Browsing tag: increased thirst

Sammy’s Story – Feline Diabetes Isn’t As Scary As It Sounds!

Sammy catSammy is a lovely, and much loved, 13 year old moggie who has always been the picture of health. Healthy appetite, healthy weight and body condition – and he seemed pretty happy too. But a few months ago his owner noticed him at the water bowl more than she used to. At first she didn’t think anything of it, but with the extra drinking came extra urination, and it also seemed to be associated with an increase in appetite. But still she assumed that this was normal as the weather was getting colder and he was spending more time inside. However, at his next annual check-up with me, we found out that he had actually lost almost a pound in the past year. I recommended a blood and urine test and his owner agreed, and when the results came back the answer was clear – Sammy was diabetic.

His owner was in tears. How could she possibly cope with a diabetic cat? She works full time and has two small children, and besides, she has no medical training so how on earth would she be able to give an insulin injection twice a day? She even thought about having him put to sleep because she simply wasn’t going to be able to handle his condition. But we had a nice long chat about what it means to be diabetic and what the treatment would and wouldn’t entail, and by the end of the conversation she was willing to give it a try.

What is diabetes?

This gets a bit complicated, but I’ll do my best to explain it. Sugar in the blood (also called glucose) is a very important source of energy for the body and without it the body’s organs (particularly the brain) run out of fuel and start to shut down resulting in lethargy, confusion, fits, coma and even death. Too much of it however can also be harmful and diabetes is a condition that results in the cat’s blood sugar being too high. Most of the time this is because the body doesn’t produce enough insulin, the hormone responsible for lowering and stabilising blood sugar. High blood sugar in turn results in lots of very sugary urine which leads to more frequent urination, and the increased urination causes increased thirst and drinking. A lack of insulin also means that the body’s cells can’t use the glucose, even if there’s lots of it in the blood, so the body starts to break down other tissues such as fat and protein for energy. This then causes weight loss, but also an increase in appetite as the body tries to compensate. Therefore, the four most common symptoms of diabetes are:
Amber drinking

1. Drinking more than normal
2. Urinating more than normal
3. Eating more than normal
4. Weight loss

Diabetes is not the only disease that causes these symptoms, but if all four come together, it puts diabetes at the top of the list.

How is diabetes diagnosed?

Diagnosing diabetes sounds like it should be pretty easy – if a cat has high blood sugar, it has diabetes, right? Not quite. Cats can have high blood sugar for a couple of different reasons, the most common being stress. And what cat isn’t stressed by the time it gets to the vet, let alone has its blood taken for testing? It is therefore important for your vet to make sure that it isn’t just stress causing the high blood sugar. One of the easiest ways to do this is to test the urine for sugar as well – if there is sugar in the urine, chances are the cat is truly diabetic but this still isn’t a perfect test. If your vet suspects that your cat may have diabetes, a second blood test will typically be run. This could either be, depending on your vet’s personal preference, a single test called fructosamine, or a series of glucose measurements over several hours called a glucose curve. Fructosamine measures the average amount of glucose in the blood over the past 2 weeks (thus making it a more accurate test than a single glucose measurement) whilst a glucose curve measures both the highest and the lowest blood sugar levels on a curve over the course of a day. Both tests are used commonly and both can help the vet diagnose and treat diabetes.

And now the scary bit – how is diabetes treated?

Because diabetes usually means the body doesn’t make enough insulin, the best way to treat diabetes is to give the body more insulin. This may sound easy, but unfortunately insulin can only be given by injection with a needle under the skin. And it has to be given every day, usually twice a day, at about the same time each day so a regular routine is essential. The good news is that the needles are very very small, and so is the volume that needs to be injected. Therefore most of the time the cat doesn’t even seem to notice, especially once they get used to the process. The bigger concern for the cat is having to go into the vet periodically for check-ups and blood tests to see how their body is coping with the treatment, but even that isn’t too bad and once their condition is stabilised these checks can often be done less often.

Another thing that may help is a change of diet to something that is high in protein and low in carbohydrates (the nutrient that gets broken down into glucose after digestion). It is important to monitor your cat’s diet when they are on insulin, as if they do not eat regularly, the insulin could actually hurt them. Similarly, weight loss can help the body better regulate its glucose metabolism so losing excess weight in a controlled manner could make a big difference to their treatment and in some cases may even result in the disease resolving completely.

If your cat is diagnosed with diabetes treatment is essential. It is not generally acceptable to allow the disease to go untreated as it can cause significant discomfort and severe problems for the cat. With insulin therapy, a well-managed diabetic cat can go on to live many healthy, happy years. Insulin, however, is not without risks itself, as giving too much of it can result in a condition called hypoglycaemia, or blood sugar that is too low. As mentioned above, this is a life threatening condition that can result in lethargy, confusion, fits, coma and even death. You should speak with your vet about what symptoms to look out for and how best to manage them should they arise and it’s very important that you let your vet know immediately if you think your cat may be hypoglycaemic.

I am happy to say that both Sammy and his owner are doing very well today. His owner gives him two injections a day, which she has fit into the family routine and no longer sees it as a bother, just something else that has to be done. She has even offered to speak with other owners of newly-diagnosed diabetic cats to give them the confidence they need to get through the initial diagnosis and first few weeks of treatment. So if you find yourself with a diabetic cat, don’t be discouraged, it’s not actually that scary and yes, you can do it!

If you are worried that your cat is showing the symptoms described above, please talk to your vet or try our Interactive Cat Symptom Guide to help decide what to do next.

Hyperthyroidism in cats.

This is one of the most commonly diagnosed endocrine (hormonal) diseases in cats.

Many older cats suffer from a variety of symptoms which might just be put down to ageing, or might previously have been attributed to kidney disease, but many of these will actually be in the early stages of hyperthyroidism. Over the last 20-30 years a great deal of research has been done on this disease, and treatment has improved as a result.

The thyroid glands lie in the neck, one either side of the windpipe, with occasional extra smaller glands present in some cats. The glands produce thyroid hormones which are involved in regulating metabolism, so they have an effect on most systems of the body. The glands can become enlarged and overactive, producing too much thyroid hormone. This is usually because of a benign (non-cancerous) change in the thyroid gland, but more rarely it can be caused by a tumour called a thyroid carcinoma.

Fluffy-BWThe typical cat with hyperthyroidism will be an older cat with some or all of the following symptoms:

  • loss of weight
  • increased appetite
  • increased thirst
  • increased heart rate
  • heart murmur
  • restlessness or hyperactivity
  • digestive upset
  • an unkempt coat
  • swelling of the thyroid glands in the neck

These sorts of symptoms will arouse suspicion that hyperthyroidism is the cause, but it can only be confirmed with a blood test to measure the levels of thyroid hormones. This would usually be combined with other tests to check kidney and liver function and to check for diabetes, as all these can have similar symptoms and of course there might sometimes be more than one problem going on.

If hyperthyroidism is diagnosed, treatment usually begins with tablets. The drugs reduce the production of thyroid hormone. The dose and frequency will depend on which drug is used and on how high the thyroid hormone levels were on the blood test. After 2 or 3 weeks a second blood test will show whether the levels are becoming closer to normal, at which time the dosage may be changed. If this treatment suits the patient, it can be continued long term with regular monitoring by blood tests. However, some cats are harder to give tablets to than others, and a few will suffer from side effects.

Another treatment option is surgical removal of the thyroid glands, which is usually very successful and offers a more permanent solution. The operation does involve some risks, particularly the risk of damaging other small structures next to the thyroids, like the parathyroid glands. (These are important in regulating the levels of calcium in the blood, and if damaged during surgery supplementation with calcium could be needed.) A cat with heart problems may be a poor risk for surgery, but often tablets can be used first to improve health so surgery is a better option, and additional drugs to control any heart problems may be given. In most cases, cats which have had their thyroids removed will not need to take tablets, but sometimes the problem can still return later, if for example the cat has some smaller gland tissue which was not removed with the main glands. This extra thyroid tissue, known as ectopic thyroid tissue, can be located anywhere in the neck or even within the chest. In some cats only one thyroid is affected at first so only one is removed, then some years later the same condition could occur on the other side.

The other main treatment available is with radioactive iodine, which is a specialist treatment only available at some centres in the UK. Radioactive iodine is given to the cat by injection and it becomes concentrated in the thyroid gland, where the radioactivity destroys the damaged tissue. One of the disadvantages of this treatment is that the cat has to be hospitalised for several weeks because of safety issues surrounding the radioactive material used. It is not dangerous to the cat itself but has to be handled safely to protect people working with it.

Decisions on which treatment would be best for an individual cat are best made in conjunction with the vet who knows all the details of the case. Where complicating factors like heart disease or kidney disease are present, these need to be treated as well. Once diagnosed, the outlook for a cat with hyperthyroidism is usually very good. Whichever treatment is used, it is likely to prolong life and improve the quality of life.

If you are worried that your cat is showing any of the symptoms listed, talk to your vet or use our interactive Cat Symptom Guide to help you decide what to do next.

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