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Dr. Bruce
Dr. Bruce, Veterinarian
Category: Cat
Satisfied Customers: 18774
Experience:  Small animal veterinarian with 15 years experience.
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At 8 years old my indoor male cat Pixel had a scratch on his

Customer Question

At 8 years old my indoor male cat Pixel had a scratch on his side which he had licked into a bit of a state. The vet prescribed Fuciderm Gel and a collar to stop him licking it. I wan't happy giving Pixel chemicals, particularly since it wasn't healing so stopped using it after a few days and treated it with organic extra virgin olive oil, and it healed up well. I read that EVO was safe for cats and was used to de-flea kittens so knew that it would be fine. About a month afterwards Pixel had a crisis, constantly drinking and peeing, as if he'd been poisoned and was diagnosed with chronic renal failure, and was put on a low protein, dry biscuit diet. I wondered if the Fuciderm Gel was to blame. He was fine for a year, with me constantly ensuring he drank enough water and only ate the specialist diet (Purina NF). Then he had his annual flu jab and a few weeks later had another crisis, being sick and pooping in the corridor (which he never did) and was rushed to the vet. I wondered if this was caused by the flu jab. His temperature was high and I was told he may have some sort of infection. He was put on a drip and strong antibiotics, they tried three different types and his temperature was fluctuating between normal and the high end of normal. He stayed in hospital for three nights, I want in to see him after the second night and I was told his blood tests showed his toxicity levels had doubled, the vet said if we kept him there another night it might make a difference. The next day the vet said he wan't responding, hadn't eaten or peed for 24 hours and I should consider euthanasia. I was devastated, he looked fine, his coat was lovely, eyes bright, he was looking around at the other cats and trying to get out of his cage. I had to persuade them to let me take him home for a night and they only agreed on the understanding that I brought him back the next afternoon, with the intention of euthanasia - they would do one more blood test and decide what to do from there. They took him off all medication and gave him a lot of subcutaneous fluids and we went home. Immediately he got in the door he rolled around on the floor as if to say "thank goodness I'm home" and went to his box and peed, I gave him some watery flakes of tuna and he ate three small bowls of that, he was hungry. He went to his favourite blankie and slept on and off, slept on my chest all night and seemed a lot better in the morning, was livelier. When I took him back to the vet they took the blood test but said all his levels were very high and he would go downhill very rapidly once the fluids were gone. I asked if they could show me how to administer fluids and they said it was something that wouldn't be kind, would end up being sore for him and wasn't pleasant having to go around with fluids under the skin. I asked how long he had before symptoms started to show and they said within hours or at least within the next couple of days, he wouldn't be comfortable as the toxins built up further, could develop mouth ulcers and have fits, and would suffer. I felt backed into a corner really, although they were saying it was my choice, they were really giving me no choice unless I deliberately wanted Pixel to suffer, so I agreed to euthanasia. It was the hardest thing I have ever done in my life. They took him away and were ages and ages - I thought they were going to come back and tell me they'd made a mistake but they came back and told me they had tried to put a catheter into his paw but were unable to do so because he'd had so many needles in him from the drips and antibiotics, so tried his other paw and the veins were disintegrating. So they bandaged his paws and told me they were going to give him a sedative and then put a needle into his liver. So traumatised I didn't know what to do or say, except to wait, I was seated on a chair with his blankie on my front, they brought him in and put him on me and he was already going, was unsteady and then slumped down on my front while I said soothing things to him. He was breathing, seemed asleep. He was pronounced sedated enough, and an injection was given to him, then they left the room for a while for me to say goodbye, came back in and listened on a stethoscope and told me he was gone. I can't believe that I took a lively cat back to the vet, he was jumping off the counter and exploring the room, had been eating/drinking and peeing, had a shiny coat and alert eyes, and I had been persuaded that it would be kind to end his life, simply on the result of a blood test. I can't help feeling that I may have been given the wrong advice. Can you give me any insight?

Submitted: 3 years ago.
Category: Cat
Expert:  Shantal-Mod replied 3 years ago.
Hello,

I'm Shantal and I'm a moderator for this topic.

We have been working with the Experts to try to help you with your question. Sometimes it may take a bit of time to find the right fit.

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Shantal
Customer: replied 3 years ago.


Hello Shantal, yes I would like to hear from one of the experts and I'm happy to continue to wait.

Expert:  Shantal-Mod replied 3 years ago.
Hello,

Thank you for getting back to me. We will continue to look for a Professional to assist you.

Thank you for your patience,

Shantal
Expert:  Dr. Bruce replied 3 years ago.
Hi,

Welcome. I'm Dr. Bruce and I've been a small animal veterinarian for over 13 years. I'm very sorry to hear about your loss of Pixel. These situations are ones that are very difficult to deal with and fully understand. From what you described, it sounds like he was in some state of renal compromise given that the subsequent blood work was showing progressive increases of his kidney values. Any time a case is having hear values going up despite IV fluid supportive care, that has to be taken as a very guarded situation. The idea of the IV fluids is to help diurese these waste products out. If they continue to climb it further supports that the function of the kidneys isn't where it needs to be. The ultimate unknown is if the function will return. The reason I bring this up is that some can have toxicity es or infections that compromise kidney function that has a small chance if resolving if the kidneys can repair themselves. This can happen with Lily plant toxicities, antifreeze toxicity and non-steroidal ingestions. These toxicities are almost always really, really bad and the outcome is usually the patient not making it. The reason is that too much damage has been to the kidneys and they can't repair themselves. But, every once in a while, they can recover and those that do basically over time with supportive care. In this situation could he have suddenly turned a corner and started to improve his values? I has a case at my ER with a dog similar to this that after a week of IV fluids finally started to improve. That won't was given an extremely grave prognosis, but they continued on. Is this the typical response to cases like this? No. Your vet is there to help present options and give you possible outcomes based on their experience. It sounds like they didn't want him to suffer. Would he have gotten as sick as they said? That would be the typical progression. But could he have improved? That was unlikely but not impossible. I'm sorry you felt pushed in the direction to let him go. Ultimately it is the decision of every pet won't to say what they want to do. A vet has to respect an owners decisions. Please let me know what questions all this brings up as I'm sure I didn't hit all of them.
Dr. Bruce, Veterinarian
Category: Cat
Satisfied Customers: 18774
Experience: Small animal veterinarian with 15 years experience.
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Customer: replied 3 years ago.


Thank you Dr Bruce, I think given the information I was provided with at the time, I had no choice but to go ahead, as I thought there was no hope for Pixel. However if my vet had hinted in any way that there was a chance that my lovely Pixel may have recovered enough to live on, I would have kept him on fluids for any amount of time longer. I'm heartbroken that I wasn't given the full picture. Thank you for taking the time to respond so fully. Best wishes.


 


 


Maria x

Customer: replied 3 years ago.


Regarding the use of Fuciderm Gel and the flu vaccine, could you say whether these would have caused kidney damage?

Expert:  Dr. Bruce replied 3 years ago.
From my experience and what I looked up, I wouldn't be that worried that the Fuciderm Gel or the flu vaccines were the source of any kidney damage. I wish there was a time machine to go back in and see if further fluid therapy could have had a different outcome. There is no way to do this and I try to help owners in these situations to move on. Know that in the future, you have all the power to chose what you want to be done. Don't feel pressured to go against your gut.
Customer: replied 3 years ago.


Thank you, at least I can discount my allowing the use of those from the equation. I lie awake at night wishing for a time machine myself but you're right, I will know in future not to cave in to pressure and to go with my gut instinct. I wish I had put more faith in Pixel rather than those who didn't know him as a family member.

Expert:  Dr. Bruce replied 3 years ago.
The thing I realize every day is that we can learn from the past. You are now in a position that benefits future decisions. The past is the past and the hurt will always be there. But time will help it to be less and less. I hope the special memories of this guy stay with your forever!