# Kitty with possible liver disease/pancreatitis - update



## emilyatl (Sep 9, 2013)

I apologize in advance for the super lengthy post, but I’m just trying to be thorough. One of my cats, Jem (appx. 10 year old male) started getting a teary eye last week, which he’s never had before. I looked at his eye, didn’t see any redness or irritation, so I just thought he got something in it, and kind of ignored it. A couple of days later, I noticed the same cheek beneath his eye was a little swollen (it’s hard to see because he’s very fluffy), but he was also twitching it a bit like it was irritating him. It didn’t seem sensitive when I touched it, so I looked around for any bites, punctures, etc. (he and his brother do fight on occasion) and didn’t see anything, then I looked in his mouth. I saw a lot of inflammation and redness around one of his upper molars (just beneath where the swelling was), and what looked like grey gum tissue above it (it almost looked like some of the skin had sloughed off around the tooth), and it had a foul fishy odor. He had an annual last November and the vet said his teeth looked fine and did not need cleaning (he’s never had a cleaning – his brother, the same age has had 2 because he has more tartar/buildup). He’s been eating fine (both dry and wet food), playing, peeing, pooping, etc., but still, I panicked a little and took him to the emergency vet. They took his temp, which was normal (101.4), and did an exam and said it looked like an abscess and he just needed to get a dental, and gave him an antibiotic shot (can’t remember which one, but it lasts 14 days). My regular vet could not do a dental for almost 2 weeks, and I didn’t want to wait that long, so I called back the emergency vet and scheduled bloodwork with them. The vet that saw him this time (who is a feline specialist and not the same ER vet), said it looked like a strange presentation for a simple abscess and said none of the teeth felt weak or looked loose, so she wasn’t convinced it was just a simple tooth/abscess issue. She took the blood and went ahead and scheduled him for the dental and said she would be able to see more once she got in there to try to find the source of the abscess and possibly take a sample of biopsy if she didn’t find anything. I dropped him off for what I thought would be his surgery this morning and spoke to the vet about his bloodwork results. She said his liver enzymes were very elevated so she did not want to put him under anesthesia , particularly his ALT, Bilirubin and AP. Everything else was normal, which she found suspect because his WBC counts were all well within normal range, and she would have expected to see them elevated with the tooth infection. So she thinks it could be a result of liver disease or pancreatitis. I meant to ask if he got the antibiotic shot on Friday night, and got his bloodwork done on Saturday morning – does anyone think the antibiotic could have affected his WBC that quickly? In any event, his abnormal lab results are as follows (everything else was within normal range):
· AP – 146
· ALT – 532
· GGT – 9
· Total Protein – 9
· Globulin – 5.7
· Total Bilirubin – 1.4
· Direct Bilirubin - .8
· BUN – 36
· Cholesterol – 223
· Indirect Bilirubin – .6
· SPEC fPL - 4.4 (with a notation that it’s high and should be retested again in 2 weeks)
· They also found Bilirubin in his urine.
She also took chest and abdominal x-rays and found nothing in the chest x-rays. The liver bile ducts appeared dilated and the pancreas appeared “abnormal”. She has referred me to a specialist to get a detailed ultrasound, and I’m just waiting to find out when my appointment will be, but everything so far is pointing to a liver problem. 
He eats Innova Senior wet and dry food (he prefers wet to dry He has a VERY healthy appetite and has never missed a meal (he wakes me up every morning at 7AM promptly for his wet food. He has always been a very happy, healthy, playful cat (even as a “senior”) and stays pretty active. He doesn’t drink water as much as his brother, but his brother doesn’t really like wet food, so he predominantly eats dry. He does urinate regularly (at least once a day), and his poop is pretty consistent (dark brown, relatively hard/firm). He’s never had any vomiting, diarrhea, etc. other than hair balls (he grooms himself and his brother a lot, so does get hair balls). He has no sign of jaundice (his hair is white and I can clearly see his pink skin around his ears, eyes, mouth, and paws). His eyes are very clear/white, and his gums are pink (apart from the infected tooth area).
Sorry for the lengthy post, but I’m pretty much freaking out. I guess I’m really shocked because he seems so healthy, and I feel like a terrible Mom for not noticing something sooner. I just want to do what’s best for him to keep him happy and healthy, and to me, he’s still a baby (my last cat lived to 19, so 10 is very young to me). I've heard so many horror stories about bad reactions to meds. Is there anything I should question/avoid? Should I try to go the holistic approach?
Thanks in advance all!


----------



## 10cats2dogs (Jun 16, 2013)

I don't know anything about this...
I do know how scary this must be for you, to not know what's really happening...
We have some knowledgeable people here, 
I hope you can get some ideas.
All Paws Crossed!


----------



## 10cats2dogs (Jun 16, 2013)

Emily, How is Jem? Pancreatitis/Liver?
Really hoping someone will help you out with this...
Hugs


----------



## emilyatl (Sep 9, 2013)

We went to see the specialist today and I do feel a bit better. The radiologist, internist, and surgeon all felt that his elevated liver enzymes are a result of the abscess in his mouth. They did a detailed ultrasound and saw that his spleen and liver were slightly enlarged (which supports the thought that the mouth infection is the primary problem). They said pancreatitis and liver disease are still possibilities, but they did clear him for surgery. I just got home from visiting with him before leaving him for the night. He's never been away from home before, so I was really worried about him, but he ate before I left. They want him to stay overnight again tomorrow after surgery since he is considered high risk. The internist thinks/hopes his liver enzymes will go down to normal a few weeks after the surgery (so we'll retest at that point). Now, of course, I'm worried about him undergoing anesthesia tomorrow. But I feel much better than I did last night.


----------



## 10cats2dogs (Jun 16, 2013)

Emily, Glad you got to see a Specialist! 
Do they have any idea about the abcess, like is it tooth related or ??
I know, a house always seems so empty, when our kitty isn't there....
It sounds like Jem is in pretty good hands though!
Prayers and Hugs!
All Paws Crossed!


----------



## emilyatl (Sep 9, 2013)

That's the weird thing, the surgeon said all of the teeth seem very firmly rooted and none were loose, so he wasn't sure what caused the abscess (I wonder if he got in a fight with his brother and somehow got a scratch in the mouth? Who knows?). He did say there was some necrotic tissue that he'll need to remove, and stitch up (which sounds really painful). Hopefully he won't find anything suspicious when he gets in there tomorrow. 

Thanks for the reassurance!


----------



## 10cats2dogs (Jun 16, 2013)

Emily, I don't know where you live, but do you know if the "Brown Recluse" spider lives in your area?
Necrotic tissue, means dead tissue..
If Jem found one of those spiders and he got bit by one, that is what their bites cause...I'm sure its just a shot in the dark, I just know my indoor cats are all over any bugs that find their way inside!
And we have Black Widows here! 
Let us know what you find out, I'm sure Jem will be fine!
Prayers anf Hugs


----------



## emilyatl (Sep 9, 2013)

Yes, we definitely do have brown recluse spiders down here, and Jem loves to snack on bugs, so that's a possibility. I'll ask about that. I just got a call from the surgeon and he said he removed all of the necrotic tissue and 2 teeth. He didn't want to get any more aggressive at this point because he's still not positive it's not cancer. He said the way the infection spread (and the fact that he couldn't find a source) was odd. So he's sending out the tissue for lab results, and I should get them back early next week. But, the good news is that Jem made it out of anesthesia ok and I can pick him up this afternoon instead of tomorrow morning! I'm so happy I get to bring him home today. I called the vet techs twice last night to check on him, so I'm sure they'll be glad as well. 

So now I just have to wait on the bioposy results to figure out next steps...


----------



## 10cats2dogs (Jun 16, 2013)

Hi Emily, The findings of the Vet are interesting...
Now I'm Really starting to lean towards a Spider Bite, especially since you DO have 
Brown Recluse's where you are...
I've done a lot of study and with what I've found out, I would rather be bit by a Black Widow! There's anti-venom for them.
There is none for a Brown Recluse and what it does to soft tissue is horrific! 
DO tell your Vet about Jems proclivities for
Catching and Eating bugs....
Prayers and Hugs


----------



## emilyatl (Sep 9, 2013)

So the surgeon said it's definitely not from a bit, scratch or anything else "external". He showed me the bone on that side of his face and it has a "moth eaten" appearance (it's referred to as lucent lesions), so he does believe it to be a tumor, and feels that is what caused the infection/necrotic tissue. He took a bone biopsy and sent it to the lab, and said it will take almost a week for results (bone takes much longer to analyze than tissue). He did say it could be benign. At this point, I really don't want to get too worked up over it. I feel like I've heard a million different diagnoses in the past few days, so I'd rather just wait for the biopsy results. I have him home now and he's eating, walking around, using the litter box fine, so I'm definitely happy about that!


----------



## 10cats2dogs (Jun 16, 2013)

Glad Jem's Home! 
Its going to be a long week to wait for results...
The abscess was on the inside of his mouth, right?
It will be very interesting to see what the results show.
Hope they sent home some pain med. for him and antibiotics? 
Prayers and Hugs
Keep us posted!


----------



## emilyatl (Sep 9, 2013)

Yes, they gave him a big dose of buprenorphine (which is an opiate and is supposed to last 3 days) and some oral buprenorphine to give him once that wears off if he's still in pain. And 2 weeks of antibiotics. The abscess was in the top of his mouth just under his eye/cheek. The only reason I noticed it is because his eye was tearing up, then I realized it was a little swollen, but I didn't see any bleeding, a hole, or anything, so it was weird. They removed a large portion of necrotic tissue (pretty much half of that side of his mouth), so I can only imagine how much pain he's in. Poor boy. He's had 4 x-rays, 2 ultrasounds, 2 aspirates, 2 biopsies, 2 teeth pulled, countless temps taken (which he is not a fan of at all), several shots, been fasted 3 nights in a row, etc. Needless to say he gets to hide wherever he wants and eat whatever he wants until he's all better.


----------



## emilyatl (Sep 9, 2013)

*Biopsy Results *

I just got a call from the surgeon who performed Jem's surgery and bone biopsy last week and the histology confirms it is oral squamous cell carcinoma. The tumour is in his jaw (on the top just beneath his orbital bone), so they're not sure if they can even remove that portion of the bone. He turns 10 next month, so he's still pretty young. So far, he's been eating really well, active, and doesn't appear to be in pain. We have a meeting with the oncologist tomorrow, but I don't even know where to start. Should I even try to put him through radiation? He really hates going to the vet and gets so stressed out. Does anyone have any experience/advice?


----------



## pkbshrew (Feb 13, 2013)

I don't have any experience to share with you emilycat, but I just want to say how sorry I am for you and Jem. We are thinking of you and sending you heaps of love.


----------



## NebraskaCat (Jan 15, 2013)

I'm sorry too. And echo the bit about sending lots of love your way.

I know there is a Yahoo group for owners of pets with oral SCC. Maybe they would be a good resource to check out.


----------



## emilyatl (Sep 9, 2013)

Thanks everyone. Everything I've read is pretty grim. By the time they show symptoms (he had an abscess tooth that was caused by this), it's really too late to do antyhing. Chemo isn't effective and the tumour is in his upper jaw, so I don't even think radiation is an option. But even if it is, he's very happy now, and eating well, and I don't know if I'd want to put him through that. I'd rather have his last days be as happy as possible. I feel completely heartbroken right now.


----------



## cat owner again (Dec 14, 2012)

I am so sorry. Try to be the same with Jem so the time you have will be special and I do believe in quality of life.


----------



## rabernet (Jun 4, 2008)

My thoughts and prayers are with you and Jem. I'm so sorry you're having to go through this!


----------



## laurief (Jun 22, 2008)

This is breaking my heart all over again. As you know, I lost my beloved Noddy to this cancer a year ago. It all just happened so quickly. Noddy was 17 at the time, so radical surgery was not an option I was willing to put him through. I was told that neither chemo nor radiation would do much, if anything, to improve his prognosis. So I just loved him as much as I could for as long as we had ... then I let him go.

I am so very sorry you are going through this now. My thoughts will remain with you and with Jem.

Laurie


----------



## Mitts & Tess (Sep 4, 2004)

This is heart breaking news. Im so sorry for you and Jem. But Im grateful you are the one who is there for him and will manage his days left. Cyber hugs((()))


----------



## emilyatl (Sep 9, 2013)

Thank you all for the kind comments and thoughts. Fortunately, I work from home, so I can be here for him 24/7. He's such a goofy, sweet boy. I still can't believe he's sick. I don't know how to tell if he's in any pain. I hope he's not. He is taking buprenorphine for the post surgical pain, but I only give it to him at night because it makes him so drowsy. He's been eating well, and playing, so he doesn't seem like any pain. Hopefully I can keep him this way as long as possible.

This is him this morning playing in his tunnel. 



And on the lookout for his brother trying to sneak up on him:


----------



## wallycat (Nov 10, 2012)

What a sweetie.
I am so sorry for the results. My heart goes out to you.


----------



## emilyatl (Sep 9, 2013)

So we met with the oncologist today. Based on the size of the tumor, she estimates 2 - 3 months. It all depends on how well he continues to eat (and is able to). She prescribed a steroid (predisolone), and I'll be keeping him on the clindamycin and buprenorphine. She was hesitant to give him an NSAID because of his elevated liver enzymes. 

She did also recommend palliative radiation to help with the symptoms and pain. She stressed that it would not prolong his life, but it could give him much less pain (possibly eliminate it) for up to 4 weeks. The only catch is, he'd have to have it for 5 days in a row, which means stressing him out with 5 more vet visits. Does anyone have any experience with this? Would you recommend it? I certainly don't want him to be in pain, but I also don't want to stress him out any more than needed. Right now, he still doesn't seem like he is in pain, but the ongologist said this type of cancer of the bone is very painful. Since it's localized and in the top of his jaw (not some place like a leg or hips), it's not a bone that weight is put on, so that can help. Cats are just very adept at hiding pain - which worries me even more. How do I know when he's in pain? I just want to make sure I keep him comfortable and don't want to see him suffer.


----------



## emilyatl (Sep 9, 2013)

I went to Jem's usual vet today. I've gone to her for several years, and she is really one of the most compassionate people I know. I've been struggling so much giving Jem his meds. He was on liquid Clindamycin, but I had to give him two FULL dropper fulls TWICE a day, and that stuff tastes horrible (it's very alcohol-ish and bitter). So the surgeon switched him to pills, which were huge (because he was on 75mg twice a day), and he kept gagging on them. Then I had to start him on the steroid yesterday, so that's another pill. My vet suggested giving him injections. The steroid lasts a month, and the antibiotic 2 weeks, so this is a huge relief to me. I really don't want to spend his last days fighting with him and having him mad at me. The only other med I have to give him is buprenorphine, and it's a TINY amount that just goes into his gums (I don't have to get him to swallow), so this one is much easier.

I'm still not sure how to tell if/when he's in pain. The oncologist said this kind of bone cancer is quite painful. He's been living with it for at least 2 weeks (my vet suspects over a month), so clearly he's been in pain, but hasn't shown any signs of it. Any suggestions on what to look for? He's been hiding a lot lately, but I think that due to the numerous, numerous visits to the vet. Prior to going to the ER 2 weeks ago, he was perfectly fine and his "usual" self. I just don't want him to be in pain and suffering.


----------



## NebraskaCat (Jan 15, 2013)

As you know, cat's are experts at hiding pain. When they do exhibit symptoms, it can be in a number of ways: aggression/defensiveness, hiding, crying, wanting extra attention, lack of appetite, etc. It's very difficult to pinpoint when a cat's actions are pain-driven.

Instead of trying to find if he's in pain, because he probably is to some extent, just continue to do what he loves from you best, whatever that is: laptime, treats, head rubs, cuddles in sunbeams. At some point he'll start exhibiting the behaviors where he'll try to let you know it's time to let go. Those are easier to see.

Some people will say to go ahead and put him out of his pain if he has an end-stage diagnosis that probably is painful. I am of the mind to hold on longer until I get a cue from the cat. That may be selfish because I may be prolonging the pain, but my thought is if he's acting like he still wants to be around, then he's willing to put up with the pain a little longer.

Your Jem is such a good looking cat. His personality shines through these photos. I apologize if my response here comes across as unfeeling or clinical. I'm just expressing my opinions and they are only opinions.


----------



## emilyatl (Sep 9, 2013)

Nebraska Cat - I definitely don't want to prolong his pain, and I don't think your response was unfeeling. I've read so many posts on other message boards/groups about people who are syringe feeding their cats and pumping them full of meds, doing holisitic treatments, etc. I just don't think there's any quality of life in that. If it's something that's going to relieve his pain and improve his quality of life, then I'm all for it. I know this cancer is incredibly painful, aggressive, and terminal. Nothing is going to cure him, and I've accepted that. If he can't eat on his own due to pain, deformity, etc., I do not intend to prolong his life. I dread that day horribly. But at the moment, he's eating like a little pig (he comes running when he hears a can open, which is honestly one of the best parts of my day right now). And he's still playing and running all over the house. He sleeps next to me every night (hogging up over half the bed, mind you), and the sound of his snores are so sweet. I'm trying to relish in these things while I can. He hasn't exhibited any signs of pain yet, so I can only hope he's not in any and will let me know when he is.


----------



## laurief (Jun 22, 2008)

emilyatl said:


> But at the moment, he's eating like a little pig (he comes running when he hears a can open, which is honestly one of the best parts of my day right now). And he's still playing and running all over the house. He sleeps next to me every night (hogging up over half the bed, mind you), and the sound of his snores are so sweet. I'm trying to relish in these things while I can. He hasn't exhibited any signs of pain yet, so I can only hope he's not in any and will let me know when he is.


From your description, it sounds like he is experiencing very little, if any, pain ... or that the pain med is effectively managing whatever pain he has. That's a wonderful thing! His strong appetite is also fantastic. His normal, happy behaviors are a joy for you, and you are right to relish every moment. Don't take a single one of those moments for granted.

I am compelled to offer you a word of caution, though. When Noddy developed this cancer, I had a number of long talks with him. I promised him repeatedly that I would not euthanize him until he let me know that he was ready to move on. Unfortunately, I allowed myself to forget how tenaciously many animals cling to life, even when they are in pain with failing bodies. Noddy got to the point where he could not eat enough to maintain his body; and his beautiful, massive head was horribly misshapen and constantly dripping blood from his mouth. He was clearly in pain, but in spite of it all, he was NOT ready to go. I begged him to let go, but he would not. It shredded my heart to do so, but I had to break my promise and euthanize him in spite of his desire to carry on. I just couldn't let my stoical Lion King starve away in pain. It still reduces me to tears to know that I betrayed my promise to him. I wish I had never made that promise.

Don't wait for your boy to tell you when he's ready to go. He may not. 
Promise him only that you will always love him and do what you believe in your heart is best for him.

Laurie


----------



## emilyatl (Sep 9, 2013)

He's lost about 8 ounces in the past 2 weeks. But he's had 6 vet visits (spending all day there on 2 of them, and spending one night after surgery), was fasted 3 nights in a row, had surgery, etc. So I know he's been very stressed out. When he is at the vet, he's just a shell of himself, which is just another reason I don't want to put him through radiation. He's a different cat at home. When I pick him up to put him in his kennel, he doesn't fight me at all anymore, he just trembles. I can't do that to him again. After his visit yesterday, I told him I wouldn't put him in that cage anymore. The next time he has to get his antibiotic/steroid injections, my Dad said he can drive me, so I can hold him in my lap (he's really very good in the car, he just doesn't like being in the kennel). 

I have a baby scale so I can weigh him on a regular basis and I'm keeping a diary of what he's eating. He was drooling horribly after I gave him the Clindamycin (after tasting it, I know why). The only other time he drools is when he's "making biscuits". I sleep on my side and he gets curled up in my arm pit and kneads and usually drools quite a bit (to the point the blanket gets wet), but he's always done that. And I love it. I think the Prednisilone has helped his appetite too. This morning, he woke me up about 6:30 (he tapped me on my face with his paw and meowed), so I knew he was hungry and he gobbled up his food. Then we played in his tunnel for a while (kind of a morning routine). One day at a time. That's about all I can handle at the moment...


----------



## emilyatl (Sep 9, 2013)

So Jem has not been doing well since yesterday. His tumor seemed to really be bothering him yesterday, he kept pawing at it (which he does sometimes, but he was doing it a lot yesterday). If I put food in front of him, he'll eat (pretty much the same amount he has been eating), but he's not seeking out food or going to his dish. Usually when we get up in the morning, he wants to play for a while, then he'll eat, etc. Today, he just stayed in bed, which he has done once or twice before, but he stayed there all day today, he didn't even get up in his cat bed that's by the window (which is usually his favorite place to lie). I didn't see any bleeding or excessive swelling (outside of the normal) in his mouth. I called the vet and she said to give him .1 ml more of the Buprenorphine to make sure he's not just experiencing additional pain, which of course, makes him a bit more drowsy. She did suggest that we maybe add an additional pain medication for him, like Tramadol, which can be applied as gel (pilling him or giving him oral meds that he has to swallow is pretty much out of the question since the tumor is in his jaw and I don't want to be prying his mouth open). I just don't know what to do. Obviously, I do not want him to be in pain, but at the same time, am I just prolonging things by giving him more pain meds? Is he just going to be sleeping like this indefinitely? Am I just overreacting? I know everyone has bad days, and I know he has cancer and is definitely in pain and not feeling like himself. I certainly don't want to make any sudden decisions, but at the same time, I don't want him to be suffering.


----------



## Venusworld21 (Oct 23, 2012)

My advice would be see how he is doing tomorrow. As you said, sometimes there are just bad days. Tomorrow morning he could be bounced back to his usual self. If he continues to not do well over the next few days, then you can start to think about more unpleasant options. 

Having terminally ill pets is a blessing and a burden. You're aware that their time is very short, so you are enjoying each moment, each day to the fullest. But you're also constantly on the watch for signs of "the end." It's a double edged sword. You're doing great cherishing every moment with him. Don't let the fear in just yet. *hugs*


----------



## emilyatl (Sep 9, 2013)

Venusworld21 said:


> Having terminally ill pets is a blessing and a burden. You're aware that their time is very short, so you are enjoying each moment, each day to the fullest. But you're also constantly on the watch for signs of "the end." It's a double edged sword. You're doing great cherishing every moment with him. Don't let the fear in just yet. *hugs*



It definitely is a double edged sword. I'm incredibly thankful he didn't die in surgery (my vet was worried about anesthesia because his liver enzymes were so high). So to be able to have more time with him is really a blessing, and he's been doing really well (apart from not wanting anything to do with his brother) up until earlier this week. 

This morning, he did get out of bed and got up in his perch by the window. He's still eating, using the litter box, and grooming himself, but just not interested in playing as much as he usually is. But he does seem to be doing better today. I have an appt with the vet on Monday morning. My vet has had 2 kitties of her own with this type of cancer, so she knows how it progresses, what the go through, etc., which is really helpful. 



AdoptAnAngel said:


> Emily, tramadol comes in an injectable form as well. It might be something to ask Jem's vet about. I have the both of you in my thoughts and I'm glad he is spending his time with someone who cares about him so much.


Thanks, I'll ask my vet about that. I don't know if he can be on 2 opiates at the same time? But I've read that doesn't make them as drowsy, and it also comes in a gel that can be applied to the ear, so maybe switching him to that is an option. I just hate to keep upping his bupe dose since it makes him pretty out of it. 

Thanks for the reassurance!


----------



## emilyatl (Sep 9, 2013)

Yesterday afternoon, he was refusing food, and got back in the bed and pretty much stayed there all day. I tried everything - tuna, baby food, his regular food, treats, etc. and he wouldn't eat. He finally maybe 2 - 3 tablespoons of his regular food later in the afternoon and a few treats. I got him to eat about a 1/3 of jar of turkey baby food in the evening.

This morning, he did the same thing, got out of bed for a little while, but was refusing food. He finally ate about 3 tablespoons of his regular food and 5 or 6 treats about an hour ago. This was with a lot of coaxing. I had to dip my finger in his food, let him smell it, lick it, then pretty much hand feed him for a while. He finally started eating from his plate. He did drink some water this morning that I put a few drops of tuna juice in. He's been in bed all day again today.

He hasn't vomitted and is still peeing/pooping, but he definitely seems out of sorts. I'm pretty much dreading his vet visit tomorrow. :|


----------



## 10cats2dogs (Jun 16, 2013)

Emily, so sorry to hear this about Jem...
I've lost two kitties to cancer and I do know how hard it is to decide "when is...the right time...to let go..."
All I can say is to listen to your deeper self, you know Jems spirit better than anyone...
I am so sorry you have to go through this with Jem, enjoy to the best of your abilities, your time with him, and when its time to let him go...know that, he knew he was loved and that you let him keep his dignity at the end...
Big Hugs to you and gentle strokes for Jem...
Sharon


----------



## emilyatl (Sep 9, 2013)

He's always had a very healthy appetite, even immediately after his extensive dental sugery. He's been doing so well up until several days ago. I really thought he'd make it to or even surpass his 2 - 3 month estimate. I was sure he'd make it to Christmas. But he's gone downhill dramatically in the past few days. He doesn't want to play at all anymore and he just looks so sad. And he's been struggling when he eats - it sounds like he's really congested, but it's the tumor pressing on his sinuses. And I can see that his eye is starting to protrude above his brow (the tumor is also pushing his eye up and out), so I can only imagine how much pain he's in. The vet assured me he's on a very high dose of buprenorphine and should not be in pain. He only ate a tablespoon or so of baby food last night. So needless to say, he vomitted up bile this morning. I said from the start that if he got to the point where he was unable to eat on his own, I would know it was time. I didn't sleep at all last night, I just lied next to him listening to him purr, petting him, and crying. He still wouldn't eat this morning. I know in my heart it's time to let him go. It's just so hard to say goodbye.


----------



## marie5890 (May 18, 2011)

Emily huggin you and Jem closely.
Biggest gift we can give our furbabies at the end is to not ask them to suffer but to take on that suffering with our own heartbreak and tears...

That is sacrifical love....
pet him for us....purr into his scruff for me...


----------



## Mitts & Tess (Sep 4, 2004)

Prayers for you and Jem. My heart goes out to you both. What a gift you are to him. You will give him a dignified transition. Hugs ((()))


----------



## laurief (Jun 22, 2008)

Emily, I haven't responded to your most recent posts because I, too, believe Jem's time has come, and I didn't want to make things any more difficult for you. We always expect a slow deterioration in condition with terminal illness, but in my experience, it more often happens as you have described - doing reasonably well one day, and dramatic decline the next. There just seems to be a point at which the body can no longer deal with the illness, and the illness suddenly overwhelms. It sounds like Jem has reached that point. I would not expect there to be any more good days for him.

I will tell you something about the moment of passing - something that's important for you to understand. As painful as the moment of Jem's death will be for you, it will be equally relieving for him. In the past, I found it both disturbing and guilt-inducing to feel that moment of relief when my animal companion was released from a painful body. It seemed wrong somehow to feel relieved at such an agonizing moment of loss. But once I realized that the relief I felt in that moment was coming from my 4-legged companion and not from myself, I embraced it. It helped to balance my own grief.

So, if you should feel a wave of relief amidst your sadness in the moment of Jem's departure, know that it is Jem's final gift to you. It is the release of his indomitable spirit from a body that has served its purpose.

Take care,

Laurie


----------



## marie5890 (May 18, 2011)

laurief said:


> I will tell you something about the moment of passing - something that's important for you to understand. As painful as the moment of Jem's death will be for you, it will be equally relieving for him. In the past, I found it both disturbing and guilt-inducing to feel that moment of relief when my animal companion was released from a painful body. It seemed wrong somehow to feel relieved at such an agonizing moment of loss. But once I realized that the relief I felt in that moment was coming from my 4-legged companion and not from myself, I embraced it. It helped to balance my own grief.
> 
> So, if you should feel a wave of relief amidst your sadness in the moment of Jem's departure, know that it is Jem's final gift to you. It is the release of his indomitable spirit from a body that has served its purpose.
> 
> ...


Laurie I want to thank you for sharing that not only with her, but with all of us...

As I mentioned in another thread, my step-father is in hospice. What you shared about animals, is also true for humans. I will keep this in mind when he passes...


----------



## Yuki'sMum (Dec 3, 2012)

((Hugs)) for you and Jem. I know how hard this is. I went through the same thing with one of our hedgehogs, Gromit, years ago. He had a facial tumor, probably the same kind, that was inoperable. The vet had said just to watch him and when life got too difficult for him, to bring him in. I knew one morning when he just had that look that he was ready to go. It was so hard to take that last drive to the vet. I felt guilty and awful but knew in my heart it was the right thing to do. I'm so sorry you and Jem are going through this. 


Sent from Petguide.com Free App


----------



## cat owner again (Dec 14, 2012)

Laurie, I so agree with you and I have a mother in hospice. Her body is not doing her any favors by keeping her alive. I will go one step further and it may sound shocking. I am happy that I can help my animals go before the suffering gets so bad. We have the privilege of relieving of that misery. I look at is I am taking on the suffering for them because we all know how much we suffer upon making that decision, doing it and then afterwards. The one thing that gives me comfort is that my loved one is not suffering anymore. The look on my dog's face told it all at the end. I had to wait for lab tests to be sure and meanwhile he was just hanging on. I have had to do this 6 times and it never is easy and I can cry over each one even now after 30 years for some. I wish you peace in any decision you make. I am so sorry for your pain.


----------



## marie5890 (May 18, 2011)

cat owner again said:


> Laurie, I so agree with you and I have a mother in hospice. Her body is not doing her any favors by keeping her alive. I will go one step further and it may sound shocking. I am happy that I can help my animals go before the suffering gets so bad. We have the privilege of relieving of that misery. I look at is I am taking on the suffering for them because we all know how much we suffer upon making that decision, doing it and then afterwards. The one thing that gives me comfort is that my loved one is not suffering anymore. The look on my dog's face told it all at the end. I had to wait for lab tests to be sure and meanwhile he was just hanging on. I have had to do this 6 times and it never is easy and I can cry over each one even now after 30 years for some. I wish you peace in any decision you make. I am so sorry for your pain.


Hugs cat owner. atback My beloved step-father is in hospice as well. 
Agree with everything you have said.


----------



## emilyatl (Sep 9, 2013)

Well, my vet assured me that if it was her kitty, she would say goodbye to him to. His remaining teeth on that side of his mouth were barely hanging in (she was sure she could just pull them out with her fingers) because the tissue and bone had deteriorated so much. I know there's nothing I could do to make him better. I spent all morning with him, just holding him and trying to comfort him and reassure him. I could tell from the sadness in his eyes that he knew it was time. He didn't fight me at all when I carried him down from his room, so I think this gave me a bit of relief that he was at peace with it. I gave him a kiss on his head just before he received the sedative and held his paw. He passed so peacefully in my arms lying in his favorite blanket. My heart is breaking right now, but I don't regret the decision, I only worry I waited too long to make it. Thank you everyone for the kind words.


----------



## marie5890 (May 18, 2011)

emilyatl said:


> well, my vet assured me that if it was her kitty, she would say goodbye to him to. His remaining teeth on that side of his mouth were barely hanging in (she was sure she could just pull them out with her fingers) because the tissue and bone had deteriorated so much. I know there's nothing i could do to make him better. I spent all morning with him, just holding him and trying to comfort him and reassure him. I could tell from the sadness in his eyes that he knew it was time. He didn't fight me at all when i carried him down from his room, so i think this gave me a bit of relief that he was at peace with it. I gave him a kiss on his head just before he received the sedative and held his paw. He passed so peacefully in my arms lying in his favorite blanket. My heart is breaking right now, but i don't regret the decision, i only worry i waited too long to make it. Thank you everyone for the kind words.


(((((emily)))))) :backpat:

rip jem.


----------



## CatMonkeys (Sep 27, 2012)

This has been so heartbreaking to read. I'm sorry for your loss, Emily- hugs to you. I hope Jem is happily playing at the Rainbow Bridge now.


----------



## laurief (Jun 22, 2008)

Emily, it is rare indeed that we ever feel we have chosen the "perfect" time to end the life of a beloved. It seems to be human nature to torture ourselves with the what-ifs of too soon or too late. Jem was ready. He passed in peace. Every decision you made was borne of your love for him - love he took with him. That's what you need to hold onto. 

I wish you a peaceful grief.

Laurie


----------



## NOLAKitties (May 30, 2013)

Hugs to you and the kitties. RIP Jem.


----------



## pkbshrew (Feb 13, 2013)

((((((((((((((((((((((((((((((((((((((((((((HUGS))))))))))))))))))))))))))))))))))))))
Weeping for you.


----------



## emilyatl (Sep 9, 2013)

Thanks for the thoughts and hugs everyone. The last 6 weeks have been so tough. I've pretty much been staying at home, scared to leave Jem for more than a couple of hours for fear that something would happen (he also had to get his pain med several times a day). I felt like a huge burden had been lifted off me this afternoon, but I felt SO guilty for feeling that way!  Fortunately, I have Jem's brother Scout to comfort me, and vice versa. I know he's grieving too and has been connected to my hip all day.


----------



## zuma (Nov 5, 2009)

I'm having tears streaming down my face. Big hug to you and RIP Jem. So sad, but we owe it to our pets to make this last very difficult call. Also do not feel guilty, a sick pet is a lot of work and feeling like a big weight has come off your shoulders does not mean in any way that you loved him any less. I know you'd have kept going if there was hope. 


Sent from Petguide.com Free App


----------



## marie5890 (May 18, 2011)

zuma said:


> I'm having tears streaming down my face. Big hug to you and RIP Jem. So sad, but we owe it to our pets to make this last very difficult call. Also do not feel guilty, a sick pet is a lot of work and feeling like a big weight has come off your shoulders does not mean in any way that you loved him any less. I know you'd have kept going if there was hope.
> 
> 
> Sent from Petguide.com Free App



Yes....

And saying "goodbye---I love you"....just hurts deeply...very very deeply...


----------



## 10cats2dogs (Jun 16, 2013)

Emily,
I to, am sharing with you...tears...
And heartache...
You did everything you could...
And the most important thing other than the love you two shared, is you let him have a dignified end...
It is a sacrifice on your end...
But an incredible gift to Jem...
Perhaps, if you're lucky, like I was once, he'll visit you in a dream and tell you, "it's ok, I feel good now and we will see each other again!"
Many, many hugs...
Sharon


----------



## laurief (Jun 22, 2008)

Emily, a huge burden HAS been lifted off of you today. You no longer have to stand by helplessly as cancer steals your beloved Jem from you. You no longer have to administer meds that dull Jem's senses to try to manage his pain. You no longer have to worry about Jem day and night. Those are burdens that no one would ever want to carry, but they are burdens that you stoically carried for your boy's sake as long as humanely necessary. There certainly is no shame in shedding those burdens now ... and no guilt worth feeling in doing so. 

Laurie


----------



## emilyatl (Sep 9, 2013)

Again, thank you everyone so much. You really have no idea how much hearing all of this helps. I feel it's going to be a long first night.


----------



## laurief (Jun 22, 2008)

It's likely to be a long first year. :-(

Laurie


----------



## emilyatl (Sep 9, 2013)

I don't doubt it will be a long year. 

I can't bring myself to sleep in my room tonight. It's pretty much been Jem's room lately. Everything smells like him and reminds me of him. So it looks like I'll be on the couch with Scout tonight. I did let him see Jem to say goodbye, and he seemed to understand. He was going around the house earlier looking in all of Jem's hiding places and meowing for him. But he's settled down a bit now.


----------



## Yuki'sMum (Dec 3, 2012)

I'm so sorry  (((hugs)))


Sent from Petguide.com Free App


----------



## marie5890 (May 18, 2011)

Gentle neck scritches to Scout....


----------

