Felis ISSN 2398-2950

Diabetes mellitus: management regimens

Contributor(s): Dr Linda Fleeman, Sarah Pierard

Introduction

  • The primary aims of therapy in diabetic cats are to achieve resolution of clinical signs, avoid insulin-induced hypoglycemia Hypoglycemia, and prevent other complications such as diabetic ketoacidosis Diabetic ketoacidosis
  • An additional goal in recently diagnosed cats is to optimize the chance of diabetic remission.
  • It is also very important that the treatment and monitoring regimen fits well into the owners' daily routines because euthanasia can occur due to either unmet owner expectations or the negative impact of disease management on their lives.
  • Success requires good communication and a close rapport between the cat's owner and their veterinarian. Compliance with a regular daily routine is important.
  • Before embarking on any long-term treatment, the implications of the disease and the ongoing commitment that is necessary should be fully explained to the owner.
  • It is a common misconception that a diabetic cat can be 'stabilized'; diabetes is a dynamic disease with daily pronounced variability of blood glucose concentrations. Further, diabetic remission occurs commonly and reduced insulin requirement and therefore increased risk of hypoglycemia can occur days, weeks, or even months after the last insulin dose adjustment.
  • An individual's clinical signs need to be monitored at home on a regular basis in order to identify changing trends in glucose homeostasis.

Oral hypoglycemic agents and insulin therapy

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Monitoring and blood glucose curves

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Urine glucose measurement

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Adjusting insulin dose

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Remission

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Further Reading

Publications

Refereed papers

  • Recent references from VetMed Resource and PubMed.
  • Fleeman L, Thompson A (2015) How to get the most value out of serial blood glucose curves in cats. Feline Focus March, 93-99.
  • Sparkes A, Cannon M, Church D, Fleeman L et al(2015) ISFM consensus guidelines on the practical management of diabetes mellitus in cats. J Feline Med Surg 17, 235-250 PubMed.
  • Thompson A, Lathan P, Fleeman L (2015) Update on insulin treatments for dogs and cats: Insulin dosing pens and more. J Vet Med: Research and Report 6, 129-142https://www.dovepress.com/update-on-insulin-treatment-for-dogs-and-cats-insulin-dosing-pens-and--peer-reviewed-article-VMRR.
  • Zoran D L & Rand J S (2013) The role of diet in the prevention and management of feline diabetes. Vet Clin North Am Small Anim Pract 43, 233-243 PubMed
  • Reusch C E, Kley S & Casella M (2006) Home monitoring of the diabetic cat. J Feline Med Surg 8, 119-127 PubMed.
  • Casella M, Hassig M & Reusch C E (2005) Home-monitoring of blood glucose in cats with diabetes mellitus: evaluation over a 4-month period. J Feline Med Surg 7(3), 163-171 PubMed.
  • Van de Maele I, Rogier N & Daminet S (2005) Retrospective study of owners' perception on home monitoring of blood glucose in diabetic dogs and cats. Can Vet J 46(8), 718-723 PubMed.
  • Kley S, Casella M & Reusch C E (2004) Evaluation of long-term home monitoring of blood glucose concentrations in cats with diabetes mellitus. JAVMA 225(2), 261-266 PubMed.
  • Mazzaferro E M, Greco D S, Turner A S & Fettman M J (2003) Treatment of feline diabetes mellitus using an alpha-glucosidase inhibitor and a low-carbohydrate diet. J Feline Med Surg 5(3), 183-189 PubMed.
  • Bennett N (2002) Monitoring techniques for diabetes mellitus in the dog and the catClin Tech Small Anim Pract 17(2), 65-67 PubMed.


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