The following is a true story (used with permission) of how diabetic cats can change their insulin requirements.
Sal is a 13 year old domestic shorthair cat who was diagnosed with diabetes in 2010. He had been showing the initial signs of increased urination and having accidents outside the litterbox. These signs, along with weight loss and increased drinking, are some of the most commonly noted first symptoms of diabetes or an alert to a pet owner that something is wrong. Some cats may vomit, have a decrease in their appetite, or start to walk in a flat-footed position. In later stages of not being diagnosed or treated, diabetic cats can have labored breathing and lethargy.
Back to Sal… At the time of his diagnosis, he was started on insulin and his diet was changed to a higher protein, lower carbohydrate diet. He had been doing well for a number of years and was considered to be a well controlled diabetic. As part of our continuing care of these patients, we recommend doing a glucose curve every 6-12 months as part of their annual examination. For some cats, we realize that the stress of the clinic setting might be too much for them and encourage home testing (which can be quite easy and most veterinarians will show you how!). For cats that home testing is difficult either for the patient or the family (not everyone can stand the sight of blood), we do this testing in hospital. Sal was one of these cats who fit into the latter category.
Life happens and things don’t always get to go as planned; work or family obligations change, moving might happen, or the budget might be a little tight at times. That’s okay and can be understandable…it even happens to us as vets too with our own pets and families. Sal had been delayed in coming in for his annual check up. His owner brought him in because he was seeming weak and hadn’t been eating well. I examined him and checked his blood glucose level which was 1.2 (or 21.7 depending on your units)! The average normal range for a cat is 4.0 – 9.7 (72.6 – 176).
So why did Sal present like this? His signs were easily attributed to his low blood sugar (hypoglycemia) but his insulin dose had not been increased. Well, it’s been known for some cats to convert to not needing insulin and their diabetes may be controlled by diet. This is exactly what happened to Sal. As he converted, his previously needed insulin dose essentially became that of an overdose.
Rest easy everyone. Sal is doing fine. We admitted him to the hospital and put him on intravenous fluids that contained dextrose to help bring his glucose levels up and remove the risk of seizures. We checked his glucose levels without him getting insulin as well and he never went above the high end of normal so 2 days later he got to go home and now doesn’t need insulin injections! For now he is doing well, but his family is still going to keep a close eye on him because there may come a time when he might need to start the injections again so he’ll be getting regular checkups from now on.
Disclaimer: All blog posts may contain opinions which are my own and may not reflect those of any current or former employers.
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