Dear Most Esteemed and Knowledgeable Kitties:
My (approx.) 11 year-old cat, Mama, was diagnosed with diabetes about three years ago. She has been on Vetsulin and is now on Lantus. I was giving her insulin per vet recommendation, and brought her in for insulin curves when I could afford to. I took her off the “prescription food” after visiting catinfo.org, and switched her to high-protein, low-carb wet food only (except for a small dry snack at night). Mostly she stayed stable until the last 2-3 months.
She started peeing outside of the litter box, so I took her to the vet. They said she had a UTI, and gave her antibiotics. They suggested we reduce the insulin to 2 units, twice daily after eating. Around the same time, I also started home testing with the Alphatrak 2 kit. I noticed that her blood sugar was quite unstable, and when I did a curve I saw it range from the low 200’s to the low 400’s randomly throughout the day. Otherwise she was eating and drinking and toileting normally.
Flash forward to last week, when i noticed an increase in her urinating outside of the box, poor appetite, a bout of vomiting, and lethargy. We took her to the vet, and they said she now is completely blind. He was conservative with testing, but did give her a shot for nausea, checked her blood pressure (which was normal), and she did not have a UTI. He also said to try to increase her insulin incrementally to see if we can get it stabilized to 100-200.
I’m thinking she is struggling with being blind, which may be related to the peeing in wrong places–though she usually hits a part of the pee pee pad at least. Yesterday, I put her in the litter box a few times and she did pee, but seemed to be a bit disoriented (which is understandable).
I’m trying to make this work because she has perked up in terms of eating, drinking and alertness. I don’t want to euthanize her just because she’s peeing all over my floors, but I also don’t want to keep her alive for me if she’s suffering. I’ve had to let go of pets before and it’s not easy but it was clearly appropriate in those occasions.
I’m confused, sad and very stressed. Just wanted some feedback. Thank you.
Thomas: Well, Alison, let us just start by saying that you’re doing everything right.
Bella: And everything you’re feeling is completely normal for the situation you and your cat are in
Tara: We’re pretty sure Mama’s (not our human Mama–she pees where she should every time–but your cat Mama) inappropriate urination is due to her adjusting to her blindness and her diabetes. This doesn’t necessarily mean she’s suffering. She’s just getting used to living her life without the use of her vision. The diabetes is making her urinate more, and she may be having trouble getting to a litter box in time.
Thomas: In order to help reduce the inappropriate peeing, we recommend putting a litter box in every room where she likes to hang out. This will just make it easier for her to find the correct place to pee when she needs to go.
Bella: Okay, so here’s the thing about being blind, and why it’s so important to do everything you can to help a blind cat adjust to her surroundings: when you lose your vision, your other senses eventually make up for the deficit, but it does take a while.
Thomas: Sounds, smells and textures are going to be the keys to help Mama stay oriented in her home. If you have different textures on the floor–say, area rugs or carpet in one room and hardwood or linoleum in another–that will help Mama figure out where in your home she is. If your place has wall-to-wall carpeting, maybe you can still find ways to create different floor textures in different rooms by using area rugs, floor protectors, and pee pads.
Bella: We don’t recommend picking Mama up and placing her in the litter box or on a piece of furniture because she will get disoriented, as you saw when you did that once before.
Tara: Instead of picking her up, we recommend encouraging her to come to the litter box or her dishes by calling her name and making noises like tapping her food dish, using your fingernails on her scratching post, or moving the scoop around in the litter box. You can also tap on a piece of furniture and call her name if you’d like her to get on your lap or sit next to you.
Thomas: If you do need to pick Mama up for some reason, get her attention first with a noise, then a gentle touch and a pet or two–and then pick her up. This is especially important if she’s asleep: if you pick her up or touch her when she’s sound asleep, she’ll get really startled.
Tara: Until Mama’s blood glucose gets under control, it’s going to be hard to stop the inappropriate urination. You may need to get used to having pee pads over large areas of floor at first, but as Mama adjusts to her blindness, she’ll get better at finding the litter box when she needs it.
Bella: Another thing you can do to help a blind cat adjust to her situation and keep her mind and body stimulated is to provide toys that have strong smells or that make noises. Catnip kicker toys can be a good choice, as can toys that crinkle or make noises when they’re touched. You can still even play with “thing on a string” toys as long as the “thing” is a little bit noisy so she can use her ears to tell where the toy is.
Thomas: According to Blind Cat Rescue & Sanctuary, you don’t need to stop moving the furniture forever if your cat loses her vision, but in order to help a blind cat adjust to her disability, there are a few things you absolutely cannot move: the litter box(es) and the food and water dishes. If you keep those items in the same place, Mama will be able to use those things to orient herself in space.
Bella: You’ll probably see that when Mama walks around, her whiskers are pointed forward. Her whiskers will give her a warning before she bumps into things, as they’re very sensitive to even the most minute air movements.
Tara: One thing that’s really, reallllly important: never, ever let a blind cat outdoors unsupervised. You might also want to get a tag for your cat’s collar that says she’s diabetic and blind, in case she ever does manage to escape. If your cat is microchipped, you might log into the microchip registry and find a way to note that she has diabetes and is blind–again, just in case she gets lost and she finds herself at a vet hospital or a shelter. While you’re logged in, make sure your contact information is current.
Thomas: If Mama enjoys the feel of grass under her paws and fresh air in her fur, you might consider getting her used to walking on a leash and harness or providing her with a safe outdoor “catio” where she can catch some sun rays without needing to worry about predators or accidents. But it’s going to be a while before you should do that; first, let her get used to her indoor space and get her diabetes under control.
Bella: Ultimately, Alison, we don’t believe that blindness causes suffering for a cat. Mama’s other senses will soon make up for her loss of vision. These tips to help a blind cat adjust to their situation will make her life and yours much easier.
Tara: Now, on to the subject of diabetes: we’re super-glad you’re home testing and adjusting Mama’s diet because that’ll help get her regulated and keep her from slipping into potentially deadly hypoglycemic episodes or diabetic ketoacidosis.
Thomas: We don’t know if you’re aware of this, but our Bella was diabetic when Mama (Our Mama, not your Mama) adopted her! Bella was on Lantus, and the people at the shelter showed Mama how to home test. It’s a good thing they did, because her insulin needs got lower and lower until she didn’t need insulin at all! And Bella’s been in remission for seven years now.
Bella: Which means it is possible to get a cat off insulin. Mama wrote a post all about how she got me “off the juice,” as they say in the diabetic cat community.
Tara: Speaking of Bella, today is her A-Day! That’s right: seven years ago today, Mama brought Bella home. I didn’t get to meet her when she first arrived, but Thomas did.
Thomas: And she was so sweet and cute! Mama tried to keep her in one room, but when she opened the door, Bella slipped out between her legs and said, “Hi! I’m a kitten!” And I was absolutely smitten.
Bella: Siouxsie was a little grumbly, but that’s just the kind of cat she was. I know she loved me!
Tara: Anyway, Alison, please don’t despair. Diabetes and blindness don’t mean a life of suffering for your cat–or for you! There’s lots of support out there for parents of diabetic kitties. The resources we recommend most are FelineDiabetes.com and the Feline Diabetes Message Board. You’ll find amazing resources, information and support there.
Thomas: What about you other readers? Have you had a blind cat and/or a diabetic cat? How did you help your kitty adjust to her blindness? What’s your cat like now? Let’s share some stories of hope in the comments!