Yesterday was a rough one. I euthanized three cats (due to FeLV, FIV and a case of complicated diabetes). That’s more than usual. Though all were tearful, morale-crushing events, the last of these held out a silver lining for us to marvel at long after the end of this depressing day.
Meesy was a beautiful, undemanding, even-tempered Siamese girl only a decade old. She’d been losing weight over the past few weeks and diabetes had been diagnosed. In spite of the standard diabetic cat protocol, Meesy had suddenly begun to decline rapidly this week. She was no longer responding to the medications and she’d suddenly become seriously weak and dehydrated.
We’d hospitalized her for fluid administration and blood sugar monitoring, hoping to transfer her to an internal medicine specialist in the morning, but her condition had rapidly deteriorated overnight. Once a Siamese with a brash, tuneless voice, Meesy’s cries were now faint, plaintive and pitiful. She was too weak even to swallow food.
Meesy’s owners are pragmatic academic types. They’d been devouring the feline diabetes community website I’d recommended (felinediabetes.com) and had become well versed in the issues surrounding this complex illness. They knew what they’d be up against and their demanding family, work and travel schedule had already weighed heavily on them when deciding how Meesy’s care would be undertaken.
In most cases like this, a family looks at their resources (time, schedules and finances) and often decides not to take on the care of a diabetic. They understand that psychological devotion to their pet and her care is not enough. Their life, work and family schedules must also change—sometimes too dramatically for a family to undertake without life-altering stress.
That’s why guilt is often a huge variable in this equation. Hard-working, heavily-traveling families can’t always change their complex lives on a dime to begin treating a very sick cat, much as they dearly love her—not when the vagaries of a disease process render her care extra-unpredictable. And here’s where guilt wins out and families often reach beyond their means to stem the tide of their loved-one’s decline.
Meesy’s case was by-the-book on the guilt thing. The family tried to reach beyond their limits to start the insulin carefully. But her case was not responding to their ministrations as planned, ad now they’d decided to euthanize her.
Tearfully, they came to the hospital and sat by her cage-side in her final moments. Fatefully, though, they could not bring themselves to have the thoroughly good cry they came for. The stray kitten in the cage next door kept reaching out and grabbing hold of their sweaters with her outstretched paws.
In the end, Meesy crossed the Rainbow Bridge and Turkey Sandwich (yes, that’s her name) found her way to a new home. Predictably, however, guilt trailed the owners out the door:
“Do you think we’re bad people for leaving one cat behind and taking another?”
My take? Guilt is a four-letter word. It’s a social human construct which has no place in a veterinary hospital under any circumstances where adoption is the end result. I, too, adopted my Sophie Sue not twelve hours after my former Frenchie exited this world. Sometimes connections just happen and we’d be stupid humans to ignore them based on silly impediments like self-flagellating guilt.
Sure, I can understand the pain of loss and the guilt that attends euthanasia in so many cases. But in my book, rescuing a kitten from the daily boredom and confinement of an animal hospital automatically frees you of this self-imposed torment.
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Thank you for sharing such a heartfelt story. It brought tears to my eyes. Although I have yet to loose a beloved pet, I know what a mess I will be when one of my three boys passes. And I know the struggle of treating disease - one of the reasons my husband and I have virtually stopped traveling on vacations. I agree guilt has no place when it welcomes a new kitty into the home. Many prayers and hugs to the family that lost their friend, but found a new one in the process, and to you and your staff for a long, sad day.
Jenny February 16th, 2008 11:22:00 AM
How sad and touching. I wish Turkey Sandwich the best in her new home.
Everybody deals with grief differently. There are people who swear they're never getting another pet. Then there are people like me who find themselves with that big empty hole that needs filling. It doesn't make the new pet a replacement, not at all. No animal can ever replace the ones I've loved so dearly and lost. But they can bring their new, bright selves into my life and help ease my heartache.
I hope the new kitten helps Meesy's family with their heartache.
katie February 16th, 2008 11:31:00 AM
In the early 90's when I undertook the STCNE Rescue Coordinator position, I found myself involved in a lot of grief counselling (sure wished I had a tailored course available to attend at the time) and one sentence that people found comfort in to avail their guilt, was my comment that to adopt another "like" pet was the finest and kindest tribute to the memory of the one they missed and loved so dearly.And that there was no right or wrong length of time to "grieve" and go petless.
Meesy's owners did not look for another, Turkey Sandwich reached out to them. They have big and kind hearts.
The only situation, I could never warm up to, were the people with a dog diagnosed with terminal illness, that had weeks or months left to live, and the owners were actively looking to have a "replacement" in the household prior to death. I always felt it would rob the ill dog of much needed special quality time & care and also be unfair to the prospective adoptee.
Barbara A. Albright February 16th, 2008 12:00:00 PM
Adopting the new kitten doesn't bother me but what really makes me sad is when people feel that their "highly traveled life style" isn't conducive to treating something like diabetes. With diabetes as discouraging as it sounds I would advocate euthanasia or re-homing if they decide the cat won't be treated.
If this cat was just too sick there really isn't much left for discussion but if not, surely they aren't the first family to face this decision. Imvho there are times when adjustments need to be made to honor the committment we make when we adopt an animal. Take one for the team? In my house, yes. There are other options such as boarding, petsitters that will do home blood glucose tests/insulin injections and depending on the cat and destination many people take their animal cat with them when they travel.
Jules February 16th, 2008 12:11:00 PM
Everyone must do their own thing. We can't judge by how we would lead our own lives, as much as we'd like to.
Laura Bennett February 16th, 2008 01:47:00 PM
Kudos and high fives to Turkey Sandwich and her new owners! Thank god there are people who can move forward to reach out and help another creature while still freshly grieveing their own loss.
I love my guys to death, but I guarantee you that I will be at the local rescue the minute there is an opening in my house.
I consider it a tribute to the deceased pet when owners were so touched by the love they received that they go out and immediately adopt another. What a wonderful legacy!
agadore's mama February 16th, 2008 06:16:00 PM
Why did she get worse overnight?
Was she in diabetic ketoacidosis?
Was anyone there overnight?
Stefani February 16th, 2008 09:27:00 PM
Re:
"Hard-working, heavily-traveling families can’t always change their complex lives on a dime to begin treating a very sick cat, much as they dearly love her—not when the vagaries of a disease process render her care extra-unpredictable. . . . The family tried to reach beyond their limits to start the insulin carefully. "
Wow. What if someone said that about a sick kid? At the risk of sounding ragingly insensitive, I think we should remember that we don't get to claim our pets are "family" to us unless we are willing to do the same things for them that we would for other family members.
I really am left to wonder what kind of a diabetic crisis the cat was in -- since you didn't say. If she was DKA or hyperosmolar, she should have been transferred to a 24 hour place the night before IF your place isn't. No way a cat in diabetic crisis -- DKA, hyperosmolar or hypoglycemic -- should be left overnight alone without monitoring and care. I am left to wonder if her overnight decline could have been avoided.
Stefani February 16th, 2008 09:52:00 PM
i could not in all conscience adopt out a cat to a family that just had their cat PTS because she no longer fit their heavily traveled lifestyle. diabetes is treatable.
pet adoption should be a lifetime commitment granted only to responsible people.
chris February 16th, 2008 11:25:00 PM
And what happens to Turkey Sandiwich should he become diabetic? Will he be destined to the same fate as Meesy, all because of a busy lifestyle? Yes, it's a commitment, but many people manage...even those with a busy lifestyle. I agree with Chris: I could not adopt out a cat to a family that just had one PTS under those circumstances.
Sherie February 17th, 2008 06:40:00 AM
Not all diabetes is treatable. I suspect Meesy's was seconary to another disease process--cancer, perhaps?
All new diabetic owners are similary fraught with indecision and fear--these clients and their guilt were identical to so many others I've dealt with successfully. Sometimes it just takes a while to prove to people that they CAN do it. But this case was so much worse because Meesy was not responding to the standard protocols. Her body was reacting violently to the insulin, in fact.
Having known these clients for nearly a decade, I have no fear that Turkey will be far better off in their loving hands than bouncing off the walls of a cage in our hospital. After all, their fear for Meesy was that she deserved better than what they felt they could provide--a common feeling among owners of pets *and* parents of human children under similar circumstances.
Dr. Patty Khuly February 17th, 2008 08:17:00 AM
Re:
"Her body was reacting violently to the insulin, in fact."
Wow. I have never heard of that. I have heard of some allergic reactions to lantus, but there are so many insulins to try. Perhaps you could educate me/us about this type of reaction, because I have been on the FDMB for 4 years and I have never seen a violent reaction to insulin except for hypoglycemia, which is its own distinct problem and can be adjusted for. There are SOME cats who tolerate only the smallest dose of insulin -- less than a half unit. Those kitties can still be regulated, you just have to hunker down. My own boy didn't react well to PZI, but we changed insulin until we found one that worked (lantus).
Stefani February 17th, 2008 11:05:00 AM
"After all, their fear for Meesy was that she deserved better than what they felt they could provide--a common feeling among owners of pets *and* parents of human children under similar circumstances."
I think we all can relate to this except with human children there is not an option of not treating. I've seen a fair number of diabetic cats and dogs and haven't seen any that absolutely didn't respond to some type of insulin and none that had an adverse reaction unless you are talking about a hypoglycemic reaction. It has been my experience that cats will often go into remission when cancer enters the equation based on what I can only guess is a glucose thriving type tumor.
Jules February 17th, 2008 11:24:00 AM
On Meesy and her insulin reaction: No blood sugar change with insulin, but increasingly severe weakness and vomiting, nonetheless after every injection. Her reaction was so aberrant and we'd stopped the lantus almost immediately to refer her to the internist (and possibly switch to another insulin after getting the internal medicine consult and more dagnostics) and THAT's when her blood sugar plummeted. After this, she initially responded well to fluids with dextrose yet by morning, she'd deteriorated dramatically. In spite of never achieving ketotic status, signs of liver disease and protein losing nephropathy were evident. Even before this point, it seemed highly likely that a variety of other factors were at play. Now it seemed quite obvious. Insulin reaction notwithstanding, I'm guessing lymphoma.
Dr. Patty Khuly February 17th, 2008 05:16:00 PM
Thank you for asking me to clarify my inference that diabetes in cats is not highly treatable. It *is treatable* in the vast majority of cases. Sometimes I forget that in discussing my weird cases I may inadvertently be suggesting that the case in the post is exemplary of the disease process being discussed. In this case that couldn't be further from the truth. In the end, Meesy looked like a diabetic and deserved the diagnosis, but her DM was almost certainly the result of something other.
Dr. Patty Khuly February 17th, 2008 05:36:00 PM
I'm surprised that anyone would criticise these decisions. I've dealt with many vets in my life, and most of them have been caring and ethical. The ones who weren't I only dealt with once.
This was a 10-year old cat. It's owners actually took it to a vet - unlike most cat owners. From what I read, these people cared for their cat. When it got sick, they took it a good vet. Most cat owners just let their animals run loose and put some food out.
My husband had a cat (I'm the dog person in the family), but it was me who usually dealt with the cat health problems, despite the fact that I'm somewhat allergic to cats. Dingy (short for Dingbat) lived a long time, and moved with us when we had to move to a new state. He got an untreatable tumor, but we kept him home. When he got much worse, our vet said to let him know how he was doing. The cat finally reached the end, lieing in his basket shivering and mewing. I'd had dogs die at home before (on my vets suggestion), so I was going to let the cat die at home. My vet called and asked how Dingy was doing; when I told him, he said to bring the cat to his office to be euthanized. I knew he was right, so I did it.
Meesy had a good life with caring owners. It is very difficult these days to be caring, for dogs or cats or children or unknown people. There's no money in it...or votes. Give these people a break. A sick cat died with less misery and another went to a good home.
I trust my vet's opinion more than my doctor's. But then, I'm not sure who my doctor is right now, because of insurance mix-ups. My dogs get better care than I do.
Heather February 17th, 2008 11:52:00 PM
"This was a 10-year old cat. It's owners actually took it to a vet - unlike most cat owners. From what I read, these people cared for their cat. When it got sick, they took it a good vet. Most cat owners just let their animals run loose and put some food out."
I try not to take offense at what I read online but this is just over the top on so many levels.
Jules February 18th, 2008 08:49:00 AM
Actually I think Heather's comments ring true for a lot of pet owners, maybe even more for cat owners. There are some very dedicated owners, and there are also many that ignore basic health care even if the animal seems sick. A neighbor of mine put her cat to sleep just on the fear that it might have diabetes - didn't even bother with a basic blood test to confirm. She just figured 'it was no way to live' I have a coworker that continues to not do annual blood and urine work despite the fact one of her cats has health issues - yet she takes care of her dog.
I do think the owners of this cat seemed to care based on Dr Khuly's description. Who are we to judge them? I would think it is kind of like fate that this new kitten presented himself to them in this way.
Jenny February 18th, 2008 08:56:00 AM
That's mystical that Turkey Sandwich was right there to be saved. Thank you for helping him and thank you for adopting Sophie Sue, too!
We've been involved with adoptions/rescue for 30 years. I'm convinced that most people do not how bad the overpopulation crisis is. It is worse than I can comprehend, and I think about it almost every waking minute, and some sleeping ones, too. There's a FLOOD of homeless, unwanted dogs and cats. There are millions and millions of reasons to spay/neuter and adopt. That's the number of pets dying to be adopted/rescued.
So, regarding grief and when to get another pet: when people say they lost a pet and weren't over the grief, I explain my point of view. They have to do what feels right for them and their family, but they now have space in their "lifeboat/home," and there are homeless pets "drowning" in the flood. But I beg them (and the pet's are begging for their lives) to only adopt, not acquire from a breeder/ anyone who is permitting pets to reproduce.
We live in Pennsylvania, not exactly a Third World country(!). The holding period in this state for a stray dog in a pound/humane society is 2 days/ 48 hours, but the law doesn't state that the pound must be open those 2 days! They are going to change that... sometime. Owner surrenders can be killed before the owner leaves the building. No requirement that pets must be scanned for microchips. No requirement that owners of stray pets with phone id tags must be contacted. Cats? There is NO holding time for strays at all and of course, no holding period for owner surrender cats. At our local pound, a private humane society, if you bring in a cat into the pound and the staff person, a stranger in a noisy, smelly, terrifying place (to most cats), cannot open the carrier and pick up the cat, the cat doesn't go in a cage, it gets killed. Trapped cats are poked with a pencil, if it reacts by hissing or scratching, it's put down too. At least they don't die of starvation.
When we encounter a person who owns unfixed pets, we explain that none of the pets being killed in pounds, or worse, dying from abandonment, neglect, or abuse came from outerspace. Each and every one came from an unfixed pair of dogs/cats. The only way to be 100% certain that their pets won't contribute to the overpopulation and the resulting suffering is to fix all your pets and neighborhood strays, too.
Althought is it so difficult to say goodbye to a beloved family member, the fact that the cat probably felt miserable and there was little hope of improvement, makes it a "no brainer" for me. Millions and millions of "Turkey Sandwiches", purring and playful, being killed or abandoned to die, that's what really makes me sad.
There are lots of very sad situations. A friend's dad has Alzheimers, and he doesn't recognize her anymore. So heartbreaking. But the pet overpopulation problem could be solved this year, if everyone who cared about pet suffering would fix/adopt their pets and help others to fix/adopt.
There will always be people who don't care to provide us with pets. Heck, we could even help pets in other countries, too, like the Iraqi dog, who yesterday arrived in the USA. Did you hear about him? When his American soldier/friend had to leave to go to another area, 70 miles away, the dog tried to follow them. When they pulled out, he followed. They drove faster, he ran faster. The convoy traveled 70 miles across the desert, with temps below 20. Two days later the dog walked into camp! The orders were to shoot the dog, but his soldier guardian got an email rescue mission lined up to raise the $3000, and with a vet in Jordan's help, he's been shipped to California. Far better than any Westminster story, IMHO.
Linda February 23rd, 2008 11:52:00 AM
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