They're never satisfied, these kids of mine. No matter how many different injuries and illnesses they have taught me how to handle over the decades, they still insist on continuing my education.
My big Lion King, Noddy, has recently been diagnosed with diabetes, and the diagnosis was accidental. On 5/27, Noddy was suddenly in an extreme amount of pain. Assuming he was suffering another urinary blockage (happened once years ago), I crammed his hefty 26 lb self into my largest carrier and took off for the vet. As usual, Noddy yowled in the car the entire way (1 hr 15 mins) to the vet. At one point he let out an especially sharp cry immediately followed by a hiss and repositioned himself in the crate.
At the vet, Paul found his bladder to be empty and found a bit of urine in the padding in the crate. Thankfully, an abdominal xray showed that Noddy's bladder had not burst (as I feared when he said it was empty). Still, I knew something had caused his extraordinary pain, so I had Paul run a blood panel. Noddy's blood glucose came back at 460. Normal range is 70-150 on Paul's testing equipment. Diabetes.
Since my housemate, Joe, is diabetic, I am rather familiar with the disease even though I've never had to deal with it in an animal before. Paul presribed insulin (Humilin N), 5 units twice a day with food, along with a round of antibiotics in case Noddy had a UTI. (BTW, I'm still assuming that Noddy's extreme pain that day was caused by a partial urinary blockage that cleared in the crate on the trip to Paul's).
I bought Noddy his own meter and blood glucose testing supplies and have been trying to get him used to having me handle his ears for ear pricks. I tried once unsuccessfully to do an ear prick and decided I needed more time to get both of us used to the idea before trying again. Things were seemingly going fine until day before yesterday when I found Noddy just barely responsive, cool, and limp - severely hypoglycemic. I knew immediately what was happening and started rubbing Karo Syrup on his gums and lips to raise his blood sugar. Joe just happened to be home, so he helped me alternate between administering the Karo and doing ear sticks to test Noddy's BG. Fortunately, Noddy was in no condition to argue, which was good because it took about 10 ear sticks before I finally managed to start getting blood drops big enough to test. Noddy's meter, which only tests down to 25, couldn't even register a reading on his blood. Joe's meter, which is a more expensive model, tested Noddy at a BG of 16! A minute later, his BG was up to 25. I kept rubbing Karo into his gums until he started to come around and be more alert. As soon as Noddy was able to stand up, I offered him food, and he ate a large meal. Before long he was acting normal, on his feet walking around.
Yesterday he became hypoglycemic again, though this time I noticed he has a bit "off" while he was still alert and walking. I tested his BG, and he was down to 35. More Karo to bring his blood sugar up, and more food to keep it there. By yesterday afternoon his BG was in proper range again at 89. Paul then instructed me not to give him any more insulin for 2-3 days and to monitor his BG. This morning Noddy's BG was 106 with no insulin for 24 hrs. So far, so good.
Since the first hypoglycemia incident day before yesterday, I have now learned that cats can sometimes go into spontaneous remission from diabetes. New information for me. Of course if remission occurs while the cat is receiving insulin, hypoglycemia will inevitably occur. I am hoping that Noddy has gone into spontaneous remission and will no longer require insulin. His BG results over the next few days without insulin will tell the tale.
I am also thinking that there is a possibility that Noddy was never diabetic to begin with. Pain and stress can both cause BG to spike, and Noddy was under both conditions to the extreme when Paul ran the test from which the diabetes diagnosis was made. Paul is convinced that a BG of 460 is too high to be accounted for by stress and pain alone, but I know that there are those individuals whose bodies behave in physiologically abnormal ways. Perhaps Noddy's body is capable of spiking an excessively high BG under conditions of extreme pain and stress.
Under the category of "there is value in all experience", I am understanding the value of Joe's diabetes in a most profound way these days. My experience with Joe's diabetes allowed me to accept Noddy's diagnosis without panic. Joe's experience with the disease has provided me with a living encyclopedic resource. I understand the critical importance of close monitoring of a body on insulin, which is probably why Noddy survived his first hypoglycemic reaction. I checked him every hour after administering insulin to make sure he was doing OK. If I hadn't, I might not have found him until he was in a coma and his organs were shutting down.
So, one more major disease has found its way under my belt.
My dear children, may I please go to recess now?
Laurie
