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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on September 05, 2010, 05:08:58 PM

Title: THE ETHICIST: Should We Kill Our Cat?
Post by: okarol on September 05, 2010, 05:08:58 PM
THE ETHICIST: Should We Kill Our Cat?
Henry Blodget | Sep. 4, 2010, 11:23 AM | 3,175 | comment 101

Well, it happened.

After an invigorating summer that recalled much younger days, our 15 year-old cat Tony suddenly stopped eating and started barfing.

The barfing was nothing new, but this time it wasn't accompanied by the usual hairball.

The barfing stopped after a day or two, but instead of perking up and going back to yowling constantly for a lap to sit on and laptop to obscure, Tony retreated to a chair and lay down, alone.

She (yes, she--my wife hadn't quite determined her sex when she named her) didn't eat much for the next few days. She also didn't get any perkier.  So, on Friday, we packed her off to the vet to learn that she was wildly dehydrated and, worse, that she had "kidney failure."

Now, it turns out that, as in humans, kidney failure is not an instant death sentence. They don't do dialysis with cats, but they do hook them up to IVs and pump them full of "fluids," and the fluids perform a similar service as dialysis.

To perform cat dialysis, we soon learned, you get one of those big IV bags, hang it on a hook, and put a needle on it. Then you hold the cat on the floor, grab some of the fur on the scruff of the neck, and poke the needle in. Then you keep the cat immobilized for a few minutes until the designated amount of "fluids" have dripped in.

The fluids go in too fast to be immediately absorbed, so they drain to the bottom of the cat. So when we got home from the vet yesterday, Tony had odd-looking globules of unabsorbed fluids floating around on her belly. But, miracle of miracles, she looked fluffier than she had two hours earlier. And two hours later, the globules were gone, and she was purring and stretching again.

There is a chance, the vet tells us, that through daily IV-rehydration, we can shock Tony's kidneys back to health. So that's the plan for the next three days: Daily trips to the cat nursing home to get hooked up to the IV. Then they'll check her blood levels again. And then, most likely, it will be decision time.  And here's what that decision will boil down to:

We can "prolong her life," maybe for years, by giving her IV fluids every day.

We can accomplish this by carting her off to the vet every day, where, for a fee, they will perform the procedure described above ($15-$20 a day). Or, we can order those IV bags and needles from a medical supply company and do it ourselves (apparently you don't need a license to perform internal medical procedures on your cat).

Alternatively, of course, we could order up a crate of tuna-fish, catnip, and milk, throw Tony a Bacchanalian 15th-birthday bash, and then drive her off on one last one-way trip to the vet.

So, the question is... Should we kill our cat?

Or, more accurately, should we:

1) do nothing and let her die,

2) proactively kill her, or

3) "prolong her life" by stabbing her with needles and giving her kitty dialysis every day?

This decision, it seems, is a microcosm of what is going on in our healthcare system at large. It involves questions of money, time, effort, and length of life versus quality of life.  It also involves far more profound philosophical concerns, such as playing God and being and not being.

Where are we on this decision?

Well, we're not carting the cat off to the vet for dialysis every day.  That would cost $500 a month ($6,000 a year), in addition to 30-40 hours a month.  Call us monsters, but we're just not signing up for that.

We're also not eager to have the cat killed or just sit around waiting for her to die.

But home dialysis? A few dollars plus medical equipment plus time every day?

A week ago, my wife and I would have dismissed the idea. This is a 15 year-old cat we're talking about--an awesome cat, yes, but a 15-year-old cat--and 15 is like 90 in cat years. Everyone dies eventually. Including cats. And the "prolonging life" madness has to stop somewhere.

But now, with the cat's life in our hands, I've got to admit that we're thinking about it.

And that's before we bring the kids into the discussion.

And I have no doubt what their answer is going to be...

http://www.businessinsider.com/the-ethicist-should-we-kill-our-cat-2010-9
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: Dianejt on September 05, 2010, 06:31:44 PM
We are going through this same thing with our 11 year old Jack Russell Terrior "Jelly"
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: cariad on September 05, 2010, 07:46:15 PM
We gave dialysis to our cat for a few weeks. It was not easy, and in the end, my family decide to put her down. She was a great cat, but every time dialysis would make her feel better, she would want to run off. Then they would find her deteriorating days later. She was not going to last with such inconsistent treatment, and the cat must remain still, so once they are feeling better, it is such a struggle to hang onto them for the approximate half hour it takes. I was back at university, and when my mother phoned to say they thought it was for the best if they put her down, I gave my blessing, as it were. I could not ask them to do that for my cat since I was not there to assist, and she had lived a good life (with lots of tragedy, but let's hope cats do not hang onto that as people do). When her daughter came down with the same thing at 16, I also happened to be there. Everyone said that my cat waited for me to come home (which I did erratically, some years once or twice, some years never). I agreed that we should skip the dialysis and just put her down, and I was with her when the vet made a house call and put her to sleep at home. My mother thinks she knew she was going to die, as toward the end, she would sit on the wall separating my parent's estate from the neighbor's, and just look peacefully out at the sea.
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: Jean on September 06, 2010, 12:53:46 AM
My precious cat also went thru this. I would never put an animal thru what we dont want to do. They dont understand and they quickly learn that to come near you means being stuck with a needle. Which means pain. Which means a daily struggle to get them down for the treatment. And after awhile, they either wont come near you or they will run away, to die alone. Makes no sense to just keep them alive for pain and confusion. just my   :twocents;  worth.
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: RichardMEL on September 06, 2010, 01:05:09 AM
Shouldn't it be what is best for the patient? in this case, a kitty.

Now I know cats don't (apparently) feel pain of needles and that stuff (mine just ignores when the vet sticks a huge ass needle in her neck and looks around like "so you going to do something or what?") but in that situation surely the cat would be suffering.

I have thought about this many times in relation to my own cat. When the vet said earlier this year he thought there was a chance she could have kidney failure (and looked at me and askef if I knew what that meant....  :urcrazy;) I knew at once that as much as I love my feline friend there is NO WAY I would want her to suffer at all. Yes, kitty dialysis could extend life.. but who would we be doing that for? Us or kitty? It seems kind of selfish in a way. Luckily further tests cleared my cat of apparent kidney damage (the psychic I went to claims that *I* healed her with my love?!?!) but it's still something I think about often - not just kitty kidney failure, but anything that had her suffering in some way or other.

As heartbreaking as it would be (will be??) I would rather take her to the vet and hold her and love her as she's put to sleep in a managed and peaceful way.

I just want to say that the article I think is a bit unfair. The writer uses the phrase "killing our cat" - that makes it sound like murder. I call it, if you're going to go down that line of thinking, euthanasia(sp?). Yes, OK, technically it is killing the pet, but heavens it's an act of love, not like we're going to go out and shoot it or something worse.

Of course it's not so black and white (my kitty is grey and white anyway :) ) but I sort of find the issue is akin to an elderly person with dementia and failing organs. They have little quality of life, and yet can't express coherently what THEY want, so they need an advocate. In the same way our pets can't TELL us what they want. *I* think we need to think about what is best for our pet and their quality of life. To keep a pet going with little quality of life and suffering seems like a very selfish thing to do to me.

Just my two cents.  :twocents;
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: monrein on September 06, 2010, 12:49:58 PM
Speaking as your cat here...please don't let me suffer.  I've very much appreciated your care of me over the years and I hope you've appreciated me too.  I also feel pretty sure you'll always remember me but as an animal, an intelligent one at that, I don't need a little bit more time just to be sick and feel awful.  I've always thought that one of the perks of being a "domesticated" (wink, wink...I'll let you continue thinking that I was tamed) cat was that when it came time to die I could get some help from you to go quickly and painlessly, unlike my feral counterparts who suffer some nasty and brutal ways of exiting this life.
I'll deal with whatever you guys decide but that's my input on the topic. 
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: galvo on September 06, 2010, 10:39:35 PM
Last week, with deep sadness, I had  to have my Blackman put down. A lovely old puss who had been one of my best buddies for 12 years. The poor old fella had reached the end of the line, and to keep him going would have been cruel. I miss him. 
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: RichardMEL on September 07, 2010, 01:26:55 AM
Oh Galvo?!!! Is that the kitty in your pic?!

That must have been soi hard for you to let go, but I know he appreciated that you loved him enough to do so and let him go without much suffering or pain.
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: cariad on September 07, 2010, 09:49:03 AM
 :cuddle; ((((Galvo))))  :cuddle;

I second what Richard said. You did not let him suffer an extra moment in pain, and he thanks you for that.
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: okarol on September 07, 2010, 11:50:30 AM
I hope when I am old and sickly (and if I am in pain) that the end is as kind as what we want for our pets.
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: Jean on September 07, 2010, 01:30:06 PM
Galvo, I am sooo sorry about your buddy. You did the right thing tho.
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: greg10 on September 07, 2010, 01:53:20 PM
Quote
THE ETHICIST: Should We Kill Our Cat?
Henry Blodget | Sep. 4, 2010, 11:23 AM | 3,175 | comment 101
I don't want to rain on everybody's well meaning animal loving wishes, but this original article by Henry Blodget, of all people, about ethics of animal rights, is hard to take seriously.  It is certainly nothing compared to what Dianejt and Frank are going through with their real life struggles.

Henry Blodget, if you remember, was the stock analyst who was banned from wall street after giving outrages and ultimately false analysis of the market in which he was a participant ("In 2003, he was charged with civil securities fraud by the U.S. Securities and Exchange Commission.[5] He settled and agreed to a bar from the securities industry. He paid a $2 million fine and $2 million disgorgement"). 

He may be a different person now, but it is still hard to take ethics lessons from from him.
Title: Re: THE ETHICIST: Should We Kill Our Cat?
Post by: galvo on September 08, 2010, 04:34:52 PM
Thanks gang. No, Richard, that's Camilla in the pic. I'll try and change the pic and put Blackman up for a while.