How is diabetes diagnosed?
Diabetes is diagnosed based on history, clinical signs and the results of routine screening tests (CBC, biochemistry profile, urinalysis). Other tests (urine culture, blood pressure assessment, and others) may be recommended based on the results of the screening tests.
How is diabetes treated?
Insulin therapy makes up the cornerstone of management, although dietary management is a very important considerations as well. Initial hospitalization may be recommended after the diagnosis is made, so insulin therapy can be started in the hospital. Several (2 to 4 or more) spot blood glucose levels are checked within the 4 to 12 hours after insulin is given to make sure the starting insulin dose is not too high. Once discharged, your pet will need to continue to receive insulin shots on a daily basis at home. It will likely be a bit new and confusing at first, but our nurses will help teach you how to give the insulin injections and in a short time, the process should become quite familiar and comfortable.
Increased thirst and appetite is common in the diabetic
What type of home care is recommended for the cat with diabetes?
In general, home care involves the consistent administration of insulin as well as a specially formulated diet and feeding schedule. Some general guidelines in these areas include:
1. Diet: regular daily feedings given at the same time each day (for example, 7 am and 7 pm) help to maintain optimum diabetic regulation. Maintaining an appropriate body weight is also important (we will help you determine the optimum weight for your pet). Specific guidelines for exactly how much to feed, when to feed and what type of diet to feed will be recommended.
2. Recommended diets: in general, a high protein low carbohydrate diet is the preferred choice for the diabetic cat. In some patients, additional diseases or medical concerns may necessitate alternative dietary choices. There are a variety of excellent choices available today for the diabetic cat.
Insulin & Insulin Syringes
How is insulin therapy given?
There are several different types of insulin to choose from for treatment of diabetes. Generally speaking, at the time of diagnosis, an appointment time will be set up so the nurse and doctor can go over specific recommendations as to the type of insulin recommended, dose recommended, and special precautions that need to be taken in regards to appropriate storage and handling of insulin for your pet. The doctor and nurse will also teach you how to give insulin shots, so you are very comfortable and confident before you leave the office and embark on home care on your own.
Sites to Administer Insulin Injections Giving an injection to a cat
What type of monitoring and rechecks are recommended?
Diabetes is often a constantly changing disease and frequent veterinary rechecks are often necessary to help guide therapy and provide for the early detection of complications. Some general guidelines include the following:
1. Regular rechecks: after preliminary regulation of diabetes has been achieved, your pet should return for a recheck evaluation (examination, CBC, profile, UA and urine culture) every 4 to 6 months.
2. Glucose profile
This test involves taking a very small sample of blood every 2 hours for 12 to 24 hours. It is critical in determining how your pet is responding to insulin therapy. Glucose profiles are done initially to determine the best insulin dose, as well as whenever the insulin dose is changed, or if clinical signs suggest poor regulation.
3. Planning for the recheck blood glucose profile
When you return for a blood glucose profile, the doctor will often ask you to bring with you in a small cooler your pet’s insulin, insulin syringes, and enough food for the next meal. We will likely ask you to feed your pet breakfast at home before you come. When you arrive at the clinic, a nurse will assist you while you administer your pet’s morning insulin shot. The nurse will then get your pet set up in a comfortable cage for the glucose profile, while you fill out a recent history form letting us know how your pet has been doing and if any new problems have arisen.
4. Other testing
If your cat becomes sick, or develops symptoms which suggest poor regulation (decreased appetite, increased thirst, increased urination, urinary accidents in the house, depression, etc), then a recheck visit should be scheduled more immediately.
5. What about glucose monitoring of the urine?
As excess glucose can be noted in the urine both with insulin overdose and underdose, this method is not recommended for monitoring.
What about home blood glucose monitoring?
If you are interested in performing home glucose profiles, our nurses can assist in teaching you to perform this testing (many owners do this very successfully at home). You will need to be taught how to obtain blood samples from your cat (our nurse can show you during an appointment time) and you will need to purchase a device that measures glucose levels in the blood (a glucometer). Our currently recommended glucometer is AlphaTrak by Abbott Veterinary. During the beginning stages of insulin therapy, it is important to bring along your glucometer with your pet during scheduled blood glucose rechecks (so we can compare the values with our in house glucose lab measurements to insure accuracy). Once we are certain that blood glucose values agree with those obtained in our clinic, blood glucose profiles can be performed at home and the results reported to the doctor for ongoing recommendations in regards to insulin therapy.
