A Lack Of Cats

Our kittens, Lily and Lucy, came before the children. Quiet purrers and beautiful blinkers. Velvet furred links to another lifetime. They came before my Bipolar Disorder.

In my chaotic first few months of motherhood, on a visit home from the psychiatric hospital with my baby, the cats were not impressed. The baby startled and squawked in her rocker, and the cats stalked around the noise and movement, with twitching tails and wide suspicious eyes.

Their suspicion was justified about three years later when that baby – now a toddler – ‘posted’ Lucy through my bedroom louvres out into the garden via a drop of several metres. When I found her meowing on the lawn Lucy was unimpressed, but thankfully uninjured. I sat my toddler down for a talk about treating pets kindly and keeping our indoor cats indoors.

The Easter long weekend the year the cats were eight years old I was mid prep for a family lunch when my now seven-year-old daughter called:

‘Mum, there’s vomit in the cat’s room.’

I abandoned the sprawl of recipe books and followed my daughter’s voice to clarify whose vomit it was. There were patches of it dotting the floor, and the smell of partly digested cat biscuits and bile hung in the air. Cat vomit. And Lily looked flat. I lifted her up and palpated her painful, tense abdomen.

A couple of days before, I had caught her chewing something, but she had shot away when I’d approached. By the time I’d caught her, her empty mouth had concerned me, but I decided to wait and see.

I’d waited and now I was seeing.

The time frame and signs were textbook for whatever she had probably swallowed being stuck somewhere in her gut now. She’d need surgery.

I rang around for a nurse who was free to help me, arranged to meet at the veterinary clinic we both worked at, and loaded a very unhappy Lily into the car.

The incision for an exploratory laparotomy is long. From the bottom end of the sternum to the pubic bone. The exploratory part is methodical. You start with the stomach and visually and manually examine your way down the lengths of intestines. As I worked my way down Lily’s normal looking gut I began to doubt my decision to go in without an X-ray.

And then there it was. A lump. I exteriorised it and exhaled, relieved. The affected intestine was inflamed but not perforated and confined to five centimetres. One simple incision to retrieve…a scrunched-up length of metallic gift-wrapping ribbon.

Lily recovered fully from her surgery, but both cats were mostly confined to their room and cat run, if unsupervised, after that. They were both string, hair tie and ribbon obsessed, and I could not guarantee a house free of these items with a seven and a four year old in the house.

My cat ladies grew into elderly and then old ladies. Of the two, Lucy was always more outgoing and friendly. Lily formed relationships on her own terms and was more skittish. But when we lost Lucy last year, Lily became cuddly.

My now fifteen-year-old daughter, grew into one of Lily’s favourite people. She brought her into her bed and hand fed her morsels of chicken, tuna, or steak. In return Lily was a quietly purring source of warmth, love, and comfort.

Two weeks ago Lily declined rapidly, looking all of her seventeen years, within twenty four hours. Suddenly her bones stood out. Her coat morphed from meticulously groomed to dull. She no longer looked like herself.

I took her to one of the large veterinary emergency centres, requested blood and urine tests, and waited with a deep aching knowledge. In the end she made the decision to let her go – not easy – but black and white. Her blood test results were disastrous. Kidney parameters and blood glucose levels through the roof. I’d have thought twice about tackling both of these issues in a cat half her age.

We gathered to stroke her soft head and thank her for being part of our family for so long. And I whispered my love into her beautiful ears as she slipped gently out of my life.

That night I sat next to the empty cat bed and sobbed my way past midnight.

Two weeks later, I still startle sharply when I enter the cats’ room and am met with absence.  

And when the grief hits my children in great stormy waves, I remind them that there is only one way to avoid this feeling, and that is never to have the love of a pet in your life.

You may also like to check out these:

Goodbye My Thought Food Cover Girl

Veterinary Work And Bipolar Disorder: A Podcast Interview

Our Vets Are Dying For Your Pets

Goodbye My Thought Food Cover Girl

Lucy – photo by Elsa

A dull ache sits in my centre. My cat Lucy, immortalised next to my old red keyboard on my Thought Food home page, is gone.

2 days ago the vet in me woke to a 16 year old depressed, immobile, incontinent feline patient. I  needed more information before communicating with the cat’s owner, who was also me. The owner could read the vet’s face though and it made her feel as though a cactus was growing in her chest.

The vet came back with information later in the day.

Hypothermia, likely anaemia hiding under haemoconcentration, severe azotemia in the face of likely hyposthenuria, severe hyperglycaemia, and elevated ALT

At that point the owner and the vet in me began to overlap, like a Venn diagram, and both parts of me knew enough to know this:

None of these big words gave us a definitive diagnosis. To get to the big word that was causing the multi organ system problems indicated by a physical exam and first round of blood tests, we’d need to enter a new level of the diagnostics game. And with each new diagnostic test we’d opt for we’d open up the possibility of needing still more tests to get to the bottom of it.

What justifies further diagnostics in veterinary medicine?

The chance that the definitive diagnosis is something treatable or manageable to the point of returning the patient to a good quality of life.

When I started work as a small animal vet in 1998 we had fewer diagnostic and treatment options available for pets. It is good to have more options now. There are absolutely cases where we can return animals to a great quality of life where they would have been euthanased when I first graduated.

But this advanced knowledge also complicates matters, particularly when it comes to caring for our geriatric pets.

People often assume that the hardest part of being a vet is euthanasing animals. Yes, it can be devastating. But I have always found it equally as hard, if not harder, to hand hold people through the process of coming to terms with the fact that it is time to euthanase, while their pet is put through diagnostics and treatments that may prolong life but do nothing for quality of life.

An internal medicine specialist may well have wanted to know exactly what the cause of my cat’s abnormal blood results were before giving me their blessing to euthanase.

And, with those blood test results, had my cat been 2 instead of 16, I still would have stopped to consider that euthanasia could be the end point. But I would have gone ahead with more diagnostics because the chances of them leading to an outcome with a good quality of life for my cat would have been higher.

But I also knew that had I insisted on a definitive diagnosis 2 days ago, Lucy could have spent her last days scared, in a fluorescently lit hospital having rectal temperatures, blood and urine samples taken at regular intervals with no knowledge of why it was happening. Had she been able to come home it would have been heavily medicated, and still not feeling 100%.

When I weighed this with the tiny chance that she was suffering something treatable with a chance of return to good health – the risk of putting her through fear and pain for nothing at the age of 16 was not one I was willing to take.

Instead we made the hard choice.

Instead all four of her people cuddled her. We whispered in her little round ears and wet her fur with our tears. And I stroked her velvet neck as she drifted off into anaesthesia and then away into death.

Later that night I laid down next to Lucy’s siter, Lily and burst into deep sobs. These cats entered my life before the mental illness that came with my human children. With Lucy I have lost another part of me that existed before everything changed irreversibly…and not all for the better. The waves of grief beach unexpected thoughts and feelings.

When I work, I am not brutally honest with a vulnerable client if they ask me ‘What would you do in this situation?’ I stick to the facts, lay out probabilities as best I can and make sure euthanasia is part of the conversation so that they can make their own informed decision, in as much as their own time as their pet’s welfare allows.

But if the vet in me had been advising the cat owner in me for Lucy, I would not have held back. I would have said:

‘We can do every diagnostic test under the sun and you will probably get an answer, but we are doing it for you, not for your pet.’

Just because we can do something, doesn’t always mean we should.

In loving memory of Lucy (14.2.2005 – 7.5.2021)

You can find some of my other veterinary content in these posts:

The Cost Of Canine Anxiety

Veterinary Work And Bipolar Disorder: A Podcast Interview

Veterinary Work In The Time Of Covid-19: Unspoken Truths

Our Vets Are Dying For Your Pets

Image result for veterinary euthanasia images
Image courtesy of Cascade Veterinary Hospital

Contains Confronting Content

I recently removed the key to the dangerous drugs safe in the veterinary practice I’ve just resigned from, from my key ring to return it. And as I did so, I thought:

‘I wonder if my suicidal ideations will change now?’

I’ll come back to that.

I also recalled how often I’d heard the following over the last twenty years in practice:

‘My son/daughter/nephew wants to be a vet when they grow up.’

Always uttered under the impression that veterinary work is a dream job. But the dream can morph into a nightmare. There is currently a shortage of vets (in part) because our burn out and suicide rates are sky-high.

So why, after dedicating years to entering this prized profession, do many vets want out?

Continue reading “Our Vets Are Dying For Your Pets”