Saturday, January 21, 2017

3009. A 3-year-old cat has diabetes

Jan 21, 2016

Complaint of left hind limb lameness. Neuropathy or damage to the hind limb nerves can occur in feline diabetes. Cats present with hind limb paralysis or weakness.

Tel on Jan 26, 2016

Owner happy with outcome of insulin injections SC at 4IU/kg. Cat 5.3 kg

1. No limping
2. More energetic
3. Not so hungry for food as before
4. Drinks normal amounts but did not measure volume (home monitoring for diabetes). Advised to give 300 ml and see how much consumed per 24 hours.
5. Food divided into 2 portions and fed after CANINSULIN insulin injection at 7 am and 7 pm (working and therefore unable to give 2nd injection 8 hrs after first as advised by some experts.

1. Eats a lot
2. Drinks a lot
3. Pees a lot
4. Lose weight

Blood and urine glucose high.

Blood glucose  13.5 mmol/L
 (3.9 - 6.0) from Quest Lab
(5.5 - 10) from another report.

Hb  7.4   (9-15)
RBC  4.8   (5-10)

pH 7.0  (5-9)
SG 1.028  (1.005-1.030)
Glucose 3+  (normal should be 0)

Blood trace

White blood cells 5/uL
Red blood cells  4/uL

Normal glucose level  (3.9 - 6.0) Quest Lab
Normal urine  No glucose

Normal glucose level  100 - 180 mg/dl (5.5 - 10 mmol/L) in another report, not Quest Lab which is 3.9 to 6.0
Normal urine  No glucose

Normal glucose level  80 -120 mg/dl (4.4-6.6 mmol/L)
Normal urine  No glucose

Caninsulin SC 2x/day for this cat. But it lasts around 8 hours, not 12 hours.
ProZinc (protamine zinc recombinant human insulin) last 12 hours but are not available in Singapore.
The owner gives 12 hourly injection of Caninsulin as he works and has no time for 8 hourly. as recommended in cats. Caninsulin recommends around 8.30 am and 5.30 pm injections 2 x/day.

Dietary changes (low carbohydrate diet) - weight and 2 portions after insulin injection
May take a month or more to achieve good regulation

Unlike dogs, some cats may go into remission and therefore do not need insulin injections by eating a good quality low carbohydrate diet. This is because 80-95% of diabetic cats suffer from Tupe 2 (insulin resistance) diabetes and therefore dietary control will do.  Type 1 diabetes is due to lack of insulin and is common in dogs.

However, initial treatment is by insulin injection and dietary control and home monitoring of blood glucose levels using blood glucose meters.

Blood glucose meters are used to accurately monitor the blood glucose level but most owners do not want to do it..  

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