Feline Hyperglycemia & Diabetes Mellitus: Vet Guide 2025 🐱🩺📈

Hello knowledgeable cat parents! I’m Dr Duncan Houston BVSc 🩺. Did you just learn your cat’s blood sugar is high? Hyperglycemia is often due to diabetes mellitus, a chronic disease needing careful vet care and loving at‑home support. This guide equips you to spot signs, get a diagnosis, start treatment, and help your cat thrive 😊.

🔍 What Is Hyperglycemia & Diabetes?

Hyperglycemia means elevated blood glucose above normal ranges (~75–120 mg/dL) :contentReference[oaicite:3]{index=3}. When it's persistent or causes glucosuria, diabetes mellitus is usually to blame :contentReference[oaicite:4]{index=4}. In cats, Type II (insulin resistance with impaired production) accounts for ~80–95% of cases :contentReference[oaicite:5]{index=5}.

⚠️ Why It Matters

Unchecked hyperglycemia damages kidneys, nerves, and eyes, leads to dehydration, poor healing, diabetic ketoacidosis (a medical emergency), and weight loss :contentReference[oaicite:6]{index=6}. Early diagnosis improves outcomes—and remission is possible in some cases :contentReference[oaicite:7]{index=7}.

👀 Common & Hidden Signs

• **Polyuria & polydipsia (PU/PD)**—excessive urination/drinking often parent‑observed :contentReference[oaicite:8]{index=8}.
• **Weight loss** despite normal/increased appetite (polyphagia) :contentReference[oaicite:9]{index=9}.
• Lethargy, weakness, poor coat, vomiting, diarrhea :contentReference[oaicite:10]{index=10}.
• Plantigrade stance (walking on hocks) from diabetic neuropathy :contentReference[oaicite:11]{index=11}.
• Stress hyperglycemia possible—veterinary visits may elevate glucose transiently :contentReference[oaicite:12]{index=12}.

🔬 How Is It Diagnosed?

• **Blood glucose** – fasting ≥280 mg/dL plus glucosuria prompts diagnosis :contentReference[oaicite:13]{index=13}.
• **Urinalysis** – confirms glucose is spilling into urine :contentReference[oaicite:14]{index=14}.
• **Fructosamine test** reflects 2‑week average to rule out stress spikes :contentReference[oaicite:15]{index=15}.
• **Additional bloodwork/urine** – assesses organ function and contributing conditions (e.g., acromegaly, pancreatitis) :contentReference[oaicite:16]{index=16}.
• **Glucose curves or continuous monitoring** – track response to insulin :contentReference[oaicite:17]{index=17}.

🏥 Treatment Essentials

1. Insulin Therapy

• Most cats require twice‑daily insulin (e.g., glargine, lente) :contentReference[oaicite:18]{index=18}.
• Human insulins (like Humulin) less predictable; veterinary ones are preferred :contentReference[oaicite:19]{index=19}.
• Protocols aim to maintain glucose within safe ranges and prevent hypoglycemia :contentReference[oaicite:20]{index=20}.

2. Dietary Management

• High‑protein, low‑carbohydrate canned diet supports blood sugar control :contentReference[oaicite:21]{index=21}.
• Weight loss in overweight cats enhances insulin sensitivity :contentReference[oaicite:22]{index=22}.

3. Oral & Adjunct Therapies

• SGLT2 inhibitors (e.g., Bexacat) approved for some diabetic cats :contentReference[oaicite:23]{index=23}.
• Older hypoglycemics (glipizide) less effective; rarely used :contentReference[oaicite:24]{index=24}.

4. Home Monitoring

• Blood glucose checks at home via ear or paw sticks; continuous systems available :contentReference[oaicite:25]{index=25}.
• Log daily appetite, urination, drink, weight, behavior to adjust insulin safely.

5. Treating Complications

• **Ketoacidosis** – emergency care: IV fluids, insulin CRI, electrolytes :contentReference[oaicite:26]{index=26}.
• **Neuropathy** – often improves within weeks of glucose control :contentReference[oaicite:27]{index=27}.
• **Concurrent diseases** – manage pancreatitis, acromegaly, infections for better control :contentReference[oaicite:28]{index=28}.

📈 Remission: Is It Possible?

Yes—~25% of cats achieve diabetic remission (no insulin needed for over a month), especially with early aggressive treatment using glargine and low‑carb diet :contentReference[oaicite:29]{index=29}. Factors favoring remission include early diagnosis, no other illnesses, proper insulin protocol, weight loss, and carb-controlled feeding :contentReference[oaicite:30]{index=30}.

📆 Prognosis & Follow‑Up

• With good care, cats can live long, happy lives; many stay in remission.
• Risks include hypoglycemia, diabetic crises, recurrence.
• Regular vet checks every 3–6 months: blood, glucose curves, weight, retina exams.

🏡 Home Care & Support

• Clean injection site daily; store insulin in refrigerator; rotate vial regularly.
• Use **Ask A Vet app** 📱 to track dosing, symptoms, glucose & weight logs.
• Serve meals after injections to prevent hypoglycemia; keep syrups at hand.
• Offer consistent feeding times, fresh water, cozy **Woopf & Purrz** bedding.
• Watch for signs of hypo (weakness, tremor, seizure)—treat immediately with honey on gums.

📝 Key Takeaways

• Hyperglycemia in cats often signals diabetes mellitus—careful diagnosis avoids mislabels.
• PU/PD, weight loss, appetite changes, and neuropathy are classic warning signs.
• Treatment = insulin + low‑carb diet; monitoring ensures safety & control.
• Early, aggressive care increases remission chances.
• Home dedication, monitoring tools, and vet partnership permit long, healthy lives.

📞 When to Contact Ask A Vet

If your cat shows sudden lethargy, tremors, collapse, plantigrade stance, or decreased appetite—open the **Ask A Vet app** 💬 immediately for vital veterinary advice while heading to your clinic.

✨ Final Thoughts

Caring for a diabetic cat is a journey—but with understanding, compassion, and proper tools, you can give your feline friend a joyful life. Your careful monitoring, treatment, and love can turn a medical diagnosis into a manageable lifestyle. Every dose matters—and so do you ❤️🐾.