xiphias: (Default)
xiphias ([personal profile] xiphias) wrote2007-03-30 09:16 pm
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A bit more about the Boopsie

So, we took her to a vet for an ultrasound to get some idea of what is happening, and how she is doing. Most of her internal organs look pretty good, but she's not eating. The vet suggests GI tract disease of some sort -- an inflammation in her intestines that is making her not want to eat.

She's got a very high heart rate (260 bpm, about, and about 160 is normal for a cat -- some of that was "being poked and prodded by vets", but not all of it), and high blood pressure. Those are related to her overactive thyroid, of course, and need to be brought under control. And she's not eating.

So . . . if we can control whatever's going on in her GI tract well enough to get her to eat, and if we can bring the metabolism under control, and the hypertension under control, then she may have a few more years in her.

Or not. We don't know, and maybe CAN'T know.

And the thing is -- this gets expensive.

So we now we have the awful task of trying to balance "quality of life", "quantity of life", and " time and money". What CAN we give her, what would she WANT us to give her, what are we going to do?

In some ways, if she curled up next to us tonight, and went to sleep purring and happy and warm and loved, and didn't wake up, there would be ways in which that would be good. At some point, and I hope it IS years away, we're going to have to make the choice of putting her to sleep -- I know a few cats who died of misfortune, but I know more who died because they became sick enough to be in enough pain that their people chose euthanasia for them. And part of me doesn't ever want to be in that position, and wants Boopsie to die a comfortable, peaceful, natural death, loved and at home.

But I don't think that's realistic. I think what we're actually looking at is choosing between expensive and labor-intensive care for the next several years, and eventually euthanasia (which is what many, many of my friends have done, and so I'd feel AWFULLY guilty if we didn't choose that), or palliative care for a shorter period of time, and then euthanasia.

What I WANT to happen is for Boopsie to wake up tomorrow miraculously cured. But I'm not really expecting that one.

[identity profile] beaq.livejournal.com 2007-03-31 01:20 am (UTC)(link)
{hugs} and {pets}, to whom they are appropriate.

[identity profile] pocketnaomi.livejournal.com 2007-03-31 01:45 am (UTC)(link)
What your friends have chosen has nothing to do with the case. They are the arbiters of what they can do, what they have to give. You are the arbiters of what you have to give. You can't give more than you have. There are some limits that a reasonable person accepts when they adopt a cat -- one doesn't choose euthanasia because one has redecorated and doesn't want cat hair on the new furniture, or somesuch -- but you're already a long way past that minimum.

Sometimes they surprise you, also. I had a ferret once with pancreatic cancer... almost a universal for male ferrets if they live long enough, but he was fairly young for it, only about 3. The vet told us that there was a $1500 surgery which might make it go away, thereby letting him live a normal ferret lifespan of about 5-6 years... or might kill him on the operating table; these things could be tricky. Or there was a medication which was less expensive, and might keep him alive for another 6 months to a year. We chose the medication, after ascertaining that the slow deterioration involved wouldn't cause him pain... he'd just get sleepier and less active, and eventually wouldn't wake up. Well, that's what happened, but it took more than three years. He was a nice old ferret before the morning he fell asleep for good. No way we could've predicted that, when what we thought we were giving was basically palliative care with perhaps a bit of a slowdown effect.

Good luck with your kitty, whatever you decide.

[identity profile] felis-sidus.livejournal.com 2007-03-31 02:10 am (UTC)(link)
I want Boopsie to wake up tomorrow miraculously cured, too. But what I want even more is for her not to suffer. And both the choices you describe achieve that. There is no one right thing to do in circumstances like these. Just because one approach is chosen by a lot of people, or even most people, that doesn't mean it's the best choice for Boopsie and for you. It all depends on so many things, many unknowable. You do your best to balance everything and trust that whatever decision you make will be the best one.

Unfortunately, I've learned from experience that no matter what you do, later on you'll probably feel guilty and/or worry about it. Every person who's made the choice to have a loved pet euthanized worries that it was done too soon or too late, or shouldn't have been done at all. Every person whose loved pet dies naturally at home worries that maybe they missed some symptom they should have noticed, or maybe they should have chosen euthanasia at an earlier point. It's all a miserable part of the grieving process.

I tell you this in hopes that, even if I can't spare you the feelings, at least I can give you the understanding that the feelings don't have any factual basis in the decisions you make. I wish I could make it easier! *hugs*

[identity profile] vvalkyri.livejournal.com 2007-03-31 02:31 am (UTC)(link)
Oof. :offers hugs: for want of useful words.

[identity profile] bikergeek.livejournal.com 2007-03-31 02:55 am (UTC)(link)
You and Lis are good people, with Boopsie's best interests at heart. Whatever decision you and Lis make together will come after long and careful consideration of the facts at hand, and will be the best decision you can make for Boopsie given the situation.

Boopsie is lucky to have people like you and Lis.

[identity profile] mattblum.livejournal.com 2007-03-31 03:17 am (UTC)(link)
*hugs* to you and Lis. Boopsie is lucky to have people who love her so much taking care of her.

[identity profile] vonandmoggy.livejournal.com 2007-03-31 03:31 am (UTC)(link)
Von and I are thinking of you...*hug* Boopsie is very, very lucky to have you as a friend.

[identity profile] griffen.livejournal.com 2007-03-31 03:55 am (UTC)(link)
:( I'm so sorry that your kitty child is going through this, and that you have to go through it with her.

I would say palliative and then euthanasia is probably going to cause Boopsie less discomfort in the long run... but I know that's painful to contemplate.

Thinking good thoughts for you all.

[identity profile] burgundy.livejournal.com 2007-03-31 05:13 am (UTC)(link)
Man, is this a process I know well. I actually didn't give it as much thought as you are - it was more like my brain went "My kitty! Of course I'll do anything for my kitty!" And while if I had it to do over again, I'd probably make the same choice, it was really, excruciatingly hard. By the end, I couldn't go out of town, or even spend the night anywhere but my apartment, because she needed her meds and her sub-q fluids. The financial aspect, significant though it was, paled next to the physical and emotional cost. You're not just weighing her quality of life; you're also weighing your own.

You have given Boopsie a good life thus far. I think pretty much whatever you decide, you can do it guilt-free.

And one more thing - in my experience, hypertension and hyperthyroidism are actually pretty easy to control. Eliza got medication for her thyroid that came in flavored chews, and she loved them. They were like treats for her. And they worked really well, although it did take a little while to find a balance between controlling the thyroid and making her puke. She never lost her appetite, though. And the blood pressure meds, it depends on how easy the cat is to pill. If it takes half an hour of wrestling and cursing, that's a different story.

Good luck.
gingicat: black cat - why are you disturbing me in my throne basket? (tired/stressed - Andromeda-basket)

[personal profile] gingicat 2007-03-31 02:12 pm (UTC)(link)
Ouch. *hugs*

(Anonymous) 2007-03-31 06:12 pm (UTC)(link)
When Clyde was diagnosed with feline diabetes, I was told by the vet that he would live for about three more days and have a slow miserable death. The decision to put him to sleep was easy, so that he would avoid the pain. The difficult part was that Dad, Lis and Josh did not get to say a final goodbye. You will do what is best for the Boop as long as she lives a comfortable life.

[identity profile] deerdancer22.livejournal.com 2007-03-31 06:26 pm (UTC)(link)
Do you feel you have a vet who thinks out of the box? Would it be worth it to get a second consult? You could bring all the test results with you. Down here we have holistic vets that use herbs and diet, etc. in addition to regular medicine.

I know with dogs and GI tract yogurt is almost always good to make sure they have good bateria there. I don't know about cats but it seems anything GI would have holistic methods that could at least compliment the medical model.

Sending all three of you love and prayers of healing.
spiritdancer: (Default)

[personal profile] spiritdancer 2007-03-31 08:50 pm (UTC)(link)
Hmmm ...

From a DVM who hasn't seen your cat, I'd like to point out that about 20% of my hyperthyroid patients present for not eating - there are cats out there who don't read the textbooks.

The hyperthyroidism can definitely contribute to the hypertension, as well.

A good source of information is http://www.veterinarypartner.com (search on hyperthyroidism - they have a whole section on it there, including treatment options).

(oh, and that heart rate? I expect around 180 to 200 for the cat "being poked and prodded"; anything over 230 or so raises a red flag for hyperthyroidism for me :-) That being said, my last two patients had heart rates around 200 in the exam room).

[identity profile] jehanna.livejournal.com 2007-04-01 12:26 am (UTC)(link)
I'm sure when the time comes that both of you will make the best choices for Boopsie, whatever they happen to be.

It isn't easy. The various cats we've had mostly had long lives until some final illness that got care until nothing else could help and they were suffering. I don't envy my parents having had to make that decision.

[identity profile] browngirl.livejournal.com 2007-04-02 02:56 pm (UTC)(link)
I don't knoe what to tell you, but I am thinking of all threee of you.