I have two "senior" cats, one of whom is 16-1/2, the other 12. The younger of the two was diagnosed two weeks ago as diabetic, news I should perhaps have been more prepared for, given that she had lost a fairly significant amount of weight, seemed uncharacteristically hungry, and was drinking more water. I think what threw me off was that I was _trying_ to get her to lose some weight, as she has been mildly overweight for some time, and the initial weight loss, accompanied as it was by an increase in general liveliness, seemed like a good thing. The water consumption I put down to her advancing age.
When it seemed that she was getting a little _too_ thin, I took her to the vet's, a practice I have patronized exclusively for 30 years. I spent $200 for an exam, parasite test and blood workup, and was called by the young vet (there are six or seven in the practice) the following afternoon with the results. She caught me at an awkward moment--in a noisy environment, trying to calculate a tip and sign a bill--but said 'no,' she couldn't call me back or accept a call two minutes later. She rattled off a lot of information about diabetes that I couldn't really hear, couldn't write down and, of course, couldn't process at the moment in order to formulate intelligent questions. This young woman ended the conversation by saying "I'm going to have you come in tomorrow to see Dr. So and So, who will show you how to give the insulin shots." No question, apparently, that we might consider talking about all possible options. She just concluded, without benefit of any input from me, that I had the financial, emotional, and practical resources to commit to twice-daily insulin injections, forever. (Managing diabetes is also much more involved than just giving insulin shots--in many cases it requires a substantial readjustment in one's life, particularly if that life requires frequent travel or travel that arises without a lot of notice.)
For a lot of reasons, that shouldn't have been a foregone conclusion on her part, and I greatly resented that it was. Vets need to make money, I understand this, and I believe that in the vast majority of cases, it doesn't conflict with genuine concern for what is best for their patients. Unfortunately, they also have to consider what is best for their patients' owners, and sometimes going to great lengths to keep an elderly pet alive is not it. Maybe that makes me a bad person, but there it is. This cat came to me via my then 16-year-old child; the cat was a semi-feral stray with no other prospects, and I have to keep reminding myself that taking her in and giving her love, care and medical attention for 12 years does not obligate me to do everything possible to extend her life as long as possible. My only obligation is to make sure that she doesn't suffer.
What really irritated me about being rushed into insulin therapy, even if it was with the best of motives, was that had I consented, trying other treatment options--like diet modification--would have been much trickier and potentially dangerous to my cat, due to the dramatic impact a change in diet can have on the amount of insulin required. I switched the cat to a high-protein, low-carb, all wet food diet immediately, and in less than two weeks she has regained 6.5 oz and her blood glucose has dropped almost 100 points, although it is still quite high. I made the decision to start with a new and more conveniently located vet who seems willing to give the diet modification a chance, but he was nonetheless clearly disposed to start insulin right away, notwithstanding the benefits the change in diet has produced.
We've left it that I'll continue the diet modification with a high-quality wet food, and will come in for another blood glucose check in a month, as long as my kitty's condition shows no reason for alarm. I have observed none of the signs of serious illness, even before the blood sugar dropped 100 points, but to be sure, I reviewed those with the vet. He added that if she seemed 'depressed,' I should be concerned.
She seems well, and seems more so each day, but if anyone out there has ever tackled feline diabetes without resorting to insulin, please let me know.
Didn't make it to the other intriguing questions, but they involve how to figure out when you really don't fit in...
We went to a beach bar yesterday, on an impulse after walking on the beach, and found ourselves being looked at--clearly--as curiosities. It was the more redneck of the two local beaches, with a flavor that I actually prefer to the more 'upscale' beach. Everyone in the place looked rough, but there were no fakes or posers, and most were friendly. They were following some kind of stock car race on TV with the greatest of interest. I found myself being examined intently by a man with three braids, one on either side and one down the back, who looked rather fried, like there'd been a lot of drugs in his past. (My companion said he looked dumb as a rock.) His stare was unsettling, intent and vacant at the same time.
Perhaps our T-shirts illustrate the divide better than any descriptions I can provide--mine had a book with a pair of glasses resting on it, next to which was a bottle of wine and the words "Well red." On the sleeve it said, 'Napa Valley.' My boyfriend brought it back the last time he was out that way, visiting his sister. The guy with the braids was wearing a T-shirt that said, "Please tell your boobs to stop staring at my eyes."
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