Feline Diabetes: A Different Disease to Canine Diabetes
When most people hear the word diabetes, they picture insulin injections and a lifelong diagnosis. For dogs, that picture is largely accurate. For cats, however, the story is far more nuanced — and far more hopeful. Feline diabetes resembles human Type 2 diabetes more closely than it resembles the canine version, and with early, aggressive management, a significant proportion of cats can achieve full diabetic remission, meaning they no longer need insulin at all.
Understanding why feline diabetes is different — and what that means for treatment — can make an enormous difference to your cat's long-term outcome.
What Causes Diabetes in Cats?
In cats, diabetes develops primarily through insulin resistance rather than outright destruction of the insulin-producing cells in the pancreas. The pancreas still produces insulin, but the body's cells respond to it poorly, meaning blood glucose climbs regardless. Over time, the pancreatic cells become exhausted from overproducing insulin and may sustain damage — but if treatment is started early enough, before too much damage accumulates, those cells can recover.
Several risk factors make certain cats more likely to develop diabetes. Obesity is the single biggest modifiable risk factor — excess fat tissue actively promotes insulin resistance. Neutered male cats are disproportionately represented, as are sedentary indoor cats. Long-term use of glucocorticoid medications (steroids), often prescribed for conditions such as allergic skin disease or inflammatory bowel disease, is another well-recognised trigger. Cats over the age of seven are at higher risk overall, with incidence climbing sharply with age.
Recognising the Signs
The classic symptoms of feline diabetes are the same as in dogs: increased thirst, increased urination, weight loss despite a good or even ravenous appetite, and general lethargy. Cat owners may notice the litter tray becoming noticeably fuller and heavier, or find that their cat is suddenly drinking from unusual sources like taps or puddles.
A subtler sign that is more specific to cats is a change in posture called plantigrade stance, where the cat appears to walk on their hocks rather than their toes, giving a flattened, low-to-the-ground gait. This results from diabetic neuropathy affecting the hind legs and is a sign that the disease has been progressing for some time.
Diagnosis
Diagnosis requires finding persistently elevated blood glucose alongside glucose in the urine. One important caveat with cats is that they are extremely prone to stress hyperglycaemia — a temporary spike in blood glucose caused by the anxiety of a vet visit — which can mimic diabetes on a single blood test. Your vet will therefore often also measure fructosamine, a protein that reflects average blood glucose over the previous two to three weeks and is unaffected by short-term stress. A high fructosamine level alongside elevated blood glucose gives a much clearer picture.
The Goal: Tight Glycaemic Control for Remission
The most important concept in feline diabetes management is that early, tight glycaemic control dramatically increases the chance of remission. Studies suggest that between fifty and eighty per cent of cats treated aggressively in the early stages of their disease — using appropriate insulin alongside a dietary change — can enter full remission, sometimes within weeks to months of starting treatment.
This is why delaying treatment, or treating conservatively with the aim of "just keeping glucose down a bit," is generally considered a missed opportunity. The window for remission is widest early in the disease when pancreatic cells have not yet sustained irreversible damage.
Insulin for Cats: Why Glargine Is Preferred
The choice of insulin matters considerably in cats. Long-acting insulin analogues, particularly insulin glargine (sold under the brand name Lantus) and insulin detemir, are now widely considered the gold standard for feline diabetes because they provide a smooth, sustained effect without sharp peaks that can cause dangerous hypoglycaemia. Unlike Caninsulin (which is commonly used in dogs), glargine is given twice daily and maintains more stable glucose levels throughout the day and night.
Your vet will calculate a starting dose and adjust it based on glucose readings. Never alter your cat's insulin dose without guidance, as both overdosing and underdosing carry real risks.
Diet: High Protein, Low Carbohydrate
Dietary change is not optional in feline diabetes — it is a cornerstone of treatment and one of the most powerful tools available. Cats are obligate carnivores and have evolved on a diet that is naturally very low in carbohydrates. A high-carbohydrate diet promotes post-meal glucose spikes that make diabetes much harder to control.
Switching to a high-protein, low-carbohydrate wet food (tinned or pouched) dramatically reduces the glucose burden after meals. Many veterinary diabetologists recommend wet food over dry kibble as the default for all diabetic cats, as even prescription diabetic dry foods tend to contain more carbohydrate than ideal wet food options. Diet change alone is rarely sufficient to bring diabetes under control initially — most newly diagnosed cats need insulin as well — but the combination of the right diet and the right insulin gives the best chance of remission.
Home Glucose Monitoring
Home monitoring of blood glucose has transformed feline diabetes management and is now strongly encouraged. The AlphaTRAK 2 meter is a glucometer specifically calibrated for cats and dogs, giving more accurate readings than human glucometers. Most cats can be trained to tolerate small ear-prick or paw-pad samples with patient conditioning and a food reward.
Monitoring at home allows you to track glucose trends across the day, spot hypoglycaemia before it becomes an emergency, and gather meaningful data to share with your vet at appointments. It also means you can adjust feeding and contact your vet promptly if readings are outside the expected range.
Recognising Hypoglycaemia in Cats
Hypoglycaemia — blood glucose falling too low — is the main danger of insulin therapy. Signs include weakness, wobbling, disorientation, twitching, and in severe cases seizures or unconsciousness. If you suspect hypoglycaemia, rub a small amount of honey or glucose syrup onto your cat's gums and contact your vet immediately. Keep glucose gel or honey accessible at all times.
As a cat moves towards remission, their insulin requirements drop — so monitoring becomes even more important during this period to catch hypoglycaemia early and reduce the dose in time.
Life After Remission
Cats in remission should continue on a low-carbohydrate diet indefinitely and be monitored regularly, because diabetes can recur — particularly if weight is regained or steroids are needed for another condition. Many owners continue occasional home glucose spot-checks even after remission as an early warning system. With diligence, some cats remain in remission for years.