EXPRESS: Guidelines for nutritional management of feline diabetes mellitus: a proposed classification system integrating medical considerations

The management of diabetes mellitus (DM) in cats can benefit from an integration of medical and nutritional management, based on an understanding of the dynamic nature of the disease, together with an appreciation of interrelationships between nutritional status and clinical status. In this context, a new classification system for feline DM is proposed, comprising three clinical status categories: those at risk of developing DM, those with clinical DM and those in diabetic remission. The influence of individual dietary components (carbohydrate, protein, fat, and water fractions) on clinical outcomes is discussed, followed by overarching principles for the dietary management of diabetic cats, based on both the limited scientific evidence and the clinical experience of the authors. Key aspects of nutritional assessment, the principles of therapeutic weight reduction and feeding practices are covered. Using a proposed classification framework, recommendations for nutritional management are proposed for cats at risk of development of DM, cats with clinical DM and also those in clinical remission. Successful implementation of these recommendations can be achieved by using a relationship-centred approach, where owner concerns are addressed and goals for management are agreed in partnership. It is hoped that these perspectives will help guide veterinary professionals in their clinical management decisions, thereby improving health outcomes in cats in all three DM categories.