Discovering you have a diabetic cat is, of course, very frightening at first. I have firsthand experience with the shock and fear of facing this disease when my cat was diagnosed in 1997. My cat was, well, completely incorrigible at the veterinarian's, he literally turned into one of his feline ancestors with a horrific display of violence and aggression. His cat carrier always had a big day-glow orange warning sticker on it after I picked him up. After his diagnosis, my veterinarian at the time told me I should consider euthanasia in his case. It seems this doctor didn't believe me when I told him my cat was, indeed a very sweet and loving kitty (just not when he was being poked and prodded by the vet techs!). He went on to tell me what a frustrating disease feline diabetes is, how unpredictable it can be, how he could develop feline diabetic neuropathy, and how bleak the outlook was. I listened, packed up my cat, and began looking for the best veterinarian I could, one who specializes in feline diabetes. He was only 7 years old, and he at least deserved a concerted attempt from me to manage his disease. I fled that vet's office (how dare he?) and never looked back. My cat lived from age 7 to 16 with diabetes. In the end, he did not die of the diabetes, but sadly, of intestinal cancer. He lived a healthy, happy life. He passed away in March of 2008 and I still miss him dearly. But, I know I did my all to give him the best quality of life.

I found this specialist, thankfully, she painted a much more optimistic picture for me. She did, however give me the facts:

1. It can be a very frustrating disease to treat as some cats go in and out of what's called a honeymoon period (where the need for insulin disappears for a time).
2. Most cats with diabetes cannot be controlled with oral medications and will require at least one, and probably two shots of insulin daily.
3. A feline diabetes diet is a very important part of the treatment. Some cats can be treated with a special diet alone. But the vast majority of feline diabetics require additional intervention.
4. There's no blanket treatment for all diabetic cats, each is different and requires a lot of investigation and testing to come up with the proper treatment for your individual cat.
5. As the caretaker of a diabetic cat, your life WILL change. You won't be able to leave for a weekend with your cat free-feeding, you will need to be home at specified times to give insulin shots, you will need to keep a keen eye on your cat when the insulin peaks (especially in the beginning when you're experimenting with types, amounts, and insulin timing. You will need to find a great petsitter, one who can give shots and monitor your cat. Or, you will need to board him or her.
6. Your cat may have episodes of hypoglycemia that require swift intervention. My cat had two such episodes, one so severe he was having seizures and barely survived the drive to the emergency room.
7. There is a chance your cat will develop a condition called: feline diabetic neuropathy. This occurs when sustained high blood sugar actually damages the nerves, it usually affects the rear legs. It causes weakness. clumsiness, and sometimes excruciating pain.

I swallowed the information, piecemeal and quickly began educating myself on the disease and how to be the best pet owner I could for his unique situation.

The very first thing I noticed with my cat was excessive thirst, called polydipsia. He was frequenting the water bowl and drinking copious amounts of water. In fact, he was obsessed with water, hung out at the sink, drank my water, and always had a wet chin from his frequent consumption.  He was also eating a lot, voraciously scarfing down his meals.

I then began to notice voluminous amounts of urine in the cat pan. I had three cats at the time who all liked to use the same box, so I had a difficult time ascertaining which cat was urinating so much. I began to keep an eye on him and discovered frequent trips to the pan and a lot of urine coming out with each visit.

Over time, he started becoming very thin. He was always sleek, but one day I noticed his ribs were visible.

Your cat's coat may begin to look dull and dissheveled.

He or she may get more infections than usual, or may have a wound that won't heal properly.

Your cat may have less energy, seem listless, and sleepy.

Finally, he began to vomit more than usual. It's not uncommon for cats to vomit with sustained high blood sugar (hyperglycemia).

Feline diabetes is an endocrine disorder. The pancreas is responsible for secreting the hormone, insulin into the bloodstream after food reaches the digestive track. Insulin is necessary to break down food into glucose which the body needs for energy. In a diabetic cat, the pancreas is either not doing its job by secreting the necessary amount of insulin (Type I) or the cells in the body are unable to utilize the available insulin (Type II). In Type I it appears the body actually attacks the insulin producing cells in the pancreas. These cells are beta cells that make insulin and are located in the part of the pancreas called the islets of Langerhans. Type II is by far the most common form of diabetes in cats, the kind my cat had.

Unfortunately, cats at any age may develop feline diabetes. It's more common in overweight cats to develop Type II, just as in humans. It does appear to affect male cats more than females.

The bad news for you, your cat, and your pocketbook is a lot of testing is necessary post diagnosis. Your veterinarian must discover how high your cats blood sugars are actually going in any given day. Spot checks are simply individual blood sugar tests that determine what your cat's blood sugar reading is at that moment.

After my cat was diagnosed and put on insulin, he had to go in for what are called "glucose curves". These are multiple blood sugar tests done throughout a day to ascertain how well the insulin is stabilizing blood sugar throughout the day. I'd bring him in very early in the morning before he'd eaten and the first draw would occur then. They'd feed him, give him his insulin and watch how high and low he'd go throughout the day. Depending upon the results, we might have to tweak his insulin amount. Or, in his case, we ended up having to change the kind of insulin he was on (fast acting) to slow acting. Expect a few of these in the beginning.

The tricky part about these blood sugar tests is they're not completely accurate. When cats are stressed, their blood sugar rises. So, my vet would use it merely as a guide, not as a valid representation of what his numbers would actually be at home.

Through trial and error we finally discovered the amount of insulin, kind of insulin, and when to give it. Generally, the cat will eat around the time of the insulin injection.  It it's a fast acting insulin, it's important for the cat to have food in his or her stomach when the insulin peaks, so feeding too soon before the shot is unwise. Most cats seem to do better with slower acting insulin, such as Lantus.

After his diabetes was under control,  he'd have to go in every so often for something called "fructosamine testing". This is an accurate measurement of how well controlled a cat's diabetes has been over a longer period of time, over weeks. They measure the average level of glucose control. These are an important part of monitoring your cat's diabetes, especially in cats that experience a lot of stress in the office.

Before eating, a normal cat's blood sugar will be between 70 to 100. After eating, the level will rise, but typically stay below 150. The goal for a diabetic cat is to keep blood sugar levels about 30 points higher than these average numbers. Avoiding low blood sugar (hypoglycemia) is as important as avoiding high blood sugar. You will work VERY closely with your veterinarian to determine the correct insulin dose and timing.

As previously mentioned, there are some oral medications that can work for some cats. Unfortunately, these cases are the minority. These are called oral hypoglycemic medications that stimulate the pancreas' release of insulin or reduce the production of glucose. One that's frequently used is called: Glipizide. However, if the pancreas is not working, these are completely ineffective.

My husband and I came home one night after being gone for a few hours to our Lamaze class and found our diabetic cat in extreme distress. He was in his cat bed panting, howling, and barely able to move. I immediately ran into the kitchen to get the Karo syrup my doctor recommended we always have on hand for these low blood sugar episodes. By the time I got to him, there was no way this disoriented cat was going to lick the syrup off his paws or from my hand. I did all I could to stuff it into his mouth, but he was pantingand unable to swallow. While I raced back to the kitchen and got the address of the emergency animal hospital, I heard my husband yelling: "OH NO, he's having a seizure, he's seizing."

We had that cat in his carrier in a millisecond and were out the door. I forced my husband to run red light, stop signs, to go 55 in a 30. He was not quite pleased with me as I was pregnant and he was, well, just a little concerned about my safety as well. When we arrived we found out his blood sugar was, get this: 8. I didn't know it could get that low without instant death, frankly. Anyway, there was some concern he could have permanent damage from such hypoglycemia. He stayed the night in the hospital as they worked to raise the sugar levels and restabilize the poor guy. This didn't happen once, it happened twice. My cat's insulin needs had a tendency to fluctuate wildly over time. This particular time, he'd gone into a honeymoon period where his need for insulin (unbeknownst to me) was nonexistent. I learned my lesson: get a glucometer.

Without knowing what's going on with your cat's blood sugar daily, you really are potentially setting up him or her for disaster. It becomes a guessing game and highly stressful for the owners. Not to mention some pretty hefty emergency bills should your cat develop life threatening hypoglycemia or ketoacidosis. Ketoacidosis is a life-threatening condition caused by poorly regulated, or unregulated diabetes. If the body cannot break down glucose for energy, it instead breaks down fat and protein as an alternative energy source. Too much of this type of break down causes a toxic by-product called ketones. Too many ketones causes pH and electrolyte imbalances that are deadly. The body becomes too acidic. This is a death sentence if not detected and treated early.

Without a glucometer or taking your cat to the vet daily, which I'm sure you don't want to do, you really are gambling with the health of your cat. You can certainly watch for symptoms of high blood sugar, like thirst, excessive hunger and lots of urine, but it's not as straighforward as having the ability to know exactly what your cat's blood sugars are. Having the ability to test at home provides a strong sense of security, knowledge you couldn't possibly have, and the ability to provide useful information to your vet so that treatment may be changed.

If you have a vet that's not keen on home testing, get another vet! Human glucometers are used and provide superior accuracy for optimal blood sugar control. Typically, the ear is used for the prick site. Although highly innervated and touch sensitive, a lancet prick doesn't seem to cause much pain. Alternatively, some people use the paws, but special care has to be used to avoid infection since the little puncture will have direct contact with the litter box. I'm an advocate of the ear, myself.

Finally, one can utilize urine monitoring at home using dipsticks or reagent strips. These can be purchased at your local drug store. When your cat's blood glucose is too high, the kidneys will begin filtering out the glucose and spilling it out via the urine. The strips will change colors depending upon the amount of urine glucose. The bad news about this type of testing is a delay factor. It takes time for urine to be filtered through the kidneys and finally pass into the urine, so the strips may only tell you the cat HAD high blood sugar in the previous hours. They're not the best source of information. Additionally, collecting urine from a cat is, well, difficult and not pleasant. You have to catch him or her in the act or put newspaper in the box and dip the stick into a pool of urine. Personally, I never bothered with dipsticks.

A critical component of treatment is your cat's diet. Food alone goes a long way in controlling the disease. Insulin and food must be delicately balanced, just enough insulin to cover the food that's ingested.

An overweight diabetic cat will benefit from weight loss. This will need to be done gradually, with a high complex carbohydrate, high fiber diet. You will need to work very closely with your veterinarian.

Some cats benefit from a diet that's restricted in carbohydrates only. Others respond to a much lower carbohydrate diet, while some benefit the most from a high fiber diet alone. And, perhaps the majority respond to one both low in carbs and high in fiber. See what I mean about there being a lot of variability in diabetic cats. Again, with trial and error, you and your vet will come up with an optimal diet for YOUR kitty. There is no "best" cat diabetes food, sometimes it comes down to what's the most palatable for your cat. Many studies have shown wet food to be superior to dry for feline diabetics (and even for cats without disease).  Dry cat foods are simply too high in carbohydrates for our cats.  See link below for more information.

 I experimented with a variety of needle sizes with mixed results.  I highly recommend you get  ultrafine 30-gauge (30 g), extra short needles.  After this discovery, my cat and I were both a LOT happier.  He could barely feel the pricks and didn't jump with each injection.  A lot more insulin actually got into my calm cat after using these needles!

 Disclaimer:  This article is for educational purposes and not to replace care and treatment from a veterinarian.  It is not meant to be a diagnostic tool.