I Can't Smile Without You
... You came along just like a song
And brightened my day
Who would have believed that you were part of a dream
Now it all seems light years away
And now you know I can't smile without you
I can't smile without you
I can't laugh and I can't sing
I'm finding it hard to do anything
My favorite recording by Barry Manilow

In mid-October 2004 I received a phone call from our local humane society who wanted to make a deal with me. I was needing to quickly get five spay/neuter vouchers for a little feral mom, Boopsie, and her four newborns - Smut, Toffee, Spic, and Span; I was more than eager to bargain.
The president wanted to know if Craig and I would be interested in taking off their hands a six year old diabetic cat since they had no foster folk who had dealt with diabetic animals. Because I was experienced with Feline Diabetes Mellitus and know that the disease usually affects much older cats, naturally I was keenly interested. But first I had to make sure that I would be getting those vouchers! Indeed, and to sweeten my pot even more, Yvonne stated that the society would pay for the first year's worth of diabetic syringes with needles and insulin. It was an offer I couldn't refuse.
That out of the way, I was impatient to hear this little cat's story. I sat on the phone listening in disbelief. There are some people we share our world with who are beyond a waste of skin and usage of oxygen, but I'm getting ahead of myself.
An elderly lady up in her 80s, who lived down the street from Jeri, a good friend of mine and our local newspaper's pet column contributor, had hand-raised and tamed a three member feral litter: Sparkle, WhitePaws, and Midnight. The kittens were born June 12, 1998. The elderly lady had front-declawed all three cats (argh!) and had spayed/neutered them. She had gone into a nursing home two years prior to their coming to Jeri, leaving her next door neighbor in charge of the cats. When Jeri checked in with the cat sitter after the lady had passed away, she learned that the sitter hadn't actually seen the cats in nearly two weeks, nor had bothered to look for them. Somehow, the sitter had supposedly accidentally shut the three little cats into the guestrooms without food and water - sisters Sparkle and Midnight in one room and brother WhitePaws alone in the other. (DUH. Would not the obvious first two clues something was dreadfully wrong be uneaten meals and clean litter boxes day after day?)
By then the seldom seen kids of the elderly lady showed up and heartlessly flat out said they did NOT want the cats and were going to euthanize them. Jeri, avid animal lover that she is and a dog rescuer, immediately said she would take them. Then it took days before Jeri was able to get the cats, resorting to trapping them in humane traps inside their own home. Once getting the cats to her vet, she had to call our humane society because of the diabetes diagnosis of one little girl, Midnight. Jeri simply didn't have the time to deal with a diabetic cat, so between the two of them - Jeri and Yvonne - I was elected as Midnight's guardian.
I picked up Midnight at Dr Daniel Core's office in Bossier City. What a lovely little cat she was! She was a lovely Charteaux/Tabby mix with a rich, dark blue coat of dense, soft fur and large rounded yellow eyes. He gave me her medical history and off we went to, hopefully, a much better life stopping first at our Dr Steve's office to get her on our records.
Midnight was such a sweet-natured little girl, never once complaining about the daily injections, three times weekly ear-pricks for glucose checks, and oral meds. We were so thankful nine months later that we were able to eliminate the insulin and keep her only on prescription m/d feline food for diabetic management for several years.
But Midnight continued to have a very soft stool. We had all sorts of tests run and everything would come back negative. For years she continued to suffer with the soft stools and vet visit after vet visit. Her tolerance was the most remarkable of any cat or dog I've ever dealt with in my 45 years of animal rescue. Blood work, fecals, pokes, pricks, injections, pills and tablets and capsules crammed down her throat ... none of it ever seemed to phase her. She took it all without fuss or complaint.
She never got to enjoy being a cat due to her health issues all the years we had her. She had no interest in toys or playing with the other kittens and cats, though she never got into squabbles with any of our fully clawed cats (we do NOT declaw). She loved to lay in the window sills gazing into the front and back yards. She loved being stroked and having her ears scritched. She ate up baby talk and responded to our nicknames of Little Blue Angel and Little Blue Girl. She did NOT like to be held for more than a few seconds at a time, though. Of course, brushing her was the only time I got to really fawn over her. I'd drag it out for at least 30 minutes at a time since she enjoyed her grooming sessions (and this gave me the chance to hold her).
Shortly before the loss of our beloved Goblin, she began a rapid weight loss, dropping from her always 9 pound weight to 4.3 pounds but having a huge appetite. She was always hungry, always. We began to also notice that she was having problems eating and were finding small pools of bloody saliva on the kitchen floor after her meals. A mouth check showed that she was losing teeth and had one that was very loose.
We added CatSure (kitty Ensure) and NutriCal (a high calorie, low volume dietary supplement for dogs and cats who won't eat) to her prescription diet to help moisten the kibble and add additional nutrients to her meals. How she especially loved her CatSure!
I dragged out my cat manuals and did Google searches for Feline Exocrine Pancreatic Insufficiency (EPI), a disease I am very familiar with in dogs, but had never seen in cats. My research simply confirmed my suspicions that EPI must be what she had - pale yellow, very soft and malodorous stools, rapid weight loss, a ravenous appetite, and oftentimes, dental problems.
So we loaded up our little one and went to see Dr Steve before her check up was due. His blood work showed that she had a vitamin B-12 deficiency and when I voiced my concerns about possible EPI, he agreed but said that he needed additional blood work and would have to send it to an outside lab to positively diagnose. Unfortunately, that would take at least two weeks. I OKed the expensive TL1 test and took her home to start the three times weekly 10 units B-12 injections using a diabetic syringe. Remarkably, by that evening her stools had firmed slightly and had turned a reddish-brown.
It took nearly three weeks for the test results. It was the longest wait we've ever experienced and the test did show Feline EPI. She was put for life on PancreasPlus Tabs twice a day to assist her pancreas' normal secretion of digestive enzymes. In other words, it is a digestive aid in replacement therapy where digestion of protein, carbohydrate, and fat is inadequate due to EPI. I immediately had Drs Steve and Brad (Dr Steve's son who is also a vet and co-owner of our vet clinic we've used for over 35 years) provide me with their info to write the Feline EPI article for my then web site.
In the meantime, we had to constantly adjust the B-12 injections, finally settling on 4 units twice daily before her stools became firmly formed and dark brown in color. Her glucose levels were getting high again with us trying to build up her weight, so back on insulin she went, 3 units twice a day. She did gain weight during the test result wait - up to 8 pounds - such good news!
On July 3rd (my Craig's birthday), Dr Steve felt like she had built up a good infection resistance due to the B-12 injections and weight gain, so he extracted the loose tooth and put her on Clindamycin (antibiotic) twice a day for 10 days to ward off any gum infection.
We took her back a week later on July 10th for a follow up. He was alarmed at a two pound weight gain in one week and added canned m/d to her dry m/d. She had developed an excessive amount of belly fat. The gain was probably because of good, nutritious food, but diabetic animals need to really watch their food intake just as human diabetics do. He wanted to see her again in a month to check her weight and glucose level. Otherwise, he was pleased with her follow up.
After I gave her the two Friday evening injections, I placed her on the floor as I normally do, but her front legs suddenly gave out from beneath her. I'd never seen an animal's front legs give out, only the rear legs. I watched her stagger slightly, then she gracefully recovered herself and came back towards me in her always dignified walk. I gave her the evening PancreasPlus Tab and the Clindamycin, then went to feed the outside dogs during the fifteen minute wait before her meal. When I returned I found that she had vomited up the PancreasPlus Tab. Since she had never done that before, it did concern me a bit. But, she ate her meal with her usual enthusiasm, so I didn't think much more about it or the collapse of her front legs.
Saturday was pretty much a normal day for her. She took her meds and injections, ate, eliminated well, was part of the family during the day (between all her little catnaps), and once more after giving her the evening injections, her front legs collapsed. That really worried Craig and me, but she recovered nicely and went about her business as usual. She finished her last Clindamycin capsule with her daily PancreasPlus tablet.
Sunday morning was as normal as could be - no front legs giving way after her injections. When we left at noon thirty to grocery shop for my elderly mother and visit with her, then make a brief stop at my office, Midnight was in her usual napping spot. When we returned at 4:30 that afternoon, she wasn't anywhere to be seen. I went ahead and drew up the injections but couldn't find her. I noticed that our little Spic (another special needs cat we had) was nowhere to be found either, so Craig checked behind our 52" TV we had at the time to see if she'd sneaked back there. There Spic was, but no Midnight. Suddenly I heard a yowling back there and I checked to see what Spic's problem was. But Spic was popping out without a sound and I realized that it was Midnight making all the noise. She was trapped there and I couldn't get her out; Craig moved that big, heavy thing out of the way to get to her.
When he handed her to me, Midnight went into a brief seizure, all the while making swimming motions with her legs and shuddering. She must have swam a hundred miles before her final seizure. All we could do was wait and comfort her until we could rush her first thing to Dr Steve's office Monday morning. We would be there as the staff came in before hours.
I held her until she calmed down, but she seemed so dazed that I wouldn't leave her. Though her little gums and tongue were pink, I rubbed her gums with white Karo syrup in case she was in diabetic shock, but the seizures kept coming, so I was convinced that the seizures had nothing to do with her diabetes. Every 90 minutes or so she would cry out in a loud yowl, do the swimming thing, thrash around wildly, and immediately go into another seizure. She lost bowel and bladder control several times during the next few hours. I felt that something terrible was going on with her pancreas. Was it shutting down on her?
By the time Craig went to bed, the seizures were coming every 45 minutes. Her eyes were hugely dilated, she heavily panted, she cried out frequently though the loud yowling had stopped, she constantly salivated huge amounts, loudly hissed, and went right back into another seizure. Since she was salivating so much, I kept syringing a few CCs of water into her mouth between seizures hoping to keep her from dehydrating. I stopped shortly after one am Monday because she was no longer able to swallow. By two am the seizures were coming every 15 to 20 minutes. I felt utterly helpless and absolutely heartsick that I couldn't help her. Despair overwhelmed me. Finally I must have dozed off because at straight up 3 am she was already in the throes of a very, very violent seizure. This one would not stop. It went on and on and on, tearing my heart out with each thrust of her little legs. At 3:20 am she completely flipped over, let out a sharp cry, and was still. Our Little Blue Girl was gone.
I cried and cried, holding her on my lap stroking that luxurious, beautiful blue fur wishing that I could have helped ease her out of this life, that her passing would have been easy and peaceful. She didn't deserve so many terrible illnesses and the many drugs to stay alive, and she certainly didn't deserve such a horrible end to her brief life.
When Craig awakened and came into the great room where Midnight and I were at 5:30am, he thought she was simply napping and at rest. He was devastated to know she had left us. As soon as it was light enough, we went outside to bury her in our little backyard critter graveyard.
When I arrived at the office, I called Dr Steve. He was totally stunned and dismayed. She was doing so well and he had such high hopes for a few good quality years to come. He thought perhaps she had a series of small strokes that triggered the seizures and agreed her pancreas probably simply gave out.
The following morning I called Jeri to let her know. She was heartbroken. She had lost Sparkle to Feline Pancreatitis in 2007. Recent studies show that Feline Pancreatitis is now believed to be hereditary. So far, little WhitePaws has been in excellent health. Perhaps he will live a long, healthy life without suffering from pancreatic problems as his little sisters did. We can only hope.
How I miss our Little Blue Angel. ❤

Angel In The Sky
There is a star in Heaven
and on it is a place,
that's been reserved for you since birth
a place meant for your name.
This star has watched you through the years
but it could not stand alone,
it rested high on angel wings
awaiting your trip home.
You slipped away, I held you close,
your soul flowed through my heart,
I felt your last breath through my tears
I felt your pain depart.
Tonight I looked up to the sky
and there for me to view
was one lone star shining bright
your name was shining too.
You were my angel on this earth,
you're my angel in the sky.
Wait for me, someday you'll see
our names shine side by side.
~ Author Unknown ~