Tag: diabetes

This Smart Litter Box Monitors Your Cat’s Health

Imagine a litter box that monitors your cat’s health and reports issues directly to your cell phone.  A new smart litter box in Japan will do just that.

The Smart Litter Box Technology

Cats are prone to many health issues as they age. Many common feline health conditions can be detected through evaluation of changes in weight and urination.  Unfortunately, cat owners often miss subtle changes in weight and the amount of urine their cat produces over time.  Cats often do not get regular veterinary examinations that could detect problems in the early stages.

A new smart litter box from the Sharp company in Japan will help pet parents monitor their cat’s health.  This box includes detectors and software that will monitor a cat’s weight, the amount she urinates, and the length of time she spends in the litter box.  When the system detects an abnormal change, it notifies the owner’s smart phone directly.

Multiple cats?  No problem.  The box comes with optional sensors that will detect individual cats in a multi-at household.

Why are we excited about this technology?

  1. Cat obesity: Weight gain in cats, just like in people, usually occurs slowly.  Pet parents are notoriously unreliable at recognizing weight gain and obesity in their pets.  This technology will provide consistent and objective evaluation of a cat’s weight over time.  An owner who receives an alert is more likely to take action and have their cat examined by a veterinarian. If the company has thought this through, the box will monitor improvement over time, too. Owners could use this to help evaluate the effectiveness of a diet plan for their cat.
  2. Diabetes: Changes in weight and increased urine volume are indicators of diabetes mellitus.  Cat parents may not recognize increased amounts of urine in the box, unless they are paying careful attention to the litter balls.  A tool to alert owners when their cat is urinating more frequently and with a higher volume could revolutionize the early diagnosis of diabetes in cats.   If diabetes is diagnosed early, cats have a higher chance to go into remission when treated.
  3. Kidney disease:  Kidney disease is common in aging cats.  Increases or decreases in frequency or volume of urination may signal the onset of kidney problems.  Early diagnosis and treatment is crucial to managing the progression of kidney disease.
  4. Urinary blockages: Spending a lot of time in the litter box can signal that a cat is having difficulty urinating.  Bladder infections or blockages due to bladder stones can cause this problem.  Cat parents can easily miss this sign, unless they are carefully monitoring the litter box.
  5. Hyperthyroidism: This common problem in middle-aged to older cats can cause them to drink and urinate more.

These are just the most common problems that this smart litter box could help detect.  Alerts to changes in urination and weight will encourage owners to take their cat to a veterinarian for diagnosis.

How much does the box cost?

The box is rolling out at a cost of about $224 US.  The monitoring app will cost an additional $3.00 US each month.

Will the box be available in the US?

Before you get excited, this smart litter box will be rolled out only in Japan at first.  Hopefully the Sharp company will bring this technology to the US market in the near future.  We hope this box will eventually be used with smart litter to detect things like sugar in the urine (glucosuria), an indicator of diabetes.

Your Cat Keeps Secrets: Subtle Signs of Illness in Cats

Cats are notoriously enigmatic creatures.  Like the Cheshire Cat in Alice in Wonderland , your cat keeps secrets.  She may not show pain or other signs that she is sick. That’s why subtle signs of illness in cats require prompt veterinary attention.

Your cat keeps secrets

Cats retain many of their species’ undomesticated behavioral characteristics.  In the wild, all but the largest cats are both predator and prey.   It’s important for animals that are being hunted as prey to hide their weaknesses.  Consequently, cats have become masters of misdirection.

Veterinary professionals struggle to define the signs of pain in cats consistenly.  A validated method to score pain, for instance, is useful in assessing recovery from painful procedures or illness.  Cats’ tendency to mask their pain and demonstrate only very subtle behavioral changes makes reliable detection and grading of pain difficult at best.

A large survey of feline medical specialists evaluated 91 signs of pain.  Participants answered questions about the reliability of these indicators of pain to accurately detect real pain in cats.  The participants narrowed these signs down to only 22.  You can find the full list in the article, which is available as a free full text in PubMed. 1

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Signs of illness in cats require prompt attention

Because cats hide pain and other evidence of ill health, any unusual signs you observe are probably just the tip of the iceberg.  As a cat owner, you should take any and all behavioral changes in your cat seriously.  Here are some easily overlooked clinical signs along with their potential significance.  This is not meant to be an inclusive list, so be sure to ask your veterinarian about any unusual signs in your cat.

  1. Eating less/not eating:  Cats need to eat regular meals.  Cats that stop eating, especially if they’re fat, can develop liver disease.  If you haven’t been able to get your cat to eat for 24 hours, talk to your veterinarian.  Decreased appetite in cats may be a sign of gastrointestinal disease, but may also be a sign of generalized disease and poor health.
  2. Eating more: If your cat suddenly develops a voracious appetite, he may have an endocrine disease such as diabetes or hyperthyroidism.  You should be especially concerned if your cat eats more but does not gain, or even loses, weight.
  3. Increased urination:  Although you might not directly observe your cat using the litterbox more frequently, chances are you will notice increased litter clumping or odor in the box.  You may find yourself changing the litter more frequently.  This can be a sign of diabetes, kidney disease, hyperthyroidism, or other problem.
  4. Decreased urination: Especially with a male cat, decreased urination could be a sign of developing urinary blockage.  If your cat stops urinating, this is a medical emergency.  Your cat may exhibit signs of pain or distress when attempting to urinate.
  5. Urination outside the litter box:  Urinary pain may cause your cat to avoid the litterbox.  The joint pain of arthritis may also be associated with inappropriate urination outside the box.  If it’s painful to enter the box, your cat will be reluctant to use it.  If your cat has consistently used the litter box but begins to have accidents in the house, consult your veterinarian.
  6. Increased activity level:  If your laid-back and lazy cat turns into a dynamo in constant motion, you should be suspicious of an underlying problem.  Hyperthyroidism is common in cats and can cause increased activity.
  7. Decreased activity level:  A noticeable decrease in your cat’s activity may also be a sign that your cat needs a check-up.  Arthritis can lead to decreased activity as can systemic disease.
  8. Change in vocalization:  If you notice that your cat is calling out more, or less, or has a change in her voice, it’s time for a check-up.  Changes in the frequency and intensity of vocalization may be a sign of pain or underlying disease.  Changes in tone can be due to respiratory problems, polyps, hyperthryoidism, or other illness.
  9. Ear scratching or head shaking may be a sign of infection or ear mites.
  10. Changes in coat quality: If your cat is not grooming herself, it may be because of pain or illness.  Arthritis may make grooming more difficult for cats.  Disease can sap energy and lead to decreased grooming.  Any time you notice a change in your cat’s coat, you should suspect a problem.
  11. Weight loss or loss of muscle:  If you cat is getting thinner or if you notice that the muscles feel smaller, this may be a sign of a number of systemic diseases including diabetes, hyperthyroidism, renal disease, gastrointestinal disease, and others.  These signs may develop so gradually that you may not notice the change over time.

A case study

My favorite cat, Boogey, was not doing well.  His parents hadn’t noticed anything specific, but he wasn’t as energetic as usual and just looked a little scruffy to them. He was free fed, but his owners didn’t note an increase or decrease in the amount he was eating.  He may or may not have been using his litterbox more.

Although his signs were mild and non-specific, his parents decided to have him checked out.  Sure enough, bloodwork showed that he had developed diabetes.  Once he was treated with insulin, his parents observed marked improvement in his coat condition, but also in his body condition.  They hadn’t noticed that he was gradually losing muscle tone.  Even though his diet was restricted, he was able to put on weight once his disease was treated.

Boogey’s story demonstrates that a cat can be seriously ill but show only mild signs.  He had a good outcome, but if his parents hadn’t taken him in to see the veterinarian, the story might have ended in tragedy.  Subtle signs of illness in cats require prompt medical attention.

1 Merola, I. and Mills, D., Behavioural Signs of Pain in Cats, an Expert Consensus, PLoS One, 2016, 11(2).

Photo credit: Unsplash

Diabetes in Dogs and Cats, Part 3: Treating Diabetes

For many pet parents, the thought of treating diabetes in their pet is overwhelming.   Up to 40% of cats and 60% of dogs will be euthanized within a year of diagnosis.  Treating a diabetic animal is challenging, but pets with diabetes can have an excellent quality of life with proper care.

Initial stabilization and treatment

The period of time immediately after a pet is diagnosed with diabetes may be particularly challenging.  Pets with complications of their diabetes, like ketoacidosis, or pets that also have other diseases may need to be hospitalized.  Most veterinarians put newly diagnosed pets on twice daily insulin injections.  With some types of insulin, once-daily injections may be possible.  Veterinarians adjust the dose based on blood glucose control.  Control is assessed using blood glucose curves.  This means that your veterinarian will assess blood samples at various times after your pet is fed and treated with insulin to determine how long the insulin is acting iand how well the dose controls the peak blood sugar.  Glucose curves may be done in the clinic or at home.

Just as it is in people, diet is a very important part of treating diabetes in pets.  Your veterinarian will most likely recommend a high-protein, low carbohydrate diet for a cat, or a high-fiber diet for a dog.  Exercise is also key.  Exercise helps your pet’s body use glucose more efficiently.  Increase your pet’s activity level gradually once diabetes is stabilized.

For the initial treatment phase, you will need syringes and insulin, and perhaps a blood glucose monitor and strips.  You may need to purchase a special diet for your pet.  Be prepared for frequent visits to your veterinarian during this time.  This period can be expensive, but there are options to decrease costs.  Pets with Diabetes is a good resource for parents of diabetic pets.

Treating diabetes in the long term

After your veterinarian stabilizes your pet and the dose is adjusted, you will need to continue to monitor your pet’s blood sugar frequently.  Some cats will experience diabetic remission.  This means that they will no longer require insulin.  Dogs will need to remain on insulin for life.  There are some non-insulin, oral therapies available for people with type 2 diabetes.  Unfortunately, no oral treatment has been approved for animals yet.

A number of other diseases may affect your dog’s response to insulin.  For this reason, it is necessary for your vet to monitor your dog’s health closely.   In  both cats and dogs, diabetes can lead to other health problems that pet parents should watch for.  Even welll-controlled diabetic dogs may develop cloudy eyes, or cataracts.  Cats may develop weakness in their legs, especially the hind legs. .Although it is commonly believed that a well-controlled diabetic dog or cat may have a normal life expectancy, there isn’t a lot of research on this topic.  It is certainly true that both cats and dogs with diabetes may live a full and happy life, just as people with this disease do.

If you dog or cat is diagnosed with diabetes, talk to your veterinarian and share your concerns openly. Your vet can help you find the support you need to provide the best possible treatment for  your pet.

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Diabetes in Dogs and Cats Part 2: Diagnosing diabetes

What does diabetes look like in a dog or cat?  Diagnosing diabetes in our pets is relatively straightforward.  Diagnosis is based on clinical signs and laboratory tests.

Clinical signs of diabetes

See your veterinarian if you notice the following clinical signs.

Increased drinking

Increased urination

Dehydration

Frequent urinary tract infections

As we learned in the first part of this series, diabetes causes excess blood sugar.  When there is so much sugar that the kidneys can’t reabsorb it, the sugar is excreted in the urine.  The sugar brings a lot of water from the body along with it.  This causes your pet to drink more to compensate for the loss of body water.  Your pet may even become dehydrated.  Sugar in the urine makes an excellent environment for bacteria to grow, and urinary tract infections are common in diabetic animals.

Excessive hunger

Losing weight in spite of good appetite

Decreased activity or even lethargy

Vomiting

Decreased appetite

Sweet-smelling breath

Because the cells of the body can’t utilize sugar for energy in a diabetic animal, the brain will continue to send hunger signals even after a full meal.  Your pet may eat more.  However, your pet may still lose weight as the body uses proteins and fats to produce energy.  The process of breaking down, or metabolizing, fats may lead to a build up of certain types of chemicals, ketones, in the body.  Veterinarians refer to this condition as “ketoacidosis.”  Ketones in the body may be excreted in the breath.  You may notice that your pet’s breath smells sweet or fruity.   Lack of fuel, breakdown of body fats and proteins, and ketoacidosis can lead to an obvious decrease in your pet’s activity level.  In some cases, you may even notice that your pet seems lethargic.  Ketoacidosis may also cause your pet to vomit, and your pet’s appetite may decrease.

Cataracts

Increased sugar in the blood also causes increased sugar in the fluids of the eye.  This sugar acts to cause clouding of the lens.  Your pet’s pupils will seem less transparent and even gray or white.  A majority of dogs with diabetes may develop cataracts within 4-6 months of diabetes diagnosis (Beam, 1999).  Cataracts are rare in cats with diabetes.

Frequent Skin Infections

The increased blood sugar and debilitated state of pets with diabetes can lead to increased infections.  Often, dogs with diabetes have other problems at the same time that may cause skin issues or a decreased immunity to infection.

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Diabetic neuropathy

Cats with diabetes may develop a problem with the nerves in their lower legs, most often the rear legs.  The legs may be weak and the cat may walk in a crouched position instead of on the toes.

Diagnosing diabetes with laboratory tests

If your veterinarian suspects that your pet has diabetes, she will recommend laboratory tests to confirm the diagnosis.  These tests include bloodwork for sugar levels.  Bloodwork will also rule out ketoacidosis or other diseases.  Your veterinarian will also test your pet’s urine.  In order to be considered diabetic, your pet must have elevated sugar in both the blood and the urine.  Your veterinarian may ask for a urine culture to make sure your pet does not have a urinary tract infection.  Early diagnosis and treatment is critical for the diabetic pet, so make sure you see your veterinarian as soon as possible when you notice clinical signs.

In Part 3 of this series, we will look at treatment options for cats and dogs with diabetes.

Beam S. et al, A retrospective cohort study on the development of cataracts in dogs with diabetes mellitus: 200 cases, Veterinary Ophthalmology, 1999; 2:169-172

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Diabetes in Dogs and Cats Part 1

Diabetes in dogs and cats is an important health problem that often leads to early death.  Up to 30% of cats and 20% of dogs diagnosed with diabetes are euthanized within one year of diagnosis.  Of those, up to 10% of dogs and cats are euthanized immediately after diagnosis and are never treated.  That’s a high death toll for a treatable disease.  Insulin therapy is available for both cats and dogs.  In this series, we’ll take a closer look at pet diabetes.  How is diabetes in pets different from diabetes in people?  What treatment options are available?  What are factors that influence the decision to treat or not to treat?

Understanding diabetes

Diabetes mellitus is a metabolic disease in which the body cannot properly use sugars.  In a healthy person or pet, the pancreas produces a hormone called insulin. Insulin helps sugars in the blood enter cells, where it can be used to make energy to power the body.  If the pancreas does not make enough insulin, or if the cells are not responsive to insulin, sugars become elevated in the blood.  This is called hyperglycemia.  When there is too much sugar in the blood, the kidneys excrete it into the urine.  And when the kidneys excrete sugar into the urine, water follows.  This causes increased urination and increased drinking.

Because the cells don’t take up sugars, there isn’t enough energy for them to function normally.  The body uses proteins and fats for energy, and the body is said to be in a state of metabolic starvation.  For this reason, many people and animals will lose weight when they have diabetes, even though they may be eating more.

In people, diabetes is classified as Type I when the pancreas does not produce enough insulin.  When the cells of the body can’t use insulin properly, this is classified as Type II diabetes.  Diabetes in dogs and cats is sometimes classified similarly, although the distinction in pets is not as clear as it is in people.

Diabetes in Dogs

In dogs, diabetes tends to be similar to Type I diabetes in humans.  That is, the pancreas does not make enough insulin.  Generally, diabetes in dogs begins later in life.  Most dogs are diagnosed between the ages of 7 and 10 years.  Certain breeds may be at risk.  A 2000 cohort study of 43,003 dogs (221 with diabetes) found that Samoyeds, Miniature Schnauzers, Miniature Poodles, Pugs, and Toy Poodles had increased risk of developing diabetes (Hess, 2000).  A 2007 study of 182,087 insured dogs found that Australian Terriers, Samoyeds, Swedish Elkhounds and Swedish Lapphunds were at increased risk of developing diabetes (Fall, 2007).  In this study, hyperadrenocortical disease and female sex were other risk factors for diabetes.  The differences in breeds identified is probably due to the differences in the populations studied in different countries.

In dogs, obesity does not appear to be a significant risk factor for diabetes.  Even in Golden Retrievers, a breed known for a tendency to gain weight, obesity is not associated with diabetes (Davison, 2017).  Obesity contributes to other diseases in dogs, and parents should maintain a healthy weight in their pets.

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Diabetes in Cats

Diabetes in cats is more like Type II diabetes in people.  This means that, at least early in their disease, the pancreas makes enough insulin. The problem is that the cells are insulin-resistant.  High blood sugar levels causes damage to the pancreatic cells that make insulin, leading to insulin deficiency.   In contrast to people, most cats are already insulin-dependent by the time of diagnosis.

Obesity is a risk factor for diabetes in cats.  This is one reason why it is not ok to allow a cat to eat excessively and gain too much weight.  Acromegaly, a disease in which excess growth hormone is produced, and inflammation of the pancreas, pancreatitis, are other risk factors (Rand, 2013).

Part 2 of this series will discuss diagnosis of diabetes in dogs and cats.  Future posts will consider treatment options and disease outcomes.

Davison et al, The canine POMC gene, obesity in labrador retrievers, and susceptibility to diabetes mellitus, JVIM, 2017; 31: 343-348.
Fall et al, Diabetes mellitus in a population of 180,000 insured dogs: incidence, survival, and breed disposition, JVIM, 2007; 21:1209-1216
Hess et al, Breed disposition of dogs with diabetes mellitus admitted to a tertiary care facility, JAVMA, 2000; 216: 1414-1417
Rand, JS, Pathogenesis of feline diabetes, Veterinary Clinics of North America Small Animal Practice, 2013; 43:221-231

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