OT: Cat in critical condition - WWYD? (long)

[SweetTooth]

Hello,
I've noticed that there are a lot of cat lovers on this board. My family is facing a very difficult decision & I am looking for any advice, input, anything really. Here's our situation:

Our 13 y/o Siamese cat had a borderline diabetic incidence about two years ago that was resolved & he was put on a special diet. Recently, his appetite decreased & he was lethargic. He has done this every so often, especially during hot weather & he usually bounces back. We waited to see the same return to normal but over the weekend he got progressively worse. We took him to the vet who determined he was in a near diabetic coma & he is currently at a 24-hour emergency animal hospital for treatment of a severe diabetic ketoacidosis.

We are feeling so horrible about not taking him in sooner. We did not recognize the signs & feel SO guilty. We are trying not to think of that right now & focus on what he needs, but it is eating away at us!

Unfortunately, finances are something we need to consider. This is his 2nd day & we are at about $2000. After further tests, they've found that he's not a "straightforward case" b/c he has concurrent illnesses going on (pancreas & liver), which are related to diabetes (and his age), but that complicate his care. His prognosis is guarded & we are looking at a 5 day to possibly several weeks of hospitalization to get him stable enough to come home. We are looking at thousands of dollars. Even if he gets over this hump, he will be insulin dependent & it may be difficult to get the proper dose due to the other factors. On the other hand, he may be fine & live years w/o problems with just 2 shots of insulin a day.

So far, we have agreed to all treatment necessary. Our normally vibrant, super smart and incredibly social cat is very lethargic & unresponsive. It is so hard to see. Needless to say, we love this guy, but we don't know what we should do at this point. Are we doing this for us or for him? If we could get our incredible cat back, that's one thing, but we don't know what his future holds.

Thanks for "listening" & sorry for the long & rambling post. I'm not exactly thinking straight right now. Any advice or thoughts are appreciated.
Thanks,
Andrea

[Melanie]

I'm so sorry. We had to face a hard decision with our kitty, too, though her condition degraded more rapidly. It's hard, especially with the finances part. It's hard to put a dollar amount on how much you love your family member. I think we actually had to sign up for a vet credit card.

Anyway, I think you just have to discuss with your vet and your Dh what the realistic prognosis is for your kitty to continue to live a happy existance.

[holliam]

Andrea, I am so sorry for this! Hugs to you and your cat. It's obvious how much you love him.

I can't offer any good advice because I know I'd put us into debt to save one of our cats, and I feel stupid telling anyone else to do that. Also, we lost my favorite childhood cat due to a similar illness. I left for college and my parents were not as aware of his health issues. It hurt a lot and made me perhaps a bit more vigilant about doing anything I could for future kitties.

We have 4 older cats, and 2 of them are medically needy. One of them is diabetic, and she has been now for about 4 or 5 years. So, I can speak to what life is like with a diabetic cat.

It has taken a while to get her insulin regulated, she has shots 2x daily, and she have to be tested often. Yes, it does cost $$ for her insulin and testing, etc. But, she is doing so wonderfully. She has had no other health problems and even at 13 she still runs around, plays, acts like a kitten at times.

Good luck with your decision. I know it's a hard one.

Holli

[amp]

I'm really sorry you're dealing with this. Seeing a sick pet and not knowing what to do are the hardest things to deal with. There is no right answer here. There's only what your family can do. If you had taken on a cat and couldn't afford to get him the essential care he needed with a minor illness because of finances, I'd say that was a problem, but you are talking about a serious illness, with an unknown outcome and scads of money. You have to decide if you can afford it and weigh that with his possibly quallity of life after all is said and done. It is obvious how much you love him and whatever you decide will be right for your family. No one could or should judge you for that. And FWIW, that cat knows how much you love him and that you would have protected him if you could have. And you have given him a long and happy life, whatever happens.

Good luck making a very difficult decision! Hugs to you.

[kath68]

I am so sorry you are going through this. It is hard to give advice on these kinds of things, it is such a personal decision. But as pps said, the cat knows you love him and have his best interests in mind. If you go with your heart, you will make the right decision.

The only thing I can add is that sometimes the cat can act as your guide. What will be the quality of life for him? Is he the type that takes to medical intervention well (shots, pills, etc)? My cat hated it, so even taking a pill everyday would compromise his quality of life. Would your cat want to be fussed over? Would his quality of life be what he would want?

Also, don't feel bad that money is a factor. Of course it is.

Hugs to you. It is a very difficult position, but have faith you are doing what is best for your family and your beloved cat.

[kransden]

I really think you have to look into your heart and ask yourself are you doing this for him or for yourself? How would you feel if you were the cat? You're old, sick, scared and separated from your home and family for weeks on end. The strange people are poking and sticking you with a needle making you more miserable. Is it worth putting him through all this in the chance he might get better? Some people would say "Yes, I have done everything I possibly could to help him." Others would say "No, I would rather he go now with his family holding him. In the wild this would be his time." Will you look back next year and feel bad you didn't spend enough money on the cat, or will feel bad you put the cat though all that stress? There are no easy answers to end/quality of life issues. You just have to do what you think best for your kitty.


Karin and Katie 10/24/02

[mudder17]

Oh Andrea, we've been in a similar situation with 4 of our cats, except their illness was of the kidneys/heart. One of them died suddenly at home, when she was only 2. In her case, she became partially paralyzed, but after an hour, she regained the use of her limbs. We rushed her to the vet, and they ran some tests, but couldn't figure it out right away. She was acting totally normally for about 2 weeks, and then it hit again. This time the paralysis crept up her bottom half until it reached her heart and she did die. Autopsy showed that it was her heart and kidney. In this case, we did not need to make a decision, but we were still devastated. 8 years later, another 2 became sick, but it wasn't quite the same. We started them on fluids (sub-cutaneous) and lots of tests when they first became sick (lost weight), but one of them got worse and worse and eventually, he died in the emergency room. :( We didn't end up having to make any decisions for him, but we wished we had been there with him. The next one did very well with the fluids and medication, but she eventually got so bad that she was going to die in the ER if we didn't have her put down. So we made the difficult decision of putting her down so that we could be with her. This was after speaking with the vet and making sure we understood her prognosis. It was very difficult, but we also knew that she was still happy (she still purred if we held her and petted her) and we didn't want her to die alone in the ER like her brother. Then our final cat in the bunch (all 4 who died came from the same cattery) started showing the same symptoms a few months later, and we knew it was inevitable, but we started by keeping him as comfortable as possible and we initially tried the sub-cutaneous fluids, but in his case, it really made him unhappy. His disease also seemed to progress much faster than with the girl, so we eventually did make the decision to put him down, because the treatment made him suffer (he really would freak out) and he just was so lethargic and not terribly happy about the whole ordeal. Also, we knew it was inevitable in his case, and there was nothing that could be done with him to return him back to a relatively normal life.

I agree with Andrea--you need to sit down with your vet and talk to him about what your kitty's chances are for a normal life. And you need to weigh that with how much it's going to cost and all the other pros and cons. We did end up spending thousands of dollars to test, treat, and extend our kitties' lives, but we are similar to Holli in that if it would help save their lives, we would put ourselves in debt. But once we realized there was nothing that could be done to improve their quality of life, we made the difficult decision to put 2 of them down. Each decision was different, though, based on the cat and their particular prognosis. I am so sorry that you have to go through this right now--no matter what, it's going to be very difficult for you. But remember that your cat has had a wonderful life with you and he knows that you love him very much. That is not going to change no matter what. My thoughts and prayers are with you.

Hugs, Andrea!

Eileen

http://www.mothering.com/discussions/images/smilies/candle.gif for Leah

http://www.gynosaur.com/assets/ribbons/ribbon_gold_12m.gif , 17 months & counting


http://tickers.baby-gaga.com/t/catcatcvi20040222_4_Kaya+is.png

[ribbit1019]

I know what I would do in your situation, but it isn't my Zoe that is in the hospital. So could I give you a straight forward answer? No.
Zoe has to have bowel surgery when she was two years old. The vet was convinced that she was going to die, and after the surgery said she was a miracle cat.
The surgery and emergency vet services cost only $500, nothing compared to $2K and I still nearly had a heart attack. It is hard to let a loved one go though and you want to do all you can for them. And I am glad that I forked over the cash, via a loan from my parents. But I would talk to your vet about the recovery and quality of life after the treatment. And see what decision you can come up with from there.
Hang in there!

Christy
Maddy - weaned at 13 months

http://lilypie.com/baby2/040609/3/4/0/-5/.png
Baby Grew! Yay!
http://lilypie.com/days/060301/4/0/0/-5/.png

[psophia17]

Let me temper this by first saying I grew up on a dairy farm with a highway that ran between the house and the barns, and without the funds to have extensive medical interventions for those barn cats.

There was nothing quite so horrible as seeing a well-loved cat, which every barn cat we had was, losing a battle. We had a little hospital set up for them, and three small children (my first memory of doing this was before I went to kindergarten) would sit with the cat, feed the cat with an eye dropper, and basically do whatever we could to make the cat better. 99% of the time, it didn't work, but the 1% of the time that it did was amazing. Every cat that didn't make it was lovingly buried, with funeral, in the flower garden, and if the cat did make it we carefully journaled the treatment that worked to try next time.

After years of this, the truth that I work with as far as medical intervention for pets that I live by is that I don't want to put them through agony of any kind. If there's a good chance that the cat gets better, and will live a long and healthy life after treatment is over, then I would go for it. If it isn't going to be a long life, no matter what I do, then I don't try to prolong it any more than necessary. I have seen enough animals live with pain, and won't do it to an animal that I love.

When I first moved away from home, my beloved 8-year-old dog, Heidi, started acting funny. Mom took her to the vet, and she was diagnosed with liver cancer. The vet gave Heidi 3-6 months with treatment, or 2 weeks without. When my brother, sister, and I found out, we all made our way home, and the vet was called to come euthanize (since we lived on a dairy farm, the vet would come to the house). Within 1/2 an hour of us all getting there, about 10 minutes before the vet arrived, Heidi died. Seeing her pass, seeing her pain come to an end, was almost a relief. As sad as we all were, it was better for us to know she wasn't in that pain than it was to see her suffer. She lived long enough to say goodbye to her family, and then left us. I will always have that memory of saying goodbye to her, and will always know that even if we had had her euthanized, it would've been the right decision - she was ready to go.

I'm sorry you're going through this - I hope you can come to a decision quickly and easily, and that whatever decision that is, it is the one you can live with best.

[NEVE and TRISTAN]

I don't have any advice...it is so hard to know what to do for our animals and so unfair that such huge cost are attached to saving our furry members of our family.

But I did want you to know our thoughts are with you and to keep us posted...


Neve
Reichen (6), Karsh (3), Tristan (2) and baby girl Bronwyn born March 10th!!!!

[KBecks]

If your cat has stabilized and is not in immediate danger, take your cat from the emergency facility to your regular vet for treatment.

I got a quote of nearly $2k to treat my cat's kidney problem (give him fluids for 2 days). I said I wanted him to be treated by his regular vet. Cost at regular vet? Under $300.

Unless your pet is in immediate life-or-death danger / trauma, you will most likely save money at your regular vet, who can also keep the cat overnight, etc.

Talk to your vet and see if he/she can provide the ongoing care.

Good luck,

[KBecks]

Just wanted to mention that the animal emergency hospitals can go a little crazy with the testing, etc. etc.

For example, when our cat was there, they recommended some extra sort of diagnosis procedure. When I talked to our regular vet about their recommendation, the reply was -- your cat clearly has kidney disease, I've seen dozens of cases of kidney disease -- you can spend the money ($100+) on the sophisticated testing, or we can treat what we are 99% sure we know and monitor the progress.

We saved the money and I was glad for that advice. Our cat now eats special foods which are expenisve but manageable, and the vet showed us how to do some treatment at home. Thankfully our cat did well and now doesn't need anything but the special food.

Again, good luck to you and your beloved cat.
Karen

[amp]

Okay Petra, I'm crying reading your story. Besides being a huge animal lover, I've got hormones coming out the wazoo, so you can imagine!

[jasabo]

Oh Andrea, I'm so sorry. We're dealing with this right now with our 2 dogs and it's a gutwrenching decision.

My thinking is this - as is the case with my two dogs (11 and almost 14 yrs old), your cat has lived a long and probably very happy life. Right now, he's lying in a strange place away from his family and not feeling good at all. What a scary thing to go through for such a long period of time.

For me, I don't want my pets' last experience to be in a vet's office, totally freaked out. I want them to be home with their family. If it were my dog in your cat's situation, I'd bring him home with me, get meds to make him comfortable and if he doesn't die on his own then I'd call a vet to come to my house to euthanise him when the time came.

Yes, there are lots of "what if's"...he could live to be 20 yrs old. But he's already 13, he's got diabetes and probably already has some health issues related to that, which will complicate things in the future, and he'll require ongoing medical care if he lives. My dad's dog has diabetes and they've had a terrible time controlling his blood sugar. He gets insulin twice a day, eats a very restricted diet and has still gone completely blind and has other health issues. So it's an ongoing battle.

And, I know it sounds callous, but money is a consideration. We just shelled out about $4000 for chemo for one dog. It bought us a few more months, but she's stopped responding to chemo and her lymphoma has returned. Now we're just waiting... The onco said we could try another protocol, but I decided to stop all tx b/c going in every week was very traumatic for her - she HATES the vet - and I wanted her last weeks/months to be all happy. And yes, money played a part too. Spending $1000 a month for up to a year would have been tough for us. If she were younger and had a better prognosis, I'd have done everything possible. But at 11 yrs old with a not so good prognosis, I decided to stop tx and keep her comfortable and happy.

Anyway, do what feels right for you. Also, get a second opinion. That may make your decision even easier, if you have a more complete picture.

Hugs to you.

Lisa - mom to 2 yr old twin boys

[SweetTooth]

Thank you all for your posts, thoughtful comments, advice, and for sharing your stories. I've been crying all day & cried more reading your touching stories! I appreciate the advice about focusing on what our cat will tolerate & quality of life issues. I also appreciated hearing about how emergency hospitals tend to go overboard with tests, etc. I definately got that sense after talking with them a few times.

Update: Earlier today the vet reported that there were some negative changes & our cat was still not eating. We seriously considered euthanasia & went to visit this evening prepared with questions & for that possibility. We didn't know it, but he had a good rest of the day and to our surprise, he was much perkier, meowed stronger, and we were told he started eating just before we got there! So we are optimistic & waiting to see what tomorrow brings.

Thanks again for your thoughts, comments & stories!

[HannaAddict]

I'm so glad he is feeling better. And I totally agree with pp's to get him out of the emergency vet asap. They are much more expensive than a regular vet and I think for something ongoing you will get far better care at a regular vet. I hope you have or can find an ethical, caring vet that you can entrust your kitty too. Hope things keep going better.

Kimberly
DS 3/18/04

[mudder17]

I'm so glad he seems to be doing a bit better. It sounds like you'll have to play it by ear, day by day.

Valentine, Picasso, Papageno and Calpyso send him their meows. :)


Eileen

http://www.mothering.com/discussions/images/smilies/candle.gif for Leah

http://www.gynosaur.com/assets/ribbons/ribbon_gold_12m.gif , 17 months & counting


http://tickers.baby-gaga.com/t/catcatcvi20040222_4_Kaya+is.png

[ribbit1019]

I'm glad he is feeling better Andrea!! I hope things continue to look up!

Christy
Maddy - weaned at 13 months

http://lilypie.com/baby2/040609/3/4/0/-5/.png
Baby Grew! Yay!
http://lilypie.com/days/060301/4/0/0/-5/.png

[amp]

Glad to hear he was feeling a bit better. I hope it continues.

I, too, have found that the emergency vet we have locally is crazy with the fees, testing, etc. For us, the bottom line has become, okay, if he does have such and such problem, how will we treat it? And then go with that rather than testing for a hundred different things. And there are times when we've just insisted on taking out animals home once they were stable, even though the specialists wanted to keep them, simply because of funding. Trust your gut on whether you should pull him out of there or whether you regular vet can offer the same care. I know my vet can't offer 24 care when it really is needed.

Hugs to you. Please keep us posted on your kitty's progress.