Non-treated Feline Diabetes or unregulated and on-going high blood glucose levels can lead to a number of associated conditions, some of which can be very serious or even life threatening.
Complications include:
- Diabetic Ketoacidosis
- Diabetic Neuropathy (or walking on the hocks)
- Pancreatitis (which may also be the cause of the diabetes)
- Diabetic Nephropathy (Kidney Disease)
- Clinical Hypoglycemia
- Susceptibility to infections (renal, dental, skin….)
Diabetic Ketoacidosis (DKA)
A DKA is the result of dehydration, high blood glucose levels, and the inability of cells to access energy from glucose. This situation leads to the breakdown of fat and muscle cells for fuel which causes acid ketones as a by-product.
A DKA causes severe dehydration. Acids build up in the blood, leading to a metabolic acidosis. At the same time, an electrolyte imbalance starts occurring.
A DKA can cause a severe electrolyte imbalance and dehydration, which can lead to coma and death if not treated immediately.
It is very important if your cat is in higher numbers (over renal threshold, around 225/12.5 for most cats) that you do test for ketones – the sign that a DKA may be starting to develop.
Testing for ketones is done using urine testing strips: ketostix or ketodiastix.
They are not expensive and may be bought in any pharmacy or chemist.
Some newer glucometers will also test for blood ketones, which appear before urine ketones do.
If your cat is showing positive for urine ketones or has a blood ketone test of over 0.6, you need to contact your vet as soon as possible.
If urine ketones are above trace or blood ketones over 0.6 and/or your cat is showing any of the symptoms of a DKA listed below, it is a medical emergency and you need to get your cat to the vet immediately.
Symptoms of a DKA include:
- Lethargy
- Vomiting
- Diarrhea
- Dazed, spacey, “out of it”
- Will not eat or drink
- Acetone breath (may smell a little like apples or nail polish remover)
More detailed information about DKA and what to do with lower level ketone readings may be found on the DCI Forum. Senior Members have personally dealt with DKA and can help.
Diabetic Neuropathy
Diabetic Neuropathy or walking on the hocks is a fairly common side effect of Feline Diabetes.
Neuropathy occurs when on-going high blood glucose levels cause damage to the nerves. The cat will start to have a weakness in its legs (usually the back legs) and will start walking on the full foot instead of on its toes as cats usually do, as shown in this drawing from Pet Health Pro.
Neuropathy is reversible. It is important to get your cat into normal blood glucose range, and Methylcobalamin, a specific form of vitamin B12 can help, although it may take weeks or months for full recovery.
Pancreatitis
Pancreatitis can be both a cause of Feline Diabetes.. and also a side effect of it.
Many cats suffer from at least low-level pancreatitis. One study found that 45% of clinically normal cats (showing no sign of any illness) showed signs of pancreatitis at autopsy. FD cats have a higher incidence of it.
Pancreatitis is literally inflammation of the pancreas: the digestive enzymes that the pancreas secrete to help with digestion become active in the pancreas itself rather than in the intestine as normal. They attack the pancreatic tissue, causing inflammation and also damage to the cells of the pancreas that secrete insulin.
Symptoms of pancreatitis include:
• Anorexia
• Lethargy/Weakness
• Dehydration
• Weight loss
• Vomiting – much more rare in cats than in dogs, and may be intermittent so not realised as being clearly linked to other possible symptoms
• Abdominal pain – which may only be shown by your cat trying to find “cool” places to lie on to soothe its tummy (bathroom basin, tile floor….) or sitting/lying in a “hunched up” way to avoid pressure on its tummy
• Diarrhoea
• Fever
• Jaundice – if the liver has become affected, usually only seen in severe cases
• Light coloured stools – if the liver has become affected
Pancreatitis may be acute (a sudden attack that then disappears) or chronic (an on-going disease).
Both acute or chronic pancreatitis can be more or less severe. In severe cases, extensive organ damage can take place as inflammation spreads to organs surrounding the pancreas leading even to shock and respiratory failure.
Pancreatitis and Feline Diabetes are a vicious circle: the pancreatitis causes difficult to regulate and high blood glucose levels…. which irritate the pancreas and make it worse… which increase the blood glucose levels… etc.
Full information about Pancreatitis and treatments to help may be found on the DCI Forum.
Kidney Disease
The high levels of glucose in unregulated Feline Diabetes can cause damage to the kidneys as they damage the structures that filter waste. The kidneys therefore can not clear out waste as usual.
Kidney disease can be treated even if it cannot be cured. More information may be found on the DCI Forum.
Diabetic cats with high blood glucose levels may also be prone to urinary tract infections, as the sugar in the urine provides a good breeding ground for bacteria.
Clinical Hypoglycemia (or a “Hypo”)
A Hypo occurs when the blood glucose levels drop too low and the brain does not have enough sugar to function correctly.
It occurs due to an overdose of insulin:
Symptoms of a Hypo include:
- Weakness
- Instability/lack of coordination (problems standing or walking)
- Drooling
- In a very severe case, seizures and coma
A cat that is on a 100% low carbohydrate diet is normally protected against a clinical hypo as long as no severe liver disease is present (liver cancer for example). The liver will function and push the BGs back up if they are too low. If the cat is on a high carbohydrate diet, the liver will not function as it should – it doesn’t react as high carbohydrate food is flooding the body with sugar and doing its job.
A cat on a high carbohydrate diet runs far far more risk of a hypo than a cat on a low carbohydrate diet.
Please do join the DCI forum for more information on the subject, as well as how to deal with low BGs.
Infections
In general, uncontrolled high blood glucose levels will make a cat more susceptible to infection:
- Kidney infections can occur as the sugar in the urine provides an ideal breeding ground for bacteria
- Dental infections may be more common
- Any type of wound may take longer to heal than in a healthy cat
For more information about the above potential side effects and conditions that may be associated with Feline Diabetes and how to treat or prevent them from happening, please do join the DCI Forum!
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