Euthanasia And Guilt, Euthanized too soon Options

[roberman]

I put my 12-year old diabetic cat Calvin to sleep in Feb. 1, and I have been heartbroken and filled with guilt and remorse ever since.

His diabetes had been regulated for 4 years. He got diabetes when he was 7 years old. It was a difficult process in the beginning trying to get him regulated. The hospital was unable to regulate him because he did not want to eat and was homesick. We tried two different human insulins and he resisted them both. He had two bladder infections and neuropathy in his back legs. The vet told me he would not walk right again. Finally I found bovine insulin from feline diabetes groups. We tried it, and within 2 months, he was regulated and the neuropathy went away. His only other health problem was bladder stones. That was a middle of the night emergency, but he healed fine from that.

He was not sick for four years, and I guess I got complacent. For some reason, I had the deadly mindset that the only disease he would get would be related to his diabetes (ketones, blood sugar problems, bladder infections). Either that or I unconsciously did not want to face the fact that he might be ill. He was my favorite of 4 (his brother Hobbes and my dogs Charlie and Maddie).

A few months before he got so sick this last time, when I took him for a BG reading, his sugar was very low. We kept decreasing his insulin until suddenly his BG spiked. His insulin dosage finally ended up where it had been. For a long time in the past it was 9 units twice a day. In early December he had a good reading at 6 units twice a day, and I was told I should return if he showed clinical signs of problems.

I have always known that canned food is better for diabetics than dry food, but Calvin would not eat much canned food. I got dry food with chicken or salmon as the first ingredient and no corn or wheat gluten. Still, I am sure he got too many carbohydrates.

I know I should have caught earlier the fact that something was not right with him. That’s the main way I let him down, I think, that and letting him go a couple of days without eating. In my ignorance, I did not realize that it was dangerous for cats not to eat, especially diabetics. A friend had told me that cats could go for quite a while without food as long as they were drinking (he never stopped drinking). He did not come out to eat until I called him, and then I did not watch how much he was eating. There had also been urine under the litter box. He had peed on the edge of the box before, so I just cleaned it up. It had happened before, but not to this extent.

About two weeks before he stopped eating altogether, he would stop eating early and Hobbes, his brother, would start to eat his food. When I noticed that, I would take his food away from Hobbes and give it back to Calvin, who would eat some more but not finish. I just thought he was not as hungry, and I was probably fooled about how much he ate due to Hobbes eating his food. He was not really acting differently that I noticed otherwise. A few days later, when he stopped eating altogether, I called a mobile vet to spare him a trip to the vet (he would usually hide under the bed, which I could not crawl under, and several times I would have to reschedule for blood sugar checks. I should have used a broom). This vet said he had a fever and an infection and gave me Clavamox. He did not notice the enlarged liver or seem to know that it is dangerous for a diabetic cat not to eat. I asked him if not eating was bad for the liver, since I had begun researching on the internet, and he said that if Calvin just ate a little that the liver would be fine. The next day Calvin would not eat. I called this vet, who said to give him less Clavamox and his appetite should return. That sounded wrong to me, so I called my vet, which I should have done in the first place. I stopped the Clavamox and began feeding him diluted canned food through the Clavamox syringe. Calvin was kept overnight at Capital Area and blood tests were run. They thought his liver was enlarged and possibly failing due to fatty liver or neoplasia, and said his prognosis was very poor. I considered euthanizing him then, but I couldn’t stand the thought of not giving him a chance.

The tests showed nothing very out of line except low blood urea nitrogen, not surprising since he was not eating, and elevated bilirubin and blood sugar; his liver enzymes were normal. I took him to the Animal Emergency Center, and they got his fever down and his appetite back by Monday, when I took him for ultrasound and fine-needle aspirations. It turned out he had pancreatitis, an inflamed gall bladder, cholecystitis, abnormal cells in his liver, an intestinal mass, and accompanying anorexia, fever, and jaundice.

After he got out of the emergency center, he ate OK and even did a few of his kitty things for a few days, although I suspect the ravenous eating and drinking and constant peeing may have been partly due to high blood sugar. Thursday evening he would not eat much, and Friday he ate only a very little (he ate a little of his former dry food with catnip spray; he lapped at newly opened cans of Royal Canin RS; he licked at clam juice; he showed no interest when I poured tuna and salmon juice on food). I force fed him about 30 ml. of food on Friday in addition to the little he ate on his own, and maybe 20 ml. – literally nothing - on Saturday, but I lost heart. I had to wake him up to feed him, and he kept turning his head away. He was so tired. He would drink a while and then fall asleep with his head on the water dish. It was heartbreaking. He ventured out to the bathroom once and got to the sink via the toilet. I dripped the water from the faucet as I always did for him to drink, but he just stared at it. Then he turned around and crouched. I couldn’t stand it.

I had tried to get his antibiotic into him by crushing it into his food, but found out that I needed to get it into him separately. I pilled him OK on Thursday and Friday, but I lost heart on Saturday, since I had begun to say good-bye to him in my heart. I SHOULD HAVE TAKEN HIM BACK TO THE EMERGECNY CENTER OF FRIDAY INSTEAD OF TRYING TO GET HIM TO EAT ON HIS OWN. On Sunday morning, after he peed, he just lay in his litter box (and I had to lift him down to his litter box). My heart broke. I took him to the emergency center and found out his hematocrit was 25%, down from 33% a week earlier, and he had lost a pound in a week. His fever was back. What I had thought might be purring when I put my ear to his head was audible breathing. I could not stand the thought that his breathing might become labored.

I was afraid Calvin might be chronically ill with pancreatitis for the rest of his life. It can recur, and it's painful. He was not old for a cat, but not young either, especially for a diabetic cat. A good friend told me I looked worse than Calvin. In ten days, I lost 5 pounds on an already thin frame, and I was falling asleep where I sat. I have fibromyalgia and chronic fatigue, and I was beginning to despair of my ability to care for him properly and work even my part-time hours. I took a week off to be with him, but it was unpaid, and I could not afford to keep doing that, although I would have liked to be with him all the time. I was also thinking about money, since my retirement funds are much depleted due to the economic crisis. I had spent around $3,000, including not getting paid for my week off. I could have spent more, and I am sorry I even thought about money. I have since learned that the vet who did the ultrasound was planning to get him stabilized, do a liver biopsy, and remove the mass from his intestine.

Calvin did not interact with me much after Wednesday, and he must have been very uncomfortable and in pain. He would crouch a lot of the time, I guess to avoid pressure on his organs. Once he relaxed, he looked better, but he could not stand to be petted for long. Even his insulin injections seemed to bother him, and I used a very fine needle.

I did not know what to do.

I feel so guilty that I did not put him in the hospital again to be strengthened for a feeding tube. A friend talked me out of the feeding tube and another said she would never do it, but that was the only thing that could save him. I was afraid of the anesthesia, but it turns out, I have since learned, that it is not a big deal.

The vet on call said that I could hospitalize him so that they could watch the anemia, but did not say anything about euthanasia except that it was a “fair option.” He did not help me at all. If he had recommended putting Calvin back in the hospital, I would have. He just said it was a complicated case.

The euthanasia did not give me any peace. He was wrapped in the blanket I gave him, so he did not feel the cold table, and I had one hand on his head. I told him I loved him, He had his head and paw on my other hand. When his eyes went flat after the anesthesia went into the catheter, I ran screaming from the room.

If he had cancer, I guess it would not have helped a lot to have gotten him to the vet sooner. I was afraid to get a biopsy to find out due to blood loss and the anesthesia that go with a biopsy. I just hope not all of these problems were due to my poor care. He seemed to do well for so long. I don’t have much faith in full CBC panels any more, since he had one of those several months ago and everything looked fine.

I miss his elfin kitty spirit, his naps in my lap, kisses on my neck, and the fact that his tail was always up. It will take me a long time to come to terms with his illness and his absence from my life. There is a huge hole in my heart, and I miss him inexpressibly. I feel regret and guilt that will probably last the rest of my life. I was so selfish. I have read so many stories of people who went so much farther for their pets. I was alone in caring for him, and I lost heart. Calvin, I am so sorry. I cry every morning and evening. I have cried in public places. I have spent too much consulting animal communicators. I am having trouble functioning, and I can't forgive myself. After doing my best for Calvin all his life, I failed him at the end when it mattered most.

[moon_beam]

Hi, roberman, thank you so much for letting us know how you're doing. Please believe me - - working through the paperwork and insurance mess after the accident did NOT take away from your care of your precious Calvin. You were in no way derelict in your care of him. I am so glad you had a chance to talk to your regular vet, and that she was able to give you some comfort and encouragement. Our furkids are masters at disguising how they are feeling - - it's part of their survival skills they inherited from their wild cousins and ancestors. When there are multiple kitties - - or dogs - - in the home, it's hard to know who is doing what that may need medical attention. We are merely humans - - we are not omnipotent beings, nor do we have the benefit of foresight, only the "wisdom" that comes from hindsight - - and it is the hindsight - - when we look back and start putting some of the pieces together - - that is the source of our guilt. This is part of the normal grief process, but I hope you will come to know in your heart that you did the very best for Calvin at all times and in all circumstances with the information that you knew at the time. The early stages of grief are the hardest because the grief is both physical and emotional, so it is important that you do what helps to comfort you through this very difficult time. And I hope that eventually you will be able to feel Calvin's sweet living Spirit still with you as he always has been - - sharing each day with you, and that you will be comforted in knowing that your relationship with him has just temporarily changed to a different dimension. Dawn, please know you are in my thoughts and prayers, and please let us know how you're doing.

Peace and blessings,
moon_beam