Breakfast is served

Isabella has always been a food-oriented cat. When she was a wee kitten I provided a full bowl of kibble for her grazing pleasure. And graze she did – to the point that when she saw the vet for her one year check-up and renewal of her vaccinations, I was scolded about her bulk.

I had made my cat fat.

Well, I didn’t want a fatty for a cat, so her eating plan was switched to a once-a-day measured dose of kibble. When Casey joined our household, I just added a second food bowl and put him on the same meal plan. Isabella’s weight didn’t really go down, but she didn’t get any fatter.

All was well for many years.

Then I read an article about how cats in the wild eat several small meals a day – as prey is caught. The article suggested that companion cats would fare well with the same sort of feeding routine. As I only wanted the very best for my kits (wasn’t I proudly serving them designer kibble, after all?) I decided to start feeding a morning and an afternoon meal. I’d just split the ration in two. Isabella adapted with great enthusiasm to the new routine. Casey, as always, could care less.

But the plan was flawed.

Isabella, being no dummy, figured out that she got fed when I got out of bed. It became her mission, her single-minded ambition, to get me out of bed as early as possible. If 6am was good, 5:30 was better. Or 5:00, 4:45 – whatever. She’d stand on me meowing incessantly. She’d paw at the covers. She was relentless.

And I was miserable. My boyfriend wasn’t too happy either. So I did the only logical thing and reverted back to the once-a-day, after work meal plan. The hell with her natural cat needs - I had to sleep.

Fast forward to last September in the vet’s office. Isabella, I’m told, is diabetic and will need twice-a-day insulin to be given with food. I instantly saw my sleepless future. (I’m ashamed to admit that when I got the news of diabetes, all of my first thoughts were about me: How could I ever travel? How could I sleep?)

Since I work, I knew that her insulin would have to be administered at about 6am and 6pm. And I knew that as soon as Isabella discovered that 6am brought food, she would start her campaign. I couldn’t let that happen. I needed a plan and this is what I came up with:

Food time is when the alarm goes off. Not one minute sooner. Isabella could campaign all she wanted, but I would not budge until the man in the radio was talking – and he would start talking at 6am. Every day. Weekdays, weekends.

It worked.

She might get restless at about 5:30, but Isabella hangs out pretty quietly until six, when the alarm goes off. Then, bam! she springs into action. First, she kisses the radio. (I’m not kidding. She loves that radio man more than me now.) Then she makes sure I’m moving. A paw to the face, a whiney meow. Get up! Get up! Get up! Which, of course, I do.

The switch between standard time and daylight savings is a bit of a bug. But I cope with that by changing the alarm by 15 minutes each day for several days until we’re on the new track. That seems to work out too.

It is disconcerting to see her blatant affection for the radio man. It is me, after all, who pays for and serves the food. But she knows who really holds the power.

Diabetes Geek … and Freaky Cat Lady

Last week I caught myself blathering on to my best friend about the differences among veterinary insulins. Truly blathering. Somehow, realizing how I sounded and how little she must care about the details of dealing with my cat’s disease, I cut myself off before she hung up on me.

I don’t want to be that person. I don’t want to be the freaky cat lady who only talks about her kitties and their ailments. A funny story now and then, OK. A lecture on 100% beef vs beef/pork PZI, not OK.

Save me from myself.

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In keeping with my new title of Diabetes Geek, I’ve officially become a weirdo collector of glucometers. I only need one, mind you: my beloved Freestyle Flash which requires only a teeny speck of blood. So I have my primary Flash and a backup Flash (in case the first one goes belly up at an inconvenient time).

But the makers of glucometers love to give their product away for free. It’s hard to resist free. Neither of the Flashes cost me anything. Neither did the Bayer Contour that’s sitting in its unopened package. Or the OneTouch UltraMini I picked up last night with a free coupon. I still have a coupon for a free OneTouch Ultra (not mini), and I fully intend to go get one. And, because I could, I ordered two more minis through the mail (in pretty colors!) So, when this round of free acquisistions is done, I’ll have seven meters. Sheesh.

I think I’ll order one more mini and have it sent to my father’s house. What the heck. Then, maybe I’ll make up some Feline Diabetes Starter Kits and ask the vet to hand them out to newly diagnosed cat owners. Can’t hurt – and it makes me look more like a philanthropist than a weirdo.

Right?

But, it's what cats do!

Did you just buy a brand new SUV? Are you bothered by that pesky "new car smell?" Well, here's a quick way to eliminate all traces of that odor and replace it with a scent that is unique to your car (and save gas too!):

Step one: Wait for a hot day, then pull into the garage, but leave at least one car window open.
Step two: Go into the house and forget about car (and window).
Step three: Insert one cat, preferably male.
Step four: Allow the cat to roam throughout the car and spray urine on whatever surface he needs to claim as his very own.
Step five: Let car sit overnight

By morning that new car smell be gone forever. And you'll get the added bonus of never being asked to drive a group of people anywhere, ever again - which adds up to gas savings as long as you own the car!

Tight Regulation ... or not

I’ve been toying with the idea of trying Tight Regulation (TR) to keep Isabella’s numbers lower overall. TR involves shooting insulin as needed, rather than on a twice-a-day schedule. So, if she’s rising 6 hours after her last shot, give insulin at that time instead of letting her blood sugar keep rising and then trying to drive a much higher number down. It also involves developing a dosing scale based on BG number (sliding scale).

It makes a lot of sense. It also requires a lot more ear-poking and a certain amount of guts. I decided to try it last Wednesday for the first time. Isabella’s last dose of insulin was at 4pm Tuesday, so when I tested her at 6:30 am Wednesday more than 14 hours had elapsed.

Her BG was 81.

No shot. I waited around, balanced my checkbook, did some laundry. Two hours later: 94. Still no shot. Finally, an hour after than she was up to 141 or thereabouts so I gave her one unit. (Usual is 1.8 units. I don’t have a scale developed yet.)

Finally, I could go about my day! I tested her 6 hours after the injection: 168. Two hours after that: 131. Finally, at 9pm, 12 hours after her morning insulin, she was at 297, earning her 2nd dose of the day. So much for extra insulin.

I tried again on Saturday. She got her morning dose, a test six hours later, and one more test an hour after that. She was high enough at the 7-hour mark to get a 2nd shot. The real test came around bedtime, when I should have checked her again to see if she needed more insulin to see her through the night. But I was sick and I just didn't feel like testing. So I blew it off, and I've not tried again since.

Sigh. Maybe I’m not cut out for tight regulation after all.

Report on the New Vet

Isabella saw the new vet last Tuesday. Oh My Goodness – what a difference. I brought lots of BG charts for her – showing the kitty’s response to various insulin dosages. To me, they all looked the same: jagged peaks and valleys of un-regulation. The vet looked them over and then looked at me.

“Actually, these look pretty good.”

Huh? I was stunned. Old Vet would have chastised me and implied that I was lying about her food intake or something. New Vet said “This is a cat. She’s not going to follow any rules.” New Vet was able to see an overall lower trend on the higher doses and encouraged me to try going to 2 units. I’m scared of 2 units – since Isabella has always gone low on that dose -- but I’m giving it some thought.

Other things from New Vet:
- New insulin. They dispense BCP instead of PZI Vet. Much cheaper! Though they had to order U40 for me since they normally dispense U100. I’ll wait until she’s been on the BCP a while before trying the 2 units, I think
- She’s not a believer in tight regulation. She’s a “manager,” not a curer. That’s OK, though. At this point I feel confident enough about what I’m doing to try some things below the radar and report to her.
- She only wants to see occasional BG charts via fax and the actual cat every six months, unless something urgent arises.
- She has a sense of humor and she’s not afraid to use it.

Overall, a huge improvement and I’m thrilled. I finally feel like I have a partner in this feline diabetes thing. Whew!

Vetting a new vet

Isabella has an appointment on Tuesday with a new vet. I have high hopes that this one will be a little more clued in about managing feline diabetes than her current vet.

No that the usual guy is bad – not at all. It’s just that I’m the only client he’s ever had who uses hometesting to monitor blood sugar. He can’t look at the numbers I give him and make sense of them because he just doesn’t have the experience. He needs to see my numbers, and urine test dip sticks, and blood tests for fructosamine levels and see how they all relate in order to learn. But I can’t afford to be his learning curve – those fructo tests cost 70 bucks a pop. Seventy of my bucks.

So I asked around for vet recommendations. The first place I called is not accepting new clients. The second, though, sounds pretty good. The front office gal told me that they have “dozens” of diabetic clients (it’s a cats-only practice) and that they teach owners to hometest. One of the three vets in the office sees all the diabetics. Then I talked to the vet and she basically passed my interview. So Tuesday the Isabella and I will visit to see how I like her in person. I’ll bring some blood glucose numbers and talk about curves and dosages.

I really hope I like her, and the clinic. Isabella is eight months into her diabetes experience and she’s not regulated at all. I really need some help understanding if regulation is a possibility and what I need to do to get there. I need someone to talk to who doesn’t think I’m a micro-managing head case. I need a veterinary partner.

And yet I feel very guilty about ditching the old vet. I dread the thought of calling and asking for copies of Isabella’s records. It seems like passing judgment (“Thanks, but you’re just not good enough for me.”) I’ll do it though. Because my cranky little diabetic deserves a doctor who knows what’s what.