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September 16th 05, 09:34 PM
My neighbor's cat was diagnosed with a urinary tract infection today.
The symptoms were that yesterday, the cat became lethargic and was
observed to be "squatting" without any fecal or urine discharge. He
was in pain...couldn't jump without a scream, slow moving, etc. The
litter box did not have any fecal or urine evidence since its last
cleaning the day before yesterday.

On the way to the vet, the cat evidently attempted once again to go to
the bathroom and left a bloody pool in the carrier.

The vet confirmed a UTI that there were crystals blocking his system.
There were two options provided...a 15% chance of success for $170 in
medication and a change in diet over the weekend (away from dry cat
food). Or, a $1500 operation that a much better chance for success and
a new diet, etc.

The fact that the cat did have stools and urine in the previous
litterbox cleaning and was active up until last night suggest that the
onset of trouble was fairly recent. However, it seems odd that there
are only two options...one with only a miracle chance of success or an
extremely expensive, and from what I've read, usually a last-resort
option.

Are these typically the one two given...one with very little chance and
another with an extremely high pricetag (or is it a common price tag)?

What is the (typical) effectiveness of the altered diet method?

TIA.

Karen
September 16th 05, 09:47 PM
OK, my biggest confusion is did they do a catheter at the vet? Because
really, you'd have to at least have had that done. Then yes, changing the
food, WAY increase water intake are going to be your best options. The op IS
the last resort but highly successful if you HAVE to go that way. IT really
is a matter of life and death, so if he blocks repeatedly, the operation is
truly necessary. I think I would consider it necessary in my cat after a
third blockage.

> wrote in message
oups.com...
> My neighbor's cat was diagnosed with a urinary tract infection today.
> The symptoms were that yesterday, the cat became lethargic and was
> observed to be "squatting" without any fecal or urine discharge. He
> was in pain...couldn't jump without a scream, slow moving, etc. The
> litter box did not have any fecal or urine evidence since its last
> cleaning the day before yesterday.
>
> On the way to the vet, the cat evidently attempted once again to go to
> the bathroom and left a bloody pool in the carrier.
>
> The vet confirmed a UTI that there were crystals blocking his system.
> There were two options provided...a 15% chance of success for $170 in
> medication and a change in diet over the weekend (away from dry cat
> food). Or, a $1500 operation that a much better chance for success and
> a new diet, etc.
>
> The fact that the cat did have stools and urine in the previous
> litterbox cleaning and was active up until last night suggest that the
> onset of trouble was fairly recent. However, it seems odd that there
> are only two options...one with only a miracle chance of success or an
> extremely expensive, and from what I've read, usually a last-resort
> option.
>
> Are these typically the one two given...one with very little chance and
> another with an extremely high pricetag (or is it a common price tag)?
>
> What is the (typical) effectiveness of the altered diet method?
>
> TIA.
>

September 16th 05, 09:59 PM
To my knowledge, no, there was nothing more than listening to his heart
and feeling around.

Karen
September 16th 05, 10:58 PM
They need a NEW vet PRONTO or that cat will DIE.

> wrote in message
ups.com...
> To my knowledge, no, there was nothing more than listening to his heart
> and feeling around.
>

September 17th 05, 12:18 AM
Karen wrote:
> They need a NEW vet PRONTO or that cat will DIE.
>

I am, unfortunately, following up after-the-fact. The family could not
afford the surgery and felt pressured by the circumstance...they
believed the vet in that there was almost no chance of success with the
medicinal route and the vet continued to talk about how the cat would
probably not respond to the medicine and how they would wind up in
surgery anyway. Not wanting to put the cat through further pain for a
pre-determined failed attempt through medicine, they put an otherwise
healthy, friendly, good-with-children, cuddly, unobtrusive cat with a
relatively treatable problem to sleep because they could not afford the
surgery nor the continual (estimated) medicinal costs.

They are heartbroken because they are now finding out that they
probably did not need to make that decision.

Everyone is sad, because we recognize an unusual increase in fees,
tests, and the costs of animal care. I'm not sure how to justify $1500
for a simply procedure that is common among cats. Maybe another BMW
payment is due, but in this case, there was no intervention to say
"let's look at alternatives," or "there's something else we can try."
>From what I was told, it was "ok, we'll put him to sleep."

I can't tell if I'm more sad than angry.

Phil P.
September 17th 05, 12:21 AM
> wrote in message
oups.com...
> My neighbor's cat was diagnosed with a urinary tract infection today.
> The symptoms were that yesterday, the cat became lethargic and was
> observed to be "squatting" without any fecal or urine discharge. He
> was in pain...couldn't jump without a scream, slow moving, etc. The
> litter box did not have any fecal or urine evidence since its last
> cleaning the day before yesterday.


>
> On the way to the vet, the cat evidently attempted once again to go to
> the bathroom and left a bloody pool in the carrier.


Bleeding is usually caused by inflammation or irritation of the lower
urinary mucosal from crystals cutting into the bladder and/or urethral
walls-- or tearing of the bladder mucosa from straining to urinate-- or from
overdistention of the bladder in male cats with a urethral obstruction.


>
> The vet confirmed a UTI that there were crystals blocking his system.


A UTI cannot be confirmed without analyzing a urine sample that was taken
directly from the bladder (cystocentesis) to avoid contamination with
bacteria that normally inhabit the distal urinary tract. Most cats with
UTIs have *no* clinically observable symptoms. The vast majority or cats
'diagnosed' with UTIs actually have idiopathic cystitis, and/or crystalluria
and/or urolithiasis.

Your neighbor needs to find a competent vet. The cat probably has
crystalluria or more likely urolithiasis which is causing a partial or
complete urinary tract obstruction. Male cats can *die* from urinary tract
obstructions. A complete obstruction produces a pathophysiologic state
equivalent to oliguric *acute renal failure* and is a true urologic
*emergency*.




> There were two options provided...a 15% chance of success for $170 in
> medication and a change in diet over the weekend (away from dry cat
> food). Or, a $1500 operation that a much better chance for success and
> a new diet, etc.


Did the vet catheterize the cat and try to flush the crystal/urolith back
into the bladder so the poor cat could urinate? Sometimes stones and
crystals can be retrieved by catheterization.



>
> The fact that the cat did have stools and urine in the previous
> litterbox cleaning and was active up until last night suggest that the
> onset of trouble was fairly recent.

The cat needs to be treated *immediately* before permanent damage is done to
bladder and or urethral mucosa.




However, it seems odd that there
> are only two options...one with only a miracle chance of success or an
> extremely expensive, and from what I've read, usually a last-resort
> option.
>
> Are these typically the one two given...one with very little chance and
> another with an extremely high pricetag (or is it a common price tag)?
>
> What is the (typical) effectiveness of the altered diet method?


The usual treatment is either catheterization to flush the stone back into
the bladder or cystocentesis to relieve the pressure behind the stone.
Neither of these procedures are expensive. Often the catheter is sewn in
place for a few days while drugs and/or diet are used to dissolve the
crystals or stone (if the stone is struvite). Fluids should be given to
restore the cat's electrolyte balance and help flush the bladder.

Before drugs or a special diet can be recommended, the stone *must* be
analyzed. Otherwise, the vet might prescribe a diet to treat the wrong
crystal-- which will make the problem enormously worse.

Surgery is a last resort. The procedure is called "perineal urethrostomy"
which literally turns a male cat into an anatomical female and creates a
urethral opening too big to become obstructed again.

Your neighbor should not delay treatment. The must be treated
*immediately*.


Good luck,

Phil

Ramboyd
September 17th 05, 12:24 AM
wrote:

> My neighbor's cat was diagnosed with a urinary tract infection today.
> The symptoms were that yesterday, the cat became lethargic and was
> observed to be "squatting" without any fecal or urine discharge. He
> was in pain...couldn't jump without a scream, slow moving, etc. The
> litter box did not have any fecal or urine evidence since its last
> cleaning the day before yesterday.
>
> On the way to the vet, the cat evidently attempted once again to go to
> the bathroom and left a bloody pool in the carrier.
>
> The vet confirmed a UTI that there were crystals blocking his system.
> There were two options provided...a 15% chance of success for $170 in
> medication and a change in diet over the weekend (away from dry cat
> food). Or, a $1500 operation that a much better chance for success and
> a new diet, etc.
>
> The fact that the cat did have stools and urine in the previous
> litterbox cleaning and was active up until last night suggest that the
> onset of trouble was fairly recent. However, it seems odd that there
> are only two options...one with only a miracle chance of success or an
> extremely expensive, and from what I've read, usually a last-resort
> option.
>
> Are these typically the one two given...one with very little chance and
> another with an extremely high pricetag (or is it a common price tag)?
>
> What is the (typical) effectiveness of the altered diet method?
>
> TIA.

This happened to my cat just over a year ago. Snoopy was at the point of
throwing up bile when I took him in to the vet.
He spent a few days there. A catheter was used and his bladder was rinsed
of crystals. The cost of the process was $1000.00 Cdn.
A change in food seemed to cure the problem. The operation basically
involves widening the urinary canal and removal of the penis, virtual
changing it into a vagina. This would allow any further crystals to pass
through. So far Snoopy hasn't had a need for this operation. (whew! - from
both of us)

I still give some dry food but only that certified for urinary problems. I
also moisten some of the dry food over night and mix it with canned food.
The canned food also is certified for urinary problems. Since starting
this regiment, I (or rather the cat) hasn't had any problems.

Good luck


Ramboyd

======

"My Ottawa Includes Corruption"

Karen
September 17th 05, 01:16 AM
On 2005-09-16 18:18:35 -0500, said:

>
> Karen wrote:
>> They need a NEW vet PRONTO or that cat will DIE.
>>
>
> I am, unfortunately, following up after-the-fact. The family could not
> afford the surgery and felt pressured by the circumstance...they
> believed the vet in that there was almost no chance of success with the
> medicinal route and the vet continued to talk about how the cat would
> probably not respond to the medicine and how they would wind up in
> surgery anyway. Not wanting to put the cat through further pain for a
> pre-determined failed attempt through medicine, they put an otherwise
> healthy, friendly, good-with-children, cuddly, unobtrusive cat with a
> relatively treatable problem to sleep because they could not afford the
> surgery nor the continual (estimated) medicinal costs.
>
> They are heartbroken because they are now finding out that they
> probably did not need to make that decision.
>
> Everyone is sad, because we recognize an unusual increase in fees,
> tests, and the costs of animal care. I'm not sure how to justify $1500
> for a simply procedure that is common among cats. Maybe another BMW
> payment is due, but in this case, there was no intervention to say
> "let's look at alternatives," or "there's something else we can try."
>> From what I was told, it was "ok, we'll put him to sleep."
>
> I can't tell if I'm more sad than angry.

Oh my God. That is HORRIBLE :( Too many people just do not have
enough education on cats and stupid vets don't help. That is awful :(
My Grant had a partial blockage. He needed to be catheterized twice and
since it was the emergency vet it came altogether around 375.00. One
other time he had partial blockage, but we caught it VERY early and it
was a little sludge that my regular vet could manually work out. As a
preventative, I put water bowls all over the house and switched him to
primarily wet, high quality food and got Feliway diffusers for the
house to reduce stress. He never had another episode, although he died
this year from stomach cancer. Please, if these people get another pet,
they need education and to establish a relationship with a feline
doctor (there are more and more feline only practices) because then you
can work out payments. If I had my way, there would be animal care
courses in every elementary and middle school in the U.S. I swear, if
kids could learn basic care from an early age of pets (cat AND dog) I
would guess it would lead to less of a pet overpopulation problem and I
personally believe it would lead to greater kindness to both pets and
people. Sorry, I'm rambling now, but this is just another case of where
you can't trust just any vet. This is just a tragedy.

September 17th 05, 02:40 AM
Karen,
While I agree that people may not have enough education in pets...the
cat was behaving as normal as possible until the last night. The vet,
on the other hand, was trusted to know what to do...a catheter,
options, etc. From my experience with my dog (who has encountered many
vets due to relocation, etc.), some vets are more interested in the
turnkey solution rather than helping the animal. From what I know of
the encounter, there was no "there might be a better way" offer once
the decision was made to put the cat to sleep...no comfort, but a very
clinical, "ok" and then taking the cat from the room.

My neighbors, tonight as they've had time to think about things, wish
they would have gone the medicinal route because if for no other
reason, it would have afforded them time....time the vet was not giving
them...time to ask for a second opinion....

It's a bad situation...they feel horrible...not because of their
decision, but because the decision was made on bad information in a
pressured circumstance.

Karen
September 17th 05, 03:00 AM
On 2005-09-16 20:40:28 -0500, said:

> Karen,
> While I agree that people may not have enough education in pets...the
> cat was behaving as normal as possible until the last night. The vet,
> on the other hand, was trusted to know what to do...a catheter,
> options, etc. From my experience with my dog (who has encountered many
> vets due to relocation, etc.), some vets are more interested in the
> turnkey solution rather than helping the animal. From what I know of
> the encounter, there was no "there might be a better way" offer once
> the decision was made to put the cat to sleep...no comfort, but a very
> clinical, "ok" and then taking the cat from the room.
>
> My neighbors, tonight as they've had time to think about things, wish
> they would have gone the medicinal route because if for no other
> reason, it would have afforded them time....time the vet was not giving
> them...time to ask for a second opinion....
>
> It's a bad situation...they feel horrible...not because of their
> decision, but because the decision was made on bad information in a
> pressured circumstance.


I totally understand that. That is what I mean about education because
unfortunately you can't trust all vets. I certainly hope they never go
to that vet again :(

Phil P.
September 17th 05, 09:36 PM
> wrote in message
oups.com...
>
> Karen wrote:
> > They need a NEW vet PRONTO or that cat will DIE.
> >
>
> I am, unfortunately, following up after-the-fact. The family could not
> afford the surgery and felt pressured by the circumstance...they
> believed the vet in that there was almost no chance of success with the
> medicinal route and the vet continued to talk about how the cat would
> probably not respond to the medicine and how they would wind up in
> surgery anyway. Not wanting to put the cat through further pain for a
> pre-determined failed attempt through medicine, they put an otherwise
> healthy, friendly, good-with-children, cuddly, unobtrusive cat with a
> relatively treatable problem to sleep because they could not afford the
> surgery nor the continual (estimated) medicinal costs.



Oh no. That's absolutely horrible. The continual medicinal costs might have
only been a prescription diet. The vet is real low-life.


>
> They are heartbroken because they are now finding out that they
> probably did not need to make that decision.


They made the decision based on an incompetent or greedy vet's erroneous
information. Some vets only want to deal with cases that involve expensive
procedures and treatments- they don't seem to want to be bothered with
routine cases.



>
> Everyone is sad, because we recognize an unusual increase in fees,
> tests, and the costs of animal care. I'm not sure how to justify $1500
> for a simply procedure that is common among cats. Maybe another BMW
> payment is due, but in this case, there was no intervention to say
> "let's look at alternatives," or "there's something else we can try."
> >From what I was told, it was "ok, we'll put him to sleep."
>
> I can't tell if I'm more sad than angry.



When the sadness subsides, you'll become infuriated- as I am.

Please tell you're neighbors that their vet is unethical and incompetent and
*never* entrust him with another animal's life. I would let as many people
as possible know what the vet did. Plaster the story along with his name
and practice name all over. That's not libel because the story is true.
The only thing you can do now is try to spare as many animals from the same
fate.

Phil

PawsForThought
September 17th 05, 09:47 PM
wrote:
> It's a bad situation...they feel horrible...not because of their
> decision, but because the decision was made on bad information in a
> pressured circumstance.

I'm so sorry to hear about this. What a terrible thing and what a
horrid vet :(

Lauren
(and Mickey & Meesha)
Raise Your Paw for Raw!

See my cats: http://tinyurl.com/76tg8

September 17th 05, 11:56 PM
Just to follow up...I was given a document that outlines "Feline
Urologic Syndrome," which was given to the pet owner on their way out
the door of the veterinary office and were told that this was so that
if they ever have another cat they can recognize the symptoms. I have
my own opinion about this documenth because I find that the document
does not follow what was performed at the office, but I am posting it
for review/opinion...there may be a few typos, but there were several
in the original document and I'm posting this without much review...I'm
leaving their typos in.

"Feline Urologic Syndrome is a very frustrating condition to the
veterinarian, client and the cat.

It is of the most serious and distressing cat diseases confronting cat
owners and veterinarians. FUS occurs in all breeds and ages, male and
female, neutered and non-neutered, indoor and outdoor cats, and in
those fed all type foods.

Feline urinary problems are currently the subject of much research, but
the exact cause is still unknown and considered very complex. Possible
causes may include heredity, diet, infections and stress.

Early signs of trouble include:
- Irritability and restlessness
- Bloody urine
- Frequent trips to the litter box
- Straining while in a squatting position
- Urinating in unaccustomed places about the house

Cats with more advanced FUS may vomit or drool, cry with pain, strain
constantly, or have a tender abdomen. These later signs often mean
that the cat cannot pass urine because of sand stones or mucus plugs in
the urinary passages plugging the urethra so urine cannot be expelled.
If a veterinarian does not relieve the obstruction promptly, the cat
will die!

FUS can be an EMERGENCY situation if complete blockage has occurred.
Prompt treatment is essential for survival! Treatment is directed at
removing the obstruction, preventing infection, and maintaining the
normal body fluid balance. With early treatment, most FUS cases
respond well; however, recurrence within a few hours to a few months is
common, and some patients dies from the disease complications. In
recurring cases, surgery may be recommended to enlarge the urinary
opening to prevent the BLOCKAGE.

HOME CARE:

MEDICATIONS:
- Antibiotics as directed for the infection
- Use a MINIMUM of 3 WEEKS!
- Antispasmodics as directed for spasms and straining
- Drugs to encourage water consumption, increase urine volume, and
stimulate bladder function.

DIET: (Most IMPORTANT to prevent RECURRENCE!)
- After 60 days, feed nothing but Prescription Diet C/D to prevent
recurrence
- Clean, FRESH drinking water (change daily)
- Feed NOTHING BUT Feline Prescription Diet s/d for 60 days. (Two
months).

- The foods that is acceptable, BUT much less desirable than the above.

- 9 Lives Country Chicken & Gravy
- 9 Lives Choice Cuts & Cheese
- 9 Lives Tuna & Chicken
- 9 Lives Savory Stew
- 9 Lives Beef & Egg
- Friskies Beef & Liver Buffet
- Tender Vittles varieties that do NOT contain fish
- Purina One for UTI

ACTIVITY: Encourage exercise.

MANAGEMENT:
- Do NOT leave your cat unattended for extended times, indoors or out
(days)
- If you must board your cat, be sure to inform the attendant to watch
for danger signs.
- Check litter pan daily for signs of urination and abnormal urine.
- Use tomato juice to acidify the urine (1/2 cup given 2-3 times/week)
if cat will drink it
- Willingly - most will!

NOTIFY THE CLINIC IF ANY OF THE FOLLOWING ARE OBSERVED:
- Straining to urinate
- Crying when urinates
- Urinating in areas other than normal for you cat
- Frequent trips to the litter box
- Vomiting
- Refusal to eat
- Bloody urine
- Depression
- Any other abnormality for your cat.

Proper diet and urinary acidifiers will successfully manage most cases.
Recurrences usually are the result of failure to properly regulate the
diet or failure to give medications as directed. In practically EVERY
case of recurrence we see, the owner has switched off Prescription Diet
C/D!

When recurrences do occur, surgery may be recommended to enlarge the
urethral opening. This will usually prevent urinary obstruction BUT
does NOT prevent recurring cystitis (bladder infection). Once a
bladder infection has occurred, it often will return later in life,
just as in humans.

PROPER DIET IS THE KEY TO PREVENTING RECURRENCE!"

Karen
September 18th 05, 01:02 AM
On 2005-09-17 17:56:15 -0500, said:

> Just to follow up...I was given a document that outlines "Feline
> Urologic Syndrome," which was given to the pet owner on their way out
> the door of the veterinary office and were told that this was so that
> if they ever have another cat they can recognize the symptoms. I have
> my own opinion about this documenth because I find that the document
> does not follow what was performed at the office, but I am posting it
> for review/opinion...there may be a few typos, but there were several
> in the original document and I'm posting this without much review...I'm
> leaving their typos in.
>
> "Feline Urologic Syndrome is a very frustrating condition to the
> veterinarian, client and the cat.
>
> It is of the most serious and distressing cat diseases confronting cat
> owners and veterinarians. FUS occurs in all breeds and ages, male and
> female, neutered and non-neutered, indoor and outdoor cats, and in
> those fed all type foods.
>
> Feline urinary problems are currently the subject of much research, but
> the exact cause is still unknown and considered very complex. Possible
> causes may include heredity, diet, infections and stress.
>
> Early signs of trouble include:
> - Irritability and restlessness
> - Bloody urine
> - Frequent trips to the litter box
> - Straining while in a squatting position
> - Urinating in unaccustomed places about the house
>
> Cats with more advanced FUS may vomit or drool, cry with pain, strain
> constantly, or have a tender abdomen. These later signs often mean
> that the cat cannot pass urine because of sand stones or mucus plugs in
> the urinary passages plugging the urethra so urine cannot be expelled.
> If a veterinarian does not relieve the obstruction promptly, the cat
> will die!
>
> FUS can be an EMERGENCY situation if complete blockage has occurred.
> Prompt treatment is essential for survival! Treatment is directed at
> removing the obstruction, preventing infection, and maintaining the
> normal body fluid balance. With early treatment, most FUS cases
> respond well; however, recurrence within a few hours to a few months is
> common, and some patients dies from the disease complications. In
> recurring cases, surgery may be recommended to enlarge the urinary
> opening to prevent the BLOCKAGE.
>
> HOME CARE:
>
> MEDICATIONS:
> - Antibiotics as directed for the infection
> - Use a MINIMUM of 3 WEEKS!
> - Antispasmodics as directed for spasms and straining
> - Drugs to encourage water consumption, increase urine volume, and
> stimulate bladder function.
>
> DIET: (Most IMPORTANT to prevent RECURRENCE!)
> - After 60 days, feed nothing but Prescription Diet C/D to prevent
> recurrence
> - Clean, FRESH drinking water (change daily)
> - Feed NOTHING BUT Feline Prescription Diet s/d for 60 days. (Two
> months).
>
> - The foods that is acceptable, BUT much less desirable than the above.
>
> - 9 Lives Country Chicken & Gravy
> - 9 Lives Choice Cuts & Cheese
> - 9 Lives Tuna & Chicken
> - 9 Lives Savory Stew
> - 9 Lives Beef & Egg
> - Friskies Beef & Liver Buffet
> - Tender Vittles varieties that do NOT contain fish
> - Purina One for UTI
>
> ACTIVITY: Encourage exercise.
>
> MANAGEMENT:
> - Do NOT leave your cat unattended for extended times, indoors or out
> (days)
> - If you must board your cat, be sure to inform the attendant to watch
> for danger signs.
> - Check litter pan daily for signs of urination and abnormal urine.
> - Use tomato juice to acidify the urine (1/2 cup given 2-3 times/week)
> if cat will drink it
> - Willingly - most will!
>
> NOTIFY THE CLINIC IF ANY OF THE FOLLOWING ARE OBSERVED:
> - Straining to urinate
> - Crying when urinates
> - Urinating in areas other than normal for you cat
> - Frequent trips to the litter box
> - Vomiting
> - Refusal to eat
> - Bloody urine
> - Depression
> - Any other abnormality for your cat.
>
> Proper diet and urinary acidifiers will successfully manage most cases.
> Recurrences usually are the result of failure to properly regulate the
> diet or failure to give medications as directed. In practically EVERY
> case of recurrence we see, the owner has switched off Prescription Diet
> C/D!
>
> When recurrences do occur, surgery may be recommended to enlarge the
> urethral opening. This will usually prevent urinary obstruction BUT
> does NOT prevent recurring cystitis (bladder infection). Once a
> bladder infection has occurred, it often will return later in life,
> just as in humans.
>
> PROPER DIET IS THE KEY TO PREVENTING RECURRENCE!"

Wow. Bad typos (or grammatical errors, hard to tell which). Mostly
correct info. Never heard the bit about tomato juice before. Good
points about boarding cats. I just do NOT understand how the vet could
give that out, but not have treated the cat in any manner. I begin to
think the vet looked at the family and the brain said "can't afford"
and decided just to offer worst case scenario expensive treatment
because he didn't want to be bothered. Rat. Scum. Jerk.

September 18th 05, 03:57 AM
Karen wrote:
> Wow. Bad typos (or grammatical errors, hard to tell which). Mostly
> correct info. Never heard the bit about tomato juice before. Good
> points about boarding cats. I just do NOT understand how the vet could
> give that out, but not have treated the cat in any manner. I begin to
> think the vet looked at the family and the brain said "can't afford"
> and decided just to offer worst case scenario expensive treatment
> because he didn't want to be bothered. Rat. Scum. Jerk.

What is perplexing is that the document talks about treatment prior to
surgery. Even when discussing advanced stages, it talks of the vet
removing the obstruction, but that was not even proposed. Furthermore,
I asked whether there was any reaction to the decision, but there was
no attempt to 'explore further options' or deter the decision.

The little girl next door has been in a daze since she came home from
school on Friday. The parents are mad at themselves for, at the very
least, not taking the drug option to buy time and/or get a second
opinion.