Instead of euthanasia, a long and happy life

Dear Dr. Fox:

My daughter found Mulligan as a kitten on a golf course in Richmond.

Mulligan had partial paralysis in her hind legs but quickly regained the use of them. She had extreme difficulty with bowel movements, probably because of the injury that created the partial paralysis in her legs. No amount of Cat Lax, the natural laxative, helped.

About two months after we got her, she developed a prolapsed rectum from straining to defecate. After an emergency visit to our vet to repair the damage and take X- rays, we took her to a specialist at an animal hospital.

The doctor confirmed that she had a megacolon, and surgery was performed that day to remove all but 11 / 2 inches of it.

The vet prescribed mixing Metamucil with her food to provide near-normal bowel movements. For 15 years, we did this, with generally successful results.

Mulligan ate a 5.5-ounce can of wet food each day, and although she struggled at times in the litter box, she led a fairly normal life as an indoor cat. She was a joy to my wife, who took care of her all those years.

J.B., Potomac, Md.

DF: Thank you for sharing the encouraging success story about your injured cat, which, after appropriate diagnosis and treatment, enjoyed a long and happy life.Many people in your situation would have elected to have the cat euthanized. Costs notwithstanding, and with never a guarantee of total recovery, cats and dogs have amazing recuperative abilities when coupled with the expertise of a veterinarian.

Above all, animals need the commitment and patient support of their in-home caregivers, without whom the possibility of even partial recovery might never become a reality.

HOME HOSPICE Care

Dear Dr. Fox:

There seems to be no palliative care for pets the way there is for humans who are suffering, and I don’t understand why that is.

Jingles was about 16 years old. I’d had her for 12 years. In early December, she started to have upper respiratory problems. I took her to my vet Dec. 5, and she was given a shot of what I believe was an antibiotic for a possible sinus infection.

She continued to get worse, so I took her back Dec. 12. She was given a blood test — she had high white blood cell counts, but otherwise normal liver and kidney values — and Pepcid and dexamethasone injections.

In a last-ditch effort, I brought her back to the vet Dec. 13. She was given a Convenia injection, but Jingles only got worse.

My vet doesn’t do in-home euthanasia. The people the vet’s office recommended didn’t want to do the euthanasia unless I had taken her to an animal hospital, which I did Dec. 14. I was there for hours. I knew she was dying, but I made her go through all these tests in her weakened state because they wanted to make sure she was sick.

Four hundred dollars later, the diagnosis was that she probably had lymphoma. She had lost half her weight, was no longer eating and was the sickest I’ve ever seen any living thing. Because of her age, I opted for euthanasia rather than chemo.

Before I left the hospital, they gave her mirtazapine, a famotidine injection and subcutaneous fluids. She found peace Dec. 16 with the help of the in-home vet.

What I’ve left out of this narrative is the emotional wreck I was. I carted her all over town in her final days, made her get shot after shot, missed work, cried at work, etc. I understand that animals get old and sick. What I don’t understand is why there doesn’t seem to be any type of hospice mentality in the veterinary profession.

I’m no doctor, but I think all those injections were a futile attempt to save her, and none was to ease her suffering, except the final one. I knew she was dying — surely these professionals did, also.

Why is there no kitty morphine or even kitty aspirin? Why did my sweet old girl have to toss and turn in pain in her final days, waiting for the in-home vet, when she could have had some of her discomfort ameliorated with a little palliative care?

M.T., Oakton

DF: Your detailed account of the last days of your poor cat raises serious ethical questions for veterinarians to address.

Providing security and relief from fear and pain when there is no chance of recovery is the best medicine.

In-home hospice care for humans is a blessing that is becoming more widely practiced in the United States. It is just a matter of time before such services are provided for pets. Yours had the unquestioned benefit of in-home euthanasia.

There are a few veterinarians where I live (in Minneapolis) who operate an exclusively in-home hospice care practice. I hope your letter encourages more veterinarians to follow this compassionate path.

ANXIETY ATTACKS

Dear Dr. Fox:

In late August, we adopted a very handsome, neutered, longhaired German shepherd, Bear. He is about 5 and as sweet and gentle as can be.

A month or so after we got Bear, he began to whine loudly whenever we went anywhere in our truck. He willingly jumps into the truck when we are ready to go, but the whining starts before we’ve left the driveway. There appears to be nothing in particular that causes this behavior.

Because we were driving to see my mother on Christmas Eve, we got a prescription of alprazolam from the vet to try to calm him while on the road.

At 7:30 that morning, we gave him a half-tablet. We left at 9. We had not gone a block before he started howling. It continued to get worse and worse until we stopped 10 minutes later and gave him the other half.

We opened the window and let him hang his head outside for a few minutes — when his head is out the window, he is 90 percent better — but it was cold. After his behavior while under the influence of the prescription drug, we probably will not drug him again.

Today, we took him to the dog park, which is about 25 minutes away. Loud howling started immediately. For the few minutes I allowed him to have his head out the window, he was okay, but when the window was closed, he howled until I filled his Kong toy with treats to keep him quiet and occupied. Sometimes even when the window is open, he whines.

It appears to be an anxiety attack, but what would bring on such behavior? His Bark Buster trainer has no ideas. At his suggestion, we tried the Thundershirt, but it made no difference.

C.B., Springfield

DF: Your dog is probably suffering from a combination of anxiety and excitement.

Alprazolam is a potent anti-anxiety drug, effective for many dogs that are afraid of fireworks or have developed specific phobias. But the effective dose for many dogs can make them groggy and uncoordinated, which can have the effect of making the dog more fearful, possibly because they feel more vulnerable.

Many dogs benefit from wearing a bandanna imbued with a few drops of lavender oil around the neck.

Because getting treats out of his Kong works briefly, fill it with peanut butter and freeze it so it will last longer. Get two or three for a longer drive, and store them in a cooler. Try giving him a Nylabone. For motion sickness, a big piece of ginger candy can provide relief.

Michael W. Fox, author of a newsletter and books on animal care, welfare and rights, is a veterinarian with doctoral degrees in medicine and animal behavior. Write to him at United Feature Syndicate, 1130 Walnut St., Kansas City, Mo. 64106.

2012 United Feature Syndicate

 
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