Monday, January 7, 2013

Steroid Induced Diabetes In Cats

Diabetes mellitus is a common medical condition that can affect cats. Some cats just have the right genes for it. Others may be at risk due to their weight and diet. But were you aware that cats can actually come down with diabetes after receiving steroid treatments?


There are many cats out there who are plagued with itchy skin due to allergies. Many vets today are more cautious with their use of steroids in feline patients, but sometimes they may feel that steroids are necessary. In a cat with horribly itchy skin, a steroid injection could be recommended for relief. 

One method of treatment is an injection called Depo medrol which is a steroid injection with effects that last a few weeks. If your cat is already at risk for diabetes, a steroid treatment like this could give them that push over the edge and some become diabetic after the injection. Repeated long-term use of steroids in cats also puts them at more risk of becoming diabetic.

Steroids also have a number of side effects on cats. Increased urination, thirst, and hunger are a few. Steroids raise a cat's blood glucose levels. These are some of the side effects of diabetes mellitus as well. Diabetes is not caused by the steroids alone, but is more like a "side effect" of the drug. 

Photo: Sarah G.
Fortunately, steroid induced diabetes in cats can go away in time with treatment, but this is not always the case. After the cat has been weaned slowly off of the steroids, given an insulin regimen, and started to eat a proper diet, it is possible for the diabetes to go away all together. The patient will need to return to his or her veterinarian for regular check ups and blood tests to regulate how their treatment is going. 

Of course, a cat who is diagnosed with diabetes should not receive steroids. Taking steroids will make it difficult, if not impossible, to treat diabetes in cats. Cats with allergies should seek different treatment options to help their itchy skin. 

Always keep a cat with severe skin allergies on a flea prevention. Even one bite from a flea can cause a severe reaction in cats with allergies. Try a hypo-allergenic diet with a novel protein and less grains. This may also help with your cat's diabetes. 

I don't think that it is wrong to have your cat treated with steroids when it is needed, but you should keep in mind that steroids can have unwanted side effects. I treated my own cat with steroid injections and pills for asthma and oral ulcers on several occasions. It may be easy to tell the vet that you just want to get a shot and stop your cat's itching, but it might not be in their best interest over time. A quick and easy fix is not always the best answer. 

I am inspired to write this by one of my favorite cat patients. He had steroid induced diabetes and severe skin allergies. Unfortunately, his steroid induced diabetes did not go away with time and treatment. His family eventually decided to let him cross over the rainbow bridge due to his poor quality of life. I don't typically become very attached to patients, but this cat was one that I will never forget and his story has always stuck with me.


42 comments:

  1. That is interesting. Is it the same for dogs? Have a marvelous Monday.
    Best wishes Molly

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    1. You know, I'm not sure... I have never seen this happen to a dog before or really heard of it. Steroids do cause dogs to basically have Cushings though.

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  2. Ok I sort of wish I never read this. Cody gets frequent allergy attacks during the year but he does NOT get allergy injections. He DOES get put on prednisolone a number of times during the year. I have no choice.
    You can't let him walk around with oozing and bloody lesions on his head. It saddens me because I always think about how he might not live as long as my Bobo did (Bobo was 18 when he passed)...but Cody's allergies are so frequent that there is nothing else I can do.
    Sometimes for me, in reference to some medical issues and treatments..."ignorance is bliss"

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    1. Sorry Caren! I think you are doing the right thing with him. Just try not to worry too much, it isn't all that common. This cat had some depo medrol injections for his allergies and then got a urinary blockage. Had to give him some dexamethasone for his urethra and then he became diabetic. I think he probably never recovered because he had to eat a special urinary diet and he was always very obese.

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  3. This crucial information that unfortunately not enough people are aware of. Thanks so much for getting it out there!
    So very sorry about your patient.

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  4. sad story but great info Ann!xx Speedy's mum

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  5. Great but sad, sorry we haven't been around, real bad family issue's, so catching up. If we ever get a problem, first call is you, not the vet. :) xx00xxx

    Mollie and Alfie

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    1. You guys can ask me for advice anytime!

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  6. I learned a bit about this at school, but this is very informative thanks, will keep in mind.

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  7. This is important information and we are so glad you shared this with us!

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  8. Mom says she loves steroids, but she kind of hates them too. Schroeder, my kitty, has asthma. Mom has tried almost a billion things to help him, but that Depo-Medrol stuff is the only thing that really seems to work. Luckily he has only had to have it twice in about 4 years, but now he sounds like is needing it again. Poor Schroedie...

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    1. I agree with your mom Remy. Steroids can be great, and sometimes not so much. Doesn't sound like your Schroedie has had to have too many of those shots. My KKMM had about 2 or 3 that I can remember. She got rodent ulcers and also had asthma.

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  9. I get itchies all the time and take benadryl, my Vetlady doesn't like to give me steroids very much unless she has to. This was a very interesting post and thank you.

    Loveys Sasha

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    1. Itchies are no fun! My dog gets them too Miss Sasha. I hope the benadryl works for you.

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  10. Very sad to hear but great that you are bringing attention to it so others can be helped.

    Oink oink,
    Katie and Coccolino the mini pig

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    1. The whole story actually seems sadder to me, but I left it a little short. Thanks for stopping by!

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  11. Boris, a before me cat was given pred for many years because of chronic chin acne and his lower lips would swell...he never contracted diabetes and went OTRB at 17. Giving him the pred was always a roll of the dice andn toss of the coin...sigh, paw pats, Savannah

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  12. VERY very interesting. Thanks so much for posting this! Ryker took prednisone every other day for IBD for quite a while, so very glad he didn't contract diabetes on top of it all....

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  13. My Mr. Gray had this exact thing happen to him. The vet thought he had food allergies. He had exactly what Caren described--oozing and bloody lesions on his head. The steroids were the only thing that gave him any relief. He did develop diabetes. He was overweight too. He was on insulin for about 2 years and has been off now about 2 years I believe. We were warned about the diabetes, but took the chance because he was so miserable. He probably had the steroids 5 times over the course of 2 years. Actually, the diabetes was easier on him that the allergies.
    Now he is facing hyperthyroid problems. I would appreciate an article on that sometime.
    Thanks.

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    1. I would have probably done the same thing. Glad to hear that he no longer needs insulin! The patient I mention at the end of the article actually was euthanized because his family could not relieve his allergies. He was scratching himself to death and his family felt that he was suffering too much. Thanks for checking in and commenting. I actually have it on my to-do list to write about hyperthyroidism, so you can look forward to that sometime soon.

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  14. My cat had a steroid injection in October 2012 because of an allergy problem. Now, three months later, she is still extremely thirsty and hungry. How long does it take before the steroids are out of her system?
    Thanks for your reply. ;)

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    1. Hi Leontien, I would have expected the effects from the steroid injection to be gone by now. The long-lasting steroid injection called depo medrol lasts approximately 6 weeks.

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  15. Thanks so much for this post. My cat recently had a perineal urethrostomy. While healing he developed ringworm on his ear that went unnoticed because of his Elizabethan collar. When the collar came off we discovered the ring worm and started treatment, but he began scratching and licking himself all over after a few weeks so I took him back to the vet's to see if he thought the ringworm was spreading. He said he thought the additional itching was allergies or dry skin and gave him a corticosteroid injection. The very next day he began drinking and urinating in copious amounts. Searching on the internet I found that this could, indeed, be a side-effect of the steroids, but it continued for nearly 3 weeks so I called the vet again. A urine test was done this week and it showed 'moderately high' glucose. He's having a blood test on Tuesday. It seemed to me that this could not possibly be a coincidence that this all started immediately after the steroid injection. And here is your post to confirm that. I certainly hope it can be reversed over time as you describe. Thank you again!

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    1. Hi I'm so glad you found this useful! I certainly hope that this isn't your cat's problem :( It does sound similar to the kitty I spoke about above.

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  16. Thanks for this article. My cat is currently in the hospital after he had a spike in blood sugar from a cortisone shot given to him because of asthma and allergies. This is really useful information.

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    1. Thank you :) I hope your cat recovers quickly and sorry that it happened to him.

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  17. My cat got a steroid shot just under two weeks ago for an upset tummy and fever. She gets this once every year. This year is the first time she has become famished and thirsty. The vet said give it another week and come in, what if she is still famished In a week, what kind if treatment can I expect for her? Does this mean I should not let her have steriod shots in the future for upset tummy? She went from eating contently 1/2 cup kibble to one cup and still wanting more! She's at a healthy weight now but in the past she's been chubby, so I'm concerned about her wanting to eat so much. I Am letting her eat 1 cup for now but I don't want to forever.

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    1. Well, the side effects of the shot itself are pretty much the same as you are describing here. You can ask your veterinarian about other treatment options for her upset tummy. I've mostly seen the steroid injections used for skin issues, personally.

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  18. I've been reading all these posts and my concern has been mounting. Eight years or so ago I adopted my boy cat and soon after he was diagnosed with asthma. At first he was treated with a steroid injection but it was effective for a few weeks. Then his symptoms returned so his vet gave him another injection that was effective for only a couple of weeks and then it was no longer effective at all. So then his vet prescribed Flo-vent and I purchased a special mask/tube called Aerokat so I could do his 2x a day treatments. This lasted for a couple of years before it was no longer effective. Then his vet put him on Prednisolone; 0.5 ml 2x a day which he has been taking now for about 4 years or so. As long as he gets this dose regularly his breathing is not labored nor does he cough at all. However, in February of this year he weighed 10 lbs. but when I took him for his regular exam in June he had lost 2 lbs. Blood tests were taken that showed a glucose level of about 180 but his vet said it could be from stress because he hates going to the vet. Since then I noticed his appetite became vastly increased, he is very lethargic, and he looks unkempt. Had him at his vet last Friday, more blood tests as well as a urinalysis. Blood test showed glucose of almost 500 but urine was normal. I'm almost certain he has steroid induced Diabetes. I have to take him in again for a second Fructosimine (sp?) and urine test. His vet doesn't seem to know how to treat him but I think he should start insulin. He's 13 years old. Can he continue to take the Prednisolone as well as insulin injections?

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    1. So sorry to hear about all of this... it sounds like a pretty sticky situation. To my understanding, you can't take insulin and Pred at the same time. The cat that I mention above had the same issue... needed steroids for relief, but couldn't take them because he was diabetic. I hope your vet is able to get things sorted out soon.

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    2. I just got an email regarding your reply to my post of October 30th. The vet started David (my cat) on 2 units of insulin (Lantus). After 2 weeks I took him in for a stick test that showed his blood sugar level decreasing, but not enough. Insulin was raised to 3 units and now he's on 4 units. I have to take him back to the vet this week for another stick test to see if this dose has lowered his blood sugar. If not we will increase the dose by 1 unit and keep monitoring. His vet may order another Fructosimine test and we'll go from there. I have to say though that his symptoms have decreased. He is drinking less water, doesn't eat as much and his coat no longer looks unkempt. He has more energy as well. He also seems to have gained some of his weight back but I won't know for sure until he gets weighed at the vet visit. What is the reason that steroids and insulin can't be taken together? Is there some dire consequence I need to know about? I'll ask this question at the visit but I'll be doing research on this subject as well.

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    3. Hi Gloria, let's see if I can explain the right way. Your vet may do a better job! In the article above I do mention that steroids can cause the same side effects that diabetes do. They essentially have the potential to cause a cat to become diabetic. "Diabetes is not caused by the steroids alone, but is more like a "side effect" of the drug." Therefore, giving insulin and steroids at the same time would be pretty counter-productive.

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  19. I have a cat with allergies, and she had been receiving steroid shots maybe once or twice a year for several years, and no side effects up to this point (she is now 11). We've moved and changed vets a few times, and our newest vet recently put her on the special non-allergy food (costs a whopping $56 for a small bag!). It is crazy in our household because I have four cats, and trying to get them to eat separately and only a few times a day is more than I have patience for, I admit. At the time when I did the food trial, the vet told me my cat should lose a pound to help prevent diabetes. However, after two months on the special non-allergy food, she gained 2 pounds, and mostly got rid of her skin condition, although it started to come back right at the end of the two-month trial. I visited the vet again, and I was told to keep her on the food, but to have her lose those 2 pounds. Hmm. I complied, but she is not losing any weight, and appears to actually still be gaining. I have had to put her back on her normal Indoor/weight loss food, and her weight is almost back to normal, but the skin condition returned. At this point, I'm not really seeing any alternative than to have her get the shots twice a year again.

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    1. Allergies are tricky. And finding something that your cat isn't allergic to as far as food goes can be difficult and also expensive as you mention. If your cat were to eat anything other than her special food, it could potentially mess up the food trial. The shots can be a wonderful treatment for some cats who are itchy. The shots can also cause weight gain.

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    2. I also have 4 cats, David, Fuzzy, Sassy, and Lulu. About 6 months ago I noticed Fuzzy was losing hair around his neck and he was scratching all the time. He was on a weight reducing food. I read the ingredients and saw it had grain including wheat. I started feeding all of them a grain free diet and am happy to report his hair is growing back and the scratching has stopped. Maybe this might work for you. They are all being fed with Solid Gold Indigo Moon, expensive but it works.

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  20. Hi, I have a cat who was diagnosed with inflammatory bowels disease. We put her on aggressive therapy of prednisolone (10 mg a day) for one month. She did well and in the second month we started at 5 mg a day. Within the first week she started drinking excessive water and urinating. We reduced the prednisolone to 2.5 mg every other day. She still was drinking and urinating heavily. Went back to vet and checked her. She has become diabetic. After 6 weeks of steroid therapy we have stopped all steroids. We have not put her on insulin yet. The vet wants to wait for a month and see if her diabetes will revert to normal.

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  21. It has been a week now after stopping steroids. She is drinking and urinating less. However, she does seem nauseous at times and has poor appetite. Also not interested in the diabetic food I have bought her. Any advice on what to do?

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  22. Some cats don't like the diabetes food, so maybe you can try feeding her something she will eat. Eating something is better than nothing at all. As far as the nausea goes, I'm not sure... maybe she is still getting adjusted to taking insulin. It can take some time to find the perfect dosage of insulin. Taking her in to the vet for regular glucose curves can help the vet find the right insulin amount to give and/or making any changes as necessary.

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  23. Thank you for this post. My 13 year-old cat received her first Depo shot about two months ago to treat a skin allergy, which one vet said was caused by fleas (despite no evidence of fleas) and another vet said was caused by something inhaled. She has never had health problems prior to this. Since the shot she has had a urinary tract infection, has continued to drink and urinate a lot, and has lost 2 pounds (from 11). We just learned today that she is now diabetic. Reading this makes me somewhat hopeful that we may be able to stabilize her glucose levels with a change in her diet and hopefully not insulin shots. I am very upset the vet did not warn us about the risk factors of the Depo shot, but I am trying to just move forward and now I know this for the future. I appreciate all of the time and knowledge that you put into this blog.

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    1. Thank you very much for the kind words and visiting the blog. I am glad this post is making it's way to people who are looking for the information. I wanted to write it because I wasn't able to find much information regarding this topic online myself. I hope your kitty is able to recover from her diabetes and other issues easily.

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    2. Smooch's Mom: Since my post in December I've been able to slowly decrease David's Predsolone dose by 0.01 from 0.05 to 0.04ml without any adverse effects. Also, his insulin dose has stabilized to 4 units. He's such a good boy. I give him his meds right after getting up (5am) and again right before his supper. He sits quietly while I administer the shot and stays put until I give him his oral meds. Then I tell him what a good boy he is and only then does he move to his "spot" where he always eats. I was afraid to do the shots at first but now it's old hat. His vet showed me how to do it by pinching up a little "tent" of skin on his back and that gives me more target area. He's only complained a couple of times and so did I when I accidentally stuck myself (in the beginning) He's gained 2 pounds and is, once again, playful. I took him to his vet every other week for a stick test and finally the last 2 were the same so now he doesn't have to go back until late April. I'm hoping to decrease his Predsolone slowly, slowly, slowly and then perhaps his diabetes can be controlled just with diet. Keep the faith and don't lose hope. After all, I'm sure Smooch is treated like your kid and just like me, I'd do anything to keep my "kids" healthy.

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