• The most common form in cats (over 90% of cases).
• Characterized by insulin resistance coupled with some insulin production.
• Often has the potential for remission with aggressive management.
• May require temporary or ongoing insulin.

Secondary Diabetes

• Triggered by other underlying conditions or medications.
• Common causes include pancreatitis, Cushing's disease, acromegaly, and chronic steroid use.
• Obesity is a significant contributing factor.

Recognizing the Symptoms

Early Warning Signs

Early detection is crucial for effective management. Be vigilant for these common symptoms:

Advanced Symptoms

If left unmanaged, diabetes can lead to more serious complications:

• Hind Leg Weakness (Diabetic Neuropathy): A plantigrade stance (walking on the hocks).
• Vomiting and Anorexia
• Severe Dehydration
• Sweet-Smelling Breath: Caused by ketones (a sign of diabetic ketoacidosis).
• Collapse or Coma: A medical emergency indicating diabetic ketoacidosis (DKA).

Risk Factors

Understanding risk factors can aid in prevention and early screening.

The Diagnosis Process

Veterinary Examination

Your veterinarian will perform a thorough physical exam, assessing:

• Body weight and condition score.
• Signs of muscle wasting.
• Neurological function, especially in the hind limbs.
• Eye health for early cataract detection.
• Overall hydration and health status.

Diagnostic Tests

A definitive diagnosis requires specific testing to rule out stress-induced hyperglycemia.

1. Blood Glucose Testing: Measures current blood sugar levels. Consistently elevated fasting glucose is indicative.
2. Fructosamine Test: Measures average blood glucose over the preceding 2-3 weeks, unaffected by stress.
3. Urinalysis: Checks for glucose in the urine (glucosuria) and ketones, and screens for urinary tract infections.
4. Additional Testing: May include tests for pancreatitis, thyroid function (in older cats), a full blood chemistry panel, and urine culture.

Treatment and Management Strategies

Insulin Therapy: The Cornerstone of Treatment

Most diabetic cats require insulin injections. Your veterinarian will select the most appropriate type.

Common Insulin Types for Cats:

Starting Protocol:

• Begin with a conservative dose (often 1-2 units) twice daily.
• Doses are carefully adjusted based on blood glucose curves.
• Never adjust the insulin dose without explicit guidance from your veterinarian.
• Consistency in timing is paramount.

Blood Glucose Monitoring

Regular monitoring is essential for assessing control and safety.

Methods:

1. In-Hospital Glucose Curves: The cat stays at the clinic for a day, with blood glucose checked every 2 hours to map the insulin's effect.
2. Home Glucose Monitoring: Using a pet-specific glucometer, you test a small blood sample from the ear or paw pad. This is less stressful for the cat and provides more accurate daily data.

Target Blood Glucose Ranges:

• Initial Goal: Keep pre-insulin levels between 200-300 mg/dL to avoid dangerous lows.
• Nadir (Lowest Point): Aim for 100-150 mg/dL.
• Danger Zones: <80 mg/dL (hypoglycemia risk) or persistently >400 mg/dL.

Dietary Management: A Critical Component

Diet is a powerful tool in managing feline diabetes and achieving remission.

Key Nutritional Principles:

1. Low Carbohydrate: The single most important factor. Aim for diets with <10% of calories from carbs. Canned/pouched food is vastly superior to dry kibble.
2. High Protein: Provides essential amino acids, promotes lean muscle mass, and increases satiety.
3. Moderate Fat: Supports energy needs while aiding in weight management for overweight cats.

Recommended Food Types:

Feeding Schedule:

• Feed a measured meal immediately before each insulin injection.
• Maintain strict consistency in meal times and food type.
• Avoid free-feeding.

Implementing a Successful Home Care Routine

Daily Schedule Example

Consistency reduces stress and improves glycemic control.

Morning (e.g., 7:00 AM):

1. Provide fresh water.
2. Feed the measured breakfast.
3. Wait 20-30 minutes.
4. Administer the morning insulin injection.
5. Record food amount, insulin dose, and any observations in a log.

Evening (e.g., 7:00 PM):

1. Repeat the morning routine.
2. Check the litter box for urine output.
3. Observe your cat's energy and behavior.

Weekly/Monthly:

• Perform a home glucose curve if recommended.
• Weigh your cat to track body condition.
• Take inventory of insulin, syringes, and test strips.

Administering Insulin Injections

With practice, this becomes a quick, stress-free routine for both you and your cat.

Step-by-Step Guide:

1. Gently roll the insulin vial to mix; do not shake.
2. Draw air into the syringe equal to your dose, inject it into the vial, and withdraw the correct dose.
3. Gently "tent" a fold of skin at the scruff or along the back.
4. Insert the needle (usually 31G) at a 45-degree angle into the tented skin.
5. Pull back slightly on the plunger (aspiration). If blood appears, withdraw and try a new spot.
6. If clear, inject the insulin smoothly.
7. Withdraw the needle and praise your cat! A small, low-carb treat can create a positive association.

Recognizing and Handling Emergencies

Hypoglycemia (Low Blood Sugar) - ACT FAST This is a life-threatening emergency caused by too much insulin, missed food, or excessive exercise.

Hyperglycemia (High Blood Sugar) & DKA While less immediately critical, persistently high levels are harmful. If blood glucose is consistently >400 mg/dL or your cat shows signs of DKA (vomiting, lethargy, sweet breath), contact your veterinarian promptly for a plan adjustment.

The Goal: Diabetic Remission

What Is Remission?

Diabetic remission occurs when a cat maintains normal blood glucose levels without insulin injections. With intensive early management, 30-50% of cats can achieve remission.

Factors That Increase Remission Chances

Maintaining Remission

• Continue the low-carb diet for life.
• Monitor weight and body condition.
• Perform periodic glucose checks (e.g., once a month).
• Watch for the return of classic symptoms.
• Schedule regular veterinary check-ups.

Potential Complications

• Diabetic Neuropathy: Hind leg weakness that often improves with glycemic control. Supplements like methylcobalamin (B12) may help.
• Diabetic Ketoacidosis (DKA): A metabolic crisis requiring intensive hospitalization.
• Cataracts: A common long-term complication that can lead to blindness; surgery is an option.
• Urinary Tract Infections: Diabetic cats are more susceptible; regular urinalysis is recommended.

Cost Considerations for 2026

Initial Diagnosis & Setup

Monthly Ongoing Costs

Annual Costs

Costs are estimates and vary significantly by location and clinic.

Tips for Long-Term Success

• Establish Ironclad Routines: Use phone alarms for feeding and injection times. Keep a detailed logbook.
• Minimize Stress: Stay calm during injections. Create a comfortable, dedicated space for testing.
• Seek Support: Utilize online forums dedicated to diabetic cats, consult with a veterinary internal medicine specialist, and lean on your veterinary team.

Frequently Asked Questions (FAQ)

Q: Can I give my diabetic cat treats? A: Yes, in moderation. Opt for low-carb options like small pieces of freeze-dried chicken, turkey, or commercial treats designed for diabetic cats. Avoid all high-carb treats.

Q: What if I accidentally miss an insulin dose? A: Contact your veterinarian for advice. The general rule is to skip the missed dose and resume the normal schedule with the next dose. Never give a double dose to "catch up."

Q: Is it safe to travel or board my diabetic cat? A: Yes, with careful planning. The best option is a pet sitter who can follow your precise routine. If boarding, choose a facility experienced with diabetic pets and provide clear, written instructions.

Q: Will my cat inevitably go blind from cataracts? A: Not necessarily. While cataracts are a risk, maintaining good glucose control can delay or prevent their development. If they do occur, cataract surgery is a highly successful option for many cats.

Q: Is diabetes painful for my cat? A: The condition of high blood sugar itself is not typically painful. However, complications like neuropathy or untreated DKA can cause discomfort, which is why proactive management is so important.

Last Updated: 2026 | This guide is for informational purposes. Always work closely with your veterinarian to develop and adjust a personalized treatment plan for your cat. Never change insulin doses or treatment protocols without professional guidance.