When Janet called to say that Rindin, her sweet tempered brown tabby cat was drinking excessive amounts of water and leaving large urine clumps in the litter box, I told her to bring Rindin in for a visit. I was worried because there are several reasons why a patient may have increased thirst, and most of them are serious problems. Rindin had appeared normal just 5 months prior at her annual visit. Her weight had been good, and there were no concerns about her drinking too much water. Regular veterinary visits establish a baseline for a cat's weight and other parameters and opens dialogue about symptoms like increased thirst and other indicators of disease. Now, in addition to changes in her drinking habits, Rindin had lost nearly half a pound. Weight loss accompanied by increased thirst in an older patient are often caused by kidney disease and diabetes. Diagnosing these diseases requires a blood test, so we took Rindin to the treatment area where we shaved her neck and swabbed it with alcohol in order to get a sample from her jugular vein. The blood work showed that Rindin had a significantly elevated blood glucose (sugar) characteristic of diabetes.

      Janet knew that drinking more water could signify disease because she had worked at a feline practice for several years. It was there that she met her husband, Erik. Erik had just gotten Rindin as a kitten, “because he was lonely.” When a certain red haired technician caught his eye, Erik was happy to comply with regular visits to the veterinary clinic for kitten boosters. It's a match made in heaven when two feline fanciers fall in love!

      Diabetes is a relatively common problem in cats and dogs. It occurs when the pancreas does not produce enough insulin or the body becomes resistant to the effects of insulin. Insulin allows the cells to take in glucose for energy. Obese cats are particularly prone to the condition. In the canine species, certain breeds (like schnauzers) are predisposed. In some patients there are other underlying diseases that have caused diabetes.

      Treating diabetes requires diligent management and regular blood glucose monitoring, and Janet and Erik were up for the challenge. Like with humans, insulin shots are given to allow the body to absorb glucose. For someone like Janet, who has worked in a cat clinic, giving injections is not hard, but individuals without this experience may feel overwhelmed. They shouldn't! Once clients overcome their initial fear of giving their cat or dog an injection, it becomes easy. Insulin needles are very small, and pets often don't realize that they have gotten a shot.

      Sometimes cats who have been on insulin for a while stop needing it. These patients are called transient diabetics. When this happens they can unexpectedly become hypoglycemic after receiving an insulin injection. I told Janet about the symptoms of low blood sugar: weakness, staggering, loss of mental sharpness and even seizures. I advised her she should have some high fructose corn syrup or honey on hand to put on Rindin's gums if she noted any of these warning signs.

      The cost of treating a patient depends to a large degree on its weight. Treating Rindin requires much less insulin than treating a large dog. Syringes are affordable and must match the type of insulin that is prescribed. U 100 insulin must have U 100 syringes, and U 40 insulin must have U 40 syringes. The needle on either size syringe is very small and causes minimal pain when injected. Monitoring glucose levels is also a cost factor, and until patient's show a blood glucose value in the normal range, they will require regular visits to the veterinarian.

      Rindin has not been easy to regulate. Her blood glucose remained over 300 until her last visit, and it has been necessary to increase her insulin dose several times. She spent one day with us in the hospital getting a blood glucose curve where we drew hourly blood tests. Rindin was a real trooper and tolerated her ear pricks bravely.

      Finding the right insulin type and dose can take time, and doctors and clients alike may feel frustrated. Once the correct regimen has been determined, most patients do very well for years.