Thursday, November 08, 2007

The Talk

I saw a cat today for "check mouth, and eye." That's what the appointment book said. I looked at the history and saw it was a geriatric, thin cat diagnosed with Inflammatory Bowel Disease in July.

The cat I saw was emaciated. Sharp bones sticking out through her fur. At a glance, I could tell her eye was bulging, her face deformed by a mass lurking within.

But the people who loved this cat for 16 years could not see that. They saw a beloved, furry family member. "Something's wrong with her mouth; she can't eat," the owner said. "We're not ready to put her to sleep yet, but we don't want her to suffer or be in pain."

"Let's take a look," I said, and did a full exam. Her eye was pushed out of the socket and not tracking like the other eye. The iris worked, but it was injected, the sclera was red, and she couldn't blink properly. While the other side of her face was bony, this side had a firm swelling around the cheek bone. The molar on that side had a large pocket all around it where the bone had been eroded. I really don't know what was holding it in place. The tumor was also invading the TMJ, because she could only open her mouth about a half a centimeter.

Things were grim. I told him about the tumor, that it most certainly was causing her pain, in her eye, in her mouth, in her jaw. She was too emaciated to even consider the kind of aggressive surgery she would need, and frankly, I wouldn't even put my young robust cat through a hemimaxillectomy like she needed (removing basically half the face). There was nothing I could do for her -- pain meds would likely just induce coma.

I told him about euthanasia, what the process was, what to expect. He needed to talk to his wife first, of course. I hoped they would call soon.

It feels like such a defeat, to say there is nothing I or anyone can do. I hate it, and fear the owner will think I am just too lazy to properly work up and treat their patient.

However, usually the opposite is true. Owners want to know honestly when it is time. It is such a burden to make this decision, it helps when someone else shoulders a little bit of it by saying, "Stop. You could do some other procedure, but it's time to give this beloved pet the gift of an easy death. Let them go."

I didn't know, however, I was going to have this discussion tonight with someone I love, about a pet I am fond of. My MIL's old sheltie has been in decline for the past year. He has some neuromuscular disorder (probably degenerative myelopathy), making him shuffle and stumble. He grows weaker all the time.

Now his mind is going, too. He has little joy left in life, and hardly recognizes the people he's lived with for 16 years. "What do I do?" my MIL asked me. "We have to do something; he's not in pain, but he can't go on like this."

Poor old Fox. I remember when he was the young upstart, pestering Terlingua to play. Hard to believe he's so old and decrepit.

She's bringing him down this weekend. Most of Fox is already gone, and I'll help the last part of him let go. "I don't want a stranger to do it," my MIL said. Me, neither. It's the last gift we can give him.


mr man said...

every time you post an appointment like this, it brings up so many memories and thoughts....

they all seem trivial and pale next to your account. so wonderfully encapsulated and illustrated. i have a hard time even commenting at all. we are so lucky to have you as a friend.

get2eric said...

It is such a difficult decision to make. It helps when the vet is caring and thoughtful.

I hope the skinny cat's owner resolves the inner conflict and comes back soon for your help.

Poor old Fox.

Sinda said...

I've probably posted this thought before, but I am always so grateful that we're able to practice euthanasia on our pets. I think there is a point when you know, you know with certainty, that it's time for your pet.

A close friend's parent in Belgium has been terminally ill for some time. There, you can apply for the right to practice euthanasia, which he did. When it got to the point where they knew that additional pain meds would cause him to slip into a coma, they knew that would be the end, and they were able to plan for it and prepare for it, as was he. You can't get more dignified than that, I think.

Anonymous said...

Amend to mr man's comment....

We are so lucky to have a daughter like you!

God bless Fox and Marion.

Love, M

Anonymous said...

Oh so sorry for the mis-spelled word. Hope you know my thoughts....Love you!

Alissa said...

I agree, it is always hard to discuss the end, but sometimes we have to be an advocate for the animal. I hope the cat's owners make a decision and come in today. Sorry about Fox, I know that will be sad.

Emily said...

I saw you once with a family right after a euthanasia. You were wonderfully comforting.

And, of course, I was there for Terlingua's. I'm sure it will help Marion to have you there.