Ian helped me take Sal to the vet Monday morning, where a test showed his blood glucose level to be 26.6 m/mol. While his glucose level may have been elevated by the stress of the car ride and the vet's exam, "normal" is 3.5 - 6.5 m/mol. While he was at the vets having more tests Ian and I went to the pharmacy and bought testing supplies, needles and insulin.
For the first three days of treatment we have to monitor his blood glucose levels very carefully. This means a blood test every four hours from morning until bedtime. In a cat the blood is obtained by pricking the outer edge of the ear with a lance. The drop of blood is then drawn up the test strip by capillary action and in a few seconds you have a reading.
His readings were all pretty much the same all day yesterday, 17.00 - 18.00, but down significantly from Monday. This afternoon he had the "best" reading since we started monitoring, 15.3. The insulin we're giving him is a slow-acting form, and I had read that it would take a couple of days before the blood sugar started to drop appreciably. Hopefully it is starting to take effect.
He does not appreciate being poked though and who could blame him? I am so incompetent. I poke him, and it's too shallow, so he doesn't bleed enough to test. I have to poke him again, and again, and again... Or I poke him too hard and blood goes everywhere.
He's fed up with my clumsiness and no wonder, but I am amazed that he's already learned that I am going to poke his ear with a sharp object and then milk it for blood. He gets this resigned face on, like, "My Mama has flipped her lid, but whaddya do? She's still my Mama." He's cuddling me as soon as it's done, so he's learned that while it's unpleasant it's not diabolically painful. He pays no attention to the insulin injections. The needles these days are tiny, not much bigger than a hair. They are coated with silicone to slide in easily, and they are very sharp.
Hopefully I'll get better at it because monitoring is vital to effective management. The cat we had when the boys were small was a huge FAT creature (30 lbs). His name was Buddha John Three Fish. Buddha because he really was a Great Soul. How do you say a cat is "spiritual" without sounding like a freak? But this guy was. But he was also hungry, which is how he got the John Three Fish part of his name. He ate Ian's pet turtle, named John, and the three goldfish we bought and put in a fishbowl on the mantel.
He was a huge cat, but so very patient and gentle. Once he was outside and somehow had an encounter with a cholla cactus. This kind of cactus has barbed spines, the ends of the spines are like fishhooks. He came inside and up to me and said, "Meowff". I reached to pet his head and found him loaded with spines. Some had gone through his tongue and nailed it to the roof of his mouth, some had gone into his nose. Some were around his eyes. Many went through his cheeks. Most animals would have been wild with pain. But here he was, quietly asking for some help.
I got needlenose pliers and a pair of nail scissors. I'd cut the protruding end off of a spine, so it could collapse, and then I'd yank it out. He whimpered, but he never raised a paw to scratch me, never growled, never hissed. I took 112 spines out of him, and afterwards he curled up in my arms and purred. He was a wonderful cat.
He developed diabetes when he was nine. He did well, but it was harder to manage diabetes in those days. There were no blood glucose meters. I relied on dip sticks that you had to poke into the pee stream. (HE thought I had gone a little strange when I started following him to the litter box and poking a strip of paper under his tinkle!) But I rotated injections sites for his insulin, and he kept track of where the next shot should go, and would jump up on the counter and present the appropriate site every morning before breakfast. In those days we gave insulin once a day, now they've learned it's better to give a smaller dose twice a day.
The things we do for our beloved four-leggers.