Dr. Ellen N. Behrend
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Managing diabetes mellitus is a huge commitment for pet owners and can be a daunting task. Here are eight tips that can make
life easier for the owners of diabetic pets.
1. The quicker diabetes is controlled, the more likely remission will occur.
In a study evaluating remission in diabetic cats initially treated with insulin, 55 diabetic cats were included whose owners
followed a highly intensive monitoring and blood glucose regulation protocol using insulin glargine and a low carbohydrate
diet.1 Remission was achieved in 35 cats (64%). Cats that had received glucocorticoid treatment within six months prior to a diagnosis
of diabetes mellitus, that required a lower maximum insulin dose, or that were intensively managed using glargine within six
months of diagnosis were more likely to achieve remission, while cats with a peripheral neuropathy present at diagnosis (such
as difficulty climbing stairs or a plantigrade stance) were less likely to do so.
2. Diet is important, and canned food is preferred.
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Veterinary low carbohydrate-high protein therapeutic diets such as Purina Veterinary Diets DM (Nestlé Purina) or Prescription
Diet m/d (Hill's Pet Nutrition) are the first-choice dietary recommendation in most cats with diabetes mellitus.2-4 However, a carefully selected over-the-counter high protein-low carbohydrate diet can provide the same degree of effective
glycemic control as therapeutic diets do when financial constraints are present or when a cat will not readily eat a veterinary
therapeutic diet.5 Many canned over-the-counter diets are relatively low in carbohydrate content (< 5 g/100 kcal), but information must be
obtained from the manufacturer on specific brands and flavors to ensure that the goal nutrient composition is being met. Most
dry over-the-counter diets are higher in carbohydrate content. Thus, if a therapeutic dry veterinary low carbohydrate-high
protein diet is not an option, it may, unfortunately, be more difficult to identify a good-quality dry food with low carbohydrate
content.
3. Make giving insulin part of a pleasant experience for the cat—and the owner.
Insulin syringes, as compared with other types, are recommended because of the small needle size, but a needle prick can still
be an unpleasant sensation. A good practice is to make the injections part of a good experience. For diabetic pets that are
meal-fed and enjoy their food, inject them as they are eating and when they are close to finishing the meal. For others, owners
can give the injections while doing a pleasurable activity. My cat Madison loved getting brushed every day. When he became
diabetic, I started brushing him twice daily, and I gave him the injection midway through each brushing.
For any patient that needs a small amount of insulin, 0.3- or 0.5-ml insulin syringes should be used for accurate dosing.
These are referred to as low-dose syringes. The scale on the syringe is easier to read for small doses.
The site of insulin injection is important. An appropriate location must be chosen, as absorption of insulin from various
sites in the body differs. In dogs and cats, the dorsal neck, or the scruff, has commonly been used as an injection site,
but this location may not be ideal because of low blood flow and increased fibrosis caused by repeated injections. A better
option may be to administer the insulin along the lateral abdomen and thorax. The chosen area should be rotated daily to prevent
fibrosis at an injection site.6
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