March 05, 2008
Yesterday Nekko had a visit to the vet to get one of her annual vaccinations and to have a blood glucose curve test completed to measure the effectiveness of her current insulin treatments.
Her blood glucose curve was very good. I gave her a shot of insulin at 8 am, just before we took her to the vet's office. Her initial blood glucose (BG) was 125. Over the course of the day it went up to 140 and stayed there, which is exactly what it should do. A reading of 100-120 is normal. Anything below 100 is dangerous. In the case of an 11-year old cat, anything under 200 is good, so she is doing very well.
We have noticed an increased amount of urine output and increase water intake. Since her BG is normal the doctor felt that the increase drinking and urination could be a sign of kidney disease or failure. At our prompting they did a quick blood test and urine analysis. All of her blood values are normal except for the amount of glucose, which was 215. Given that we were 9 or 10 hours into the insulin cycle he wasn't concerned with that value. He also observed an increased amount of glucose in her urine. The doctor explained that if she hadn't urinated in a while that the concentration of glucose would be higher.
There is slight evidence of infection (raised amounts of protein and something else in her urine), possibly in her bladder, which the doctor said is common with diabetic cats. The test is subjective (matching colors on a test strip to a graph) and he didn't seem overly concerned by the infection.
We had three options: wait a week and test again, liquid antibiotic, or tablet antibiotic. Nekko is not a pick-up-and-hold-me kind of cat. Trying to give her an oral medication would be trying for all involved; worse it would make subsequent injections harder to complete as she would start avoiding contact at all.
When we explained to the doctor her reluctance to be handled he offered that he could provide the antibiotic in an injectable form - subcutaneous - just like the insulin. We opted to wait a week, watch Nekko for increased signs of lethargy. We'll do another quick blood test then and if the infection indications are still present we'll go the injectable antibiotic route.
We asked him about her occasional inability to complete a short jump up onto the bed. He said that neuropathy (disease or dysfunction of one or more peripheral nerves, typically causing numbness or weakness) is common in diabetes. This might also explain an episode earlier where she chewed or licked off most of the fur on her forelegs.
The firmness of her belly is not unusual or anything to be concerned with he said. Cats store fat in that area and it can often feel quite hard. Her weight was 14.6 pounds, up from 11 fifteen months ago, and a low of 10 when she was first diagnosed in September 2006.
All in all she is in very good shape for a cat who is about to be 12 in May, who has diabetes.