Typical symptoms of diabetes mellitusIf symptoms are not recognized, an uncomplicated diabetes can become a complicated diabetes and thus a life-threatening emergency.
Table of Contents
– When thirst becomes a problem – When hunger knows no bounds – When the cat becomes a bear – When uncomplicated becomes complicated – So that the therapy has a hand and a foot – Typical symptoms of uncomplicated diabetes mellitus
from Dr. med. vet. cats suffering from diabetes mellitus suffer from diabetes type 2 in 80% of cases. This type of diabetes is characterized by an increasing destruction of the insulin-producing beta cells of the pancreas. Characterized by a decrease in the responsiveness of the body's cell insulin receptors to insulin (insulin resistance). This type of diabetes is characterized by progressive destruction of the insulin-producing beta cells of the pancreas. Characterized by decreasing responsiveness of the body's cell insulin receptors to insulin (insulin resistance). Insulin synthesis and secretion decreases, while the secretion of the insulin gene glucagon increases. As a result there is a loss of body mass. To an increase of the blood sugar level.
The typical cat patient with diabetes mellitus is older than nine years, male, neutered, overweight, and kept as an indoor cat. As a rule, owners of these cats come to the practice because they have to clean the litter box more often. Many also come because the cat suddenly becomes unclean and urination occurs in undesirable places (Periuria). Some notice the changed gait or the lack of jumping power of their cat. The weight loss is usually not noticed or perceived as positive, as the owner has been advised during previous visits to the practice to have his severely overweight animal lose weight. The same is true for increased drinking, which is often equated with health. Also constant hunger (Polyphagia) is not perceived as pathological, because the cat eats well from the owner's point of view.
When thirst becomes a problem
A major symptom of uncomplicated diabetes is increased thirst (Polydipsia) and the accompanying increased urine excretion (Polyuria). This in turn can lead to uncleanliness, as many cats are reluctant to revisit a litter box that has already been used. In addition, many cats with diabetes mellitus also have a urinary tract infection, which can also lead to periuria due to pain or increased urine output.
The lack of insulin leads to an increased secretion of the insulin gene glucagon. Glucagon promotes glycogenolysis, d. h. the breakdown of glycogen from the liver cell to glucose. Furthermore, glucagon increases gluconeogenesis, d. h. The formation of new glucose from z. B. Amino acids. Both mechanisms increase the blood glucose level and together with the decreased uptake of glucose into the cell lead to an increased blood glucose level, a Hyperglycemia. If blood glucose rises above 250 mg/dl (14 mmol/l), glucose is excreted in the urine. Can be detected in the urine with a test strip. Glucose has a strong osmotic effect. Leads to increased water loss via the urinary tract. the cat tries to compensate this by drinking more water. Since the excreted urine contains glucose and is also highly diluted, the body's natural defense mechanisms fail, opening the door to urinary tract infections. Some infectious agents (e.g. B. E. coli) produce toxins that block water reabsorption in the kidney. Further fluid loss occurs, which further increases the feeling of thirst and thus water intake. Fluid loss through urine may be so high that the cat cannot compensate for it by drinking more. These patients are markedly dehydrated, which is clinically reflected in decreased skin turgor. Depending on the fluid deficit, a skin fold that has been pulled open may only disappear slowly or remain in place.
Diabetic cats have increased blood glucose levels, but this can also occur in healthy, stressed cats! Only an elevated long-term blood glucose (fructosamine) in cats is evidence of diabetes mellitus. The fructosamine value reflects the average blood glucose of the last ten days.
When hunger knows no bounds
In the course of an uncomplicated diabetes mellitus affected cats show ravenous hunger (Polyphagia). Owners feed as before or significantly more because the cat is constantly hungry and yet there is increasing weight loss. Absence of insulin prevents glucose from being absorbed into the cell. The storage of glucose in the form of glycogen in the liver. At the same time there is a loss of glucose through the urine. The body loses important energy reserves. Increased glucagon secretion also increases the breakdown of proteins to provide amino acids for new glucose (Gluconeogenesis) to be provided. Main source of protein is the muscles. This leads to a loss of muscle mass and, due to the protein breakdown, to an impairment of the immune system and to disturbances in wound healing. Fat metabolism is also increased under the influence of glucagon. There is a hasty breakdown of fat (Lipoplysis) takes place, which causes an increase of the blood lipid level (Lipemia) causes. Released fats are stored in the liver, a fatty liver develops. Fatty liver causes reversible damage to liver cells and an increase in liver enzymes AP (alkaline phosphatase), ALT (alanine aminotransferase) and cholesterol in the blood serum. The Hyperlipidemia can be detected in the blood as an increase in triglycerides.
When the cat turns into a bear
Some of the patients are presented because of abnormalities in the gait pattern. Cats belong to the toe-walkers, in contrast to bears, which touch down with the whole foot, as they only touch down with the tips of their toes. Some diabetic cats, on the other hand, walk on the whole sole in the area of the hind paws and have problems to jump on elevated places. This "plantigrade" gait is the result of nerve damage caused by hyperglycemia (diabetic neuropathy). This posterior weakness must not be misinterpreted as an orthopedic problem. It disappears during therapy of diabetes.
When uncomplicated becomes complicated
If diabetes is not detected or remains untreated, an uncomplicated diabetes can become a complicated diabetes. Fat metabolism is derailed and masses of ketone bodies are formed in the course of precipitated fat breakdown. The ketone bodies can be detected in the blood as well as in the urine. The blood pH shifts to the acidic range (acidosis), the patient develops ketoacidosis. These patients stop eating (inappetence), become increasingly apathetic and their lives are acutely threatened. You have to be hospitalized. Intensive care is needed. Mortality is high.
So that the therapy has a hand and a foot
Many cats suffering from diabetes mellitus have concomitant diseases such as z. B. Urinary tract infections or diseases of the teeth, which make it difficult or impossible to treat the diabetes. Therefore, the diagnosis of diabetes always includes a thorough examination of the mouth and a urinary status. In addition, it is recommended to check the feline specific pancreatic lipase, since some of the patients suffer from inflammation of the pancreas. In older patients, the T4 value should also be determined to exclude hyperthyroidism (overactive thyroid). diabetes mellitus is accompanied by increased drinking (polydipsia). Glucose excretion in the urine (glucosuria) is associated with. The patients may be dehydrated. Elevated glucose and fructosamine levels are noticeable in the blood.
Patients suffer from cravings (polyphagia) and weight loss (loss of muscle mass and body fat). You develop a fatty liver. Blood chemistry shows elevated AP and ALT, triglycerides, and hypercholesterolemia (elevated cholesterol levels).