Not many cat owners would greet the news that their cats are diabetic with sangfroid. That diagnosis does carry a life sentence of needles and injections, and, to most owners' way of thinking, eventually devolves into worsening symptoms and dead-end complications. Mosette Eibert is an exception to that rule. When Eibert learned that her pudgy, 13-year-old domestic longhair, Perry, had diabetes, her response was immediate.

"I was so happy," she says. "I was glad that's what it was."

Eibert, a veterinarian, specialized in feline medicine while serving her residency at Kansas State University. Thus, she understood that Perry's symptoms--which included a compelling thirst, frequent urination, and weight loss---could have spelled life-threatening disease in capital-punishment letters. Moreover, she already knew several heartening facts about feline diabetes: The prognosis for diabetic cats is generally good. Feline diabetes is usually manageable; and diabetic cats do not suffer blindness, circulatory problems, or other complications that human diabetics do.

"Diabetes is an easy disease to live with," Eibert says. "At first it seems terrible and overwhelming, but it just takes a little getting used to. It's one of the easier chronic diseases to manage, and it's not fatal when treated."

Nor is treatment all that expensive. The initial cost of diagnosis and insulin adjustments can run several hundred dollars. After that, say one Canadian couple who have been treating their diabetic cat for seven years, insulin and needles cost about $ 200 a year. (Those costs, of course, will vary from one country, state, county, and city to the next.)

Cause and Effects

Diabetes results from the pancreas' inability to produce adequate amounts of insulin, a hormone especially important for metabolizing carbohydrates. The chief signs of diabetes are increased drinking, increased urination, and weight loss.

"When food is digested," explains Michael Henson, D.V.M., "it's broken down into basics such as sugars and amino acids, which are then absorbed into the bloodstream." Insulin is needed for transporting basic food substances, particularly sugar or glucose, into body cells, says Henson, a resident in internal medicine and a feline-diabetes researcher at the University of Minnesota. The body uses sugar for energy, growth, and repair. What's more, sugar opens the cells' gates so that glucose can move from the bloodstream into tissue cells where it's needed--in muscles, for example.

Without enough insulin, glucose accumulates in the bloodstream. Because it cannot move into the tissues where its presence is required, it is lost in urine. Body water is lost in urine, too. Consequently diabetics produce a large volume of urine. This, in turn, "causes changes in urinary habits," says Henson. "Cats urinate more frequently, or they urinate outside the litterbox. The high urine output also increases thirst."

Although blood-glucose levels are excessively high in diabetic cats, their tissues are starving for energy because glucose cannot get into their cells. As a result, diabetic cats usually lose weight.

Who's at Risk?

Diabetes is one of the most common hormonal imbalances in cats. It affects one in 400 cats [one quarter of 1 percent]. Most of its victims are more than seven years old, and males are more likely to be stricken than are females. Because obesity by itself can cause insulin resistance, overweight cats are more likely to be afflicted with diabetes. A recent study of 2,000 cats in 31 veterinary clinics conducted by researchers at Cornell University's College of Veterinary Medicine revealed that overweight cats were four times as likely to contract diabetes than were cats of average weight. In addition, cats with hyperthyroidism, Cushing's Disease, acromegaly (excessive growth hormones), or chronic pancreatitis are predisposed to diabetes, as are cats taking the drug Ovaban, which is often used to combat behavioral problems.

Arriving at a Diagnosis

Veterinarians look for clinical signs of diabetes and the presence of high sugar levels in the blood and urine when making a diagnosis. Examining both blood and urine samples is critical for an accurate diagnosis because cats that get bent out of shape by veterinary offices may release stress hormones, and these will cause blood glucose to rise, albeit temporarily. If elevated blood-sugar levels are merely stress induced, however, a urine sample will usually put the lie to those figures. It will not reflect a similar increase in blood sugar because the newly released sugars will not have had time to accumulate in the urine.

Prognosis? Not That Bad.

There is no cure for diabetes, but it is neither fatal nor progressive if it is managed properly, although diabetic cats are more susceptible to urinary-tract infections. "With treatment," says Henson, "most cats can live a happy life for many years, provided they don't have any other illnesses. Even cats with concurrent illness can still be managed for several years, depending on the problem."

Managing Diabetes

Medication and diet are used to control diabetes in most cats. The majority of feline diabetics receive insulin injections, but some are given oral hyperglycemics (blood-glucose-lowering drugs) such as glipizide instead. Although some cat owners prefer pills to injections, the majority of veterinarians believe insulin injections are the best choice for most cats.

"Current data suggests that approximately 40 percent of cats respond to glipizide," says Henson, "but insulin gives a more consistent response."

There are several types of insulin available, so a veterinarian must find the best type, dosage, and frequency of administration for each cat. Three out of four diabetic cats need twice-daily injections, usually at 12-hour intervals. The rest need only one shot a day. In determining a cat's insulin regimen, a veterinarian usually selects a type of insulin that works for the majority of cats and administers a dose to see if it evokes a response in the cat. In order to monitor a cat's response, the veterinarian may have to keep the cat in hospital a day or two.

"Cats are sent home fairly quickly," says Henson, "even when we know they're not well-regulated, to allow them to get used to the new insulin. The cat's appetite, attitude, and activity levels are different at home than in the hospital, so sending cats home to get used to that dose of insulin is ideal."

On Pins and Needles

Before a cat is discharged, its owners are shown how to administer insulin injections. While cat owners may cringe at the idea of injecting their cats, most cats find injections far less horrid than pilling. "You don't really have to restrain the cat," says Eibert. "Just pick up the skin between the shoulder blades, stick the needle in, and you're done."

Henson advises holding the syringe so that "you can insert the needle and push the plunger without having to adjust your grip. One finger should be poised over the plunger when you insert the needle into the skin. Some people put the needle in and then let go of the syringe for a second so they can get their finger over the plunger. This makes the needle bounce around and hurt."

Some owners arrange their cats in a favorite position, perhaps slung over a shoulder or cuddled on the lap. Others quietly approach their cats and inject them while they're sitting or lying down. Many owners prefer that another person hold the cat, at least until they become more adept at giving injections. No matter what the approach, using a minimal amount of restraint, which cats naturally resist, helps to keep the experience stress and scratch free.

Food rewards also help, says Eibert. "Whenever it's time to give an injection, I also do a food reward. When my cat hears me getting out the insulin and syringe, he always comes running into the kitchen and sits there while I give him the injection. I pet him and praise him and give him some food."

Reusing needles is foolish economy. After one use needles are no longer sterile, and bacteria from the cat's skin can contaminate the whole bottle of insulin when a used needle is stuck back into the vial. Moreover, needles become dull very quickly, and dull needles hurt.

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