I am referring to an AVMA study for the information. “[The] median survival time of diabetic cats was 516 days (range, 1 to 3,468 days)” from diagnosis. The word ‘median’ can be taken to mean the average. So on average a domestic cat will live for 1 year and 5 months after a diagnosis of diabetes. Although “70%, 64%, and 46% [of the cats in the study] lived longer than 3, 6, and 24 months, respectively”.
The study citation is at the end of the article.
114 cats were diagnosed with diabetes. The conclusion of the study was that domestic cats newly diagnosed with this disease “had a fairly good prognosis”. Do you agree with that? It does not look that good to me.
Importantly the degree of kidney damage caused by the diabetes can be directly correlated with the expect shortened lifespan (survival times). “Survival time was shorter with each incremental increase in serum creatinine concentration.”
With regard to prognostic factors, an interesting finding was that greater creatinine concentration at diagnosis was significantly associated with shorter survival time, with a hazard of dying approximately 5% greater for each increase of 10 μg/dL in serum concentration
Carolina Callegari DVM the lead author of this study (see citation at base of article).
I explain creatinine concentrations below thanks to Bing’s Copilot (AI).
What is “creatinine concentration” in cats with diabetes?
Creatinine concentration is an important marker used to assess kidney function in cats, including those with diabetes. Let’s delve into the details:
Chronic Kidney Disease (CKD) in Cats:
- CKD is a common diagnosis in cats, especially those over five years old. It is the most common cause of mortality in older cats.
- Classic clinical signs of CKD include polyuria (increased urination), polydipsia (increased thirst), inappetence, vomiting, and weight loss.
- Early diagnosis is crucial to intervene and manage the disease effectively.
Diagnosing CKD:
- A diagnosis of CKD is often made when azotaemia (elevated blood urea nitrogen and creatinine) is detected along with a reduced urine specific gravity (USG; less than 1.035).
- However, creatinine and urea levels can be influenced by factors other than kidney function (such as hydration, muscle mass, and feeding). Therefore, they should be interpreted carefully.
- Measurement of glomerular filtration rate (GFR), which is routine in humans, is not commonly performed in cats but can provide valuable information about kidney function.
- Cats may maintain concentrating ability despite having renal disease, so early diagnosis is essential.
Creatinine Concentration and Diabetes:
- Cats with diabetes may also have elevated creatinine levels, especially if potassium and phosphorus levels are normal.
- However, creatinine alone is not a perfect indicator of kidney function, and CKD should not be assumed based solely on creatinine measurements.
- In diabetic cats, serum creatinine levels can vary. For example:
- 80% nephron loss may result in a serum creatinine concentration of 2 mg/dL.
- With further progression, serum creatinine concentration may reach approximately 4 mg/dL when 90% nephron loss occurs.
- Monitoring creatinine levels alongside other markers helps assess kidney health in diabetic cats.
SDMA (Symmetric Dimethylarginine):
- SDMA is another marker used to assess kidney function.
- Elevated SDMA concentrations in blood (plasma or serum) persistently above 14 µg/dL in cats with normal creatinine may indicate early kidney abnormalities (IRIS stage 1).
In summary, creatinine concentration is a valuable tool for evaluating kidney function in cats, including those with diabetes. Regular monitoring and early intervention can help manage CKD and improve the quality of life for affected cats. If you have a diabetic cat, work closely with your veterinarian to monitor kidney health and address any concerns. 🐾
How does diabetes damage kidneys?
Diabetes can lead to kidney damage through several mechanisms:
Glomerular Damage:
- The glomeruli are tiny filters within the kidneys that help remove waste products from the blood.
- In diabetes, chronic hyperglycemia (high blood sugar levels) damages the delicate blood vessels in the glomeruli.
- Over time, this damage affects the filtration process, leading to glomerular dysfunction.
Increased Filtration Pressure:
- High blood sugar causes the glomeruli to filter more blood than usual.
- This increased filtration pressure strains the glomerular capillaries, leading to their thickening and narrowing.
- As a result, the kidneys become less efficient at filtering waste products.
Proteinuria:
- Damaged glomeruli allow protein (usually not present in urine) to leak into the urine.
- Proteinuria (presence of excess protein in urine) is an early sign of kidney damage in diabetes.
- Persistent proteinuria can further harm the kidneys.
Renal Hypertrophy:
- The kidneys respond to hyperglycemia by growing larger (renal hypertrophy).
- While this initially helps maintain function, it eventually leads to structural changes and reduced efficiency.
Renal Fibrosis:
- Chronic hyperglycemia triggers inflammation and scarring (fibrosis) in the kidney tissues.
- Fibrosis disrupts normal kidney architecture, impairing filtration and blood flow.
Activation of Renin-Angiotensin System (RAS):
- Diabetes activates the renin-angiotensin system, which regulates blood pressure.
- Overactivation of RAS contributes to kidney damage by causing vasoconstriction and promoting inflammation.
Ischemia and Hypoxia:
- Reduced blood flow due to narrowed vessels leads to ischemia (lack of oxygen) in kidney tissues.
- Hypoxia triggers further damage and cell death.
Advanced Glycation End Products (AGEs):
- High blood sugar leads to the formation of AGEs.
- AGEs accumulate in kidney tissues, promoting inflammation and fibrosis.
Oxidative Stress:
- Hyperglycemia generates excessive reactive oxygen species (ROS) in the kidneys.
- ROS cause oxidative damage to cells and exacerbate kidney injury.
Nephropathy:
- Diabetic nephropathy refers specifically to kidney damage in diabetes.
- It progresses through stages (microalbuminuria, macroalbuminuria, and end-stage renal disease).
- Early detection and tight blood sugar control are crucial to prevent or slow down nephropathy.
Study citation: Survival time and prognostic factors in cats with newly diagnosed diabetes mellitus: 114 cases (2000–2009). Link: https://doi.org/10.2460/javma.243.1.91
Kidney disease is a familiar, major health issue with people suffering from Type 2 diabetes. Human Type 2 diabetics can put the disease into remission by losing weight and it does not have to be a weight loss to take the individual to an ideal weight.
Can diabetes in cats be reversed with weight loss?
Yes, for Type 2 but no for Type 1.
Type 2 diabetes, on the other hand, is known to be reversible in many cases by losing weight
Hills Pet
Cat weight loss must be carried out slowly and in a controlled manner ideally with the input of a vet to avoid another serious disease hepatic lipidosis (fatty liver disease).
RELATED: Cat diabetes – home treatment – first hand experience – this is a very useful article which I highly recommend for cat caregivers looking after a diabetic cat.
