Vet360 Issue 4 Volume 2 | Page 14

FELINE MEDICINE Owner impression of control (PU/PD, appetite, weight gain) is a very valuable monitoring tool. Serum fructosamine reflects glucose levels over the preceding week. Using the change is fructosamine over time in individual cats is probably more reliable than onceoff readings, as concentrations can vary considerably between individual cats. 4. Dietary management - changing to high protein diet for obligate carnivores. The aim of dietary modification is to normalise the cats’ body condition –be it obese or suffering from muscle loss, decrease post-prandial hyperglycaemia and minimise fluctuations in blood glucose. Which diet? The ideal diet should have a high protein content > 40% of metabolisable energy (ME), (>10g/100kCal) and low carbohydrates <15% ME (<25% DM / < 3g/100kCal). Cats on a high protein weight loss formulation will lose weight more rapidly, maintain lean muscle mass and will remain weight stable after weight loss. The carbohydrate should be a complex carbohydrate with a low glycaemic index (GI) for example barley. The “carbohydrate load” takes into account both the amount of carbohydrate as well as the GI factor. Carbohydrate restricted foods typically have a higher fat content for calorie provision and vice versa. Carbohydrates exacerbate the post-prandial glucose response - which can be attenuated by the addition of fibre more research is however needed in this area. Control of energy intake is the next step. The average indoor cat needs 40kcal/kg/day. The optimal feeding regimen for cats with diabetes has not been researched. It does seem however, that when feeding a low carbohydrate (low GI) diet, the timing of the meals does not need to be matched to the insulin injections as clinically relevant, post-prandial blood glucose increases are unlikely. Multiple small meals as well as ad lib feeding routines can be followed, as long as the amount is measured out in the case of overweight cats and is at least the amount required on a daily basis.3 Automatic feeders can be used in these situations. Feeding multiple small meals in the day is also considered a better approach to manage a feline XX