jennifer Schil ing’s baby brother was born, it was
decided that Je
nnifer needed a baby, too, and a kitten was
the answer. She was seven years old when she first met the
hissing, scratching bal of calico fluff. “I just grabbed and I
caught her,” says Jennifer. “I held on for dear life.”
Today, Jennifer works as a lab specialist at Virginia Tech in
Blacksburg, Virginia, where she does cancer research.
Momma Kitty, a mostly white cat, with a stylish checkerboard
brown and black face, has been her constant companion for
nearly two decades. The cat acquired her name as you’d
imagine--“She started having kittens, and the name just
stuck.” She was spayed many years ago, though. Last year,
Momma Kitty celebrated her 18th birthday in August.
“My whole childhood was involved with Momma Kitty and
dressing her this way and that,” says Jennifer. “If I was going
to bal et class where I wore tights, she wore tights, too.” The
pair grew up together, and when Jennifer had to live in the
dormitory her freshman year in col ege, it nearly kil ed them
both. “That’s the only time I’ve ever been apart from her,”
says Jennifer. “I would go home on the weekends and she
would eat. And she would not eat again until I came home
the next weekend.” When school began for her sophomore
year, Jennifer took Momma Kitty with her. “She’s been with
me ever since.”
As she grew more mature, Momma Kitty gained more
confidence, and expected visitors to the house to
acknowledge and pet her. When Jennifer and Wes got
married two years ago, Momma Kitty welcomed him to the
family. A three-year-old orange cat came as part of the
package, and the older cat took Fezzik in stride.
Lately, Wes and Jennifer noticed she’d slowed down, and
seemed much more mel ow than Fezzik. “We adjusted
furniture so she never has to jump more than a foot and a
half,” says Jennifer. “She can jump on the kitchen counters if
she real y wants to, but I don’t try to force that out of her.
Then her behavior completely changed. “It was like a
switch went off,” says Jennifer. Momma Kitty began sleeping
20 to 22 hours a day, and developed a lot of hind leg
weakness. She’d always had a weight problem, and Jennifer
had been careful about feeding her a control ed amount
twice a day. “She became ravenous, wanting to eat nonstop.
If you sat down to eat, she’d get in your lap to try and eat
from your plate,” says Jennifer. “She started losing weight