I thought that it would be a good idea to share some of the questions that I get from the diabetic pet owners that I meet with. Maybe you have had similar questions. If so, I hope that you can also benefit from the below dialogue:
Q: Do I have to check my pet’s blood glucose? Can’t I just use the urine dipsticks?
A: In 1993 when I started practicing, it was very common for vets to have owners use urine dipsticks rather than checking glucose levels in the blood. Glucose meters were not as readily available as they are today, and they required a larger drop of blood than what current meters require. Certainly, there are times when checking urine for glucose is appropriate, but the glucose in the urine reflects the glucose that has exceeded the kidney threshold over several hours (time since the pet last urinated). The kidney threshold for glucose to spill into urine is about 180 mg/dl in a dog and 220 to 240 mg/dl in a cat. Urine dipsticks give us a general idea of what the blood glucose has been over several hours. Checking the glucose of the pet’s blood (using a glucose meter and a drop of blood) tells us exactly what the blood glucose is at that moment. If we have a pet owner who is unable to check the blood glucose (due to fear of seeing blood or physical inability), doing urine dipstick certainly gives us information – but not as much information as blood glucose. For diabetic cats that have gone into diabetic remission, I definitely advocate periodically checking for glucose in the urine. Each patient and situation is different. Discuss your options with your own veterinarian.
Q: I hate needles! Can’t I use an oral hypoglycemic medication instead of giving insulin injections?
A: Oral hypoglycemic medications only work for non-insulin dependent diabetics (also known as type 2 diabetics). Most dogs are insulin dependent diabetics (type 1 diabetics), so vets don’t even try oral hypoglycemic agents on dogs. Cats, on the other hand, are usually type 2 diabetics. This means that they may have insulin resistance or may just not produce enough insulin. Cat’s often start as non-insulin dependent diabetics (type 2) and progress to insulin dependent diabetics (type 1) over time. Although the response to treatment with an oral hypoglycemic medication is typically not nearly as good as with insulin, sometimes owners opt for such an oral med if they just can’t bring themselves to giving insulin injections. Unfortunately, this only works for borderline diabetics. Again, it isn’t nearly as effective as insulin injections for most feline diabetics.
For the majority of diabetic cats, it is best to start on insulin and get good control of their blood glucose levels while we change their diets to low carb diets and strive for proper body weight. Type 2 diabetic cats are typically obese when diagnosed. Lack of exercise, obesity and high carb diets are common triggers to diabetes in cats. Type 2 diabetics may have resolution of their diabetes with more exercise and diet changes.
NOTE: Consult your veterinarian to confirm that my recommendations are applicable for the health needs of your pet.