Diabetes with Coma in Cats

Janice Thomas, DVM
Written by:
Published: June 7, 2022
Diabetes with Coma in Cats

What Is Diabetes with Coma in Cats?

Diabetes mellitus in cats, commonly known as diabetes, is a hormone imbalance disorder. When cats eat, carbohydrates from their food are digested and converted to glucose. Glucose, a sugar, is used by the body as energy and is essential for life. The hormone insulin helps move glucose from the bloodstream into cells, where glucose is used for energy.

A cat develops diabetes mellitus when the pancreas does not produce enough insulin or, more commonly, if the body cannot use the insulin made by the pancreas. The result is a high blood glucose level without the ability to use it as an energy source.

When left untreated, cats will become increasingly hyperglycemic (have a high blood glucose level), and it can cause a coma. If a cat with diabetes is given too much insulin, they may become hypoglycemic (having a low blood glucose level), which can also cause a coma.

Both cases are emergencies and must be treated in a veterinary hospital. Without intervention, cats will not survive. 

Symptoms of Diabetes with Coma in Cats

The signs of diabetes are usually slowly progressive over weeks to months.The earliest and most frequent signs are listed first:

  • Increased thirst
  • Increased urine volume (either more frequent trips to litter box or larger clumps of urine in the litter)
  • Urinating in inappropriate locations
  • Increased appetite
  • Weight loss
  • Odd gait or plantigrade stance (walking or resting on rear legs instead of paws only)
  • Decreased energy/weakness

In severe cases of diabetes, cats may experience vomiting, loss of appetite, and lethargy. Although a rare occurrence, unregulated diabetes can cause a coma. 

Signs of a coma are:

  • Profound lethargy
  • Unconsciousness
  • Unresponsive to sounds
  • Unresponsive to touch
  • Loss of urine control

Causes of Diabetes with Coma in Cats

There are two reasons for a diabetic coma in cats: either the blood glucose (blood sugar) level is too high, or it is too low.

Hyperglycemia (high blood glucose level): Cats can become hyperglycemic if they are undiagnosed. However, they would usually show other signs of diabetes, as listed above, before they would develop a coma. In a diabetic cat under therapy, other causes of hyperglycemia are:

  • Too little insulin given
  • Extra meals/treats
  • Weight gain
  • Other underlying infections or illnesses
  • Change in the body's need for insulin
  • Medication interactions
  • Decreased activity

Hypoglycemia (low blood glucose level): In a diabetic patient under therapy, causes of hypoglycemia are:

  • Too much insulin given
  • Missed meals/feedings
  • Changes in diet or amount fed
  • Other underlying infections or illnesses
  • Decreased appetite
  • Vomiting
  • Change in the body's need for insulin
  • Medication interactions
  • Increased activity
  • Remission of diabetes

How Veterinarians Diagnose Diabetes with Coma in Cats

A diagnosis of diabetes mellitus is based on clinical signs and a persistent high blood glucose level and high glucose in the urine. A diabetic coma is confirmed based on history, clinical signs, and blood glucose level readings at the time your cat is affected.

Additionally, a urinalysis checks for byproducts of muscle breakdown (ketones) and urinary tract infections and helps determine the extent of any kidney damage. A complete blood count checks for other conditions, like severe anemia, that can also cause a coma. A blood chemistry panel will indicate if there is any damage to internal organs, like the kidneys, pancreas, or liver.

Treatment of Diabetes with Coma in Cats

Cats can die while in a coma or during treatment, so intensive treatment is needed as soon as a coma is diagnosed. Hospitalization is required, to provide breathing support and intravenous (IV) fluids. Treatment is aimed at correcting the abnormal blood glucose level and controlling any other symptoms.

If the cause is hyperglycemia, insulin is administered in smaller, more frequent doses until a normal blood glucose level is achieved. If the cause is hypoglycemia, a sugar substance called dextrose is administered until the blood glucose level is within a normal range.  Any underlying diseases found in blood and urine samples are also treated simultaneously. Without treatment, cats will die from  diabetes while in a coma.

Recovery and Management of Diabetes with Coma in Cats

After a pet suffers a coma, they will not be discharged from the hospital until their blood glucose levels are stable, they are eating, drinking water, and urinating on their own. The length of their hospital stay can range from 2–7 days, depending on the severity of their symptoms and how quickly their blood glucose levels can be controlled. Once a cat is out of a coma and stable, preventing another coma and watching for other symptoms of uncontrolled diabetes are the primary goals of home care.

Prevention of Diabetes with Coma in Cats

To prevent a diabetic coma, you must maintain a healthy blood glucose level in your cat. Routine healthy management of a diabetic cat is possible with the following factors, which are easier to remember with the mnemonic “diabetes:”

  • Diet: Feed higher-protein, lower-carbohydrate diets
  • Inform your veterinarian of changes in:
    • Behavior
    • Activity
    • Diet
    • Urinary habits
    • Response to insulin
  • Avoid diet changes
  • Be consistent with meals (feed the same amount of the same diet at the same time every day)
  • Eliminate treats outside of feeding times
  • Test blood glucose levels at home, as directed by your veterinarian
  • Exams should be scheduled every 3–6 months when your cat is stable
  • Stay alert for changes in your cat’s behavior

Some diabetic cats will enter remission and no longer need insulin. It cannot be determined which cats will enter remission and which will require lifelong therapy.

Prognosis for recovery after a diabetic coma is better if the coma was caused by hypoglycemia, and if therapy is started quickly and aggressively.

Diabetes with Coma in Cats FAQs

How do I know if my cat is in a coma?

A cat in a coma will not respond to a strong stimulus like name calling, touching, or loud noises. They may have shallow breathing or may be breathing very slowly, less than 10 breaths per minute. If you notice these signs, take your cat to the emergency vet immediately.

How do you know if your diabetic cat is dying?

A cat in a coma is in a deteriorated state, and if medical care is not started soon, your cat could die. Other signs that your pet is near death include a loss of urine or stool control, shallow breathing, a low temperature, foaming from the mouth or nose, and seizure-like activity (convulsions or rigid limbs).

Can a cat recover from a diabetic coma?

With immediate and very aggressive care in a hospital, cats can recover from a diabetic coma. The prognosis is better if therapy is started early and if the cause is underlying hypoglycemia.

Featured Image: iStock.com/FatCamera


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