When do you "call it a day"?

On Apr 24, 5:55*am, Eddy
wrote:
cindys wrote:
Well, I'm sure our vet would prefer that we get all the meds from her
(the ones she carries anyway), but when we don't, she doesn't say
much. I have never discussed it with her. I simply told the
receptionist that we would be getting the medications from PETMEDS
(where applicable). We are certainly not the only family who shops
elsewhere (the receptionist told me it was quite common for clients to
get meds elsewhere). A lot of people must be doing so, as 1-800-
PETMEDS is a booming business. When you place an order with them, they
phone the vet for you and request the prescription. Additionally, the
vet doesn't dispense everything, and it is not unusual for her to
write us prescriptions to be filled in a local drugstore. For sure,
she doesn't dispense Plavix. My cat is on the following meds (I've
indicated which ones I COULD be getting from her). The last three she
simply doesn't carry, and we couldn't get them from her even if we
wanted to:

Tumil K (available from the vet).
Enalapril (available from the vet).
Furosemide (available from vet).
Clear empty capsules (available from vet).
Plavix (she wrote us a prescription to be filled elsewhere). At my
request, the vet office faxed the prescription to the Canadian
pharmacy.
Diltiazem (she wrote us a prescription to be filled elsewhere).
Lactulose (she wrote us a prescription to be filled elsewhere, but it
is sold over-the-counter in Canada).

(When we had a cat who required Lantus insulin, we had to get that
from the drugstore as well).

Our vet practice is a very wealthy practice with multiple offices. The
veterinarians who work in each office are considered part owners.
(FTR, it's not one of the national chains. It's a local business that
simply grew over the years. The original vet retired and started
selling parts of the practice to the vets who worked for him.)

I don't feel bad about buying meds elsewhere because the practice is
wealthy and because we currently have four cats, one of whom is
currently elderly (i.e., lots of vet visits). We have had several
elderly cats in the past few years (two of whom had CRF and one who
now has the cardiomyopathy), so that's a lot of medical care. That's a
lot of checkups, grooming, dental procedures, x-rays, etc. This other
stuff more than makes up for the loss of profit on the meds.
Best regards,
---Cindy S.

Hi, Cindy. *I think you've put your finger on why we feel reluctant not
to buy the meds from our vet: the practice is small, independent, and
there are certainly no signs in the humble little building they have
that they are raking it in. *They also seemed worked off their feet,
what with the pets being brought in and all the other problems with
livestock - this area is all about sheep, cattle, and horses. *So I
guess this is why we feel we at least ought to buy our meds from them,
in return for their good practice. *But if they had all the trappings of
wealth, like yours, I think we would feel happy about shopping online.
--------------
I can understand why you want to buy meds from the vet. In your
situation, I would do the same.
Best regards,
---Cindy S.

On Apr 24, 6:00*am, Eddy
wrote:
cindys wrote:
The only caveat is that you have described that your cat has required
thoracocentesis multiple times. This has not been the case for my cat
(after the initial crisis in December 2007). The Plavix will prevent
clot formation but can't do anything to prevent the fluid buildup in
your cat's chest.
Best regards,
---Cindy S.

Hi again, Cindy. *It hasn't been necessary to mention it before, but
possibly I should mention it to you now: we are in the UK so the whole
business of getting meds through the post could be quite different here,
not so easy. *Trying to buy ANYTHING online from the States or Canada is
problematical with regard to getting through Customs. *I bought
something from Australia a while back, and the postman wouldn't give it
to me until I paid him a hefty Excise duty first! *

Eddy.
------------------
On another of the regular newsgroups I participate in, there are
mostly American posters, but there are a few from the UK. I am smiling
as I think of all the times the one UK poster reminds us that the
whole world isn't American. Sometimes a poster will say "this
country," and he'll respond "which country? The UK?" And he was not
too happy when many of us were discussing our recent presidential
election, so he was sure to include a few posts about politics in
Britain. So, I apologize for making this assumption. I agree that
ordering things online from America or Canada may be difficult for
you. And WRT the Plavix/clopidogrel, if clopidogrel (generic) is
available in the UK, you may be able to buy it at your local pharmacy
for the same or less as it costs me to buy it from Canada online. It's
only in the United States that the generic clopidogrel is
unavailable.
Good luck.
Best regards,
---Cindy S.

cindys wrote:
------------------
On another of the regular newsgroups I participate in, there are
mostly American posters, but there are a few from the UK. I am smiling
as I think of all the times the one UK poster reminds us that the
whole world isn't American. Sometimes a poster will say "this
country," and he'll respond "which country? The UK?" And he was not
too happy when many of us were discussing our recent presidential
election, so he was sure to include a few posts about politics in
Britain. So, I apologize for making this assumption. I agree that
ordering things online from America or Canada may be difficult for
you.

Hi, Cindy. I always keep in mind when I visit this group that it is
mainly composed of Americans and so I write accordingly, i.e. I try to
make what I write non-UK-specific!

And WRT the Plavix/clopidogrel, if clopidogrel (generic) is
available in the UK, you may be able to buy it at your local pharmacy
for the same or less as it costs me to buy it from Canada online. It's
only in the United States that the generic clopidogrel is
unavailable.

Thanks for this. Have made a note to ask the Vet about its availability
here, and its price. I'll see what she says.

Many many thanks for all your great help.

Eddy.

Hello. Three months ago I asked in this group when people thought it
was time to "call it a day" with regard to a very ill pet and putting
him/her to sleep. Some people were extremely helpful, most particularly
CindyS, and in the end the advice proved to be very helpful. When the
time came, we knew.

Out extraordinary little cat is no more. We have both cried and cried.
Two days before he was put to sleep he was so alive and active that he
had brought in a baby rabbit. And even the day before he died there was
a wild commotion and cries in the hedge with a pheasant then fleeing
into the field opposite: the cat with the tragic heart condition then
being discovered looking gleeful and victorious beside the point of
exit! So, right up until the day when he suddenly went right downhill,
he had had about four months of great quality life - all due to his
four-meds-a-day routine. It was very demanding cutting up the tablets
accurately and administering them to him twice a day and at exactly the
right time, and of course we had had to indulged in all sorts of
subterfuges with pate, yoghourt, and tuna to get the meds down his
throat. But every further day of health made it worthwhile.

On the morning of the day of his passing however he didn't come eagerly
for his breakfast. He moved from the porch window through to the
kitchen in three segments, each at my repeated urging. Then as the
morning went on we saw he was in difficulty. By lunchtime we had
noticed that he could not even lie down: he would rapidly get up again
and crouch, bewildered, his mouth open to maximise intake of air. I
discussed it all on the phone with the vet and the options were either
to transport him up hill and down dale to be hospitalised for a second
shaving and operation to drain his lung cavities, or let him go quickly,
in peace. The first option would have been too traumatic for him in the
state he was in and clearly the treatment he has been on, the only
treatment there is, cannot provide permanent relief. The vet came
quickly once I had rung a third time. He seemed very professional. We
didn't know him. Unfortunately the vet who had been caring for the cat
was off duty on the day in question. By the time the vet arrived the
cat had become so desperate he had leapt up onto my desk to look at me
and plead for assistance, just as he had leapt up onto the mantelpiece
at Christmas to gaze down upon me and beg for help. He just knew that
somehow I help. He didn't know how, but there was such trust there. We
brought the vet up to my study and he sat at my desk, took the cat in
his arms, petted him a little, and then proceeded to give him the
injections.

Now I wish to broach the reason for sharing this experience with you. I
need information from people who are familiar with putting cats to
sleep.

The beloved cat has been treated with respect and dignity since it was a
kitten. He was only four and a half years old. He behaved towards us
like a loving child. He would never attack us, scratch us, hiss at us,
or anything like that. In hindsight I wish I told the vet this before
bringing him into the room, but as it was we were in such an emotional
state and we just assumed that the vet would treat our "child" with the
same care and love that we have.

The vet sat in my chair, placed two syringes and a stethoscope on the
desktop, took the cat in his arms and pressed him down so that the cat's
head was in the crook of his left arm. The cat looked comfortable and,
of course, in spite of his great difficulty with breathing he was
looking at me with some alarm. (Who on earth was this stranger?)

Holding the cat on his lap with his left arm, with his right hand the
vet picked up one of the syringes and pushed it into the scruff of the
cat's neck. This was done quickly and with a degree of force. The cat,
on death's door all morning, immediately became extremely alarmed, his
eyes dilated with fear, and he pushed himself upwards and sought to
escape. The vet put down the syringe and then used his right hand to
grab the cat by the scruff of the neck and hold him up for about five
seconds, getting control of him. We were freaked out by this. It was
totally unexpected but we assumed, in the moment, the vet knew what he
was doing. But it did seem unnecessary, to us at least. He then
lowered the cat down, back into the previous position, saying it would
take five minutes for the anaesthetic to take effect. As he lowered the
cat back down into the crook of his left arm, the cat began harkling and
fighting at its throat with its two front paws. The cat was so clearly
distressed. I felt like I had utterly betrayed him. Throughout this
whole sequence of events the vet was so cool and professional, talking
quietly, and in control. Within 15 seconds or so the cat stopped
physically resisting. In hindsight I think that maybe although it
looked like the cat was being cradled in the vet's left arm he was
actually being quite forcefully held.

After five minutes the cat was truly immobile. His eyes were wide and
open and he seemed to be looking at me, kneeling on the floor looking
into his face and stroking his head, but the vet said he was "under".
The vet then took the second syringe and pushed it into the same area,
the scruff of the neck, as before. It was then just a matter of waiting
for the heart to stop beating. During this period, the vet stroked the
animal but I couldn't help noticing he was looking around my study,
noting things, like the pictures on the walls and so on. At one point
he remarked on one of my books and said he had read it as a youngster.
With tears streaming out of my eyes I wasn't about to start yabbering on
about some book so I didn't develop that conversation.

After another five minutes the vet said he believed the heart had
stopped beating. He then took his stethoscope, listened, and confirmed
that the creature had passed on. We then laid him gently on a plastic
bag in case any fluids etc should escape from him. We briefly discussed
how deep down we need to dig before burying him and arrangements as to
paying the bill, and then the vet left.

This happened about two weeks ago. Since then we have been wondering
occasionally about the manner in which the cat was relieved of his
suffering. As I said above, we didn't know the vet at all, but we have
come to understand that ordinarily, in this farming area, he deals with
large animals, livestock, horses, and so on, possibly including dogs.
We understand the vet who had been caring for our cat all along deals
with "small animals". In hindsight we wonder if the vet put our cat to
sleep as if he were a sheep or a calf, rather than a cat that was a
gentle as a child - as opposed to a feral cat.

We wonder if the "small animal" vet might have used an entirely
different approach. Might she have been more gentle? Might she have
shaved him a little first in order to find a vein and then ensure that
the anaesthetic circulated intravenously, so that the cat might simply
have drifted off like human beings do when they are put under general
anaesthetic in a hospital situation?

On the other hand, our cat had serious cardiomyopathy which was causing
a serious breathing problem, since fluid had clearly once again built up
around his lungs and impeded his breathing capacity. Maybe such a heart
and such a pair of lung react to anaesthetic with alarm and violence?
Maybe the vet's manner of administering the anaesthetic was perfectly
normal in the circumstances?

We would be so grateful for people's thoughts. We have thought about
seeking to have a private word with the "small animals" vet who had
cared for our cat for so long, but the problem is that she is not likely
to indict the other vet, who is her employer. Furthermore, we realise
we could cause strain between the two of them.

Obviously it would be easy to damn the vet's behaviour and say he was
out of line and claim that the cat should have felt no more pain or
alarm that what he was already feeling prior to the vet's arrival.
However, we realise that quite possibly in the circumstances the vet
handled the procedure as well as anyone could.

Thank you.

Eddy.


cindys wrote:
In my opinion, you make your decision on the basis of the cat's
quality of life. If medications are keeping him alive but he's
spending his whole day lying in the corner, it's time to call it a
day. OTOH, if the medications are keeping him alive, but he's spending
his day frolicking, it's too soon to call it a day. Even if you know
you may have a downturn in a week or a month. You can always call it a
day when you see the downturn.

I have a cat with very severe heart disease (although he has not
experienced the repeated episodes of fluid-buildup-induced respiratory
distress followed by periods of dehydration that you have described in
your cat). My cat ended up in the animal emergency room on December
30, 2007. His prognosis was grim. He was in respiratory distress,
every chamber of his heart was enlarged, he had leaky valves, blood
clots just asking to form. They drained his chest, prescribed some
medication and gave him "a few months at most." Our regular vet
estimated his remaining lifespan to be "maybe another month."

It's now been nearly a year and a half, and we still have the cat, and
he is still enjoying a really good quality of life, eating well
(thanks to Pepcid), going up and down the stairs, jumping onto (low)
tables, sleeping in my son's bed, etc. When the time comes, we won't
hesitate to call it a day, but that day will come only once. In the
meantime, the cat is happy, and we're appreciating every day we have
him. Every living creature is going to get sick and die someday. You
don't want to hasten that day but neither do you want to prolong the
suffering when it comes. I would say it is time to call it a day if
and when: Your cat is spending much of his day lying in a corner. He
doesn't want to eat (and you're already tried giving him Pepcid - ask
your vet for the proper dose for a cat, and don't use the extra
strength). He stops grooming. He stops using the litter box. He hides.
He's wobbly on his feet. These are all signs that he's had enough. But
if he's happy and frolicking, it's too soon. Take your cue from him.

(BTW, I saw that you wrote in another thread that you're giving your
cat aspirin - I would assume to prevent clots. You might want to think
about using Plavix (clopidogrel) instead. Our cat is taking four or
five different meds for his heart, but I believe it's the Lasix
(furosemide) and the clopidogrel that are responsible for keeping him
alive. The potential for blood clots is huge for cats with heart
disease. The medication is expensive in the USA because we only have
the brand-name available to us, but you can get it generic from a
Canadian pharmacy. I used Canada Pharmacy online. It cost me around
$80 for 100 pills. The cat takes only 1/4 pill per day, so 100 pills
are enough to last for a year and a half. In the USA, it costs $135
for 30 pills at CVS or Rite Aid.)
Good luck to you and your kitty.
Best regards,
---Cindy S.

"Eddy" wrote in message
...
Hello. Three months ago I asked in this group when people thought it
was time to "call it a day" with regard to a very ill pet and putting
him/her to sleep. Some people were extremely helpful, most particularly
CindyS, and in the end the advice proved to be very helpful. When the
time came, we knew.

Out extraordinary little cat is no more. We have both cried and cried.
I'm so sorry for your loss, and I can tell your cat had the best care. Bless
you. I'm sorry the end was hard. I think having a compassionate vet is
important, more for the human's good than the cat's even. We have had two
cats "put to sleep." In both cases there were two shots. In both cases the
vets were very kind. One of our cats, though she was suffering terribly, was
very strong and had to be given extra stuff in order to pass, and that was
terrible, but I would not say she suffered, just that her body rightly
protested the process. (It was in keeping with her personality, she fought
everything she didn't like, including reflections in ceramic mugs and such
.... ) I think it may be different with each cat.

The most important thing is, you were in a position to save your cat
suffering, and you were strong enough to do it. Where he is, he understands
now, and loves you for it. That's what I believe, anyway. Still and all,
what you did has to be the hardest thing we ever have to do for a loved one.

cybercat wrote:
One of our cats, though she was suffering terribly, was
very strong and had to be given extra stuff in order to pass, and that was
terrible, but I would not say she suffered, just that her body rightly
protested the process. (It was in keeping with her personality, she fought
everything she didn't like, including reflections in ceramic mugs and such
.... ) I think it may be different with each cat.

Thanks for this, Cybercat. We haven't considered that maybe it was just
a natural self-preserving instinctive reaction that our cat had. But
even if it was, I'm now wondering if a good vet can accommodate that and
give the first injection in such a way that the animal doesn't freak
out.

Anyway, I appreciate your kind words, Cybercat. Yes, I know we did all
we humanly could . . . except maybe talk to the vet first and make him
understand that our cat was the gentlest and most agreeable creature.
We have a friend who was so distraught when his cat needed to put to
sleep that he tells me he just handed the animal over to the vet and
then left and ran in floods of tears. He doesn't know what kind of end
the animal came to. Better to see it happen, I think.

Thanks again.
Eddy.

"Eddy" wrote in message
...
cybercat wrote:
One of our cats, though she was suffering terribly, was
very strong and had to be given extra stuff in order to pass, and that
was
terrible, but I would not say she suffered, just that her body rightly
protested the process. (It was in keeping with her personality, she
fought
everything she didn't like, including reflections in ceramic mugs and
such
.... ) I think it may be different with each cat.

Thanks for this, Cybercat. We haven't considered that maybe it was just
a natural self-preserving instinctive reaction that our cat had. But
even if it was, I'm now wondering if a good vet can accommodate that and
give the first injection in such a way that the animal doesn't freak
out.

Anyway, I appreciate your kind words, Cybercat. Yes, I know we did all
we humanly could . . . except maybe talk to the vet first and make him
understand that our cat was the gentlest and most agreeable creature.
We have a friend who was so distraught when his cat needed to put to
sleep that he tells me he just handed the animal over to the vet and
then left and ran in floods of tears. He doesn't know what kind of end
the animal came to. Better to see it happen, I think.

Thanks again.
Eddy.

I have never had to put a cat to sleep but did my "heart dog" I held her as
the vet shaved her paw and did what he had to. There was no trying to get
away of such. I KNOW two of my cats would fight like hell if it came to it.
They don't like strangers touching them.

In the end, your cat trusted you to do your best by him and you did. Please
don't punish yourself in second guessing things. I am sure every cat reacts
differently.

Granby wrote:
I have never had to put a cat to sleep but did my "heart dog" I held her as
the vet shaved her paw and did what he had to. There was no trying to get
away of such. I KNOW two of my cats would fight like hell if it came to it.
They don't like strangers touching them.

Thanks, Granby for your thoughts.

Your reference to your vet shaving your dog's paw a little, is the first
confirmation I have had that some vets do this when putting an animal to
sleep. If this can assist in a cat going peacefully, then this could
easily have been done in the case of our cat. I now need to find out if
this method is used for cats - or perhaps they shave them somewhere else
to find a vein.

In the end, your cat trusted you to do your best by him and you did. Please
don't punish yourself in second guessing things. I am sure every cat reacts
differently.

Thanks for this too. It might sound like we are punishing ourselves,
but we do need to know if these last moments of terror were unavoidable
or not. There are two reasons.

Firstly, for the six months that we were aware that out cat had serious
cardiomyopathy we troubled ourselves to give him the very best care and
quality of life WITH THE EXPECTATION that when the time came we could
ensure he passed away peacefully. In the event, that expectation was
completely dashed. To put it bluntly, we paid a considerable amount of
money to have the cat put peacefully to sleep . . . and he wasn't.

Secondly, the deceased cat has a twin brother, just as delightful and,
fortunately, without any obvious health problems. But one day he too
will probably need an assisted death. If at all possible we would like
to avoid his death coming at the end of five minutes of terror. No
animal or human being should have to die like this.

Eddy.

Eddy wrote:

Your reference to your vet shaving your dog's paw a little, is the first
confirmation I have had that some vets do this when putting an animal to
sleep.


We just lost our fourth last week. Ripley was 16, the grand old man of
the house, a long haired ball of fluff who was the acknowledged leader
of the pack of six cats. He lost a very long fight with diabetes and
went into kidney failure from which there was no recovery. We were
both present at the end, my wife holding him, as she was always his
favorite. With Ripley, as with the three before, the vet shaved a
spot, injected a sedative, followed by the final injection. The end
was very peaceful and dignified. Ripley was big on dignity.

"Eddy" wrote in message
...
Granby wrote:
I have never had to put a cat to sleep but did my "heart dog" I held her
as
the vet shaved her paw and did what he had to. There was no trying to
get
away of such. I KNOW two of my cats would fight like hell if it came to
it.
They don't like strangers touching them.

Thanks, Granby for your thoughts.

Your reference to your vet shaving your dog's paw a little, is the first
confirmation I have had that some vets do this when putting an animal to
sleep. If this can assist in a cat going peacefully, then this could
easily have been done in the case of our cat. I now need to find out if
this method is used for cats - or perhaps they shave them somewhere else
to find a vein.

In the end, your cat trusted you to do your best by him and you did.
Please
don't punish yourself in second guessing things. I am sure every cat
reacts
differently.

Thanks for this too. It might sound like we are punishing ourselves,
but we do need to know if these last moments of terror were unavoidable
or not. There are two reasons.

Firstly, for the six months that we were aware that out cat had serious
cardiomyopathy we troubled ourselves to give him the very best care and
quality of life WITH THE EXPECTATION that when the time came we could
ensure he passed away peacefully. In the event, that expectation was
completely dashed. To put it bluntly, we paid a considerable amount of
money to have the cat put peacefully to sleep . . . and he wasn't.


I understand how you feel, but I think you need to let this go. Don't use
the vet again, let him know how you feel, then drop him. But you are doing
nobody--including yourself--dwelling on this.