Living With Feline Diabetes

Parents Speak
Living with Feline Diabetes
By Jennifer Hearin
September 17, 2010

Gump is my “soul kitty”. I have always loved and had cats in my life. But I’ve never had a cat that was so special,
loving and part of my heart - from the time he was a kitten. Up until he was 12 years old, he seemed healthy. I
always fed him dry cat food, and sometimes gave him a little canned food. I fed him IAMs and then started
feeding him a “holistic” labeled brand, but it still had lots of grains and even fruit and veggies in it (which I
thought was so healthy).

Gump became ill one day in the fall of 2006 (he was 12 years old at the time). He stopped eating and was not
doing well at all. I soon took him to the vet, and this vet made a point of telling me several times that he might not
make it. His blood work showed several problems, one of which was high glucose levels. He probably had
developed a diabetic condition called diabetic ketoacidosis (DKA). This is a very serious condition that occurs
with high BG levels and lack of insulin. When Gump became ill he probably should have had 24-hour vet care (I
now know not eating can be deadly), but that vet didn’t push it hard. So I took him home and we went back and
forth getting fluids for several days. Gump eventually pulled through this crisis, started eating and recovered. But
he still had high BG (blood glucose) levels, as he was diabetic.

I thought Gump was healthy up until that crisis, and I think he generally was, except for the last year or so, there
were actually several serious signs that I missed or just didn’t pay attention to. He began drinking a lot of water
and he also started having huge urine clumps. He also didn’t seem to have quite the energy that he had, and I
attributed that to aging. He would go outside after eating and just lay down when he used to love to explore.

Though this diagnosis was difficult and this is a disease that requires daily care, the silver lining is I have learned
a lot -- about feline health beyond just diabetes. It has become a strong interest of mine. And the good news is
that this year (spring/summer 2010) my sweet Gumpy boy has gone into remission after being diabetic since late
2006.The whole time he was getting insulin shots twice (sometimes 3 times) a day and getting ear pokes several
times a day to test blood glucose levels. With correct diet and keeping his BG regulated with insulin -and some
luck - Gump’s pancreas has healed and is working again! YAY for my sweet 16-year-old tuxie boy!

What is diabetes?
Diabetes (type 2 - adult onset) is a growing condition in cats. A small number of diabetic cats are born with a
damaged or non-functioning pancreas - this is type 1 diabetes and it shows up early. Type 1 diabetics do not
have a chance for remission or recovery; type 2 diabetics do. Though this is a complex disease, in simple terms
diabetes is when high blood glucose occurs because the pancreas is not producing enough insulin and/or there
is insulin resistance, and the result is high blood glucose levels. One of the functions of the pancreas is to
secrete insulin which helps regulate glucose levels --glucose is converted from food into energy for the cells to
use. By the time cats with diabetes have developed symptoms, their blood glucose is high because the pancreas
is not producing enough insulin. Gump had a lot of symptoms as I mentioned above that I didn’t pay attention to.
These symptoms are actually similar to symptoms humans experience with type 2 diabetes. Again, major
symptoms of diabetes are: drinking a lot of water, large urine output, weight loss while still eating a lot and being
hungry, and just general decrease is appearance of fur and loss of energy, etc.

Possible causes:
Diabetes is on the rise in cats, estimates are somewhere around 1 in 200 cats and up to 1 in 50 may develop the
disease, usually later in life. Though genetics and other factors may be involved (such as damage and
inflammation of the pancreas, pancreatitis, exercise and weight), experts generally agree that one big
environmental factor is high carbohydrate, highly processed, grain-based dry food. This is (or has been) the diet
of most cats, including Gump (before diagnosis).

Dr. Elizabeth Hodgkins DVM, a leader in feline diabetes, states in her book, “Your Cat”, that diet is by far the
most important environmental factor in type 2 feline diabetes. Why is dry food such a problem and considered
the main environmental factor in type 2 diabetes? Most dry foods are 25 - 50 % carbohydrate. A cat’s natural diet
is high in protein, moderate in fat, very low in carbohydrate (2 - 5%) and moisture-rich. So how does eating dry
food contribute to the development of diabetes? My understanding of what happens is this: the cat who is eating
high carb dry food year after year is able to handle the carb load for a while, but over time the continuous load of
high carb, processed food becomes too much for the pancreas of many cats to handle. These carbs from grain-
based foods are converted to sugar, and also because this food is highly processed and “predigested”, the
carbs enter the system essentially as a form of sugar.

The pancreas is then putting out more and more insulin to handle the unnatural carbohydrate load, and the cat,
being a generally strong species, can handle this for a while (and some cats can stay healthy without diabetes
their entire lives - good genes are important). But eventually, for some cats the pancreas becomes overwhelmed
and damaged with all this excess work and sugar. The pancreas and insulin producing cells become damaged
and/or stunted, and the pancreas stops producing insulin or the amount produced is insufficient.

And now with insufficient insulin, the cat’s blood glucose levels are high. With elevated blood glucose levels for a
period of time, the pancreas and other organs can also become more damaged from these high levels of
glucose. Once the BG is elevated you will usually see the typical symptoms. And, no, not all cats will develop
diabetes. There are those cats that are genetically strong enough to handle this unnatural diet. Just like there
are people who seem to be genetically stronger, who can handle more toxins than others (I always like to remind
people that George Burns lived to 100 years old with hard drinking and smoking 10 -15 cigars day -- he was
genetically strong). And while some cats may have a genetic predisposition, from my understanding
environmental factors may be what finally pushes the cat into the disease state, or at least contributes.

How are we going to know if our cats will be the ones who will develop diabetes or IBD, urinary ailments,
allergies and other diseases -- all of which in most cases have at least have an environmental contributor of diet
(dry food), in my opinion. In veterinary medicine (just like human medicine) there is always new information,
studies and understanding of disease processes and treatment. This is certainly true with feline diabetes and
veterinary medicine. In my opinion, vet medicine still seems unwilling to fully realize that feeding felines an
unnatural diet can and does create problems.

It also needs to be pointed out that some cats can develop steroid-induced diabetes from corticosteroids, which
may develop from long-term steroid use or an immediate reaction from an injection. Diabetes is one of the
possible side effects of steroid use. Though there may be an additional factor with steroid-induced diabetes,
which should be pointed out. Dr. Hodgkins feels that steroid use can become even more problematic when a cat
has on been high carb dry food. Because the pancreas, liver and other organs are already stressed due to the
dry food diet, the steroid may stress the organs even more and push cats into diabetes. My little 2-year-old tortie
girl, Nadia, developed some asthma symptoms this past spring, and we did give her a steroid injection and some
oral prednisolone. The good news is it seems that the asthma was seasonally related, as she hasn’t had
symptoms since then. I was a little nervous about giving her the steroid, but it did help her, and I felt somewhat
okay about it since she was generally healthy, young and eating a quality wet food.

Treatment:
Once a cat has been diagnosed with diabetes the good news is that it is generally a manageable condition, and
there is actually a good chance for cats to go into remission and cease needing insulin. There are three main
components of treatment (though this is NOT always standard vet treatment): Insulin, diet (low carb wet food)
and home-testing blood glucose levels. “Regulation” refers to a cats BG levels becoming stabilized with insulin. I
was able to get Gump regulated fairly soon with insulin. I also choose to use “tight regulation” methods because I
feel it’s healthier and it has shown that keeping a cat’s BG levels in or close to the normal numbers increase
chances for remission.

There are some cats that take more time or are more difficult to regulate. And additionally, there are some cats
that need more, sometimes much more insulin than average cats; cats with increasingly large insulin needs often
means there is an another underlying condition along with the diabetes (such as acromegaly, which has been
considered a rare condition, but has recently been shown to be not as rare as previously thought). But most cats
can become regulated and a large number even go into remission (with correct treatment).

When I first found out Gump had diabetes, I made some mistakes. When he was diagnosed I went online and
learned about feline diabetes, nutrition and the problems with dry food. I felt like I was hit over the head with this
information that I SHOULD have gotten all along from my vet. So my mistake in his early treatment was mainly
that I thought by changing him over to a high protein, low carb canned diet would allow him to recover and he
wouldn’t need insulin. So I didn’t start him on insulin right away, which was a mistake.

Diet change sounds good, because it makes so much sense that a high carb diet likely caused/contributed to
this disease; but the reality is most cats when they are diagnosed have had high glucose levels for some length
of time and the glucose toxicity has shut down the pancreas to some degree. The insulin producing cells have
been damaged and/or stunted to varying degrees. So at this point just changing diet is often not going to be
enough. Although for a few cats it may very well be enough - these are cats that are fortunate to have been
diagnosed very early. But for most cats, the damage has been too much and the pancreas is not functioning.
Most cats do need insulin. But the good news is the insulin treatment may only have to be short course.

One of the important things in treatment is to start insulin therapy as soon as possible. If you are going to try to
diet change (low carb wet food) you should only try this for a couple of weeks at the most. If the glucose levels
have not come down with diet within that period of time, it’s important to start insulin. Why? The thinking is that
when you start insulin you are bringing the BG levels down and ceasing the constant glucose toxicity and cellular
damage. This allows the pancreas to rest and heal from all the high sugar and constant work. It has been shown
that cats are more likely to go into remission when treatment is started soon after diagnosis.

Again the three main factors of feline diabetes treatment are: insulin, diet (low carb wet food), and home-testing
blood glucose levels. Though vets often don’t include home-testing and often just recommend a prescription dry
diabetic food (which is not good quality or low enough in carbohydrate). And the standard treatment for vets
usually involves the cat staying at the vet to determine an insulin dose, returning to the vet often to see how the
dose is working; and typically there is no testing of BG levels at home. The problem with this traditional treatment
is you really don’t know how the insulin dose is working once the cat is home, and it may be dangerous to inject
insulin blindly into a cat. If a cat suddenly started healing and producing more insulin and you were to inject
insulin you could create a serious (potentially life-threatening) hypoglycemic crisis. And the cat may need more
insulin as well. This is why home-testing of blood glucose levels is so important. Human diabetics would never
inject insulin without knowing what their BG is - why should it be different with a cat?

It should be pointed out that though diabetes is a manageable condition, that doesn’t mean it is always simple.
And though many cats become regulated and managed fairly easily, there are some potentially life-threatening
complications with this disease. Diabetic ketoacidosis is a very serious (and potentially life-threatening) condition
that can occur when the cat has high BG levels and a lack of insulin for a period of time. This can occur in early
diagnosis or even if you are giving insulin (though it may not be a sufficient dose).

Hypoglycemia can also be a serious (potentially life-threatening) condition. Hypoglycemia occurs when the blood
sugar drops too low, sometimes dangerously low. And if too much insulin is given, the BG can drop too low.
Though the body, specifically the liver, has the ability to produce excess glucose to prevent the BG from
dropping too low, it may not always be able to produce enough when far too much insulin is present -- and this
has the potential to become life-threatening (seizures, coma, brain damage and even death can occur). With
Gump we did experience some low BG numbers occasionally (with meter numbers in the 20’s, and also the
meter read “low” which meant less than 20). Gump did act a bit frantic to eat, but he never had any other
symptoms. His body was able to handle the lows and bring the numbers back up. After these lows, he’d have
some higher numbers; this is called “rebound”. Dr. Hodgkins points out that dry-fed cat’s livers are less able to
handle these low blood glucose events because the liver has been stressed from dry food and is often not fully
functioning. Though in most cases, if you are monitoring your cat (and feeding a correct diet) serious
hypoglycemic episodes will be unlikely, but you do need to be cautious.

Both of these conditions, DKA and hypoglycemia, are two of the reasons why it is so important to monitor and
test BG levels at home. And it should also be pointed out that if you don’t treat your cat, it will most likely,
succumb to complications of this disease; diabetes has to be treated.

Insulin:
Insulin is a hormone. In healthy cats, the pancreas is producing and excreting small bursts of insulin throughout
the day to keep BG and the endocrine system in balance. But with diabetes the pancreas isn’t functioning, so
insulin must be given exogenously. Insulin is sort of like hormone replacement therapy. You are giving the body
what the pancreas should be producing.

There are several different kinds of insulin available for cats. Cats metabolize insulin faster than humans and
need injections twice a day. The standard veterinary treatment involves determining a dose (from a few tests, or
a full “curve” done at the vets) and injecting insulin twice a day. But many people on feline diabetes support
websites are choosing to test their cats at home, do their own curves and in many cases determine dosing. If you
are going to do your own dosing you need to have some experience and data, and you can also get good advice
from experienced caregivers online (such as the FDMB). And, certainly, dosing decisions can be done in
conjunction with your vet. Though many people on FD websites determine their own dosing - I did with Gump.
And when injecting insulin, you should be cautious.

There is also more aggressive treatment called “tight regulation” which may involve injections more than twice a
day (not always, it depends on the insulin). The purpose of tight regulation is to try to keep the BG levels as
close as possible to the normal range; the thinking is that this allows the pancreas a better chance to heal and
the possibility of remission is greater. Using a longer-lasting insulin is much easier to keep cat tightly regulated.
Recent research by Dr. Jacquie Rand has shown that a significantly greater number of cats went into remission
with tight regulation using a specific treatment and insulin (that being Lantus insulin). Tight regulation involves
more effort with home-testing. And you do have to be careful as you are trying to keep the BG levels in the
normal/healthy range, because you may end up bringing them down too far. So the potential for hypoglycemic
numbers is possible. However, if you are testing the BG levels at home, hypoglycemic crises can be averted and
BG levels can be brought back up - with wet food preferably (or syrup if needed).

I used tight regulation (Dr. Hodgkin’s approach with PZI insulin) and worked at keeping Gump’s BG’s in the
normal or close to normal ranges. This took more testing, and sometimes I injected PZI three times a day. There
were a few times when we got very low numbers on our meter. But with food to bring up the numbers we never
had a serious hypoglycemic event and he would often rebound after going too low. You can read more about
rebound on the resources/links I give below. If someone considers doing tight regulation, you do need to be
cautious. There is a lot of good help available in online forums and I recommend thoroughly learning about
diabetes, taking your time, and having some sort of support if you are interested in tighter regulation.

There are several different insulin options for cats. There are insulins that are specifically for cats; Prozinc, PZI
and Vetsulin* (please see note below for information regarding Vetsulin). And there are also some human
insulins used in cats, two of which have shown to be very effective (that being Lantus and Levemir). The current
thinking is that cats do better on longer-acting insulin. Lantus, PZI, Prozinc, or Levemir are longer-acting, gentler
insulins used with cats; being longer lasting allows the BG levels to remain more stable longer = better regulation
and more potential to heal. There are other insulins available, but those are considered to be shorter-acting and
harsher with cats. These commonly include Humulin N or Vetsulin (also called Caninsulin). On the FDMB,
felinediabetes.com message board, and elsewhere, Humulin and Vetsulin are not recommended as the best for
cats (though they are usually less expensive). It should also be noted that some cats do better on different
insulins, so if you are having trouble getting the BG levels regulated, sometimes trying a different kind of insulin
can be helpful.

Now, I am an educated, intelligent person, but a cat being
diabetic just wasn’t something I thought of. I thought it was
good that he was drinking water - more water is good for you...
I have learned so much since that time! Some of the major
signs of diabetes are excessive water drinking, large urine
output, also diabetics become very hungry all the time, but
they lose weight. This is because with insufficient insulin they
are unable to utilize food correctly. Gump had also lost weight,
while over the previous years had gained a lot of weight (while
eating not much dry food - he was eating about 1/2 cup of dry
a day a one point, and he was overweight).

Home-testing BG levels:
Many vets still don’t recommend home-testing BG levels in
diabetic cats, though it is becoming more common. There are
articles in scientific publications about home BG monitoring for
cats, and there is even a pet-specific glucometer available from
vets. But, it’s still not standard treatment. Why? I guess because
vets think people won’t know what to do with the information and
could make problematic dosing decisions, maybe vets think it’s not
accurate, or maybe because it just hasn’t been standard treatment
in the past -- who knows exactly what all the reasons are.

But I will say home-testing BG levels is very important and one of the factors that helped Gump become well
regulated with insulin and eventually into remission. To test a cat’s BG levels you need a glucometer (as well as
test strips and lancets). Most people on FD support websites use human meters - the ones you can buy from
your local drug store. There are pet meters that the vet will sell you, but these are much more costly and you can
only buy test strips from the vet (a problem if you run out of strips and the vet’s office is closed). Most people
have had good results and accuracy using human glucometers. The last time Gump had blood work, his blood
glucose lab value was right on with my meter’s numbers. Learn more about meters and testing at the sites given
below.

You test a cat’s BG levels by pricking the outside rim of the ear (a few people do paw testing, though it’s not
recommended or used as much). There is a vein on the rim of the ear and very few nerve endings there so it’s
really not painful. I have tested Gump’s BG at least twice a day (usually more than that), while I was trying to
keep him tightly regulated, sometimes up to 8 times a day (doing “curves”) -- so I could to see how the dose was
working. He was rarely ever bothered when I poked his ear. Now, of course, you don’t have to test that much.
But you should always test before each shot and try to get a test at least 4-6 hours after, or a few mid-cycle
tests, to see how the dose is working. And then once a month or so you can do a full “curve” -- testing about
every 2 hours. Once you learn how to test, it’s a lot more affordable to do it yourself rather than taking your cat to
the vet all the time. Also BG levels may be elevated at the vet due to stress, so tests from the vet may not be as
accurate and thus the dose may not be either.

There is a lot of information available online to help people learn how to home-test. It can be a little difficult at
first when you’re learning, but most people say it becomes very easy once they learn. It only takes a couple
minutes to test your cat’s BG and it pays off in many ways. And again, you can always consult with your vet
about the numbers. Here is a link with a good video that shows how to home-test a cat:
www.youtube.com/v/_zE12-4fVn8&rel=1

Diet:
As stated above, diet is a critical component in the treatment of FD. In most cases a high carb diet is at least a
contributor if not a cause of this disease, and eating an appropriate diet can help a cat heal. But, like I wrote
above, most cats need more than just diet change (for a small number this works when FD is caught very early).
So what do you feed a diabetic cat? Do you need a special vet food?

In feline diabetes (and for all cats, actually), cats need to eat a diet close to their natural diet - that is, high
protein, low carb wet food (canned, or raw correctly done). Any meat-based canned food with no grain and as
little fruit and veggie content as possible is generally good. There are many choices available. There is a chart
called Janet and Binky’s food charts (see link below), which includes the carbohydrate content (and protein, fat,
etc.) for many canned food based on more accurate numbers than are on the can (she uses the “as fed”
numbers which you have to get from the company - this is different than the “guaranteed analysis” on the label
which are just minimums and maximums). Choosing a canned food that is under 10% carbohydrate is
recommended.

There are a few “diabetes prescription diets” available from the vet, but you do not have to feed these; there are
many better choices with better quality ingredients. The “diabetic prescription” diets are just lower carb foods
(but they aren’t low carb enough and they use poor quality ingredients). You really don’t want to feed dry food in
any case. Cats just need low carb, wet food. The so called “low carb” dry foods are not as good a choice,
because the highly processed nature increases the glycemic value and also the grain-free dry food tends to be
higher in calories (according to Dr. Lisa Pierson’s catinfo.org site), and the lack of moisture is problematic in
other diseases. If your cat doesn’t like wet food, try different varieties, and don’t give up; sometimes it takes time
for cats to get used to an entirely different food. I’m lucky, Gump will eat anything and he loves all canned food! I
know getting a cat to eat certain foods can be a problem, but there is info on tips and tricks available on this
website on the switching foods page: ibdkitties.net/switchingfoods.html

I have fed Gump quality canned food and some raw and at one time I was feeding all raw. I got pre-ground raw
from a source called Hare-Today, with bones and organs, which I froze in little baggies and added supplements.
This became too much and I also decided that quality canned was as good to feed. I currently feed canned
Wellness grain-free varieties, some Evo 95%, sometimes a little Fancy Feast (the varieties without gluten or
grains), or Boots & Barkley, and some Nature’s Variety raw. I try to avoid canned food with a lot of fruit and
veggies, as cats don’t need it and these contain excess carb. But, the fruit and veggie content in Wellness and
NV raw is apparently only about 5%, which I think is very low.

Cats evolved to eat meat and get their moisture mainly from food. This constant diet of highly processed high
carb food is potentially dangerous with diabetes and several other chronic diseases. We need to feed cats what
they are meant to eat. Though diet won’t prevent all disease, it can do a lot to keep cats healthy.

Remission in feline diabetes:
There have always been a percentage of cats that go into remission from type 2 diabetes and no longer require
insulin. This usually occurs after a short course of insulin along with diet change, and usually within the first year
of diagnosis. Remission rates have been increasing due to the emphasis on correct diet and better regulation
with BG testing at home and the use of better, longer-acting insulins.

Though there is a good chance of remission in feline diabetes, it needs to be said that there will be those cats
that for whatever reason won’t go into remission. Maybe treatment was started late or the cat was diagnosed too
late into the course of the disease, there may be some unalterable damage to the pancreas, or maybe with
standard treatment the BGs were not kept in the healthy range. So while there is a good chance for remission to
happen, there will be those cats that will always be diabetic. However, these cats can live long, normal lives with
good insulin therapy daily. There are many cats who have lived long, normal lives with daily insulin injections,
and when they pass it’s usually from another condition.

Another point is that even if a cat goes into remission, relapses can occur; diabetic cats are always going to be
sensitive and relapse will be a possibility, so even if a cat goes into remission it doesn’t always mean they’re
cured. Diabetic cats are often called “diet-controlled diabetics” because they will almost always go back to the
diabetic state if they consume a carb-based diet. And occasionally high BG levels will return even on a correct
diet -- again, diabetics will always be sensitive and having a damaged or sensitive pancreas means that relapse
can occur. And it may coincide with another illness. So if a cat goes into remission you should always keep an
eye on them and monitor BG levels, especially if you notice behavior out of the ordinary. And, there are certainly
many cats that remain off of insulin for the rest of their lives.

Most cats that go into remission do so within the first year of treatment and often in the first months. However,
Gump is a longer-term diabetic who has currently gone into remission after three years. It’s not as common, but
there are a number of longer-term diabetics who have gone into remission. I did utilize tight regulation methods
(based on Dr. Hodgkins approach) and tried to keep Gump fairly tightly regulated in healthy BG numbers as
much as possible. This could have something to do with him finally going into remission... Whatever the reason
is, I am very happy and proud of my little boy. He is 16 now and seems as healthy as ever (knock on wood). He
has been producing healthy BG numbers most of the time. Occasionally I still have had to give him a tiny dose of
insulin if he has a slightly higher number. While writing this I tested him in the afternoon and I got a 72 - this is a
perfectly healthy normal number. Sometimes he has higher numbers in the morning (in the low 100’s), but his
pancreas has been bringing the numbers back down in the afternoon. A cat’s normal range is anywhere from 50
- 120, with 60 - 90 being about best. To note, BG numbers are measured differently in Canada and Europe, so
you if you from another country, numbers will be different on your meter and from the vet.

In conclusion:
Cats are a naturally strong species, as Dr. Hodgkins explains in her book, “Your Cat”. But learning about
diabetes and other feline health issues and the relationship with diet has shown me that many cats can only
handle an unnatural diet for so long before some disease shows up - diabetes being one possibility. Diet is
important and I believe there would certainly be fewer cases of feline diabetes if we were feeding our carnivores
a more species appropriate diet. We have been given these little creatures as beloved companions. But we need
to care for them and respect them as the species they are.

There is much more information available about feline diabetes, a lot of it online; some of it is very good, and of
course, some may not be as good. And, unfortunately, it must be said that your vet may or may not be up on all
the latest diabetes information. Just like in human medicine, ideas, treatment and thinking changes and evolves.
If you’re lucky you will find a vet with experience and who is up-to-date on the current thinking and treatment and
open to home-testing and the latest treatments. And you must be a proactive advocate for your cat in treating
diabetes and for their overall health.

I feel very fortunate that Gump has gone into remission and does not need insulin injections everyday. I
hope he has many more healthy years. Diabetes can be a tough disease, and it does require daily care and
effort. But, diabetes is not a death sentence, it's a treatable disease and many cats even cease needing insulin
treatments. It does take a lot to learn about and understand this disease, and it's not always easy, but it's doable
and empowering to know you can handle this and care for your beloved cat. Treatment for diabetes becomes an
everyday routine. And there is much assistance available to help you handle this disease.

Additional resources:
FDA’s Center for Veterinary Medicine Alerts Veterinarians About Problems with Vetsulin® to Treat Diabetes in
Dogs and Cats. www.fda.gov/AnimalVeterinary/newsEvents/CVMUpdates/ucm188752.htm

*FelineDiabetes.Com

*The FelineDiabetes.com Message Board -- excellent overall help, and insulin support groups available
www.felinediabetes.com/FDMB/

*Catinfo.org -- the feline diabetes section and the whole site.
www.catinfo.org/?link=felinediabetes

*FelineOutreach.com -- for information and additional links on feline diabetes and other feline health concerns.
www.felineoutreach.org/Education/DiabetesMellitus.html

*PetDiabetes.Wikia.com petdiabetes.wikia.com/wiki/Main_Page

*YourDiabeticCat.com -- Dr. Hodgkin’s site for tight regulation and more general diabetes and diet information.
yourdiabeticcat.com/index.html

*Janet and Binky’s food charts. Lists nutritional content with more accurate “as fed” values and includes
carbohydrate content for some foods (which is not on labels). http://binkyspage.tripod.com/index.html .
It should be noted the last time this list was updated was in 2008.

* “Your Cat” Simple Secrets to a Longer, Stronger Life, By Dr. Elizabeth Hodgkins. An excellent book!
Information on all aspects of feline health with lots of feline appropriate diet info. I really recommend this book.

Update: September 12, 2012
After a long battle with diabetes, pancreatitis and CRF, Gump passed away comfortably in his home with the
help of his vet today. Rest in peace sweet boy, you deserve it.