Rescue Journal

how i decide on which medical treatment options if any...

Carol · Apr. 8, 2009

each of these guys is an individual...each of them has their own health issues which they react to in their own special ways. each of them have a different history and a different outlook on actually being unwell. sometimes we just do symptom control...sometimes we are after an out and out cure...sometimes the disease they are currently dying from is not the one that is wrecking their day today.

like......jed with his end stage cardiac disease whose entropian was making his eyes really sore. or the rock who has terminal feline leukemia but it was an upper respiratory infection that was killing him last week. or the ones with cancer thru out their bodies that come in with painful, rotting abcessed teeth.

there was ronnie who fought the good fight against his disease for 2 long years. and i choose this last time to treat him supportively only, he was tired of the aggressive route. shilo who has never been more than just biding her time here or really healthy since she arrived...i am not going to force her to fight a fight she doesn't want to win.... so tomorrow, we are letting her go.
some i choose to treat aggressively...like rock with 3 antibiotics, force feedings and fluids because my goal is to return him back to the relatively healthy state he was in before he got sick. or betsy who had a gastric feeding tube inserted today. two weeks ago she was pretty healthy, no sign of her FeLV, but then she got a cold, stopped eating and developed fatty liver disease. we can maybe reverse the liver damage and return her to feeling good and eating again on her own. but we can only do that if we get enough calories in her to reverse the fatty liver disease...hence she needs that feeding tube because she is too difficult to force feed.

we did some pretty massive surgeries on star because she so obviously wanted to live. today our vet who is fostering her told me that altho she is STILL running and playing and having fun, she is starting to fill up with fluid and her end is coming near.

cats like tikko who was comfortably hanging by a very thin thread, i won't even let have an xray to check what we suspected because the sedation he needed for the xray could have pushed him over the edge...he died within a couple of weeks and we knew it was that tumour that the vet could feel but not actually see.

every time one of the guys gets sick here with either the original or a totally new (for them) kind of disease..i have to weigh the options, look at their history, figure out what the near future is bringing, consider their personality and coping skills before i can decide what treatment option is appropriate for them.

it is alot of responsibility.

it would be nice if the easy answer was always...just let them go. but it is not that easy because if they do value their life and want to live it some more then we are obligated to help them for as far as they want to go.

and how do you know that? how do you truly understand what kind of light or hard grasp that they have on their life...it comes from knowing them, living with them, loving them and honoring the trust that they gave you to hold.

sometimes i get angry and stubborn..."you are NOT going to die from something so trivial as this" and sometimes i am passively accepting..."ok, you are tired and done with it all." so maybe where ever i am at emotionally has something to do with it too. but i don't honestly thinks so...i am probably more attached to shilo who lives in my house than i am with betsy who lives in the felv room altho i am quite attached to her too.

but shilo i see and touch many, many times a day. with shilo i stop each time i walk past her to check if she is doing ok. she has been here longer, she has been a greater long term worry, she i have felt so truly sorry for because of the trauma in her life AND she is my direct line of sight every time i have to go to the bathroom.

and shilo... i am saying... ok you can go now. but betsy... i am saying.... not yet, it ain't your time, so no freaking way.

anyway... just wanted you to know that there is some pretty hard thinking and reasoning for each treatment decision i make. it is not about who i like more or less, or who's life i value more..it is about doing what i think they each would ask if they could actually talk to me.

peaceful journey tomorrow shilo... and betsy, it is time to get better now babe.

Comments

Carol

rest in peace gatsby, i am so sorry for your loss elizabeth...20 years is a huge lifetime of sharing to lose.

Elizabeth

I sent my 25 yr old flame point on his journey last nite.

i know the back and forth you describe - the gut feeling they give you when it's time.

My Gatsby had fought through some wasting in his hind legs and was getting thinner and thinner. My once huge and vital boy was having trouble staying upright to eat. We sat together quietly on his last day and I took him outside to feel the grass beneath his pads and watch the last sunset together.
He gave me a look through his half cast eyes that said "i'm ready - this body hurts". I'd nursed him through worse than this before - but this time was different for him - he was ready, he was mostly deaf and blind and the joy of being alive - chasing a string, hearing birds sing etc seem to hold no interest for him.
I made the call to our wonderful vet - dr katharine and she came to the house and helped us let him go. He left surrounded by family, love and home.
After 20 years of sleeping with his head on my shoulder - I didn;t sleep well last nite. He is loved and missed - but I hope that I set him free.

I hope that Shilo and Gatsby both find release and that their souls are comforted by how much they were loved, and how good it feels to be released from the aging body that betrays them.

Godspeed my friends.

Heidi

Hi Cheryl and Steph, I posted the comment on Cushings November 17th 2007 under update on Raymond and other things. Hope all turns out well for your dog! Nina did well with meds and vigilent monitoring, she was 12 when diagnosed and died at 15.5 years old from oral cancer.

Patti

Thinking with your heart always leads to the right answer. You can tell when they just want to go... no more fighting... Bless you Carol. It's a hard thing to do, but also the right thing to ease their suffering.

Carol

i don't know where that post is...try doing a search on cushings on the sidebar search thingy.

anyway...what i know about cushings is not all that much. it is an adrenal gland problem...sometimes caused by a tumour, sometimes not. the prognosis depends on the length of time of untreated disease and the long term damage done. but i do know they can be successfully managed for years sometimes with a good medication regime. a good majority of these animals eventually die of seizure related illness probably due to a tumour in their adrenal gland which is close to the brain.
we have had a couple of cushings animals but a whole lot more who we suspected were cushings but upon testing were not...(like les and sparkles the pony...sparkles the dog was a confirmed cushings...she did eventually die of seizure related brain damage.)

Cheryl Stef

CAROL WONDERING IF YOU COULD POST SOME INFO ON CUSHINGS. ONE OF OUR DOGS IS GOING IN NEXT WEEK FOR SOME TESTING AND THEY ARE THINKING MAYBE CUSHINGS. YOU HAD THANKED SOMEONE IN NOVEMBER OF 2007 FOR POSTING INFO ON CUSHINGS BUT I CAN NOT FIND IT...ARE YOU ABLE TO SEND IT TO ME...
AND ANY OTHER INFORMATION YOU KNOW ABOUT IT...

I HAVE LOOKED ON THE INTERNET FOR INFO BUT AM ALWAYS LEARY IF I AM GETTING CORRECT STUFF...

I WILL ASK THE VET NEXT WEEK ALSO BUT EXTRA INFORMATION ALWAYS HELPS

THANKS

Lynne

does it ever get any easier knowing what to do . it is their whole being dependent on you and you have the final say. thank god you love all those beautiful animals and will do what is best for them. they are very lucky they have you and i know you have heard it a hundred times before or maykbe a gazillion but it is so true and can not be said enough.