An Introduction to Diabetes Mellitus; AKA Feline Diabetes

This is Sneakers:

Sneakers has feline diabetes. Feline diabetes is very similar to the disease in Humans. There is Type 1 Diabetes where the body fails to produce enough insulin, and there is Type 2 Diabetes where the body develops insulin resistance. Sneakers has Type 2 Diabetes. He's an old guy, about 13 at this point and was an outdoor cat until he moved to NYC with his mom about 5 years ago. His diet had mostly been dry cat food and whatever he managed to catch outside. While there are many contributing factors to why cats may develop diabetes, such as obesity, increasing age, physical inactivity, male gender, neutering, and glucocorticoid (steroid) therapy, I feel the most probable cause in his case was the transition to an indoor lifestyle combined with consuming dry food.

Dry food is a super convenient way to feed your cat. It enables you to free-feed (which is honestly not great for a lot of cats). I remember when we could leave for the weekend and just have his automatic feeder take care of him, put out some extra water, and an extra litter box and he'd be fine. Unfortunately, it's also a terrible diet for cats. Dehydration is a common concern for cats on a dry food diet. It can lead to bladder and kidney infections, as well as kidney stones, especially in male cats. Additionally, cats are obligate carnivores. Unlike dogs they are unable to metabolize plant proteins into all of the essential amino acids they need, meaning most grains and plants are useless to them nutritionally. Essentially all dry cat food, unless they are mostly comprised of freeze dried meat, is just empty calories for cats. Obesity can be a common issue for cats on dry food diets because while they are eating a lot of calories, those calories are nutritionally poor and they eat more food than they need to make up the difference. This is a problem because normal and overweight cats who eat dry food were found to have a significantly increased risk of diabetes.

After Sneakers moved to NYC, he gained a bit of weight and became an indoor cat. This just sort of seemed normal with his age. When I moved in with his mom and he was on his own as a cat (her previous roommate also had a cat), we decided to stop free-feeding him and use an automatic feeder to control his portions since he was overweight. It seemed to work well, but we also noticed that curiously he was drinking an abnormal amount of water. Like we were going through almost 20 pounds of litter a week abnormal. We thought maybe he just really liked the water fountain we bought him. It turns out when cats are diabetic, the body works to excrete the excess glucose in the urine, and in doing so causes dehydration due to over urination and he was compensating by drinking tons of water. The weight-loss and excessive water consumption are also some of the earliest signs of Diabetes in cats. When we finally took him to the vet, a blood test confirmed that he was diabetic.

Treatment for Sneakers meant insulin shots, urine glucose monitoring, and a change in his diet. Out vet told us that special diabetic food would not be necessary as long as we switched him to a mostly lower carb wet food diet. This is mainly what he eats now since it's the most affordable food that he likes and fits our criteria. Thankfully his medicine is pretty widely available since long lasting human insulin is also effective for cats (we were prescribed Lantus). Unfortunately thanks to the high cost of medicine in this county it's rather expensive (about $300 for a six month supply + $30 for a 100 syringes). Thankfully that six month supply would usually only be good for a month for humans. I can't imagine how expensive managing diabetes is for people, the cat is hard enough. The urine test strips are also readily available at any pharmacy. In order to test it's suggested that you replace their litter with shredded newspaper and wait for them to use the litter box and then dip the strip in it.

It's definitely been a challenge since his diagnosis. He was used to free-feeding so not being able to eat whenever he felt like it was new to him. He's also a grumpy old man now so he has no qualms about complaining at 2:30 am when he wants food. We use an automatic feeder for wet food to try and keep him on a schedule and not have him wake us up, but that doesn't always work out. It's become some decent practice at never being guaranteed a full night's sleep for if we decide to have kids. He took to the shots OK, we always give it to him at meal time both to ensure he does not become hypoglycemic, but some days he is really over it. It was also meant now when we go out of town that we need to have a cat sitter come by and feed him twice a day and give him his shots. Thankfully although it's intimidating at first we've been able to train a few people how to do it.

We were also worried that the disease was making him tired and he seemed pretty depressed when we got home. We decided he needed a friend, but we also didn't want to commit to an entire cat's life. We were accepted to foster kittens for the ASPCA, but it was taking a while and he didn't seem to be doing well so we went down there to see if they had any old cats with similar needs to Sneakers. They didn't have an diabetic cats who could share a house with another cat, they did however have a little guy with kidney issues who needed someone who would only feed him wet food. Perfect. The staff was thrilled to have someone asking specifically to adopt an old broken cat. This is Wiley:

He's about 11 and a little more broken than they told us originally (has no teeth and came from an NYPD seizure, likely a hoarding situation), but he is by far the cuddliest cat I have ever met. We're happy to have him join our family; Sneakers is tolerant of his presence. They don't really play together and Sneakers has a bad habit of picking on him a bit when he's hangry, but even though he won't admit it you can tell he's much happier having a companion now. Of course now I have to deal with two cats who want attention when I have to work:

The prognosis for Sneakers is pretty good. He may have some kidney damage from before he was treated but it's been a year now and he's keeping a healthy weight and is an old but happy cat. He should have at least a few more years of annoying us in the middle of the night, trying to steal steak off my plate, and picking on Wiley ahead of him. He's a jerk but like all cats he's sweet enough sometimes to make me think he does love us.