Choosing Euthanasia: A technician’s perspective

 How do you know when the time is right to say goodbye to your cat?

Due to the advances in veterinary medicine, the average lifespan of the cat has increased significantly over the years. Once upon a time, a typical backyard cat could be expected to live about 4-5 years. Now, pampered felines average about 14 years of good life, and a good number of our patients are seeing the other side of 20 years! Our own hospital cat, Ginger, was 22 years old when she developed an inoperable squamous cell carcinoma in her mouth, and we had to say goodbye.

How did we make that decision? How do you know when the time is right to say goodbye? Sometimes the choice is easy, or there is no real choice – if your cat has a traumatic accident or rapid organ failure that medicine cannot treat, it is kindest to end his or her suffering and pain. However, if your cat develops a treatable or manageable but incurable disease, knowing when to make the decision to euthanize can be hard.

I recently posted about my cat, Curie, who was being treated with chemotherapy. Just before Christmas, I had to make some decisions about her further care, and after considering her quality of life and weighing the options, I came to the decision to euthanize her. It was no easy decision, and I cried all day on the day I made the decision. I also cried on subsequent days, after we had euthanized her. However, I stand firm in my belief that it was the right decision for her. What follows are some of the factors that I considered when making my decision.

Deciding how to feel about Euthanasia

One thing to keep in mind is that, as a pet parent, you are your pet’s caretaker, their champion, and their advocate. Your veterinary doctor and staff, your friends and family, your breeder – they can all offer advice to you, but ultimately, the decision is yours. No one can make the decision to euthanize for you, and it is both a terrible and wonderful power to have.

Being able to make the decision to euthanize your cat is a huge responsibility because, even though you are not making decisions about a human being, you are still making decisions about life and death. Perhaps the decision is even harder than if it were a human being, because your cat can’t tell you what their wishes are. This is a very emotional and sensitive decision for most people. In my experience, as a caring human being who loves their cat, you will almost always second-guess your decision – no matter what decision you make - even if you know it is the right thing to do. Did I wait too long and let my cat suffer needlessly? Did I make the decision too soon? Would a little more time have made a difference? You wonder and worry simply because you care about your cat, and take your responsibility so seriously.

The power to decide can also be a relief, because when you know your dear friend is failing and there is nothing more that can be done, you can release them from suffering and spare them the misery of crippling pain, slow starvation or mental distress. I think most people know in their hearts when it is the right decision, even though it is not a decision they want to make. Once you have made the decision, you have to be firm with yourself that the decision was the right one - made with compassion and love.

As much as we may hate to admit it, for many of us, financial concerns may come into play. We may wish in our hearts to run every recommended diagnostic test, or try every possible treatment, no matter how new or experimental, but for most of us, a wall of dollar signs will eventually rise up. There is no reason to feel guilty that finances come into the equation. What good is it for you to have a kidney transplant performed for your cat if you cannot then afford to buy a high-quality, kidney-protective diet to feed her?

At some point, we may need to try to distance ourselves from our cat and pragmatically ask questions such as – What will continued treatment gain my cat? Am I continuing to treat her for her benefit or for mine? What is my cat’s current quality of life? Will continued treatment improve her quality of life? What is the likelihood of relapse? What kind of post-treatment care will be required at home? We may hate to ask these questions of ourselves, or of our cat’s veterinarian, but they can provide helpful decision-making information.  

Your veterinarian does not offer up euthanasia as an option lightly. The veterinary oath stresses that top priority is animal health and welfare, and their goal is to diagnose and treat your pet to the best of their ability. However, most veterinarians also know that there must be a balance between quality of life and quantity of life. What good does it do to have extra time with your cat when you can see that your cat suffers every day? In the veterinary office, we can only evaluate your pet based on a snapshot in time – the visit to the office. Ultimately, you know your cat better than we do, and are best equipped to make the final decision – based on the scientific, objective information that we veterinary staff can provide, and the contextual, subjective information that your cat displays at home, as well as your own emotions about your cat’s health and well-being, and any religious beliefs that you hold or financial factors that may affect your decisions about your cat’s care.

Assessing your cat’s Quality of Life

Many animal welfare organizations abide by rules called “The Five Freedoms”. These guidelines were developed in the UK for farm animals, but are applicable to any animal living under human care.

The Five Freedoms:

1. Freedom from hunger or thirst by ready access to fresh water and a diet to maintain full health and vigor
2. Freedom from discomfort by providing an appropriate environment including shelter and a comfortable resting area
3. Freedom from pain, injury or disease by prevention or rapid diagnosis and treatment
4. Freedom to express normal behavior by providing sufficient space, proper facilities and company of the animal's own kind
5. Freedom from fear and distress by ensuring conditions and treatment which avoid mental suffering

Evaluating your cat with these guidelines in mind can help make your decision less complex.

Ideally, if you are preparing for the eventual need for this decision, you should set aside some time each day or every few days and evaluate your cat’s quality of life. Does your cat still enjoy the Five Freedoms? Does he or she get a passing grade on the Quality Of Life scale (shown here: http://aplb.org/resources/quality_of_life.html)? Does your cat seem to feel “good” more than 50% of the time or have more “good” days than “bad” days? If so, you can relax and enjoy a few more special days with your furry friend. If not, then you should call your veterinary office. You may be able to ask your veterinarian for alternative methods of medication or treatments that would allow you to delay your decision to euthanize, and keep your cat comfortable longer.

The most important thing to realize about the decision to euthanize is that there is no one “right” decision in all cases. Each case has special considerations and is the “right” decision for the cat and the person or people involved.

If I Should Grow Frail

-         Author Unknown

If it should be that I grow frail and weak

And pain does keep me from my sleep,

Then you do what must be done

For this – the last battle – can’t be won.

You will be sad I understand

But don’t let grief then stay your hand.

For on this day, more than the rest

Your love and friendship must stand the test.

We have had so many happy years,

You wouldn’t want me to suffer so.

When the time comes, please let me go.

Take me to where my needs they’ll tend,

Only stay with me till the end.

And hold me firm and speak to me

Until my eyes no longer see.

I know in time you will agree

It is a kindness you do to me.

Although my tail its last has waved,

From pain and suffering I have been saved.

Don’t grieve that it must now be you

Who has to decide this thing to do.

We’ve been so close – we two – these years,

Don’t let your heart hold any tears.

Meet Princess January!

Princess Sabrina

My Fairy Tale:  My fairy tale began the moment I first graced my royal family with my presence.   My mom (the Queen) was in her palace and spotted me as a tiny wild kitten playing outside in the garden.  She ran out to the gate house and told my dad (the King) “there’s a Siamese kitten in the garden!!”.  Well, they both ran outside just in time to see me dashing away.  Mom had always wanted a Siamese kitty so she set out a live-trap every day hoping I would be lured back into their lair.  Well I surprised her…I didn’t come back…for a MONTH!  By this time she had given up hope of ever seeing me again, but one day she looked out the window and there I was sitting ON TOP of the trap.  She thought I was quite the little jester!  So she set the trap with some delightful tuna and went back in the palace.  Three minutes later I was captured and transported in some type of carriage to my new palace.  From that day on I have been the Princess of our palace…and I must say, I was BORN to be a Princess!

My Palace:   My palace is of course quite elaborate….we have 8 cat trees, two kitty pods, two kitty hammocks, one kitty cottage, one bamboo kitty ball bed, and the list goes on.  For dining we eat on Wetnoz Fat Cat dishes and drink from beautiful fountains.  Did I mention the Litter Robot?!  There is also a secret passageway from the hall to the royal kitty room that keeps the guard dogs out.

My Favorite Throne:  Since I pretty much rule the house I like to change my preferred sleeping location depending on my mood.  This week it is in the pink kitty bed, but my usual night time spot is wrapped around the top of my mom’s (the “Queen’s”) head.  I also like any look-out point where I can have full view of my kingdom.

My Loyal Subjects:  As Princess I have many loyal subjects.  There are my four guard dogs who’s sole purpose in life is to project me (though one of the Pomeranians chases me at times), my Ladies-in-waiting which consist of several female kitties who make sure I am clean and comfortable, my suitors which consist of several male kitties all who completely adore me and then there is my Queen and King who confirm for me every day that the world revolves around me.

My Favorite Amusements:  I am a bit of a mouser so I love to play with toy mice.  One time we had real baby mice in the Palace and I got to lick them…yum!  I also like “Da Bird”, my FroliCat laser toy and my Fling-Ama-String.

My Royal Duties:  A Princess needs her beauty rest so sleeping is important to me.  But I also like to chatter at birds outside and chatter for treats and chatter when I don’t like something.  So I suppose you could say I like to “talk” a lot.  I am also tasked with making sure the guard dogs stay in line which often requires me to implement my papping punishment….and I have at times been heard meowing “off with their heads!”  MOL!

My Favorite Fare:  Fancy Feast of course!  I also enjoy tuna, soft cat treats, cheese and any type of meat the royal family may be dining on.

My Titles:  Chewbacca, Chewy, ChewChew, Cheweenie, Weenie, Sasquatch, Sassy Sasquatch, Chupacabra, Sa-Brina-A, Sabrina the Witch, oh and don’t forget my formal title PRINCESS Sabrina!!  Ok, so I must explain the Chewbaka & Sasquach titles…my family says that when I chatter and talk I make sounds like Wookie.  I don’t really know what they are talking about because all I hear when I am talking is sweet music!

On the Fourth Day Of Christmas, my True Love Gave to Me, Four Mewling Kittens: How to Help Your Cat Avoid the Animal Shelter this Holiday (pt. 4)

While this part of the holiday hazard series is not about emergencies, it does address another serious holiday pet topic. As pet ownership is a huge commitment, giving a kitten as a gift should be considered with great caution.  For one thing, cost is a huge consideration – not of the cat itself (depending on the breed), but of the financial commitment that is involved in the cat’s day-to-day care in addition to veterinary costs. If you Google “yearly cost of owning a cat” you’ll get hundreds of results, ranging from $100/month to over $1000/month for food, litter, veterinary care and toys. These estimates do not take into account medical emergencies (hopefully no holiday-related problems, since you’ve read this blog!) or chronic health issues. The first year of life also tends to be quite a bit more expensive because kittens receive a series of vaccines, and will need to be spayed or neutered (this will cut down on medical costs later in life by preventing unwanted pregnancies, reduces the risk of certain types of cancer, and prevents unwanted behavioral problems for which many cats end up unwanted in shelters). 

Whatever the cost per month, you should be certain that the recipient of the cat is aware of the ongoing cost and prepared to give the cat the financial investment to keep it healthy. Often, especially in this time economic slump, many pets end up in shelters or on the streets because people are no longer able to provide care and shelter for their pets. 

Also, consider the effect on other pets and people in the household. Are you giving a kitten to a teenager who will be going off to college in a few months and possibly be unable to house the cat in the dorm with them? Is anyone in the household allergic to cats? Do you own a large, hostile dog or a boa constrictor that might find a tiny kitten to be a great snack?

Kittens are hard to come by at Christmas time because cats tend to breed during the summer months, so also consider that, if a feline friend is welcome as a gift, maybe an older cat would be a good choice. It may be best to plan to visit the shelter or rescue* together to pick out the new cat, to make sure that the person receiving the cat is getting a cat that they feel a connection with.

If forethought is put into the decision to make a gift of a cat, then the gift can be up to 20 years or more of valuable companionship, but it is not a gift to be given lightly.

*While many people choose purebred cats, remember that only about 20-30% of shelter cats ever get adopted. Consider adopting a rescued pet. Petfinder.com can even help you locate purebred cats that need adoption at local shelters and rescues, if only a purebred will do.

On the Third day of Christmas, my True Love Gave to Me, Three Family Parties: How to Help your Cat Avoid the Emergency Room this Holiday (pt. 3)

Depending on how you feel about your family, you may just want to crawl under the bed with your terrified cat when the time comes for holiday parties and family get-togethers. Depending on your cat, these parties can be fun or they can be extremely traumatic. Some cats hide for days after a party.

Hiding

If you are planning a boisterous holiday party with lots of guests, you might want to consider boarding your cat during the holiday. Otherwise, to help a shy cat cope, you can prepare a sanctuary in advance – a bed, food, water and litter – in a low-traffic area, a closet or the basement where sounds will be more muffled, and plan to keep them in their sanctuary for the duration of the party. Feline pheromone spray or a diffuser and items with your kitty’s own smell on them will help create a calming scent. Show your cat this area before the big day so she will know it’s her safe place. Cats that are frightened because of large numbers of people might dash for the door, or curious cats may slip outside along with an unwary visitor. This is an excellent reason why even indoor cats benefit from being microchipped. It is also a good idea to request that family members keep their own pets at home. Cats are creatures of habit, and the holidays are stressful enough without having an interloper to deal with. In addition, the last thing that you want to be doing just before Christmas dinner is rushing your cat to the ER with a bite wound if the animals decide that they don’t want to play nicely anymore.

Other concerns about holiday parties and visitors include inappropriate elimination. Some cats will urinate or defecate outside the box when they are overly stressed or anxious – another reason to consider isolating your cat in its sanctuary or planning to board her.

If you have specific concerns, antianxiety drug therapy could be discussed with your veterinarian. There are many calming medications available, ranging from human anti-anxiety drugs to herbal and homeopathic supplements, so you and your veterinarian can discuss which option would be most effective for your cat.

Foxy poses in a boarding cage

If you will be traveling throughout the holidays and your cat is not going with you, the most ideal option for pet care is to have a non-traveling family member stay in the home with the cat. This allows the cat the comfort of a familiar face and surroundings to provide the least interruption of his or her normal routine. A qualified pet sitter is the next best choice – someone who is trained to recognize signs of illness. Ideally, the sitter would stay in your home with the cat, or visit a minimum of twice daily for 30 minutes or more.  The third option would be for cat owners to board their pets at a reputable feline-only boarding facility. There are a lot of holiday hazards that a cat can get into at this time of year, so cats should not be left alone unattended. Cats with medical problems and daily medications should not be without their medications at this time of high stress.
 

On the Second Day of Christmas, my True Love Gave to me, Two Toxic Plants: Helping your Cat Avoid the Emergency Room this Holiday (pt. 2)

Many people decorate their homes with festive holiday plants that are gorgeous to look at, but may be deadly if eaten. In addition, many are busy baking and cooking in preparation of big family meals together. Since we’re so busy, sometimes we may not notice if our mischievous cat is trying to snack on something she shouldn’t.

Here are some of the top holiday items that cats love to eat (but shouldn’t!):

Plants

Mistletoe should be kept well out of cats' reach

First of all, it is important to note that even non-toxic plants can cause coughing, choking, stomach upset or mild vomiting. Sometimes a leaf can even become lodged in a nostril or scratch or irritate an eye. If your cat eats a plant and needs to seek medical attention, it is always a good idea to bring the plant that was eaten with you to the vet – that way if you are uncertain of the species, your vet may be able to identify it and determine the treatment needed. Also, bringing the plant helps to evaluate exactly how much and what part of the plant was eaten. A tiny bite of a certain plant leaf may be safe, while the berry or flower of the same plant is lethal.

Holiday plants vary in their toxicity. Lilies (all of the Lilium family and Hemerocalis species), amaryllis bulbs and mistletoe are the most dangerous. If you or anyone in your household suspects that your cat may have ingested any part of a lily, no matter how small, please seek immediate veterinary attention. Hesitation may mean the difference between life and death for your cat! If more than 6 hours pass between lily ingestion and treatment, your cat’s chance of recovery decreases from fairly good to guarded-to-poor, and you can expect some long-term kidney damage.

There are several species of mistletoe including Phoradendum and Viscum – some of which are highly toxic and some of which are less so. Any type of mistletoe ingestion should be brought to the attention of your veterinarian.

Cats should be monitored around holly

Holly (Ilex spp.) – certain species contain the methylzanthine Theobromine (also theophylline which is used as a respiratory aid, and caffeine – I'm sure you know what that does!) in all parts, but concentrated in the leaves. Theobromine is the toxic substance that is also found in chocolate. Leaves can cause cuts or irritation in the mouth and esophagus. The berries, which contain glucosidic saponins, are mildly toxic to humans in small quantities, but can cause toxicity to varying degrees in pets. It is best to contact a veterinarian if your pet has ingested holly.

(for more about Holly toxicity)

Jerusalem cherry (Solanum pseudocapsicum) is a decorative species of nightshade with bright red berries that are poisonous.

Poinsettias (Euphorbia) have gotten a bad rap as an extremely poisonous plant due to an urban legend dating back to 1919. They do cause some intestinal upset, but rarely cause death. Pine needles and Christmas cactus usually cause irritation and intestinal upset but are less toxic. The most common signs of plant toxicity are: vomiting, diarrhea, abdominal pain, and excessive salivation (drooling).

Poinsettias aren't as bad as many people think

If you have a live tree, Christmas tree water may contain fertilizers or preservatives and stagnant tree water can breed bacteria, but ingestion of a small amount of water does not usually cause severe issues. Covering the water with chicken wire or other mesh allows you to refresh your tree, but prevents your cat from drinking the water. Pine sap is not toxic but is sticky and hard to remove. Cats may lick excessively or pull at their fur if sap becomes adhered to their fur. Vegetable oil works better than shampoo when removing sap from your cat’s fur.

Exposure to plants in the Lily family is far and away the most serious holiday threat. Dr. Bailey has seen more deaths in cats due to this, than all the other toxic plants combined.

Some non-toxic winter plants that you can safely place in your home include: Christmas palm (Veitchia merrillii), Christmas orchid (Cattleya trianaei), Christmas dagger fern (Polystichym spp), and Mistletoe cactus (Thipsalis cassutha).

Foods

Cats and the onion family don't mix

All members of the genus Allium (onion, garlic, leek, chives, shallots, and scallions) can be poisonous to both dogs and cats. Toxicity can cause damage to the red blood cells (RBC), resulting in Heinz body anemia. In particular, cats are 2 to 3 times more susceptible to RBC damage from these components than other species. While specific studies have not been done with garlic as to the safe levels of ingestion, acute onion toxicosis occurs in animals that eat more than 0.5% of their body weight at one time (less than 2 Tbsp. for a 10lb. cat). However, smaller doses given regularly over a period of time will cause the same problem.

Drinks with milk or cream such as alcoholic eggnog are a concern both because most cats are lactose intolerant and because cats are very sensitive to alcohol due to their small size. Even small amounts of alcohol can be fatal.

Goncharoff cat-shaped chocolates

Chocolate ingestion can be serious, leading to seizures, if a large quantity is ingested. Chocolate toxicity varies by type of chocolate ingested – baker’s chocolate contains a higher concentration of Theobromine than white chocolate. Any ingestion of chocolate should warrant a call to your veterinarian, however. This is usually less of an issue for cats than dogs since they don’t seem to want to eat pure chocolate, but it should still be kept out of reach.

You should refrain from giving bones to your cats. Unlike dogs, cats do not have the instinct to gnaw on bones – and even dogs can damage or prematurely wear down their teeth with too much bone-chewing. Small bones can cause choking or bowel obstructions. Ingestion of broken bones can cause perforations of the intestinal tract, so if you offer turkey meat, make sure it is boneless.

In addition, the herbs and spices that the turkey or chicken is cooked with can be a problem. Sage is an herb that cats are extremely sensitive to, and can cause an upset stomach or depression of the nervous system. Also, as above, onions and other members of that family can cause anemia. If you want to offer your cat turkey, cook up some unseasoned bits on the side, rather than sharing from the family’s bird. It is doubtful that cats can taste the spices the same way humans can, anyway.

Medications

Many of the poisoning cases we see are due to pill ingestion

Medications are not something that people think about as a holiday hazard, but during this chaotic time, when many guests may be staying in your home, be vigilant about any medications that may spill, especially as family members that may be coming to stay may bring in medications that aren't usually in your house.

Cats lack some liver enzymes and metabolize many medications poorly; one Tylenol or Ibuprofen can be fatal to a cat. If your cat is on medications for her own health issues, ingesting additional human medications may interact with those she has already taken with devastating results.

If you think your cat has ingested someone's medication, please call a veterinarian right away. Have the pill vial handy while you are on the phone and bring it with you to your appointment so that you can give all the important information to the doctor about what kind of medication it was, the dose and an estimate of how many pills were in the bottle. Make sure that you are also aware of all the medications your cat normally takes and when the most recent dose was given. If your cat has ingested someone else’s medication and is due for a dose of their own medications, DO NOT give the normal medications until you have spoken with your veterinarian.

Most of the poisoning cases we see at Exclusively Cats Veterinary Hospital are due to improper medication ingestion - either cats eating dropped pills from a human or other pet in the house, accidental overdoses when more than one family member gives the medication on a busy or chaotic day, or from mixed up medications such as a dog parasite product being accidentally applied to a cat.

Return to the First Day of Christmas

Meet the December Cats!

 Sadie and Devo

Age:  Just turned 9 on November 13th!

Weight:  Average sized kitties I would say we are.  Both of us are about 13 pounds.

Demeanor at vet:  Going to the vet is no treat for us.  I (Sadie) really dislike it and cry the whole way there.  My brother Devo does too.  Once there, Devo doesn't mind wandering about and typically hiding in the corner under the chair or curling up on mama's lap.  Instead, I prefer to just hide in the cat carrier and hope no one sees me.

How we found our home: Mom found us as wee kittens in a local pet store.  We had another sibling there too, but unfortunately mom knew she could only take two of us.  Our other sister was NOT interested in mom at all anyways.  Devo knew right away he wanted to go home with her.  I was a bit apprehensive at first but eventually curled up on her comfy lap and felt right at home.  We moved around a lot and met a lot of people, but have been comfy and cozy in our home now with mom & dad for about 5 years!

Favorite Toys: We are simple cats and prefer just a string and a bell or a little ball of fur to play with.  My brother Devo loves paper bags to curl up into and play around with.  Mostly our days are spent hiding out from the beast that mom & dad brought home one day.  I think her name is Emily.  There's another one too, but he doesn't seem so bad.....yet.  They call him David.  Only time will tell.  My favorite places to hide are under the dining room table.  Emily seems to leave me alone when I'm under there.  My brother usually fancies the bathroom sink upstairs.  

Food and Treats: I'm pretty okay with anything food-related!  I wish I got more of what mom and dad ate.  My brother is a bit more picky and I think mom is still trying to figure out what he likes best.

How we got our names:  Mom loves her music, so of course she had to come up with names that were music-related.  I am named after a song by The Beatles - Sexy Sadie.  My brother is named after a band - Devo.

On the First Day of Christmas, my True Love Gave to Me – a Cat in a Christmas Tree: Helping your Cat avoid the Emergency Room this Holiday (pt. 1):

While most people enjoy the holiday season of friends, family, feasting and frivolity, your cat may not feel the same way. The holidays are a time when we are busier than usual, so our cats may be bored and looking for excitement. In addition, we bring lots of new fun (and hazardous) toys into the house. What a perfect opportunity for your cat to get into some mischief!

Here are some of the top holiday items that cats love to play with (but shouldn’t!):

Ribbons

Cats love to play with ribbons and tinsel, but they can be devastating if swallowed, knotting up and clogging the intestinal tract. Tinsel, especially the loose "icicle" type, should be avoided if you have cats in your household.

Any ribbon-play should be supervised. Make sure that all package-wrapping materials are put away where the cat cannot access them when you are done wrapping. Once the packages are wrapped, make sure the cat is not nibbling at the ribbons and bows under the tree, or wherever the presents are displayed.

If you notice a string or ribbon hanging out of your cat’s mouth or rear end, do not attempt to pull it out. If the string is knotted up inside, tugging on it can cause devastating trauma to the intestinal tract. Seek a veterinarian’s care immediately if you suspect your cat has swallowed a length of ribbon, string or tinsel.

Signs that your cat may have been “Naughty” instead of “Nice” include vomiting, especially multiple times in a row, or unproductive vomiting, lethargy, depression, fever, poor appetite or refusal of food, or a tense or painful abdomen (vocalization when picked up, sitting in unusual positions, hiding).

Ornaments

Fragile ornaments, especially those made of glass, may be broken and ingested, as can the ribbon, hooks or wire holding the ornaments on the tree. If you have a young cat, it is best to put a tree up first, before decorating it. If the kitten shows any inclination to climb the tree, you may want to minimize how many family heirlooms you hang on it! Also, you may want to stabilize the tree by attaching a guide wire to the wall so that the cat doesn’t knock it over. If it is possible to keep your tree behind closed doors, all the better, but many cats do begin to ignore the tree after they have thoroughly investigated it. Hang the most non-breakable and “boring” ornaments at the bottom of the tree where they are in the cat’s line of sight, and the most interesting ones where the cat is less likely to see them. Ornaments that move on their own should be avoided, unless your cat is uninterested in the tree as they are more tempting than regular ornaments.

Liquid Potpourri

Liquid potpourri can be toxic to the liver as well as causing burns if heated. Additionally, the cationic detergent in liquid potpourri is a corrosive substance and can cause severe chemical burns to the skin or eyes. Part of the concern about liquid potpourri is that it is an oily substance that is not easy to remove quickly and will remain on the skin and hair coat, continuing to cause damage as you try to remove it. Cats that have skin contact with liquid potpourri should be immediately bathed in mild liquid dishwashing soap, with special attention paid to the area between the toes since they may have walked in the potpourri. It should be assumed that if the cat has potpourri on its skin, it has probably tried to groom itself and will likely have eaten some, which is a much more critical problem. Liquid potpourri can cause severe ulceration of the mouth, tongue and esophagus, some of which may not become apparent until several hours after exposure. Cats that have been affected with liquid potpourri should see a veterinarian as soon as possible.

Candles

Candle flames are hypnotizing to cats and look like great toys to a cat. Make sure they are placed in areas where the cat cannot play with them and burn a paw, singe off all its eyebrow whiskers, or knock them over and start a fire. For those with extra-curious cats, a battery-operated candle may be a better option.

Cords

Electric light cords may also be tempting to cats but can cause serious burns in the mouth if chewed. Keeping cords hidden and out of reach will help. “Bitter Apple” is a spray that is available at most pet stores that has a bitter taste to discourage your cat from chewing on cords. You can also wrap dangling cords with bubble wrap or double-sided tape to discourage chewing. Cords can also be a strangulation hazard.

Walk around your house with your cat in mind, and remove possible hazards from temptation. Make sure to take a few extra moments each day and spend some time with your cat. Keeping your cat feeling like he is still the center of the universe will help prevent boredom and the need to find new things to play with. The holidays are a busy time, but a few extra moments’ consideration can save you and your cat from a devastating situation.

Meet Mr. November!

Wily

Age: 11 years

Weight: 19.8 pounds, overweight

Birthday: May 27, 2001

Gender: Neutered Male

Breed: Pixie Bob

Demeanor at the veterinary office: Mostly a very nice boy, sometimes a bit cranky

  

Wily is a very special cat that is exceeding all our expectations! He had chronic diarrhea and soft stools all his life.  As a young cat, he had a parasite called Tritrichomonas which contributed to his diarrhea, but even after being treated for the parasite, he continued to have soft stools. Over time, Wily developed a mass in his colon. Dr. Bailey surgically removed the mass in November 2010. The mass was extensive, and so much of the colon was removed that Dr. Bailey was concerned that Wily would have even worse diarrhea after surgery. The colon is the part of the body that extracts water from our waste and returns it to the body. Without much room to extract water, it is expected that the waste will be a liquid consistency, or diarrhea. In order to counteract this problem, Wily started eating a high-fiber prescription diet called Science Diet R/D, and by March of 2011 was having solid stools for the first time in his life! 

The mass that was removed from Wily's colon was sent in to a pathologist to determine what it was. The pathologist reported that it was cancer - a high-grade lymphoma. The outlook for Wily was pretty grim. Strangely, however, Wily is thriving! He has gained weight, and continues to eat like there's no tomorrow.  We contacted the pathologist and had the sample re-examined, both by the same pathologist and others. They confirmed that the mass removed was definitely a high grade lymphoma.  

Wily is just one more example that while we have all kinds of statistics about medical conditions and know how the body should respond, sometimes a special patient will beat all odds! We love you Wily! You continue to amaze us!

Cats, Cancer and Chemotherapy – a technician’s personal experience

Curie receiving Adriamycin administration

Cancer. Whenever people, myself included, hear the “C” word, we enter into a state of despair. In its many forms, cancer is one of the most common problems affecting humans and animals today, but still very poorly understood. We either hear stories about or watch loved ones who go through terrible side effects of chemotherapy – nausea, pain, infections, long hospital stays, hair loss, and this is what we picture when the veterinarian mentions chemotherapy as a treatment option for your cat’s cancer. However, human chemotherapy is much more aggressive – we know what we are going through and why. People choose to subject themselves to the treatment in the hopes that they can soldier on. Should we make that choice for our cats?

In veterinary medicine, the goal of chemotherapy is to control the cancer without causing excessive pain and suffering in your pet. While some animals will experience side effects, most tolerate the drugs we use much better than humans do. Cats do not usually experience hair loss, though hair may be slow to regrow if shaved. While some cats do experience nausea, most of the time, it is easily controlled with anti-nausea drugs. Many cats will eat shortly after receiving a dose of chemotherapy! Some cats will feel tired for about 24 hours after treatment, but most will continue to keep their normal routines, and feel quite good.

Many small lymphocytes and two dividing cells or "mitotic figures"

Many know that chemotherapy is a method of cancer treatment that uses drugs to try to kill the cancer cells, but really, chemotherapy refers to any kind of treatment that involves medication. By definition, taking an aspirin for a headache is a form of chemotherapy, and it should not be a “bad” word. Not all cancers are treatable with chemotherapy. One of the most common cancers in cats is a cancer called lymphoma, which is also a very treatable cancer.

My cat, Curie, has been with me since college. She was an adult stray that showed up on a friend’s doorstep. I took her in, took her to the vet, got her spayed, vaccinated and treated her for parasites. She’s had bouts of dental disease issues, but otherwise has always been a healthy, hearty girl. In 2010, she started to lose weight - gradually, at first, but I kept bringing her in for bloodwork and it all looked fantastic, especially considering she was over 10 years of age. So, I put down more food. I joked that since all her bloodwork was so good, her weight loss must mean she had cancer.

Many lymphocytes of varying sizes, suggestive of lymphoma

The spring of 2012, I brought her in, and she was being cranky (always a feisty girl, she’s gotten more cantankerous with age!) and so we anesthetized her to draw her blood. Once she was asleep, we noticed two lumps on the left side of her neck, right near her jugular vein. After we drew her blood, one of the doctors collected a fine needle aspirate sample of the lumps and looked at it under the microscope. It was determined that the lumps were probably enlarged lymph nodes, based on the cells the doctor saw under the microscope. Enlarged lymph nodes could occur due to some sort of infection in the body, or could be due to lymphoma. We collected a slightly larger sample, called a TruCut biopsy, and sent it into the lab for a pathologist to examine.

Meanwhile, her bloodwork was still great, she still seemed to feel good other than her weight loss, and her x-rays came back with no sign of metastasis (cancerous spread) to the chest or abdominal lymph nodes.

My little chatterbox the day before surgery. See the swelling on the left under her jaw?

The pathologist determined that she had lymphoma. Often, when only cervical (neck) lymph nodes are affected, surgery will cure the disease. This is known as Feline Hodgkins-like lymphoma. We took Curie to surgery and she did very well. The lymph nodes were much larger than they appeared from the outside, and were very close to some important nerves. Dr. Bailey was concerned that Curie might have some lasting laryngeal paralysis and lose her voice, or might have some other nerve damage, but she recovered 100% of her function and has been just as talkative as ever!

I started monitoring her neck at home, just as a precaution, making sure to pet her under her jaw every evening when she sat on my lap while watching television. Unfortunately, there are a lot of lymph nodes in the neck, and while they looked normal at the time of surgery, about 2 months later, two more lymph nodes in the same chain (on the same side) became enlarged. At this point, rather than play “chase the cancer” through the rest of her cervical lymph nodes two by two, and put her through more surgery, we decided to try chemotherapy.

Curie's incision post-surgery.

Curie started with a dose of Vincristine, and then we checked her white blood cell count the next week. She seemed to feel no adverse effects from her first dose, and her lymph nodes were back to normal size. Every week after that, she returned for a CBC to check her white blood cell and red blood cell counts, and then got a dose of chemotherapy. We usually use a rotating cycle of drugs to treat lymphoma called the Modified Wisconsin Protocol (Vincristine, Cyclophosphamide, and Adriamycin in the hospital and Prednisolone given at home). We did have to delay one dose a week because she caught a cold, and developed some anemia (low red blood cell numbers). After some antibiotics and antivirals, and some injectable medication to stimulate her red blood cell production (Iron, B12 and Epogen), she was ready to continue the process.

Seven months post-surgery.

There were only a couple times that Curie had any kind of reactions. Both times she got cyclophosphamide, she vomited right after getting the drug. If she has to repeat chemotherapy, we will pre-treat her with an anti-vomiting medication before giving the cyclophosphamide. Five days after her first dose of Adriamycin, Curie had a seizure. She had a seizure of unknown origin in 2010, so we don’t know if this seizure was spontaneous or related to the chemotherapy. The second time she got Adriamycin, she did not have a seizure, but she did have some vomiting and diarrhea 6 days after treatment. She also vomited two large hairballs – did she vomit because of the chemotherapy or because of the hairballs or both? Who knows? Other than that, in 9 weeks, she felt very good for the majority of the time. She gained a little weight and then maintained it, when she had been losing weight for a long time prior to starting chemotherapy. Her appetite improved – she actually started knocking the butter dish off the kitchen counter, trying to get to the butter – something that she has never done before in the last 13 years. In fact, before this, she rarely got on the kitchen counters at all!

Leukeran is a tiny pill

Now that she has completed her injectable chemotherapy, and her lymph nodes have reduced in size, Curie can take oral chemotherapy at home (Leukeran and Prednisolone), as long as she continues to get a CBC checked every three weeks to make sure her cell counts don’t drop too low. Her hair is a little thinner on her belly, she has fewer whiskers than she used to, and her hair still has not fully regrown from where she had surgery, but she still seems to feel good. In fact, when I head to the kitchen in the evenings to get her pills, she runs ahead of me because she knows that she will get her favorite treats afterwards!

As a technician, I have always felt that cats seem to do well with chemotherapy, and so far my experience with my own cat has reinforced that belief. While she is not as robust a cat as she was before she developed cancer, her attitude is the same, her habits are the same, and I know that it is unlikely that I would still have her at this time if we had not started chemotherapy. I am so happy with how well she has done the last 5 months while being treated with chemotherapeutic drugs, and I hope that she continues to do well, and eventually goes into remission.

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Still begging for treats!

One of the best ways to tell if your cat is handling chemotherapy well is to see how they respond to their first dose or two. Usually, you will see your cat improving in 1-2 weeks. My other cat Marley also has lymphoma (in his nose, and therefore, inoperable), and I always notice that he stops wheezing and sneezing about 5 days after a dose of chemotherapy. With chemotherapy, it is fairly easy to evaluate, and help the doctor evaluate, whether the chemotherapy is working after only a few doses. Committing to start chemotherapy does not mean committing to the entire process – if at any time your cat is not tolerating the treatment, or not responding well, the chemotherapy can be stopped. In most cases, if chemotherapy is offered, it is definitely worthwhile trying.

Possible side effects include:

1. Suppression of the bone marrow
   The type of white blood cell that normally prevents development of serious bacterial infections (neutrophil) can be decreased. If this happens the cat can be at risk of developing severe life-threatening infections. This is the most serious potential side effect, and it is one of the reasons that we monitor the CBC while cats are being treated with chemotherapy – weekly in the initial phase and every 3 weeks after that. If the neutrophils are too low then further treatment is delayed until they have returned to normal. The CBC also allows us to monitor for anemia (decrease in red blood cells) and look for chemotherapy-related changes in the blood smear. Monitoring the cat with these blood tests helps us identify and treat problems before they become serious.
2. Gastrointestinal side effects (nausea, vomiting and diarrhea, inappetence)
   With the most common drugs used at the recommended doses, digestive effects are uncommon. A few cats will, however, develop various gastrointestinal side effects. Most of the time appetite stimulants and anti-vomiting medications easily manage these effects and keep the patient comfortable. If more severe or long-term side effects occur, then the drug causing them can be stopped and an alternative drug can be tried that may be better tolerated.
3. Extravasation of drug
   Chemotherapy drugs that are administered into a vein can be extremely irritating and painful if inadvertently given outside of the blood vessel. If your cat is grumpy or wiggly at the veterinary office, he or she may need sedation for the placement of IV catheters or even while giving the chemotherapy drug in order to make sure that things go smoothly and safely for all involved.

Additional resources:

Cat owners' personal chemotherapy experiences

The Conscious Cat - Chemotherapy

Pet MD Fully Vetted Blog - The Price of Chemotherapy

Veterinary Hospital of the University of Pennsylvania - Treatment and Prognosis of Lymphoma