By Dr. Becker
I occasionally hear or read about diabetic cats whose disease goes into remission, but then returns at a later date. The pet parent is understandably confused and concerned, and the poor kitty is back on either oral or injectable insulin.
The ability to be cured of diabetes (even temporarily) appears to be a unique characteristic of feline physiology, since dogs with the disease rarely, if ever, enter remission.
I suspect I know what may be happening in many cases of diabetic cats who "fall out of" remission.
Most 'Prescription Diets' for Diabetes Are Junk
Diabetes is a complex endocrine disease that is unfortunately very common in cats today. We don't yet know all the causes of the disorder (more about that shortly), but we do know that many diabetic cats improve significantly once they're transitioned to a low-carbohydrate diet.
Many kitties stop needing insulin altogether; others require much less than when first diagnosed.
Unfortunately, many veterinarians recommend prescription diets for diabetic cats that are wholly inappropriate. As cat nutrition expert Dr. Lisa Pierson points out, these diets "… are expensive, low in quality, contain species-inappropriate ingredients and are not necessarily low in carbohydrates."1
"Feeding a high-carbohydrate diet to a diabetic cat is analogous to pouring gasoline on a fire and wondering why you can't put the fire out," says Dr. Pierson.
"While some cats are more sensitive to the detrimental effects of carbohydrates than others, the bottom line is that cats are obligate carnivores and are not designed by nature to consume a high-carbohydrate diet or one that is water-depleted (dry kibble)."2
There are two general guidelines for selecting the best diet for a kitty with diabetes:
- Avoid dry food (kibble), including treats
- Calories from carbohydrates should be less than 10 percent of the total calories consumed each day
It's not always easy to determine the carb content of commercial cat food, and you won't find the information on the label.
In fact, when I attended an Association of American Feed Control Officials (AAFCO) meeting last year, I witnessed reps from Blue Buffalo pet food argue against having to list carbohydrates on the label because it may "confuse people."
In reality, pet food companies don't want to list the amount of carbs on the label because you, the pet owner, would be stunned to learn the amount of cheap, unnecessary filler (starch) that is added to premium pet foods to keep costs low and NOT to promote health.
To get a rough estimate of the amount of carbs in dry pet food, add up the percent of protein, fat, fiber, moisture and ash and subtract the total from 100.3,4 Alternatively, you can try searching the manufacturer's website.
Just last week I met a woman who had calculated that her "grain-free" dry food contained 42 percent carbohydrates.
She thought she had done the math wrong and called the company to ask if there was any starch or sugar in the food. The customer service rep said, "Do you see sugar on the label? Of course there's no sugar in our food, it's grain-free."
Unfortunately, the rep either didn't understand that the tapioca in the food is instantly converted to sugar in a pet's body, or she chose not to disclose this fact to the pet parent on the phone.
In any case, you'll find many of the "grain-free" dry foods have a higher carb (starch) content than regular dry cat food, and you can't count on the pet food manufacturer to disclose this fact.
What to Do About a Dry Food-Addicted Diabetic Cat
The ideal nutrition for cats is whole, fresh and unprocessed animal meat, organs and bones, with a small amount of vegetables. Unfortunately, the majority of middle-aged and senior kitties with diabetes are completely addicted to processed pet food, usually kibble.
Despite what many cat guardians believe, it's possible to transition almost any kitty from kibble to a high-quality canned food and/or raw diet with patience and persistence. It can take weeks and even months, in some cases, to make the full transition.
Some diabetic cats are always hungry, which works in your favor when transitioning to a better diet. But some diabetic kitties don't have much appetite at all, and it can feel like mission impossible to convince a finicky cat who feels lousy to sample a new type of food.
I recommend sticking with it as long as your cat is eating well each day. If she absolutely must have kibble or she won't eat, try to add as much grain-free, potato-free and low-carb canned food to her dry diet as she'll tolerate.
Meanwhile, continue to try to move her away from the kibble to a 100 percent canned and/or raw diet. It's my belief that for many (not all) diabetic cats who can't achieve remission, or who do but ultimately fall ill again, the problem is often diet-related.
2 Principal Causes of Feline Diabetes
1. Obesity and High-Carbohydrate Diets
Obesity is hands down the biggest cause of feline diabetes. The majority of cats in the U.S. are fed a high-calorie, high-carbohydrate diet loaded with grains they have no need for, such as corn, wheat, rice, soy, millet or quinoa.
Grain-free dry foods also contribute to obesity and diabetes, because they are calorie-dense and contain high glycemic potatoes, chickpeas, peas or tapioca, which require a substantial insulin release from the body.
All the carbs (starches) in your cat's food — which can be as much as 80 percent of the contents — break down into sugar. Excess sugar can trigger diabetes.
You can help your cat stay trim by feeding a portion-controlled, moisture-rich, balanced and species-appropriate diet consisting of a variety of unadulterated protein sources and healthy fats, and specific nutritional supplements as necessary.
2. Sedentary Lifestyle
Most house cats are couch potatoes. They don't get nearly enough exercise to benefit their health. If Fluffy is lying around the house all day while you're at work, her heart rate isn't being elevated for the 20 minutes per day she needs to achieve good cardiovascular conditioning.
Unless you're giving kitty an incentive to be physically active, her exertion will be anaerobic — short bursts of energy followed by long periods of rest. Anaerobic exercise won't condition her heart or muscles or burn the calories she consumes. I recommend a minimum of 20 minutes of daily aerobic exercise for your cat. You'll probably need to get creative to get her moving, but it can be done, especially if you learn how to bring out her natural hunting behaviors.
The Best Treatment Is Prevention
Feline diabetes is most often seen in overweight and obese adult cats fed dry food diets. And since dry food is biologically inappropriate nutrition for cats (high in carbs and deficient in high-quality protein and moisture), it makes sense that years of eating kibble could cause diabetes in mature kitties.
If your cat's diabetes is diagnosed early and you're committed to bringing the disease under control, it's possible to normalize blood glucose levels and put the diabetes into remission, which means your kitty will no longer need to be on insulin or other medications.
Unfortunately, in cats who have been diabetic for a significant period of time, the cells in the pancreas may be worn out and unable to secrete insulin any longer. In this case, the animal may require lifelong insulin therapy.
Treatment of diabetes in cats is complex and time consuming. It involves regular monitoring of blood glucose levels, ongoing dietary adjustments, insulin given by injection or oral glucose-regulating drugs and keeping a constant, careful eye on your sick kitty.
Frequent veterinary visits are essential, and the cost of checkups, tests, medical procedures and insulin therapy add up fast. One estimate: treatment for diabetes, including regular blood work and long-term medication, can cost in excess of $10,000 over the life of the animal.
Needless to say, the toll the disease takes on your kitty's health and quality of life can be devastating. So for the sake of your furry family member, I hope you'll give serious consideration to the importance of nutrition, exercise and maintaining your pet at a healthy weight in preventing diabetes and other serious diseases.