? Black may be approaching end - opinions on labs?

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zerovector

zerovector

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Initially when I started him on insulin, he gained weight (1.5lbs) and his fur looked better. Nevertheless, his numbers never stopped bouncing, then I started noticing a reversal in his weight. He finally made it back to the weight he stared at when we began insulin, and then I noticed another thing - his skin was yellow. I rushed him to the vet.

The vet, while thorough and knowledgeable, didn't have the best bedside manner. He believes Black is in some kind of end stage liver failure. The recommendation was immediate euthanasia. I didn't want to do this, because in regards to his quality of life so far it's fine. He's eating (he always has a strong appetite), drinking, using the litter box, enjoying cuddle time with his favorite person. He doesn't seem to be suffering. That being said, this is the list of symptoms and key lab notes

Ascites (not enough that I could see it, this was discovered via x-ray)
Jaundice
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TBIL - 12.7 u/l
ALT - 406 u/l
RBC - 5.81 10¹¹
HGB - 8.6 g/dl
HCT - 24.78%
AMY - 1315 u/l

The vet indicates that there is no way out for him at this point. It just also felt cruel to end him right then and there without being able to spend any time with his favorite person. I am crushed over this, and am not sure what to do.
 
It is always hard to know when their time is up. I myself just them one what can be don but more importantly of how they are acting. Eating and enjoying life is important for me. Most of mine told me by not eating and not doing anything. This year I didn't have to make decision for my Moxie. She ate and acted normally in the morning and then later I went to look for her to give her Adequan shot. I found her in her bed motionless and cold.
 
Larry and Kitties said:
It is always hard to know when their time is up. I myself just them one what can be don but more importantly of how they are acting. Eating and enjoying life is important for me. Most of mine told me by not eating and not doing anything. This year I didn't have to make decision for my Moxie. She ate and acted normally in the morning and then later I went to look for her to give her Adequan shot. I found her in her bed motionless and cold.
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I just couldn't do it knowing he seems to be enjoying things still. He's had 4 meals already today, asks for them by name. Spent time cuddling...etc.
 
zerovector said:
I just couldn't do it knowing he seems to be enjoying things still. He's had 4 meals already today, asks for them by name. Spent time cuddling...etc.
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I think you need to trust your gut here and your judgement over the vet, Black is not his cat, we all know our cats much better than a vet ever could, if you ask me.

You'll know when it's time.
 
I'm not there with you watching Black eating and cuddling and I'm not a vet so this is not medical advice. Every cat is different, every owner knows his or her cat better than anyone else ever will. I once had two big longhair Toms one of which lived to 23. BJ got some kind of oddball cancer usually related to dogs at age 17 and I was in complete denial about it. Those were the first two cats I ever took really good care of and they flew 3,000 miles with me to my new life here so it all seemed so unfair.
Even when he started sleeping in the litter box I couldn't bring myself to end his life. On a Sunday morning I ran into an emergency clinic crying my eyes out and they rushed me in ahead of everyone else. They shaved one leg and he was so jaundice I finally snapped out of it and ended his suffering. We all make mistakes that are totally forgivable, it's our love that blinds us. Forgivable isn't even the right word, it implies some kind of sin when all you've done is love him.
Everyone says "You'll know when it's time" because it's true, it's not a thoughtless rehearsed reply. I regret having to rush him to a strange clinic and that my future wife never had the chance to say goodbye but it's a life lesson that's easy to talk about but a lot harder to do. I've done this 13 times in the last 20 years and it never gets easier but you learn a little bit more every time.
When the time comes guilt is the last thing anyone deserves and if he's suffering Black would want you to know he knew you loved him all his life and he'd thank you with one simple look.
Safe journey my friend. :bighug:
 
Noah & me (GA) said:
I'm not there with you watching Black eating and cuddling and I'm not a vet so this is not medical advice. Every cat is different, every owner knows his or her cat better than anyone else ever will. I once had two big longhair Toms one of which lived to 23. BJ got some kind of oddball cancer usually related to dogs at age 17 and I was in complete denial about it. Those were the first two cats I ever took really good care of and they flew 3,000 miles with me to my new life here so it all seemed so unfair.
Even when he started sleeping in the litter box I couldn't bring myself to end his life. On a Sunday morning I ran into an emergency clinic crying my eyes out and they rushed me in ahead of everyone else. They shaved one leg and he was so jaundice I finally snapped out of it and ended his suffering. We all make mistakes that are totally forgivable, it's our love that blinds us. Forgivable isn't even the right word, it implies some kind of sin when all you've done is love him.
Everyone says "You'll know when it's time" because it's true, it's not a thoughtless rehearsed reply. I regret having to rush him to a strange clinic and that my future wife never had the chance to say goodbye but it's a life lesson that's easy to talk about but a lot harder to do. I've done this 13 times in the last 20 years and it never gets easier but you learn a little bit more every time.
When the time comes guilt is the last thing anyone deserves and if he's suffering Black would want you to know you loved him all his life.
Safe journey my friend. :bighug:
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My plan was just to give him whatever he wants and when it's time call a mobile vet so he can pass here at home.
 
I've watched too many people die in hospitals on a lumpy mattress in a cold and soulless room. My dad got to die at home in his own bed and if you could call death peaceful that's exactly what he wanted and what he got. That sounds like a good plan.
In the Grief forum many members find comfort being able to talk about this when you think no one will understand. It will hurt for a long time and can only help to know you have friends here who know what it's like and care more than you can imagine. Promise you won't just disappear when this is over and give it a try. It helped me with both cats, dogs and humans. You can share as little or as much as you want, that's what friends are for.
 
I agree there are vets who suggest euthanasia as the first line of treatment.
I’m surprised he didn’t suggest some tests to see what was causing the jaundice.
Maybe a second opinion? But first be armed with some knowledge which Suzanne @Suzanne & Darcy may be able to help you with.
If he is eating and drinking and seems to be enjoying life I would not have followed that vets advice either.
Some people have no empathy!
 
Bron and Sheba (GA) said:
I agree there are vets who suggest euthanasia as the first line of treatment.
I’m surprised he didn’t suggest some tests to see what was causing the jaundice.
Maybe a second opinion? But first be armed with some knowledge which Suzanne @Suzanne & Darcy may be able to help you with.
If he is eating and drinking and seems to be enjoying life I would not have followed that vets advice either.
Some people have no empathy!
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The tests and X-rays revealed what he believe to be liver failure, but nothing more specific.
 
zerovector said:
I'm going to get a second opinion. He's alert, hungry and active.
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I think that’s a very good idea. Try and gain some knowledge about jaundice in cats and what are normal values in the blood and signs and symptoms if you can as that will help you to be able to ask questions. Try googling liver failure in cats
 
Hendrick Cuddleclaw said:
I think you need to trust your gut here and your judgement over the vet, Black is not his cat, we all know our cats much better than a vet ever could, if you ask me.

You'll know when it's time.
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Im agreeing here with @Hendrick Cuddleclaw trusting your own instincts is so important with end of life decisions. I have gone against my instinct and it was hard to shake afterward. You can never know for sure, but you want to feel more sure than not. Hugs and well wishes to you @zerovector
 
Lando demando said:
Im agreeing here with @Hendrick Cuddleclaw trusting your own instincts is so important with end of life decisions. I have gone against my instinct and it was hard to shake afterward. You can never know for sure, but you want to feel more sure than not. Hugs and well wishes to you @zerovector
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last night was somewhat scary with the sudden ataxia but that seems to have gone away and he's greedly requesting food this morning. I am getting a second opinion tomorrow morning.
 
Lando demando said:
Im sending you and your guy well wishes and empathy. He is lucky to have you as an advocate. Its so very hard when you are fresh with loss from your other cats ( ive been there)
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Thank you. I have to give him a chance. Overall, he doesn't seem to be in pain - just slightly wobbly and still very food motivated. Didn't seem right to put him down right then and there. He's been with me since 2004, I can't do that to him.
 
zerovector said:
Thank you. I have to give him a chance. Overall, he doesn't seem to be in pain - just slightly wobbly and still very food motivated. Didn't seem right to put him down right then and there. He's been with me since 2004, I can't do that to him.
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That seems like a logical decision. Im hoping for the best for you both!
 
Sorry to bring this up again. When I said BJ was jaundice and that was the end I did not make it clear he also had an untreatable cancer for two months and that is what made my decision. I don't know if jaundice is caused by an irreversibly damaged liver or one that can be healed with the right treatment. Hopefully we'll find out soon.
 
Diane Tyler's Mom said:
Start crying on the phone and beg them to see him:bighug::bighug::bighug:♥​
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They were pretty matter of fact "we are book solid through friday". there's a shortage of vets around here so everyone has a long wait. i'm not sure how anyone gets help with dismissive vets and emergency vets that kill your animal rather than help.
 
zerovector said:
They were pretty matter of fact "we are book solid through friday". there's a shortage of vets around here so everyone has a long wait. i'm not sure how anyone gets help with dismissive vets and emergency vets that kill your animal rather than help.
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I know I can't understand that either, god forbid one of the vets stayed a little late to see him. I pray you can find one to see him asap
 
Next friggin week! That's outrageous. From the first day of the pandemic neither of my vets took a single minute off. Oh boo hoo, I don't want to get the plague from a client I've been milking money from for 20 years. Put a mask on and grow a pair, then think about your hiring practices.
Small town hospitals here routinely close their emergency rooms without notice. Imagine pulling up with a compound fracture or your dad in cardiac arrest and seeing the stupid sign below with instructions to call 911 in a "real" emergency or to go to the next town over. Well I don't live around here, there's no volunteer handing out maps and don't know where Butthole Regional hospital is. There's just the sign, sorry you're s*** out of luck.
Our minister of health thinks this is okay because it's much worse on Mars. Pay the nurses more and get them some mental help!!!

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At this point I have to wait until 2 pm for walk in clinic where I'm still going to have to wait in line with him.
 
I know other people use VCA and they're not all the same to be fair but we call ours "The cat killers of ***town". I'm with you on that one.
Lots of shiny equipment, black hearts and empty souls.
 
Noah & me (GA) said:
I know other people use VCA and they're not all the same to be fair but we call ours "The cat killers of ***town". I'm with you on that one.
Lots of shiny equipment, black hearts and empty souls.
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Mainly the thought of him being in a cage for hours while they don't do anything, and he dies anyway - is what bothers me. If he has to die it needs to be here at home with the people he loves.
 
Looking at the labs they don’t look bad. I wonder if he’s not absorbing the nutrients in his food. Maybe EPI? But the labs I see are from 3/22. Where are the new ones? Are the ones above all you have?
 
The ALT is high but not that bad. The question to me is why does he have hepatic lipidosis. That definitely points to a liver issue. His kidney values are not too bad. Maybe stage 2/3. Has he ever had pancreatitis?

Edit: Now that I see all labs liver values are high. Goes along with hepatic lipidosis. They didn’t offer to treat it?
 
tiffmaxee said:
The ALT is high but not that bad. The question to me is why does he have hepatic lipidosis. That definitely points to a liver issue. His kidney values are not too bad. Maybe stage 2/3. Has he ever had pancreatitis?
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He's never had pancreatitis. As for Hepatic Lipidosis, I don't know how that could have happened - this cat eats like a pig, he's eating right now. He doesn't forget to remind us when it's time to eat.
 
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