Diabetes in cats: symptoms, treatment, outlook

This article is about diabetes in cats — for people whose vet has recently told them their cat has diabetes, and for those who only suspect the disease. After reading it, you will understand what is going on in your cat’s body, how the diagnosis is confirmed, what to realistically expect from treatment, and what your part will look like from day to day.

How to tell if your cat may have diabetes

The most common signs of diabetes in a cat are visible without any tests. She drinks a lot — she turns up at the water bowl noticeably more often than usual, and sometimes drinks straight from the tap. That makes her urinate more, and more often: the litter box fills faster, and puddles appear where there used to be none. Her appetite usually grows at the same time, and she eats more than she used to — but instead of gaining weight, she is losing it. General lethargy may come on top of all this.

Eating a lot while losing weight looks illogical — and that combination is the clearest signal of all: the body cannot use what the cat eats. You don’t need to see all of the signs at once — any single one of them is reason enough to have tests done. Waiting and watching in the hope that it will pass on its own is not a good plan: starting treatment early can noticeably raise the chances of remission, which we will come back to below.

There is also one rare but very telling sign. When blood sugar has been high for a long time, a cat’s gait can change: the hind legs stop bearing weight on the toes, and the cat walks on her whole foot instead. This is called diabetic neuropathy — nerve damage caused by prolonged high blood sugar. If you notice this stance, see a vet without delay; as a rule, cats with neuropathy find it harder to reach remission.

How a vet confirms the diagnosis

It may seem that a single blood test showing high sugar should be enough. In practice it isn’t: the stress of the car ride and of the clinic visit itself raises blood glucose — sometimes quite a lot, though only for a short while. That is why a diagnosis is never made from one high reading.

The vet relies on a combination of data: the signs you have described, repeat measurements of blood sugar, sometimes the presence of glucose in the urine. If the clinic results are thin or don’t add up, the vet may order a fructosamine test. It shows what your cat’s blood sugar has averaged over roughly the last 7–10 days, which is why a single stressful visit barely distorts it. And sometimes the vet will ask you to skip the repeat clinic test and measure blood sugar at home instead, in surroundings where your cat is calm — such readings say more.

Interpreting test results and making the diagnosis is the vet’s job. As for which blood sugar counts as high in the first place, there is a separate article on normal blood sugar in cats.

What’s happening in your cat’s body

Diabetes in cats works much like type 2 diabetes in people, not the «childhood» type 1. Insulin — a hormone that helps sugar move from the blood into the cells — is produced in the cat’s body, but the body responds to it less well than it should. Sugar is not used up properly and stays in the blood.

Persistently high sugar wears out the pancreas, the organ that produces insulin, until it becomes exhausted. A vicious circle takes hold: the higher the sugar, the worse insulin works, and the sugar climbs even further. Everything else follows from this mechanism: why the vet prescribes insulin, why food and weight matter so much, and why remission is possible at all.

There is usually no single cause: heredity, age, and lifestyle all play a part. But two factors are well known. The first is excess weight. The second is corticosteroids — hormonal drugs that cats are given, for example, for allergies and certain other conditions; in cats whose diabetes developed while on such a drug, remission after it is stopped is more common — but stopping or replacing the drug is always done by the vet, because abrupt withdrawal is dangerous in itself. If one of these factors applies to your cat, that is most likely where her diabetes came from — and this is not about blame; it is about what you can influence.

Can it be cured? Remission and outlook

The first question after the diagnosis is usually «is this forever?» A complete cure — treating diabetes once and forgetting about it — is rare, but in a noticeable share of cats the disease goes into remission. Remission is not a cure; it is a state in which the cat needs no insulin for at least four weeks and shows no signs of the disease.

Across studies, roughly a third of cats treated with insulin reach remission — the spread between studies is wide, so «roughly a third» is a guide, not a promise. When remission happens, it most often happens within the first six months after diagnosis. Much here depends on the owner: starting treatment early, keeping blood sugar under steady control, and bringing excess weight down all improve the odds.

Remission also does not mean the disease can be forgotten: it can return even after a long break, so monitoring continues — measurements remain part of life, just less frequent. The statistics above describe only cats treated with insulin; they cannot be extended to other forms of treatment. With the disease well controlled overall, many diabetic cats live ordinary lives for years.

Our own cat Manishka is one of them: she was diagnosed in October 2025, at about 13 years old, and by December she was in remission — on a routine of daily blood sugar checks at home. One case proves nothing, but it shows that remission is real (her story).

How diabetes in cats is treated

For most cats the backbone of treatment is insulin, given as injections just under the skin, usually twice a day. The words you may hear from your vet — glargine, detemir, PZI — are different kinds of long-acting insulin, and there is no evidence that any one of them is better than the rest. The dose is chosen and adjusted by the vet. Treatment always starts with a small dose that is raised gradually until it is right — this is the safe way, so don’t be surprised if you don’t see an effect straight away.

Many owners are afraid they won’t manage the injections. That fear is normal, and the answer to it is not teaching yourself from the internet but training at the clinic: over a few sessions, a veterinary nurse shows you how to draw up the insulin and where and how to inject it. With that support, most owners do learn to give the injections. How the whole thing works, step by step — in the article on insulin for cats.

There is also an alternative to injections: pills given once a day. They make the body get rid of excess sugar, but they are not for every cat. They are prescribed only for cats that are in good shape at the time of the exam and have no severe complications of the disease — the vet calls this «clinically stable». These drugs carry serious risks, so whether this path suits your cat is something the vet decides only after additional tests.

One situation that reliably panics new owners is a shot that goes wrong: part of the dose leaks out, or you can’t tell whether it went in at all. There is no universal rule about whether to give another dose, and this is not a decision to make in the moment. Agree with your vet in advance on what to do if it happens — then the episode follows instructions instead of panic.

What you’ll need to do every day

Everyday care comes down to three habits. The first is giving the medication on the vet’s schedule, at the same time each day. The second is feeding: most diabetic cats do best on food low in carbohydrates, and that usually means wet food; if your cat has other diseases, the right diet may look different, and it must be discussed with the vet. The third is weight: if your cat is overweight, gradual weight loss is itself part of the treatment and noticeably raises the chances of remission — and weight depends above all on you.

And the main habit: measuring blood sugar at home. Home readings show how the treatment is working in familiar surroundings, without the stress of a clinic visit, and they are considered the preferred way to monitor the disease. Usually you prick the edge of the ear — your vet will show you how — and write the result down. These records are what let the vet see the whole picture and make the treatment more precise. Keeping such a log is easy in Diabnostic, an app built exactly for home readings: your records are always at hand, and you can show them to the vet. The one thing this does not change is that the dose is still not yours to adjust — every change in dose, food, or schedule goes through your vet.

Home measurements are covered in detail in a separate article on how to measure your cat’s blood sugar, and there is a dedicated piece on the first days after the diagnosis.

Dangerous drops in blood sugar: what to do

The main risk of insulin treatment is hypoglycemia — a drop in blood sugar that goes too low. Most often it happens when the dose turns out to be too large or the cat hasn’t eaten after her shot — or when her own insulin production has partly recovered. You need to know its signs on sight: lethargy, sleepiness, strange behavior, a wobbly gait, weakness, trembling.

Here is the line between a mild and a severe episode. Mild means the cat is conscious and responds to you — she is simply unwell: sluggish, wobbly, acting strange. Severe means seizures, loss of consciousness, or a cat who does not respond to you at all. The difference is crucial, because a severe episode calls for a completely different course of action — more on that below.

Help for a mild episode starts right away, without waiting:

1. Rub sugar syrup or honey onto the gums — a small amount is enough (corn syrup works). Do not put your fingers into the cat’s mouth: she may bite.
2. If the cat comes around within a few minutes, feed her ordinary food containing carbohydrates. If she is conscious but not improving, that too is a reason to go to the vet without putting it off.
3. Show the cat to the vet the same day, even if she looks completely normal. The episode itself means the dose or the schedule needs to be reviewed.

If the cat has seizures or does not respond to you, this is an emergency, and the order of actions is different. Do not feed her and do not pour anything into her mouth: an unconscious cat can inhale food or liquid, and that is more dangerous than a temporarily missed meal. Rub syrup or honey onto the gums and go to the nearest clinic immediately, or call the vet right now — not «later that day».

None of this is a reason to panic. A mild episode usually passes quickly, especially if you give sugar right away and feed the cat afterwards — and it is almost never life-threatening. It still means a same-day visit to the vet, even if the cat looks completely normal: reviewing the dose together with your vet is what that visit is for. The dangerous scenario is the severe one described above. If you remember this boundary, you won’t lose time in either case.

Agree with your vet in advance on the syrup dose and on the first-aid rule itself — in the same conversation where you settle what to do about a shot that goes wrong. Keep syrup or honey at home, so you are not looking for it in the middle of the night.

Low blood sugar is not the only emergency. A diabetic cat who refuses food, vomits, or suddenly becomes deeply lethargic needs a vet immediately — these are separate warning signs, unrelated to insulin doses.

What to read next

If you have just come back from the clinic, start with the article on the first days after the diagnosis. After that, as needed: how insulin therapy is organized, which blood sugar counts as normal, how to take home measurements, and the story of our Manishka — for those who want to see what all of this looks like in practice.

We are also preparing separate articles on the topics this overview could not cover: pills instead of insulin, food and weight, remission and its pitfalls, lab tests for diabetes, a detailed first-aid protocol for hypoglycemia, neuropathy, and living with a diabetic cat over the long run.

Sources

• Sparkes AH, Cannon M, Church D, et al. ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats. J Feline Med Surg. 2015;17(3):235–250.
• Taylor S, Cannon M, Church D, et al. 2025 iCatCare consensus guidelines on the diagnosis and management of diabetes mellitus in cats. J Feline Med Surg. 2025;27(11).
• Bugbee A, Rucinsky R, Alvarez E, et al. 2026 AAHA Diabetes Management Guidelines for Cats. J Am Anim Hosp Assoc. 2026;62:65–93.