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Diabetes Control
There are two considerations when giving advice for diabetes control that you should be aware of. The first is that vets develop a routine that works for them and even though there may be a theoretical "best" approach, it may not work well for your vet. The second is that someone has tried and probably recommended in writing, almost anything you can think of as a method of helping control insulin in diabetics.
The ideal situation for feeding would be a cat who eats very small amounts very frequently throughout the course of the day, probably. We recommend leaving dry food out for cats all day and feeding three supplemental meals of a canned food to entice them to eat, one when the insulin injection is given, one later in the afternoon and then one in the evening. The total calories consumed should stay approximately the same each day, if possible. Many cats are cooperative about this and will consume roughly the same amount from day to day.
The ideal diet is controversial but currently the moderate fiber diets seem to be the most favored by nutritionists and endocrinologists. Hill's version of this is w/d and there are similar diets available from Purina, I think. Consistency is important and if it is easiest to get this using c/d I think that would be OK, personally. I don't use it for my diabetic patients simply because most of them already have favorite foods that they have taught their owners to use and I want the cat to want to eat and to eat consistently -- so feeding its favorite foods when they don't seem harmful seems best to me.
If you can get your cats insulin requirements regulated the increased hunger and thirst will lessen or even disappear. Insulin "unlocks" the cell's ability to transport glucose (the sugar the body uses for energy) into the cell. When it is not present in sufficient quantities the effect is a little like stacking up a ton of food just out of reach of a person in a cell -- they have all the food they need but they can't reach it. In diabetes there is plenty of sugar in the bloodstream but the cells have no way of getting it. The thirst comes because the sugar causes diuresis and dehydration, leading to thirst.
Ultralente insulin given once a day does not work to control diabetes well, it is best to go to twice daily injection of the insulin. In some cases switching types of insulin is helpful, too. Lente insulin (Lente Iletin 1 or Humalin L, rx) given twice daily is more successful in some cats and NPH insulin is also used in some resistant cases. It takes a lot of cooperation between the cat owner, the vet and even the cat to regulate insulin well.
Please see http://www.vetinfo4cats.com/cdiabetes.html for more information.
Last edited 01/13/08
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