Puff's Story
by Pat Schneider

When we adopted Puff in 1990, she seemed like a normal enough three-year-old cat. A beautiful brown classic tabby, she was shy but sweet. She purred and napped and loved tummy rubs - all the little cat things.

Then, in 1993, she started drinking A LOT! We had never seen anything like it. She seemed to live in her water bowl. She slept next to it. She demanded ice every time the refrigerator door opened. And she urinated gallons. It was impossible to keep the litter box clean; she started urinating on the floor.

Of course, we took her to the vet. He thought that maybe she had a kidney infection. So we tried antibiotics. Unfortunately, she could not take oral antibiotics; they made her vomit. So we found injectable antibiotics. But still, she was worse and she was miserable. We changed antibiotics. Still no improvement. She lost a third of her body weight! There was no time or room for eating. There was only constant drinking. We thought we would lose her.

Puff was referred to a specialist. He suggested a water deprivation test. He told us it was dangerous and that because she had been drinking so much for so long, we would have to restrict her access to water for a few days before the test. We had to weigh her every two hours to be sure she was not dehydrating too much. She got very little water and had to be caged so she did not “cheat.” It was hard to watch. She suffered even more because she could not get to water. To make everything worse, the stress of restricting her water caused her to get an upper respiratory infection. Not only was she desperate for water, she also had a bad cold.

Finally, the water deprivation test was done. It had taken nearly five months to get a diagnosis: Puff had central diabetes insipidus (CDI).

The first time we gave her DDAVP (nasal spray used as eye drops), she didn’t drink anything for six hours. We called the vet: “It’s a miracle!” After eight hours, she was back in the water bowl. For the next year, she got eye drops twice a day. She used a bottle of DDAVP every 21 days. She put back on some of her weight and went back to faithful use of her now drier litter box. She started enjoying life again. But, since she didn’t have medical insurance, the DDAVP was a very expensive drug habit. And, with time, she started to need more and more of it. Maybe her mucosal membranes became scarred; maybe she just got very good at flinging drops out of her eyes! She ran when it was time for her meds making every 12 hours a small contest of wills that we always won!

By chance, we found a reference about DI in a veterinary text book. The authors mentioned injecting the DDAVP nasal spray subcutaneously instead of using it as eye drops. The amount needed for treating this way was about 1/10th of what we were using for drops. We called the specialist and soon were trying the injections. What we found when we tried it made a huge difference to Puff and to us.

The injections are much more effective at controlling the symptoms of DI for a longer time than the eye drops. They lasted from 12 to 15 hours. So, after a year of rushing home to medicate Puff, we were able to stay away from home a little longer; maybe even do something after work. Our lives seemed a bit more normal. Puff did not mind the injections; she didn’t seem to feel them at all. So, she stopped running from us. And, our cost for medicating her dropped to less than 15 percent of what it cost the first year. The injections were better for her and definitely better for us.

Puff is now 15 years old. She still gets her DDAVP (she uses the generic desmopressin actetate now) twice a day by injection. She has had some other health problems. She has a little kidney trouble and gets meds for that. She had a tumor on her liver a year ago. It was successfully removed and the surgery was pretty uneventful. We are hoping she will be with us for years to come.

Puff wants to share her experiences so others can learn without having to go through what she did. She has her own Web site devoted to DI (http://www.SurroundedByCats.com/dicentral.html) and frequently answers letters from people whose pet has or may have DI. And now, Puff shares the house with two other cats who have CDI - Ziggy, who has both DI and diabetes mellitus, and Simone.

Puff is certainly one of the lucky ones. But then, so are we!

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