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Case of the Month February 2005 Feline Diabetes
9-year-old male neutered Domestic Short Hair cat HISTORY: A two-week history of increased hunger, increased thirst, and increasingly larger urine puddles prompted his owner to bring him to our hospital for examination. He had not been vomiting but his stools had been a little loose. His activity level had not appeared to have changed but given his status of couch potato, activity level was difficult to assess. It was also noted that he had lost one pound of body weight since his last exam one year ago. PHYSICAL EXAMINATION FINDINGS:
PROBLEM LIST:
We began our diagnostic work up by running a complete blood count serum chemistry profile and urinalysis. A fecal test was run to check for internal parasites abdominal x-rays were obtained. LABORATORY RESULTS: The complete count of his red and white blood cells was within normal limits. His blood chemistry panel indicated normal kidney, liver, and pancreatic function. His electrolytes as well were within normal limits. The fecal test was negative for parasites and abdominal x-rays were unremarkable. We did find that his blood glucose level was markedly elevated out of the normal range = 552 g/dl (normal range 64-170). His urine also contained high levels of glucose = +3 (normal = 0) but there was no evidence of infection. DIAGNOSIS: A diagnosis of diabetes mellitus was made based on the clinical symptoms of polyuria, polydipsia, polyphagia, and weight loss in conjunction with lab results showing elevated blood glucose (hyperglycemia) and elevated urine glucose (glucosuria). DISCUSSION: Feline diabetes mellitus is a complex metabolic disease that results when the pancreas fails to produce the hormone insulin or when the cells in the body are unable to use the insulin the pancreas has secreted into the blood stream. In normal metabolic function, food that is eaten is broken down into small sugar molecules called glucose. Glucose is needed by ever cell in the body for its energy to perform its specific function. The job of the hormone insulin is to help glucose get into the cells so they can function properly. Therefore, when there is a problem with insulin production or insulin usage, the energy source glucose is trapped in the blood stream and unavailable to the cells. The end result is that the cells starve and the body is forced to break down its fat as an alternative form of energy. Clinically this is demonstrated by the physical symptoms of weight loss in the face of a ravenous appetite. The other characteristic clinical symptoms of increased thirst with subsequent increased urination occur because the increased glucose molecules in the blood steam osmoticaly draw water form the cells into the blood stream leaving the body cells dehydrated. Diabetes can be diagnosed in cats of any age bt the mean age at the time of diagnosis is 10 years. Diabetes is predominately diagnosed in neutered male cats and frequently these cats are over weight. Cats are presented for examination when the clinical signs mentioned earlier become apparent. Generally speaking diabetes is a treatable condition although some patients respond better to treatment than others. Treatment usually consists of giving insulin injections once to twice daily although a small minority of cats can have their blood sugar controlled with oral hypoglycemic. Because a defect in carbohydrate metabolism is thought to contribute to this disease, switching to a high protein low carbohydrate diet is now recommended. (The "catkins diet") FOLLOW UP EXAMINATION: This patient has the very good fortune of having "parents" that have made the commitment to help their cat live with diabetes. They learned how to give the insulin injections, and they worked closely with the veterinarian. For the first 2-3 months he came to the hospital weekly to have his blood sugar levels monitored throughout the day so adjustments to his insulin dose could be made. Fluctuations in blood glucose levels can occur even after the dose seems to be correct and the best way to recognize this is by checking levels daily. They purchased a home glucose monitor, check his levels three times a day and alert us when there are problems. This love and dedication is truly admirable and definitely deserving of being our "Case of the Month". - The Bay Park Pet Clinic Staff |
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Phone: (619) 276-1616 - 1102 Morena Blvd., San Diego CA 92110 |
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