Dear Dr. John,
Our cat has been overweight for years and came down with diabetes two years ago, at 11. We have treated it with a prescription diet and insulin shots twice a day. The food hasn’t really made much difference in his weight, and we have had to increase the insulin dosing slowly over time. Is this typical? Apparently, there is a new treatment for cat diabetes that does not require daily shots and our question is if that might make sense for our cat? F.C.
Dear F.C.,
As you have learned, cat obesity or being overweight is a common predecessor to diabetes mellitus in the species. For my entire career, I have urged owners of overweight cats to put their pets on diets to avert diabetes from developing. It is said that almost 2/3 of all cats are overweight! Diabetes, once developed, is not treated but managed and doing so is usually very effective, allowing the cat to live for many happy and healthy years.
Various forms of insulin have been used over the years and different practitioners have their favorite types. Lantus is one of the more popular choices. Insulin management commonly requires regular monitoring and occasional dosing adjustments to the twice a day needed injections. Diet is also a huge factor in management requiring diets that typically are higher in fiber, lower in carbohydrates, and higher in protein. Sometimes proper diet and weight management, along with early intervention and insulin dosing management, can put diabetes into remission but that usually occurs within less than six months.
Even though it is unlikely that your cat could go into diabetes remission after two years, I would still urge you to get him to lose weight. In the last year, two different names have emerged for the once-a-day dosing of an oral agent to manage cat diabetes. They are Bexacat tablets and Senvelgo liquid. Unfortunately for you and your cat, it is contraindicated for cats that are currently or have previously been managed with insulin due to some serious negative outcomes so your veterinarian would not recommend it for your cat.
Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.