Diabetes in Cats

A diabetes diagnosis can seem daunting for guardians. After all, it  appears as a difficult-to-manage disease filled with complex numbers, injections, diets, and more.


Obese cats, males, and middle-aged to senior cats have a higher risk of developing the disease, and many vets say it is also under-diagnosed in cats and has been increasing over the years. Fortunately, with a good treatment plan and a healthy diet,  diabetes can be managed, and cats can continue to live full lives.   

What is Diabetes?

Diabetes mellitus, typically shortened to just diabetes, is a disease of the pancreas. It is a condition that occurs when the body can’t use glucose normally. Glucose is a type of sugar and is the main energy source for the body’s cells. The levels of glucose in the blood are primarily controlled by insulin.

Insulin is a hormone produced in the pancreas, a two-lobed organ behind the stomach responsible for producing enzymes and hormones to assist digestion.

The pancreas works to regulate blood sugar, and it does this by detecting increases in blood sugar. When the cells of the pancreas detect an increase in the blood sugar concentration, insulin is released directly into the blood. The blood then carries glucose into the body’s cells throughout the body. The higher the blood sugar, the more insulin is secreted. Insulin lowers the blood glucose concentration. Additionally, the hormone, glucagon, has an opposite function and is released when blood sugar is low to increase blood sugar.

Diabetes occurs when the pancreas either does not produce or underproduces insulin. When insufficient insulin is produced, blood sugar can become too high, called hyperglycemia.  As a result, serious side effects develop. 

Identifying the Types of Diabetes

Feline diabetes comes in two types: type 1 is when the cat’s pancreas can’t make insulin, and type 2 is when insulin is produced, but it’s either not enough or the cat’s body doesn’t respond properly to it. Type 2 is most common in cats (as opposed to dogs, where type 1 is most common). 

Feline Diabetes is almost always a chronic development, whereas juvenile diabetes (Type 1 Diabetes) is incredibly rare. 

The normal blood glucose levels of cats should be between 80 and 120 mg/dL, which is the same for dogs. Anything higher than that can be indicative of diabetes.

However, it is important to note that cats can develop something called “stress hyperglycemia.” It is acute (sudden onset) and typically develops at the veterinarian’s office due to struggling and anxiety spiking the blood sugar by as much as 180 mg/dL. Cats without clinical signs of diabetes can have high blood sugar readings because of this condition. If this is suspected, veterinarians will do follow-up blood sugar checks upon entering the room or as quickly and calmly as possible. 

What are the Causes of Diabetes in Cats?

Genetics plays a role in the onset of diabetes because we can see certain cat breeds and family lines are more predisposed to developing the disease.

However, while genetics plays a role in diabetes, research shows that genes are greatly affected by epigenetic factors such as environment and diet.

Some potential causes of diabetes in cats include:

  • Poor diet with excessive intake of carbohydrates/sugars
  • Species-inappropriate diets
  • Obesity
  • Chronic pancreatitis or other damage to the pancreas
    • Can destroy the insulin-producing cells
  • Chronic inflammation
  • Excessive use of steroids (such as Prednisone or Dexamethasone)
    • Steroids can cause insulin resistance over time

What are the Symptoms of Diabetes?

There are a wide variety of symptoms of diabetes, but several signs are very prominent in most diabetes cases. Diabetic cats may also show additional symptoms based on other underlying disorders.

Signs of diabetes most commonly seen include:

  • Increased thirst
  • Increased urination
  • Increased appetite
  • Obesity 
  • Lethargy
  • Easily fatigued and sluggish
  • Weak Hindlimbs 
  • Inability to jump on to things 
  • Walking unusually

How Can You Help Your Diabetic Cat?

Obesity is strongly linked to the development of diabetes in cats. The cascade of metabolic events that occurs over a lifetime of a species-inappropriate diet for cats leads to a pattern called metabolic syndrome.  


There are two components to caring for your diabetic cat. One is treating the present situation, i.e. managing diabetes, which requires a long-term relationship with your veterinarian. They will assist you in proper medications and care to minimize blood sugar levels and all of the negative effects that go with that. Your veterinarian will direct you on the use of oral or injectable insulin as well as discuss diet.  


The second component of caring for your diabetic cat is diet, which needs to be a species-appropriate diet.  Cats are carnivores, and as such, need animal-based proteins and minimal carbohydrates. The long-term high carbohydrate diet is the root of all that occurs within the metabolic syndrome in cats. 


Since obesity and diabetes go hand in hand, it is also very important for obese cats to lose weight. The first and most important step is the correct diet. As your kitty continues to eat a low carbohydrate diet, he will start to feel better and move around more. This is where you can start to implement cat toys and chasing games to encourage movement. But remember, everything in moderation, especially if your diabetic cat has any neuropathy to their hind limbs. 


If your cat has neuropathy to his hind limbs, he needs special care. The condition causes weakness to the hindlimbs, so it is more difficult for him to jump up onto things like the couch or windowsill to watch birds, etc. Help him with his daily routine by having cat stairs or easy ways for him to get up on to his things. The last thing we want is for him to hurt himself trying to jump. 


How you feed your diabetic cat is also important. You will want to have a very consistent routine for mealtimes. Feeding the same food at the same time of day, rather than free-feeding.  


Be sure to monitor your cat’s symptoms. If anything changes, especially with appetite, thirst, or urination, they need to go to the vet for a check-up.  

Diet’s Role in Diabetes Care

Diet is one of the best ways to help manage diabetes. Cats are true carnivores, and as such, require a high percentage of their diet to be animal-based proteins, meaning meats and organs. They have no requirement for carbohydrates, especially sugars. They generate energy via a process called gluconeogenesis which is making glucose from the amino acids of protein versus a dog or a human who tends to make glucose from dietary carbohydrates. This difference in metabolism is why a species-appropriate diet is so important for cats. A metabolic health diet is essentially a healthy cat diet. 

A Metabolic Health Diet aims to nourish the body with biologically-appropriate meats and organs and low carbohydrates, especially sugars.

There are several important aspects of a diet suitable for a cat with diabetes:

  • It should be made with mostly meat and animal-based proteins 

  • It should be low carbohydrate but more specifically low in sugars 

  • Any sugars found in the diet should have a low glycemic index 
  • Minimally processed and high quality without any artificial preservatives or synthetic ingredients. Real, whole foods are the best option.  
  • Food must also be nutritionally complete, species-appropriate, and balanced, so your cat receives all the nourishment they need 


All ingredients in your cat’s food should be fresh, highly bioavailable, easily digested, and highly palatable.

The Importance of Real Whole Food Nutrition in a Diabetes Diet

To feed the indoor carnivore, we need to provide them with food that can come as close as possible to the wild or feral cat diet. Recent research looked at just that. The analysis of combined carcasses of wild rodents and small birds revealed water content of 67%, crude protein of 62%, crude fat of 11% and ash of 14.8%, and 2% carbohydrate (nitrogen-free extract). The average energy content of the prey was 3,929 kcal/kg DM. These numbers can be matched using whole foods like chicken, wild-caught salmon, and sardines. 


The quality and source of protein are very important to a cat suffering from diabetes. Clean, wholesome meats and organs are easily absorbed and contain high protein and moderate to high fat. The protein is easily digestible and is utilized for continual maintenance of the tissues of the body, which helps satiation. Plus, it prevents nutritional imbalances in cats by providing essential nutrients such as amino acids that they can only get from meat sources.  


Good quality meat like pasture-raised, cage-free chicken, and wild-caught salmon are optimal proteins because they are rich in a wide variety of vitamins, minerals, and bioavailable protein.  


Providing organs like liver is crucial too because liver is a bioavailable multivitamin for your cat.  

Omega-3 fatty acids help decrease inflammation throughout the body. All cats can benefit from them, but especially cats with chronic diseases caused by inflammation. Omega-3 fatty acids are some of nature’s strongest anti-inflammatories and are very important for cats. In addition to being anti-inflammatory, Omega 3s are crucial for immune and nervous system functions.  


Ground krill and sardines are both great sources of these omega-3 fatty acids. And unlike fish oils, krill and sardines are so low on the food chain that they do not accumulate toxins like larger fish.


The ratio of Omega-6 fatty acids to Omega-3 fatty acids is important in the evaluation of a diet. Dry cat kibble diets tend to have omega 6 to omega 3 ratios in the range of 40:1. A species-appropriate diet should have a ratio of 1:1 Omega 6:3. The Medicus Metabolic Diet not only has high omega 3 fatty acid content but a healthy omega 6:3 ratio of .99:1. 

The research shows that the wild prey of feral cats contained 2% carbohydrates (nitrogen-free extract). And those carbs tended to be from the ingesta of the prey they consumed. The average cat kibble diet has 35-50% carbohydrates while the Medicus Metabolic Diet has 5.5 % carbohydrates as a % of kcals.

Providing the body with exactly what it needs can drastically impact cats with diabetes, slowing the progression of the disease and improving their lives for the better.  

Note: The information provided is educational and does not represent medical advice regarding pets. Please see your vet for an accurate diagnosis of your pet’s condition.

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