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Speaking of diabetic cats...


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. 


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