Diabetes Resistance

Dear goodness, I have no idea what to do with my girlie. She remains resolutely hyperglycaemic despite escalating doses of insulin. We have a great vet at the Vet School Hospital who has been totally engaged in researching, asking external experts and generally trying to puzzle out what the heck is going on. She is now up to 8units of insulin glargine and still her readings are pretty horrendous. Even the vet is beginning to develop a twitch each time we increase the insulin as we are getting near the 2units/kg range.

In herself, she is doing ok and is still a wise, loving and adored little cat. However, her coat is not its usual sleek velvet and she is often quite subdued preferring to go and lie quietly in cold places. She's lost weight and is now 4.8kg despite stealing Red's dinner if she can. I test her blood sugars twice daily to ensure it is safe to administer her insulin and again if she shows any odd signs in case she is having a hypo.

I've no idea what is going on with her so we are pursuing more testing. We've started with testing for acromegaly. This seems to be the newest theory for insulin resistant cats and it is estimated it can affect 1 in 5. As a newer theory it seems a little light on definitive evidence and the testing can result in false negatives and positives. As she's been diabetic for four months the likelihood of a false positive or negative is reduced in her case. The test itself is £150 and if positive leads to ever more expensive MRI scanning and if a tumour is found the treatment is stereotactic neurosurgery +/- radiotherapy. In discussing it with the vet her rationale of testing simply so that we know what we are dealing with seems a plausible route forward given how resistant Magic seems. Even if we do nothing more it will give us some reassurance that increasing the insulin is the right thing to do as acromegalic cats often need high doses.

What I don't want to consider is neurosurgery or radiotherapy. I find it very hard to contemplate allowing this irrespective of cost. This kind of surgery is still very new in cats and though recent research and outcomes are promising it has nowhere near the safety margin that this type of surgery has in humans. On top of this no-one ever returns from neurosurgery or cranial radiotherapy unchanged and right now I consider the risks to Magic far outweigh the benefits. I have 8yrs experience of caring for a relative with an acquired brain injury post neurosurgery and it is this which drives my concern. Magic is an amazingly wise little cat and I feel I owe her a great deal as during some dreadful life disasters it was her coat I cried on. However, to risk her life and fundamental personality is a decision which would need a great deal of consideration which is why I would much rather we manage her medically rather than surgically or radiologically. I really hope I don't have to face the dilemma of making this decision.

The blood has gone to Cambridge for testing and they only run the samples once a week so her results should come back in the next week or so. I'm trying not to over think things but if it is positive then the issues above need a decision, if negative then it will be other organ testing to see if the culprit can be identified. I know this sounds rather grim and at the moment the result is unknown so I am just praying that whatever happens she and I still have many years to go together.

Red is as cute as he always is and has been more keen for cuddles. I'd like to think it is my magnetic personality but I suspect the dropping temps are the real reason. Both cats have been very attentive as my Mum has gone into hospital again and, though their attentiveness is heartwarming, I am waking up roasted alive as I have one as a Davy Crockett hat and one as a foot warmer.