Insulin? I’d Rather Euthanize My Cat Than Go There (and Other Stressful Diabetic Cat Encounters)

By Patty Khuly, DVM on Jun. 6, 2011

I just don’t get it. Here I’ve got the proverbial crazy cat lady seated before me. I mean, she’s long ago confessed to keeping ten cats in her tiny apartment. And don’t get me wrong — I adore her for it. Problem is, she currently says she’ll not be treating her just-diagnosed diabetic cat with insulin because (a) she has too many others to worry about, and (b) she doesn’t want to "put her through it."

Now, in case you’ve not heard my spiel on this before, lean into your seats and grab hold of your desk now: Who exactly are we putting through what? Because if I was nine-out-of-ten cats, I’d be loving life as a diabetic cat. That is, as long as my owner cared enough to coddle me through the process.

And since a full fifty percent recover fully enough not to require insulin within four short months post-diagnosis, I’d say not wanting to "put her through it" would rank high among the crappiest reasons to let any animal die an uncomfortable death in the face of an eminently treatable disease.

But then, as most of us who labor long enough in veterinary medicine know, a large percentage of don’t-want-to-put-her-through-it cases are really just an excuse for economic euthanasia. Or more depressingly, don’t-want-to-put-her-through-it is the code for death offered by the I-just-can’t-deal-with-this-right-now mentality I encounter so often among my emotionally overwhelmed client base. This latter group means well. But they just. can’t. deal.

And somehow, diabetic cats rank really, really high among the cases that fall into this emotionally trying category. Somehow, it seems people want to draw the line at diabetes. But then, that’s probably only because diabetes in cats almost inevitably means insulin. Injectable insulin. Twice a day insulin.

There’s no doubt about it: Managing a diabetic cat is not easy. And make no mistake, I’d rather have clients tell me how it is up front so that we can euthanize a sick cat before he has a chance to suffer rather than have them take him home to die a drawn-out death of neglect. But that doesn’t mean that veterinarians shouldn’t try to evangelize on the merits of diabetic cat management.

Frustrating though it inevitably is to hear a client wax poetic on the many ways in which s/he will decidedly NOT engage in the insulin-giving, prescription diet-feeding, careful-watching type of diabetes management modern veterinary medicine recommends, knowing that I succeed in changing hearts and minds on this issue in more than fifty percent of my stubborn cases is more than enough to keep me going.

Sure, their mystifying excuses never fail to get me down. But if I can just hang in there long enough to get them to agree to move onto the next step — stone soup-style — I find that most pet owners will follow me, step after perilous step, as we move into the not-so-stressful-as-I-thought-it-would-be territory of diabetic cat management.

My profession is about healing animals — mostly. But in a large percentage of cases I’m really just Tom Sawyering others into doing the healing for me. And nowhere is this more obvious in my version of veterinary medicine than when it comes to treating the diabetic cat. Sure, I can tell them exactly what to do, but unless I can persuade pet owners into believing that both they and their cats will be happier in the end … it’s all over.

Luckily, the truth about insulin is this: Most cats mind it far less than getting a pill or liquid medication foisted upon them twice a day. What’s more, most cases of feline diabetes are incredibly rewarding adventures in what it takes to really love animals. Now, if only I could convince ALL my clients…