Inspiration for this article came from Wilfred Brimley. No, really. He's an actor who, for the last half of his life, it seems, has been cashing in on his perfect portrayal of a grumpy old man. He told us for about 10 years that eating oatmeal was "the right thing to do." But his real claim to fame are his commercials urging people suffering from "diabeetus" to call an 800-number for good deals on diabetic testing supplies and free cookbooks.
I got to thinking about his admonishments to "test your blood sugar, and test it often." That's one thing for a diabetic person, but for my patients well ... let's start from the beginning.
Your cat drinks water like it's going out of style. Which, you think, explains the veritable sea of urine you've noticed each time you scoop the litterbox. But doctors say we should drink lots of water to stay healthy. What could be wrong with drinking a lot of water? Water's good for you, right? And what goes in must come out. It makes perfect sense. Besides, the cat has slimmed down some, which is a vast improvement over her previous - er - vastness. Weirdly, your husband noticed (and he doesn't notice anything) that the cat's been extra-hungry, having caught her nibbling the top of his sandwich recently, which is not like her at all.
I'd say it's time for you to listen to that little voice in your head that worries all the time. "Something's wrong - take her to the vet." It may surprise you to learn that diabetes is not the only disease that can cause these symptoms in animals. In fact, increased urine production (polyuria) and increased water drinking (polydipsia), together, called "PU/PD" in medicine, has a list of causes that fills a page in a standard textbook.
So, let's assume, after some diagnostic tests, your pet is officially diagnosed with diabetes mellitus. I agree, it's upsetting, but it's really not that bad. Really. I mean, as far as diagnoses go, it could be far worse. A diagnosis of diabetes is no more a death sentence for our pets than for us. Diabetes, while incurable, is treatable.
Diabetes mellitus is a disease of the endocrine pancreas, in which the body does not produce enough of the hormone insulin, or does not respond appropriately to the insulin that is present. Insulin is responsible for driving glucose into the cells of the body where the glucose is used for energy. Without insulin, glucose sits in the bloodstream, doing little to help the body. The body is so driven to use glucose for metabolism, its depletion from the cells causes the body to go into starvation mode, turning on various mechanisms to raise the glucose level of the blood even higher. Muscle and fat stores are broken down to make more glucose, raising the blood sugar levels, but the glucose cannot be utilized by the cells, further worsening the situation.
Without insulin, glucose builds up in the bloodstream, accumulating to dangerous levels. At a certain point, the excess glucose blows past the filtration of the kidneys like water spilling over a dam and leaks into the urine. The sugar in the urine draws water with it, which causes increased volume of urination and increased thirst. Eventually, this process can lead to dehydration.
"How can he be dehydrated - he drinks TONS of water?!" - a common question owners ask. These patients become dehydrated when the water lost through the urine exceeds what the patient can absorb by drinking in a given period. That is, he can't drink enough water to replace what he's peed out.
Can he take a pill for diabetes, like your Aunt Edna does? Well, not exactly. While there are certain oral medications that can help some people with their diabetes, none that are currently available work well or consistently in animals. And while a few cats can be type II diabetics, responding to dietary changes and weight loss (initially), this is uncommon; most animals are type I diabetics and have no functional insulin of their own at the time of diagnosis.
This means it is much more likely that your veterinarian will enter the exam room armed with a bottle of insulin, syringes and pages of written instructions when the diagnosis is made. Don't panic! You can do it - lots of people use needles and syringes to administer insulin to their pets, and so can you.
We veterinarians and our staff have pep talks prepared for these situations - and are devoted to the cause. There's no question: treating a diabetic animal is a serious commitment, but if you allow us to spend time answering your questions and concerns, you should walk away feeling more confident and capable.
Insulin is given in very small doses by way of very tiny needles, and its administration is often more traumatic for the owners (emotionally) than the pets. Believe it or not, most of our feline and canine patients don't even seem to be aware of the prick of the small needle. Animals sense their owners' anxiety (they aren't stupid!) and tense up when approached at medication time.
This is a natural response. But, with some practice, and a lot of Zen meditation, even the most squeamish needle-haters (I'm talking about the owner here) can be converted into diabetic management pros. Even so, I think anybody who's treated an animal with insulin injections should put that skill on their resume - it's a true achievement for some folks and (seriously) shows great strength of character and an intense love for animals.
Urine samples may be used to monitor the sugar that is passing into the urine, and this has been the method many veterinarians prefer to use in dogs. It is common to schedule periodic checks of the blood glucose in our diabetic patients, which can help to determine if they are being regulated well. Testing animals' blood sugar can be done at home with the proper training, equipment, and very mild-tempered patient.
In cases where this is possible, it can be very valuable in fine-tuning the regulation of diabetes in pets.
To view informational web pages about diabetes and an instructional video about home glucose testing, visit www.veteri narypartner.com and type "diabetes" into the search field. This website is very user-friendly, and can provide a wealth of reliable veterinary information for concerned pet owners on a vast array of topics.
Don't bother calling on Wilfred Brimley or Liberty Medical to obtain "diabeetus" testing supplies for your cat. I'm afraid they only concern themselves with people. And if you're still not sure of what's "the right thing to do," I guess you could eat some oatmeal until you decide.
Daverio is a veterinarian at Williamsport West Veterinary Hospital. Her column prints every other Sunday in the Lifestyle section.
She can be reached at firstname.lastname@example.org.