Ohm .... Ohm .... Ohm ....

I have mentioned once or twice that Isabella’s personality is a bit challenging. Some may say that’s an understatement. I just like to call her quirky. Whatever the label, Isabella is a cat who knows what she wants, and even more importantly, what she doesn’t want.

As a general rule, what she doesn’t want is anyone else in her house. Or anyone else touching her. She’s pretty good at letting people know when they’ve overstayed their welcome with snarls, growls, hisses, and smacks – claws extended.

Despite her less-than-sunny personality, Isabella sometimes gets gifts from my friends and family. For instance, several years ago my sister presented Casey & Isabella each with their own Christmas stocking filled with kitty goodies. Among the booty was a catnip-filled mini stocking, which Isabella loves and carries around the house with her to this day.

But Isabella’s best-ever gift came from my best friend’s young daughter. She had tried valiantly to make friends with my snarky cat, to no avail. Ever the optimist though, Christianne wrapped up an aerosol can of Feline Calming Spray (“the calming pure essential oils of lavender and peppermint can help with nervousness”) along with the accompanying note:

(My camera truly sucks at closeups, so I’ll translate. It says: To Nancy’s mean kitty Isabella. With love (and hope) from Christianne.

The spray, of course, had no effect. But you’ve got to love little kids.

Stalking Casey

Casey is my other cat. The one you don’t hear too much about. The innocent bystander. The civilian. The one with normal blood sugar.

Normal blood sugar. Oh, how I wonder what normal blood glucose looks like in a normal cat. Lately, I’ve been wondering that a lot.

I guess things with Isabella aren’t exciting enough, so I’ve been looking at Casey’s tender, un-poked little ears with longing. Would he let me? Could I get blood out of those? His ears are always so warm… The blood flows out of warm ears so easily…

The problem, I feared, was that Casey was an eyewitness to the early, gut-wrenching efforts to test Isabella. Those were, uh, dramatic, times, and poor little Casey would make himself scarce whenever the meter and lancet appeared. Nowadays, they both come running when they hear the snap! of the test strip vial (can you say bonito flakes?) but Casey, like an elephant, never forgets.

Nonetheless, this past weekend I decided to give it a go. I knew he’d never just sit in place like Isabella, so I planned to poke, then scrape the blood droplet onto my fingernail and set him free. Piece of cake.

On Saturday I told him what I had in mind, picked him up, and carried him to the couch where I test Isabella. He squirmed; I lightly restrained. He feinted left; I talked sweet to him. He ducked under my arm, hopped to the floor and looked back at me as if to say “you’ve got to be kidding.” That was that.

Alrighty then, I’d have to come up with another approach. On Sunday, I saw my chance. The little guy was taking his midday snooze on a chair. He was relaxed and warm. I grabbed the lancet pen, crouched down, and grasped his as-yet-unmolested right ear. Poke! Casey flinched, but wasn’t distressed. Alas… no blood. Again: poke! Bigger flinch this time (and now I’ve got his full attention) but still no blood. I figured I could get maybe one more poke done before he’d flee the scene so I quickly cocked the pen and pressed it to his ear. I was right: now I had no blood and no cat. (Along with a much greater appreciation for how easily Isabella’s ears bleed.)

Undaunted, I tried again tonight. Same scene: Casey snoozing in the chair. Different reaction: as soon as I leaned over him and touched his ear, he flattened them and gave me the stink eye. I determinedly unfurled an ear and whipped out the lancet pen, and Casey, just as determinedly, shot off that chair and out of the room.

But he paused long enough to look back at me: you’ve got to be kidding.

Score: Casey -3; Me – 0

And that, I think, is that.

Something You’ve Never Seen Before

The web is a resource for all the strange-but-true things in the world, and then some. Today, for you crafty types, I present something I’ve never seen before: a complete digestive system created entirely by knitting.

From tongue to anus, it’s all there. I especially like that bright green gall bladder (because gall bladders really are green). And the pancreas – how can such a pretty little specimen cause so much trouble?

My knitting skills are rudimentary at best, but I may just see if I can conjure up a pancreas for Isabella. Why not? I’ve tried writing letters, poetry, and Christmas carols to bring her lazy islet cells back to life. How could a knitted endocrine organ be any worse?

(More pictures and patterns are here.)

BGPs

I’m at a crossroad with Isabella’s diabetes. It’s been nearly 18 months since diagnosis, and her blood glucose is really no better now than it was the first day. I’m seriously considering a switch to a different insulin – Lantus – to see if that will help. Unfortunately, I can’t just go to the drugstore and get Lantus; it requires a prescription. A prescription requires the vet’s OK, which makes me anticipate all the questions the vet might ask before she agrees to write that prescription.

Such as:

Have I really done all I can with the PZI?

The truth is, I’m not sure if I have done everything. I have not seriously tried aggressive dosing with Isabella. I lean heavily toward the timid when it comes to injecting insulin, but lately there’s been this little voice whispering (OK, screeching) in my ear: Try higher doses. Don’t be such a weenie. She’ll be fine, and (gasp) maybe even improve for a change.

In other words: buck up baby and try something new.

In the PZI insulin group on the Feline Diabetes Message Board, braving the higher doses is known as putting on the Big Girl Panties – or BGPs. (In my mental picture, the BGPs are silky nylon and feature rows of ruffles across the backside. Much like the pair that was given to me for my 8th or 9th birthday by up-the-street neighbor Denise M. They were red, for pete's sake, and yes, I opened them at a party. Yes, in front of all my friends. The humiliation is only just now starting to fade. So, a side question to Denise’s mother,who I feel certain is the truly responsible party here: What on earth were you thinking?)

But I digress.

I decided yesterday that the time had come to pull on the BGPs and wear them proudly. In the morning, I gave Isabella 2.6 units – her current “normal” dose. I tested several times throughout the day to see how she responded to the insulin, and the answer was: she didn’t. It was like nothing was there. So, after seven hours of nothing, I shot her again, this time with three units. (Never, in my wildest dreams did I ever think I’d give a dose that big.)

Well? What happened??

Her blood sugar went up. And then up come more. Screw it. Off came the BGPs, ruffles and all. I waited until this morning to give another dose – this time only 1.6 units.

The result: all day I’ve been watching her blood sugar drop, just like it’s supposed to. To me that means my plain ol’ cotton panties are just fine, thank you very much.

Let's Hear It For Innovation

A few weeks ago I was at work surfing craigslist for jobs* (show of hands: who else looks at other jobs while at work?) when I saw a listing for a company that is developing a non-invasive blood glucose monitor. I’m sure I’m not remotely qualified for whatever opening they were advertising, but boy, the idea of testing Isabella’s blood without actually having to see Isabella’s blood is mighty exciting. For two seconds, I dreamed of getting free prototypes to test. Of convincing the company that there’s a whole diabetes pet market they could exploit, and on and on.

That got me thinking about how diabetes technology has changed so much and how our little four-legged diabetics get to benefit from innovations made on behalf of humans.

For instance: not so long ago the only way human diabetics could monitor their blood sugar was by peeing on a test strip. Then came portable blood glucose meters (the early models of which, near as I can tell, required the user to practically sever a finger to get enough blood for the test). Those meters got smaller, faster, and required a smaller blood sample as time went by, putting them into the mainstream of human diabetes management. Bye-bye urine strips for first-line monitoring.

In the veterinary world, I’m not sure that home urine testing was ever the norm, but it was – and is – certainly used by some people to monitor their cat. (Here Isabella, pee in this cup…) It’s a tricky business that means you have to catch the kitty doing hers. Understandably, many folks balk at the idea.

Finally, in 2000, some smarties in Switzerland published an article about poking a diabetic cat’s ear for blood testing, noting that the technique could be used at home. Yay!! Since then, more articles have been published and the Canadian Veterinary Association has even stated that home BG testing should be part of standard therapy.

Still, the blood-letting aspect of testing puts a lot of people off. It puts off more than a few cats, too, I’m sure. That’s why I watch with interest for non-invasive methods. A non-invasive BG monitor was approved by the FDA several years ago, but it obviously didn’t make a big splash or diabetics all around would be sporting the wristwatch-type gizmo.

So we’re still waiting. There’s one under development that clips to an earlobe (hey – we’re all familiar with ear-testing!). I think the new technology focuses on shooting light through the skin or something. Infrared? Near infrared? Do I care? Not really: I just want to know two things: When? And will my cat’s fur mess up the reading?

Perhaps the next fashion trend for diabetic cats will be the shaved ear. Oh, I’d do it. You bet I would. Could taking a razor to my cat be any harder than getting her to to pee in a cup?



*Note for Mary, who I know will read this: don’t worry, I’m not really looking for another job, just keeping an eye on the landscape, if you know what I mean.

Life in Dullsville

Since I try to have a new entry in this blog once a week or so, I’ve been searching my brain and my life for something to write about. A couple of weak ideas came up, but nothing that really resonated, which made me mentally complain about how dull things are. My feline diabetes life is currently so routine that it’s unremarkable. But on the drive to work this morning, it dawned on me: Dull is good. Dull is stable. Dull is proof that the cat’s diabetes doesn’t run my life.

The way things are right now is the way things were before Isabella was diagnosed: Predictable. Steady. And so I’d like to offer up my boring life as a testament to those who are new to feline diabetes that it really does get better. Really.

In the early days, Isabella’s disease dominated my days and nights. There was so much to learn. Like how to give shots or what food and treats she should eat. I had to learn a whole new way to shop. Testing her blood sugar was such an ordeal I was literally sleepless with dread -- afraid of being maimed with each attempt, but scared to give insulin without knowing her BG level. I was constantly vigilant about her condition, concerned about hypoglycemia. I worried all day while I was at work.

Gradually, though all the new things became habit. Even the blood glucose tests settled into an easy routine. I found a pet sitter I trust and I’m able to get away without (much) worry. I learned to trust myself when choosing an insulin dose and to have confidence that I’ll know what to do if Isabella does have a problem.

Oh, I’m still vigilant. I still assess how the cat is doing each time I look at her. I’m always aware of where she is in the insulin cycle, if she's eating and peeing normally and if she's smacking Casey around like usual. And I’m nowhere near happy with her blood glucose levels overall. Isabella still trends way too high and no tweaking of dose or timing seems to change that -- so I’m seriously thinking about changing to a different type of insulin. (That ought to shake up the routine a bit!)

Overall though, it’s Dullsville. Boring, blah, same ol’, same ol’, and that equals good news in the land of Feline Diabetes . Newbies, take heart -- if I can get to Dullsville with a ornery cat like Isabella, you can get there too.

Getting Started

I wrote a while ago about my growing collection of glucose meters. I’ve planned all along to donate them to my vet for her to give to people just starting out. A consolation prize, of sorts. Your cat has an expensive, chronic disease. Here’s a parting gift.

Anyway, with that in mind, I typed up a little information sheet called “Feline Diabetes Hints, Tips, and Tricks.” I sewed up some ear-warming rice bags (in very pretty purple fabric) and I gathered up some cute little gift bags.

Then I discovered that not all of the meter kits met my very stringent standards: Three of my spare kits did not come with a starting supply of test strips.

Now, understand that the test strips are the priciest part of diabetes management. (Well, except for trips to the emergency vet, but we won’t go into that just now.) Odds are that the person who receives this wee kit will get it along with a rather big vet bill, so the last thing I want is for them to have to run to Walgreens and fork out another 50 or 100 bucks to get going.

That means, by my standards, three of my spare kits are useless and only one was up to snuff. I didn’t want to bring the vet only one kit, that seemed cheap. So I went back into hunting mode and scored two more meters – with strips – the last of which arrived in the mail last weekend.

Now I’m good to go. I have three fully-equipped meter kits. I have three rice bags. Three “tips & tricks” sheets. Two cute gift bags.

Uh oh. Two.

It turns out I have standards about the bags too. I want nice plain bags in a solid color. No holiday motif. No birthday hats. No fish. Rummaging through my supply of bags I turned up a two-tone silver bag that will have to do. It’s not the same size as the others, which bugs me, but I’m trying to cope.

Now, each bag is cheerfully marked “Diabetes Starter Kit” and stocked with the stuff. They sit lined up and ready to go to the vet’s office tomorrow.

In the meantime, does anyone want a glucose meter kit without strips? I might just have something you’d like…