Just days before his trip to the vet, everything with Zee seemed fine. This is him with his beloved girls – daughter Peanut, “wife” Zoey, and daughter Mia.

Cats have always had the reputation of being mysterious. Egyptians believed them to be magical creatures, capable of bringing good luck to the people who housed them. They are also notorious masters of disguise, especially when it comes to hiding weakness or pain, including chronic conditions like dental, kidney, and heart disease. This goes back to their existence in the wild when trying to avoid attracting the attention of would-be predators, and even a purr, which humans consider a sign of contentment, can be a signal the cat is in pain. All this means pet guardians may not immediately see physical signs that something is wrong, bringing me to the story of Zee and his emergency trip to the vet.

Zee is 15 and has been showing the signs of his age – some weight loss, decreased physical activity, a bit crankier around the other cats, sleeping more, and less consideration to grooming. But that said, cats can live well into their 20’s now. He’s still mentally alert, he still enjoys playing with his plush toys, and he still has a good appetite. But on the morning of December 9th, something was clearly wrong. He was drooling – something he’s done in the past, but the drool had a pink tinge to it. He was also extremely lethargic with that far-away, vacant look in his eyes that those of us that have lost a cat know only too well.

It was one of those crazy days for me. I had remote meetings scheduled all day for a major military contract the company I work for was trying to secure. And Dan was working, too. And much as we want to be responsible pet guardians, we’ve also gone through some very traumatic times in our past, and that knee-jerk part of the brain that doesn’t want to deal with reality and reliving painful memories was desperately trying to convince us everything would be okay with Zee.

But we knew it wouldn’t be, so choked with tears, I made the call to the vet asking if we could come right away. Zee was our special boy – he trusted us to provide him with the best quality of life possible – and we had to find out what was wrong. Especially if he were in pain, and even more so, in case we could do something to help him get better.

Zee in his Sleepypod carrier, drooling profusely.

We easily picked up his frail body and put him in his Sleepypod carrier. There was no hiding, no struggle, and no fuss from him like he might have put up in years past. When we got into the car and Dan started driving, I unzipped the top of the carrier to pet Zee and he perked up instantly, popping his head up in amazed bewilderment, absorbing the sights and sounds around him like a dog taking a ride to the beloved park. He was fully alert and that’s when we knew he had lots of fight left in him and the fears Dan and I didn’t want to think out loud began to quietly turn to hope. Somehow together, we’d figure this out.

As per our current COVID world, we parked the car and called the office for someone to come get Zee to begin his exam. The vet tech came out in her mask and asked what seemed like a million questions while we were in the car – was he drinking water excessively, was he using the litter box, how was his appetite, how long had he been drooling, and so on. Based on our answers, she thought it could be a thyroid issue and after thinking about it, I realized he had been drinking a lot of water lately, but I did not think to connect any dots. I’m good at understanding cat behavior issues, but medical ones are outside of my area of expertise.

It’s not unusual to see Zee in the guest bathroom as that’s where we keep Mia’s water bowl. Here’s Zee hanging out with buddy, Kizmet.

I reflected – we have eight cats and one of them, Mia, eats separately each day in the guest bathroom to keep away from the others who bully her and steal her food. She also has her own water bowl and Zee loves drinking from it. I just attributed it to the novelty of the location, but the conversation with the tech opened my eyes to the possibility he was seeking more water sources, so maybe he was drinking excessively. But obviously, everything was speculation until he was examined, and blood is drawn.

She took Zee inside and Dan and I waited patiently in the car for someone to come back with some news. We held hands, I cried a bit, and finally, after what seemed like hours, the vet herself came out, telling us they found an exceedingly high level of glucose in Zee’s urine – 330mg – and that he had diabetes. A simple carbohydrate sugar that circulates in the blood, glucose is a major source of energy for the body, and normal levels for a cat range between 75-120mg.

Waiting in the car for the vet to come out and talk to us about Zee’s examination results.

Dan and I were stunned. We never even considered diabetes and listening to the vet explaining to us how to manage the glucose, inject insulin, diet, etc. was overwhelming and daunting. She invited Dan and me inside (with our masks on, of course) and since the office was closing and she was staying late for us, we gratefully came inside so she could teach us how to do things like draw blood from a vein in Zee’s ear each morning (and maybe twice a day, depending on the results) to test his glucose level (necessary to begin a journal and history of levels to determine the proper insulin injection amount), how to lift the skin from Zee’s fur to create a pocket to inject the insulin, and more.

It was terrifying, but Dan was a trooper, watching everything the vet did and even practicing on Zee. We were not happy with the prospect of pricking our sweet boy every day with needles, but if it would make him feel better and give him more time with us, we were prepared to do it. The vet gave Zee his first insulin shot – 1 unit – as the starting point to determine his needs, but there were still puzzle pieces to manage too, like the drooling. Did Zee need dental work? Did he have an infection? And they also felt a small lump on his thyroid. What did that mean? But the vet wanted to manage one symptom at a time to make sure we were on track, so controlling the diabetes was our first task.

I’m so grateful for all the extra time and attention our vet gives us when it comes to our beloved cats.

We came home armed with what seemed an arsenal of medical supplies – a case of specially formulated canned cat food to manage glucose, insulin syringes, vetsulin, and a glucometer and test strips to draw blood. We were exhausted but relieved we at least had a direction. The other cats immediately went into distress mode, reacting with hisses and fighting to the strange smells Zee brought home. Zoey actually went into hiding for the rest of the day, but Zee was thrilled. He had a bounce to his step, almost as if telling his catmates of a great adventure he went on, and he ate his new dinner with an invigorated gusto.

He was in good spirits the rest of the night and he happily ate again in the morning. Dan began day 1 of what would become a daily routine – pricking Zee’s ear to draw blood to test on the glucometer. The vet did not want us to give any insulin if the level read 250 or below, preferring to monitor the situation a bit more, and after an exceptionally long, unnerving bout of trying to find Zee’s ear vein and draw blood, we were shocked at the glucometer reading – 102.

My vet had given me her private cell phone so she was always accessible and when I called her, she was pleasantly surprised, confirming that yes, we were not to give him a shot that day but to draw blood again the next morning. She said, believe it or not, that the insulin shot may have boosted his system and he might not actually have diabetes, despite the glucose levels the day before. She said diagnosing a cat is not always as apparent as it might seem on the surface and using a blood test to diagnose diabetes isn’t always straightforward, because cats under stress, such as from the experience of the veterinary visit often have high glucose concentrations in their blood (called stress hyperglycemia).

And even drawing blood from a cat’s ear can alter test results because it can change their temperature reading. But Zee had high glucose levels in his urine, too, making his diagnosis a bit more puzzling and she didn’t want to rule diabetes out completely. Day 2 Dan drew blood again, this time he was more confident in his approach and the reading dropped to 90. With this news, we called the vet, and she felt the next course of action was to concentrate on the thyroid, especially since she had felt a lump. And Zee was still drooling severely, with his jaw elongated, so we decided an antibiotic was in order in case there was an underlying infection in his gums. I gave her the go-ahead to run a thyroid test and we got the results back rather quickly that he had a high reading – 5.3 – which meant a hyperthyroid. This made sense – the symptoms of hyperthyroid and diabetes can be similar – weight loss and an increased water intake.

I feed the cats 3 times a day, starting with Zee, his special food, and his pill hidden in a ball of cheese. It typically takes me about a half-hour from start to finish to feed my gang, which includes food prep, getting each cat into the proper room, scooping litter, and washing the food dishes.

Unlike diabetes, the treatment plans can vary, from surgery to a specifically managed diet, to medication. Bringing Zee in for a further examination, we settled on a two-prong approach – clindamycin drops for the drooling (with possible periodontal work down the road) and methimazole for the thyroid. We would start with a ¼ pill, twice a day to see if there were any adverse symptoms, such as lethargy, loss of appetite, and vomiting. If one of these side effects occurs, medication is discontinued until the symptoms resolve. If the pills worked, they would probably be required for life, and the main goal now would be to get Zee to gain weight.

So, day 3 began as such. Mix a pill into Zee’s food (easy – a ¼ pill is tiny, especially hidden in a small ball of cheese) and lock him into our bedroom, alone, to eat his food undistributed. After that, an oral dose of the clindamycin drops and off to the scale to weigh him. He started at 9 pounds and a full week later, we are ecstatic to report he has gained a whole pound!

The best news? Zee is back! He’s got a kittenish spring to his step and he’s playing with his plush toys again. He still naps most of the day, but that’s okay, he deserves to sleep in if he wants. His appetite is fantastic, and he licks his bowl clean. He also loves the special treatment – I prepare his food dish before I do for the other cats and when I say, “Come on, Zee,” he follows me to the bedroom with a puppy-dog prance, tail held high, with a look as if to say, “Look at me! I’m the king of the castle again!”

We know it’s not over and we’ve learned our lesson to be particularly diligent, monitoring everything, as even the tiniest change in behavior can signify something. He also needs to go back to the vet at the beginning of the year for a follow-up exam and to retest his thyroid reading. And we still can’t completely rule out diabetes. But for now, everything is great and that’s the very best gift I could have ever received for Christmas this year.

Zee’s favorite napping spot is under our faux Christmas tree. He seems to love the colors and warmth of the lights.