Diabetes Series Part 6- What else should I be monitoring for?

By: Kathy Raepple


Hyperglycemia is an overabundance of glucose in a cat’s blood.[1]  This condition will almost always lead to Diabetic Ketoacidosis (DKA) if left untreated for too long.  The symptoms can vary depending on any underlying cause:

Signs of Hyperglycemia:

  • Increased Thirst
  • Obesity
  • Increased Urinations
  • Dehydration
  • Weight Loss
  • Liver Enlargement
  • Increased Appetite
  • Tissue Damage
  • Depression
  • Bloodshot Eyes
  • Non-healing Wounds
  • Nerve Damage (legs – walking “flat footed”)
  • Severe Depression (happens with extremely high blood glucose levels)

The cats that are considered most at risk for hyperglycemia are middle aged or older cats.  No particular breeds are more susceptible to hyperglycemia than others, but male neutered cats have shown to be at a higher risk than others.

There are many different reasons that could cause hyperglycemia in cats.  A few of the more common ones are:

  • Pancreatitis
  • Infection (dental, urinary, skin, etc.)
  • Diet
  • Hormones (especially females)
  • Stress

Your veterinary team will work with you to find the reason for your pets hyperglycemia and will work with you to help control and manage it.

Diabetic Ketoacidosis (DKA)

Ketoacidosis is an extreme complication of diabetes mellitus.  Generally, this condition is seen in previously undiagnosed cats causing the owner and pet to have to deal with 2 serious diagnoses: one acutely life-threatening and expensive and the other requiring serious on-going commitment and daily treatment.
Ketoacidosis represents an extreme metabolic derangement.[2]  This condition is usually brought on by some kind of stressor like a previously undiagnosed infection, inflammatory disease or pancreatitis, which can cause a severe loss of glucose regulation.  A cat’s cells will act like they are starving for glucose even though there is plenty in the blood stream.  Without insulin this glucose cannot enter the cells.  In response to the starving body, all stored fuels are mobilized including fats.  Extreme fat burning leads to the production of ketone bodies.  When these ketones are burned for fuel, pH and electrolyte imbalances occur and your cat’s life could be at risk.  Shock and dehydration are only a part of this body-wide crisis.

Signs of potential DKA:

  • Nausea
  • Loss of appetite
  • Lethargy

Blood glucose testing will show that the glucose levels are extremely high and ketones are usually detected in a urine sample obtained from your cat.

If your cat does suffer from DKA, he will require several days in hospital on Intravenous (IV) fluids, receiving medications to help him recover, multiple blood samples to monitor, at minimum, his electrolytes and blood glucose level and insulin injections (using a “regular” insulin that is short acting and will bring his glucose levels down slowly and safely).  Most veterinarians will want to keep your cat in hospital until there are no more signs of DKA with your pet – no ketones in the urine, blood glucose regulating well with longer acting insulin, good spirits and eating well.  The time your cat will have to spend in hospital will vary from one patient to the next and should be discussed with your veterinarian.


Hypoglycemia is caused by low blood sugar which can result in a severe decrease in energy levels and could lead to the cat becoming unconscious. This can be a very dangerous situation for cats and requires quick, appropriate treatment.  Hypoglycemia can quickly become life-threatening to your cat.

Hypoglycemia can also indicate another, previously undiagnosed, underlying health problem.   The best way to determine if your cat is suffering from hypoglycemia is to do a blood glucose reading when there are signs present.

Signs of Hypoglycemia:

  • Loss of appetite (anorexia)
  • Increased Hunger
  • Weakness and low energy
  • Anxiety, restlessness
  • Disorientation and confusion
  • Tremors/Shivering
  • Loss of Consciousness
  • Heart Palpitations
  • Visual Instability (walking into things because of blurred vision)
  • Seizures (rare)

The most common cause of hypoglycemia is an overdose of insulin or other diabetic medications.  If a diabetic cat is given an overdose, or higher than usual dose, of their medication when their glucose levels are already higher than normal it could cause their body to process too much glucose thus decreasing the glucose level in their blood making it too low for the body’s needs.[3]  Without quick intervention, hypoglycemia could lead to brain damage that is irreparable and could also cause death.

If you notice any of the signs of hypoglycemia, get your cat to your veterinarian immediately.  If your cat has already lost consciousness or is acting like he is about to collapse, phone your vet to find out what to do for him at home for immediate treatment, then get him to the vet as soon as it is safe.

Even with at home treatment, it is highly recommended that your cat see his veterinarian as soon as possible when signs of hypoglycemia have been present.  Your veterinarian will likely want to run some bloodwork and a urinalysis. (See “Diabetes Series – Part 7” for more information on additional testing).

[1] www.petmd.com/cat/conditions/endocrine/c_ct_high_blood_sugar
[2] http://www.veterinarypartner.com/Content.plx?P=A&C=&A=3054&SourceID=
[3] www.petmd.com/cat/conditions/endocrine/c_ct_low_blood_sugar