Diabetes: Pets and People

Stone - Diabetes

November is American Diabetes Month. To highlight how veterinarians care for pets with diabetes, I thought I would tell the story of one of my patients, a fluffy, grey and white cat named Stone.

Stone is a youngster, just under two years of age. He came to see me because his owner had noticed weight loss and excessive drinking. Weight loss and excessive drinking are common clinical signs of diabetes, but Stone was much younger than the typical cat with diabetes. Hyperthyroidism can also cause weight loss and increased drinking, but typically occurs in older cats.

Another cause of weight loss and excessive drinking is chronic kidney disease, but again, typically in older cats. I wasn’t really sure what was wrong with Stone until the blood tests showed sugar in his urine and an elevated blood sugar.

Dogs and cats have different forms of diabetes. Dogs commonly have Type I diabetes, which is a total lack of insulin production by the pancreas. Cats have Type II diabetes which occurs most commonly in middle to older overweight cats. Unlike humans with Type II diabetes, cats require insulin injections where humans can often manage Type II diabetes with oral medications and diet. Strangely, with weight loss, insulin therapy, and a special diet, some diabetic cats will become normoglycemic again and no longer require insulin. This happened to my own cat and he stopped needing insulin for a year. Then became permanently diabetic and required insulin for the rest of his life. I think chronic inflammation of the pancreas (known as pancreatitis) was the likely cause of the diabetes.

Stone was in to see me just a few days ago. On twice daily insulin therapy, he has gained back some of the weight he lost and is eating his special diabetes diet with gusto. Blood tests indicate his blood sugar is well controlled and his owner notes it is getting harder for her to test his urine to measure the urine sugar level. I am suspicious he may be heading for a period of diabetic remission.

To help my readers understand the similarities between their own diabetes and that of their pets, I included a table below with a comparison of the common features of the disease.

Comparison of diabetes between people and their pets:

  Cat Dog Human
Occurrence 0.58% of cats 0.35% of dogs 9.4% of Americans
Type I diabetes No Yes Yes
Type II diabetes Yes No More than 90% of diabetes
Diabetic retinopathy No Rare Yes
Diabetic nephropathy No No Yes
Association with pancreatitis Yes Yes No
Oral treatments No No Yes
Insulin injections Yes Yes Yes
Spontaneous remission resolution Yes No No
Diabetic cataracts Rare Yes Yes
Linked to obesity Yes Yes Yes

Lifestyle Factors Related to Feline Obesity

Buster Brown

June is Adopt-A-Cat Month and every blog post in June will focus on some aspect of our furry feline friends. Today’s topic is obesity.

I saw one of my favorite patients the other day. Okay, I admit, all my patients are my favorite. Buster Brown is a mink-coated Tonkinese cat, just a bit over one year of age. Because he is young and healthy, I haven’t seen him since before he was neutered and was a bit shocked when I put him on the scale. He had gained three pounds during the five months since I had last seen him. When his family saw the numbers on the scale, they asked, “How did this happen?” Below, I have outlined a few of the contributing factors to feline obesity that cat families can use to keep their furry friend at an ideal body condition.

But My Cat is Big-Boned
You are right, the significance of weight gain depends somewhat on the size of your cat. A slinky Siamese can gain less weight and still have a good body condition than the king of cats, the Maine Coon, but adding three pounds is probably too much for just about any cat. When I assessed Buster B’s body condition score, a scale which looks at a cat’s distribution of fat in various parts of the body, he scored 8/9, which is considered obese for a cat of his size.

Fixing Him, Even Though He’s Not Broken
Although Buster B is extremely handsome, he is a pet and was not going to make babies. Thus, he was neutered before he had a chance to start spraying urine on the furniture or drapes. Male cats that have not been “fixed” have very stinky urine and for that reason, pet cats are typically neutered. Neutering is a known risk factor for obesity in cats and portion control is a good practice after neutering. Decreasing a cat’s food intake by approximately one-third after neutering surgery is a good rule of thumb to prevent unwanted weight gain.

He Likes Crunchies and I Hate Those Smelly Cans in the Fridge
I am with you on this point. Cats like what they like and I find those little cans of congealed salmon and tuna pate revolting sitting next to my kale and organic chicken breasts. But, a diet of more than 50% dry food has been shown to be associated with obesity. If you feed your cat dry food fed free choice, without regard for portion control, your kitty can pack on the pounds. Ditto for treats; limit how many your cat consumes per day since snacking predisposes cats to obesity.

Kitty Gymnasium
In a recent scientific study published in Preventive Veterinary Medicine, risk factors for obesity in cats at two years of age were identified. Cats kept indoors were more likely to be overweight or obese. I suspect this is related to exercise or the lack of it in a confined space like your apartment. While research indicating cat calisthenics helps to keep weight off is lacking, exercising your cat with a laser light, fishing pole toy or encouraging them to run up and down the stairs can’t hurt. Better yet, provide a cat tree for climbing as cats love to be up high.

One third to one-half of American cats are considered overweight or obese. Be proactive and keep your kitty slim and trim by controlling his food portions, including some canned food in his diet, and making sure he gets plenty of exercise.

Why Being a Fat Cat is Not as Good as it Sounds

The allure of being a fat cat with a private jet, international residences and a Swiss bank account is undeniable; having a fat cat of the feline species as your pet is undeniably a recipe for a health care disaster.

Obesity runs rampant in American pets. Estimates by the Association for Pet Obesity Prevention indicate over 50% of dogs and cats in the United States are overweight or obese. That percentage translates to 89.5 million overweight or obese pets and over half of them are cats.

But, I Hear You Say…
But, she is soooo cute when she dances around for a cat treat. But, he wakes me up at 5 am if I don’t fill the bowl extra full. But, she loves her food. How can I deny her that pleasure? But, he eats the food of my other cat that eats slowly.

Feline Research Shows
In a recently published study from the Journal of Feline Medicine and Surgery, researchers at the University of the Grand Canary Islands tested respiratory function in normal and obese cats. These researchers used a cat-sized Plexiglas chamber to measure barometric whole-body plethysmography. Roughly translated, the researchers measured respiratory rate, amount of air in each breath, and how fast air was inspired or expired. Fat cats and ideal body condition cats had the same rate of respiration, but fat cats had a decreased amount of air in each breath and a lower speed of inspired and expired air, suggesting obesity impairs lung function. All the cats in the study were healthy, with the exception of obese body condition. But if you have a cat with asthma or heart disease, obesity could seriously impact their ability to breathe.

Fat Cats Have More than Respiratory Problems
In addition to worsening respiratory problems, obesity in cats has been associated with a number of diseases. Obesity puts cats at greater risk for developing feline lower urinary tract disease and subsequent urinary tract obstruction.  Fat cats are the ones veterinarians monitor most closely for diabetes because early intervention and weight loss can reverse that disease in cats. Obesity initiates a vicious cycle of decreased activity and weight gain, leading to even less activity and more weight gain.

Preventing Obesity in Cats
Step one to preventing obesity in your cat is to recognize what a cat with an ideal body condition score looks like. Many cat owners believe their cat’s weight is perfect when my observations indicate their cat is overweight. Next, talk to your veterinarian about your cat’s diet and have them calculate the correct amount of food per day to keep them at an ideal body condition score. Finally, measure their food rather than just pouring into their bowl what you think is the correct amount. Your cat will thank you for NOT making them a fat cat.

Scarlett’s Diet

Last week Scarlett, a ruby Cavalier King Charles Spaniel, had an urgent visit to The Animal Medical Center to see her cardiologist. Since she has been diagnosed with early stage heart valve disease, a condition common in Cavaliers, her family is always concerned about her breathing, which, on that day, was heavier than normal.

The cardiologist says…

Her cardiologist found her lungs to be clear, her pulses strong and her respiratory rate to be normal. Using his stethoscope, he heard a heart murmur, but Scarlett always has a heart murmur because she has leaky heart valves. After determining her heart was not the problem, he then honed in on what her problem was: a two pound weight gain between August and February. For this little Cavalier, a two pound weight gain was equal to 12 pounds in a 120 pound person. The extra weight she is now carrying on her small dog frame puts extra pressure on her diaphragm and contributed to her heavy breathing.

Scarlett, the scavenger

Scarlett’s dog sister, Jackie is a patient of mine. Due to her jaw tumor, she has become a bit of a messy eater. Scarlett believes neatness counts and has been tidying up the kitchen floor after her Jackie eats dinner. The extra calories from Jackie’s fallout have resulted in Scarlett’s weight gain and probably her episode of snorting and heavy breathing.

Diet time

To get Scarlett back to ideal body condition, she has been pulled off clean-up duty after Jackie’s dinner. I recommended her family purchase a kitchen scale to weigh each serving of Scarlett’s food. Families can cheat on their dog’s portion more easily with a measuring cup than with a scale. Scarlett already eats a light food, so I calculated how many calories a day she needs and translated those calories to ounces of her brand of dog food. No weight loss plan would be complete without some little treat every day. Scarlett’s favorite is chicken. I allotted 10% of her daily calories to broiled chicken breast and the other 90% to her light kibble.

In addition to decreasing her calories, we have increased her exercise. Scarlett comes twice a week to work out on the treadmill at The AMC’s Tina Santi Flaherty Rehabilitation & Fitness Service. When the beaches open this summer, Scarlett will have a waistline as tiny as that of another flirty redhead, her namesake, Scarlett O’Hara!

Lessons from Scarlett

  • Review what ideal body condition looks like for both cats and dogs. This will help you recognize weight gain in your pet early.
  • Monitor your pet’s food intake and recognize other sources of calories in their diet such as the other pet’s enticing food bowl, food dropped from the high chair or the nice lady next door who cannot resist giving your dog 10 extra treats per day.
  • Get your veterinarian’s recommendation on the amount to feed your dog for successful weight loss. All dog foods do not have the same number of calories per cup or can. Even foods promoted as weight loss diets have a wide range of calorie content per cup or can.

Let’s Move: Simple Activities to Get Your Cats Moving

First Lady Michelle Obama believes in physical activity as a way to combat childhood obesity in America. Her program, Let’s Move, aims to raise a healthier generation of kids. Americans are also raising a generation of obese cats because most cats now live indoors. Research has shown that cats living in apartments and inactive cats have the highest risk of becoming obese. Cats with a bowl full of food available at all times are more likely to be obese when compared to cats fed at specific meal times. Many cat owners are unable to recognize obesity in their pet, so there is little early intervention. Here are my suggestions for simple, inexpensive cat activities to get your feline friend moving as part of a healthy cat lifestyle.

Going up, going down
One of the features lacking in most apartments, which may contribute to cat inactivity, is stairs. Using stairs is a good way to build strong muscles in your kitten or cat. My apartment doesn’t have stairs, but I have a step stool which I use to get to the top shelves in my kitchen. Some days I put the step stool out with a favorite treat or toy on top to encourage my kitten to move. The photograph shows my kitten playing on the step stool.

Cats recycle
Kittens don’t need expensive toys; in fact they find trash to be treasure. One of the favorites in my house is an empty toilet paper, paper towel or wrapping paper roll. They can chew, scratch and roll the tubes to their hearts’ delight and the toys are easily replaced when completely destroyed. Another great toy is a wide, sturdy ribbon. I saved one from a gift and tied it to the kitchen drawer handle. I pull the drawer out four or five inches so the ribbon flutters in a breeze. My kittens love to jump up and bat the ribbon and at the same time get excellent exercise.

Cats like shopping [bags]
A shopping day means a bonanza for your cat. Maybe they get a cute new toy, but what they are most excited about is the pile of shopping bags you bring home. My kittens adore a large shopping bag with a small cardboard box slipped inside. The box supports part of the bag where the kittens play king of the hill. The box also creates a space inside the bag for hiding, resting and planning a surprise attack on my ankles. If given a choice, they like bags with stiff paper loop handles which they slip through like children with a hula hoop. The photograph shows how I set up the bag and box and how much my kitten likes playing in it! Do you have a favorite kitten or cat activity? Write back and let everyone else know how you keep your cat moving.