Different Approach To Treating Cat Diabetes

Dr. Jennifer Coates writes that she recently started taking a different approach to treating cat diabetes and it is an approach that that many veterinarians are starting to follow. The new technique has been called the Ultra Loose Control Approach.

This method was developed because a Dr. Norsworthy, a feline specialist, believed that too many cats were being euthanized due to the hassles and expenses associated with the previous approaches.

“Dr. Norsworthy says that his Ultra Loose Control Approach is built on the premise that
• Cats tolerate hyperglycemia with minimal/tolerable clinical signs.
• Cats do not have significant complications from diabetes such as cataracts, peripheral vascular disease, and renal disease.
• Cats tolerate hypoglycemia with no or minimal clinical signs (though this shouldn’t be overstated because severe hypoglycemia can be fatal).”

“The process basically boils down to feeding the cat a low carbohydrate diet (canned if at all possible) and if initial blood glucose levels are high enough, starting twice daily injections of a long-acting insulin at a low dose. Cats are rechecked approximately once a week with a single glucose measurement taken when blood sugar levels are expected to be highest (approximately 12 hours post insulin). Based on the results of this single measurement and MOST IMPORTANTLY a discussion about how the cat’s clinical signs are or are not improving, the doctor will decide whether to increase the insulin dose or leave it alone. Weekly rechecks continue until the cat’s peak blood glucose level is under 350 mg/dl and the symptoms of diabetes have resolved.

Once the cat reaches this point, rechecks can be spaced further apart. Usually this starts out to be around once monthly. Again, a single glucose measurement is taken when blood sugar levels are expected to be highest, and the vet and owner go over a detailed history of the cat’s clinical signs.

If the blood glucose measurement is 300-350 (or even higher) and the cat is symptom-free, all should continue as is. If the cat has clinical signs of diabetes the insulin dose needs to be adjusted upward in the manner that was described previously. If the blood glucose level is below 250 mg/dl and the clinical signs are gone, either the insulin dose needs to be reduced or stopped entirely. These cats may be heading into a diabetic remission.”

This approach reduces the number of vets visits and regular glucose testing. We have always advised regular glucose testing at home and believe that cats get used to having their ears pricked if carried out in the safe environment at home. However this research seems to suggest that a once a week checkup seems to be alright for most cats. It’s a good thing that a low carbohydrate diet is mentioned!

Results obtained by Dr. Norsworthy are as follows:-

“Approximately 30% of cats go into remission
Hypoglycemia is rare
Most live 3-6 years and die of non-diabetes related disease
80% or more are over 10 years old at the time of diagnosis
Many are over 14 years old”

It’s also wise to remember that if the cat has complications such as other illnesses then this approach may not be suitable. It’s difficult to say how this compares with the traditional approach. However the cat may be getting a better quality of life and if it saves lives due to less cats being euthanized then this different approach to treating cat diabetes has got to be a good thing and worth considering.