Expert: Jana Connell RVT, CVT - 1/29/2010

Question
Dear Jana,

This is a report of what is happening with our kitty, Casey. As you know, she is getting near the end with Chronic Renal Failure.  If what I say is possibly useful to others who go through this experience, please answer and add any advice you will.  If this “non” question of mine is useless, you are free to turn it down and that is ok.   You see, we are seeking support of a certain sort.

Our kitty has reached a point where she has little strength and will stay where we place her all day or all night.  For three days we have tried to feed her gently and provide water but she rejects that.  I do wish she would take a little and the portion of blood pressure med in the food.  She had difficulty with water a few days ago and now will not take any nourishment.  Honestly, I cried my eyes out on the way home from work yesterday, fully expecting to find her gone over to the bridge.  Then, today the same but she is hanging in there.  We have spoken to her and emphasized it is ok to leave this life.  To those who might laugh, check your heart and compassion and hope you are able to say the same thing to a terminal pet which someday might be in your care.

Tomorrow if she makes it through the night we will go to our vet.  Why?  Sure, we have considered putting her down, assisting her crossing to a new world.  Yet, when the time is here we need support in the decision.  That is why the visit to the vet.  We want him to give his opinion on whether he believes she is in pain, does she know what is happening around her and are we making the right decision.   If so, if he believes the time is here, we will very likely go through with the procedure.
Sure, his decision is support for me certainly after all is done. The decision is truly ours, not the vets.  We do not want to feel we are pushing to make the decision too early.   If too early, we will wait but out kitty must be comfortable in that wait!

When she was in my arms tonight, she was like a rag doll but for a moment placed her front paw on my cheek and took a few deep breaths, once crying out in a weak voice different from what I have heard before.   I do believe she is ready, if that makes sense.  

Jana, in facing a choice to euthanize our kitty of right at 19 years, I feel very, very mortal.  I feel anything but god-like in the decision.  This decision comes with tears and pain borne of love, memory, compassion and the desire to do the best even if quite difficult.  I have not had to make such a decision since the late 1980’s and it is not easy when hearts are tender and the kitty has been a wonderful companion long enough to be part of us.

She will get her sub-q saline tonight.  We do not want pain to build in her from dehydration regardless of how alert she may be or not.

My advice to others is this: Seek help in understanding the disease of CRF and the paths it takes.  Learn the basic procedures to help your kitty feel better and function better even if dealing with a certainly terminal disease.   Providing saline fluid beneath the skin takes only once to learn and is not difficult.  Holding a water bowl up and supporting the kitty or what might be needed is not difficult when drinking and eating may be difficult otherwise.   And, do seek out advice from a caring vet or ask this wonderful technician here on allexperts.com.   Some vets are too quick to put down animals as I see it.  A caring veterinary medical adviser will provide sound counsel and help you a bunch with treatment options and decisions you make as the disease progresses.  

Jana, I have written a full page question. Sorry.    When Casey is gone by nature or assistance, I will let you know.    Reply if you wish and if you believe anything said here will be of value to others.  I find in virtually every situation, as personal as it might be, we are not alone and are not the first to face such a situation.  Other caring people are out there who do know.

God Bless and Peace.        Thomas.

When I went to send this to you, maxed out showed.  I am used to being maxed out myself.  A little while ago after going to bed and saying a prayer for an easy ending for Casey, my wife called me to the room where Casey was.   She had taken some gasps.  She is gone now. We were there and it was quick.  At about 11:22 tonight a cat who was in this family just shy of 19 years left her body and her spirit flew to a special place of peace.   We were fortunate and so was she to die at home, gently as it can be in natural death.   We were not going to allow her to suffer and knew the visit to the vets tomorrow would be a good bye.  She did not want to wait that long.


Answer
Oh Thomas,
I sit here in tears with your wonderful letter. I am so glad you wrote to tell me all of this. I am glad that Casey is in a better place but I know that you are left with tears also at her absence.

Let me just say this. If you had taken her in tomorrow it would have been the right thing had she hung on another night. She was in pain and she told it was time when she stopped eating a few days ago. That is always their way of letting go. I have told clients that for years. When they stop eating they are saying loud and clear- I am done, I am ready.

Casey was ready whether or not it was today or tomorrow. Had you made that choice it would have been the greatest gift you could have given her. She knew that but her little body couldn't wait any longer.

I understand your feeling about having to make that choice Thomas. When my cat Crouton died in May I had to make that choice myself. She was 15 and in one swift week went into kidney failure herself. I think I told you this. I gave her sub-q fluids for a week and told her to let me know when she was ready. The idea of me making that choice was more than I could bear.  In the morning, I found her under the bed and she gave me "the look". That look said, I can't handle any more of this. She was not in pain, but I found out afterward that her kidneys were so small she was really being poisoned from within. That is the awful thing about renal failure. Their own body poisons them with the wastes that are normally excreted with the kidneys.

So Casey was in this place herself and she couldn't have felt well at all. Her lack of eating was the clue. Crouton had also stopped the night before. So she let you know when she touched your face- I am ready Dad.

You were blessed. I wanted Crouton to go that way, but alas I had to make the choice that rips my heart out. However, once it was over, I knew I had done the right thing. I had given her the gift of peace. Casey gave it to you also in her own way.

Bless you all Thomas. I know this is hard, but she is, as you put it so beautifully, in a special place of peace.

Thank you again for letting me know. You are a wonderful pet owner and she was blessed to be loved by you both. I have been blessed by you writing to me.

Namaste to you and your family.
Jana