• Purina DM is the most CHO restricted diet on the market; dry diet ~15% CHO on dry matter basis, canned ~5% CHO on dry matter basis.
• Hill's Science Diet kitten (Science Diet feline growth); reformulated and now contains ~15% CHO on a dry matter basis (~same as canned w/d). Hill's consultation line still recommends w/d for obese cats with diabetes. For non-obese cats, they are recommending canned p/d (equivalent to Purina DM).
• Canned p/d has ~12% CHO on dry matter basis. If cats will not eat canned food, Purina has the best dry food formulation for diabetic cats.
• Fancy Feast is an appropriate diet for cats that are picky eaters.

• Use ~2 units q12 hr. If cats are already on a low dose of insulin (1 to 1.5 units per injection), consider discontinuing insulin when switching to a CHO restricted diet.

• Monitor urine glucose using Glucotest indicator. If urine glucose is negative for 2 consecutive days, reduce insulin dose to 1unit q12hr. If urine glucose is negative for 2 subsequent consecutive days, reduce insulin dose to 1unit q24hr. Stop insulin if cat continues to be euglycemic.

• Insulin requirement will recur in some cases, the exact % is not presently known. As many as 50% may ultimately become dependent on exogenous insulin long term.
• Relapses may be related to dietary non-compliance.

• Nephropathy may be related to diabetes. If cats have poorly regulated diabetes they are in a catabolic state, breaking down body protein, which is essentially equivalent to feeding them a high protein diet.
• Good regulation of diabetes is considered the main priority, rather than having cats on a renal failure-type diet. If dietary phosphorus restriction is necessary, feed canned renal failure diet.

Can be used to reverse glucose toxicity, but needs to be administered in conjunction with a CHO restricted diet. Takes considerably longer to reverse glucose toxicity with glipizide than it does with exogenous insulin.

Can lead to resolution of insulin dependence, but time taken is longer than with insulin and diet combined.

Experimental studies have found no difference between CHO restricted diet alone, versus diet and acarbose administration. Acarbose best used for cats that will not eat canned food; give acarbose with meals.
[Material for this topic was provided by Dr. Deb Greco]