I hate diagnosing diabetes. It’s a frustrating disease, made worse by the fear that washes across people’s faces when they hear the news. I see them hoping I won’t say anything about insulin injections, then watch them deflate when I finally do.
Diabetes is a hormonal disorder that comes in a few varieties, but always results in the same basic thing—a reduced ability for insulin to do its job. Most people know insulin as the hormone that regulates blood sugar, which it is. But it does so much more than that. At the risk of oversimplifying, insulin is responsible for announcing when energy is abundant and when it is not. After a big meal, insulin levels go up. This informs the body that there’s plenty of energy to go around, so it can fuel itself with blood sugar and store the excess as fat.
Conversely, low insulin signals that times are tough and that it’s a good time to dip into emergency savings, breaking down fat and muscle for energy. In essence, a diabetic patient exists in a permanent state of starvation.
And this has two main consequences. The first—the one most people are familiar with—is that all that unused blood sugar needs to go somewhere, and it starts to spill into the urine. Because of a phenomenon called osmotic pressure (remember science class?), that sugar drags extra water along with it, accelerating urine production. To replenish that wasted water, affected patients have to drink more. This accounts for the most recognizable symptom of diabetes—a pet that is drinking and peeing all the time.
Fewer people are aware of the second consequence which is, in many ways, the more serious one. When fat is burned, it produces nasty compounds called ketones (which are chemically similar to nail polish remover). Ordinarily, this is no problem. Fat is usually just burned in small amounts when necessary, and the body can handle a trickle of ketones with no trouble. But because diabetics are functionally experiencing starvation, they burn fat way too quickly, flooding the bloodstream with ketones that quickly reach toxic levels. This ultimately results in a life-threatening state called ketoacidosis, and requires emergency medical treatment to correct.
Cats and dogs can both become diabetic, but they tend to develop different forms of the disease. The canine version is akin to Type 1 diabetes in humans, in which specialized cells in the pancreas lose their ability to produce insulin. It is thought to have a strong genetic component, but may also be linked to factors like obesity and other underlying diseases. These patients absolutely need insulin injections to replace the missing hormone, and will need them for the rest of their lives.
Feline diabetes is more like human Type 2 diabetes, and is closely associated with obesity. It begins when cats’ bodies become resistant to the effects of insulin, but eventually progresses to include decreased production as well. They usually require insulin to get the disease under control, but unlike dogs, they stand some chance of eventually being controlled with proper diet and exercise. That sounds promising in writing, but it doesn’t always work, and I’d rather see cats lose weight before they get sick to begin with.
When faced with diabetes, pet owners are immediately concerned about the difficulty of administering insulin shots to their pets. To be honest, that’s almost always the easy part. Especially with cats, most people find that giving shots is a whole lot easier than trying to wrestle pills into their mouths. But insulin can be expensive, and it can take weeks or months of experimentation and careful blood monitoring before we get the dose right. In cases where that process drags on for too long, I find a lot of owners grow dispirited.
But it’s worth hanging in there. Once controlled, most diabetics do well. Before long, those dreaded shots will be as routine as breakfast.
Dr. Mike Fietz is a small-animal veterinarian at Georgetown Veterinary Hospital. He received his veterinary degree from Cornell University in 2003 and has lived in Charlottesville since.
Pets of the Month
Visit the Charlottesville Albemarle SPCA to meet these pets, as well as other adoptable animals.
Bella So I’m not gonna lie: I’m on the large side for a cat. But please don’t call me Miss Piggy; my kitty curves mean there’s more of me to love! I also have an awesome, sweet personality, and I enjoy a good nuzzle from time to time. I know I might look like a regular old black-and-white feline who can put away her share of groceries, but looks can be deceiving. Take me home, and you’ll discover I’m the jewel in your crown.
Balto I’m a big guy with a lot of love to give. Once I’ve had my fill of adventures, I like to lean in and give you doggy smooches and hugs. I walk pretty well on leash with a harness, but I need someone who is strong enough to handle my size and strength. My person will also have to pamper me in the way I deserve. Is that person you?
Bessy I’m a sweet, curious little girl who is about 3 months old. I was very scared when I first came to the shelter, and I’m still a bit nervous. I just need a little patience and a lot of love. I enjoy being petted and having my neck scratched, but I prefer not to be held.
I also get along great with other cats, and I might even like gentle dogs. I dare you to meet me and not fall in love.
Scooby I know, I know, everyone tells me how handsome I am. And I love it when they speak baby-talk to me. I’m a happy, people-oriented dude, but I’m often unaware of my extra-large size and tail. I’m also well-mannered and I know some cool commands. Someone must have loved me very much, and I’m not sure why my owner didn’t come for me after I arrived here. Could you be my new person?