November 2, 2013

The Unforgettable September & October


What happened?

On 10th Sept, we took Kitty to see the vet because the ulcer ointment which we use was unable to contain the ulceration in her mouth. She was active and able to eat on her own, though she turned fussy. The blood test result showed that her kidney condition was stable, so vet concluded that the ulceration was caused by infection. Gave her a Convenia injection (antibiotics which could last for 12 days) and pain-killers.

l          However, the mouth condition worsened, as the ulcers burst into the full blown condition, affecting the tongue and surrounding areas as well. Saliva dripped out wetting the fur in her chest and front paws. She did not show any interest in food or water, and moved around less. So we started to feed her by syringe.

l          After consulting others, we believe we need to strengthen her immune system and heal the inflammation. Apart from giving her the Renal medication, on 14th Sept, we started to give her lysine (500ml) per day, a drop of Propolis (diluted in 1.5 tablespoon of water), Aloe Vera (max. 1 ml per day, preferably applying it onto the ulcer areas).

l          Her daily feeding timetable is as follows:

-      6.30am – breakfast

-       10.30am – water

-       Noon - 1.30pm - lunch

-       Teatime – water + honey

-       Dinner – 6.30pm

-       Midnight snack – 10.30pm

l          On 20th Sept, when we revisited the Vet, the amount of saliva that came out had lessened. We were given 2 weeks of painkillers and with no objection to our continue giving her the above mentioned supplements.

l          For the following 2 weeks, her ulcer condition did improved. The white area shrunk in size, the color of the red area also paled with some returning to normal. Only in some occasions were saliva found in the lips. Though tired, she walked around the house a bit more and sometimes even waited in her dining/kitchen area, as if waiting for food.

l          When we took her favorite food to her, she smelled it, and sometimes even sat up, but did not open her mouth to eat. During the feeding time, after she swallowed the food, we would make some “um um” sound with our mouth to encourage her to swallow. Just like a baby, very often she followed us, making us very happy and hopeful. Overall, we found her to be more tired than a fortnight ago.

l          The vet said the progress was within his expectations when we revisited on 8th Oct, though we were a bit worried with the weight loss. Since this sickness, she had lost a total of 0.5kg, leaving her with only 2.2kg. We were advised to give her 1.25 pack of wet renal food daily as we might have under-fed her.

l          We continue feeding the supplement, but in reduced amount since the ulcer is healing, and avoid over-burdening the kidney. However, we started to observe that at times, she used her hand to wipe her face/mouth, as if something is sticking onto her teeth. This frequency increased. If use a dry tissue to wipe her mouth and chin area gently, it seemed to help, strange? Also, some doubt crept into my mind—if the mouth ulcers are healing, she should be able to start eating on her own, at least a bite or two, right? (At hindsight, it might be the tumor getting big and causing pain and discomfort in her mouth for which she tried to relief with her paws.)

l          On 6th Oct, we fed her honey water at tea time, and after the first feed, found blood coming out from her mouth. Initially we thought she might have bit her tongue or cheek, but to be safe, we took her to visit the vet immediately. The vet suggested to “gas” her down for a thorough examination of the mouth condition and see what caused the bleeding. The bad news came, a tumor was found underneath her tongue, and it had grown fast making insertion of the breathing tube impossible.

 

Be prepared. As parents, your feelings would know guide you when the time comes – that’s the advice I received from parents with similar experiences.

l          Vet advised that the tumor condition would not improve and that ultimately, she would not be able to swallow. If we want to keep her around, a feeding tube would have to be inserted. Her life expectancy was shortened to at most a few months.

l          The key words that came to mind were – “not be able to eat on her own again” and “at most a few more months to live”. What quality of life would she have?? A living robot?? Seeing her lying in the operating table in such peaceful manner (under influence of the “gas”), a sudden thought of letting her go came to mind.

l          Lately, I had in my daily prayers, asked the Lord to heal her and let His will be done. I had also wished that when the time comes, Kitty could go in her sleep -- in a calm and peaceful manner. Also, I had wished that if Kitty had to be euthanized, that it be performed by her vet and with her favorite veterinary assistant around. By the grace of God, all these seemed to have been fulfilled at that very moment. With the consent of family members, though very unwilling, we decided to let her go. So, being surrounded by the presence and love from grandpa, mummy and Auntie Z, Kitty left us at around 5.30pm on Sunday 6th October, 2013. Ending her 18years and 9 months of mission on earth in flying colors.


Other thoughts at that moment

l          In the past Kitty had been “gas” down for taking blood samples when she chose not to co-operate and it usually took her a day or two to return to normal. Now in such weak health condition, the “normalization” process would likely be a lot longer, which means more discomfort to her.

l          The wound in her tumor needs time to heal, which means feeding by syringe could cause additional pain to her.

l          I asked myself, do I want a living robot? I think it’s unbearable to see her end up like that. It would really be a torture to her by keeping her alive at that stage. The quality of life for which we give utmost importance to is not there; needless to say it’s selfish and inhumane.

l          How would she feel with the feeding tube – apart from discomfort, likely helpless and lost all her self esteem; probably lying in a quiet corner with her head down for most of the time.
 
 

 
 
After thoughts

l          Readers are advised to consult your Vet before giving your children those supplements, as though they could help raise her immune system and cure mouth ulcers, they should not be taken for long due to some side effects on protein absorption and potassium level. Besides some cats could be allergic to honey.

l          We wrote this posting, not to justify what we have done, or to let others know how great we were. The aim is to share our experiences in a detailed manner to interested parties, hoping that if the inevitable comes, they could handle it better than us.

l          Did we regret not taking her to see the Chinese doctor? Sought of! We think the likely outcome could be lengthening her lifespan for a while. But would the quality improve significantly? Doubtful. Its because the lump near her tail and arthritis is affecting her movements, making them fairly rigid and painful.

l          Would I let her go earlier - say at the time when the mouth ulcers were at full blown stage? Some say they would, for shown in the video, I’m sure you would agree with me that those were very rough moments and that Kitty is suffering. It really requires strong will to survive, love and dedication from all sides to make it part of your daily life. For me, I think I would still give her the chance as unlike a lot of patients, her kidney condition is “acceptable” and that mouth ulcers could improve with her immune system. But I must admit, the decision might be different, if we found the mouth tumor in day 1.

l          Would I take her home first and give ourselves more time to think about euthanasia? Likely not. Apart from the painful normalization process, the only advantage is that we might be able to seek her opinion as to whether she is prepared to go. Deciding on the date to do it might not be too difficult, but waiting for the time to come, could be horrendous to the entire family – both human and pets. So better let it be a quick decision, provided it’s done with thorough analysis, love and to Kitty’s benefit.

l          Acupuncture is useful in enhancing mobility for Kitty and help alleviate the pain. It would only be used as a supplement for her case and not a cure.

l          Feliway is useful in alleviating stress for Kitty. The unfortunate thing is that I thought of using it too late (started in the evening of 5th Oct). I should have thought of it when the mouth ulcer problem starts to get worse in early September, so that Kitty could be more relaxed and hopefully in less pain.

l          The idea of setting up a fund for the children’s rainy days expense should be taken seriously. Only when we don’t have to worry about the financial issues, would we be able to give our children the best medical care warranted. 

 

Kitty, my dear, I hope you understand and agree with what we have done. So please do look forward and go in peace and joy. Only memories will remain forever, firmly enshrined in the special place on our hearts.

 

P.S. Kitty was cremated on 10th October 2013 at 2pm. It did provide some relief to us in seeing Kitty lying peacefully in her usual sleeping posture, her soft fluffy tail and above all, her white bones (which suggest that she is healthy, despite her age). By dispersing her ashes, Kitty has returned to Mother Nature and fulfilled her life motto “To lend a hand” to help the plants grow healthily!
 




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It had been a close to month since Kitty had left us, but home is never the same again. Though we seldom talked about Kitty openly nowadays, we could sense the pain of her absence amongst us. To me, Sunday after around 4-6pm still remained the most disturbing moment, with watery eyes at times. Overall, I constantly remind myself that the arms of the clock could not be turned back. Whatever had happened, had happened. So hopefully, time will slowly heal the wound. 

 

We are grateful to have Goldie around. She has made great effort to accompany and divert our attention at times. Her presence is effective in relieving our pain, though we believe she too is still undergoing the transition. Goldie, we treasure your presence and care. Thank you, my dear.