Understanding Feline Diabetes: Symptoms, Treatment, and Care

People usually land on a feline diabetes page because something has shifted at home: the water bowl is emptying faster than usual, the litter tray is wetter, or a cat that eats well is still losing weight. Sometimes the change is quieter—less jumping, a strange hind-leg weakness, a dull coat that won’t quite come good.

Diabetes is treatable, but it doesn’t reward guesswork. The safest path is to recognise the signs early, confirm the diagnosis properly (cats can show “stress hyperglycaemia” at the vet), then settle into a steady routine that protects your cat from both high blood sugar and the more immediate danger of hypoglycaemia from treatment.^{1, 2}

What feline diabetes is (and what it isn’t)

Diabetes mellitus in cats happens when the body can’t use insulin effectively and blood glucose stays high. In most cats, it resembles type 2 diabetes in people: insulin resistance plus gradual strain on the insulin-producing cells of the pancreas, rather than an immune-driven “type 1” picture.^{4, 6}

High blood glucose spills into urine once it rises above the kidney’s threshold, dragging water with it. That’s why increased urination (polyuria) and thirst (polydipsia) are often the first changes people notice at home.¹

How common is diabetes in cats in Australia?

Australian clinic data suggests diabetes is diagnosed in well under 1% of cats seen in practice (about 7.4 cases per 1,000 cats over a five-year period in one Brisbane study). Burmese cats in that dataset were around three times more likely to be diagnosed than other cats, and males were over-represented.⁷

Rates vary between studies and populations, but the practical takeaway stays the same: diabetes is common enough that any cat with persistent PU/PD, weight loss, or unexplained weakness deserves a proper work-up.¹

Causes and risk factors

Diabetes rarely has a single cause. It tends to appear where biology and environment overlap, slowly tipping a cat from “coping” into persistent hyperglycaemia.

Key risk factors

• Overweight and inactivity (linked to insulin resistance).^{1, 2}
• Ageing (middle-aged and older cats are diagnosed more often).¹
• Breed predisposition, including Burmese cats in Australian studies.⁷
• Medicines and concurrent disease that reduce insulin sensitivity (your vet will ask about corticosteroid use and other conditions).¹

Signs you might see at home

Diabetes can look plain at first, then suddenly become urgent if ketones build up or blood sugar drops too low during treatment.

Common early signs

• Drinking more, urinating more (including larger clumps in the litter).^{1, 2}
• Weight loss despite a good appetite.^{1, 2}
• Lethargy, reduced grooming, a dull or “untidy” coat.²
• Weakness in the back legs, trouble jumping (can be diabetic neuropathy).¹

Red flags (same-day vet care)

• Not eating, vomiting, obvious dehydration, marked weakness or collapse (possible diabetic ketoacidosis).²
• Wobbliness, tremors, seizures, sudden profound sleepiness (possible hypoglycaemia, especially if your cat is on insulin).²

How vets diagnose diabetes (and why it can take more than one test)

Diagnosis usually rests on a pattern: compatible clinical signs plus persistent hyperglycaemia and glucose in the urine. In cats, stress can temporarily raise blood glucose during a clinic visit, so your vet may use additional checks to separate true diabetes from a stress response.¹

Common parts of the work-up include:

• Blood glucose (often repeated or interpreted alongside other findings).¹
• Urinalysis to look for glucose and ketones, and to assess hydration and infection risk.¹
• Fructosamine (a marker of average glucose over the prior 1–2 weeks, helpful when stress hyperglycaemia is a concern).¹
• Broader blood and urine testing to look for concurrent problems that can destabilise diabetes (including infections).¹

Treatment options

The core aim is simple: control clinical signs while avoiding hypoglycaemia. That usually means insulin plus diet, with monitoring that’s realistic for your household and safe for your cat.^{1, 3}

Insulin therapy

For most diabetic cats, insulin injections are the mainstay. Long-acting insulins such as insulin glargine or protamine zinc insulin (PZI) are commonly used, typically given every 12 hours, and your vet will start conservatively and adjust based on response and safety.³

Early, effective control matters. Some cats—particularly those treated promptly with an appropriate insulin protocol and a low-carbohydrate diet—can enter remission and no longer need insulin, though relapse can occur and ongoing monitoring still matters.^{5, 8}

Dietary management

Many diabetic cats do best on a high-protein, low-carbohydrate diet to reduce post-meal glucose spikes and support weight management where needed. Your vet may recommend a prescription diet or help you choose an appropriate over-the-counter option, especially if other conditions (kidney disease, food intolerance) also need to be considered.^{2, 9}

Consistency is quietly powerful here: similar food, similar timing, similar portions. Sudden diet changes can shift glucose control and insulin needs.

Oral medications (why they’re not the usual first choice)

Oral glucose-lowering drugs have a limited role in cats compared with insulin, and they’re not appropriate for every diabetic cat. Your veterinarian may discuss them in specific situations, but they should never be started as a DIY alternative to proper diagnosis and a tailored plan.¹

Managing diabetes at home

Once the initial diagnosis settles, diabetes care becomes a rhythm: food, insulin, observation, record-keeping. Cats tend to cope best when the household is steady and predictable.

What to monitor (the practical home checklist)

• Appetite and demeanour (bright/quiet, grooming, interest in play).²
• Water intake and urine volume (often the first clue control has slipped).^{1, 2}
• Body weight (weekly is useful; rapid loss is a warning sign).²
• Insulin doses given (time, amount, and any difficulties).¹
• Home blood glucose monitoring if your vet recommends it (often more reliable than in-clinic curves for cats prone to stress).^{1, 2}
• Urine glucose/ketone checks when advised, especially if your cat seems unwell.¹

Giving insulin safely

• Keep to a consistent 12-hour schedule unless your vet directs otherwise.³
• Use the correct syringe/pen for your insulin type and concentration.
• Never “double up” a dose if you’re unsure whether one was given—contact your vet for guidance.
• Ask your clinic to watch you give an injection at least once. Small technique tweaks prevent sore skin and missed doses.¹

Hypoglycaemia: what it looks like and what to do

Hypoglycaemia (blood glucose too low) is the complication vets worry about most, because it can become life-threatening quickly. If your cat is weak, wobbly, trembling, having seizures, or unusually hard to rouse, treat it as an emergency.²

If your cat is alert enough to swallow, offer food. If they won’t eat, your vet may advise rubbing a small amount of glucose source (such as honey or a dextrose gel) on the gums while you organise urgent veterinary care. Do not put fingers or liquids in the mouth of a convulsing or unconscious cat.²

Prevention and risk reduction

You can’t change genetics, but you can shape the daily conditions that make diabetes more likely.

• Keep body condition lean: slow, supervised weight loss if your cat is overweight, with regular weigh-ins.⁹
• Build gentle activity into the day: short play sessions, food puzzles, climbing options, and movement that suits your cat’s age and joints.
• Regular check-ups for older cats, and earlier testing if PU/PD, weight loss, or appetite changes appear.¹

Living with a diabetic cat

A well-managed diabetic cat often returns to a familiar life: steady weight, steady thirst, normal curiosity in the household. The work is mostly in the background—measured doses, quiet observation, and the willingness to adjust when the numbers or the behaviour drift.^{1, 2}

It helps to plan for the mundane details: a reliable place to store insulin, a way to log doses, and a backup person who can step in if you’re away. If your cat enters remission, the routine doesn’t vanish; it simply changes shape, with ongoing attention to diet, weight, and the early signs of relapse.⁸

References

1. American Animal Hospital Association (AAHA) – 2018 Diabetes Management Guideline (Diagnosis and assessment)
2. Cornell University College of Veterinary Medicine – Feline diabetes
3. MSD Veterinary Manual – Diabetes mellitus in dogs and cats (treatment notes for cats)
4. Rucinsky R et al. (2018) – AAHA Diabetes Management Guidelines for Dogs and Cats (JAAHA)
5. Marshall RD, Rand JS & Morton JM. (2009) Treatment of newly diagnosed diabetic cats with glargine insulin… (Journal of Feline Medicine and Surgery) – PubMed
6. Roomp K & Rand J. (2009) Intensive blood glucose control is safe and effective in diabetic cats using home monitoring and glargine – PubMed
7. EveryCat Health Foundation – Diabetes in Australian cats (summary of Lederer & Rand et al., 2009, The Veterinary Journal)
8. Gottlieb S, Rand JS & Anderson ST. (2024) Frequency of diabetic remission, predictors of remission and survival in cats… (J Feline Med Surg) – PMC
9. AAHA – 2018 Diabetes Management Guideline (Dietary management for cats)