joints; and cataract surgery that can restore vision to cats. Cutting-
edge heart treatments such as open-heart surgery are available in
only a handful of veterinary teaching institutions, such as Colorado
State and University of Pennsylvania.
Experimental and cutting-edge treatments can be hard to find and
are often expensive. If your veterinarian doesn’t offer alternatives, it’s
up to you to ask. “We should not be afraid to offer the best care,” says
Jeff Johnson, DVM, a general practitioner with Four Paws Animal
Hospital in Eagle River, Alaska. “It depends on what the client wants
to do.” It’s important for the owner to understand the pros and cons,
and what home care may be required before making these care
decisions.
Research into feline longevity and health care is stil very new.
Studies of age-related disorders in other animals, including humans,
stand to benefit our cats as wel . In the best of al outcomes, both
humans and their special cats wil enjoy longer, healthier lives—
together.
Golden Moments: Zepp’s Last Chance
Five years ago, attorney Marc M. Gorelnik, from El Cerrito,
California, decided he wanted to adopt a cat. While visiting the San
Francisco SPCA, he fel in love with a 12-year-old longhaired feline.
“He weighed about 18 pounds, and had very light fur with darker on
top—a cameo color,” says Marc. “He was real y sweet, crawled up in
my lap and purred and purred. He was very mel ow and affectionate.”
The cat’s original name—“Peach Pie”—didn’t seem to fit, so
Marc settled on Zeppelin or Zepp for short, because of the cat’s size.
Zepp’s heart was as big as his furry outside, and he constantly wanted
to be held and petted. “He’d fol ow you from room to room, wanted to
be in your lap, and was al over you when you were on the phone,”
says Marc. “He was almost a nuisance at times he was so
affectionate.”
The first four years together, Zepp had no health problems. “He
was a very low-maintenance cat,” says Marc. When the cat’s weight
crept up to 20 pounds, it was easily managed with a reduced-calorie
food until he slimmed down to a svelte 16 to 17 pounds.
When he was 16, though, Marc saw a change. “He’d always had a
great appetite. I noticed he wasn’t finishing his food, was lying around
and keeping his distance. He just didn’t seem to feel comfortable.”
The veterinarian ran blood tests on Zepp, but they were from the low to
high normal ranges, nothing that convinced the doctor that treatment
was necessary. She suspected he might be hyperthyroid, and
recommended periodic rechecks to monitor the situation.
Meanwhile, Marc decided to get Zepp a pal—a Maine Coon kitten.
He contacted various breeders in January, interviewed and decided
on one, and made arrangements to choose a kitten.
Zepp continued to have good days and bad days, and Marc grew
more and more concerned. “He’d never had any health issues at al ,
and he very obviously was not feeling wel .” After further tests in March,
the veterinarian was persuaded Zepp was hyperthyroid, and Marc
was referred to a local practice to receive what is known as an I-131
radioactive iodine procedure.
“It took a long time to get an appointment, so we put him on
Tapazole,” says Marc. Tapazole is an oral medication to counter the
effects of the hyperactive thyroid gland. “The doctor said there might
also be a kidney issue, but we’l deal with it after taking care of his
thyroid.”
When specialists reviewed Zepp’s symptoms and tests prior to
his I-131 treatment, they told Marc the cat was in advanced chronic
renal failure. “Then Zepp essential y crashed. I knew immediately this
poor cat was dying,” says Marc.
Zepp was hospitalized and given fluid therapy. Marc was dispensed
a couple different kidney diets, and instructed how to give
subcutaneous (subQ, or beneath the skin) fluids at home. “But he
didn’t improve at al . He wasn’t eating, his weight was dropping like a
stone, down to about 13 pounds,” says Marc. “My family urged me to
get a second opinion, so I made an appointment at University of
California-Davis.”
Zepp weighed only 12 pounds by the time he was seen at
Davis, and had suffered a lot of muscle wasting. Marc brought copies
of the previous lab work, and they ran additional tests as wel . Al his
kidney values had climbed. To counter his weight loss, they placed an
esophagostomy tube to get some food inside the cat.
Dr. El en Mcdonald, a resident and internist at the teaching hospital,
told Marc there wasn’t much they could do. They’d try and stabilize
Zepp and perhaps improve his quality of life for the time he had left. “I
was beside myself, and in tears through most of this,” says Marc.
“They said short of transplant there’s real y nothing can be done.”
Marc was given instructions how to feed Zepp a slurry of food
through the tube. “It was real easy to medicate him, but he needed to
be fed three times a day.” He found a local vet tech wil ing to come
during the day, and Marc handled the morning and evening food and
medication.
Despite intensive care, Zepp continued to decline, to the point he
was unable to get out of the litter box once he climbed inside. He was
rushed back to the Davis hospital on a Friday. “I thought it was his last
trip. I was trying to be realistic about it,” says Marc. “He had lost quality
of life. This was no way for him to live.”
At the hospital, Dr. Mcdonald asked if a transplant was a
consideration. They could run the tests to see if Zepp passed the
criteria. Marc asked surgical resident Dr. Ian Holsworth to look at
Zepp and his tests. Only a couple minor tests were lacking to qualify
him for the procedure. “And they had a slot open,” says Marc, stil very
emotional remembering the events. If the last tests were okay, Zepp
had a chance to get a new kidney. Marc knew it was the one, final
chance to save Zepp’s life.
He took the sick cat home to wait for the phone cal that would mean
life or death—and Zepp got his miracle. Three donor cats were good
matches. Zepp was admitted on Saturday morning, and surgery was
performed by Dr. Holsworth and Dr. Clare Gregory the fol owing
Wednesday. “They cal ed to tel me everything was fine, and the donor
cat was also doing fine,” says Marc.
Part of the arrangement of the transplant procedure is that the
owner of the recipient cat also adopts the donor cat. Newton, a 17-
month-old gray tabby, was Zepp’s savior. “Newton is a fabulous cat,”
agrees Marc. “He is aggressively affectionate, and loves to be rubbed
on the bel y, but he is brutal y strong. My brother says Newton is hard
like a tabletop with fur. He’s been neutered but stil has the tomcat
physique.”
Newton is the best thing that’s ever happened to Roger, the brown
mackerel tabby Maine Coon kitten that arrived. They are constant
pla
y-buddies, chasing each other and wrestling.
It took about a month for Zepp’s new kidney to become ful y
functional. He came home with the feeding tube stil in place. “He was
not good when he came home,” says Marc, but once the feeding tube
was removed he became a different cat altogether.
Today, his kidney is fine. His extravagant displays of affection have
not returned, and he’s stil relatively quiet compared to before his
il ness. Today, his kidney is fine. “But his quality of life is back,” says
Marc.
Since the transplant Zepp has faced other chal enges. Most
transplant cats get both prednisolone and cyclosporine daily for the
rest of their lives to prevent organ rejection. But he developed
diabetes, and it is a balancing act to regulate him because the
antirejection drugs also affected insulin/glucose levels. “I don’t mind
giving him insulin shots. It’s easier than dealing with giving him a pil ,”
says Marc.
His experience has taught him that veterinarians are very busy,
and unable to offer the detailed attention an owner could give your pet.
“Trust your instincts,” he says, and educate yourself to what’s involved
in the health needs of your cat. “If you have an older cat these things
are going to happen,” he says. “Try to know your limits and try to know
your cat’s limits in terms of what they can take.”
He would do everything again in a heartbeat. “Fortunately, I can
afford it, so I did it. And I’m glad,” he says. “Zepp has brought me such
joy. Looking at Zepp right now, lying on the couch a couple of feet from
me, grooming himself—it’s worth it when you see that. When you see
him doing normal cat things and enjoying it, it’s worth it.”
CHAPTER 6--MAKING CHOICES
Today we are privileged to enjoy sharing the company of our cats for
longer than ever before. Of course, even two decades of time together
isn’t enough. Most cats wil not outlive their owners, however. That is a
sad fact we must accept when we welcome a pet into our heart.
As they age, we know our cats may develop a health problem or
disability. We understand that someday we will lose them to death. If
anything, that makes the short time we share with them even more
precious. But as our strong connection with special cats grows
stronger year after year, making choices about her life and death
becomes ever more difficult. Is it selfish to want to prolong her life?
When is the right time to say goodbye? Cost of care, concerns over
her comfort, and guilt about making these choices can make your last
weeks or months together even more difficult.
There is no wrong answer. Take a moment to look at your cat,
stroke her soft fur, and smile through any sadness because you know
she trusts you to make these decisions for her. She’s not worried. She
won’t “blame” you, no matter what choice you make on her behalf. And
what’s more, it doesn’t matter what other folks think, or what they’d do
—every situation is different, and what applies to others may have no
bearing on your situation. Give yourself permission to say yes, this is
hard. It hurts. In a strange way, it’s supposed to be hard. It wouldn’t be
so difficult if you didn’t care so much.
A hard decision is often the right decision when it comes out of love
for your cat. Take comfort because the best any of us can hope to do
is to make informed choices with the best information available at that
time. Any choice you make that’s based on love and concern for her
welfare cannot be wrong.
The Final Gift
Cats are born, live for a time, and then they die. Accidents may tear
them away from us while they’re young. Some drift off in the gentle
sleep of old age and never awake. Others linger, in questioning pain,
begging for relief with silent eyes. These last need our help, a gift that
comes with equal measures of love and pain—that is, giving them a
calm, dignified and gentle death through euthanasia.
When do you know the time has come? When you begin asking
yourself that question, it’s time to consider the possibility the end is
drawing near.
Does she stil like her life? Does she enjoy being with you? How
many more days wil she have that are as good or better than today?
“I think that’s one of the most meaningful measures,” says Susan G.
Wynn, DVM, a certified veterinary acupuncturist practicing in Marietta,
Georgia. “If today is real y bad, and almost every day fol owing this is
going to be as bad, it helps for you to make that cal .”
When pain or il ness consumes her with little hope of recovery; when
your cat knows her fight is done; when prolonging her life offers no
hope for enjoying that life; these are determinations only you, as your
cat’s best friend, can make. People who are closely bonded to their
special cats just know when the time is right. Listen to your heart, and
your cat wil tel you when she’s ready to say goodbye.
Preparing for the End
Veterinary oncologists routinely deal with owners struggling
with life and death decisions and ultimately grief. “For me, grief
counseling is part of the therapeutic process,” says Dr. Kitchel . “We
know what the outcome is going to be. It’s just a questions of how long
it takes to get there.”
prepared, and they’ve had time to think about their options,” says Dr.
Garrett. “If you see it coming, you can plan things.” For the most part,
geriatric cats with chronic diseases such as cancer or kidney failure
wil not overcome their il ness. Treatment actual y gives back time the
cat wouldn’t otherwise enjoy. Treatment offers the owner time to come
to grips with the reality of eventual loss. “Prolongation of life isn’t real y
my primary goal,” says Dr. Marks, “but if that quality of life leads to
quantity of life, then that’s tremendous.”
Dr. Garrett says the best time to talk about pet loss is before you
lose your cat. “The diagnosis of a terminal disease is often the time
that the grieving process starts,” says Dr. Garrett. An important part of
the veterinarian’s job is to talk to clients about their thoughts and
feelings, and help them through the process to make the right choices
for themselves and their animals.
It’s common for owners at some point during a chronic
treatment to ask about what to expect as the end draws near. That’s
beneficial because it helps eliminate surprises, and helps you
prepare. Typical y, veterinarians wil explain treatments and the
average prognosis at the time of your cat’s diagnosis. There’s no way
to predict survival with any accuracy, but the doctor can offer an
average life expectancy based on the condition and the chosen
treatment. “If it’s a cancer, I’l explain that we can prolong the life very
comfortably but not cure them, and in the end, you wil lose her to this
disease,” says Dr. Garrett.
There may be instances in w
hich owners prefer to euthanize
the cat while she’s stil feeling good. For example, a brain tumor could
prompt a seizure or hemorrhage that causes a traumatic, scary or
painful death that they don’t want to risk their children witnessing.
“That’s a horrible memory, with no beauty to it at al . They’d rather talk
it over with the family, and plan a euthanasia, have the family there,
have her favorite toys there,” says Dr. Garrett. “When she’s fighting a
terminal il ness, any time is the right time to decide to put her to
sleep.”
But remember, this is your choice to make, and many people can’t
make this decision as long as the cat looks and feels good. “I respect
that, too,” says Dr. Garrett.
Talking to Children
Being there for the euthanasia can be a gift to both the adults and
children in the cat’s life when the passage into death is painless, calm,
and loving. The loss of a beloved cat typical y is the first experience
children have with death and losing someone they love. Dr. Kitchel
believes it’s very important that children are involved and a part of the
process. “It hurts to see this,” she says, “but it would hurt anyway to
lose somebody if you love them.” The bond is often deeply shared by
children in the cat’s family as wel as adults, and this needs to be
recognized.
Children learn valuable lessons from the death of a pet. Parents
shouldn’t fear including them, says Dr. Kitchel . “This is not just about
the biology. The relationship has to be honored and has to be
respected. This is about the spiritual side of that bond between a
person and an animal.”
Your children are most affected by the way parents, as role models,
react. “When they see the parent afraid of death, they’re going to be
frightened, too,” says Wal ace Sife, PhD, a psychologist and president
of the Association for Pet Loss and Bereavement. Instead he advises
parents to explain that al things must die, that even though cats live
shorter lives, we become better people because of the wonderful love
that we’ve shared. The younger your child is, the easier it wil be for
him to accept that death is a normal process, and that your cat wil go
to kitty heaven.
Dr. Sife warns that trying to help cushion the pain with euphemisms
may backfire and terrify the child. “Parents wil say, God wanted him