Case 1, Answer 5f

Correct! The easiest things to rule out will be insulin administration issues and concurrent medications. A thorough owner history will be all you need. As for the other possibilities, remember that our feline patients typically have type-2 diabetes, which means that depending on a variety of factors, they may be able to make some of their own insulin. If we can reverse glucose toxicity by treating their diabetes, these cats can regain beta cell function and go into remission. In other instances, however, there may be progressive beta cell loss which will require a higher dose of insulin. Other diseases may also play a role in inducing insulin resistance, including urinary tract or oral infections, obesity, hyperadrenocorticism, and acromegaly.2 Finally, what clinically looks like unregulated diabetes in cats may be caused by too much insulin, not too little. In these cases, they become hypoglycemic and then experience rebound hyperglycemia (the Somogyi effect). Since they spend more time in the rebound hyperglycemia phase, they exhibit the clinical signs of diabetes (PU/PD, polyphagia, weight loss) and may even have an elevated fructosamine level.

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