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Princess's  Princessstory is about diabetes management complications which are caused by other problems. Even though her diabetes couldn't be regulated, it wasn't the diabetes that took her life.  But if it wasn't for the diabetes, we might have been able to prolong her life a bit longer. I hope our story won't be discouraging to others, but other owners should know that it's possible that other problems can interfere with the diabetes treatment, regardless of how much effort is put into it. 

Princess and I shared many wonderful years together. I adopted her in late October 1987, when she was, I was told, 1-1/2 years. Due to stress and worms, she hardly ate at first, and was close to being force fed. After a couple of weeks of care, I offered her some tuna salad, which she ate out of the container. Soon after, she was eating dog food out of her bowl. Eight months later, we were joined by 6 week old kittens Bootsie and Gizmo. Even though Princess was jealous of any attention I gave them, she was a good momma to them... their idea, which you can below. Four years later, kitten Sassy joined us and raised havoc in what once was a harmonious home.  Except for minor skin problems, Princess remained in good health for almost eight years.

In late summer 1995,Princess with Bootsie and Gizmo Princess was attacked by a neighbor dog. While she recovered, this marked the beginning of her serious health problems. During a follow-up exam that November, a pea-size malignant growth was found in one of her anal glands, and removed along with the gland. She didn't tolerate well the 3 rounds of chemotherapy which followed. At the time of the surgery, Princess' kidney values (BUN and Creatinine) were borderline, and I began feeding her kidney diet food, along with W/D which she needed to keep her stools firm.

Once over the effects of the chemo, Princess' stayed in relatively good health for three years, with kidney values at high normal. Our family grew by two more cats, Whiskers and Spook, whom Princess accepted and played with.

In late Fall of 1998, she developed Kennel Cough. Despite antibiotics and other medicines, the chronic coughing continued. In July 1999, I asked the vet about trying prednisone. We reluctantly put her on the lightest dose possible, along with a bronchodilator. The coughing all but stopped, but soon after there was a significant increase in urinating, and her kidney values shot up. In mid-August, I began giving her almost daily sub-q fluids.

Also during August, her blood glucose went into the 500's. The vet thought it was due to the prednisone, and she was quickly weaned off it. I tested her urine each day for a week, but it was too late. Princess was now diabetic. I honestly feel, along with the vet, that she was headed this way, and the prednisone pushed her over the edge. Insulin was begun on September 1, 1999.

We were never able to fully regulate Princess. The most minute changes in insulin sent her urine glucose up or down. But our vet, who I respected after his care of her cancer, felt she was regulated. I disagreed and considered taking her elsewhere, but I didn't want to put Princess through the stress of additional tests and possibly having to stay in a vet hospital for several days.

I found the Pet Diabetes website and the email list, where I learned about home glucose testing. At first, the thought of doing this scared me, but a friend with a diabetic cat sent me her Glucometer Elite, and because I saw the advantage of doing it, I gave it a try. Since Princess had no elbow callouses and her floppy ears were thick and sensitive, I had to try the lip prick. While it didn't seem to hurt her, Princess resisted and put her tongue in motion, so any blood drops I got were contaminated. But even when she was quiet, I couldn't get enough blood. (The vets found it difficult to draw venous blood from her.) Only once did I get enough pure blood for a successful reading. I was very discouraged and frustrated, but with Princess being 13-1/2 years and frequently not seeming to feel well, I didn't want to add stress to either of us. So I stopped trying, feeling that I'd failed this step. I continued to rely on urine glucose readings and occasional BG readings obtained when I had Princess at the vet for tests and acupuncture treatments.

Interestingly, my vets were initially opposed to home blood glucose testing, but even though I wasn't successful, I at least partially convinced them of the advantages of doing it.

Princess' diabetes management was complicated by early stage chronic renal failure (CRF). Diabetes and CRF have almost opposite food requirements, and I learned that elevated kidney values raise the BG, and high BG's raise the kidney values. Further, during a week at home, I did the sub-q fluids in the early afternoon, the furthest time from the insulin injections. Her UG readings went down, even as I lowered the insulin dose by 1/4 units. As soon as I was back at work and went back to doing the sub-q's an hour before the evening injection, the UG went back up. I then began to do the sub-q's at least 2 hours following the insulin, but her UG readings were still bouncing.

The likelihood of diabetic cataracts was constantly on my mind, and I tried to keep the urine glucose readings down, even though the vets kept telling me that higher is safer. I now know they were right. Princess was losing her sight regardless. By November, she had early stage cataracts, and the veterinarian ophthalmologist also noted she had virtually no night vision, an indication of deteriorating retinas.

There might have been another complication making diabetes management impossible for Princess. About the time the diabetes was discovered, she had nose bleeds, which the vet and I thought were the result of all her sniffling and the dry air. Eventually, I started using a vaporizer at night. Tests of her sinuses showed only an infection. Despite medication, she continued to sniffle, sneeze, and sometimes cough, and a couple more minor nose bleeds. I had a feeling the vets suspected something else may have been going on. We learned later there was, something which might have prevented any chance of regulation.

The mild Fall season in New York City lasted well into December, during which time Princess seemed to feel good, enjoyed our walks, sometimes breaking into a run. But when the weather turned very cold, much of her normal behavior, like greeting me at the door and getting up from a nap when I moved, became rarities. She was slower in getting up and, although she never cried, the vet said she had arthritis. Neither Cosequin nor Rimadyl helped, and both were stopped. The vets learned that Cosequin interfered with insulin absorption in humans, something I had previously read on the diabetes email list. (Etogesic seemed to help.)

Increasingly, when I sat on the floor to give her attention, Princess walked by me and lied down on her living room "bed" with her back towards me. She didn't seem to like petting or massaging or even her favorite rump skritches. I had to "jumpstart" her almost every morning with baby food, and she rarely enjoyed walking outside. At night she refused to go out for walks, which I thought was because of low vision, altho the area is brightly lit. I wondered how much the lack of exercise was affecting her glucose levels.

Even though her blood values remained relatively stable and there were still times when she seemed to feel good, I could see that Princess' health was going downhill, and I sadly sensed that she wouldn't be with me much longer. I started thinking about the quality of her life, but felt that as long as she enjoyed eating and continued to "forage" for cat food crumbs, she was okay. I also thought I was finally getting her glucose under control, and that with the warmer weather, she'd feel better.

In February, Princess started yelping when I gave her the insulin injections. I followed suggestions from the email list that I take her into another room for the shot. She stopped yelping, but she made giving the shots difficult by turning her head and neck. Looking back at this and other indications, I think Princess and the 5 cats knew that her time was very close.

On Sunday morning, February 27, 2000, I could see that something was very wrong with Princess. She ate lying down, fell asleep afterwards, and when I woke her, could barely stand and her head hung to the floor. Following Karo syrup and consultation with one of our vets, I rushed her to the Animal Medical Center (in Manhattan). The immediate diagnosis was hypoglycema. Since her urine glucose was between 100 and 250, and she had just eaten a substantial breakfast, and it had been less than two hours post insulin, there was no apparent reason for the hypoglycemia, so she was admitted into the critical care unit of the hospital to find out why. Both the emergency and critical care vets told me that Princess had indications of a brain tumor. The following morning, she had a major seizure, and they almost put her down. I saw her later in the day. She was very groggy from the valium given to stop the seizures, but after a few minutes, I saw that she recognized me, and I knew she wanted to go home.

I visited her again on Tuesday. We put her on the floor, and she started walking around the room, she ate, and she responded to her name. The vet was impressed with the sudden improvement, and had the neurologist look at her. They both agreed I'd be wasting my money having a brain scan done, that she could die under the anesthesia required for it, and that I should take her home. The critical care vet instructed me to reduce her insulin to 1-1/2 units. When I told him that our vet did only a 3 draw BG curve, he said that was a waste, which I had felt all along. I told him I wanted to bring Princess to him for diabetic care.

But my plans and tentative elation lasted only minutes. From the time I put her into the car, I saw that something was wrong. At home, she paced most of the time, most of the night, accompanied by heavy panting, and crying out when she hit a wall or obstacle, not knowing to turn around. She didn't seem to respond when I called her name, even if I bent down. Very telling to me, the five cats, two of whom spent their first year thinking she was their mom, ignored her. Most of who I knew as Princess no longer seemed to be there. But her tail stayed up and sometimes wagged, and there were some moments of lucidity, which made the decision I had to make excruciatingly difficult and made me second guess myself. I called the vet and said, "It's time."

Before we left, I fed her a combo of the cats' Fancy Feast, which she always wanted but couldn't have, and baby food. She lapped it up, but kibble that I put in her mouth fell out. I brought her to each cat to say goodbye. They still ignored her.

If I had been able to test her blood glucose, she might not have had that hypo. But, if the vets were right, she still would have seizured the following morning, at home. I might have been at work, and come home to find her gone and not known why. Instead, she had a final seizure right after she was given the first shot to sedate her. I wanted her last memory to be of her favorite activity, eating, so she had baby food and Fancy Feast in her mouth. She was back in my arms and, due to the seizure, probably -- hopefully -- had no awareness when the end came.

-- Contributed by Kami

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Contributed April 2000
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