My 2 year old cat was just diagnosed with Diabetes

by Laureen
(Hawthorne, NY USA)

Hi Dr. Neely,

I went to the vet yesterday with my 2 year old male cat Smokey because, in a matter of 2 days, he seemed to get lethargic and was sleeping a lot. He had a fever of 103.7. The vet gave me feline antibiotics and did blood work on him.

The veterinarian called today and told me that my cat has feline diabetes and has to eat special food (that he sells) and that I will have to learn to give my cat insulin injections. (Once again, he sells everything to me.) I asked my veterinarian, since my cat is overweight (15 - 16 lbs), whether I can try a dietary change first.

These are the numbers that were high on my cat’s blood work and urinalysis:
Glucose 244, CPK 1,377, WBC 18.0, MCHC 38.2,
Neutrophils 84, Absolute Neutrophils 15,120
Urinalysis: Specific gravity 1.070, Protein 2+, Glucose 3+.

Can his numbers be elevated for feline diabetes because he has an underlying infection? Can I try a dietary change first before giving him injections? He did not have excessive thirst or any other symptoms other than being overweight, which I contribute to his appetite.

Please help if you can. I don't know what to do in this situation. I feel as if the veterinarian is rushing me into the insulin shots.

Thank you,

Dear Laureen,

I have often seen blood glucose readings in that range simply from stress. Cats can become quite stressed from the trip to the veterinarian, from other animals in the hospital, and even from the process of drawing blood. However, many of those cats in this range will go on to become diabetic. Especially in a cat that is overweight, as yours is, this can be an early warning sign for feline diabetes.

I detect a bit of suspicion in the tone of your letter when you mention that your veterinarian sells the prescription diet and insulin for your cat. Vets are supposed to sell these items, and any ethical veterinarian would not recommend these things unless it was medically necessary. If you do feel suspicious of your veterinarian’s recommendations, or if you are otherwise unhappy with the care your veterinarian has been providing, I would suggest that you look for another vet. Ultimately, you need to feel safe with and trust your veterinarian to provide the best care for your kitty.

Insulin should not be started based on a single glucose test. Your cat’s blood glucose should be tested a number of times before beginning insulin. This is not to say that your veterinarian is wrong in his diagnosis, because as I said before, your cat does have warning signs for feline diabetes. An inconsistency with this diagnosis is the specific gravity result in your cat’s urinalysis. The specific gravity of your cat’s urine is inconsistent with feline diabetes because it shows that your cat’s urine is very “concentrated.” Generally, diabetic cats have very dilute urine. The presence of glucose in your cat’s urine could be the result of two different cat illnesses. The first, of course, is feline diabetes, but the other could be kidney disease, which could be the result of an infection or other kidney problem.

I would not begin your cat on insulin without repeated tests. However, considering the elevated glucose levels in your cat’s blood and urine, and his increased weight, I would strongly recommend feeding a low carbohydrate diet. For great information on feeding cats low carb diets, please see the Diabetic Cat Care website and visit Binky’s Page for a list of the carbohydrate content of many types of cat foods.

Best wishes,
Dr. Neely

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