Diabetes with Coma in Cats

Owners must be very careful to monitor insulin dosages, because the dosages may need adjustment depending upon appetite, infection, energy level or behavior. If an insulin overdose is accidentally administered, the cat may become disoriented and sleepy and lose consciousness. 

Diabetes is divided into two diagnoses for cats, insulin-dependent and non-insulin-dependent. One out of 1,200 cats will become diabetic, and most diabetic cats will become insulin-dependent. These felines will require oral medications or insulin injections to control their diabetes.

Hypoglycemia, or low blood sugar, may occur in cats receiving insulin orally or through injections. 

The cat may show signs of:

• Restlessness
• Shivering
• Lack of coordination
• Seizure
• Coma

Diabetes mellitus is a common condition of older, obese felines. Male cats are more likely to become diabetic than females. 

Causes other than or combined with obesity may include:

• Hypothyroidism
• Cushing's disease
• Chronic pancreatitis
• A medication like prednisolone

The Burmese breed of cat seems to be more susceptible to diabetes in Australia, New Zealand and the United Kingdom. The disease does not seem more prevalent in North American Burmese cats.

Most diabetic cats will require injectable or oral insulin at some point. Each cat is quite different in eating habits and requirements of insulin. Maintaining insulin levels for some cats is easy for a pet owner to manage, but some cases prove more difficult. Regular blood sugar testing is necessary to determine the correct amount of insulin needed. If the insulin dose is too high, the cat will become lethargic and fall into a coma. 

Diabetic coma is a medical emergency.

When insulin is not produced or a cat is insulin resistant, the cat cannot use sugars as an energy source. Then the body begins to break down and use fat and protein as an alternative. This is when pet owners begin to notice ravenous eating and weight-loss simultaneously. Water consumption and urine output increase noticeably.

A veterinarian will administer the following tests:

• A urinalysis to check for glucose or infection in the urine and ketones indicating improper fat metabolism.
• A complete blood count, or CBC, to check for abnormal blood cell components, as blood cells may rupture due to loss of electrolytes.
• A serum glucose sample to determine blood sugar levels.

If the cat is in a diabetic coma the animal will be unresponsive and need immediate treatment.

If the cat is in a coma, oral glucose solution or corn syrup will be given immediately. Fluids forced into the mouth of an unresponsive cat may be aspirated and result in pneumonia. The veterinarian will rub the gums with the glucose solution or corn syrup if this is the case. An IV dextrose solution will be run if oral administration proves ineffective.

Oral medication like glipizide may sometimes be ordered for diabetic cats in good condition. This is a medication that lowers blood glucose. Some side effects include vomiting and liver damage. Glipizide medication is dependent on frequent checks of blood glucose levels. Eventually, most animals on oral dosages will require injections.

Most cats with diabetes need insulin injections twice daily. Although it sounds counter-intuitive, injections are usually easier to administer than oral dosing. The veterinarian will provide instructions on how to administer the injections at home. The insulin must be given at specific times every day. Every individual cat is different, so the veterinarian will determine exactly the type of insulin, the dose, and frequency of the injections.

Management of a diabetic cat requires strong motivation and commitment. Obesity limits insulin sensitivity, so if the cat is overweight, he will need to lose weight. Weight loss in obese cats should be gradual, so a safe dietary plan will be provided by the veterinarian. A diet high in fiber and complex carbohydrates is filling and the fiber helps control blood sugar. 

If the cat is underweight due to diabetic metabolic disorder, a high-calorie diet will be ordered until proper weight level is achieved.

Many cats have no routine in feeding, unlike dogs. For diabetic cats, a feeding routine is necessary. In the best circumstance, a diabetic cat should be presented with half rations before each insulin injection. He can then eat the other half of the ration as free choice. If the cat is receiving oral medication, food timing is not critical, but intake should be closely monitored.

Caring for a diabetic cat at home requires close effort between owner and veterinarian for optimal results. Monitoring of urine output, weight and water consumption is necessary every day. If multiple cats live in the house, a separate litter box for the diabetic cat to use is ideal. Feeding the same amount of food every day will help determine the amounts necessary for diabetes control. 

Home glucose testing is available if suitable to owner and cat.

Diabetic needs change over time. Veterinary treatment is imperative when signs of thirst, weight loss, increased urination or ravenous appetite recur.