How to Monitor my Diabetic Cat at Home
Cats are very sensitive to transient stress-induced hyperglycemia. Stressed healthy cats can have their blood glucose concentration increase above 300 mg/dL (17 mmol/L), that is 3 times above their normal fasting glycemia. Hence, it is very important to take a cat away from stress when measuring blood glucose and, this is more easily obtained at home than in a vet clinic.
In addition, daily cares have to be provided at home by the pet owner: watching symptoms, monitoring weight, noting if the cat has actually eaten all food. These are very important information for the vet so that she can adjust the therapy.
Blood glucose sampling
The Blood Glucose Curve is a one-day long series of blood glucose measurements. The results are key to helping your veterinarian assess the effect of insulin on your cat diabetes and adjust the dose. It consists of regular blood sampling involving drawing one tiny drop of blood (usually taken in the ear) every 1 to 3 hours for a period of 12 hours maximum. The first blood sample is taken just before the first insulin injection in the morning.
Because the cat is very sensitive to changes in its environment and prone to hyperglycemic stress your veterinarian will probably ask you to perform the blood glucose test yourself at home. A portable home blood glucose-monitoring device will measure blood glucose.
Do not be afraid of taking off some blood drops from your cat. It generally accepts it quite well, especially if you stay calm and, do not show signs of nervousness.
Blood monitoring will be frequent at the beginning of the treatment (every one to two weeks) because it will be necessary to adjust the insulin dose. After a few months, the cat may go into remission and, the treatment may end. If the diabetes becomes chronic, blood glucose monitoring will help evaluate the progression of the disease. Thus, a Blood Glucose Curve is indicated in case of worsening of the cat clinical condition (hyper- or hypoglycemic symptoms), or soon after a change in the insulin dose.
Interpretation of the Blood Glucose Curve:
Ideally, all measurement results should range between 100 and 300mg/dL
(5.5 to 17 mmol/L).
Insulin effectiveness: your vet will assess the ability of insulin to bring down your cat’s blood glucose concentration. She will look at the difference between the highest and the lowest blood glucose values that she will compare to the injected insulin dose. For instance, she will infer a strong insulin resistance from a weak hypoglycemic effect of a high insulin dose.
Lowest blood glucose (= glucose nadir): the treatment goal is to attain a glucose nadir between 100 and 125 mg/dL (5.5 to 7 mmol/L). In no case, it should fall below 80 mg/dL
(4.5 mmol/L) that is clear signal of ongoing hypoglycemia. A glucose nadir above 150 mg/dL (8.3 mmol/L) indicates the insulin dose probably needs to be increased.
Duration of insulin effect: it is the period of time between the insulin injection and the lowest blood glucose or nadir. If the veterinarian notes that the duration of action is not appropriate (too short in most cases), he may decide to change the number of daily injections or the insulin type.
Your vet has prescribed a diet to your cat. It is an integral part of its treatment. It is coordinated with the insulin injections. When assessing the efficacy of the treatment, your vet will need to know what part of the food has actually been eaten by your cat. Your vet will probably ask you to record daily this information. A practical way to do so is to note the food leftovers.
Assessing real calories intake also helps understand the reasons for weight changes.
Relieving or suppressing symptoms is the goal of any diabetes treatment. The objective is to help your cat live a normal life. Noting the presence and the nature of symptoms are one of the main ways to assess the diabetes stage and progression. In addition, the cat owner is in the best position to observe them and write them down. Your vet will ask you to record them on a daily basis and report them to her.
Especially, you will have to pay attention to symptoms of hypoglycemia or to signs of ketoacidosis. Both conditions require that you contact quickly your veterinary surgeon or an emergency veterinary clinic.
Diabetic cats are often obese or overweight. Other cats will be thinner because of overt diabetes. Hence, weight is an important parameter your vet will want to assess. The diet he has prescribed is aimed at reaching progressively a normal weight. Your vet or you might want to visualize these long-term improvements.
Finding glucose in the urine shows that your cat’s diabetes is not controlled. Your vet may ask you to check regularly for glucose in the urine by using urine sticks.
Testing urine for glucose and ketones can confirm a Diabetic Ketoacidosis syndrome (DKA).
All these demanding tasks require you get well informed about the disease. Read diabetes in cats section.