It is estimated that between 0.2 and 1% of cats will be diagnosed with diabetes during their lifetime (Gottlieb and Rand, 2018). If you are an owner caring for a diabetic cat then it is important to be aware of diabetic remission. This article will cover the foundations of diabetic remission, how it is achieved and the clinical signs to watch out for. 

Table of contents

What is feline diabetes?

Diabetes has a Greek meaning ‘to pass through’ and mellitus has the latin meaning ‘sweetened with honey,’ referring to the glucose (sugar) excreted in the urine. Diabetic mellitus (DM) is a condition very well recognised in both the Veterinary and the human field. In animals with DM, their pancreas fails to produce an appropriate amount of insulin. This leads to dangerously high levels of glucose in your blood (this is termed hyperglycaemia). Insulin is required to facilitate uptake of glucose from the bloodstream into cells. Therefore, in diabetic patients their cells are essentially starved of glucose.

Alternatively, rather than their pancreas failing to produce adequate insulin levels, sometimes their cells can become ‘resistant’ to their insulin, consequently leading to hyperglycaemia.  

As diabetes is often categorised in the human field as being type 1 or 2, type 2 diabetes is more common in 90% of cats (Gottlieb and Rand, 2018). But unlike humans with type 2 diabetes, they do require daily insulin injections along with dietary alterations.

The most common signs of feline diabetes development include weight loss, ravenous appetite (polyphagia), excessive thirst (polydipsia) and excessive urination (polyuria). Diabetic patients are also more likely to experience urinary tract infections (UTI’s). This is because the glucose in the urine acts as a favourable substrate for bacterial growth. 

Your Vet will make a diagnosis of diabetes following a clinical examination and blood/urine diagnostic testing. It is a lifelong condition that requires a lot of commitment from owners, particularly early on after the diagnosis because initial stabilisation can be challenging. 

What is diabetic remission?

Diabetic remission is a state where the cat becomes once more able to regulate and maintain normal blood sugar levels without the use of insulin injections (this is termed normoglycaemia). In a state of diabetic remission, your cat is not fully ‘cured of diabetes’. But they will be experiencing a period absent of clinical signs and with normal blood glucose regulation. Also, your cat may start to show lower blood glucose and fructosamine concentrations during insulin therapy which may indicate a state of remission.

Obviously, remission would always be the desired outcome and aim in any feline diabetic case but there are a few factors that can increase the chance of achieving diabetic remission (this list is not exhaustive):

Making a quick diagnosis 

This is because starting insulin therapy as early as possible, monitoring glucose levels and assessing their response very closely can also increase the likelihood of achieving a state of diabetic remission.

Timescale 

If your cat has not entered diabetic remission within the first 6 months, sadly they are more likely to require insulin injections for the duration of their lifetime. 

Appropriate diet

Diabetic cats should be fed diets high in protein and low in carbohydrates. The high protein content will maximise metabolic rate and ensures a more constant and steady release of energy. High levels of carbohydrates can lead to high blood glucose levels which is not desired, therefore limiting carbohydrate intake avoids these high blood glucose peaks after eating. 

Weight control 

Similar to humans, obesity is one of the major risk factors in developing diabetes in cats. Did you know that overweight cats are 4.6 times more likely to develop diabetes than cats in an ideal body condition? (McCann et al, 2007).

Owner compliance and commitment 

Being an Owner of a diabetic cat requires a full time commitment and daily insulin injections. Your Vet will teach and support you to ensure that you are comfortable with injection technique and dosing. If you do have any queries with medicating your cat with insulin please contact them to enquire. Ensuring that your cat receives their appropriate insulin dose correctly and at the exact time will maximise diabetic control. 

What happens after my cat is in diabetic remission?

Once your cat has achieved a state of diabetic remission, the initial main priority should be to ensure that your cat is continuously receiving an appropriate diet. Correct diabetic diets are absolutely invaluable and whilst providing all of your cat’s nutritional needs and calorie requirements, they also have benefits on an even greater scale. 

Generally, diabetic diets should be high in protein and low carbohydrate which helps them to stabilise blood sugar levels. Your Vet will be able to guide you in the most appropriate diet for your cat in diabetic remission. 

Whilst your cat may currently be experiencing diabetic remission, there is a 25-30% chance that they may come out of remission and relapse, requiring insulin therapy again (Gottlieb et al, 2015). As a result, it can be a very frustrating scenario which is why close monitoring both at home and at your Vets via blood tests is crucial.   

Conclusion

Caring for a diabetic feline can be a very overwhelming and terrifying task, but remember that your Veterinary team are there to support you also. Achieving diabetic remission is always the desired outcome and although it isn’t always achieved despite best efforts, there are considerations to be applied to try to maximise this outcome. One major point to take away from this article is that if diabetic remission is achieved, diet management with controlled protein and carbohydrate levels should remain a real focus point.

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