Oscar, a ten year old cat, had started to lose weight, despite the fact that he was eating well. His coat had begun to look bedraggled, as if he was not grooming himself as much as usual. His owner had noticed him visiting his water bowl more frequently, and she had needed to fill up the bowl every day, rather than every three days.
When I examined him it was clear that Oscar had lost a significant amount of weight. His ribs were prominent, and I could feel the sharp tips of the bones of his back. When I weighed him, I discovered that he had lost a kilogram since his previous visit.
Physically, I could find no obvious cause of a problem, so I decided that a blood profile was needed. Fifteen minutes later, the printout from the biochemistry analyser gave me the clear-cut diagnosis of his illness.
Oscar’s blood glucose was around four times higher than normal. The only possible reason for this was the condition known as diabetes mellitus. Oscar’s pancreas had stopped producing the hormone called insulin, and as a result, his blood glucose was not being controlled. Weight loss, ravenous appetite and copious thirst are classical signs of diabetes, in cats just as in humans and dogs.
As I explained the diagnosis to his owner, I could see a worried furrow developing across her brow. I explained that Oscar’s condition was treatable, but that he would need to have a daily injection of insulin for the rest of his life. Her shoulders slumped, and she looked at me sadly. “Nobody would dare to give Oscar an injection”, she told me. “He’d just get so annoyed with us if we tried something like that!”
I reassured her that the injection was given with an ultra-fine needle, and that only a tiny amount of liquid would be needed. For a cat of Oscar’s size, the volume of insulin would probably be around one hundredth of a teaspoonful, which is literally a single drop. It was very likely that he would barely notice the injection.
I demonstrated the injection technique, using a piece of fruit – an orange – as a practice target. It took a few attempts until she had learned to hold the syringe correctly, but soon she was able to insert the needle steadily and firmly into the orange. She was still very anxious about injecting her cat, so we decided that it would be best for her to bring him in to see me for his injection every morning for the first week.
The technique was simple. I gave Oscar a bowl of his favourite food, and as he lowered his head to eat, I quickly slipped the injection into the scruff of his neck. He stopped eating for a moment, and looked suspiciously at me before recommencing his meal. On day three, his owner gave the injection herself, and by day five, she was able to do this quickly and confidently.
After several dose adjustments over a few weeks, Oscar’s blood glucose had returned to normal. At the same time, his owner reported that his excessive thirst had disappeared. It seemed that his diabetes had been controlled.
The success of his treatment was confirmed at his final visit six weeks later. As the cage door was opened, Oscar stepped out in a confident and dignified fashion, with his head held high. He had put on weight, he was grooming himself again, and even his whiskers looked alert and bristling. He was definitely a healthy cat again.
One of the challenges for veterinary surgeons working in the media is that is that they are often asked about one specific patient, with a particular problem. While it's helpful for the individual owner to discuss their own pet, it can be less enthralling for other readers.Here are a couple of examples:
Mrs Kennedy was an elderly widow, whose only companion was a small seventeen year old cat called Puss. Mrs Kennedy had phoned me because she thought that Puss had broken her leg after chasing another cat.
I wasn’t expecting anything too serious. Cats commonly hurt themselves while fighting with each other. An owner may think that the leg is broken, but in most cases the problem is a simple cat bite abscess, which can be easily treated. However, this time it was different. The owner was right.
Mrs Kennedy explained how a neighbouring cat had sneaked into the kitchen, and Puss had leapt up to chase it away. Immediately afterwards, she’d started limping, and since then she had barely moved from her bed.
When I touched Puss’s shoulder I could feel heat and swelling, and when I gently probed deeper, I could feel the rough ends of broken bone. I asked a few more questions, and it turned out that Puss had been drinking more than normal for a few months, and she had begun to be fussy about her food. She had also started to vomit occasionally. The pieces of the jigsaw began to fit together, and I explained it to Mrs Kennedy.
“Puss is very elderly and at this stage in her life, her body is gradually failing her. Her main problem is that her kidneys have stopped working properly, which is why she has developed an increased thirst and a poor appetite. As a result of her kidney failure, her bones have become very fragile. Unfortunately, advanced kidney failure in a seventeen year old cat is not easily treated. And worse again, a broken bone in a cat like Puss cannot be fixed. At this stage, all of her bones will be as weak as egg shells. If she carried on, Puss would continue to suffer from further broken bones during normal activities.”
Mrs Kennedy sadly shook her head. “ So it’s time to say goodbye.” She knelt down beside her cat, and gave her a last, long hug. I gave the painless injection, and Puss quietly passed away, as her owner whispered into her ear.
Mrs Kennedy told me how Puss had originally been a wild stray cat. She had finally been tamed after months of coaxing her into the kitchen with food. She had been Mrs Kennedy’s closest friend, but she would never have another cat. She was elderly and she could not bear to think about what might happen if she died herself. I tried to tell her that somebody would look after her cat, and that this could be arranged in advance, but she just shook her head again. I felt very sad as I left her house.
Two weeks later, I received a call from someone who had a half-tame feral kitten in their garden. They were moving house, and they didn’t know what to do with it. An idea occurred to me. I collected the kitten, and drove on to Mrs Kennedy’s house. When she answered the door, I smiled and I said that I had something that might interest her.
Mrs Kennedy could not take her eyes off the kitten in the basket beside me. “He is just like Puss used to be –the poor frightened creature. Bring him inside”. She went to her kitchen cupboard and took out a tin of cat food. I stood back, as she spooned the food onto a plate, and opened the cat basket. The kitten licked the food hesitantly, and then began to eat heartily. As he ate, Mrs Kennedy chucked his cheek gently. He looked up at her, and to my surprise, he purred. A new friendship had begun.