18 April, 2011 at 8:46 pm #44668
Hello, I have been lurking (and occasionally posting) for awhile, but usually didn’t have too much to say. But now I think that I need some advice, or at least a sympathetic ear, from confirmed cat-lovers. (My husband said, “She’s nine years old, and we already spent 2K on her previous surgery. Maybe it is time to consider her ‘totalled’”)
My cat Polly is an estimated 9 years old, and was referred for an ultrasound to evaluate her kidneys after she was found to have high-normal BUN/creatinine levels and abnormally dilute urine in November. Well, I put it off because of holidays and stuff, and then in March or so the u/s showed two masses in her liver, one 2.5cm and one <1cm. Chest x-ray is negative, echo for her heart murmur showed some myocardial fibrosis. She is slightly anemic. Needle biopsy was non-diagnostic. So, the million-dollar question, to operate or not? I will have to draw out of my savings, sure, but it’s not like it is a choice between surgery or groceries. But what is the right thing for her??
Right now, she has a waxing/waning appetite and has been losing weight, but is relatively asymptomatic. The vets are pretty sure that these are tumors, whether benign or malignant. One mass appears about 0.5cm larger on repeat u/s one month later; however that vet said that she might live months to years before these masses got large enough to cause her trouble.
The surgeon feels that she may or may not be able to completely remove the smaller mass, because of where it is located. She thinks that debulking would likely extend her survival (assuming she does not have metastases that we don’t see on u/s). However, because of her age and comorbidities, surgery carries a 30% mortality rate up-front, plus risk of worsening her heart disease or pushing her over into frank renal failure. Also, she gets pretty terrified at the vets and didn’t eat for 24 hours after the biopsy-she hid when she came home.
Just background, I adopted my little tuxedo polydactyl as a “stray”; she acts semi-feral, however. She was NOT happy when I married and we became a multi-cat household, and was terrified by Catkin when we adopted him as a 10-wk old kitten. I thought about finding her a new home, but she has intermittent litterbox issues, and I was afraid that not everyone would be so patient; I only noticed it after my husband and his cat moved in, but still… She also walks with a wide-based hindlimb stance and occasionally runs into you if bolting, but shows no tremors and can jump to counters, etc. So I am not sure if she has a mild form of cerebellar hypoplasia or something else. They would have a neurologist look her over before surgery. In 2004, she had a bile duct obstruction and underwent surgery. She has an enlarged spleen, which showed extramedullary hematopoesis on biopsy. She also has chronic respiratory congestion, likely feline herpes.
If she dies on the table I’ll blame myself for killing her for the rest of my life. But can I sit there and watch her die of cancer without trying to do anything? I know that this is irrational, but I was worried about what would happen to her after I die, and now I feel as though I made her sick/she will predecease me. And I feel guilty that she hates living with other cats; during the day, she stays with Zappo up in the bedroom, but in the evening the other cats keep her cornered on the plant rack. (I bought her a heated bed to put there; I think originally she was attracted to the heated seed starting mat.) Whereas when it was just her an me, she would sit on my lap. I feel as though I have failed her. I just don’t know what to do.18 April, 2011 at 8:49 pm #657323
Is she in pain?18 April, 2011 at 8:57 pm #657324
It doesn’t seem like it; she doesn’t yelp if I pick her up or touch her anywhere. She’s always spent most of her time sleeping. The only difference really is that she often doesn’t finish her food anymore.18 April, 2011 at 9:04 pm #657325
These decisions are always personal and fraught with should’a could’a would’as
that we are truly unable to be much more than sounding blocks saying uh-huh at every full pause.
Perhaps this list will help you in this emotional mine-field.
Another site that may help you
Best of luck and follow your heart as far as it is possible.18 April, 2011 at 9:14 pm #657326
Her QoL is not bad right now. Except for the eating…and she will eat yogurt, baby food, etc. But if I am going to take a gamble on the surgery, the time would be now. Once she becomes symptomatic, her risk would be even higher, and the expected benefit much less, if any.18 April, 2011 at 9:18 pm #657327
Kiplings: I’m so sorry you have to deal with this decision, it’s never easy to choose between a surgery and humane euthanasia. I had to go through this myself in December, and even now I question if I did the right thing or not. I did have him euthanized because he had a diaphragmatic hernia that meant his intestines were in his diaphragm preventing him from breathing and eating. He was in a lot of pain. The surgery would have cost over $4000 and plus some. I cried over the next week and into a second week each day and night, having Duchess and Mr. DG comfort me. It was hard to decide, but in the end I had to decide, no matter what the advice everyone else gave to me.
I cannot tell what I think is best, but either way, I send you healing thoughts, and prayers.18 April, 2011 at 9:19 pm #657328
One added thought…Do (what ever you decided here) for Polly. Don’t do it for Kiplings_Cat.18 April, 2011 at 11:28 pm #657329
One question I have asked my vet is “if this was your cat what would you do?” Sometimes their answer can tell you a lot.19 April, 2011 at 1:06 am #657330
ditto to the others above!… ask a vet!…… and welcome to TDK, hope your baby is ok!19 April, 2011 at 4:50 am #657331
Has the vet actually said it’s cancer? Some tumors are benign. Ask the vet if there’s a possibility of getting a clearer diagnosis if she has another biopsy.
If it’s just a question of money, maybe you should ask your spouse how much money he wants you to spend on him or the kids in a similar situation.19 April, 2011 at 1:39 pm #657332
Hi KC – a tough decision indeed. Sending you strong healing and clarifying vibes.19 April, 2011 at 3:54 pm #657333
CBM, the vet and I discussed repeating the needle biopsy. He does not think that it would yield better results, as he did it under ultrasound and is sure that he actaully sampled the mass. They are cystic, so FNA does not necessarily give you anything except cast-off cells. They (multiple vets! Specialist plus surgeon) are pretty sure that they are tumors, but cannot say whether they are more likely benign or malignant. They do appear to have grown slightly in a month’s time (? more fluid) so they almost certainly will become symptomatic some time in the future, even if they are benign, because of their volume/mass effect. However, they can’t predict how long- I was told “months to years”.
Regarding the money, I am still working and have my own bank account. And my father offered to help if I need it. My husband comes from the kind of rural background where they let their cats roam around outside unneutered and they just “disappear” after a year or so…when his parents finally neutered a cat, he lived 10-15 years before being hit by a car. To give them credit, they then started neutering their cats and keeping them inside, so they did learn. (And they quit the alcohol, which isn’t usually associated with good judgements…) But still, my husband doesn’t really believ in taking them for 6 month checkups, thought the ultrasound was a gimmick to make more money off of us…you get the picture. I am disappointed in him; it seems that he thinks of our cats as just property. So it is really difficult for me to discuss it with him as I feel a much greater responsibility to them.
I guess that I could call our regular vet and ask her. The specialist seemed to think that doing nothing was better. The surgeon didn’t really reveal her opinion.20 May, 2011 at 4:02 pm #657334
Sorry I missed this thread earlier. I have you & Polly in my special thoughts & prayers. I too had a similar experience w/my Dot who has developed diabetes at her 15 years young age. Two of the youner/female vets suggested I give her a chance with a few meds & insulin to see how she does. The other elderly male vet suggested she is old & how much time/$$ is required with an end in sight anyway. Hmm, needless to say I gave her a shot w/her shots and take the next step when time comes. TLC hang in there hugs for you too!21 May, 2011 at 2:36 am #657335
if it was one of mine I would just keep them comfy till they let me know it is time. (I have made these decisions multiple times and would make the same decisions again) I would say no to surgery. Liver is a very vascular organ and cutting there has much higher risks of bleeding and with her other problems I wouldnt want to risk it. Also treating cancer is a terrible thing to watch. Very truthfully I would make the same decision for a human (alot of my views come from working in healthcare and seeing the results of treating things to the very end) that being said it is a personal decision and what ever you do has to be right for you and your baby. I hope this helps,
tkn21 May, 2011 at 3:22 pm #657336
Let me start off by saying you have done more for her than 90% of the worlds population would. Your a good mommy, its okay. You cant say your wronging her by living your life.
As for her health. Sweety she has things going wrong that can’t be fixed. She is never going to get better. She is never going to recover from the heart disease. You could put her threw 100 surgries and it wont ever fix her. I am so sorry. I really dont want to say this but I know you know, its all down hill from here.
If Polly were to die in the surgry on the table, Why would you feel bad? She would be peacfully asleep and never feel athing, there is no stress no nothing. There are much much worse ways to go. If she were to die on that table why would to blame yourself for killing her? If it wasnt for you she would probly be dead already. How long do you think she would last if you just stopped taking her to the vet? If you wernt doing (exuse the langues) a damn good job with her now, how much pain could she be in? You really are doing all you can for her.
I have an older kitty to and I know that your at a point where I will be soon. I dont know when its going to happen but its going to happen. Everyone dies you cant change that. So how would you want to go? If the rolls were reversed what would you want? Would you want to pull out all the stops and fight to the bitter end? Would you like to be made as comfortable as possible and just have the people that love you let go of you? Would you like it just to end short and sweet? Once you know how you want to go, sit with her. Just you and her. Look into her eyes and see if she looks ready to fight to the end. Does she look tired? Or does she just look like she is ready to be done with it? And ontop of all this, what is her quality of life going to be like? Not the other cats or your husband. How is she going to be feeling? How is this going to change her physiclly,emotionally,mentally?
None of this is your fault. You can’t blame yourself for something no one has controll over. This is what nature or god or fate or whatever has in store of all of us. Its going to be okay. Its just going to hurt for a while. At this point in her life you cant wrong her. You have stuck by her and loved her. You have cared for her and are will to continue it if need be. The one differnce that makes you such a good mom is that you are concidering if its what is best for her. You are putting her first, which I bet you do more than you realize.And putting her first is the right thing to do. Which means you cant blame yourself from here on out. Thats not putting her first. Feeling gulity about getting married or anything thats not putting her first. And when the end finally comes, you can take comfort in knowing you put her first and did what was right for her.
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