Hypurrrglycemia

A routine part of any standard doctor's appointment involves updating the patient's family history, including any new diagnoses that have been given to immediate family members or otherwise. Usually, no news is good news.

I almost dismissively asked this question to a patient who had relatively recently been diagnosed with Type 1 Diabetes. We see these patients every 3 months and there is usually not much to report by way of health changes in such a short time period.

She looked at me with a smile and said that someone in her family was recently diagnosed with Type 1 Diabetes. Her smile confused me, and so I glanced at her parents who threw their arms up in the air in disbelief. "We can't believe it!" her mother exclaimed with exasperation, "there is only so much diabetes I can handle!"

They could tell I was in need of a lot more information than this, but they were toying with me.

"And it was me who picked up on the signs and made the diagnosis, " her father piped in proudly.

They finally divulged that their 6 year old cat was diagnosed with Type 1 Diabetes. The father noticed that the automatic water-bowl filler needed to be refilled daily instead of every 2nd or 3rd day, and that the litter box was more full than it had ever been.
The mother called the veterinarian and told her that their cat has diabetes. Skeptical (as anyone would be) the vet asked to examine the cat and re-assured her that it was likely not diabetes. The vet was forced to eat her words the next day via telephone when she delivered the diagnosis. It just goes to show that D-parents know their stuff!

The cat was started on twice daily injections of NPH. I asked if they check his blood sugar, and they explained that it is a long, tortuous process involving the warming of a rice pack in the microwave, chasing down the cat, pressing the warm pack to the cat's ear, and then wrangling the cat down while trying to prick his ear for the test. Needless to say, they don't test him all too frequently.

I wondered aloud about hypoglycemic episodes, especially being on an insulin like NPH with all of it's peaks.
My patient said that her cat sometimes goes low, and she knows because his walking becomes wobbly and that "one time he walked straight into the wall."
"He also slurs his purrs," her dad joked.
When this happens, the family has to again wrangle the cat and try to coax it into drinking sugar water. And I thought taking care of a small child with diabetes was difficult! I never thought about a cat! But if it had to happen, at least the cat ended up with a family who really gets it. Slurred purrs and all.