Carey, our six-year-old cat, is diabetic. We are having a problem keeping her stabilized and find that she still drinks and urinates too much. Can you give us any help?
Diabetes, relatively common in cats, usually requires insulin injections to help keep it under control. It is important to be very observant with a diabetic cat because some of them can be very difficult to regulate. As you note, drinking and urinating indicate how well the problem is controlled. When Carey is doing better, both should return to near normal. At this point, I recommend hospitalization so glucose levels in Carey's bloodstream can be checked every two hours for 12 hours. She will receive an insulin dose in the morning and have blood samples taken through the day. Over the 12 hours, this will show what is called a glucose curve that indicates if the insulin dose needs to be changed. It will also show if Carey is using her insulin too fast and needs injections every 12 hours. About 20-50% of diabetic cats need injections every morning and night. The testing will indicate if Carey is resistant to the insulin. This can happen if there is a bacterial infection such as a bladder infection. Diabetic cats need to be watched because they are prone to infections since bacteria can grow more easily in their bodies when glucose levels are elevated. Resistance to insulin also can be caused by pregnancy, hyperthyroidism, and other less common hormone problems. Diet is important. Avoid semi-moist food (in the plastic pouches) because they are metabolized too quickly. Your veterinarian can recommend specific foods. Carey should do much better if you follow these steps. Prepare yourself to be patient. Determining the right amount of insulin can require repeated testing and retesting