Here's Mimo. He and his house-mate Perry are boarding at the clinic for a few days. "While they're here I want to get their vaccines up to date, and Mimo needs his teeth cleaned. He has really bad breath." The admitting staff asked if he had any other problems. "Well, he vomits a lot, but he seems to feel good. He eats really well." The owner okayed pre-anesthetic blood-work before the dental, signed the release forms, and headed off on vacation.
When I did Mimo's physical exam, he did look pretty good, except for the periodontal disease. Several teeth have been lost and the gums are really inflamed around those that remain. Here's a funny thing: the last time we saw him (two years ago), he weighed over 15 pounds. Today, 11.9 pounds. That's a 20% weight loss… and he vomits a lot…(but "he feels good"). Maybe we ought to do that lab-work right now.
I've had a surprise diabetic patient before, and here's another one. His blood glucose was 460mg/dl. It shouldn't be over 150. Let's check a little urine, and it's not only full of sugar, it's full of ketones, as well. That's those two really dark pads at the bottom of the dipstick. They ought to be the same color as the pads on the left, rather than dark brown. Full of ketones is bad.
When you can't utilize sugar for energy, you lose it in the urine. You also have to have something else to use for energy. So you break down body fat and use fatty acids for energy. That works, but if you do too much, too fast, the waste products from that process (the ketones)can make you really sick. Fortunately, Mimo still "feels good", still eating well, so we're not in the crisis that we could be in.
We've started Mimo on insulin injections and his prognosis for a normal quality of life is great. I've got to talk to his owner about something, though.
My notes in the record say that Mimo never goes outside. I've got to wonder about who's changing the litter box. This cat put out four ounces of urine during the night. He has to have been soaking the litter-box. I would think somebody would have been concerned over the fact that the cat is peeing like a race-horse. The owner must have a maid.
That excessive water-drinking and urination completes the classical picture of the diabetic patient: big appetite, weight loss, excessive water-drinking and urination (usually the first thing you see).
Oddly, in obese cats who develop diabetes, sometimes the first thing we see is vomiting when the ketones go crazy. The cat hasn't lost weight, no change in the water intake/output.
Mimo is a little more on the classic lines. Me, too. I look like Michaelangelo's "David" (only not so muscular and good-looking).