Today was Sindar's last day on this Earth. Last night, I said goodbye to him. This morning he was too sick to go on. His death was peaceful. I will leave you with only one further remembrance- Last night as I was petting him and saying goodbye, I said to him at one point that when he wakes up again, he will be surrounded by beauty. He will be healthy and he will be able to look down upon his loved ones from heaven. At that moment he turned his body and head toward me- as if in silent recognition. I know you are in heaven now. Our love is eternal, our lives joined and there is a place for you in the stars. God give me the strength to go on as you would want me to. Goodbye great friend. Maybe I will join you one day.
One Further Note: Now that I am strong enough, I must write the following. During his last three days, I began giving Sindar a homeopathic remedy for pets designed to "detoxify" his system and stimulate liver and kidney function. This remedy was alcohol based and contained herbs such as Bryonia and others. The day before his death I may have given him a dose beyond the recommended dose. This dose (he hated the taste of it), given quickly and inadvertently and probably up to 3X the regular dose (a total of 9 drops versus 3), may have precipitated a crisis that resulted in a loss of liver function and a further decline in kidney function. However, the company that made the preparation assured me that even a dose far exceeding what I actually gave him could not have hurt him. I believe that the company is sincere. They indicated that in their homeopathic preparations the dilution factor is so high that it is impossible that I could have caused him harm by administering their preparation.
The vet felt that in any case his prognosis was very poor. Even before administering the homeopathic remedy he was far from his former self. When I brought him in on Saturday with full fledged liver toxicity, I could have put him back on IVs. I decided not to. The vet felt I made a good decision based on the blood work , but also based on the x-rays done of his kidneys. I had trust in this vet and felt he had a deep caring for cats and their owners. The vet still thought that FIP or lymphoma was a serious, even likely possibility. The FIP anti-body test was inconclusive, but this is often the case. The ultrasound test needed to confirm FIP if positive would have resulted in a fatal, untreatable prognosis. I did not want to see him suffer any longer. He knew he was not himself. There was little evidence of infection causing his condition. I pray that wherever Sindar is, he understands how much I love him and that I was merely trying to make him better. I wish we lived in the world where medical care for humans and other animals was free so that we could always strive to preserve life. On the other hand, I decided that I needed to do what was best for him. I made a hard decision on the life of someone I loved so dearly. But I feel it was the right decision. He was not going to get better. Death is either freedom, being lost in the nothingness or it is was what I told Sindar, a happy resting place over the Rainbow Bridge. No one, not even myself, can remove the love I have for him. I will do my best to devote myself to doing good so that others may suffer less. But remember, death is an inevitable part of living. A parting, which at least seems final, but may very well not be. We all must die. I pray it was his time when I made the decision yesterday. I believe it was. I wish I was perfect, but I am not. Please forgive my imperfections and let me do good. This is so hard.
There is no answer to dealing with grief, but perhaps sharing with others is a start. See: Crisis, Grief and Healing. I have decided to standup to my grief. To know that my cat loved/loves me dearly as dearly as I loved/love him. To begin anew and from tears find joy and hope and allow goodness to spring forth.
Remembrance of the Last Days
A remembrance of his end and my final efforts, however unsuccessful, to prolong his precious life. Placed here to be of some benefit to others.
Today is a very sad day in my life. My beloved cat, Sindar, is very, very sick. He is eight years old. Up until a couple of weeks ago, he seemed to be his normal stubborn, independent self. He was very happy to have me home from my summer break (which may be more than just a summer). But last week, he gradually started losing his desire to eat. Otherwise he seemed quite normal. But my concerns grew, so I took him to the vet a day ago. He was, according to the vet, very dehydrated. She did blood and urine tests the following day. The results were not encouraging. As a matter of fact, I doubt there was one single test result that was normal. If the vet is to be believed he is suffering from some combination of diabetes, chronic kidney/renal failure and infection, possibly pancreatic or kidney. It seems I caught all this more towards the latter than earlier stages of disease progression.
Perhaps- I write this more in denial than true belief - his condition will reverse itself once the infection is treated. More likely it will grow progressively worse. Sindar is not in great discomfort now. He knows something is wrong, but like a child, is unsure of exactly what. He doesn't really care for all the attention he is getting now. It is hard to know where to turn.
I wonder if I treated him as well as I could have over the years. Yes, he always had quality food, a warm house, annual vet visits, all his vaccines, etc. But did I let my love for Tasha, my dog, supplant my love for him both in my eyes and his? He was not well exercised. It was hard to motivate him!!!.
I always felt that he would live to twenty, perhaps even outlive me. That seems to no longer be the case. I suppose from the perspective of many others, his dying is of little consequence given the vast scheme of things. But for me, the vast scheme seems to fold upon itself a billion times when I look into his eyes.
At this time I feel quite deserted and alone. Tasha and I will have to take care of him as long as we can. He is our friend and even if the world grows darker, he will light up our lives. I am not ready to say goodbye yet. But before I forget let me say just once:
Sindar, I love you- always.
July 30, 1998
Sindar returned from the vet today. During his brief stay at the Vets he was on IVs and received Sub Q injections of water and electrolytes. His BUN and creatinine levels have come down, but they are nowhere near normal. He still has no appetite and will not voluntarily eat his food. He is drinking water at a tremendous rate (symptomatic of kidney failure). In the past, when Tasha and I ate, he would eat with us (like a family). Today, while we were eating, he got up, went to the bathtub and urinated. Presumably he did this because he was too weak to jump up to his litter box which is on a table. He also wanted to be courteous and considerate by "going" in the bathtub. Obviously his need was urgent as a result of consuming so much water due to his kidney problems.
He hides in the closet or under the bed because he is not feeling well and wishes to be left alone (this is often the case with cats who feel ill). I may need to force feed him or feed him by syringe. He may need Sub-Q injections. He is receiving an anti-biotic for infection, a potassium supplement and Reglan to prevent vomiting after he eats. He remains a very sick cat. The best I can do is treasure, what at least for now, seems our last few days or weeks together on this Earth. I will not allow him to decline to the point that he is in pain or obvious, strong discomfort.
August 1, 1998
I am slowly, adapting to Sindar's condition. I am "force" feeding him three times a day. All he can barely tolerate (without vomiting) is 3 oz. of Select Care Modified diet per day (about 1/2 of what he should be getting daily). I am giving him Tumil-K gel twice per day to supplement his need for potassium. In addition he is receiving an anti-biotic, liquid vitamin supplement and anti-nausea medication before he eats. Pilling him is not difficult, but I am not at all times confident that every pill goes down. I am trying however to monitor this closely. I let him outside and he seemed to have an interest in smelling and even EATING some of the outdoor plants.
Shortly, I will be giving him Prozyme, a digestive enzyme supplement to help with the absorption of what little nutrients he is getting AND retaining. He continues to have diarrhea and will all to easily vomit if I am not very careful with what I give him, how I give it to him (including the order of foods/supplements) and when I give it to him. Because of his diarrhea, I must constantly clean him after he "goes." Also, after he has his "force" feeding session, I must clean him around his chin area. Both of us are getting better with the feedings and the mess is now minimal. He seems to enjoy when I comb and clean around his chin after he eats.
He is lethargic, but seems comfortable. His hydration seems acceptable, though I will need to monitor this more carefully. He continues to drink copious amount of water. I have replaced his tap water with distilled drinking water. There are three water bowels (including the dog's bowel) that he can drink water from.
August 2, 1998
I took Sindar to the vet again for a follow-up visit. He was according to the vet, 8%-9% dehydrated. I requested and received materials to administer subcutaneous fluids at home. Sindar is extremely compliant and the current plan is to administer 50 CC, twice per day. The vet we visited today (Sunday) is the "partner" of the vet who has been treating him this week. It is interesting to note how different what she conveyed to me was compared to the other vet. She indicated his kidney's were enlarged and that the IV's were, according to her partner, unsuccessful. Her partner, indicated to me, that the creatinine and BUN levels, while not normal had gone down dramatically while on IVs and would take another couple of days to possibly stabilize. Further, he hinted the condition might be acute (rather than chronic) and related to kidney infection.
Enlarged kidneys are symptomatic of polycystic kidney disease. Polycystic kidney disease may afflict up to 35% of all Persian cats and is primarily of genetic origin. The disease is also present in the human population. The original vet indicated that the kidney biopsy he performed did not show evidence of cysts (of course an ultrasound would be far more conclusive (my own analysis)). Conclusion: Neither vet communicates well with each other or their patients. Next week I will seek out a second opinion and additional recommendations.
Sad incident: Last week, while I was watching over Sindar during his stay at the pet hospital, the vet, in an adjacent room, was putting to sleep a stray cat that had been brought to him for a "medical estimate." Apparently the medical estimate was to high for the person that "recovered" the cat and it was decided to put the cat asleep. I would assume that every attempt was made to locate the rightful owner. While performing the cat euthanasia, the vet made loud and sarcastic remarks to the cat as it died- telling it that it was going to join a bunch of kitten fetuses waiting in the "back." Perhaps the vet's "exhortations" were just a way of relieving a stressful situation (for him). Or perhaps his words demonstrated marked insensitivity to a poor, abandoned cat who loved and ultimately was unloved. Or perhaps both. I doubt he was aware of my presence.
August 3, 1998
After my post on the Acme Pet Cat Health Discussion Board, a wonderful, caring woman named Tania shared with me her holistic remedies for her cat Chester who is experiencing CRF as well. She is working closely with a holistic vet. Chester seems to have made solid gains in weight, coat condition and general health. Tania is an extremely sensitive and well informed woman with knowledge of both holistic and conventional (allopathic) medicine. Her advice made a great deal of sense to me and so I will reproduce it for others who may need help or advice. However, while I have begun using her suggestions with Sindar, success or lack of success with one cat is no assurance of success or lack thereof with another. A great deal of Tania's healing strength undoubtedly stems from her compassion, sensitivity and devotion (both in time and love) to her cats.
Tania's Suggestions: Please remember these are only suggestions, always consult your veterinarian.
August 5, 1998
I finally realized that Sindar needs multiple feedings of very small amounts of food throughout the day. For now, he can not tolerate two or three "major feedings" over the course of a day without vomiting. I have switched him back to the Select Care modified diet. The organic baby food I was feeding him contained too much fiber and sodium and too little protein and therefore was not a diet I wanted to continue any longer than necessary. Sindar is very affectionate now, even more so than before his illness. He sleeps a great deal and at times seems slightly disoriented, but nevertheless content. He continues to have little interest in food, hence I still need to spoon feed him by gently opening his mouth. However, he offers no resistance to the feeding and he has developed ways to tell me when it is time to stop the feeding. That lesson, I have learned well! The weather was cooler today and he seemed to need less water, though he continues to drink well. At times I will move him over to the water dish to remind him to drink if he is thirsty. I have water bowls throughout the house.
I have the plastic pouch and NaCl solution to give him Sub-Qs, but haven't done so since Sunday. He seems to be adequately hydrated or only slightly dehydrated. Since he is drinking well, I do not see the need to do Sub-Qs daily. My thinking on this might change however.
Postscript 11:00 PM: He threw up for the first time today. Course of action: Continue with multiple feedings throughout the day; Give Reglan three times daily (before meals); Daily Sub Q's (50 ml/2X per day). Have vet fax all test results/work to me so that I can take Sindar to another vet for a precautionary second opinion. Notice how quickly my thinking changed! Another contributing factor is that he appeared wobbly toward the end of the day. The Sub Q amounts are very conservative and may need to be increased and/or have special additives such as vitamins/electrolytes. This is another reason for a second opinion. Also, my vet (or the new vet) may need to change the anti-vomiting /anorexia medicine. He still does not have an appetite. I am assuming this is due to nausea, but I may be wrong. Another reason for a new vet is better proximity to where I live.
Quoting from the book Unspeakable Losses:
"Grief, when allowed to progress naturally, tends to come in waves. After the first initial shock of the loss abates, waves of sorrow begin to wash over you rather unpredictably. At first the waves are huge and close together and you are afraid that you will drown. Eventually, they get smaller and more manageable, and you grow less afraid of them, although a big one can still take you by surprise. The phrase 'working through' grief means that you are able to get to the point where you can just stand there and let the waves sweep over you and not try to run or pretend you're not getting soaked. Standing there feeling the waves, you start to realize that this is as bad as it's going to get and you begin to understand that you are going to survive. That's when you start to pass through to the other side of mourning: accepting and making peace with your loss."
August 7, 1998
I took Sindar to a second vet today. Naturally the vet wanted to retest his blood and urine. He also did x-rays and is testing for FIP. One of Sindar's kidneys is very enlarged, the other is normal size. Both kidneys however are "hard/dense" (based on touch and x-rays), which according to the vet may indicate an immune response to the FIP virus, lymphoma or infection. Sindar continues to have no appetite. The vet gave me a liquid diet solution to feed him three times per day. Within two hours after feeding, he threw-up. This was three hours after Sindar received a Reglan injection to prevent vomiting.
He is losing weight fairly rapidly despite my feedings. Hydration is adequate. At times he seems disoriented and looses his "footing." He is very affectionate and pliable- too much so. Yet his pliability enables me to easily "force" feed him and deliver Sub-Q injections.
If his condition is FIP it came from exposure as a kitten before I had him. If Sindar has FIP his prognosis is very poor. I must focus now on eliminating any condition or medication that may be inducing nausea and causing him to throw up. We must restore his appetite. I am very suspicious now of Reglan and his antibiotic. His weight must be stabilized. His phosphate level must be brought up. Everything is day to day. I will extend every effort to stabilize him. While not his true self, he seems nevertheless comfortable