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Diet as an Aid to Treatment of Diabetes Mellitus in Cats
Veterinary & Aquatic Services Department, Drs. Foster & Smith
Liver and Pancreas
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What role does diet play in the treatment of diabetes mellitus in cats?

With diet, we attempt to supply adequate nutrients, maintain the ideal body weight, maintain proper levels of blood glucose, and provide for any underlying diseases or conditions. Also important, along with the actual diet, are the number of feedings, the quantity fed, and the relationship of feedings to insulin or administration.

What are the calorie needs of diabetic cats?

In general, the caloric needs of a diabetic cat are the same as those of a normal cat. If the cat is obese, the daily calorie intake is reduced by 25%, under the guidance of your veterinarian. The cat should not lose more than 3% of her body weight per week. Too rapid weight reduction can lead to hepatic lipidosis. As weight decreases, the insulin dose would also decrease in most cases. If a cat is underweight, feeding foods with high caloric density (a large number of calories in a small amount of food) may hasten weight gain.

How often should a diabetic cat be fed?

Cat with food bowl It will be very helpful for your veterinarian to know your cat's usual feeding habits before beginning diabetes regulation with insulin. There are two main feeding schedule options for a cat with diabetes.

If your cat is used to eating 2 or 3 meals a day, the cat may be able to be kept on that schedule. For these cats, the insulin is usually given twice a day (12 hours apart) at mealtime. It is very important that your cat eats around the time the insulin is administered, or her blood glucose level may go too low. For some cats who tend to be finicky, it may be best to feed the cat right before the scheduled insulin injection. If she does not eat, contact your veterinarian who may recommend that you postpone or lower the insulin injection.

Always consult with your veterinarian before changing the dose or timing of the injection or feeding.

Some cats tend to eat small amounts throughout the day rather than two or three larger meals. This feeding schedule, too, can usually be accommodated by varying the type, amount, and frequency of insulin administration.

What type of diet should be fed?

It is very important that the diet is palatable to the cat. If the cat does not eat well, it will be very difficult to maintain the proper glucose level. Hypoglycemia (low blood sugar) could occur, and if it is severe, could be life-threatening.

High Fiber: High amounts of fiber in the diet can affect the absorption and metabolism of glucose and fat in the diet. The fiber will slow glucose absorption from the digestive tract so there is not a high peak in blood glucose level right after eating. High fiber diets also promote weight loss. To be most effective, diets with high fiber must also contain significant amounts of complex carbohydrates. These diets can decrease the need for insulin. High fiber diets can result in an increase in intestinal gas, an increase in the frequency and amount of stool produced, and may not be as palatable as other diets.

High Protein, Low Carbohydrate: The most recent studies have suggested that a diet high in protein and fat, and low in carbohydrates may be more beneficial for most cats than high fiber diets. High protein and fat levels are typically found in kitten foods (especially canned) or in new diets made specifically for diabetic cats (such as Purina Veterinary Diet DM). A starch blocker called acarbose may be added to the treatment regimen. Initial studies using a canned high protein/low carbohydrate diet (Hill’s Feline Growth) and the acarbose have shown that 58% of cats can discontinue insulin injections and those with continued insulin requirements could be regulated on a much lower dosage (1 unit twice daily). In comparing canned high fiber diets versus low carbohydrate diets, cats fed low carbohydrate diets were 10 times more likely to discontinue insulin injections.

Since the dietary requirements of diabetic cats depend upon numerous factors, discuss your cat's diet with your veterinarian. Do not change your cat's diet except under the direction of your veterinarian.

Should diabetic cats be fed dry food, canned food, or semi moist?

Canned foods are generally preferred. Semi moist foods are not a good choice of diet for diabetic cats. These foods often contain a relatively high sugar content. You and your veterinarian should choose the type of food prior to the start of insulin regulation.

May a diabetic cat be fed table scraps?

A diabetic cat should not be fed table scraps. Feeding table scraps will change her insulin needs.

Can the diet of a diabetic cat be changed?

Remember that the type, dose, and frequency of administration of insulin are determined using a blood glucose profile while the cat is eating a specific diet. Changing the diet, even from canned food to dry food, may change the insulin needs of the cat. Always consult your veterinarian if you would like to change your cat's diet, or if your cat is not eating well.

What should diabetic cats with other diseases be fed?

Diets may need to be modified if a cat has or develops another disease or condition such as pancreatic insufficiency, kidney disease, or heart disease. Your veterinarian will help you choose the most appropriate diet for your cat.

Summary

Diet can assist in controlling the blood glucose level in diabetic cats, and in reaching and maintaining ideal weight. In general, diabetic cats should be fed diets high in protein and fat. Diets high in dietary fiber may serve as an alternative. The form of the food (dry or canned), ingredients, amount fed, and frequency and timing of feeding all contribute to the ability to control the blood glucose level. These factors should remain constant from day to day; changing them could change a cat's insulin needs.

 
References and Further Reading

Ellis, CJ. Diabetes decisions. Veterinary Forum; September 2008:26-34.

Feldman, EC. Diabetes remission in cats: Which insulin is best? Supplement to Compendium: Continuing Education for Veterinarians; 31(7A).

Hess, RS. Diabetes mellitus. Part 1: Diagnosis. NAVC Clinician's Brief; October 2009: 9-11.

Hess, RS. Diabetes mellitus. Part 2: Treatment. NAVC Clinician's Brief; November 2009; 21-24.

Kintzer, P; Monroe, E; Scherk, M; Scott-Moncrieff, C. Managing the diabetic cat. NAVC Clinician's Brief; July 2008 Supplement; 2-7.

Rios, L; Ward, C. Feline diabetes mellitus: Diagnosis, treatment, and monitoring. Compendium: Continuing Education for Veterinarians; December 2008:626-640.

Scherck, M. Managing diabetes mellitus in cats: What makes it work? Clinical Edge; June 2008:3-7.

Schermerhorn, T. Treatment of diabetes mellitus in dogs and cats. NAVC Clinician's Brief January 2008:35-39.


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Regulating & Monitoring a Diabetic Cat Using Insulin 
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