First published March 21, 2023
As we discussed in our last post Moxie got sick and it turned out to be pancreatitis.
Check out that story here: https://www.furryornotpetcare.ca/post/illness-in-cats-observe-and-act-fast
After his tests and treatment for that Moxie started to eat again, thank goodness, but then he also started to pee a lot. Way more than ever before. I was concerned it was kidney failure since my cat Hal went through that, but diabetes was also a risk factor. I would guess he was peeing 2 or 3 times more than before in volume and frequency and drinking a lot too, way more than normal.
At our subsequent vet visit, they confirmed he did now have diabetes and since his blood work came back normal just the week prior it was 100% a result of the pancreatitis. At first, I was relieved in a way since kidney failure is terrible. But, then as it started to sink in I was upset. Diabetes would mean injections, buying insulin, more tests, and would change our routine. It also means a chance to prolong Moxie’s life, and once the correct insulin level is sorted out we can maintain his health and wellbeing.
Signs of Diabetes in Cats
Typical signs of diabetes in cats:
increased thirst
do you need to refill their water bowl more often? Moxie's intake more than doubled.
increased urination
is their volume of pee greater (larger clumps)? Moxie's clumps doubled in size.
are they peeing more often (more clumps)?
weight loss
are they eating well but appear thinner?
increased appetite
are they eating more than before or demanding food more often?
Moxie gained weight back after his pancreatitis attack but did experience the other signs.
Depending on the cause or situation the signs may be subtle. But in Moxie’s case, it was dramatic. At first, I was trying to get him to eat again and I was so relieved when he got his appetite back and using the litter box regularly. But within only a few days I noticed that he was peeing longer and the clumps in the litter box were huge. He was drinking much more than ever before. I dismissed it at first, hoping he was just ‘making up for lost time’ so to speak, after spending a week not eating. But it continued and things did not level out.
Diabetes is very common in cats
Apparently, diabetes is the 2nd most common endocrine disease in cats, the first being hyperthyroidism. Endocrine disease is caused by an imbalance in hormone levels, specifically too much or too little of a specific hormone such as thyroid or insulin.
The pancreas produces insulin so it makes sense that a severe pancreatitis attack may affect insulin production. This is considered ‘Type 1’ diabetes. Age, obesity, and physical inactivity are risk factors for developing ‘Type 2’ diabetes. Males are also at a greater risk.
Depending on the situation it may be possible to manage diabetic cats through diet, and sometimes after some time using insulin the pancreas may recover. However, I got the impression that for Moxie that was very unlikely if not impossible.
Insulin Shots
Moxie started getting 2 units of insulin twice a day. Out of the 3 cats, Moxie is the easiest to give medication to. He LOVES cuddling and pets and any attention at all so he will happily tolerate me rubbing his back and pulling up his scruff and does not seem to notice the needle at all.
Luckily I have some experience with insulin shots as part of the job. I learned how to give them to a friend’s cat before I founded Furryornot Petcare. It can certainly be a challenge to do it solo if the cat does not stay still. And, is always nerve-racking when a pet is scared or uncomfortable with the process, especially with a relative stranger. But, having had to do it many times over the years made this transition easier.
Ziggy is awful about pills but I think perhaps with some bribes I could get him used to shots. He is extremely food-motivated. Bean is just hard to catch and does not sit still so it would take more skillful handling in her case for me to do it solo. Hopefully, neither cat ever has to deal with that in the future. Paws crossed!
Nutrition and Lifestyle Recommendations
I participated in the Pet Sitters International Summit which focused on pet health. And, luckily one of the panelists was Dr. Lynn Bahr a Veterinarian and co-author of “Indoor Cat“. She was discussing Diabetes and also did another talk about arthritis which I will discuss in a future post. This could not have been more timely!
Most of what Dr. Bahr discussed has a lot to do with ‘Type 2’ Diabetes and specifically recommended a low-carb diet and exercise. The reason exercise helps is that fat loss reduces insulin resistance, exertion of energy burns glucose, and increased blood flow improves insulin absorption.
For the low-carb part, standard kibble can be made of 41%-60% carbohydrates so it is helpful if your cat is willing to eat wet food or other low-carb alternatives. It can be tricky to get some cats to try different foods so if you do go that route just take it very slowly and test things out to find out what they will like. It is also easier on them physically if you slowly transition their food to the new kind, and do not just switch over immediately.
New Alternatives
For cats newly diagnosed with Diabetes, there is a brand new medication called “Bexacat” that is an alternative to insulin injections. This is unfortunately not an option for Moxie (it is not suitable for cats that have kidney disease or had pancreatitis) but could be helpful in other cases and would be something to ask your Veterinarian about before you start insulin treatment. Dr. Bahr was very excited about this.
It is reported that 1 in 10 cats are euthanized when diagnosed with Diabetes, and another 10% of cats are euthanized within a year of diagnosis. That is so heartbreaking. Hopefully, this alternative will be presented so people know all their options.
Monitoring
Both Moxie’s Vet and Dr. Bahr recommended monitoring the following in a log with the date:
appetite/amount eaten daily
water consumption/water bowl level
urination/# and size of clumps
# of poops
insulin amount and time of day
What I need to do is take a photo of what I scoop each morning and evening so I can more easily tell from day to day where he is at. Our feeding routine was significantly altered after he got sick so I just need to get back into the habit of measuring it and make note of how much is eaten by the end of the day.
It may be best to create a log so it is easy to jot down notes quickly.
Vet Visit
Moxie’s vet requested a follow-up visit for what is called a 'blood glucose curve test'. In general, his appetite was huge and he still seemed to be peeing a lot more than before he got sick so I suspect the dosage of insulin we started with may be insufficient.
Additional monitoring and regular checkups will be needed to check his insulin levels and adjust the medication dosage.
Further reading:
Endocrine disease: https://www.ascotvet.com.au/endocrine-diseases-cats/
Bexacat: https://www.ctvnews.ca/lifestyle/new-pill-treats-diabetic-cats-without-daily-insulin-shots-1.6243398
Additional risks and emergency situations: https://www.petmd.com/cat/conditions/endocrine/c_ct_diabetes_with_ketoacidosis
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