Feline diabetes is rising in parallel with feline obesity -- both are consequences of modern indoor cat life and high-carb diets. The good news: unlike in humans, many diabetic cats can achieve COMPLETE REMISSION with aggressive early treatment, meaning they no longer need insulin injections.
Table of Contents
Recognizing Diabetes
- Excessive thirst (polydipsia): Drinking noticeably more water
- Excessive urination (polyuria): Larger/more frequent urine clumps in litter
- Weight loss despite good appetite
- Increased appetite: Body cannot use glucose, so cat feels constantly hungry
- Lethargy: Less active, sleeping more
- Plantigrade stance: Walking flat on hocks (hind feet) -- sign of diabetic neuropathy
Diagnosis
- Blood glucose: Persistent elevation above 200 mg/dL (stress can cause temporary spikes to 300+ in cats)
- Fructosamine: Measures average blood sugar over 2-3 weeks -- eliminates stress spike confusion
- Urinalysis: Glucose in urine confirms persistent hyperglycemia
Treatment Protocol
1. Insulin
- Glargine (Lantus) or ProZinc: Most commonly used feline insulins
- Typically twice daily injections: Given at meal times
- Starting dose: Usually 1-2 units BID, adjusted based on glucose curves
- Home monitoring: Pet glucometer (AlphaTRAK) for spot-checking
2. Diet Change (Critical)
- Switch to low-carb wet food IMMEDIATELY: Below 10% carbs dry matter
- This is not optional: Diet change is as important as insulin
- Low-carb food reduces insulin requirement and enables remission
3. Weight Management
- If overweight: controlled weight loss (1-2% body weight per week)
- Weight loss alone can improve insulin sensitivity
The Remission Path
- Start insulin + low-carb diet simultaneously
- Monitor blood glucose regularly
- As glucose normalizes, vet reduces insulin dose
- Some cats achieve remission (normal glucose without insulin) in 1-4 months
- Remission rate: 50-80% of cats with early, aggressive treatment
- Continue low-carb diet FOR LIFE even after remission
Hypoglycemia: The Dangerous Side Effect
- Low blood sugar from too much insulin: Below 60 mg/dL is dangerous
- Symptoms: Weakness, wobbling, disorientation, seizures, collapse
- Emergency action: Rub honey or corn syrup on gums immediately, then rush to vet
- Prevention: Never give insulin if cat has not eaten
Frequently Asked Questions
If my cat goes into remission, will diabetes come back?
Relapse occurs in approximately 25-30% of cats who achieve remission, usually within the first year. Common relapse triggers: returning to high-carb food, weight regain, corticosteroid use, or illness. Continue low-carb diet permanently, monitor weight, and watch for return of symptoms (increased thirst, urination, weight loss). Regular vet checkups with glucose monitoring catch relapse early when re-treatment is most effective.
