"Emma Jean's blood glucose is over 400. She's diabetic," the vet said.
But all I heard was "Emma Jean blah blah blah DIABETIC." (She was also ketoacidotic, but that's another story.)
Panic set in and I imagined all sorts of horrible medical things. I would be completely unable to care for my little Emma Jean — willing, but unable.
How untrue that was! It turns out that feline diabetes, a treatable and manageable disease on the rise, affects approximately one in 200 cats nationwide. And a lot has been developed for the at-home management of diabetic pets.
Some very knowledgeable and wonderful friends taught me to check Emma Jean's BG (blood glucose) by doing an ear stick, and how to use a human glucometer. Thank goodness it worked, because Emma Jean was an extremely uncontrolled diabetic. She would be acting just fine and eating well, but her BG would only be 40. Conversely, when she didn't eat her BG would sometimes be over 400.
Had I not been able to check her glucose level, there's no doubt I would have given her insulin at the wrong time with disastrous results. After a time, I even learned to adjust her insulin depending on how high or low her BG was.
My vet loved that I did BG curves at home, since Emma Jean wouldn't undergo the stress of being at the clinic. I loved it because it was much less expensive. Nevertheless, Emma Jean wasn't particularly fond of getting her BG checked every hour for 12 hours. After all, she had some serious napping on her schedule.
I've always been convinced that Emma Jean's diabetes was steroid-induced from being on a low dose of Prednisolone for 5+ years. Unfortunately, due to a chronic inflammation in her eye, we couldn't risk stopping the steroids.
She eventually succumbed to an undiagnosable neurological something-or-another in 2002, which baffled several doctors. Still, I took comfort that it wasn't the diabetes and that I didn't contribute to her demise.
By the time Winston became diabetic in 2009, it wasn't a life-altering diagnosis for either of us. It was just one more thing to do since he had lymphocytic lymphoma and was already on all sorts of medications. His was also steroid-induced, but if we stopped the steroids, he quit eating.
He would calmly sit on the kitchen counter while I pricked the edge of his ear with a needle and checked his BG. He was consistent with his glucose numbers, though, and I didn't have to check it more than twice a day. Still, I always felt better knowing he only got insulin when he needed it.
The thing about diabetes that really strikes fear in my heart is its potential to bring about hypoglycemia (low blood sugar). One time I checked Winston's BG about two hours after his injection and it was only 80. Ack! An hour later it was even lower. When it hit 56 I panicked and brought out the corn syrup. It was too thick for an eye dropper, so I resorted to putting it on my finger and rubbing it on his gums. (That's supposed to work, isn't it?) His BG dropped even lower. I force fed him Hill's a/d. By the time we were done, the cat, the bathroom and I were all covered in syrup. But Winston, trooper that he was, was no worse for the wear.
After a while, his BG finally started going back up and everything was fine. Of course, I was checking it every 15 minutes for the next several hours.
Every couple of months I set aside a Sunday to do a curve on Winston. Bless his heart; he wasn't the sharpest pencil in the box. I firmly believe that he saw the once-an-hour testing as individual attention. He loved being picked up, carried to the kitchen and placed on the counter — even if it meant his ear was going to get pricked. We did that for two years, until cancer got the best of him.
And then there was Stella, my CRF (chronic renal failure) kitty. No steroids. No medications (other than Amlodipine for blood pressure and LRS fluids for her CRF). No warning. Just "Stella blah blah blah DIABETIC" from my vet.
We caught it fairly early because she got a full checkup with bloodwork two to three times a month for her CRF. Oh, how the vet hated to tell me her glucose was high!
Stella was not the most agreeable patient, and she hated — I mean HATED — to be restrained in any fashion. It was enough of a challenge to keep her in one place for twice-a-day fluids, but adding a BG check and insulin injection to her schedule was daunting. We had to go the wrap-the-kitty route. By the time I wrapped her up and fastened the towel with clothes pins, she looked like a very unhappy Catasaurus.
All the supplies had to be laid out: the pills in the pill popper, the insulin drawn and everything at the ready before corralling Stella and wrapping her like a taco. I learned to work quickly before she started struggling and yowling. (And, at my house, if one cat yowls, the Thundering Herd makes a beeline to see what's going on.)
We started her on Lantus brand insulin, but never quite got her regulated. During one of her checkups, I opined that PZI insulin was no longer available. The doctor looked up and happily told me that a "new" PZI was available. It was not the beef-pork recombinant that PZI used to be and that worked so well in cats, but it was worth a try.
Of course, PZI takes different insulin syringes so I had to stock up on U-40 syringes. (Always be cognizant of the syringe size to use with a particular insulin.) It was kind of fun, though, because they came packed in a cool sharps disposal container that still sits on my kitchen counter.
Stella regulated beautifully on the PZI. However, her CRF was still getting worse. We hoped that a stay at the clinic on a fluids drip might help her kidneys, so we packed her bags and put her in the hospital for a few days.
She got lots of attention every time someone walked by, I visited every evening, and she didn't have to deal with the other kitties at home. I swear she loved it and probably thought of it as her vacation home! Other than having that darned needle in her leg, she was pretty happy.
Her kidney numbers didn't come down as hoped. But since the clinic was vigilant about checking her BG, she didn't need insulin during her stay. Stella had actually reverted and wasn't diabetic any more. Good news for a change!
Sadly, after fighting the CRF fight for two years, her kidneys worsened regardless of what we tried. She left us in September.
All of this to say that diabetes is manageable — at least in the case of my cats. Also, doing the BG checks, insulin injections and curves really isn't a big deal once it's part of a routine. In fact, I'd do it all over again (and probably will) for any of my critters that might ever need it.
Image: Kim Smith / via Flickr