This week I received an email from one of our readers asking what to expect as her cat seems to be going into diabetic remission. So I got out my crystal ball and… Wait! I don’t have a crystal ball. How it plays out varies from pet to pet. I suppose what I can share with you is what I have seen over the years with some of my feline patients who have gone into remission. And I can offer some pointers to help keep the kitty in remission.
Cats are usually type 2 diabetics, meaning they may yet produce insulin but don’t react to it as well as they should. This is called insulin resistance. Factors that commonly cause insulin resistance include obesity, high carbohydrate diets (such as cat kibble), infections (such as dental disease) and lack of exercise (rampant with indoor kitties). If we address these issues and provide them with supplemental insulin, a good portion of cats can go back into a non-diabetic state. This is called remission. How amazing is it that we can turn the situation around and actually “cure” these cats!
Now, how this plays out varies. If you are very attuned to your diabetic feline and monitor the blood glucose at home, you will have a better outcome. As much as we hope for diabetic remission, if we fail to notice signs of diabetic resolution, the typical dose of insulin that had been working just fine for months might result in hypoglycemia. Mild hypoglycemia may not be noticed. Moderate hypoglycemia may look like a drunken cat. If the blood glucose gets below 20 or 30 mg/dl, the pet could seizure. If no one is home, this could be life threatening.
To avoid tragic events like this one, I want all my clients with a diabetic to have a glucose meter at home. I keep close contact with them. If the pet is acting odd or goofy in any way, I have them check a glucose value. If the glucose level is low I have them feed the pet immediately. All my clients have my cell phone number so they can text me in case of emergencies. And I make sure they know the locations of the local ER clinics in case I’m unavailable. And of course, they do periodic blood glucose curves and monitor the pet’s weight and how much the pet is drinking and peeing.
I’ve had a few cats present to the clinic in hypoglycemia and we’ve never had to give insulin again. I’ve also seen kitties present in hypoglycemia and we’ve had to progressively lower the insulin dose. When a diabetic pet owner is observant, it is more common for us to gradually wean the cat off insulin.
Some diabetic pet owners will check a blood glucose before each injection of insulin. I don’t think this is necessary for all diabetic pets, but if a client with a diabetic cat is striving for tight glucose regulation in hopes of remission (a cat phenomenon), they probably do already check the blood glucose twice daily. If we suspect that a cat is going into remission, I definitely want the pet owner to check the glucose before each injection. If the glucose level is in the normal range I would skip that dose of insulin. Or, if the glucose level is elevated but nominally so, they might give half the regular dose. I won’t say specifics here, as this is something you must discuss with your own veterinarian who has physically examined your pet.
Okay, let’s say you have seen your cat through to the point where you have achieved diabetes remission. Does this mean you can sit back and resume old habits, most specifically dry cat food? Nope. You should continue to feed a canned, low carbohydrate food to your kitty. You should also strive to keep your cat’s waistline slim. Obesity, high carb diets, and lack of exercise are the most common risk factors that triggered the type 2 diabetes in the first place.
If you’ve finished this article and wonder why I kept referring to cats regarding possible remission, it is because cats usually start as type 2 diabetics (non-insulin dependent diabetics). Some cats may later become type 1 (insulin dependent diabetics), but initially we have a chance of turning their diabetes around. Dogs, unfortunately, are most often type 1 diabetics. It would be quite rare for a diabetic dog to go into remission. Dogs may have insulin resistance from obesity, infection and lack of exercise. Addressing these factors can significantly improve their quality of life and diabetic control. Nonetheless, diabetic dogs will probably never go off insulin.
Thanks to our reader who suggested this week’s article idea! If you want to get in touch with me, you can email me at Joi.SuttonDVM@adwdiabetes.com
NOTE: Consult your veterinarian to confirm that my recommendations are applicable for the health needs of your pet.