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Ask Dr. Michael Salkin Your Own Question

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 24443
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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We had to say goodbye to or beloved cat last night and it was

Customer Question

We had to say goodbye to or beloved cat last night and it was the most traumatic ending I could imagine for him. Far from peaceful and I cant help thinking we failed him when he needed us the most. Our kitty had advanced hear disease and was congested. He also had a growth in one of his lungs so he was experiencing respiratory distress and we decided the 'kindest' thing to do would be to let him go. He had already had fluid drained from his lungs 3 weeks earlier and the tablets didn't prevent it returning. The vet took him to another room to insert an IV but couldnt find a vein so she returned saying he would need to be sedated and it might make his breathing worse - little did we imagine hat was about to happen. She returned him to the room in his box and he had already urinated all over his blanket. We couldnt get him out of the box to hold him because it looked as though he couldnt move. We spoke to him as his head dropped so he knew we were there. The vet had left the room to see to someone else at this point! When she came back she lifted him out of the box and it was horrendous. He cried out then proceeded to hasp for air as though he was drowning. His eyes open and scared the whole time - he continued to do this while she located his heart so that she could inject the anaesthetic directly - I know they say the gasping can occur after death but he must have been alive at this point if she found the heart beat right? As she injected into his heart his whole body went into spasm and this lasted about a minute and he was finally gone. I will never put an animal through this again. I just need to know how aware he was likely to be after the sedation. Please help.
Submitted: 10 months ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 10 months ago.
I'm sorry that your question wasn't answered in a timely manner and I'm sorry that you and your cat had to experience such a nightmare. I understand how difficult it can be to place an IV catheter in a failing cat who is so hypotensive that in order to find a vein, I might have to perform a "cut down" - opening up the skin and directly visualizing the vein. We obviously want to avoid having to do such a thing at the most inopportune time imaginable and so, instead, we sedate or, more accurately, disassociate our patients so they can't feel our poking and prodding when searching further for a vein. Sedating such a patient is likely to cause more hypotension and more difficulty finding a vein. Disassociating such a patient is preferred because a drug used for that purpose may actually increase blood pressure while altering our patient's consciousness to the point that there is no connection to what is happening.And therein lies the problem as I see it. Your cat wasn't given enough of the sedative or disassociative drug and so was still aware of what was going on. I assume this was the case because her vet didn't want to euthanize your cat with those drugs which could have inadvertently occurred in such a patient. It's difficult for me to know just how much your cat was aware of but it sounds as if she were aware of too much. My cats are disassociated to the point of non-responsiveness which, of course, is preferred in such a situation. My condolences for your loss.Please respond with further questions or concerns if you wish.
Customer: replied 10 months ago.
I have spoken to the vet who performed the procedure. She thinks he had such a large dose of sedative combined with his already Ill health that he was probably dying as a result of the sedative. She thinks the gasps were more of a reflex because his mouth was already purple. The combined effect of sedative and reduced oxygen to the brain would have meant he had very little awareness but his body would still have struggled to survive. The sedative also had some pain killers. It's a strong sedative they use instead of anaesthetic for minor operations like stitches so the pain killers must work somewhat. Given that a vein could not be found and trying was causing him a lot of distress it is hard to see what else could be done now that I understand more. Would you agree with this evaluation?
Expert:  Dr. Michael Salkin replied 10 months ago.
Yes, I would defer to the attending vet who knows best which drugs were used and has a better understanding than I of what occurred. The scenario his vet presented is reasonable and sensible.
Customer: replied 10 months ago.
Ok thanks for your time
Expert:  Dr. Michael Salkin replied 10 months ago.
You're quite welcome. You may receive an inappropriate follow-up from the site ostensibly sent by me. It wasn't and I apologize in advance should you receive it.

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