Struggling with life and death decision

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Rachel & Gus

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Gus has been in and out of the hospital first with pancreatitis, IBD, then a UTI. Then he stopped eating, turned jaundiced and they admitted him to the hospital to save his life. It was all going well and then he was released Friday and stopped eating again on Saturday.

They found some good and bad news with Gus when I took him back today for blood work and they are doing an ultrasound to determine if he would need surgery. More than likely, he will need surgery, but I am going to have to talk to the doctor about his long term prognosis and whether he is going to be battling one problem after another or whether they can fix this with surgery and he will have a long happy life. I've been on the phone with my parents and will meet with the doctor later this afternoon to discuss the options. They think he has a blockage in his gallbladder and I'm pretty certain he does and he would have to have surgery to remove it. It is certain that he will die without the surgery. But I also have to think long term about his life quality with all of the problems he has. They have definitely been able to get the vomiting from the IBD under control, but long term with the pancreatitis, I'm not sure how things will go. He also has a mild heart condition which doesn't require medication at this time.

Has anyone been through this? Have any advice? If I know he would get better and go home with a great quality of life then I would do it in a minute, but I worry about his life and if we will be in and out of the hospitals dealing with needing plasma transfusions for the pancreatitis and how well they IBD can be controlled.

Gus hasn't been sick since January and even then I was able to fix it at home and we didn't need to go to the vet. However, he is now 13 and seems to be gathering more problems, not less.

He is the love of my life and I want to make the right decision. Has anyone dealt with a similar problem?

Thank you.
-Rachel, Gus and Carma
 
Dearest Rachel, and, of course, you too, precious Gus,

My heart aches for both you and Gus. You are truly in between a loving rock and a loving hard place...





Sigh...






My humble suggestion would be to meet with his vet this afternoon as you've planned before making any decisions.

And, to listen to your heart... And, look in Gus's loving eyes and listen to him...




Keeping you both close our hearts, thoughts, and prayers, Rachel. Please remember whatever decision you make will be the right one because you love Gus so very much. And, he knows that...


Much love and countless gentle hugs for you both,
Deb and Nikki -- and, Giz, forever whispering in my heart...
 
What a heart-wrenching place to be in.

If it were me, I'd go with the surgery. He has a chance then.

Otherwise, no chance.

See what the vet says for chances of Gus coming through the surgery.

My prayers are with you.
 
In humans, gallbladder surgery is pretty straightforward - its a replumbing of the bile tract so there is no resevoir to hold any stones, the bile continuously flows into the digestive tract, rather than being released by eating.

If he has doing fairly well to this point, I know I'd be likely to try, because the other ongoing conditions were being managed OK.

The vet will discuss the risks of surgery and the possible benefits. I don't know if a constant dribble of bile into his intestines will irritate them more or not, though frequent small meals could possibly counter that by providing something for the bile to act upon.
 
This is totally from a human-gall-bladder point of view, so may be entirely irrelevant ... But maybe not ...

Something over 10 years ago I had my gall bladder taken out. I wasn't aware of huge problems, but the surgeon discovered huge and obviously long-standing problems during the surgery. She kept me in the hospital overnight (the procedure is usually day surgery) and had me on intravenous antibiotics for 24 hours. All worked out fine, and all sorts of problems that I had only been dimly aware of disappeared. My quality of life improved vastly, as did my ability to deal with other health issues.

What I'm trying to get at is that gall bladder problems can be extreme *and* can have far-reaching effects on other aspects of health. Getting the bad gall bladder removed may help with the other issues, also. And if how I, as a human, felt after the surgery is any indication of how a kitty would feel, getting that thing removed may help resolve all sorts of other problems.
 
Years ago I adopted Mario, then 15 years old as an untreated diabetic kitty. He was responding well to treatment but in a couple of months he started vomiting and would not eat. Ultrasound showed a blocked bile duct. He had surgery and recovered. However, they took biopsies and they showed small-cell-intestinal lymphoma. With oral chemo treatment he recovered well and lived more than two years.
 
In humans they take the gall-bladder out after 2nd attack of pancreatitis. Often on the first attack. My husband didn't have stones but they said he would have had sludge in his gb. He went 4 yrs between attacks. If he gets another attack there is one more procedure they will do - it's widening one of the pipes (I think). It's too early to tell whether he will have more attacks. DH is a stoic man re health issues - but pancreatitis brought him to his knee's. He fears more attacks coz of the pain. Does Feline removal of gb cause digestive issues coz not so many digestive enzymes?

We waiting to the results of blood test for our 13 yo kitty with suspected pancreatitis. I had four weeks away recently after 20 months of looking after him with FD - even missed being with my father when he passed away. He died alone coz 3 other siblings couldn't find a way to be with him either. I have to live with myself - deep down I feel I had my priorities screwed up. What gets into our heads that we give our cats so much love, help and dedication, in my case to the exclusion of other important duties. A touch of the OCDs?.

I came home full of resolve towards LB but after two weeks of nursing - and $1200 spent on him with cattery and vet bills - and struggling to get his numbers under control and to clean up his accidents - it gets exhausting. Escpeciallly as he wakes me up at night and now I'm getting up at 5.30 to test him. It feels like a treadmill of insanity.

On the other side of the coin, LB looks quite well. He is as loving as our children - takes about as much as they do from us. Why shouldn't he be looked after - I think of all life as equally important - except maybe flies and mosquitos. Don't like to kill spiders even. Scared of them but rather put them in another environment. I hate it that I eat meat. Life and how we behave to animals doesn't sit well with me. Their life is as precious to them as ours is to us.

For me, I am finding it impossible to end my kitties life even though he causing us so much hassle. There is something in my brain that cannot let go. I have to go back to UK next March for DD's first baby - I can't leave LB in a cattery again. I've told DH he has to go and help with new baby - but I think that's a bit OTT. I will see what the results are. Would I allow a gb operation? If it helped a lot, I probably would. :roll:

thought I'd rave on to let you know that you are in good company here - many of us know how you feel..

marilyn
 
We are going through almost the same thing you are. Wendall hadn't been eating well for a few days, then started vomiting so went to the vet last Thursday. Liver values were high and he was Dx'd with hepatic lipidosis, though he doesn't really fit the profile for it. I also had a SPEC fPL test done and he has pancreatitis as well. He wants to eat but can't keep anything down, vomits undigested food when his stomach is full, and has been in and out of the hospital nearly every day since. My vets mentioned the possibility of an obstructed bile duct and his ultrasound is tomorrow. I just wanted to say that you're not alone.

Larry, thanks for sharing your experience with Mario. If that's what is wrong with Wendall, you've given me more hope than I've had in days.

Best,
Deborah
 
I feel your pain. My Shiloh had bouts of pancreatitis for 5 years Twice he lived with a feeding tube. Once for 7 months and once for 3 months. He was on lots of meds when it struck. He was a diabetic for 9 years. I would opt for the surgery if the vet thought it would go well, just as you said.

I had to make the decision in February to end my Shiloh's life journey. He had gotten another attack in Dec, along with a corneal ulcer from the stress. We thought it healed. He was only doing fair. Then in Feb, he stopped eating again and his pancreas looked worse (on ultrasound). AND his eye . from the ulcer, wasn't healed inside and they would have to remove it. It was infected and he was in great pain. I quickly said, no, he has had enough. He was almost 15. I feel I made the right decision, but boy, that decision left my heart in shambles. There does come a time when quality of life must be weighed very carefully.

Yahoo has a site called: Feline Assisted Feeding group. It's very helpful for anyone with a cat with fatty liver or other ailments resulting in a poor appetite.

You have my best wishes for a good outcome. Donna
 
I just wanted to post on update on what happened because I disappeared with no follow up.

I went to the specialist to pick Gus up and he told me Gus's bilirubin had doubled but his other liver values improved. The ultrasound found sediment, but no blockage or mass. The specialist then said "that doesn't mean there isn't a blockage so we have to operate or Gus will die". Then he said if I didn't want to do the operation, I could put Gus to sleep that day. As you can imagine, I was a mess!!! He said Gus had to have the surgery by the next day.

My regular vet also spoke to him and she too felt this specialist was too "surgery happy" and said she didn't feel Gus was a good candidate for surgery and couldn't we try some other treatments. The specialist then told my vet the same thing - Gus was going to die.

During all of this, they took Gus off the Ursidiol - which he was on a very high level of - 100mg for a 14.3 pound cat. Low and behold, Gus began eating after 36 hours off that drug. I never made the association, but the first day after his hospital stay he was doing fantastic - had a plasma transfusion - eating and acting like Gus. His appetite slowly decreased while he was there and then I took him home and he stopped eating altogether. That damn medication was either not agreeing with him or too strong a dose. It's a good medication, but like all meds, it has side-effects and I didn't realize what they were.

I found another diabetic group online with two people who had similar experiences. They put together a treatment plan for Gus and my vet looked it over and did her own research in the vet forums. Milk Thistle and probiotics are the main supplements along with vitamin B12 shots. Since last Tuesday Sept 27th, Gus has almost lost all of his yellow color. His appetite is great and each day he starts to act more and more like himself. He did have an episode of vomiting Monday morning so I put him back on Metronizadole and that stopped it right away.

I'm now doing research and am going to slowly transition Gus to a raw diet. In January, Gus had explosive vomiting and I didn't realize it was IBD. All I knew was that it might be the food so I bought a meat grinder and made him food and he got better. Then my vet scolded me for feeding raw so I stopped.

I'm not sure that raw will be a "magic cure" but I'm willing to try as it seemed to work before and Gus and his sister loved the food.

This has been the most gut wrenching experience. Being told Gus was going to die and deciding against the surgery was horrible. I could still be wrong and maybe Gus will die from this, but right now he seems pretty good. He about tore my limbs off last night when I brought him some raw chicken home as a treat. A week ago this poor cat just slept and wouldn't eat.

Gus is going to the vet on Friday to get his liver values tested and I will let everyone know what we find out. Again, I'm not saying that I made the right decision - only time will tell - but the fact that he started eating again and lost the yellow color is a good sign. I'm hoping I did the right thing. I guess we will find out when we go to the vet in a couple of days.

I'm hoping our experience can help some other people in some small way. At least do some research and don't let anyone pressure you into a surgery you aren't sure about. I agree that animals sometimes need surgery - Gus has had surgery in the past, but if you feel like something "just isn't right" then it's ok to question it and get a second opinion. In addition to my vet, I called another surgery place and did a phone consult with them so I felt I had a good amount of info before my decision.
 
Good for your (((Rachel))). I'm glad he's eating and the yellow has disappeared. Continued possitive thoughts going out for Gus' recovery and feel even better vines being sent.
 
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