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Checks and Balances
Cats usually exhibit a favorable response to insulin injections within seven days. Nevertheless, cats may need to be rechecked weekly by their veterinarians for the first month or two in order to fine-tune the dosage, frequency, and insulin type.
"The only way to determine accurately the right type of insulin, the right dose, and the right frequency of administration is with blood-glucose curves," says Henson. "The owner drops the cat off for the day so we can measure the cat's blood sugar every two to three hours. With this information we try to determine when the insulin starts to have its effect, how low the blood sugar level goes, and when the insulin starts to wear off. That's how we tell if we need to make adjustments."
Rechecks can be reduced to one every six months after the right insulin therapy is determined--as long as the cat seems to be happy, healthy, and stable and is maintaining its normal body weight, urine output, and water intake. At six-month intervals, says Henson, the veterinarian will examine the cat, check body weight and possibly do a spot check of the blood sugar to see if a blood-glucose curve is necessary.
Diets for Diabetics
Diet is also critical in managing diabetes because cats that are either overweight or malnourished may be insulin resistant. Many veterinarians recommend high-fiber diets for diabetic cats because they help maintain blood-sugar levels that are closer to normal. "Fiber slows down digestion," says Henson. "If you're digesting more slowly, you're trickling in the sugar rather than having a big jolt of it right after a meal."
Once a diabetic cat is on a suitable diet, changes should be avoided because they can sometimes cause an upset stomach, vomiting, and diarrhea in some animals. "Because we suspect diabetic cats may have some disorders of digestion," adds Henson, "stability in the diet leads to the least amount of problems."
For most people, learning to wield a needle is the most difficult part of managing a diabetic cat, though cats might add that the office stays required to regulate insulin therapy are no great fun either. Additional problems such as insulin shock, a missed injection, scheduling difficulties, vacations, food refusal, and a cat's resistance to injections can arise, however, and owners of diabetic cats should be prepared to cope with them.
Cats given too much insulin--because of pilot error or shots that were administered too close in succession--can suffer from low blood sugar, also known as insulin shock or hypoglycemia. This condition is usually temporary. Its symptoms ordinarily range from anxiety, mental depression, disorientation, tremors, or a wobbly gait to seizures or coma, but sometimes insulin shock can lead to death.
"If a seizure occurs," says Henson, "call for veterinary help. Try putting a small amount of corn syrup on the cat's gums and tongue with a teaspoon. Take care not to get bitten. Hold the head slightly lower than the body to minimize the chance of choking."
An occasional missed injection usually won't harm a diabetic cat. He may exhibit diabetes symptoms such as increased thirst and urination, but they will disappear after the next injection.
Administering injections every 12 hours is not always possible when work or other obligations intervene. If they do, the interval between injections can be stretched to 14 hours, beyond that the owner runs the risk of causing insulin shock if the late dose is administered too closely to the next regularly scheduled one. In that case the owner should arrange for someone to come in and give the cat its injection at the regular time or skip that dose and start back on the regular schedule the next time. It's better to miss a dose than to give two doses too closely together.
Unlike cat owners, diabetes doesn't take vacations. Owners who cannot take their cats on vacation should arrange for a reliable and competent pet sitter to come in and administer the insulin, or they leave their cats with a veterinarian or a boarding facility capable of administering insulin shots.
Some diabetic cats whose diets must be altered do not take eagerly to their new food. Their insubordination can be short- circuited if the new food is smuggled into their current menu in tiny, but steadily increasing, amounts. If necessary owners should begin by replacing a tablespoon of a cat's customary fare with its new diet, and after that change has been accommodated, add additional tablespoons gradually until the changeover has been effected.
Cats may also be cajoled into accepting new food if it is warmed slightly in a microwave oven. Nuked food sometimes contains hot pockets, so cat owners should check its temperature before serving.
"If they won't eat it, it's not the end of the world," says Eibert. "We can probably manage them on their original diet, as long as it is dry or canned food and not one of the soft, moist diets. Those contain a lot of simple sugars which are [not recommended for] diabetic cats."
No matter how careful an owner might be when administering injections, cats may begin resisting the idea fang and claw. If so, an owner should examine--and perhaps change--change his or her injection technique. If a cat has been restrained while injections were administered, eliminating the restraint and administering injections while the cat is sleeping or curled up on its owner's lap--or even when that cat is eating--may eliminate the cat's resistance. If a cat always tries to flee during its injections, putting a towel over him may calm him down.
"Cats love to have their heads covered up," says Eibert. "Pretty much cover up the whole cat, including around the claws, and just part the towel between the shoulder blades."
Sometimes a second person holding or comforting the cat can help to reduce a cat's injection phobia. Owners should also remember the powers of positive reinforcement and give their cats praise and safe, tasty treats following each successful injection.
If changing injection techniques doesn't work, owners should talk to their veterinarians to find out what they (the owners) might be doing that causes resistance in their cats. Even if an owner isn't doing anything "wrong," a vet might be able to recommend a change in technique that will alleviate the problem.
Maintain and Monitor
Once cats are stabilized with regard to insulin and diet, owners should continue keeping a weather eye on their cats' eating and urinating habits, their weight and attitude. Litter should be observed to see if it's soggier than usual. Water bowls should be monitored to see if a cat is drinking more than usual. Any changes, of course, should be called to a veterinarian's attention promptly.
Some owners keep a diary of their cats' food intake, weight, and other habits, This can help to detect change quickly. Other owners use test strips in the litter box to monitor their cats' urine. These strips are not altogether helpful because results can be influenced by several factors, including the length of time urine was contained in the bladder before the cat last voided and when the cat was last fed and injected with insulin.
Regular conversations with a veterinarian are also important in monitoring a diabetic cat. "Diabetes makes owners more frustrated by the lack of proper communication than by the disease itself," warns Eibert. "They need to be on really good terms with the veterinarian. If they're not comfortable with that veterinarian, they should go to someone they are comfortable with."
The Last Words
"Through proper communication and education," says Eibert, "including pamphlets on diabetes available from veterinarians, people can learn what to do when a cat has problems. Then it won't be a big surprise if the cat gets a urinary-tract infection, or if it becomes hypoglycemic and you already know to put corn syrup on its gums. You won't freak out as much if you know what to expect and the possible things that can be wrong."
Indeed, diabetes is a serious problem, but it doesn't have to be a deadly one. Given good care and proper management, diabetic cats can live happy, comfortable lives, just like Eibert's cat Perry, who is now 14 and still going strong.
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All electronic rights© Marcia King 1997.
Published here with permission of the author.
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