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.

All Buttered Up

I’ll bet that you watched the superbowl yesterday, didn’t you? I planned to watch, or at least keep one eye on the game while I did other things ( being as that I was in a couple pools, and all). Technically, I did as planned: I kept one eye on the score while I did other things. It’s just that the “other things” got seriously out of whack.

Let me set the stage: The weather in the bay area was pretty nice this weekend. Sunny, and inching toward warmish. On Saturday I got a tub of Tanglefoot and smeared it around the trunk of the grapefruit tree in the backyard. (That tree is the bane of my existence, but I’ll save that for another post.) Tanglefoot, which is supposed to keep ants or other crawly things out of the tree, allowing natural predators to kill off pests like aphids, scale, and the like, is a thick, gooey substance, about the consistency of axel grease. Or caramel ice cream topping. Take your pick. So I smeared and watched the ants get all confused. Kind of fun.

On Sunday, shortly before game time, I went out back again to let the cats have some nature and to do a few other things – like see how the confused ants were doing. As I peered at the tree trunk I learned a very valuable lesson:

Do not apply thick gooey (waterproof) substances at cat level.

Right in front of my horrified eyes, Isabella rubbed against the band o’ goo and instantly became “cat who is not allowed to touch anything.” "Cat with a weird haircut in her future" "Cat with paper towel stuck to her side."

Allow me to reiterate. It’s thick. It’s waterproof. And now, it’s on my cat.
No mere paper towel is going to remove it, and I can’t allow her to lick herself. I tried clipping the fur. My scissors couldn't cope with the gooey mess and I was seriously afraid that one of us would end up mortally wounded. I called the emergency vet clinic. How to remove goo? Butter, I was told. Then a bath.

Well, this actually makes sense. We all know that peanut butter breaks down chewing gum, so regular butter should oughta break down Tanglefoot. I chased Isabella around with a stick of butter. Rubbed and worked it into her fur. Like magic the goo disappeared and I was left with …

A buttery cat. Or, more precisely: A buttery, pissed off cat.

Into the bathroom for a spongebath. There was a fair amount of bleeding involved since I forgot the gloves, but the end result was a cat only slightly greasy, sorta soapy, and not at all gooey.

In my estimation Isabella spent the next three hours licking herself. I can’t claim that I got all the butter and soap off. And there may have been a speck or two of goo lingering in there somewhere. One thing is for sure: That combination of ingredients is bound to rise up and explode out of my cat. One end or the other. It’s just a matter of time.

In search of ... Bonito Flakes

Having a diabetic cat meant a bunch of changes around my house, largely centering on food. When, how much, and (very important) what. Diabetic means low-carb. It was out with the old food, and in with the new. Out with the old treats and in with freezed dried bonito tuna flakes. These changes have been very popular with the kitties.

But I realized last night that the bonito flake supply is getting a wee bit thin. I'm down to little slivers. Now, I'm new to this feline diabetes gig, but one thing I already know, for sure, is that Isabella will put me in a headlock and take me down if I don't keep the bonito coming.

It happens I had a little time on my hands (OK, I skipped my workout. Sue me.) so I popped over to the Asian supermarket to pick some up.

Popped. Right.

In the door, I was first relieved to see that the signs over the aisles were in English. Snacks? No -- I'm pretty sure it's not a snack, except for my cat. Sauces? No -- but it's gotta be pretty flavorful (judging from the stench, er, aroma), so I'll start here. Wow, lots of sauces. Never noticed if there are this many at Safeway. No sign of bonito flakes.

Ah! At the end of the sauce aisle -- cans and containers of fried ground fish. That's pretty close. I studied everything in the vicinty. No dice. And now I realize that I'm not certain what sort of package I'm looking for. My inaugural supply came from the pet store (where it's conveniently located under the "Cat Treats" sign) in a little tub similar to faux butter spread. Here, I'm sure it ain't in the cat treat section and it could be in anything from a tub to a bag to ...

On to the next aisle. Seaweed: dried,canned,jarred. Lots of mushrooms (in states similar to their seaweed neighbors). Turnips that really, really, don't look like turnips. Seriously. I picked up a pack and thought it was squid. No bonito.
Next aisle: "Japanese items" says the sign. Oh, crap! I never gave a thought to what sort of asian market this is. What if bonito is a Japanese thing and they don't stock it in this not-japanese market?

I asked the lady shopping in the aisle with me. She had exactly no idea what I was talking about. I was probably speaking the wrong language. I'm two miles from home, and I can't communicate. Double crap. Why didn't I go work out?

Next aisle: Noodles. Both sides. The whole aisle. Only noodles. Wow. I backtrack to that "snacks" aisle. Ya never know! At this point, all bets are off. Nothing. Back to the canned fried fish. Again: no.

I'm determined to find this stuff. I slowly cruise aisle 2 (Seaweed, if you recall) and BONANZA! There it is! Bags. Big, lovely bags of bonito. All the writing on the bag is, um, not readable by me, but I recongize it! Look -- a wee tag: "shaved bonito." I would have seen it on the first pass if I hadn't been distracted by those weird turnips.

Sweet success. I scored a big bag, for which I paid one dollar more than the pet store bonito and it's easily 20 times more. (Probably 20 times as smelly, too.)

While in line to pay it dawned on me that this would be a good store to find things like hearts and livers and other icky (but low carb!) cat treats. I deduced this from the large bags of unidentifiable meaty things purchased by the shoppers in front of AND behind me.

Now, if you'll excuse me, I'm exhausted.

Meet the kitties

This blog is to be about my experiences caring for Isabella, my diabetic cat. But before diving into that, I'll introduce both of my cats and their considerable quirks.

Isabella

Oh, so aptly named, for she is the Queen. I adopted Isabella from the Humane Society as a wee kitten. She was so cute – a tiny little black and white fur bundle with a perfectly symmetrical mask-like marking on her face. I now know that it’s probably the mark of the devil. Forget 666. Meet my cat.

Our first night together set the stage. I set up a cozy little cat bed in my room, upon which I deposited young Isabella and turned out the lights. Within minutes that eight-inch-tall kitten clawed up the bed skirt and comforter to re-deposit herself next to me. I moved her back to her bed. And then I did it again. And again, many more times. I finally recognized that Isabella would outlast me in this battle, and so it has been that she chooses her sleeping arrangements, and everything else, ever since.

Isabella is my cat (or perhaps it is that I am her person). She follows me everywhere. Where I sit, she sits. Everything would be perfectly fine in the Land Of Isabella if it was just the two of us. Other people be damned – if you come to visit, she wants you out. If you won’t leave, she wants a piece of you. Bottom line, my cat is never nice to other people and is frequently not that nice to me. Her teeth are her weapon of choice. Claws come next.

Casey

Isabella was about 1 ½ when Casey joined our happy band. He was a wee kitten found in the bushes near my office. Separated from his mother and siblings, my feral baby used his considerable lung power to announce his distress. His mother was too slow to the rescue – instead he was snatched up, boxed up and taken home by me.

I deposited that terrified little guy in my downstairs bathroom with a litter box, food and water, and shut the door. Isabella’s expression clearly said “what the f*** did you put in there?” Her world was shattered. It was no longer just the two of us.

After a few days of isolation (and a trip to the vet for shots and deworming) Casey was allowed out of his bathroom to meet his new sis. Love at first sight. He adores Isabella. She disdains him. She grooms him, then bites. She knocks him off my lap, off her favorite chair, off the bed at night. Even after ten years, Casey is so far down the cat-ranking totem pole, that Isabella sometimes won’t allow him in the same room. She’s such a bitch. And he loves her to pieces.

Alas, I didn’t introduce Casey to enough people when he was young. He’s never overcome his feral roots and is wary of strangers. Many of my friends and family members think I’m lying about having two cats. They’ve never seen him. Too bad, since Casey’s as sweet and nice as they come. He never bites, even when he’s scared.* His sister makes up for that just fine.

*Maybe he does bite. As a kitten, Casey spent a day at the vet’s office for a deworming procedure. When I picked him up, the vet tech brought Casey in his carrier from the back. “This isn’t a kitten. This is fur with teeth.” I had warned them that he was feral. They believed me now.