Why I am writing about Bertie...

Six and a half years ago Bertie, then aged eight, was diagnosed with diabetes.  The vet who did the diagnosis suggested that I have him 'put to sleep'.  I considered what she was saying - very seriously.  And got a new vet....
The new vet considered that feline diabetes was treatable.  Bertie was started on insulin.  He's thirteen and a half now, and still seems in fine fettle.

Very recently I met a lady who was deeply upset at having lost her "beloved cat" to diabetes.  I offered my condolences and said that I also had a diabetic cat, who I'd been looking after for over five years.  The lady's jaw dropped.  It transpired that she had never considered treating her cat's diabetes.  She took the decision not to treat at the suggestion of her vet, and had the cat 'put to sleep'.  The only difference between that lady and me was the information we had about whether feline diabetes was treatable or not.  I was just the lucky one.

So I've decided that I want to write about Bertie and about our experience of treating feline diabetes.  Who knows, maybe our experience will help someone else. 

If your cat has just been diagnosed then please take heart: Feline diabetes is NOT a death sentence.  I'll say that again a bit louder: FELINE DIABETES IS NOT A DEATH SENTENCE!  There are many stories of diabetic cats who are alive and well because they have human companions who are willing to look after them.  Let me tell you my cat's story...

Bertie's Story

Bertie was a stray cat who came to visit us - and decided to stay.

When Bertie was about eight years old his health deteriorated.  He'd lost weight over the course of a summer (quite common for cats) but he didn't put the weight back on when the weather got colder.  In fact, he became thinner - despite being hungry all the time and wolfing food down as though he was starving (which, technically, he was...).  His coat was dry and flaky.  He drank loads of water.  And  he peed all over the house.  His back legs seemed weak too.  I feared that he had kidney or thyroid problems and took him to the vet.

The leg weakness led the vet to suspect feline diabetes, and she wanted to do some tests to confirm the tentative diagnosis.  She asked us to return in a couple of days to discuss the results.

I cried on the way home.  What if it was diabetes?  What would that mean?  The conversation in my head went something like this: "Surely he'll need insulin injections and there is absolutely no way I could do that!  I'm really squeamish about needles.  And my cat will hate me for it.  He'll start getting frightened every time he sees me.  He'll be even more miserable than he is now. Maybe he'll even run away from home....   Aaarrgghhh!!!!" 

However, some common sense must have prevailed, because when I got home I sat at my computer and did an internet search for 'feline diabetes'.  I very quickly found out that there were people out there in cyberspace who were managing to look after their diabetic cats very well.  And the cats didn't get scared and want to leave home.  Some sites in particular were hugely helpful at that initial stage; and Bertie and I owe a debt of gratitude to Deborah at 'Sugarpet'.  It was she who gave me the confidence to treat Bertie's diabetes.  (Thanks, Deborah!) :-)

We returned to the vet.  The diagnosis of feline diabetes was confirmed.  To my surprise the vet was not at all encouraging about treatment, and implied that euthanasia would be a better option. "...Diabetes in cats is just SO difficult..." she said.   And added that their practice nurse also had a diabetic cat diagnosed 6 months earlier, and even she, a veterinary nurse, was struggling to get any success.  I looked across at the nurse.  She stood with arms folded, nodding in agreement with the vet.  "...And even if you were to consider treating the diabetes it would be like having a two-year old around the house the whole time..."  I never did quite understand what she meant by that!  But I decided that I'd heard enough.  I had no intention of getting rid of my cat.  But I had every intention of changing my vet...!

Our New Vet...

By some extraordinary good fortune a new vet had recently set up an independent practice just two streets from where we lived.  I went along for a chat.  He was warm and friendly and very receptive to my decision to treat Bertie's diabetes.  Brilliant!  I took Bertie along to see him and we got started on insulin right away. "Of course...." he said, "....giving the injections is the easy part. Feline diabetes can be pretty tricky to deal with...."  But all I could hear at that time was his mention of "giving the injections".  Because I hated needles....

Giving Insulin Injections ('oranges are not the only fruit' but they are pretty useful...)

Some of the advice I'd read about giving insulin injections to cats suggested practicing the injecting technique on oranges (why 'oranges' and not 'lemons' or 'limes' or 'grapefruit' (or other citrus fruit) remains a mystery..).  This was indeed helpful advice though.  Oranges are pretty placid and don't feel the need to run away and hide behind the sofa. And you get used to handling syringes without involving your cat! Hurrah!  I became quite expert at injecting water into oranges.  But I imagined that injecting a warm, furry, squiggly, wriggling cat was not going to be as easy as injecting  an orange.  And I was right.  But not for the reasons I thought...   It transpired that my cat was pretty calm about being given injections into the scruff of his neck.  There are very few nerve endings there.  Give an injection properly (ie, under the skin and not into the muscle) and the cat feels no pain at all.  The problem was not with the cat.  It was with me.  I was just SO nervous the first time; especially about the possiblity of hurting Bertie...

I put down some of Bertie's favourite food to keep him occupied.  Then I took a firm grasp on the skin on the scruff of his neck and sort of yanked it up away from the muscle.  Then I pushed the needle into the skin and...straight through the skin and...out the other side and...into my own finger.... Ouch!!!  But Bertie kept on eating as if nothing had happened!  Needless to say, I got better with practice.  In fact, I learned pretty quickly.  And so would you in the same situation.  Honestly.  If I can do it, YOU can do it. :-)

NOTE:  It's quite possible that your vet will show you how to give the injections.  If the vet doesn't offer to show you then don't be afraid to ask.   Here is a link from the Sugarpet site with some great pics: http://www.sugarpet.net/injecting.html

Food (wet, wet, wet... )

Both the vets I've seen in connection with Bertie's diabetes said that he'd need to go on a 'special diet' for diabetic cats.  I really didn't know how I could manage this because there were four other cats living in the house.  I didn't think it possible to feed one cat separately from the others.  So I carried on feeding as normal.  I fed a mix of ordinary canned (wet) food and dry food (Science Plan).  And I carried on 'free feeding' (having food available all the time rather than set meal times). I also - of course - had out plenty of fresh drinking water for Bertie, and that needed topping up a couple of times a day.  He was SO thirsty. 

But I wondered if I could do things better, so I got online again to find out people's experience with regard to feeding their diabetic cat.  Was I doing my cat harm by feeding him 'ordinary' canned food. What was the best thing to feed?  I went to the Feline Diabetes Message Board (see link top right).  'FDMB' is a phenomenal resource.  So much information, and all based on the real everyday experience of caring for diabetic cats.

  The combined experience of people on FDMB was that the very best food that you can feed a diabetic cat is wet/canned food (and some folks prefer to feed raw food rather than canned).  People's experience was that dry food can raise the cat's blood glucose levels (and in some cases quite significantly).  I was relieved, and somewhat astonished, that the best foods for diabetic cats were found to be ordinary low-carbohydrate canned foods (in jelly, NOT in gravy) that could be bought easily, either from supermarkets or online.  But I was concerned about how to phase out the dry food, which all my cats loved SO much...

About removing dry (or high carb) food from the cat's diet...

In fact, the people at FDMB warned against getting rid of the dry food at first!  And this was because I was not 'hometesting' ('Hometesting' means testing a cat's blood glucose at home).  I was told that removing dry food from a cat already on insulin can be extremely dangerous - unless the blood glucose levels are being carefully monitored.  The cat's blood glucose levels could drop too low resulting in hypoglycemia, and 'hypos' can be extremely dangerous.  A severe hypo can cause injury or even death. So, needless to say, I kept dry food available initially.  And I was totally in awe of anyone who could 'hometest' because I really wasn't sure that was something I could ever do.  Heck!  I'd only just got my head around the idea of giving insulin shots!

To reiterate:  It can be dangerous to remove dry food from a cat ALREADY on insulin unless you are hometesting and monitoring the effect of the diet change at home.  This is because the cat's blood glucose can drop significantly on a lower carb diet, and the insulin dosage may need to be adjusted downwards accordingly.    

Testing, testing....

The vast majority of people on FDMB hometest.  And they mostly use glucose meters made for human diabetics. In essence, hometesting involves pricking the outer edge of the cat's ear to produce a teensy weensy droplet of blood.  This is transferred to a test strip in a glucose meter, and in just a few seconds, the meter should give a result.  

(Note: The normal blood glucose range for a non-diabetic cat is between 2.7 to 7.2 (or a smidge lower or higher than that in some cats)). 

In the early days of Bert's diagnosis the new friends I'd made at FDMB were extremely supportive and encouraging of my efforts to manage Bert's diabetes.  But I found the ongoing suggestion that I hometest extremely daunting.  My main concerns were these:  Firstly, that testing Bertie's blood glucose would hurt him. And secondly, that because I was hurting him he'd come to fear or hate me; and that could damage his quality of life. But I still knew that if I could  learn to hometest then management of Bert's diabetes would improve enormously, so I didn't entirely give up on the idea...

Some people take to hometesting like 'ducks to water'.  Some people actually find it easier to hometest than to give insulin shots.  But most people seem to need to have a few goes at it before getting a 'successful' test.

Bert is around 6.5 kg of pure 'attitude'.  He doesn't tolerate being handled much, so testing was only going to happen if Bert agreed to it...  So, I approached the idea of hometesting very gently by getting Bert used to the sight, sounds and smells of the test kit, and by rewarding him with treats.  I'd set the kit up and let Bert sniff it, and then give him a treat.  Then I'd click the lancet pen (ear-pricking device) next to Bert's ear, and give him a treat, etc etc.  I also got him used to having his ears handled by holding or massaging an ear and then giving him a treat.  

Then came my first real test attempt.  Bert seemed in a mellow mood so it seemed a good time to give it a go....I set up the test kit.  I crumbled a couple of cat treats for Bert to munch on.  I took hold of his right ear and clicked the lancet pen against the outer edge.  A droplet of blood appeared.  I put the test strip against the blood droplet so that the strip absorbed the blood.  And the meter counted down and gave a result. Hurrah!!!  Oh, and Bert got a few more treats as a reward.  And I ate a chocolate bar to reward myself for my efforts.... :-)

Bert's blood glucose result on that first test was pretty high, about 21mmols.  But at least now I had a fantastic tool that could enable me to see what his blood glucose was anytime I needed to.  And I have to say that the difference between 'not hometesting' and 'hometesting' is like the difference between night and day.  It's one of those things that, once you've learned it, you wonder how you ever managed without it...

More to follow very soon; including 'hometesting tips'....