This detailed analysis looks at what has changed in caring for cats with diabetes, including why the AAHA guidelines move away from routine in-hospital glucose curves and what a successful insulin plan looks like.
Kelly Cairns, DVM, MS, DACVIM (SAIM), reflects on how feline diabetes management has evolved during her time in practice and what the updated American Animal Hospital Association (AAHA) guidelines mean for newly diagnosed cats and those already receiving insulin. Her conversation covers expanding treatment options, more patient-friendly monitoring, and a renewed emphasis on clinical outcomes that matter to cats and their owners.
Below is a partial transcript of the conversation.
dvm360: AAHA updated its diabetes guidelines for cats this year. In your time in practice, how has treating cats with diabetes changed?
Kelly Cairns, DVM, MS, DACVIM (SAIM): I think the biggest change is that we have a lot more tools now, and we're becoming more thoughtful about how we use them. Insulin has been the cornerstone or central treatment for feline diabetes for a really long time, and while insulin is still super important, we now have other medications, including the sodium-glucose cotransporter-2 (SGLT2) inhibitors, which can be super helpful for very carefully selected newly diagnosed cats that have never received insulin.
At the same time, the way that we monitor these cats has changed the information we can get from insulin-treated cats. Instead of trying to make decisions after a stressful day in the hospital, we’re turning more to using continuous glucose monitors to look at trends while the cat is in its normal home environment.
One of the things that I think is super striking about the AAHA guidelines is that routine in-hospital glucose curves are no longer recommended. That’s not saying that glucose curves are unimportant. It’s saying we should do it in a way that’s going to produce more useful information in a less disruptive environment for the patient. And the last thing that I think has changed with the new guidelines is an increased emphasis on clinical outcomes, really looking at if the cat is feeling better. Is their thirst and urination normal? Is their weight stable? These are very meaningful measures of success, not just looking at the glucose numbers.
