Just Call Me Nancy Drew

I solved a couple mysteries over the past couple days. First was The Messy Wall Mystery. The second was The Riddle of the Rotund Kitty.

You see, as Isabella has dropped weight over the past year, the formerly slim Casey has plumped up like a Ball Park frank. (New nickname: Rotundo.) I've cut his food ration and given the extra to Isabella to no avail - she's still scrawny and he looks ready to burst.

On top of that, the wall by Isabella's bowl is flecked with bits of food. And the floor is gross. Casey's area is neat and tidy. I clean up after Isabella but soon it's all icky again. I normally fill their bowls and leave them be, so I had no idea what went on in there while they ate. But since I'm really getting concerned about Casey's weight, I decided to sit down and watch. What I saw made me understand why I've got a fat cat and a big mess. Here's the routine:

The bowls are full and both kitties dive in with gusto. Casey is like a hoover. He can polish off his ration in under a minute. He devours every bit and then licks the sides and bottom of the bowl spotless. Isabella, on the other hand, is very diligent but slower. Much, much slower. Once Casey is done with his meal, he sidles up close to Isabella. Her face is in deep, leaving little room ... but there's just enough space for a little white paw to sneak in and flip! a hunk of food out. Some lands on the floor. Some hits the wall. Some is still on the little white paw. The stolen bits are gobbled up and the little white paw goes sneaking in again and again, Isabella paying no attention at all to the intrusion.

Eventually, Isabella steps back to take a breather. Never mind that she's been eating for ten minutes, there's still at least a third of her meal left in the bowl. This is the moment Casey's been waiting for. As Isabella rests and licks her lips, Casey dives in and polishes off what's left.

Yikes - it's laundry room larceny going on right under my nose. Casey is a thief and he leaves a huge trail of evidence. He's clearly addicted, so it's up to me to put a stop to the pilfering.

I'm now the food monitor. I serve up the meal, and sit down on the step and watch. Casey knows darn well he's not supposed to steal and watching him trying to resist is hilarious. He sits by me, but his attention is on Isabella. Soon, he s t r e t c h e s out his neck toward her bowl. Then a paw. Like I won't notice! I drag him back. When Isabella takes her break, Casey makes a dive for the goods, but I snatch up the bowl until she's ready to eat again.

I'm not thrilled about this new routine. I suppose I could separate them, but I dread the drama that would accompany such a change. So I'll just play cop until my little furry thief is reformed. Or forever - whichever comes first.

Talk the Talk

Like many things, feline diabetes comes with its own lingo - words and phrases that might be confusing to strangers but make diabetic cat owners nod knowingly or laugh out loud. I've taken a stab at compiling a list of these words along with definitions. Did I miss anything?

Baileys scale: A guide to how many shots of Baileys Irish Cream it will take to cope with the cat's antics, ranging from one shot for a normal day to the whole bottle - for those times when... well, you can read it yourself. (A tip of the hat to Jenn, who devised the scale, and to Chris, who taught all of us that there is no apostrophe in Baileys.)

BAM!: Straight-in injection method used with short needles. No "tenting" of the cat's skin - just a direct stab-and-go.

Bean: Human being / cat owner. The cat's having a good day; her bean, on the other hand, is a wreck.

BGPs: Short for Big Girl Panties. A phrase used to encourage owners to stop being scared about making a change to their cat's therapy - more insulin, less insulin, new insulin ... whatever. Put on the BGPs and raise his dose.

Cauliflower ear: The dreaded result of poking the cat in the ear too many times. There are no actual documented cases of cauliflower ear; it's just one more thing for diabetic cat owner to torture themselves about.

Fur shot: Insulin injection that somehow ends up on the outside of the cat rather than on the inside. Grrrrrrrr.

Gusher: An ear poke that hits directly on the vein producing a nearly unstoppable flow of blood. Especially messy when cat shakes its head or runs freely around the house, trailing blood in its wake.

Honeymoon: The much hoped-for revival of the insulin-producing capabilities of the kitty's pancreas, eliminating the need for injected insulin. Can be elusive, and signs of the cat packing its bags for a honeymoon trip are spoken of in whispers with liberal application of anti-jinx. AKA "da fallz:"

Insulate: To inject insulin. Isabella's blood glucose was 237, so I insulated her with 1.6 units.

Kitty crack: Dry food. Much craved by many diabetic cats to a degree that mimics an illicit street drug.

Shoot the cat: Give insulin injection. As in: I've gotta get going; it's time to shoot the cat. Usually gets a double-take from outsiders.

Tunarita: Low carb drink for diabetic cats, used for celebrating low blood sugars (fictitious, of course). As in: Tunaritas all around! Isabella is at 93 today.

Vampire Club: A members-only organization for diabetic cat owners who have successfully gotten blood from their cat for a blood glucose test.

The Good Ole Days

I never thought I'd see the day when Isabella's diabetes seemed the least of my problems. Well, her problems, technically - but let's not quibble over semantics.

I may have mentioned in passing that Isabella had a bit of cancer a while back. It was a vaccine-associated fibrosarcoma, a tumor that develops at vaccination injection site. In her case, the tumor was high on her right leg, just about where the rabies vaccine was typically administered. It was just a wee little thing, maybe the size of a garbanzo bean when it was removed, but nonetheless the prognosis for this type of cancer is (in a direct quote from her pathology report) "guarded."

The lousy prognosis isn't so much that the cancer will kill the cat, it's much more a case of the cancer just keeps coming back. Take it out; it pops up again. There's only so many times it's reasonable to cut a chunk out of a kitty, so what happens is that owners finally give in, the tumor keeps growing and gets to a problematic size (I'll spare you the gory details) and the cat is put down.

When Isabella's cancer popped up, I told myself she got one shot. One surgery. I wasn't going to keep slicing into her. That was three years ago - and I had all but stopped thinking about it coming back. After all, I had the whole diabetes gig to keep me occupied. But a few weeks ago I had to finally admit that the little lump near the base of her tail wasn't my imagination. It was back. I took her to the vet, who agrees with me. Now I must decide - schedule surgery or let nature take its course?

Not an easy choice. It's something that has to rumble around inside my head for a bit. But one thing was sure, suddenly, her diabetes seems so inconsequential.

Then Isabella stopped eating. Yep - my little hoover of a cat, my cat who lives from meal to meal, my cat who wakes me up before the alarm lest breakfast be one minute tardy, went off her food. Now, even the cancer seems inconsequential.

I've put out food of every variety imaginable. Open cans of cat food with just one dollop removed litter the counter. Isabella sniffs, then turns away. Sometimes she eats a bit then returns to her bed looking miserable. What the heck!?

Back to the vet, who found nothing of significance and had no real recommendations. He fluffed her up with fluids, gave her an appetite stimulant injection and sent us on our way. Isabella ate a bit, then went back to looking miserable. She added in a bit of vomiting, just to spice things up. Was this how it was to be? Was my cat with multiple major problems going to waste away for no apparent reason?

This morning I spotted a question on the Feline Diabetes Message Board - what to do about a cat not eating? I scanned the suggestions and ran across an option I hadn't tried:

Dry food.

I had offered Isabella multiple varieties of canned food. I had warmed it. I had sprinkled it with cheese. I had added tuna flakes. But I hadn't broken out the dry food - the bain of the diabetic cat. The only reason I had any dry food in the house was that I hadn't gotten around to tossing out the prescription stuff the vet sold me the day her diabetes was diagnosed. It was sitting inside a plastic bin on the top shelf of the laundry room closet.

I pulled the bin down. Untouched for more than a year, it was the same container where I had stored the kibble pre-diabetes. Isabella is very familiar with the bin. To her, the bin, filled with kibble, is a sort of kitty nirvana, a sea of yumminess. And the sound of me pulling that bin down brought my inappetant, lethargic, miserable-looking cat running - yes running.

Needless to say, she's getting kibble if she wants kibble. For her, it's back to the good ole days. For me, I have a feeling it's going to be a very tough summer - and that I'll be looking at her "only diabetes" period as the good ole days.

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.