A while back, I talked about a relatively new kind of insulin that is doing wonders for diabetic cats. It's called glargine insulin (the brand name is Lantus.)
I continue to be thrilled with the results we are seeing with this
insulin for our diabetic felines. In studies done comparing the use of
glargine insulin to other insulins for diabetic cats, the results with
glargine insulin were far better - in fact, in one study, all newly
diagnosed diabetic cats treated with glargine stopped needing insulin
within four months!
I am seeing the same thing in my patients: all the new diabetic cats
I have put on glargine have gone into remission (no longer needed
insulin); some within just a few days, some after a few weeks or months.
There
are some important things to be aware of. One, for the best chance of
remission, the cat should be given glargine twice a day. This insulin
can be administered once a day, in situations where the cat's family
absolutely cannot give twice-a-day injections, but the chance of
remission is reduced in tis case. Second, it is also very important
what the cat is fed - it seems that carbohydrates in the diet can lead
to feline diabetes (among other health problems), and diabetic cats
should eat a high protein, low carbohydrate diet, unless other health
issues preclude this (speak to your vet). Because dry food is generally
high in carbs, it is felt that diabetic cats (and perhaps all cats)
should eat moist food (such as canned, pouch, or a balanced
homemade high protein/low carb diet). Third, the chance of remission
from diabetes is highest in cats starting insulin for the first time.
If a cat has already been diabetic for years, switching the cat to
glargine may be desirable if the cat's diabetes has been difficult to
regulate, but there will not be the same likelihood of remission as we
see in newly diagnosed diabetic cats.
To achieve the highest
chance of remission, the diabetic cat should be closely monitored and
the insulin dose adjusted carefully. Most diabetic cats have the
capability to produce insulin, but often are not making enough because
of what is called "beta cell exhaustion". This refers to the fact that
insulin is made in the body by cells called beta cells, which are found
in the pancreas. The theory is that when a cat's food contains too many
carbs, these cells are forced to produce insulin at a very high rate,
and basically burn out. Once the beta cells are too worn out to produce
adequate insulin, the cat becomes diabetic. By placing the cat on
insulin injections, we give the beta cells a chance to rest and
recover. We need to make sure that we are giving the cat the correct
insulin dose to ensure that the beta cells really get the rest they
need; if we give an inadequate dose and the beta cells must still
attempt to produce additional insulin, they may not recover. So if you
have a diabetic kitty, follow your veterinarian's instructions closely
and be sure the dose is adjusted as needed.
Vets have various
ways of adjusting a cat's insulin dose: some vets teach the cat's owner
how to take a tiny drop of blood from the ear (it's much easier than it
sounds and many of my clients do this with no problem using human
diabetic supplies). Other vets have the owner test the urine for sugar
with dipsticks, and adjust the dose based on the results. Whatever
method your veterinarian uses, the most important thing is to follow up
regularly and adjust the insulin dose as needed. This is also important
since with proper treatment your cat may stop needing insulin at some
point, and you don't want to continue giving insulin in this case!
If
your cat's diabetes is difficult to regulate, or you and your vet want
some expert advice regarding your cat's diabetes, you may decide to
consult a veterinary internal medicine specialist. Often an internist can help to fine-tune a cat's diabetes, and help increase the chance of remission.
