Not Today.
These past weeks have hurled me headlong into a decision that I'd hoped never to face. When is it time to say "enough"? When is it time to say
"goodbye"? Six weeks of staring that question dead on, and I still don't
know the answer.
I've watched my second-best friend in the entire world slowly declining over the past weeks. In all honesty, the decline started several years ago. Occasional bouts of diarrhea, the once a month refusal of dinner, the slow weight loss that brought a once tubby figure down to svelte cat status. I've discovered how easy it is to ignore early warning signs when they
disappear into the following day's dawning. I've discovered how easy it is to foresee the future from yesterday's signs when the future is today. That's the stuff guilt is made of.
They tell you that when it's time, you'll know. This same they assure that your pet will let you know when he's ready. They are full of bullshit. Or maybe they are right, and I'm simply too blind to Clueless's needs, too deaf to his voice. It's a toss-up if I've learned too much or not learned enough. I know exactly what
Clueless's diseases are doing to him, I know the best way to treat him to
relieve discomfort and help his compromised organs to do the best they can.
But nobody has ever taught me how to quantify quality of life. When is it
time to say "enough"?
The medical reports haven't been discouraging, but neither are they a death sentence: constrictive heart failure, chronic kidney failure, pancreatitis, inflammatory bowel disease, liver damage, a cyst that may or may not be cancerous. It's all treatable, and any one of these might be something a pet could live with for months or years and continue to have a near-normal quality of life.
The treatments have forced me back to my pharmacology books, and have honed habits gone rusty. There's metronidazole (immunomodulation to help control the inflammatory bowel), captopril (a vasodilator to help in congestive heart failure), butorphanol (a narcotic analgesic to relieve the pain of pancreatitis and inflammatory bowel disease), vitamin K (to reduce the chance of bleeding that comes with an insult to the liver), atenolol (slows down the heart rate and increases cardiac output while helping fight the hypertension that the captopril can cause), prednisolone (to reduce the
inflammation from the inflammatory bowel and from the pancreatitis), cyproheptadine (an antihistamine that has the happy side effect of making cats ravenous) and plain old Ringer's solution (a balanced electrolyte fluid administered just under the skin to help the failing kidneys do their job as best as they still can). I never used to be any good at pilling cats; now I can get seven pills down one in under a minute while keeping the stress factor to a minimum. I used to wince every time I had to push a needle into the tough, resisting skin of a dog or cat's back; now I can pop that sucker in so smoothly that Clueless doesn't even notice what I've done until I've administered most of the fluids.
Guilt pervades everything now. Am I doing too much? Am I doing enough? Is he suffering when he lies with his nose to the carpet, or just tired? Am I refusing to let go because I'm selfish, or am I tempted to let him go because the costs connected with his medical attention? No matter how I look at things, no matter what action I consider taking, it all feels wrong.
Sometimes, at night, when it's just Clueless in front of the space heater and me in front of the television, I watch him bask and think up fragments and phrases that should go into his memorial when his time comes. I can plan what to say, but yet I can't make the hard decisions before their time. Cremation or illegal burial in the garden by the deck? Do I stay during his last minutes at the vet's, or should I leave lest I break down and upset him? Do I give the sisters a last chance to say good-bye, or do I keep this to myself and MathMan, if he wishes to be there? And still the guilt. Am I
doing too much? Am I doing enough? How dare I think of this while he's still alive and comfortably snoozing in the warmth? When is it time to say "enough"?
Clueless was perky this morning. He's having trouble with the stairs, but he still made good time making his way from the master bedroom to the
kitchen. He ate an ounce or so of slurried canned chicken food thinned to the consistency of creamed corn and a tablespoon or two of kibble, and then made the arduous climb back upstairs to nap in the master bedroom. I took his food upstairs and set it next to his cat bed in case he decided he was still hungry. When I left, he was again lapping at the chicken gruel.
When is it time to say good-bye?
posted by Salamander @ 1:09 PM
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7 Comments:
Damn. That's one of the hardest decisions to make. You just can't be objective about it, not when you're dealing with a member of your family. I can offer absolutely no advice in the matter, but I can offer a hug. I'm hoping that when the time comes, it really will be obvious what you should do.
I can't offer you much advice, as you are far more experienced in animal medicine. I have, however, lost three very special animals in my less-than-21 years, and can say that it is never easy, and very difficult to judge when it is their time to go. In these three cases, I never had the say-so when they went (my mom, the oncology nurse sees suffering at work every day, and couldn't let the animals suffer like her poor patients would could benefit from euthanasia themselves); in fact, I only got to carry my first cat home (the two dogs I would come home and they would be gone), and I took it rather easily.
Of course, I was only about 10-11, and only remember them coming out to tell me that it wasn't going easy, and as old as she was (17 and weighed about 8 pounds), she wasn't going anywhere without a fight. I wasn't allowed to go back with her, so they sedated her and eventually put her down. She was not in the best of shape, but we felt it was better to let her down when she could no longer get downstairs, and could no longer jump a counter to get her food. Often, she wouldn't eat her dry cat food, and wet food made her sick, so we gave her some shrimp in her last days, and took her in.
Our first dog that I can remember, Dot, started going downhill once we took Dash in to be put down. He was getting to the point where you couldn't touch his head without him whining, and he seemed very uncomfortable. We later found he had massive tumors in his ears, but he was better off being put to sleep than the abuses my dad put him through for his constant whining.
Dot slowly declined, even though she always seemed indifferent to Dash. She started losing her eyesight, running into walls, wetting more on the carpet than on the grass, and eventually, wouldn't finish her bowl of food. We knew that her quality of life had been next to nothing at that point, because she lived to eat. We decided that when my parents went away for a weekend to visit me, noone could take care of her like she needed (24-hour care for pills and deterring wetting accidents) and decided that she had had a good run of 13 years, and had her put down.
I have a clipping of Dash's fur in an envelope in my glove compartment and my cat Orson's tag on my bulletin board at home, but it doesn't make it easier.
In the end, it's really up to you. I know it doesn't help, but it's all I can offer. That, and a hug.
(Sorry this is so long, I just started going and couldn't stop).
I don't know. My only frame of reference is my father, and I wasn't there through all of it. I guess there was a point at which he pretty much stopped being the things that made him "him" - lost his sense of humor, his love of food, his curiosity and remarks about what was going on in the lives of the people around him, and he talked a couple of times about killing himself, once when he was diagnosed and once during a humiliating situation the year he died. In his case, I would say the last three months he was just living with no object. He did actually make a joke, about three days before he passed away, though. So the light does seem to flicker, even toward the end.
When you have to make the decision for a pet, I guess it just gets to the point one day where you can't take watching it anymore. There may be one more "good day" in store for Clueless some day in the future after that, but you just have to draw the line and take that chance. Or just wait till the end comes naturally.
This, I know, is little help to you in answering your question. I guess I just wanted you not to feel isolated. That and a virtual hug are all I can really offer.
I ache for you going through this. We have the ability to decide "enough" for our pets, but it's a heavy burden. There can't be an easy answer because, to put it bluntly, there can't be a happy ending.
The experience is different with every animal, just as it is with every human. Sura was (apparently) healthy, and certainly very active, till the last week of his life. His decline was rapid, and it was clear he was in pain and just plain miserable. So the decision was... straightforward. Not easy. Horribly painful and difficult, but clearcut.
With Kimi it was a little more like it's been with Clueless. He gradually got weaker and thinner. We watched him like hawks, and every day judged that elusive thing called "quality of life". In the last few months Mr Kimi was away a lot, but I was fortunate enough to be able to be home most of the time, and Kimi-cat and I got even closer than we'd ever been. He wanted human contact. He wanted cuddles and strokes and just to be near us. He walked around less and less, but he got into a routine of going outside with Mr Kimi every night for a walk around the house with the air of "checking up on things". He looked so proud of himself as he tottered around.
I'm sorry for dwelling on my own experience, but it's the only way I can express my thoughts on this. We knew Kimi-cat was tired, and knew he probably had a level of discomfort. But he was still getting pleasure from life, and every day we weighed up the pleasure against the suffering. While the pleasure came out ahead, he stayed with us.
It was much simpler for us in many ways: he only had kidney disease, so he had far less medical intervention and drugs. I took him to the vet every few weeks for an injection, and a couple of times to be rehydrated, and he became quite laid-back about going there (and was a great favourite there). We risked a tooth-removal operation that gave us a few precious more weeks.
A night came when he drank and drank every few minutes, but was clearly horribly thirsty. His legs suddenly couldn't carry him any more, and the memory of seeing him try to drag himself to the bowl makes me cry when I recall it even now. When I say he "told" us he was ready to go, that's what I'm thinking of. He had an air about him that clearly said it had all got too hard. He could no longer be comforted by cuddles and fussing. The pain had got too strong. We took him to the emergency after-hours vet, and he lay down as if he was asleep in less than a second. The vet remarked that it had taken very little.
Weighing up the continuing pleasures in his life against the discomforts, and the unavoidable factoring in of what you can afford, both in time and in physical and emotional energy, is all you can do, I think. You know him better than anyone.
None of that makes it easy. It's part of the price of loving creatures whose lifespan is so much shorter than our own.
sending hugs and good thoughts to you and CW.
f
I don't know when it's time... but I'm so glad you are back. You have been missed.
dawn
when is it time to make THE decision for a friend? i wish i knew the song so i could hear the beat. i'm so sad for you and clueless, sal 8( he has the most caringest and knowingest eyes watching him. sigh.
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