Remission Strategy
Remission is the ideal goal, but not possible or appropriate for all patients. The ISFM Guidelines on Diabetes Mellitus state: “If negative glucosuria and/or euglycaemia are maintained for 2–4 weeks without insulin, the cat has likely achieved remission.”
- Need to establish goals with owner based on each client’s circumstances
- Insulin administration with the goal to keep BG <220 mg/dl (12.3 mmol/L)
- More likely achieved with intensive regulation utilizing insulins shown to have a longer duration of action in the cat (i.e., detemir, glargine, PZI)
Home BG monitoring
- Adjust dose based on pre-insulin and nadir values
Dietary Recommendations
- Restricted carb diet <3g/100 kcal
- Carbs <12% of ME
- Regularly monitoring weight and BCS
Management of Obesity
- Target loss of 0.5-2% of body weight per week
Mitigation of Insulin Resistance
- Management of other diseases (i.e., endocrinopathies, dental disease, UTI, pancreatitis, etc.)
- Withdrawal of corticosteroids and progestins
- Management of obesity (see above)
In the Clinic
- If remission seems likely, more frequent clinic appointments may be necessary
Remission Frequently Asked Questions
Click here for Remission FAQs. There are answers to questions such as, "Is it worthwhile to try for remission?," "What is the chance a patient will go into remission?," "Which patient is most likely to go into remission?," and "What else should I consider about remission?"
© American Association of Feline Practitioners, 2019
