Part-time pancreas

I have a great deal of respect and admiration for people living with diabetes. Type 1, Type 2, no matter. If you’re coping with that disease, day in, day out, along with going to work and raising your kids and doing the laundry and all the other crap that comes with a normal life, then I bow at your feet.

You, my friend, are amazing.

I don’t have diabetes but I do live with it. Diabetes has reshaped my days. In my case it’s not a family member (exactly) – but my cat. My cat, Isabella, has this chronic and frustrating disease. Incurable. Expensive. Exasperating. So exasperating that I make oral pleas to her pancreas. I make bargains with God. I have a vial of insulin in the fridge that, administered in the proper dose will make her feel better. (For a while.) The improper dose, on the other hand, can kill her – either slowly or within hours.

Every day, twice a day, I choose a dose and inject my cat. Twice a day I hope I’ve chosen right and that she’ll feel better for a few hours until her next injection.

Before Isabella was diagnosed, diabetes was just one of those diseases warned of by earnest actors in dramatic TV ads. I knew it vaguely. Bad feet, sugar substitute, might go blind. But it was nothing for me to worry about. Now, well it’s a different story. Now, I am Isabella’s part-time pancreas. I know about beta cells and islet cells and glucagon and Somogyi rebound. I understand the action profiles of various insulins, both human and veterinary. I know what normal blood sugar is for a healthy cat (60-90 mg/dl). I know – and furthermore, I care! – about the carbohydrate content of various canned cat foods. I know where to get cat food on sale.

When Isabella was diagnosed, her vet showed me how to inject the insulin and instructed me to give her 2 units, twice a day and to change her food to lower carb. And to keep a bottle of Karo syrup handy in case she started acting funny. I thought that was simple enough. But that was before I started reading. And learning. And obsessing.

How could I just blindly inject my cat with a substance that could kill her if I didn’t know her blood sugar reading? Human diabetics don’t do that, and neither would I. So I got a glucometer and learned to get blood from a cat. (Not easy – particularly with a bad-tempered beast like Isabella, but that’s a story for another post.)

Now that I had the numbers, I assumed I’d just learn how the numbers and the insulin dose interacted and we’d be home free.

Not so fast, little bucko.

This is a cat. I don’t know about human diabetics, but cats are notoriously hard to regulate. The dose that one day takes her from the mid-300s to the lovely low-100s might just do nothing the very next day. Nothing. Or, it could take her low and keep her up all night. (And Isabella’s clueless caretaker might just spend the night yelling at her to go to sleep, only to realize – when 49 mg/dl pops up on the meter the next morning – that the poor little cat was probably very uncomfortable and trying to tell her something.)

She can go along happily on one dose, hitting highs of the mid-200s (not too bad) without restless-night lows. And then, suddenly, double digits. Or 400s. What?? WTF?? Just when you get complacent, something happens to shake things up. The cat starts drinking a lot again and lying like a lump by the front door. Pre-diagnosis behavior. Doses need adjustment. Frustrations run high. Pleas to the pancreas become more frequent and more sincere.

I operate on hope a lot. I hope I’m choosing a good dose. Hope I’ll get blood to test. Hope – every day – that when I get home from work, Isabella will greet me at the door. I hope I’ll never see a hypoglycemic seizure, and if I do, that I’ll cope with it and get her fixed up. When her numbers are high, I hope that ketoacidosis won’t strike her down before I can get her glucose under control. I hope to keep urinary tract infections and pancreatitis at bay. I hope I’m not making my cat miserable with all the poking.

This, for a cat. It’s not my disease; it’s not me that feels lousy. But because of this cat and my role in her disease, I have a tiny glimpse into the life of a person with diabetes. And you, my unseen friends, are remarkable.