RVC: Diabetes remission research progress

Diabetes mellitus (DM) is a common disease among domestic cats and is estimated to affect 1 in 200 cats in the UK. Although this prevalence might not seem overwhelming, diabetic cats require daily insulin treatment and frequent consultation by veterinary surgeons and so managing diabetic cats accounts for a substantial amount of time within veterinary practices. Furthermore, caring for a diabetic cat places a care-giving and financial burden on cat owners, and this pressure sadly results in many cats being euthanised early in the course of their diabetes. Many diabetic cats have a form of DM that resembles Type 2 DM in humans and is linked to factors such as being overweight and physical inactivity. Type 2 DM is largely responsible for the diabetes epidemic observed over recent decades in human medicine, and research supports that DM is becoming more common in cats too. There is also concern that obesity in cats and dogs has increased during the COVID-19 pandemic, and this increase in overweight cats could result in more cats developing DM. Some diabetic cats can enter a state of diabetic remission and stop insulin therapy. Reported remission rates vary but are typically up to a maximum of 30-40%. As would be expected, entering remission is hugely beneficial for both diabetic cats and their owners as it relieves the financial, treatment and caring pressures placed on owners, and removes the need for frequent veterinary examinations. Diabetic cats that achieve remission also have a greater life-expectancy compared to those that remain diabetic. The RVC’s Diabetic Remission Clinic, based at the Queen Mother Hospital for Animals in Hertfordshire, researches the best treatment methods for feline DM and is currently recruiting overweight cats with Type 2-like DM to trial a new prescription diabetic food. The trial has been running since March 2021 and the team is delighted with early results. The RVC currently has 22 cats recruited to the trial and approximately 70% of these have achieved diabetic remission after switching to the trial food. In addition, the first trial recruits have remained in remission throughout the duration of the study. This is a considerable achievement because diabetic relapse is common among cats in remission. One cat that has benefitted from trial participation is Loki, a nine-year-old domestic shorthaired cat from Ashford in Surrey. Loki was diagnosed as diabetic in May 2021 and joined the RVC’s new trial in June 2021. At the time of diagnosis, Loki was suffering with diabetic neuropathy, which has previously been associated with a lower likelihood of achieving diabetic remission. However, Loki was able to stop insulin therapy three weeks after starting the trial diet and has been in diabetic remission ever since (Picture 2). Loki’s owner, Joy Bailey said "I was so worried when Loki was first diagnosed with diabetes and wasn't sure if the weakness in his back legs would ever improve. The team at RVC were so helpful, providing loads of information about the trial and what to expect. After just a few months, Loki lost weight and went into remission! He's made amazing progress and seems happier and healthier than ever – and he absolutely loves the food! I'm so happy our vet put him forward for the trial." The Diabetic Remission Clinic team is delighted that the trial diet has not only improved the lives of many trial recruits, but also shows such promise as a valuable tool for the future management of feline diabetes. The trial is recruiting until December 2022 and further information about the study can be found here: www.rvc.uk.com/feline-diabetes-diet-research. The trial team would be delighted to hear from veterinarians with potential cases via email (fdrc@rvc.ac.uk) or phone (01707 666605) and is hugely grateful to the cat owners and vets who have already assisted us in this exciting project.

RVC: Diabetes remission research progress

Ruth Gostelow, Lecturer in Small Animal Internal Medicine, discusses how the latest feline diabetes trial at the Royal Veterinary College (RVC) is reversing diabetes in many recruited cats.

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