diabetes mellitus is caused by an absolute or relative deficiency of insulin. Animals with an absolute or relative deficiency of insulin are called diabetics.

Insulin deficiency can develop for different reasons:

• Disorders of the pancreas – the pancreas is unable to secrete enough insulin
• Other diseases or the presence of other hormones – may be antagonistic to insulin or cause resistance to insulin. Insulin is unable to function normally in the body.
  

The most common signs of diabetes mellitus are:

• Increased drinking
• Increased urination
• Increased appetite
• Weight loss
• General signs, such as lethargy and poor coat condition

• Polyuria – the passage of excessive amounts of urine in a given period (e.g. per day)
• Polydipsia – excessive thirst
• Polyphagia – excessive hunger

Your veterinary surgeon will measure your cat’s blood glucose and test your cat’s urine for the presence of glucose and ketones and for a urinary tract infection.

Persistently high blood glucose levels along with glucose in the urine usually mean that your cat has diabetes mellitus. Diabetic cats may also have a urinary tract infection.

Cats and of all ages can get diabetes. Diabetes most typically occurs in older cats. Castrated male cats are affected most commonly.

Problems associated with diabetes are generally seen in long standing cases, they include hindlimb weakness in cats.

Cats with diabetes mellitus drink and urinate a lot. They may also have a good or increased appetite but usually lose rather than gain weight. Other common diseases where some or all of these signsare also seen include:

• Hyperthyroidism
• Kidney failure

To reach a definitive diagnosis of diabetes mellitus your veterinary surgeon will test your cat’s blood glucose and urine glucose and ketones.

With dedication, the correct treatment, lifestyle and adequate monitoring a diabetic cat should have the same expected life span as a non-diabetic cat of the same age.

No. Freezing will destroy the insulin and reduce the effectiveness of the product. If a vial of insulin accidentally freezes in the fridge, it should be discarded and a new vial should be used.

Caninsulin should be stored upright, protected from light, between 2 and 8°C. If the Caninsulin vial has been accidentally stored outside the refrigerator consult your veterinary surgeon for advice on whether the Caninsulin can still be used or not.

Crystals sometimes form around the stopper of the Caninsulin vial. This is normally minimal and is due to the vial being stored or transported on its side or upside down. To keep crystallization to a minimum, the vial should be stored upright in the refrigerator. However if a limited amount of crystals do form, Caninsulin is usually fine to use. The Caninsulin vial should be gently inverted a few times to properly mix it before use.

Following withdrawal of the first dose the Caninsulin should be used within 28 days.

Caninsulin is currently only approved for administration via syringes. For the following reasons it is not advisable to use insulin pens intended for human use:

1. Caninsulin is the only 40 IU/ml insulin on the market meaning that all the other injection systems are not correctly calibrated to administer it.
2. We have no experience injecting Caninsulin using needleless injectors and have some concerns that the techniques used may in fact damage the insulin crystals and alter the pharmacokinetics of the insulin.
3. Caninsulin is not currently available in a vial that is compatible with the insulin pens that are on the market.
4. These devices have been designed to deliver insulin through human skin. There is no evidence that insulin can effectively be injected through dog or cat skin. The presence of hair might make the injection even more difficult.

Do not try to top up the insulin dose. It is best to leave your pet until the next insulin dose is required and then continue as normal. A brief period of high blood sugar (hyperglycaemia) due to too low an insulin dose is not as serious or as dangerous as the possibility of causing low blood sugar (hypoglycaemia) by topping up with too much insulin.

Contact your veterinary surgeon and explain the situation.

Monitor your cat carefully for signs of low blood sugar (hypoglycaemia):

• hunger
• restlessness
• shivering
• unsteadiness
• very quiet or sleepy

If you see any of these signs try to encourage your cat to eat a small meal or if this fails rub some glucose solution or honey onto your pet’s gums.

The following signs may indicate hypoglycaemia:

• restlessness
• trembling or shivering
• unusual movements or behaviour
• unusual quietness or sleepiness.
• loss of consciousness (coma)

What to do if you see these signs

1. Provide food immediately.
2. If your pet refuses to eat or cannot eat, administer glucose as quickly as possible. Always keep a source of glucose ready to make a solution when needed, for example glucose powder which can be mixed with tap water. Give one teaspoon of glucose per 5kg (11lb) bodyweight. Administer the solution very carefully, particularly if your pet is unable to swallow properly or is unconscious. Make sure the solution does not go down the wrong way. If your pet is unconscious or unable to swallow, rub the glucose powder into the gums and especially under the tongue. Watch your fingers to avoid an accidental bite. If glucose is unavailable, use honey or jam.
3. As soon as your pet shows signs of recovery, feed it a small amount of its normal food. Watch your pet closely for several hours to make sure that the signs do not return and feed small amounts of food regularly. Inform your veterinary surgeon.
4. If your pet’s condition worsens or you are unsure, telephone your veterinary surgeon immediately.

It is perfectly safe for your diabetic pet to receive their annual vaccinations. In fact, this annual check up also gives your veterinary surgeon a good opportunity to give your pet a complete check up. By keeping your diabetic pet healthy, there will be fewer fluctuations in his/her insulin requirements.

Your diabetic cat may need an anaesthetic for a minor procedure like teeth cleaning. Mouth infections could affect your cat's insulin requirements so keeping teeth clean is advised.

Normally animals need to have an empty stomach before they are anaesthetized. A diabetic pet that has not been fed needs less insulin. Your veterinary surgeon will advise you how much insulin to give your pet before it is admitted or may wish to administer a reduced dose of insulin for you. Usually a diabetic pet is administered intravenous fluid therapy during anaesthesia. This is a means of giving fluid to the animal when it cannot drink itself. Apart from needing a reduced amount of insulin and fluid therapy (which is also given to some non-diabetic animals undergoing anesthesia), your diabetic cat is not at any additional risk from anaesthesia compared with a normal cat of the same age.

Diabetic cats must be fed regularly. Some cats prefer eating small amounts throughout the day. If this is your cat’s habit, your veterinary surgeon probably will not try to change it. Many cats simply refuse to eat different food. If your diabetic cat will not eat the diet prescribed, your veterinary surgeon will advise you on another suitable diet. If your cat is overweight, your veterinary surgeon will advise a weight management programme to help reduce its weight gradually. Weight loss will make your cat’s diabetes easier to manage.