Diabetic neuropathy in cats: plantigrade stance
11-year-old domestic shorthair cat, diabetic for 8 months with poor glycaemic control (persistently high fructosamine). For weeks it has walked with its hocks touching the ground, struggles to jump and has pelvic limb weakness. Potassium is normal.
Which measure is most effective at improving the plantigrade stance?
chevron_right Show answer and explanation
A. Anti-inflammatory prednisolone to reduce nerve inflammation
Diabetic neuropathy is not inflammatory, and corticosteroids worsen insulin resistance and diabetic control.
B. Oral methylcobalamin as the main treatment, without changing insulin
Methylcobalamin has been used anecdotally, but it does not replace glycaemic control, which is what allows the nerve to recover.
C. Optimise glycaemic control (appropriate insulin regimen, high-protein low-carbohydrate diet and monitoring)
Correct. The neuropathy is caused by persistent hyperglycaemia, which damages Schwann cells (demyelination). With good control or diabetic remission, the stance usually improves or normalises within weeks to months.
D. Lumbosacral MRI to rule out a compressive disc herniation
A bilateral plantigrade stance in a poorly controlled diabetic cat is typical of distal polyneuropathy; it is not the first thing to investigate.
lightbulb Key takeaway
A plantigrade stance reflects gastrocnemius weakness (tibial nerve); in advanced cases a palmigrade stance also appears. Before attributing it to diabetes, rule out hypokalaemia. It is a sign of poor glycaemic control: review the insulin regimen and look for causes of resistance (acromegaly, infections, dental disease).
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.