What Does It Mean When the Vet Says My Pet Is "Prediabetic"?

November 02, 2026 • After the Vet Visit • All Posts • Cats • Diabetes • Dogs • Health & Wellness • Prediabetes • Weight Management

By Theresa Gibilisco, owner, The Hungry Puppy

"Your pet's blood sugar is a little high. Let's call it prediabetic and keep an eye on it." If you heard something like that, you probably walked out with more questions than answers. Is it diabetes or not? Is there a special food? Can we stop it? We hear these at the counter, so we went to the veterinary guidelines to see what they actually say. Some of it may surprise you.

This is general information to help you talk it through. Your vet has the final word on your pet's diagnosis and care.

Is "prediabetes" a real diagnosis in dogs and cats?

Not officially. The American Animal Hospital Association (AAHA) diabetes guidelines don't use the word "prediabetes." They describe these pets as "at risk" for diabetes, and the 2026 cat guidelines also use the term "subclinical diabetes." Subclinical means there's a lab change but no outward signs yet.

Your vet may still say "prediabetic" because it's a word people know from human medicine. It's a fair shorthand. Just know that in the guidelines, it maps to "at risk."

What does "at risk" actually mean?

AAHA describes an at-risk pet as one with:

Mild to moderate high blood sugar (hyperglycemia) that isn't caused by stress
No sugar in the urine (glucosuria)
No symptoms

That last part matters. Diabetes usually shows up as more thirst and more urination, because once blood sugar climbs past what the kidneys can hold back, sugar spills into the urine. Merck and AAHA put that spill-over point at roughly 180 to 200 mg/dL in dogs and roughly 250 to 300 mg/dL in cats. An at-risk pet hasn't gotten there.

For comparison, AAHA's 2026 dog guidelines describe diagnosing diabetes in dogs by "documenting glucosuria and concurrent hyperglycemia," meaning high blood sugar plus sugar in the urine at the same time.

Could it just be stress at the vet?

In cats, quite possibly. AAHA describes stress hyperglycemia in cats as a temporary sugar spike, usually below 250 mg/dL, that goes back to normal once the cat leaves the stressful situation. A car ride and an exam room can do it.

That's why a vet may recheck before using any label at all. A fructosamine test helps here, because AAHA says stress doesn't usually affect it. It reflects blood sugar control over roughly the past 1 to 2 weeks. Our post on glucose curves and fructosamine tests explains it in more detail.

Will my pet need insulin?

No, not at this stage. AAHA says at-risk pets do not get insulin. For cats, the 2026 guidelines say there is no evidence to support an SGLT2 inhibitor (a newer diabetes pill), insulin, or any other diabetes drug for at-risk cats. The plan is about everything else.

Can we prevent diabetes?

Here's the honest answer: AAHA says "there is currently no known strategy to prevent DM" (DM is diabetes mellitus). Nobody can promise that weight loss or a new food will keep diabetes away. What the guidelines do is lay out a plan that removes things known to make blood sugar harder to control and catches trouble early.

What does managing an at-risk pet look like?

AAHA's management list for at-risk pets includes:

Weight loss if the pet is overweight.
Diet changes guided by your vet.
Avoiding steroids and progestins (hormone drugs) when possible. Both can work against insulin. Whether your pet can do without a medicine it already takes is strictly your vet's decision, so never stop one on your own.
Treating other diseases. AAHA lists conditions that cause insulin resistance, meaning the body responds poorly to insulin. These include infections such as urinary tract infections, dental disease, pancreatitis, kidney disease, Cushing's disease, thyroid disease, and in cats, acromegaly (too much growth hormone).
Monitoring with blood glucose tests and urinalysis.

What raises a cat's risk?

Most diabetic cats have the Type II form, where the body's cells don't respond properly to insulin, according to Cornell's Feline Health Center. Cornell lists these as the most important risk factors:

Obesity
Increasing age (Merck says most cases are in middle-aged to older cats)
Inactivity
Being male
Corticosteroid (steroid) use for other conditions

Two of those, weight and activity, are things you can work on at home with your vet.

What about dogs?

Dogs usually get a different kind of diabetes. VCA describes it as "total or near-complete destruction of the insulin-producing beta cells" in the pancreas, and Merck says the cell loss comes from either immune destruction or severe pancreatitis. That's why weight isn't the whole story in dogs.

Tufts explains it this way: being overweight isn't a risk factor for developing diabetes in dogs, but extra body fat can cause insulin resistance. Weight still matters. Tufts says overweight diabetic dogs should lose weight slowly once the diabetes is under initial control, with close vet monitoring, because extra fat makes insulin work less well. Merck notes most cases happen in middle-aged dogs.

One note: the "at risk" description above comes from AAHA's 2018 guidelines, which covered dogs and cats together, and from the 2026 cat guidelines. Ask your vet how they're defining it for your dog.

What does this mean for food at home?

The guidelines list diet as part of the plan without giving separate nutrient numbers for at-risk pets. So the specifics are your vet's call. Here's what the research does give us to work with:

For cats, replace food treats with play. That's straight from AAHA's 2026 section on at-risk cats, which also recommends environmental enrichment, giving your cat more to do.
Know where the diabetic cat diet points. For cats that do become diabetic, AAHA's targets are protein above 40 to 45% of calories and carbohydrate below 12 to 15%, ideally about 12%. Canned food is preferred because it's lower in carbs, easier to portion and less calorie-dense. Ask your vet whether they want your at-risk cat moving in that direction now.
But watch calories in heavy cats. VCA warns that many low-carb foods are calorie-dense, and a review in Today's Veterinary Practice says high-calorie, low-carb foods aren't right for obese cats. For obese diabetic cats, AAHA suggests a lower-calorie diet with moderate carbohydrate (15 to 25% of calories) and weight loss of 0.5% to 2% of body weight per week.
For overweight dogs, go slow. AAHA's dog guidelines set weight loss in obese diabetic dogs at 1% to 2% of body weight per week. Your vet will tell you whether that pace fits your at-risk dog.
Measure and count. Measure meals, count treats in the day's calories, and weigh your pet on the same scale regularly. For dogs, the general rule of thumb, used in AAHA's weight management guidelines and by VCA, is to keep treats to 10% of daily calories or less.
Skip the sugar. For diabetic dogs, Merck and Tufts say to avoid semi-moist foods, which contain simple sugars. Check labels for sugar, corn syrup or honey.

Our weight management section is a good place to start a conversation, and we can help you compare calories per cup or can.

How will my vet keep track?

With repeat blood sugar checks and urinalysis, per AAHA. At home, AAHA's cat guidelines suggest weighing monthly and noticing any change in drinking or urination. More thirst and more urination are the classic signs of diabetes. If you see them, call your vet sooner rather than waiting for the next recheck.

What words might I hear?

At risk: AAHA's term for mild to moderate high blood sugar without stress, urine sugar or symptoms.
Subclinical diabetes: lab changes in a cat without outward signs.
Hyperglycemia: high blood sugar.
Glucosuria: sugar in the urine.
Stress hyperglycemia: a temporary sugar spike from stress, common in cats at the clinic.
Insulin resistance: the body responds poorly to insulin.
Fructosamine: a blood test showing average sugar over about 1 to 2 weeks.

What should I ask my vet?

When you say "prediabetic," do you mean "at risk" as AAHA defines it?
Could this be stress? Should we run a fructosamine or recheck?
Was there any sugar in the urine?
Is my pet overweight, and what's a safe weekly pace for weight loss?
Do you want me to change foods now? What carb and calorie level?
Are any of my pet's current medicines a concern?
Is there another condition we should look for, like dental disease or a urinary infection?
When should we recheck, and what signs should make me call sooner?

Where to go from here

If your vet's main concern is weight, see what it means when the vet says my dog is overweight. For the general picture on therapeutic feeding, read special diets for dogs and cats. And if pancreatitis is part of your dog's history, see what it means when the vet says my dog has pancreatitis.

Prescription diets need your vet's authorization, and we're happy to reach out to your vet for you. Our own trucks deliver free on each town's route day, Tuesday through Friday, with a $20 minimum. Find your day on our local delivery page, or call 732-938-4470. For a sit-down conversation about your pet's food, book a free 45-minute Personal Pet Consultant appointment.

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