2025 iCatCare consensus guidelines on the diagnosis and management of diabetes mellitus in cats

Practical relevance: Diabetes mellitus (DM) is a common feline endocrine disease. Developments in therapy mean there are now more options for treatment, including various types of insulin and novel oral medications. Use of continuous glucose monitoring (CGM) devices has increased, providing more detailed information on affected cats. Selecting the appropriate treatment for DM, monitoring the cat’s response and treating complications can present challenges, but these patients are nonetheless rewarding cases to manage for clinicians. Aim: The ‘2025 iCatCare consensus guidelines on the diagnosis and management of diabetes mellitus in cats’ provide practical information on the management of complex as well as more routine cases. The importance of a team approach, involving veterinary professionals and the caregiver, is emphasised as this is likely to optimise patient outcomes Clinical challenges: The pathogenesis of DM in cats, including absolute or relative insulin deficiency, can complicate management. Moreover, conditions such as hypersomatotropism, which is a prevalent underlying cause, as well as comorbidities that are common in affected populations of cats, warrant special consideration. Selecting the most appropriate therapy for the individual cat with DM relies on a thorough assessment of the case, including testing for comorbidities, if indicated, and excellent communication with caregivers. Treatment with either insulin or sodium–glucose cotransporter-2 inhibitors may be appropriate and should be combined with a diet and a monitoring regimen that are suitable and manageable for both cat and caregiver. Monitoring, to determine the response to treatment and to detect complications such as diabetic ketoacidosis or hypoglycaemia, may include placement of a CGM device. Evidence base: These Guidelines have been created by a panel of experts brought together by the International Cat Care (iCatCare) Veterinary Society. Information is based on the available literature, expert opinion and the panel members’ experience.