What is Diabetes?
Diabetes mellitus is a metabolic disease of the pancreas. The pancreas is a soft, delicate organ that is situated adjacent to the intestine, within the abdomen. It has two major roles to play in the body. Firstly, it releases enzymes and other substances into the intestine to aid in the process of digestion. Secondly and most importantly, it releases hormones into the bloodstream to control the blood sugar levels in the body – principally, blood glucose levels. The important hormone involved in this role is insulin which is responsible for lowering high blood glucose levels (especially after a meal has been consumed, for example). In the case of diabetes, the pancreas produces too little, or no insulin and the blood glucose remains persistently high. This causes abnormal body metabolism.
The Role of Insulin
All organs in the body, whether it be the heart, brain, kidney , liver or muscle, require glucose to provide energy for everyday metabolism. Even though glucose is in ready supply in the bloodstream, it does not simply diffuse into these organs to provide them with the energy that they need. These tissues require insulin to be present in order for them to take glucose out of the bloodstream and without insulin, the tissues are denied a major energy source. After each meal the level of glucose in the blood rises. This is detected by the pancreas which then releases insulin to allow the body tissues to absorb the glucose out of the bloodstream and the blood glucose levels drop back to normal again. This cycle is repeated several times a day after every meal. In the case of diabetes the body is unable to utilise blood glucose due to an insulin deficit and the blood glucose levels remain high all day.
The Effects of High Blood Glucose Levels
Because of an inability to utilise the sugars they normally produce, the metabolism of diabetic cats is adversely affected. This results in several characteristic signs being exhibited by diabetic cats of which the most prominent in the early stages are:-
1.Excessive Thirst- because high glucose levels are always present in the blood, the kidneys are required to pass a large amount of it into the urine. As the glucose passes into the urine manufactured by the kidneys, it pulls a lot of water with it from the bloodstream by the effects of osmosis. This means that large amounts of urine are formed and diabetic cats tend to urinate larger amounts of urine than normal. This causes overall body dehydration and these cats therefore need to drink a lot more water to compensate. Hence diabetic cats have an excessive thirst and pass large volumes of urine.
2.Ravenous Appetite- because blood sugars are not used, the body has an energy deficit. This increases hunger as the body attempts to increase its energy intake by consuming more food. In cats that are big eaters anyway, this phase may not always be obvious.
3.Weight Loss- because glucose is unavailable to the tissues for energy, the body must look elsewhere for an energy supply. It therefore draws on its fat reserves to provide the energy required. As fat reserves are depleted, weight loss becomes apparent and even though these cats are eating more than usual, ironically there is weight loss, even emaciation in advanced cases.
– is very simple and effective. All one has to do is to provide the diabetic with the insulin that is lacking. This is done by twice-daily injections. There are a couple of different insulins to choose from when treating cats and the aim is to get the cat’s high blood glucose levels under control as quickly as possible.
If the glucose level can be normalised for extended periods of the day, then it is possible for the pancreas to recover some function. And if the cat has been diagnosed early enough then some cats will actually go into remission and will start producing insulin again by themselves. If this is achieved then these cats can come off their insulin injections. For all cats, this is our initial objective.
However not all insulins suit all cats and some cats are actually insulin resistant, meaning they do not respond to the insulin injections. Fortunately the majority of cats are not in this group and the prognosis for treatment is usually very good. If a cat manages to achieve remission, it is not usually permanent and at some stage in the distant future, insulin injections are required again for life.
Initially, we admit these cats to the hospital for a day or two to run blood glucose curves. We do this to establish the correct insulin dosage for them to be on before we send them home. Nowadays, blood glucose meters are cheap and easily purchased at your local chemist, so that afterwards owners can run these glucose curves at home. A painless needle gun enables one to get a drop of blood from the cat’s ear and this is used by the blood meter to measure the blood glucose level. This is not absolutely vital but it can be useful in monitoring diabetic cats in the home.
Diet is the other consideration. These cats should be on low carbohydrate diets. Glucose is a sugar carbohydrate so the less that is in the food usually, the better. Cats do not utilise much of their dietary carbohydrate anyway so we strive to get them onto high-protein, low-carbohydrate diets. Diabetic control is always easier when cats are on these types of diets.
Giving the Injection
1. Mix the contents gently prior to injection by inverting the bottle 3-4 times. There is no need to shake the bottle.
2.Insert the needle into the bottle and draw up the required amount of insulin. Ensure there are no air bubbles in the column of insulin either in the needle hub or syringe. To accomplish this: tap the syringe barrel with your finger several times to expel any air bubbles from the column of insulin. Once a solid column of insulin is achieved without any air bubbles, the excess air above the insulin column can be expelled from the syringe. Now only a solid column of insulin remains in the syringe barrel from the tip of the needle back to the syringe plunger. Inject any excess insulin back into the vial. Keep going until you have only the correct amount of insulin left to inject.
3.Pick up a large fold of skin in the hand and insert the needle at right angles to this skin.
4.Allow the skin to fall back into place and then inject. Remember it is painless and usually hurts the owner far more than the cat!
Handling the Equipment
1. Although the syringes and needles used are disposable, they may be used for several injections in a row before being discarded.
2.Remember to keep the insulin in the refrigerator when not in use.
3.It is wise to give breakfast first and then give the injection immediately after or while they are eating. You may then feed again in the afternoon.
Please revisit in 10-14 days to let us know how you’re both doing and for us to run another glucose curve. If you have any problems or queries in the meantime, please contact the clinic before then.
It is absolutely vital that you give the correct dosage of insulin each time; if you forget or miss a day don’t worry and simply start again the next day.
This is important.
DEFINITELY DON’T GIVE EXTRA INJECTIONS TO MAKE UP FOR MISSED ONES.
The biggest complication we see is overdosage of insulin and it is dangerous to give too much or to give an extra shot to make up for a forgotten or missed one.
Remember if you forget the odd injection no harm is done.