and decreased activity. If the diabetes has been present for many weeks, the cat may show hind limb plantigrade stance and joint sensitivity (pain while being restrained for blood collection). Cats are predictably unpredictable, so some diabetic felines are inappetent rather than polyphagic, more active rather than less, and/or gain weight instead of losing body condition. Often, owners are unaware of increased drinking and urinating. Early cases may have only mild weight loss.
Cats are not deficient in, and are not responsive to, chromium, zinc, manganese or vanadium. All these minerals taste bad to cats and therefore decrease their food intake.
Designed specifically for geriatric pets, Cholodin® may help with the following symptoms: Disorientation, confusion • Loss of appetite • Increased sleep time
Feline diabetes mellitus – part 1
It’s a disease we see all too often in cat patients. Here’s a look at diagnostics as well as managing early DM with diet, medication and herbs. by Dr. Lea Stogdale, DVM, Diplomate ACVIM Small Animals
Diabetes mellitus (DM) in cats is similar to human Type 2 diabetes in humans. The causes in cats include: • Obesity • Inactivity • High carbohydrate food • Pancreatitis (probably exacerbated by grain in cat food) • Hyperthyroidism • Hypersomatotropism (large cats) caused by excessive pituitary growth hormone secretion. These conditions all increase blood glucose (BG) or insulin resistance. The first four predispositions can be eliminated by feeding grain-free moist cat food. Hyperthyroidism can be controlled. Hypersomatotropism is untreatable at present except at a couple of universities that ablate the pituitary
12
integrative veterinary care
gland using either surgery or stereoscopic radiation therapy. Pathophysiologically, diabetes mellitus in cats is a combination of chronic hyperglycemia due to the feline deficiency in glucose oxidase and excessive carbohydrate ingestion, and/ or thyroid or somatotropin hormone excess, and insulin resistance. Hyperglycemia leads to pancreatic islet beta cell toxicity and exhaustion. Rapidly bringing the BG under control often allows the pancreatic islet beta cells to recover their insulin-secreting ability with resulting normoglycemia.
Diagnosing feline DM The accurate diagnosis of diabetes mellitus and all complications is essential. Typical history and physical findings are polyphagia, polydipsia, polyuria, weight loss
Diagnosis is made on the results of urinalysis, complete blood count (CBC) and differential, serum chemistry and total thyroid (T4) level. A blood glucose above 8 mMol/L = 145 mg/dL is abnormal. If the level is under 11 mMol/L = 200 mg/dL and the cat was stressed by the blood collection, then a confirmation of hyperglycemia is required. Strong glucosuria with some ketones, or a non-stressful ear prick BG, is confirmatory. Very occasionally, we require a serum fructosamine to confirm diagnosis because we are unable to collect a non-stressed blood sample. In uncomplicated diabetes, the CBC may show a mild stress leukon or leukocytosis. The serum chemistry is generally unremarkable, with mild increases in liver enzyme levels in severe cases. Typically in cats, the alkaline phosphatase level is normal due to its short halflife and urinary excretion. The serum creatinine may show a pre-renal, mild elevation due to dehydration. In a cat losing weight, the T4 should be less than 25 nMol/L = less than 2.0 ug/dL.
Consider T4 levels When an animal is ill and losing weight, the body’s reaction is to increase stress hormones. This results in adrenal cortical hyperplasia, hyperactivity and an increase in the serum cortisol level. This suppresses thyroid function, causing sick thyroid syndrome. T4 needs to be considered within the context of the patient’s disease status. In a cat with uncontrolled diabetes, weight loss and dehydration, the T4 level should be low; the cat has sick thyroid syndrome.
•
Impaired hearing
Poor, thin, or dry coat Inappropriate urination
800-856-4648
www.mvplabs.com
Available through your Veterinary Clinic
“I recommend Cranimals Original for patients with high pH levels, post urinary tract infections, and to decrease the incidence of urinary stones. I am also a fan of the antioxidant properties and the dental benefits. Overall, this product has made many of our clients very happy and I am pleased with the results!” Dr. Gary J. Duhr, Ramapo Animal Hospital, New Jersey, USA.
detoxification
antioxidant urinary tract
skin, eye & brain joint + mobility
calming
Visit www.cranimal.com to view our complete line of pet health supplements
integrative veterinary care
13
