• The most common form in cats (approximately 80-95% of cases).
• The body produces insulin, but cells become resistant to it.
• Strongly associated with obesity and inactivity.
• May be reversible with aggressive diet and weight management.

Secondary Diabetes

• Triggered by other medical conditions or medications.
• Common causes include pancreatitis, hyperthyroidism, Cushing's disease, or long-term corticosteroid use.
• May resolve if the underlying cause is successfully treated.

Risk Factors for Cat Diabetes

Identifying risk factors aids in prevention and early detection.

Age and Gender

• Age: Middle-aged to senior cats (8+ years) are at highest risk.
• Gender: Male cats are approximately twice as likely to develop diabetes as females, with neutered males having the highest risk profile.

Obesity

• Overweight cats are 2-4 times more likely to develop diabetes.
• Excess body fat directly causes insulin resistance.
• Free-feeding and high-carbohydrate diets are significant contributors.

Breed Predisposition

• Burmese cats have a well-documented genetic predisposition.
• Norwegian Forest Cats show increased incidence.
• Maine Coons, Russian Blues, and Tonkinese are also at higher risk.

Lifestyle Factors

• Inactivity: Indoor-only cats with limited exercise and environmental enrichment.
• Diet: High-carbohydrate dry foods and free-feeding practices.

Concurrent Health Conditions

• Pancreatitis
• Hyperthyroidism
• Chronic kidney disease
• Acromegaly (excess growth hormone)
• Long-term use of corticosteroids

Recognizing the Symptoms of Feline Diabetes

Early detection is critical for successful management. Watch for these warning signs:

The Four Classic Symptoms (The Four Ps)

Polyuria (Excessive Urination)

• Frequent litter box visits with larger clumps.
• Possible accidents outside the box.
• Caused by the kidneys excreting excess glucose.

Polydipsia (Excessive Thirst)

• Drinking significantly more water; bowls empty quickly.
• The body's attempt to compensate for fluid loss from urination.

Polyphagia (Increased Appetite)

• Constant hunger and begging despite eating regular meals.
• Occurs because the body's cells are starved for glucose.

Weight Loss

• Noticeable decrease in body weight and muscle mass over weeks.
• Happens despite a good appetite as the body breaks down fat and muscle for energy.

Additional Warning Signs

• Lethargy and Weakness: Decreased activity, reluctance to play or jump.
• Poor Coat Condition: Dull, dry, or unkempt fur due to lack of grooming.
• Neurological Symptoms (Advanced): Weakness in hind legs, a flat-footed "plantigrade" stance, difficulty jumping.
• Recurring Infections: Urinary tract or skin infections, poor wound healing due to high glucose feeding bacteria.

Diagnosing Diabetes in Cats

Your veterinarian will conduct a series of tests to confirm a diagnosis.

Physical Examination

A thorough check of body weight, hydration, neurological function, and abdominal palpation.

Blood Tests

• Blood Glucose: Fasting levels typically exceed 200-250 mg/dL (normal: 70-120 mg/dL). Multiple tests may be needed due to stress-induced hyperglycemia.
• Fructosamine Test: Measures average blood glucose over 2-3 weeks. Values above 400 μmol/L suggest diabetes.
• Complete Blood Count (CBC) & Serum Biochemistry: Assess overall health, organ function, and rule out other conditions.

Urinalysis

• Detects glucosuria (glucose in urine), which should not be present in healthy cats.
• Checks for ketones, indicating diabetic ketoacidosis (DKA).
• Identifies urinary tract infections.

Additional Testing

• Thyroid Testing: To rule out hyperthyroidism.
• Pancreas-Specific Testing (fPLI): To check for pancreatitis.
• Blood Pressure Measurement: Diabetes can cause hypertension.

Treatment Options for Feline Diabetes

Successful management requires a multi-faceted approach.

1. Insulin Therapy

Most diabetic cats require twice-daily subcutaneous insulin injections.

Common Insulin Types for Cats:

2. Dietary Management

Nutrition is a cornerstone of treatment.

• High-Protein, Low-Carbohydrate Diet: Mimics a natural feline diet, stabilizes blood glucose, and promotes healthy weight. Canned food is preferred over dry.
• Prescription Diets: Options include Hill's m/d, Purina DM, and Royal Canin Glycobalance. Cost: $40-$80 per month.
• Feeding Schedule: Meals should be timed with insulin injections. Avoid free-feeding.

3. Weight Management

For overweight cats, aim for gradual weight loss (1-2% per week) through portion control and increased activity.

4. Oral Medications (Rare)

Glipizide may be used in rare cases but is less effective than insulin and not a first-line treatment.

5. Monitoring and Follow-Up

• Home Glucose Monitoring: Using a pet-specific meter ($50-$100 initial, $30-$50/month for strips).
• Veterinary Rechecks: Every 2-4 weeks initially for blood glucose curves and dosage adjustments ($50-$150 per visit).

Potential Complications of Untreated Diabetes

Without management, diabetes leads to severe complications:

• Diabetic Ketoacidosis (DKA): A life-threatening emergency requiring immediate hospitalization. Treatment cost: $1,500-$4,000.
• Hypoglycemia: Caused by insulin overdose; symptoms include weakness and seizures. Treat with corn syrup on gums and seek emergency care.
• Diabetic Neuropathy: Nerve damage causing hind leg weakness and a plantigrade stance.
• Chronic Issues: Increased risk of kidney disease, pancreatitis, infections, and hepatic lipidosis.

Cost Breakdown of Feline Diabetes Treatment

Managing diabetes is an ongoing financial commitment. Below is a detailed cost analysis for 2026.

Initial Diagnostic Costs

Ongoing Monthly Treatment Costs

Annual Veterinary Follow-Up Costs

Annual Total Cost Summary

Cost-Saving Strategies

1. Home Glucose Monitoring: Reduces frequency of veterinary glucose curves.
2. Discuss Generic Insulin: Ask your vet about more affordable options.
3. Bulk Purchasing: Buy insulin syringes and test strips in larger quantities.
4. Pet Insurance: Consider a policy before any diagnosis for future coverage.
5. Charitable Aid: Some organizations offer financial assistance for pet medical care.

Can Feline Diabetes Be Reversed?

Yes, remission is possible. Approximately 20-30% of diabetic cats can achieve normal blood glucose levels without insulin, especially with:

• Early diagnosis and strict treatment adherence.
• High-protein, low-carb diet and achieving ideal body weight.
• Excellent glucose control from the start.

Important: Remission can be temporary. Never stop insulin without veterinary guidance, and continue dietary management for life.

Prevention of Feline Diabetes

Reduce your cat's risk with proactive care:

1. Maintain a Healthy Weight: Monitor body condition, use portion control and puzzle feeders.
2. Provide Proper Nutrition: Prioritize high-protein, low-carbohydrate diets; limit dry food.
3. Schedule Regular Veterinary Care: Annual exams (biannual for seniors) for early detection.
4. Ensure Environmental Enrichment: Encourage activity with climbing structures and interactive play.

Living with a Diabetic Cat

With commitment, diabetic cats can enjoy a high quality of life. Establish a consistent daily routine for feeding and insulin. Plan carefully for travel, using trained pet sitters or veterinary boarding. Most owners find the management process becomes a rewarding routine that strengthens their bond with their cat.

When to Seek Emergency Care

Contact your veterinarian immediately if your diabetic cat shows:

• Lethargy, collapse, or seizures.
• Vomiting, diarrhea, or refusal to eat for >24 hours.
• Difficulty breathing.
• Signs of hypoglycemia (weakness, disorientation, trembling).
• Sweet or fruity breath odor (sign of DKA).

Conclusion

Feline diabetes is a serious but highly manageable condition. With early detection, a dedicated treatment plan, and a strong partnership with your veterinarian, diabetic cats can live happy, comfortable lives for many years. While the costs are significant, the reward of your cat's health and companionship is invaluable. Stay vigilant, adhere to treatment schedules, and never hesitate to ask your vet questions. With proper care, diabetes does not have to define your cat's life.

This article is for informational purposes only and is not a substitute for professional veterinary advice. If you suspect your cat has diabetes, schedule an appointment with your veterinarian immediately.