Treatment options and care for cats with diabetes mellitus

Abstract

Approximately 10% of cats with diabetes mellitus (diabetes) are euthanased at diagnosis and a further 10% euthanased within the first year of treatment, despite diabetes being a treatable disease. This review presents a spectrum of veterinary care aimed at providing practitioners with a range of treatment options to discuss with owners, potentially helping to prevent euthanasia at the time of diagnosis. Barriers such as owner concerns about lifestyle impact, pet welfare and presence of comorbidities contribute to decisions to euthanase, while financial limitations can significantly restrict access to veterinary care for cats with diabetes. This highlights the urgent need to implement a spectrum of care approach for feline diabetes with the aim of reducing euthanasia rates and improving owner and cat outcomes. Plain language summary Spectrum of veterinary care in feline diabetes mellitus Diabetes mellitus is a common and increasingly diagnosed disease in cats. Unfortunately, about one in 10 cats are euthanased at the time of diagnosis, even though diabetes is a treatable condition that can be managed. Decisions about euthanasia are often influenced by both cat-related factors (such as age, temperament or concurrent diseases) and owner-related factors (including time and financial demands, lifestyle impacts, pet welfare, fear of hypoglycaemia and giving injections, and challenges with boarding or travel). These factors reflect the significant caregiver burden that can accompany management of a diabetic cat. To support both cats and their owners, veterinarians should focus on clear and thorough owner discussions and developing individualised and flexible treatment and monitoring plans tailored to each cat’s needs and the owner’s circumstances. By applying a ‘spectrum of care’ approach – offering a range of practical and affordable options – veterinarians can make diabetes care more accessible and sustainable for all clients. The ultimate goals in managing feline diabetes are to reduce euthanasia rates, empower owners through education and shared decision-making, and improve quality of life for both cats and their caregivers without compromising care. The primary costs of diabetes management arise from treatment, monitoring, diet and veterinary care. Substituting a more affordable option in any of these areas can reduce overall expenses generally without impacting care. By being aware of the available options and their associated costs, veterinarians can offer flexible, individualised and informed treatment plans that address financial and practical barriers, ultimately reducing treatment costs and enhancing prognosis, owner satisfaction and feline wellbeing.