When to see a vet urgently
A cat with diabetes, or symptoms consistent with it, needs urgent help if any of the following occurs:
- Your cat stops eating, vomits or is noticeably weaker than usual.
- Your cat staggers, trembles, has seizures or loses consciousness.
- Breathing becomes difficult or abnormal alongside a poor general condition.
- Your cat cannot drink or appears dehydrated and apathetic.
These signs may be associated with low blood sugar or ketoacidosis. You can find a vet near you.
Overview
Insulin is a pancreatic hormone that regulates the entry of sugar into the body's cells. In diabetes, either insulin production falls (deficiency) or tissues stop responding to it properly (resistance). Sugar accumulates in the blood while the cells remain 'hungry'. This disrupts metabolism and damages the liver, kidneys, nervous system and eyes.
Feline diabetes usually resembles type 2 diabetes in people, involving excess weight and insulin resistance. Over time, however, the disease exhausts the pancreas and the cat becomes dependent on insulin.
Disease progression and treatment needs vary. In some cats, pancreatic insulin production recovers when blood sugar is controlled and insulin resistance decreases. This can lead to remission, a phase in which blood sugar stays within a suitable range without diabetes medication. Remission does not mean a permanent cure, and monitoring continues.
When glucose, or blood sugar, passes into the urine, it draws water with it. Urine volume increases, and the cat drinks to replace the loss. Increased drinking is therefore not usually the original cause of the problem. Do not restrict a diabetic cat's water to make the litter tray less wet.
Causes
- Obesity, the main risk factor.
- An inherited predisposition, seen more often in some breeds, such as Burmese and Siamese cats.
- Chronic pancreatitis.
- Hormonal diseases, including hyperadrenocorticism and acromegaly.
- Use of glucocorticoids and progestogens.
- Older age.
Concurrent inflammation, dental disease or another organ disease can make diabetes harder to control. Acromegaly involves excessive growth hormone production; it may be investigated particularly when the treatment response is poorer than expected. A poor response does not automatically mean another hormonal disease, however: administration technique, medicine storage and dietary changes are checked too.
Risk factors
- Age over seven to eight years.
- Obesity and little exercise.
- Males are affected more often than females.
- Neutered males are an at-risk group.
- Susceptible breeds, including Burmese and Siamese cats.
There is no absolute age threshold for diabetes, and younger cats can develop it. Breed-related findings vary between countries and populations. Evidence for a general predisposition in Siamese cats is particularly limited, and breed alone does not establish the disease. Weight and lifestyle are also considered when assessing risks associated with neutering.
Typical symptoms
- Persistent thirst (polydipsia).
- Frequent urination (polyuria).
- Increased or variable appetite.
- Gradual weight loss despite a good appetite.
- Tiredness and reduced activity.
- Deterioration in coat condition.
- Hind leg weakness (diabetic neuropathy).
- In severe cases, ketoacidosis, with vomiting, an acetone smell on the breath and coma.
At home, the first change may be larger urine clumps or a water bowl emptying faster than usual. Weight may fall even when your cat asks for more food. With neuropathy, the hocks may drop close to the floor and jumping becomes difficult. Hind leg weakness can have other causes, however, so it needs investigation.
In ketoacidosis, ketones accumulate in the body and the blood becomes more acidic. Your cat may lose its appetite, vomit and become dehydrated. Do not wait for an acetone smell or coma before seeking treatment. The good appetite commonly associated with diabetes does not protect against this complication.
Complications and consequences
- Diabetic ketoacidosis, a life-threatening condition.
- Fatty liver disease.
- Chronic kidney failure.
- Deteriorating vision: cataracts are less common in cats than in dogs, but are possible.
- Diabetic neuropathy, causing hind leg weakness.
Not every diabetic cat develops all the organ changes listed. Kidney or eye disease may also occur alongside diabetes, and not every such finding is a direct consequence of it. An important additional risk during treatment is hypoglycaemia, or excessively low blood sugar, particularly when insulin requirements change.
Sudden weakness, trembling, staggering and seizures are consistent with hypoglycaemia. If your cat is conscious and can swallow, offer food while contacting the vet immediately. Do not force food, fluid or fingers into the mouth of an unconscious cat or one having a seizure. Ask the practice in advance for written first-aid instructions.
Diagnosis at the vet
- Clinical examination and history.
- Blood tests showing persistent hyperglycaemia.
- Urinalysis for glucose and ketones.
- Fructosamine, which indicates a sustained rise in blood sugar.
- Exclusion of stress hyperglycaemia: cats' blood sugar often rises temporarily because of stress.
A single high glucose measurement at the practice is insufficient for diagnosis, because stress can raise it considerably. Diagnosis combines symptoms with evidence of persistent high blood sugar. If needed, measurements or urine samples can be obtained in a calm home environment, so assessment does not depend on one stressful visit.
Fructosamine reflects average blood sugar, but does not show the highest and lowest values during the day. It may be normal early in the disease, and conditions such as hyperthyroidism or protein-losing disease may affect the result. It is therefore interpreted alongside symptoms and other investigations.
Urine is assessed for ketones as well as glucose, and for possible infection when appropriate. A blood count, organ values and selected additional tests help identify concurrent illnesses. In an unwell diabetic cat taking certain oral diabetes medicines, ketones are checked even if glucose is not particularly high.
Treatment
The treatment plan includes medication to regulate blood sugar, appropriate feeding and monitoring. Many cats need insulin. The practice teaches you how to prepare the medicine, use the correct equipment and give injections. The syringe must match the product's concentration, and instructions for another insulin must not be applied directly. Ask for an individual plan for missed or unsuccessful injections.
An SGLT2 inhibitor, which increases glucose loss through the urine, may be considered for selected cats. It is not suitable for every cat and does not replace insulin in a cat whose own insulin production is insufficient. Previous medication and other illnesses affect the choice. Do not switch from insulin to this type of medicine yourself.
During SGLT2 treatment, ketoacidosis can develop without an obvious rise in blood sugar. A good glucose result alone therefore does not rule out danger. Treatment also requires ketone monitoring and prompt contact if appetite or general condition deteriorates. Ketoacidosis is treated in hospital; suspected ketoacidosis must not be managed simply by increasing medication at home.
Feeding and weight management
A low-carbohydrate complete food may be chosen for a diabetic cat, but other illnesses and palatability are also considered. Overweight cats should lose weight in a controlled way. A cat that is already thin or eating poorly needs enough energy and must not be fasted to reach a target weight.
Dietary changes can alter medication requirements, so agree them with the treating vet. A regular routine makes eating and symptoms easier to monitor. If your cat will not eat, ask for advice about medication and further care rather than waiting for the next routine check-up.
Home monitoring and remission
Keep a record of appetite, drinking, urination, weight, activity and medication given. Blood sugar can be monitored using a drop of blood or a sensor placed on the skin. Sensor readings and possible low values are assessed alongside symptoms and, when necessary, a blood measurement. Do not change treatment on the basis of a single reading without agreed instructions.
Check-ups assess both glucose control and your cat's condition. Reduced thirst or regained weight may indicate improvement, but does not confirm remission on its own. If insulin requirements fall, treatment is adjusted under supervision to avoid hypoglycaemia. Even a cat in remission can develop diabetes again, so weight and symptom monitoring continues.
Prevention
- Keep your cat at a healthy weight.
- Feed appropriately, including specialist foods for blood sugar control and a low-carbohydrate diet.
- Provide enough exercise.
- Treat chronic pancreatic disease.
- Avoid hormonal medicines without veterinary monitoring.
A healthy cat does not need diabetes medication for prevention or automatically require a specialist diabetic food. Reducing risk centres on an appropriate weight, a balanced diet and exercise. Do not stop prescribed corticosteroids or other hormonal treatment yourself; discuss its need and monitoring with the vet.
Important for cat owners
Diabetes is a serious disease, but many cats live for a long time with appropriate treatment. Remember that regular veterinary visits, blood sugar monitoring, diet and insulin when needed are the foundations of successful management. The earlier diagnosis is made, the better the chance of stabilising the condition and even achieving remission.
This article provides general information and does not replace veterinary care. Contact a vet if you notice signs of illness in your cat.
Frequently asked questions
Can diabetes in cats go into remission?
Yes. Some cats manage without diabetes medication after treatment when their own insulin production recovers. Remission is established through monitoring, and relapse is possible.
Is one high blood sugar result enough for diagnosis?
Usually not. Stress can raise a cat's glucose considerably. Symptoms, repeated or home measurements, urinalysis and fructosamine help build the overall assessment.
Can diabetes be treated without injections?
An oral medicine suits some selected cats, but many need insulin. The treatment depends on the cat's own insulin production, other illnesses and the ability to monitor safely.
Is vomiting in a diabetic cat always dangerous?
It can indicate ketoacidosis or another problem requiring treatment, particularly alongside loss of appetite or weakness. Contact the practice promptly; normal glucose does not rule out ketoacidosis associated with SGLT2 treatment.
This article is for general information only and is not a guide to treatment. If you notice the first signs of illness, contact your vet.
Paw4care editorial team
Sources
- 2026 AAHA Diabetes Management Guidelines for Cats, AAHA / Journal of the American Animal Hospital Association, accessed 2026-11-03.
- Overview of Diabetes Mellitus in Cats, American Animal Hospital Association, accessed 2026-11-03.
- Recognising and Managing Cats at Risk for DM, American Animal Hospital Association, accessed 2026-11-03.
- Feline Diabetes, Cornell Feline Health Centre, accessed 2026-11-03.
- Section 6: SGLT2 Inhibitor Treatment and Monitoring, American Animal Hospital Association, accessed 2026-11-03.
- Insulin Treatment and Monitoring, American Animal Hospital Association, accessed 2026-11-03.
- iCatCare 2025 consensus guidelines on the diagnosis and management of diabetes mellitus in cats, Journal of Feline Medicine and Surgery / International Cat Care, accessed 2026-11-03.
- Troubleshooting in Diabetic Cats, American Animal Hospital Association, accessed 2026-11-03.
- Section 12: Diabetic Ketoacidosis in Cats, American Animal Hospital Association, accessed 2026-11-03.