Complete Care for Your Aging Cat - Amy Shojai [99]
“Twenty-five to 30 percent can be treated with oral medication,” says Dr. Nelson. Obese male cats with type 2 diabetes are the best candidates for oral hypoglycemic agents. Glipizide (Glucotrol) boosts the production of insulin in the pancreas. Some of these cats do well on oral medication for a long time. Other times, this only works for a few months and they end up having to go on insulin. Reversal of glucose toxicity using a short course of insulin therapy prior to or in combination with oral hypoglycemic agents may improve the response to oral hypoglycemic agents, says Dr. Greco.
Initial studies using a canned high protein/low carbohydrate diet and the starch blocker acarbose have shown that 58 percent of cats discontinue insulin injections and those with continued insulin requirements could be regulated on a much lower dosage (1U BID). Comparison of canned high fiber versus low carbohydrate diets showed that cats fed low carbohydrate diets were three times more likely to discontinue insulin injections.
“About 50 to 60 percent of cats have an absolute requirement for insulin at the time of diagnosis is made,” says Dr. Nelson. They’ll need insulin injections, usually twice a day. Various types of insulin are available, and different ones may work better for individual cats. “The two best are recombinant human lente and PZI insulin,” he says. There are other kinds as well, but they may have different durations of effect and require more frequent injections. The amount and frequency of insulin injections varies from cat to cat and depends on activity level and metabolism. Usually it takes time and experimentation to find the right dose, best insulin, and ideal schedule. Most owners become quite adept at giving insulin injections.
Bottom Line
The initial testing and regulating is the most expensive part and may run a couple hundred dollars because typically the cat must be hospitalized for several days. Once that’s done, though, managing diabetes with special food, oral medicines and/or insulin can be quite reasonable. The cost varies in different parts of the country but usually is well under $20 a month.
Testing
Usually, blood tests are monitored for blood sugar levels, and the amount and frequency of insulin shots are adjusted accordingly. “There’s a trend towards clients actually measuring blood sugars at home,” says Dr. Nelson. An instrument called a glucometer tests the blood, and a sample is obtained by performing an ear prick. “In the kitty, you heat the ear with a warm washcloth,” says Dr. Nelson. Put a damp washcloth in a plastic baggy, warm it in the microwave for about 5 to 10 seconds, and then massage the damp warm cloth against the ear for about 30 seconds. “That brings the circulation to the ear, and then you use the lancet to prick a drop of blood just as a human diabetic does on their fingertip. I have 10 or 12 clients now that routinely do blood sugar measurements and send me the information,” he says. Home monitoring can be a big advantage because stress can affect the reading, and bringing the cat to the hospital may mean the tests aren’t as accurate as when done by the owner.
A newer in-hospital monitoring test examines the blood for levels of fructosamine. “It’s a marker of average blood sugars over a period of two to three weeks, and it’s not affected by stress,” says Dr. Nelson.
Comfort Zone
Many owners of diabetic cats like the Ascensia Elite XL glucometer (formerly the Bayer product called Glucometer Elite XL) because it requires a very small amount of blood to monitor the glucose level. The care system is available at most pharmacies.
A cat box additive can turn conventional litter into a glucose monitoring system. Glucotest Feline Urinary Glucose Detection System (Purina Veterinary Diagnostics) is thoroughly mixed with the cat’s usual cat box filler and reacts to urine with distinct color changes to indicate the