My wife and I made the tough decision to euthanize our 11+ year old cat yesterday and I've been searching the internet trying to find information that supports the info we were given by a couple of vets so that we can be sure we did the right thing.
I apologize for the long post but I'm really hoping that people that are knowledgeable about cats or that may have had a similar experience might chime in and offer us advise about whether we did the right thing.
Here is the detailed story:
In September the cat was diagnosed with a thyroid problem and was put on 2.5mg of methimazole twice a day. She improved within about a month, became more active, coat improved, etc. We were thrilled.
About two weeks ago we noticed that she had lost a lot of weight (she was 10.5 lbs at her last check up, and maybe 12 lbs before the thyroid diagnosis) and was acting funny, sitting and staring off into space, mentally disconnected etc.
We took her to the vet and she weighed in at 8lbs (-2lbs in about a month) and the vet noticed that she was jaundiced. He said that it was probably cancer, however a quick search on my phone revealed that methimazole can cause jaundice, so at the time I was sure it was a reaction to the drug. We discontinued methimazole last Wednesday.
She ate her last food willingly last Friday, and we fed her with a syringe on Saturday and Sunday. We took her to an emergency vet on Sunday to get a second opinion and possibly to have a feeding tube inserted because she was fighting us over the syringe feeding and vomiting. The emergency vet gave us meds to combat nausea and an appetite stimulant and we continued to syringe feed per until Monday when we took her to our regular vet.
Our regular vet did a bunch of additional tests and confirmed that she had hepatic lipidosis (fatty liver) and agreed to insert a feeding tube on Tuesday. The vet also performed an ultrasound and found an inflamed bile duct.
The vet informed us that she had a 50% chance of getting over the fatty liver, and that after she was over it she needed surgery to correct the bile duct issue, and that the overall chance of survival would be 30%. They wanted to do additional tests but were vague about what they would be, mentioning xrays, an additional ultrasound and a cat scan to try and figure out what the bile duct problem was. Since we were told that she would not survive the surgery until she improved, we figured that additional tests were not worth it if we couldn't have the corrective surgery done anyway. We declined to do the tests and resolved ourselves to getting her healthy enough to be able to have the surgery.
I did a bunch of research and found that the survival rate for fatty liver was approximately 90% if the cat was properly cared for, which my wife and I were prepared to do.
The cat spent the entire day at the vet on Tuesday and Wednesday receiving food via the feeding tube, a bunch of drugs and subcutaneous fluids.
On Thursday (Thanksgiving) my wife and I spent the entire day feeding her 20-25ml of food every two hours. After each feeding the cat would get very depressed and was obviously uncomfortable. She was drooling constantly and clear liquid would come out of her nose for a while after feeding. She would also grunt and her breathing became noisy. I thought maybe we were feeding too much but I checked the internet and confirmed that we were giving the right amount, if not less.
We gave her subcutaneous fluids (200ml) twice as directed by the vet, and within about 15 minutes of both treatments she urinated wherever she was and immediately laid down in it. At this point we had to confine her to our bathroom because she was hiding from us wherever she could and urinating all over the place.
My wife and I decided to go back to the vet yesterday with the intention of pursuing the additional tests to try and find out what the issue with her bile duct was. At this point we did not want to put her through weeks of tube feeding if she wasn't going to survive the corrective surgery anyway.
Our vet had already spoken to the surgeon (we talked to her on Thanksgiving, she was so helpful) when we arrived at her office on Friday, and the surgeon advised us to skip the additional tests and go straight into surgery.
We were given a price of $3500 for the surgery and $1000 for post-op care, and were told that she had a 50% chance of survival, and that the surgery may not even correct the issue. The vet did some blood work and determined that the cat had improved in some areas and deteriorated in others. Her total bilirubin level had gone up (indicating her liver had gotten worse) and she had low blood pressure and her blood was very thick. She had also lost another pound (in 4 days) and was down to only 7lbs.
Our vet said she didn't feel like she had a good chance of surviving an operation, and that she would not survive if she didn't have the surgery. If she survived the surgery and it corrected the issue, we STILL had to tube feed her for 4-6 more weeks to correct the fatty liver.
We didn't want her to die during the surgery or post-op because we wouldn't be there for her and she would have been afraid. I'm afraid this was a selfish decision.
We also didn't want her to come out of the surgery only to go through 4-6 weeks of tube feeding to find out that we couldn't correct the fatty liver and still lose her, which would have made the last 2 months of her life very uncomfortable.
Ultimately we decided to have her euthanized. It was very hard on both of us but with the information given to us by the vet and the surgeon her total chance of recovery would have been around 25% and would have required 2+ months of recovery time and tube feeding.
The vet offered to do an autopsy free of charge and we accepted. She worked until 8:30 last night to perform the procedure and called to inform us of what she had found.
The vet said that all of the internal organs were very jaundiced, the pancreas was 3-5 times normal size, the bile duct had a bunch of abnormalities and was inflamed, and the gallbladder was inflamed. Additionally a lymph node in the area was enlarged and contained abnormal bacteria. She did save a tissue sample and offered to send it somewhere else to be examined but we declined.
I asked the vet directly if we had done the right thing and she said yes, and I asked directly if the cat could have been saved, and she said it was doubtful. I was relieved by this information, however I decided to search the internet for confirmation in case she was just being reassuring.
Ultimately based on the autopsy it is clear the cat had pancreatitis which had caused the inflammation in the bile duct and gallbladder, and hepatic lipidosis (fatty liver) had been caused by decreased appetite secondary to the pancreatitis.
I found two sources that confirmed that pancreatitis and fatty liver combined had a "poor" prognosis or about a 20% chance of survival, however I found many more sources that claimed that both problems were correctable and that the prognosis was "good".
It is killing me to think that we made a rash decision in putting the cat down. If anyone has any information or a personal experience they can share that can help my wife and I believe that what we did was best for the cat we would really appreciate it.
Ultimately my specific question is, if we had done the surgery, and the pancreatitis was discovered, and the cat survived the surgery, what are the chances that the cat could have been brought back to full health?
From what I have read on the internet the only way to cure such a severe case of pancreatitis is to withhold food for 3-5 days to keep the pancreas from producing enzymes. Given the fatty liver condition, it is doubtful the cat would have survived this fasting. We would have had to cure the fatty liver problem first, however with the blocked bile duct I don't believe this was possible. Can anyone confirm the accuracy of this?
I apologize for the long post but I'm really hoping that people that are knowledgeable about cats or that may have had a similar experience might chime in and offer us advise about whether we did the right thing.
Here is the detailed story:
In September the cat was diagnosed with a thyroid problem and was put on 2.5mg of methimazole twice a day. She improved within about a month, became more active, coat improved, etc. We were thrilled.
About two weeks ago we noticed that she had lost a lot of weight (she was 10.5 lbs at her last check up, and maybe 12 lbs before the thyroid diagnosis) and was acting funny, sitting and staring off into space, mentally disconnected etc.
We took her to the vet and she weighed in at 8lbs (-2lbs in about a month) and the vet noticed that she was jaundiced. He said that it was probably cancer, however a quick search on my phone revealed that methimazole can cause jaundice, so at the time I was sure it was a reaction to the drug. We discontinued methimazole last Wednesday.
She ate her last food willingly last Friday, and we fed her with a syringe on Saturday and Sunday. We took her to an emergency vet on Sunday to get a second opinion and possibly to have a feeding tube inserted because she was fighting us over the syringe feeding and vomiting. The emergency vet gave us meds to combat nausea and an appetite stimulant and we continued to syringe feed per until Monday when we took her to our regular vet.
Our regular vet did a bunch of additional tests and confirmed that she had hepatic lipidosis (fatty liver) and agreed to insert a feeding tube on Tuesday. The vet also performed an ultrasound and found an inflamed bile duct.
The vet informed us that she had a 50% chance of getting over the fatty liver, and that after she was over it she needed surgery to correct the bile duct issue, and that the overall chance of survival would be 30%. They wanted to do additional tests but were vague about what they would be, mentioning xrays, an additional ultrasound and a cat scan to try and figure out what the bile duct problem was. Since we were told that she would not survive the surgery until she improved, we figured that additional tests were not worth it if we couldn't have the corrective surgery done anyway. We declined to do the tests and resolved ourselves to getting her healthy enough to be able to have the surgery.
I did a bunch of research and found that the survival rate for fatty liver was approximately 90% if the cat was properly cared for, which my wife and I were prepared to do.
The cat spent the entire day at the vet on Tuesday and Wednesday receiving food via the feeding tube, a bunch of drugs and subcutaneous fluids.
On Thursday (Thanksgiving) my wife and I spent the entire day feeding her 20-25ml of food every two hours. After each feeding the cat would get very depressed and was obviously uncomfortable. She was drooling constantly and clear liquid would come out of her nose for a while after feeding. She would also grunt and her breathing became noisy. I thought maybe we were feeding too much but I checked the internet and confirmed that we were giving the right amount, if not less.
We gave her subcutaneous fluids (200ml) twice as directed by the vet, and within about 15 minutes of both treatments she urinated wherever she was and immediately laid down in it. At this point we had to confine her to our bathroom because she was hiding from us wherever she could and urinating all over the place.
My wife and I decided to go back to the vet yesterday with the intention of pursuing the additional tests to try and find out what the issue with her bile duct was. At this point we did not want to put her through weeks of tube feeding if she wasn't going to survive the corrective surgery anyway.
Our vet had already spoken to the surgeon (we talked to her on Thanksgiving, she was so helpful) when we arrived at her office on Friday, and the surgeon advised us to skip the additional tests and go straight into surgery.
We were given a price of $3500 for the surgery and $1000 for post-op care, and were told that she had a 50% chance of survival, and that the surgery may not even correct the issue. The vet did some blood work and determined that the cat had improved in some areas and deteriorated in others. Her total bilirubin level had gone up (indicating her liver had gotten worse) and she had low blood pressure and her blood was very thick. She had also lost another pound (in 4 days) and was down to only 7lbs.
Our vet said she didn't feel like she had a good chance of surviving an operation, and that she would not survive if she didn't have the surgery. If she survived the surgery and it corrected the issue, we STILL had to tube feed her for 4-6 more weeks to correct the fatty liver.
We didn't want her to die during the surgery or post-op because we wouldn't be there for her and she would have been afraid. I'm afraid this was a selfish decision.
We also didn't want her to come out of the surgery only to go through 4-6 weeks of tube feeding to find out that we couldn't correct the fatty liver and still lose her, which would have made the last 2 months of her life very uncomfortable.
Ultimately we decided to have her euthanized. It was very hard on both of us but with the information given to us by the vet and the surgeon her total chance of recovery would have been around 25% and would have required 2+ months of recovery time and tube feeding.
The vet offered to do an autopsy free of charge and we accepted. She worked until 8:30 last night to perform the procedure and called to inform us of what she had found.
The vet said that all of the internal organs were very jaundiced, the pancreas was 3-5 times normal size, the bile duct had a bunch of abnormalities and was inflamed, and the gallbladder was inflamed. Additionally a lymph node in the area was enlarged and contained abnormal bacteria. She did save a tissue sample and offered to send it somewhere else to be examined but we declined.
I asked the vet directly if we had done the right thing and she said yes, and I asked directly if the cat could have been saved, and she said it was doubtful. I was relieved by this information, however I decided to search the internet for confirmation in case she was just being reassuring.
Ultimately based on the autopsy it is clear the cat had pancreatitis which had caused the inflammation in the bile duct and gallbladder, and hepatic lipidosis (fatty liver) had been caused by decreased appetite secondary to the pancreatitis.
I found two sources that confirmed that pancreatitis and fatty liver combined had a "poor" prognosis or about a 20% chance of survival, however I found many more sources that claimed that both problems were correctable and that the prognosis was "good".
It is killing me to think that we made a rash decision in putting the cat down. If anyone has any information or a personal experience they can share that can help my wife and I believe that what we did was best for the cat we would really appreciate it.
Ultimately my specific question is, if we had done the surgery, and the pancreatitis was discovered, and the cat survived the surgery, what are the chances that the cat could have been brought back to full health?
From what I have read on the internet the only way to cure such a severe case of pancreatitis is to withhold food for 3-5 days to keep the pancreas from producing enzymes. Given the fatty liver condition, it is doubtful the cat would have survived this fasting. We would have had to cure the fatty liver problem first, however with the blocked bile duct I don't believe this was possible. Can anyone confirm the accuracy of this?