By Dr. Becker
Biddie is a neutered male cat who is 15 years young.
About six months before I met Biddie, his mom noticed he was drinking more water, urinating more frequently, and he was also dropping weight.
Biddie’s local veterinarian diagnosed diabetes mellitus (page 1).
Diabetes mellitus is a somewhat common disease in older cats – especially those fed dry food diets. According to a 2006 study1, low-carbohydrate, high-protein diets are as much or more responsible than insulin for remission of diabetes in cats. Since most kibbled cat food is high in carbs and deficient in high-quality protein, it stands to reason a lifetime eating the stuff could cause diabetes.
The pancreas produces insulin based on the level of glucose (sugar) in the blood. Insulin is necessary in order for glucose to enter the cells of the body. When glucose levels are high (which normally occurs after a meal), insulin is released.
When there is a situation of either not enough insulin being released from the pancreas, or an abnormal release of insulin coupled with an inadequate response of the body’s cells to the insulin, diabetes mellitus is the result. Sugar in the bloodstream cannot get into the cells of the body, so the body starts breaking down fat and protein stores to use as energy. As a result, no matter how much the cat eats, he loses weight.
In addition, the glucose builds up in the bloodstream and is eliminated through urination. This leads to excessive urination and thirst.
Diabetes is not a death sentence for pets – it can be managed. But as you’ll see, it can sometimes take a tremendous commitment of time, resources and energy to get an animal’s diabetes under control.
Biddie’s Body Doesn’t Respond to Insulin
Immediately following the diabetes diagnosis in January 2009, Biddie’s local vet started him on Humulin-N insulin injections once daily.
And Biddie’s owner learned how to check his blood glucose levels at home. This approach dramatically reduces the stress most cats feel with constant vet visits necessary to get blood sugar levels regulated. Biddie’s situation was further complicated by the fact that his body was resistant to many types of insulin.
Biddie’s local vet continued to increase the amount of insulin he was given, but his body did not respond. The poor guy continued to lose weight and his blood glucose levels remained frighteningly high.
Two months after diagnosis, in March 2009, his local vet switched Biddie to Vetsulin (another type of insulin) twice daily and increased the dose incrementally over the next six weeks.
Unfortunately, Biddie’s blood sugar levels remained very high on the maximum dose recommended for Vetsulin. So his vet suggested a third type of insulin called PZI. But again, even at maximum recommended dosage, there was no improvement in Biddie’s condition (page 2).
In May 2009, Biddie was switched from injectable insulin to Glipizide. Glipizide is a blood sugar regulating pill (taken by mouth) used for Type 2 diabetes in people. It is sometimes used in companion animals, with mixed results.
I Meet Biddie in June 2009
When I met Biddie in June 2009, his weight had plummeted from 14 pounds to 8.5 pounds. His most devastating symptom, however, was terrible diabetic neuropathy.
Unregulated diabetes can lead to profound rear limb weakness in cats, giving them a plantigrade walk, meaning their ankles are actually on the ground as they walk.
Poor Biddie had spent most of the previous six months dragging the back half of his body around thanks to his metabolic condition. He was so weak from hoisting his hindquarters into the litter box that he would lie down to relieve himself. This required his committed mom to give him a bath every day. Biddie, like most cats, hates baths, but he had to endure them so his skin could be cleaned and he could avoid infection from fecal contamination.
Needless to say, Biddie was absolutely miserable.
Biddie’s mom had been told euthanasia was a humane option given the cat’s debilitated condition and poor quality of life. But… she refused to give up.
Biddie’s Healing Protocol
One of the first things I did was help Biddie’s mom transition him from Science Diet w/d to a grain-free formula of canned and dry food.
Science Diet has marketed their weight loss diet (w/d) as potentially beneficial for animals with diabetes. Unfortunately, no diet could be more inappropriate for the nutritional needs of diabetic pet patients. The results of this diet are disastrous, in my experience.
There is only a small amount of rendered protein in this food, and a tremendous amount of fiber (filler). The theory is that because the formula is low in fat, it forces carnivores to burn excess body fat. But most patients with serious diabetes mellitus like Biddie don’t have any fat to lose.
Biddie was wasting away, and his protein deficient diet forced his body to metabolize its own muscle, which only exacerbated the muscle loss and rear limb weakness.
It was extremely important that Biddie eat well, twice daily. I would have preferred not to feed him any dry food at all, but he wasn’t interested in eating only canned food, and we never force cats to do anything they don’t want to do. Especially sick cats. So Biddie’s diet included dry food along with canned food.
We slowly increased the Glargine dose until Biddie’s blood sugar was finally controlled in August 2009 (page 3).
The strength in Biddie’s rear limbs also increased during this time and his ability to walk improved with each subsequent visit to my clinic. His blood sugar levels had stabilized and his quality of life was returning.
Biddie Stays Healthy in 2010 and 2011
In March 2010, Biddie’s fructosamine levels were good (page 4). Fructosamine levels help vets determine if diabetic patients’ blood glucose levels have remained stable since their last blood test, and Biddie was doing great.
All signs of neuropathy had resolved, he had gained weight and was feeling like his old self again. His fall 2010 and 2011 fructosamine results continued to be excellent (pages 5 and 6).
Then something interesting happened. Because his mom regularly checks Biddie’s blood sugar levels at home, she noticed his overall fasting blood glucose levels were consistently dropping, meaning he may need less insulin to keep his levels in balance.
Even Better News in 2012
Biddie’s mom was planning a trip in May of this year, so we decided during this time we would see how Biddie did without insulin.
And he did great! His blood sugar remained totally balanced without insulin after his owner returned home. After several years of very hard work on the part of his mom, Biddie’s diabetes was in remission!
Of course, it’s impossible to say whether Biddie will need insulin at some point in the future, but at this point in time, he is a thriving, healthy, geriatric kitty that does NOT have diabetes, thanks to his very resilient spirit and his very committed guardian.