So, in my last post I talked about my sister and her husband wishing they were clearer about what the negative ramifications of jaundice were, and what to look for to know things weren't going well.
I know firsthand what can happen when you don't know what to look for with someone who can't articulate to you how they feel. No, not a baby, but a pet.
Read on for the story (Be warned: there are some unpleasant details.)
2 years ago one of my two 15 year old cats, Gabby, was diagnosed with lymphoma. Up until earlier in that year both of my cats had seemed the picture of health. Everyone was always surprised at their age. I attribute it to their being completely indoors always, and to the fact that I took them to regular check-ups.
Of course I immediately got on the Internet and found several online groups dedicated to feline lymphoma.
You may be surprised to hear it but chemotherapy is actually a common treatment option.
As my vet explained it, and I've written about before: they don't give dosage levels high enough to try to eradicate the cancer...as the animal can't sign up for the really severe side effects that humans can agree to with full understanding. But they try to push the cancer into remission and get a few more healthy years in there. As I recall my vet said it's successful about half the time. And she said you figure out pretty quickly if it's doing what it's supposed to do. After only one treatment, she said, she expected to feel a difference.
Anyway, the vet explained that Gabby's mild kidney issues made it a little more risky for her, but that she still might have a chance for it to work.
After the first treatment my vet told me that Gabby might seem a little "lethargic" and not very interested in food for 24-48 hours, but that she would perk up after that. I should make sure that if she vomited blood I take her in right away, because that would mean her kidneys were not handling the treatment.
The next morning Gabby had diarrhea outside the box (which she never did.) And yes, she seemed very lethargic and wasn't hungry. I kept watching her and watching the clock. I certainly didn't want to drag her to the vet for nothing...she hated the vet. It was very traumatic for her, and we'd already been there enough in the previous few weeks.
Here's the thing: when she went outside the box, it was quite dark. Looking back on it now I kick myself. Of course dark stool means there's blood in it. And if vomiting blood was a bad sign, why wouldn't blood in the stool be one?
But I didn't connect those dots, and I feel like I didn't ask enough questions to know the difference between "normal" chemo side effects and "bad" chemo side effects.
This story doesn't have a happy ending. Within 24 hours Gabby was dead. By the time I decided that she was definitely not right, even though 48 hours hadn't passed, and rushed her to the vet hospital on Sunday morning, it was too late.
Sure, she was a really sick cat. Even if I had taken her in right away, and they had done something (not sure what) about her kidneys, it seems obvious that if the treatment had that effect on her kidneys then it seems clear we wouldn't have been able to continue it, and she would have had a very short life span indeed.
But I still feel like had I only asked mroe questions and known better what to look for, the outcome might have been different.
It's kind of overwhelming to sift through medical information and try to make an informed decision. My vet was great, and the online groups were really helpful, but next time around, whether it's about me, someone else or my other cat, the first question I will ask is: "how do I know if something is going wrong?"
Of course we need awareness in and print media along with the medical press could have to play more active role as this is most decidedly public health medicine issue.
Posted by: Andrew Spark | March 30, 2006 at 03:12 AM