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relaxed burmese cat

Remember Stephen?

Stephen is having a cat nap.  So I guess it’s up to me to tell you all a little bit more about diabetes in cats.

In my previous article – What Does a Cat With Diabetes Look Like? I talked about what diabetes mellitus actually is, what I think about people who taste urine to check for its sweetness, and gave some pointers on signs to watch out for that might indicate your cat has this disease.  Now it’s time to have a quick look at how diabetes in cats is diagnosed and most importantly, what the heck we can do about it.

How Can My Veterinarian Tell if My Cat has Diabetes?

There are two main test results required for a vet to be able to diagnose diabetes in a symptomatic cat:

  1. A high fasting blood glucose (i.e. loads of glucose floating around in their blood even when they haven’t eaten recently)
  2. Glucose present in their urine (known as glucosuria)

Testing these parameters is a piece of cake!  See what I did there?  But here’s where it gets tricky.  Cats can get enormously stressed out by a visit to the vet (kind of like I feel about sitting in the dentist’s chair), and a really important effect of this stress can be a transient elevation in their blood glucose, which can even be significant enough to see glucose spilling over into the urine.  What this means is that cats who do not have diabetes may have a high blood glucose reading, and even occasionally glucose in their urine.  These tests aren’t always diagnostic on their own.

It is best to run a full blood profile rather than just checking the glucose alone.  This assists us with detecting any other illnesses that may either be the sole cause of your cat’s problems or could just be lurking around complicating the situation.

If there is any doubt about the diagnosis of diabetes, a good test to do next is a plasma fructosamine level.  This test gives an estimate of the ‘average’ blood glucose over the preceding five to ten days, so takes out the “cheese and whiskers! I’m at the vet clinic!!!” freak out factor.

come at me bro cat

 Sadly, not all cats are won over instantly by my great looks and razor sharp wit. 

Ok, So We have a Diagnosis, What Next?

burmese cat

Seriously Stephen, I’m starting to wonder what I pay you for!

This is the stage where it’s really important that your vet takes some time to sit down with you and go through things.

 There is more than one option, and to make the right choice for you and your cat, you need to be properly informed.  If you have a very very sick, old cat with diabetic ketoacidosis and maybe even other things going on, your choice may not be the same as if you have a healthy, younger cat that has had diabetes picked up on a routine blood test.

Broadly speaking, the options are to treat, or not to treat.  If you elect not to treat a diabetic pet, that’s ok, and no one should judge you for making this difficult decision.  However,

a sick cat can’t be left untreated

They may be pretty good at hiding it, but they will be feeling miserable.  Imagine being constantly thirsty and needing to pee all the time, always being hungry and never being able to satisfy this hunger.  Diabetic humans report feeling nauseous and unwell when their blood glucose is high, as well as feeling listless and tired.  On top of this, cats can have recurrent urinary tract infections, go into kidney failure, develop high blood pressure, go blind, and experience painful diabetic neuropathy if left untreated.

They could go on like this for a year, or they could develop diabetic ketoacidosis and die within a week.

So if you elect not to treat your diabetic cat, the humane option is euthanasia.  I know this may sound extreme, but as a veterinarian it’s my job to advocate for the animal – and it’s not ok to let them suffer.

I’ve put together a list of things you should discuss with your veterinarian if your cat is diagnosed with diabetes.  It is by no means exhaustive, but I’ve conveniently covered myself by adding the last point.

diabetes in cats things to know

Treating The Diabetic Cat – What’s Involved?

There are four main things we need to cover:

  • Diet
  • Insulin
  • Exercise
  • Monitoring

Which Food Is Best?

Changing the diet can make a massive difference for these felines.  They need to eat a diet that is low in carbohydrates and high in protein.  There are commercial diets that have been designed and balanced specifically for diabetic cats.  These are a really good choice because not only are they convenient, but their caloric content is pretty consistent, and this is so crucially important for managing the diabetic cat.

Some cats might not fancy commercial food, fair enough, and for these fussy felines a home cooked diet may be best.  In these cases an appropriate, balanced and complete diet needs to be worked out with your vet.

Do I Have to Give my Cat Injections?

For most cats with diabetes, injections of insulin morning and night is the best treatment option.  Occasionally cats will not need it if managing their obesity or withdrawing a drug that was causing problems sorts out their glucose intolerance, but this is not really that common.

Some cats (maybe 10 – 20%) may respond to oral medications called hypoglycaemic agents.  However, their use is controversial, because they increase the amount of insulin released by the pancreas and so can wear it out faster.  I have personally never used these drugs in a diabetic cat.

So do you need to give your diabetic cat injections?  My answer is yes.  But wait, don’t panic, it’s really easy, I promise!  Here’s a video of how to do it that I found on YouTube, but when I get a chance I will make a riveting masterpiece of my own for you.

Of course your vet will show you how it’s done and give you the opportunity to have a practice at the veterinary clinic.

 Which Insulin Is Best?

There are many different insulin preparations, and they can come from cows, pigs, or humans (the latter is from recombinant DNA technology).  The main difference between the products is their duration of action.  The choice of insulin is a really up to you and your vet, but my personal preference for maintaining diabetic cats is glargine insulin (the one we use is called Lantus).  It is particularly good for cats that tend to graze throughout the day rather than eating their meal in one sitting.  Another good choice is protamine-zinc insulin, which many cats are well managed on.

Regardless of what type of insulin you use, for it to work best the injections will have to be done twice daily.

What About Exercise?

Bahahaha you may say, exercise!  We’re talking about cats here, not dogs!  But it’s still important to be aware of the effect of exercise on blood glucose.  Exercise lowers insulin requirements.  With cats, over-exercise is unlikely to be problem, and encouraging moderate, consistent exercise can be helpful.

Consistency, Consistency, Consistency, Consistency, Consistency

The overall goal in managing diabetes in cats is to keep blood glucose levels fairly stable, without allowing the cat to become hypoglycaemic (that blood sugar is toooo low) or hyperglycaemic (that blood sugar is toooo high).  We want blood sugar that is juuuuuust right!

So the easiest way to think about it is that insulin brings the blood glucose down, and food brings it up.  We need to match these in amounts and timing to keep everything nice and balanced.

The most essential part of managing a diabetic cat is CONSISTENCY

Sorry for getting all shouty with the caps there, but it’s important. We need a very consistent routine in terms of:

  • Diet
  • Insulin administration
  • Exercise

Keeping the type, amount and timing of food your cat eats the same every day is just as important as giving the right amount of insulin at the right time.  Generally the best time for a meal is one to two hours after each insulin injection, because this is just before the peak insulin activity.  This varies with the type of insulin chosen and is something you should discuss with your veterinarian.


Monitoring Your Diabetic Cat

There are a few ways to monitor diabetic control.

  1. Water Intake – If the diabetes is being adequately controlled, kitty should be a lot less thirsty.
  2. Body Weight – A very simple thing to watch, and if it’s stable then the diabetes is probably fairly well controlled.
  3. Single Blood Glucose Measurement – You want to do this at the time you expect the insulin to be having its maximal effect, so for a cat that has insulin twice daily this is around four to six hours after a dose.  A good reading for a cat at this time is between 7 and 10 mmol/L (or between 180 and 234 mg/dl).  See below for how you can do this at home.
  4. A Glucose Curve – Serial blood glucose measurements taken throughout a day is a more sensitive estimate of diabetic control and is done in the veterinary hospital.
  5. Urine Glucose – This is of limited value because it’s not a very sensitive test and can be affected by too many other factors.
  6. Fructosamine – This blood test gives an idea of the average blood glucose over the preceding five to ten days.

It used to be that every diabetic cat had to visit the vet clinic regularly for a glucose curve to monitor how they were going.  This means staying in hospital for a day and having repeated blood samples taken every couple of hours to plot what is happening to the blood glucose in response the the insulin they are being treated with.  While this is a useful method and certainly has it’s place, it is becoming more and more common for owners to monitor their cats at home.

This is really helpful, because it takes away that stress-induced hyperglycaemia I talked about earlier that can really mess with results.  On top of this, some cats don’t cooperate because they are too stressed to eat their normal meal in hospital, and really, it’s just nicer for them to be able to stay home!

Here’s a YouTube video showing how to monitor your cat’s blood glucose at home.  It’s easy peasy!!


Can Diabetes in Cats be Cured?

A lot of cats diagnosed with diabetes mellitus will have it for the rest of their lives, and I think owners need to be prepared for this outcome.  BUT, it is possible for them to go into remission if they are caught early, and up to half of cats picked up before things have been going on for too long and treated with insulin and a high protein, low carbohydrate diet will achieve this.

red burmese cat

Oh go home Stephen, you’re drunk.

Phew, that was a long one! Congratulations on making it this far!  

If you have a question Stephen and I would love to help you, so please, ask away in the comments section below

Joanna Paul

Dr. Joanna Paul BVSc (hons) BSc

Jo is a practicing small animal veterinarian based in Melbourne, Australia. Working in partnership with loving pet owners to ensure their fur-kids remain happy, healthy family members life-long is what brings her joy. Well, that and taking naps. Jo strongly believes that helping to maintain the wonderful bond between a pet and their human is reason enough for a happy dance.

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Showing 57 comments
  • Morgan

    Hi there. I’m hoping to get some quick advice as our situation has gotten quite bad since yesterday… My beloved cat Bear began vomiting all day 12/31 and eventually it turned from food to blood. We called our vet and took him in first thing New Years Day. Turns out after the blood work that he is very diabetic and now after his second visit to see the vet since Monday, has been put on insulin. However, since Monday he has only eaten one time. He is rapidly dropping weight (was thin to begin with) and is extremely lethargic. I called our vet tonight and he said to skip the insulin and focus on getting him to eat. Ive been attempting to feed him out of a syringe with little luck, more force feeding, which is so stressful especially for Bear. It feels like I’m just watching him slowly die… I love this cat more than I can explain, but things look so bleak and he seems so sick. In a bad case like this, is putting him to sleep something to consider? I don’t want him to suffer and he has been for days now.
    Please help.

    • Joanna Paul

      I have only just seen your message, I’m so sorry for the slow reply. I hope you came to a decision for your beautiful Bear. Whatever you chose, it was a decision made from a place of love and kindness for him. Trust that you have done the right thing. Thinking of you and Bear x

  • Cindy Bond

    Would appreciate any feedback on a situation with my Mom’s cat, Rufio. Rufio was 12 years old and had to be put to sleep yesterday. He was happy, eating and drinking but had started urinating outside of his litter pan a few months ago and it had gotten so consistent and troubling my Mom took him to the vet four days ago. He was diagnosed with a UTI and diabetes. Unfortunately, we don’t have the written records on the tests or results in hand yet. My Mom started insulin shots four days ago and he quit eating and drinking and yesterday he was put to sleep. He had a heart murmur diagnosed this summer and when he died his lungs had filled with fluid. They said he couldn’t be saved. His UTi was treated with an antibiotic. He went from eating, drinking and relatively healthy to dead in four days. Could he have been misdiagnosed with diabetes and could the insulin have killed him or was his diabetes just that bad? Any insight is appreciated.

    • Joanna Paul

      Hi Cindy,
      I’m so sorry to hear about Rufio. It’s incredibly difficult when we lose them so suddenly. I wish I could help give you some closure but I can’t give you the answers you need. Fluid in the lungs is commonly associated with heart disease and this can be very difficult to diagnose in cats. Sometimes they show no signs at all until things are really bad. This may be what happened with Rufio and be unrelated to the diabetes but if you’re unsure of what happened it’s worthwhile sitting down and discussing with the vet who treated him. I’m so sorry – thinking of you and your Mom at this sad time.

  • Heather Martin

    Hi, I have an 8 yr old neutered male who was diagnosed about 6 months ago. Injections morning and evening when he gets his soft food. Because i have 5 other cats I leave food out. He still has massive amounts of urine…….any suggestions on feeding and how to get this under control? Also he is on a ProPlan dietetic while the others get Royal Canin Urinary S/O.

  • Carla Molinari

    My little guy Leroy has just turned 16 and has recently been diagnosed with diabetes. He is currently on twice daily 2ml insulin shots and was prescribed Hills m/d cans. But 4 days after being diagnosed I noticed he was not himself so rushed him off to the vets and it was then determined that his kidneys were struggling as he was really dehydrated. The vet put it down to the new diet so was switch from m/d to k/d cans. Now the problem is that he is refusing to eat it. Also in 16 years he has never been away from me for a night so became extremely stressed at the vets. He is scheduled in for a BG curve but I am worried that his stress levels will make the test incorrect. So I have two questions 1. is there a supermarket brand of canned cat food that I can purchased that is high protein, low carb and low phosphorus and 2. is it possible to do the BG curve at home by me monitoring his levels so that he isn’t stressed?
    Thank you

    • Joanna Paul

      Hi Carla,
      Poor little Leroy (and you!). It’s never easy learning to manage diabetes and the added kidney problems really make it difficult. I would suggest having a good chat with your vet, who will be able to help you more than I can because he/she knows Leroy. Unfortunately the kidney diets can be fairly unpalatable to cats and it’s very important that he keeps eating. I would personally suggest that it may be best to just feed him whatever he will be happy to eat and try to be consistent in amounts and timing, but it really depends on the severity of his kidney dysfunction and concurrent problems. Two possible options for less stressful blood glucose monitoring are (1) doing it yourself at home via an ear prick, your vet may teach you how, or (2) visiting the clinic for a fructosamine test rather than a full blood glucose curve. It means just one blood sample rather than staying all day and its result is not affected by the stress occurring right at that moment (unlike glucose). It give an average idea of his blood glucose over the previous week or so.
      Good luck with Leroy.

  • Denise Love

    I have been searching for info for months and finally today, I came across your page. I have an 18 yr old male cat who suffers with diabetes for the last 9 years..he was doing ok until a few months ago. He can no longer go up and down the stairs very well so I had to move his litter box down stairs. One day he was acting odd. I felt as if he couldn’t see. He was walking along the walls, wouldn’t sit still, seemed to have some problems breathing. This was around 2:00am. Within 40 min he was completely back to himself. He has days where I can’t seem to feed him enough and days where I can’t get him to eat enough before his injection. I cannot afford to have him thoroughly tested plus keep up with his medication. I am definitely going to take him this week to see my vet. He has had a long and happy life. Thank you or this post and everyone’s comments. They truly helped.

    • Joanna Paul

      Hi Denise,
      I’m so glad you found the page and comments helpful. This is why Creature Clinic exists and it means a lot to me. Your cat is very lucky to have someone who has cared for him so beautifully over the years. Thinking of you.

  • Cherlyl

    Hi My Yoda 18 year old Baby Girl. I have been giving her insulin twice a day for over 4 years and for the most part it
    has worked sugar has been level. (have no life but love her so much). My situation now is she has kidney failure and back leg are so bad she pretty much stays in one spot all day and night. Also now she is eating so much not gaining weight so we are sure now her thyroid is acting up. The meds for Thyroid will make her sick and throw off the insulin and she will be miserable. I am giving her pain pills and insulin twice a day. It hurts to see her limp around. She was always a loner now all she wants is to me petted and picked up. I discussed with my Vet and there is no coming back from
    all of this and I have to decide on letting her cross the rainbow bridge. Crying as I type this how do you know it’s time.
    I don’t want to come home one day and find her in terrible Pain especially with the Kidney’s ad legs. I am making an appointment this week and will have them come to my place. Am I wrong? Cher.

    • Joanna Paul

      I’m so very sorry to hear about your precious Yoda. You’ve done so much to give her extra time and keep her comfortable. From everything you’ve said I feel you’re making the kindest decision for her, even though it’s beyond heartbreaking for you. Euthanasia is the gift of peace. She doesn’t know she’s going, and will only drift off into a peaceful sleep. There is no fear for her. It’s incredibly difficult to make such a decision for one you love, and when she’s gone you will never stop missing her, but there still comes a time when it’s the right thing to do. Thinking of you.

  • Tsmi

    My cat is 18 she has just been diagnosed diabetic and possible bladder tumor. Thoughts?

  • Rick

    My cat is just a couple months shy of turning 18 and was just diagnosed with diabetes. I have done a ton of reading and it does seem that with treatment things can go well however with his age I am just not sure about putting him through all that. It kills me to think about euthanizing him however I also think treating him will be more for me and not him at this point. Would anyone else start the treatment on a cat that old?

  • Jenny Muller

    Hi Joanna
    Really pleased to find your post. My 16 year old Burmilla, Cleo, has been diagnosed with diabetes yesterday. My Vet sent away bloods for a full report just to make sure there weren’t any other problems. I decided that if it was only diabetes I would try and manage it, but if there were kidney or liver problems as well I would put her down. Vet phoned this morning to say everything else looked good. PHEW! So Cleo is being monitored at the Vet today and tomorrow so hopefully I can ease into this with giving the insulin injections. I know diet plays a huge role. My Vet is wanting her to go onto a diabetic food, but my concern is there’s too much carbohydrate in these foods. All I’ve read is saying don’t give dry biscuits, don’t give carbohydrate, but give a high protein diet. She always has fresh meat for dinner and I did have her on Royal Canin Senior Consult Stage 2 in the morning but the carbs concern me. I’m probably a bit paranoid as I have a small dog who has had terrible stomach issues, having prescription digestive care biscuits with no good results. I decided to try a high protein, grain free dog biscuit (stay loyal) and I have a changed dog. No stomach issues anymore. A lot of these prescriptive diets, the first few ingredients are maize, wheat etc. With a lot of research I now believe it’s the meat that should be the main ingredient. I would be very interested on your thoughts of giving my now diabetic cat an holistic grainfree canned food and or fresh meat. If I were to give her biscuits (not sure though) what do you think of Black Hawks grainfree chicken cat biscuits. When I look at the ingredients on the packet, it has really good protein, but does have sweet potato and field peas in it. I know Vets must get a bit annoyed with people like myself because they’re the Vet and saying this is the food that’s best but I’m questioning it. I want to do the best for Cleo and I suppose my question is this, do you think my ideas on what I’d like to feed her are good for a diabetic cat? Thank you for your time. Have a great day.

  • Cheri

    My cat Mocha was newly diagnosed with diabetes. It really seems to have come on quickly. She suddenly started losing weight and eating like crazy. She seems obsessed with food and wants to eat constantly and is still losing weight. She has also started peeing and pooping outside of the cat box and drinking a lot of water. Mocha suffers from stomatitis. She has had a full mouth extraction, which unfortunately did not help her. For several years she has had depo injections to help with the pain. Which unfortunately seems to have caused her diabetes. Her stomatitis is so bad that without the injections she would not be able to eat at all. I guess my question for you is what can be done for a cat with stomatitis and now diabetes? She still requires steroids or she will starve but the steroids are what has caused the diabetes? Is there much hope for a cat in this situation? Thanks so much for your advice.

    • Joanna Paul

      Hi Cheri,
      this is such a difficult situation, I’m so sorry. In my opinion, you will not be able to adequately control diabetes in a cat having regular long-acting corticosteroid injections. There are a couple of possible options for Mocha. It may be possible that further dental treatment (including dental radiographs to check for any remaining tooth roots and removal of affected tissue) could make a difference for her mouth, but this depends on the state of her mouth. Otherwise, the depo is used to suppress the immune response in the mouth, and there are other drugs that can potentially have the same effect without causing insulin resistance and diabetes. If you are able to try something else and it works, there is a good chance she will go into remission from her diabetes because it has an external cause.
      I really hope that helps a little – without actually looking at her it’s difficult to provide specific advice. I hope you find a solution that keeps her comfortable, eating and keeps that diabetes in check. x


    I was so thankfull to see all the comments for a diabetic cat, I just found out my daisy has diabetes, how bad i dont know yet and i hope it can be controlled with meds, but they say 90 % have full blown diabetes, I have been wrestling with myself because i go away alot and if daisy needs shots who will do it for me and also the cost. I am struggling with a decision i have to make .

    • Joanna Paul

      Hi Judy,
      it’s an incredibly difficult decision. Sometimes cats who are diagnosed early enough and treated carefully with the right insulin and diet based on their individual needs will go into remission. Sometimes it’s just a matter of getting to a healthy weight and everything stabilises so meds are no longer required. But as you say, many need ongoing injections for life, and if you’re not in a situation to be able to give them consistently it’s just so difficult. I wish you and Daisy all the best, I hope it works out x

  • PATricia Yeomans

    I have been giving my 17 year old diabetic cat prozinc two to two-and-a-half units twice a day for the past three years she has spells every now and again as I call them where I take her to our vet and he gives her shot to help her upset stomach and inflammation sometimes it helps other times it takes four or five visits to the vet before she strains herself out he has recently increased her units to 4 twice a day that seemed to help at first her problem is at night she starts licking herself profusely moaning a lot as if she’s starving she always has fresh water twice a day and dry diabetic cat food twice a day and at shot time she also gets a different type of dry cat food in a smaller dosage she does not get any people food strictly dry diabetic food it hurts me to death but I cannot figure out why she is Moaning and licking herself so much. I keep asking the vet is there something I should be doing differently or giving her a vitamin or an fish oil or some type of a bath that will help with what I feel like is dry skin and possibly a deficiency in a vitamin but he keeps telling me no. do you have any suggestions for me?

    I should also tell you this all started when my husband and I moved into a new home the air here is very dry even for my skin her scratching and moaning started after we moved and this is only happening at night

    • Joanna Paul

      Hi Patricia,
      It sounds as though you are doing an incredible job with your diabetic kitty! The diabetic diet is important. It’s important to try and keep the amounts and timing consistent also, which I’m sure you know. Perhaps you could ask your vet if there is a wet/canned version available. Sometimes cats just prefer the texture of some soft food in their diet. The licking could have either a medical (e.g. allergies, other skin issues) or behavioural (e.g. anxiety/stress) cause. My suggestion would be that you make speak to your vet and make your concerns really clear. You should be able to work together to figure out what’s going on. If you try this and still feel that your problem hasn’t been addressed, there is no harm in seeking another opinion. Further diagnostics may be required, especially if the amount of insulin required has jumped up, because this sometimes indicates a concurrent illness is causing insulin-resistance. Thanks for reading the post, and I hope you can get to the bottom of it. Well done on caring for your kitty so well!

  • Kc Lee

    Thank you for this post. We’re currently in the process of making the most difficult decision of our lives. Smokers is our 11yr old and first furbaby. We’ve been treating his diabetes since May of 2015. Every time we think we’ve found the balance, gotten to a point where he is almost acting like himself, something changes and it’s like starting over. We can no longer afford his necessary care. And he’s started destroying things, eating tissues that I wiped my fingers on after eating, chewing holes in blankets where my husband dropped food (and immediately picked up) 2 days before. Stealing food from the kitchen while I’m putting up groceries (dragged a whole load of bread to another room and ate half before I caught him). His life now revolves around food and he doesn’t play anymore. Sometimes he’ll still come snuggle in bed with me, but those times are so few and far between. I feel like we’re giving up on him. I’m just in such a dark place right now. Reading this article and especially these comments has made it a little easier for me today. I think we will schedule for next week so we can have a little more time with our baby.

    • Joanna Paul

      hi Kc,
      I’m so sorry to hear about Smokers. It is the most incredibly difficult decision to make. You have done such an amazing job hanging in there and trying for so long, but there does come a time when we need to step back and ask ourselves if it’s best to continue on or not. I know you’ll make your decision with love and that’s all any of us can do. Thinking of you and Smokers x

  • Faith

    Thank you for writing this. It has helped me come to the hardest decision of my life. My cat, Kilala, is 19 years old and I took her to the vet after noticing a sudden increase in drinking and peeing two weeks ago. The blood test came back with mild pancreatitis and high gluclose levels, indicating diabetes. The vet advised additional testing, and outlined possible medical treatments. I could not ask further questions in regards to progression and cost, as she insisted I needed to bring Kilala back for additional tests and a second IV drip. I had spent all my money, savings and credit cards on the initial visit. To be honest, I had no money available until the next payday, a week away, unless I took out a payday loan. I combed the internet for information, while watching Kilala keep drinking and peeing, sleep a lot and not eating a lot unless I gave her treats. She has had good days and bad days, but the hardest has been to determine if she is “sick” enough to be put down. I didn’t want to shorten her life, but don’t want to extend it painfully. I had already decided I could not put her through treatment. The prohibitive cost, the lack of funds, even how she reacts going to the vet – or to taking any medicine, I didn’t want her to run away from me, making her last days miserable for both of us. But the guilt, the guilt has been no less painful then feeling like I’m trying to determine when and if she should die, as if I’m God. I have had her for 12 incredible years, since my brother asked if I could take in this strange cat who lived in his closet. My brother rented a room from friends. Whoever rented that room took care of the cat who stayed hiding in the closet. Some took better care than others, as different people rented that room for the 7 years she lived there. My brother was about to move, and was worried about what would happen to her. I took her in, and she was incredibly nervous and shy. It took three weeks to get her out from my closet, and another year before she came out of the bedroom. She still “hides” when anyone comes into the house, although now it’s just under a blanket, instead of shivering under the bed. She was never a normal cat, never jumped on furniture, always burrowed down below. Never meows, only “mehs” or just opens her mouth in a silent meow. She’s always watched me play with her toys, haha, although we played games of hide and seek. I bought a thick comforter for the bed, and it became her blanket on the floor after two days, she enjoyed burrowing so much in it. I bought one of those body pillows and dropped it on the couch while putting the other bags away, and she immediately claimed it for her own. It’s still on the couch, three years later, where she likes to curl up. I don’t know why I’m typing all this, it just feels like a release and I want people to know her, how incredible and awesome she has been. I think it’s also an absolution, maybe. I haven’t been able to talk to anybody really about this. She has grown more lethargic, and has peed a few times outside the box. She doesn’t go up on the couch, and doesn’t stay when I put her there. She is eating some of the time, and keeps drinking a lot of water. I’ve seen her “hiccup” as if she’s holding back vomit, but she hasn’t thrown up. She had a minor seizure last night, and I comforted her after while she was dazed and confused. Nothing seemed like it was enough to justify putting her down. But I don’t want her to go into more painful seizures, or go through the nerve-pain or blindness or even get to a point where she is vomiting up what little she eats. I think it’s time to let go, and you have helped me so much in clarifying that. Thank you so very much for helping me to recognize what is in HER best interest.

    • Joanna Paul

      Hi Faith,

      Thank you so much for taking the time to share Kilala’s story with me. It’s heartbreaking but at the same time so beautiful to read how she learned to trust and love over the years. I’m so, so sorry for your situation, and I hope you are okay. Thinking of you at this sad time x

  • Tommy Lawrence

    Joanna, thank you for this web page. Very insightful. I have an appt. this afternoon for our traveling vet to euthanize my 18 year old girl “Itchy”. She has severe diabetes and at this point just don’t see a comfortable future with her with treatments. This isn’t the first time I’ve had to euthanize a pet cat, but it never gets easier. I want to believe I am doing the right thing and that she won’t have to suffer anymore. Her sister was euthanized 4 years ago for the same condition. Her name was “Scratchy”. I still find it amazing at 46 years old how much love and joy a pet can bring to your life. Saying goodbye is tough.

    • Joanna Paul

      Hi Tommy,
      I’m so sorry to hear about Itchy. You’re right, it never ever gets any easier, but it is something we do out of love. The ability to end suffering is a gift, and really the final selfless and kind thing we can do for our pets. I hope you’re doing ok. Pets bring us so much happiness, love and comfort, if only their little lives were longer. I’m so sorry x

  • Faye

    I put my Wally, a sweet beautiful black cat to sleep a month ago due to him being diagnosed in DKA at just over 9 years old.. I just couldn’t bring him back from deaths door only to poke him with needles and have other complications. I am riddled with guilt as he was an overweight kitty. I also have a 19 year old cat that is on prescription kidney food and is used to grazing all day. Out of 6 cats the only overweight cat I ever had was Wally. It was very hard for me to separate them and have timed feedings as I am not home all the time due to a crazy schedule. This has been the hardest cat I had to put down because it just came out of the blue with really no warnings. I thought we would have plenty time together. Thank you so much for this blog as I know I did the right thing. Even though I still can’t stop sobbing from his loss. His loss is so painful. I wish I could see him and hold him again. I love you my Wally boy.

    • Joanna Paul

      Hi Faye,
      I’m so sorry for your loss. You made your decision out of love so please try not to feel guilt. You have my full support – it was the kind choice to make for Wally even though it is heartbreaking. Thinking of you at this very sad time. Rest in peace Wally x

  • Mary Samarine

    My 17-year-old cat has diabetes and the blood tests are not going easily. If I do not treat him, will I know clearly when to put him down? At the moment he is lethargic but otherwise in decent shape.

    • Joanna Paul

      Hi Mary, that’s a terribly difficult situation to be in and I feel for you both. I don’t have an easy answer to your question. If the blood tests are going poorly I imagine this means his diabetes isn’t responding to treatment? You can use his interest in the things he usually likes as a guide. If he stops interacting with you when he was previously very affectionate, or is unwilling to eat or very lethargic, it might be time. I hope things improve for you and your boy x

  • Janie

    such comforting information. I had my sweet Caleii euthanized yesterday; Jan 22 2016 @ 8:30 am; had severe diabetes; she was really suffering; throwing up at times; listless/ UTI; peeing outside her box. It was a painful ambivalent decision; but out of love not wanting her to deteriorate and suffer even more, we said our final goodbye. So heartbroken right now; will I ever stop crying? Would love to hear from anyone else with this type situation. by the way; she was approx. 10-11 years old; a very beautiful , sweet , discerning Calico.

    • Joanna Paul

      Oh Janie,
      I am so terribly sorry to hear about your loss. It’s obvious Caleii was very special to you and very, very loved. There are many resources for coping with the grief of losing a pet – I hope you will seek more information if that is comforting to you. You might stop crying in a few days, weeks, months, nobody knows. There is no right or wrong way to grieve: but if you are having difficulty coping, please reach out for support.
      I hope in time the wonderful memories of her time with you can bring some peace and happiness. x

    • Dawn M

      Hi Janie,

      I just made the call to the animal hospital to a an appointment to have Riley euthanized. After I hung up I sat at my desk and cried. I’m not sure how I’ll be able to say goodbye to her. She was diagnosed 2 years ago with diabetes. She has lost a lot of weight. … all bones now. She has been peeing and poopling outside the box for a while now.. It is apparent that there is a lot of sugar in her pee. Dispite that fact that she has plenty of water and food, She is always looking for more. But.. .she still sits with me when I’m watching TV. She still meets me at the bathroom sink first thing in the morning, and greets me when I come home from work at night. I am torn between not wanting her to suffer and wanting to wait for her to “act” more sickly. I’ve had 14 good years with her and I’m grateful for that. Hang in there. I’m sure you did what was best for Calico.

      • Joanna Paul

        Hi Dawn,

        Thank you so much for sharing your experience. I’m so sorry about Riley and I hope you’re ok. x

        • Jenny

          We are going through this at the moment with our Indy. Thank you for helping us with the rotten decision. Reading these stories too has helped. We will probably be making the decision to euthanise tomorrow. As mentioned, “when is the right time” and I completely relate to “when they are sick enough”. We hate seeing her like this. Thanks again and to all the lovely people here going through this.

          • Joanna Paul

            I’m so sorry Jenny.
            Humbled to have been of help, but terribly sorry to you and your Indy. Look after yourself x

  • Laura

    My poor 6 year old maincoon was diagnosed with diabetes about 6 weeks ago. I took him in because he went from 16 lbs to 10 in the matter of about a month and started peeing outside the litter box and puking up food (he has always done this because he overheats but it was troublesome with the rest of his issues). I took him in and his blood sugar was 435 and had keytones. They flushed him, started him on insulin 2x a day and he is on prescription food. I walked out of there with a $400 bill…. I have taken him in every 2 weeks sometimes more often because all he does is sleep and drink and pee (still). Last time I took him in his blood sugar was 526…they upped his his insulin and gave him antibiotics for a urinary track infection. It’s bee 2 weeks and I don’t know what to do.. All he wants to do is sleep and drink and still pee everywhere… He goes back in for another check on Monday. My husband says maybe it would be more humane to put him down. Everything is so expensive. It all just makes me so sad… Please I need some advise.


    • Joanna Paul

      Hi laura,
      I’m really sorry to hear about what you’re going through with your boy – it must be incredibly difficult. It sounds like his diabetes is difficult to manage for some reason. Hopefully clearing up the urinary tract infection will help. It can take time to stabilize a diabetic, sometimes months, and sometimes there is something else going on that complicates things.
      The worst part is not knowing if/when you will see the light at the end of the tunnel. Ultimately your decision will will be guided by his quality of life and the prognosis for him improving, as well as the emotional and financial costs of his treatment.
      My advice is to discuss your concerns with his vet in detail – maybe write some questions down before you go. I really hope things have taken a positive turn at your next appointment.

  • Jamie

    Hi there, I’m going through a tough time with my 10 year old furry baby diagnosed with diabetes in July. We’ve already switched insulins, and haven’t been able to get his sugar levels under control. The poor thing has a hard time walking and jumping up on the couch. I have always said that my cat would come with me anywhere, but now all the moving our military family does seems to be making it worse. I’m at a complete loss of what to do. He isn’t at that point of urinating outside his litter box, so euthanizing him seems wrong, but I don’t know. I don’t think he feels well, but I don’t know for sure. My husband suggested trying to find him a new home, but we’ve had zero luck. Nobody wants a diabetic cat. I really don’t know what to do. I’m very emotional about the whole situation. Any advice?

    • Joanna Paul

      Hi Jamie,
      I’m really sorry to hear about your diabetic cat and the situation you’re facing – it can’t be easy. There is no shame in considering euthanasia. It sounds as though you have tried everything and worked really hard and controlling his diabetes with disappointing results. His quality of life is the most important thing, so if he’s having super high blood glucose levels and limited mobility then maybe this isn’t optimal. I don’t know how far you’ve gone in terms of diagnostics with your vet, but frequently if a diabetic cat is really hard to stabilize it’s because there is another concurrent disease there complicating the whole situation. Sometimes it’s as simple as a urinary tract infection and sometimes it’s something more involved like acromegaly and hyperadrenocorticism. I hope you have a vet you trust and feel you can sit down and discuss things with. Ask any questions you have so you can make an informed decision, and remember to be kind to yourself. I wish you and your kitty all the best x

  • Tracey Hudson

    I am so glad that I read your article on diabetes in cats. I have a 6 year old cat and he was diagnosed with diabetes in July. We are still in the process of stabilizing him. He lost a lot of weight and was ravenous all the time and seemed to be drinking and weeing non stop. 3 months on, he seems to be more stable, he’s put on some weight, drinking a lot less, going to the tray a lot less and seems a lot happier. Your blog on diabetic cats made me feel more optimistic. Thank you.

    • Joanna Paul

      Hi Tracey,
      Thank you so, so much for your comment. I am so happy that I was able to help in some small way at a difficult time. It sounds like you are doing an amazing job with your kitty! x

  • Carole

    Thanks so much. We have 3 cats and the oldest – almost 13 – who has had bladder problems (2 ops) since birth, and was 2 yrs ago diagnosed with kidney failure was two days ago was diagnosed as diabetic!
    My son and my daughter each have one diabetic cat so they had advice and theirs was very similar to yours – yet slightly different from our vet’s!

    • Joanna Paul

      Thanks Carole,
      Of course sometimes in veterinary medicine there is more than one right answer 🙂 Very unusual that you have all ended up with diabetic cats!
      I hope your little cat is doing well, and that you are too – it’s not easy.

  • Jipsi

    I took my cat in yesterday & was prepared to hear bad news. Hes an older guy who started displaying all of the symptoms of diabetic neuropothy/ketoacidosis. About 1 year ago, i started noticing the constant drinking, lethargy & super weight loss. He was always a big cat and now hes lost a lot of weight and what i thought comical with him climing from one same leveled table to another where his back legs with five out, turns out is the neuropothy part. Im a little upset cause I raised concern about the symptoms & suggested blood work for diabetes but they had claimes it was just old age. Hes maybe 12 or 13. Im upset but cant do anything now.

    I got the call today from the vet who confirmed everything. he offered the option of doing the extensive & costly testing for further determination for insulin treatmwnt but was kind enough to ask if I would be able to provide constant care for what could be not worth it aa its pretty advanced.

    Reading this made me feeling better about thw alternative solution no one wants to do. However, Im well aware of the reality of it, he seems miserable and making a choice to put him out of misery is far better than watching him deteriorate and in pain.

    So, after so many sites ive researched, this one made me feel more confident and I learned a lot. I have 2 young cats so its a learning lesson.

    Thank you so much. 🙂

    • Joanna Paul

      Oh Jipsi,
      Your comment has made me cry. I’m so sorry for what you and your boy have been through. Deciding to take on the care of a sick diabetic cat is such a massive thing and there are so many factors to consider. I hope you never doubt your decision or second guess yourself. You’re acting out of love and consideration for his quality of life. You have my support, and my thoughts are with you at this sad time. I’m really happy that my site was able to help you, just sorry it was under such circumstances xx

  • Rhiannon

    Thank you so much for providing this information and sharing both of your situations. I have a 10 year old cat who is in the situation where I love him but cannot afford to have him on insulin, like your kitty he can be a feisty one. Based on previous cats I’ve known who have had diabetes & all the symptoms he has, I have no doubt he is diabetic. My real dilemma was when to put him down. I didn’t want to keep him alive in pain nor was I wanting to shorten his life just due to increased appetite & waste production. I never saw nor have I to this day seem outward signs of pain. However, after reading your blog I definitely think he is in discomfort. I noticed when he started to have a hard time jumping up, I moved his food to floor level to help him. I knew it was coming to that time. Thank your for your words they have helped me make a very hard decision and I feel much more reassured that I am making the best choice for my Attilla.


      My cat Simba was just diagnosed with diabetes. He will be 16 on Oct 7th. I know the right decision is to put him to sleep because I don’t want him in pain. He is my last one of three. Gizmo I had put to sleep because of severe diabetes. He was in pain and it was to much for him to be regulated. I promised I would never let Simba suffer if he was ill. It’s so hard to say the final Goodbye

      • Joanna Paul

        Hi Jean,
        I’m so so sorry to hear about Simba. It’s devastating to say goodbye, but you are making your decision out of love. It’s the last act of kindness we can offer the animals we love. Thinking of you at this sad time xx

  • Laura

    Thank you for writing this! This has been the most interesting and informative article I’ve found on diabetes. My cat was diagnosed in February this year and it has been so hard to find anything decent online, let alone Australian! I’m glad I found you 🙂

    • Joanna Paul

      Hi Laura!
      Thank you, your lovely comment has made my day 🙂 I’m sorry to hear your cat has diabetes, please drop me an email at vet@creatureclinic.com if you have any questions that I might be able to help you with. I’m so pleased to hear you found my article useful 😀

  • Pawesome Cats

    Such an informative article – and love your style of writing on this article too. Stephen is a stunner.

    • Joanna Paul

      Stephen is so seriously cute, isn’t he! Thanks for visiting 🙂

  • Hugzilla

    I never thought I would ever read through an entire article about cats with diabetes because a) I don’t have a cat and b) I don’t have a cat. Love your writing style – you had me hooked!

    • Joanna Paul

      Thank you SO much!! You’ve made my day 🙂
      Coming from you especially Hugzilla, that’s an awesome compliment, cos your blog is hilariously amazingly funtastic!
      Thank you for taking the time to read an article totally irrelevant to you and your life. If you ever do get a cat, I’m here for you.

  • Louise Rhodes

    Stephen is gorgeous! My fur kid is a brown Burmese who spends a lot of time spread out like Stephen! I was referred via Blog Chicks. No kitty diabetes in our family thankfully

    • Joanna Paul

      Hi Louise!
      Thanks for stopping by, blog chicks is a great community 🙂
      I have a special soft spot for Burmese, and the brown ones are divine!

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