Beyond insulin: What’s new in feline diabetes

This podcast episode is supported by Royal Canin

On this episode of The Vet Blast Podcast presented by dvm360, host Adam Christman, DVM, MBA, welcomes Lacie Lee, DVM, to discuss the complexities of feline diabetes. The duo explores key risk factors, the essential roles of nutrition and exercise in prevention, various treatment modalities, and the clinical features of an ideal diabetic diet.

Below is a partial transcript, edited for clarity and length.

Adam Christman, DVM, MBA: In addition to insulin therapy, we are also focusing on nutrition. What are the key features you look for in a diabetic diet, and is the strategy the same for every patient?

Lacie Lee, DVM: First and foremost, we need a palatable diet. Cats are obligate carnivores, and they value choice and flavor; if the cat won't eat it, the clinical benefits don't matter. Beyond palatability, I look for a diet designed to support weight loss while maintaining vital skeletal muscle. This is critical because many patients in this age group face comorbidities like chronic kidney disease (CKD), where muscle wasting is a negative prognostic indicator.

I prefer a diet with highly digestible, elevated protein levels and moderated, usable fats. While a lower carbohydrate content is important, it is vital to remember that not all carbs are created equal. We want a diet lower in starches but rich in beneficial fiber to support gastrointestinal motility and satiety. Finally, the nutrient-to-calorie ratio must be precisely calculated to ensure that caloric restriction and weight loss occur safely.

Personally and clinically, I have had great success with Royal Canin’s Glyco Advanced. It ticks all the boxes for me: the cats love it, and caregivers feel good feeding it because they see their pets enjoying their meals. When a diet helps me manage the patient effectively, it significantly impacts my recommendations and the cat's overall quality of life.

Christman: Where might that strategy change?

Lee: It changes when we encounter significant comorbidities. For instance, if a diabetic cat has an IRIS stage of chronic kidney disease that warrants a renal-specific diet, the high protein levels in a standard diabetic diet may not be appropriate. In those scenarios, I’ll pivot my nutritional strategy, but for the general diabetic population, this is my go-to approach.

Christman: When you’re in the exam room, how do you approach the nutritional conversation with a caregiver of a newly diagnosed cat?

Lee: I start by explaining the pathophysiology—what causes feline diabetes and what factors we can actually control. I can’t change a cat's genetics or an owner's 8-to-6 work schedule, but we can work together on diet, caloric intake, and achieving an ideal body condition score.

It truly is a team effort. This is where our veterinary technicians and nurses are invaluable. Our job isn't just to make a recommendation; it’s to follow up and ensure the transition is successful, especially in multi-cat households where feeding can be a logistical challenge.

You can listen to the full episode here or wherever you listen to podcasts!