Certain diabetic cats may maintain normal glucose levels without insulin therapy after initial diagnosis and treatment. Insulin can be withdrawn for at least 4 consecutive weeks in such cats in clinical remission. Factors associated with remission are still unclear. This study examined clinical characteristics affecting duration and likelihood of remission. Diabetic cats were identified between January 2000 and July 2009 in a Zurich hospital. A total of 90 newly diagnosed diabetic cats were included in the study and were followed up until either clinical remission or death. The impact of corticosteroid/progestogen treatment, history, physical examination findings, signalment, complete blood count, serum biochemical profile, comorbidities, occurrence and duration of remission, and type of insulin at discharge were also examined. Remission was identified in 45 cats with a median time of 48 days. Older cats were more likely to achieve remission (OR: 1.23, 95% CI: 1.04–1.46; P = 0.01), and remission was longer in cats that were alive at the end of the study (151 days; range, 28–1180 days). Elevated serum cholesterol levels were associated with a lower likelihood of remission (OR: 0.36, 95% CI: 0.11–0.87; P = 0.04); remission was prolonged in cats with higher body weight (HR: 0.65, 95% CI: 0.42–0.99; P = 0.04) and shorter in cats with higher blood glucose levels (HR: 1.01, 95% CI: 1–1.02; P = 0.02). In this study, clinical remission was not associated with sex; breed; body weight; corticosteroid/progestogen administration; white blood cell count; lipase activity; ketoacidosis; other comorbidities; or serum glucose, fructosamine, total protein, albumin, creatinine, and potassium concentrations. Study supported by Nestlé Purina PetCare

Commentary: This study examined predictors of clinical remission in cats with diabetes. Older cats were more likely to achieve remission, and those with higher body weights tended to remain in remission for longer periods. Patients with above normal cholesterol levels were less likely to go into remission and those with higher glucose levels had shorter remission durations. Although remission occurred within a short time frame, it should be noted that the median remission duration was also short with few exceptions. Clinically, this information may be applicable in determining follow-up protocols on patients and counseling of owners on the possibility of remission, especially in older patients. In addition, the study should prompt further investigations into the role of hypercholesterolemia and diabetes in cats.—Shawn Kearns, DVM, Diplomate ACVIM

Predictors of clinical remission in cats with diabetes mellitus. Zini E, Hafner M, Osto M, et al. J VET INTERN MED 24:1314-1321, 2010.