Ohana Webinars: feline diabetes - treatment and monitoring

• Diagnosis: In dogs, diabetes diagnosis relies on compatible clinical signs, persistent hyperglycemia, and glucosuria. In cats, stress can cause transient hyperglycemia and glucosuria, so fructosamine or serial urine dipsticks are needed for confirmation.

• Treatment: Dogs can eat any good-quality diet; cats require wet food with <6% carbohydrates for optimal glycemic control and remission chances. Caninsulin is not recommended for cats due to short duration of action.

• Insulin: ProZinc (protamine zinc insulin) and glargine are preferred for cats, administered every 12 hours. Caninsulin/other intermediates may be used in dogs but are suboptimal for cats.

• Diet: Many prescription "diabetic" diets exceed the recommended carb content for cats. Some commercial wet foods or natural diets are better suited. Carbohydrate content should be calculated on a dry matter basis.

• Remission: About 50% of newly diagnosed cats can achieve remission with prompt, appropriate therapy. Remission is unlikely after a year of persistent diabetes due to glucotoxicity.

• Monitoring: Home blood glucose curves are more accurate and less stressful than in-clinic monitoring. Owners generally find home monitoring empowering. Continuous glucose monitoring (e.g., Freestyle Libre) is an option, though cost and device retention can be issues.

• Curve Interpretation: Always assess whether insulin is working (glucose drop post-injection), if the nadir is appropriate (not too low/high), and if insulin duration covers the full 12 hours.

• Special Cases: SGLT2 inhibitors (e.g., Senvelgo) can be used in newly diagnosed cats with residual insulin production, but not in dogs or cats with longstanding diabetes or DKA history.

• Acromegaly: Suspect in cats with uncontrolled diabetes and weight gain. Diagnosis via IGF-1; treatment may include hypophysectomy.

• Owner Support: Diabetes is stressful for owners; support from veterinary nurses and online communities is valuable. Financial constraints require tailored monitoring and treatment plans.

Low-Carbohydrate Diets and Remission in Diabetic Cats

• Bennett N, Greco DS, Peterson ME, et al. "Comparison of a low-carbohydrate–low-fiber diet and a moderate-carbohydrate–high-fiber diet in the management of feline diabetes mellitus." J Am Vet Med Assoc. 2006;229(9):1554-1563.

Findings: Low-carb diets improve glycemic control and increase remission rates in diabetic cats.

Home Blood Glucose Monitoring Reduces Stress and Improves Glycemic Control

• Roomp K, Rand JS. "Home monitoring of blood glucose concentrations in cats with diabetes mellitus: 366 cases (2004–2009)." J Feline Med Surg. 2012;14(10):798-805.

Findings: Home monitoring is feasible, reduces stress, and facilitates better management.

Glargine Insulin and Remission Rates

• Marshall RD, Rand JS, Morton JM. "Glargine insulin (Lantus) as initial treatment of diabetes mellitus in cats." J Feline Med Surg. 2008;10(5):439-451.

Findings: Use of glargine as initial insulin increases the likelihood of remission.