Diabetes in Cats: Signs, Diagnosis, Insulin and Remission

By Tailwisp Editorial TeamUpdated October 20, 20264 min read

A diagnosis of diabetes can feel overwhelming, but in cats it is often very manageable. With insulin, diet and regular checks, many diabetic cats feel better than they have in years, and some even go into remission.

What is diabetes mellitus?

Insulin is the hormone that moves glucose from the blood into cells. In diabetic cats, the body either does not make enough insulin or does not respond to it properly, so glucose stays high in the blood and spills into the urine. Most diabetic cats have a condition similar to type 2 diabetes in people, linked to insulin resistance.

Risk factors

• Obesity, the most important modifiable risk
• Middle to older age
• Being male, neutered or inactive
• Certain breeds, such as the Burmese
• Long-term steroids or other medications
• Pancreatitis, acromegaly or Cushing's disease

Keeping your cat at a healthy weight reduces risk. See how much should I feed my cat.

Signs

• Increased thirst and urination
• Increased appetite with weight loss
• Lethargy
• Poor coat
• Weakness in the hind legs, with the cat walking on its hocks, called plantigrade stance
• Vomiting, in more advanced disease

Diagnosis

Stress can raise blood sugar in cats, so vets use several tests: blood glucose, fructosamine (an average over weeks), urine glucose and ketones. They also look for other diseases, such as infections, pancreatitis and kidney disease.

Treatment

Insulin. Most diabetic cats need insulin twice daily by injection. Your vet will choose a type and dose, and teach you how to give it with a fine needle. Most cats barely notice, especially when given right after a meal and followed by a treat.

Diet. Low-carbohydrate, high-protein diets help many cats and can raise the chance of remission. Do not change diets without advice, since the insulin dose is linked to food intake.

Weight management. Gradual weight loss improves insulin sensitivity. Avoid sudden restriction.

Treating other conditions, such as dental disease and urinary infections, which are common in diabetic cats. See cat dental disease.

Monitoring

• Weigh your cat regularly.
• Track thirst, appetite and urination.
• Test blood glucose at home, if your vet advises it, or use urine tests.
• Record insulin doses and times.
• Attend rechecks and glucose curves.

Careful tracking lets your vet adjust the dose safely.

Emergencies

Low blood sugar (hypoglycemia). Too much insulin, or insulin without food, can cause weakness, wobbling, tremors, seizures and collapse. If your cat is awake and can swallow, rub a small amount of honey or corn syrup on the gums and call your vet or an emergency clinic immediately. Do not put food in the mouth of an unconscious cat.

Diabetic ketoacidosis. Untreated diabetes can progress to a life-threatening state with vomiting, lethargy, dehydration and rapid breathing. This is an emergency. See the emergency warning signs guide, and use the US vet directory to find an emergency clinic.

Remission

Some cats can stop insulin once their blood glucose normalizes. Remission is more likely with early diagnosis, tight glucose control, weight loss and a low-carbohydrate diet. Even in remission, cats should be monitored, since diabetes can return.

Costs and commitment

Diabetes care involves vet visits, tests, insulin, syringes and food. Ask your vet to explain costs, and look for savings, such as generic syringes. See cat vet visit costs. Also plan for pet sitters who can give injections.

Living with a diabetic cat

Keep routines steady, with meals and insulin at the same times each day. Keep the cat indoors if possible, and make sure all family members know the plan. Enrichment and exercise help weight control. See indoor cat enrichment ideas.

Giving insulin

Ask your vet or a nurse to demonstrate injections, and practice until you feel comfortable. Give insulin at the same times each day, usually twelve hours apart, with a meal. Use the correct syringe for your insulin type, store the bottle as directed and mix or roll it as your vet instructs. If you miss a dose or are unsure whether the injection went in, do not give extra. Call your vet for advice. Keep a log of each dose, meal and any unusual signs, since it helps your vet fine-tune the plan.

Choosing food

Many vets recommend canned or wet food with low carbohydrate content. Measure meals, avoid free feeding if your vet advises it, and keep treats minimal. Consistency matters more than any single brand.

Travel and sitters

Plan ahead for holidays. Choose a sitter who can give injections and recognize low blood sugar, write out feeding times and doses, and leave your vet's number. Some boarding clinics offer diabetic care. Keep spare insulin, syringes and a sugar source like honey on hand, and keep insulin cool as directed. A written emergency plan reduces stress for everyone.

Senior cats

Diabetes is common in seniors, and often occurs with kidney disease and hyperthyroidism. Regular screening finds problems early. See the senior cat care guide.

This article is general educational information, not veterinary advice. Every cat is different. If your cat is unwell, or you are unsure about a symptom, diet change or medication, contact your veterinarian.