Diabetic Cat Care: Signs, Insulin, Food and Tracking at Home

Which cats get diabetes

• It's a common condition: as many as 1 in 100 cats is diagnosed with diabetes in their lifetime.
• It's most common in middle-aged and older cats. In one study, 82% of diabetic cats were older than 7.
• Cats with overweight, an inactive life, and males are at higher risk. Overweight cats are up to four times more likely to develop it.
• Most diabetic cats are mixed breed. Burmese cats have shown a higher risk.

Sources: 1, 2, 3

Signs to watch for

The first signs are easy to miss because they come on slowly.

• Drinks more water than usual
• Urinates more, so the litter box needs changing more often
• Eats more but loses weight
• Less energy than usual
• Weakness in the back legs, sometimes walking flat on the hocks instead of up on the toes
• A coat that looks unkempt

If you notice these, book a visit with your vet. Diagnosis takes more than one high blood sugar reading, because stress at the clinic can raise a cat's sugar on its own. Your vet may use blood and urine tests, or repeat readings taken when your cat is calm or at home.

Sources: 1, 2

How vets usually treat it

Your vet chooses the treatment. Here's what to expect:

• Insulin injections, usually twice a day, given under the skin. Some insulins can be given less often, but they don't suit every cat, so your vet chooses the one that fits. Please check with your vet before changing insulin. Some cats may be able to use an insulin pen instead of a syringe. Your vet can tell you if that's an option.
• A once-daily pill (an SGLT2 inhibitor) for some newly diagnosed cats. Not every cat is a good fit, so your vet decides.
• Checking sugar levels. Your vet may use a small glucose sensor worn on the skin, or a series of glucose tests with a glucometer made for pets, at home or at the clinic.
• Regular rechecks, often every 5–7 days while the dose is being set.

The goal is a cat who feels well and whose signs have gone, not just good numbers. Getting there can take weeks or months.

Sources: 1, 2, 3

Caring for a diabetic cat at home

Insulin

• Match your syringe to your insulin. Use U-40 syringes with U-40 insulin and U-100 syringes with U-100 insulin. The wrong one can give too little insulin or about 2.5 times too much, which can mean an emergency visit. Check with your vet's office before buying syringes online.
• Ask your vet to show you how to give injections. The company that makes your insulin may also have how-to videos.
• Each syringe is used once.
• Store insulin in the refrigerator. Never freeze it, and don't leave it in heat or sunlight, such as in a parked car.
• Most insulins are gently rolled, not shaken, but one type is meant to be shaken. Follow the instructions for the insulin your cat uses.
• Replace insulin that looks clumpy, discolored, has crystals in the bottom of the vial, or looks different from usual. Some insulins should look milky after mixing and others should stay clear, so ask your vet what yours should look like.
• Never change the dose without talking to your vet first.

Keep a daily record for your vet. Cornell recommends tracking water intake, urination, appetite, weight, and the insulin or medication given. How much water your cat drinks in 24 hours is one of the most practical signs of how well the diabetes is controlled. The free log below keeps it all on one page.

Weigh your cat on the same scale once or twice a month.

Ask your vet ahead of time what to do if your cat doesn't finish a meal or vomits before or after insulin.

Sources: 1, 2

Food

Your vet will recommend a diet for your cat. These are the published guidelines they work from:

• Many diabetic cats do well on a high-protein, low-carbohydrate diet. Lower carbohydrate can improve blood sugar control.
• Canned food is preferred over dry. It's lower in carbohydrate, easier to portion, and adds water.
• Portioned meals are preferred, because they make it easier to see how much your cat eats. Some cats can still graze if that's the only way they'll eat.
• High-fiber diets aren't usually recommended for diabetic cats.
• For overweight cats, slow, steady weight loss under your vet's care helps. A healthy rate is 0.5–2% of body weight a week.
• If your cat has another condition, such as kidney disease, your vet may choose a diet for that condition instead.
• Pet food labels don't always list carbohydrate. Your vet can help you compare foods.

Talk to your vet before changing your cat's food.

Sources: 1, 2, 3

What to expect over time

• With good care at home, the outlook for a good quality of life is good.
• Remission is possible. Some cats' bodies start producing enough insulin again, so treatment can stop. It often happens in the first 3–6 months of treatment. In studies, 15–100% of cats on a high-protein, low-carbohydrate diet with insulin went into remission.
• Control is the goal. Remission isn't a cure. A cat in remission still needs a careful diet and checkups, and some need insulin again later.
• A cat getting insulin who goes into remission without anyone noticing can develop dangerously low blood sugar, which can cause a seizure. That's one more reason to keep the daily record and keep rechecks.

Sources: 1, 2

Find a vet or specialist

• Your own veterinarian is your first call for anything about your cat's diabetes.
• Board-certified specialists in internal medicine and in veterinary nutrition can help with hard-to-regulate cats or diet plans. Search by ZIP code on VetSpecialists.com, the American College of Veterinary Internal Medicine's directory.
• In an emergency, go to the nearest emergency animal hospital.

Sources: 5