Discovering the reasons underlying difficult-to-control diabetes in cats


Discovering the reasons underlying difficult-to-control diabetes in cats

In the first of a two-part series, an internist reviews the insulin-related, client-related, and patient-related problems that can make a diabetes management regimen ineffective. Here is a step-by-step approach to identifying and addressing problems that underlie cases of poor diabetic regulation in cats.
Mar 01, 2010


1. Alt N, Klev S, Haessig M, et al. Day-to-day variability of blood glucose concentration curves generated at home in cats with diabetes mellitus. J Am Vet Med Assoc 2007;230:1011-1017.

2. Cohen TA, Nelson RW, Kass PH, et al. Evaluation of six portable blood glucose meters for measuring blood glucose concentration in dogs. J Am Vet Med Assoc 2009;253:276-280.

3. Thompson MD, Taylor SM, Adams VJ, et al. Comparison of glucose concentrations in blood samples obtained with a marginal ear vein nick technique versus from a peripheral vein in healthy cats and cats with diabetes mellitus. J Am Vet Med Assoc 2002;221:389-392.

4. Weidmeyer CE, Johnson PJ, Cohn LA, et al. Evaluation of a continuous glucose monitoring system for use in dogs, cats, and horses. J Am Vet Med Assoc 2003;223:987-992.

5. Sieber-Ruchstuhl NS, Kley S, Tschour F, et al. Remission of diabetes mellitus in cats with diabetic ketoacidosis. J Vet Intern Med 2008;22(6):1326-1332.

6. Martin GJ, Rand JS. Control of diabetes mellitus in cats with porcine insulin zinc suspension. Vet Rec 2007;161:88-94.

7. Wallace MS, Peterson ME, Nichols CS. Absorption kinetics of regular, isophane, and protamine zinc insulin in normal cats. Domest Anim Endocrinol 1990;7:509-515.

8. Martin GJ, Rand JS. Current understanding of feline diabetes: Part 2, treatment. J Feline Med Surg 2000;2:3-17.

9. Frank G, Anderson W, Pazak H, et al. Use of a high protein diet in the management of feline diabetes mellitus. Vet Ther 2001;2:238-246.

10. Rand JS. Editorial: glargine, a new long-acting insulin analog for diabetic cats. J Vet Intern Med 2006;20:219-220.

11. Moise NS, Reimers TJ. Insulin therapy in cats with diabetes mellitus. J Am Vet Med Assoc 1983;185:158-164.

12. Nelson RW, Lynn RC. Wagner-Mann CC, Michels GM. Efficacy of protamine zinc insulin for treatment of diabetes mellitus in cats. J Am Vet Med Assoc 2001;218:38-42.

13. Marshall RD, Rand JS, Morton JM. Insulin glargine has a long duration of effect following administration either once daily or twice daily in divided doses in healthy cats. J Feline Med Surg 2008;10:488-494.

14. Feldman EC, Nelson RW. Feline diabetes mellitus. In Feldman EC, Nelson RW, eds. Canine and feline endocrinology and reproduction. 3rd ed. St. Louis, Mo.: Elsevier, 2004;539-579.

15. Ishioka K, Omachi A, Sasaki N, et al. Feline adiponectin: molecular structures and plasma concentrations in obese cats. J Vet Med Sci 2009;71:189-194.

16. Hoenig M, Thomaseth K, Waldron M, et al. Insulin sensitivity, fat distribution, and adipocytokine response to different diets in lean and obese cats before and after weight loss. Am J Physiol Regul Intergr Comp Physiol 2007;292:R227-234.

17. Bennett N, Greco DS, Peterson ME, et al. Comparison of a low carbohydrate-low fiber diet and a moderate carbohydrate-high fiber diet in the management of feline diabetes mellitus. J Feline Med Surg 2006;8:73-84.

18. Bailiff NL, Nelson RW, Feldman EC, et al. Frequency and risk factors for urinary tract infection in cats with diabetes mellitus. J Vet Intern Med 2006;20:850-855.

19. Forman MA, Marks SL, De Cock HEV, et al. Evaluation of serum feline pancreatic lipase immunoreactivity and helical computed tomography versus conventional testing for the diagnosis of feline pancreatitis. J Vet Intern Med 2004;18:807-815.

20. Steiner JM, Williams DA. Serum feline trypsin-like immunoreactivity in cats with exocrine pancreatic insufficiency (abst.). J Vet Intern Med 2000;14:627

21. Goossens MMC, Nelson RW, Feldman EC, et al. Response to insulin treatment and survival in 104 cats with diabetes mellitus (1985-1995). J Vet Intern Med 1998;12:1-6.

22. Peterson ME, Taylor RS, Greco DS, et al. Acromegaly in 14 cats. J Vet Intern Med 1990;4:192-201.

23. Hurty CA, Flatland B. Feline acromegaly: a review of the syndrome. J Am Anim Hosp Assoc 2005;41:292-297.

24. Berg RIM, Nelson RW, Feldman EC, et al. Serum insulin-like growth factor-1 concentration in cats with diabetes mellitus and acromegaly. J Vet Intern Med 2007;21:892-898.

25. Startkey SR, Tan K, Church DB, Investigation of serum IGF-1 levels amongst diabetic and non-diabetic cats. J Feline Med Surg 2004;6:149-155.

26. Elliott DA, Feldman EC, Koblik PD, et al. Prevalence of pituitary tumors among diabetic cats with insulin resistance. J Am Vet Med Assoc 2000;216:1765-1768.

27. Gunn-Moore D. Feline endocrinopathies. Vet Clin North Am Small Anim Pract 2005;35:171-210.

28. Plumb DC. Plumb's veterinary drug handbook. 6th ed. Ames, Iowa: Blackwell Publishing, 2008;760-765.