To operate or not

[Gill (sneakiefeline)]

 

[SilkBlossom]

I really appreciate all your opinions and thoughts. I know there is no right or wrong answer to this and yeah, that makes it harder.

Gill - Coco has been referred to same place your cat was, the vet school/surgery attached to Bristol Uni. They did the surgery to put the SUB in the June and they did amazing job of it, they saved her life. And her stone is the type that cannot be dissolved.

I know more invasive procedure would determine extent of her blockage in SUB, but she isn't any worse in her condition and that makes me not want to put her through more physical discomfort. And I do wonder, how many times am I going to subject her to this? It's been 6 month since the op to put SUB in, and new blockage is starting. For all i know, it started immediately after! Vet told me even if they do determine the extent of blockage, they cannot tell how long it'll take to become serious issue - could be days, weeks, or months. So I do wonder, not negative things like 'oh what's the point', more in line that I hate to put her thru things she hate when ultimately it cannot change the outcome.

But, if I do notice anything and I mean anything going wrong again- I won't hesitate to have her treated there and then, I'm not going to stand there and just let her suffer. But so long as she is carrying on as she is now, I want her to stay happy everyday and being in the car for 4 hours, getting sedated, poked and blood taken etc - I know it makes her grumpy.

most of all I wish she wasn't ill 

 

[heather sullivan]

I think if it was my cat and she was insured I would try again with the op, as it may last longer next time? They would probably put her on a drip while under anaesthetic, to help her kidneys flush it through quicker.  I would also try and speak to someone at a veterinary training hospital i.e Cambridge to get some advice? If she is still a young cat I would not give up yet.

http://hospital.vet.cam.ac.uk/soft.html

[Gill (sneakiefeline)]

Oh what hard choices.

I am slightly going against everyone else here sorry.

What type of stone is being formed?

I think I would want to know exactly what is happening and why, if thats possible and whether there was any kind of established  treatment for long term without having to keep going through a surgical procedure.

In my defence I had a 17yr old birman who only had one working kidney, the other was shrivelled up and pea size, he had stones around it but nobody knew how long he had been like this and it came to light after an xray or scan for something else.

My vets took advice from the Bristol  University hospital and the specialist there advised to leave everything alone as he had no problem...............think he was about 15 at this time.

Sadly at 17 3/4 he became blocked and two of the stones which were really tiny had come loose and got into his bladder and he needed an op to remove them. They were also the type of stones that cannot be dissolved, so not struvite. I saw the tiny stones after they had been removed.

I did loose him about 2 weeks later because he was so upset at being in hospital he refused to eat and he ended up with renal failure...........I so wish I had taken him home after the op but was scared he would break the stitches but will never know whether this would have helped and what prognosis there would have been.

Sorry its a much longer story but more wont help you. Birmans are very sensitive and  much more so than moggies. He did die under the anesthetic but they brought him back but that was mostly due to his age. Anesthetics are very safe for young cats dependent on their health situation of course.

[Sue P (Paddysmum)]

Such a very difficult set of circumstances to be faced with Silkblossom, and my heart really does go out to you.   

If she were my cat, I think I'd have made the same decision as you, and would opt for quality of life rather than length.  For what it's worth, I firmly believe that whatever length of time a beloved cat or dog or other much loved pet shares their life with us, they give so much, ask so little and teach us valuable lessons about living in the moment.

Enjoy the time you have with Coco, honour her presence, and keep faith with the future.      Whatever it brings, you will guide her through it, with the love and compassion you quite clearly have in abundance for your gorgeous girl. 

[Lyn (Slugsta)]

 Coco is a cat, she will live in the moment with no fear of what tomorrow might bring. You are human. You will look at Coco and wonder about her future. That will cause you grief sometimes but it will also allow you to treasure every moment that Coco is with you 

[SilkBlossom]

Thanks again, for your kind words.

My mum reminded me of Buddhist teaching (she's Japanese) This mind sound corny, but we've been told that length of each creature's life is decided before they enter this world, that they have accepted what is given to them to be born. So Coco's life is shorter than what I want it to be, but I have to accept that is what she was given, and I should be grateful she was destined to spend that time with us.

Urgh, I'm speaking like she's a gone already when in reality she's just snoozing on my sofa at home!

[DaveD]

I don't know anyone who cares about their pets who doesn't have doubts about whether they're doing the right thing in difficult circumstances, so it's a good idea to check with other people, and you can't find a better bunch that these people.
And the OP here screams compassion, so I'd say "trust your instincts".

[Rosella moggy]

Having just read through the article, I can't say it would be something I would consider as need to take kidney from a live donor cat  and only likely to prolong life for a couple of years 

[Rosella moggy]

I do beg your pardon Kay  Kidney transplants in cats approved just this month it seems .......

http://www.dailymail.co.uk/news/article-169382/Just-love-cat.html

[Lyn (Slugsta)]

Hello and  I'm sorry that you have found us at such a difficult time. I'm assuming that, even if you went ahead with the next op, there would be no guarantee that it would last any longer? If there is no chance of a cure, or long-term treatment, then it seems to be a case of keeping your darling girl as well as possible for as long as possible, without causing undue distress. Only you can decide exactly where the balance lies but I am sure, from what you have said, that you will act in Coco's best interest, whatever the cost to yourself   

[SilkBlossom]

Thanks for reply and hugs :-) I didn't think transplants are done in UK - certainly it has never been suggested.

I feel reassured I'm not the only one thinking in the line I have been, I know there isn't 100% correct or wrong thing to do but I guess I just don't want to be unreasonable.

It is such shame there cannot be a cure. I don't even think there are meds to prevent from stone forming :-(

[Rosella moggy]

  to Purrs but so very sad to hear of Coco's problem.  Sending  to you and  for your much treasured girl.

I tend agree with Kay that this is an awful and very difficult decision for you to have to make but I too would be inclined on balance to maybe think more of her quality of life rather than prolong what sounds like the inevitable.  I do so feel for you 

Not sure transplantation is legal yet in UK?

[Kay and Penny]

such a difficult one - but it seems to me that putting her through  further treatment would be much more open to being seen as selfish rather than trying to keep her as well, and as happy , as possible without too much intervention

it would be different if a permanent cure was possible - as she is so young putting her through more trauma for a short while in return for a long and healthy future would be a no-brainer, but it seems from what you say that this is not an option

has anyone mentioned a transplant for her? they do do them for cats, at a price, and if she is insured would that be a permanent cure?

[SilkBlossom]

I guess I need advise, or reassurance - not sure which.

My cat Coco, only 3 yrs old, got massive kidney damage back in June due to kidney stones causing blockage, and ended up having a big operation to basically bypass the blocked tube between her kidney and bladder with an artificial tube which the vets call it a SUB. This was all done at bigger vet we were referred to, about hour's drive each way from where we are.

With SUB put in, she recovered so much it was like miracle; OK so she still had one damaged kidney and is on renal diet/meds but she's really well in herself, eating well, bouncing around the house playing, cuddling with me, all the same. Only thing is, it is not a cure, just prolonging her life. If she didn't have the op, she'd have died.

We had a follow-up check couple of days ago, it turns out the SUB is now becoming blocked again, not completely but a bit. This really was a real blow to us; we know she has type of body that keeps on creating stones, can't do anything about it. But after her having to go through such big op, we hoped it would be years instead of months before it started again. Blood works came out OK, exactly same as post-op too. So SUB is definitely still working, else her kidney would have showed more issues.

Even though nothing has changed about her - at least the way she's behaving is the same it's been since the op, the knowledge that it is happening again was like a knife through my heart.

Vet recommended her going through more detailed exam to find out more about blockage. That means her going under anaesthetic, and depending on outcome, op to replace part of the SUB. I said No to this for now, because like I said, I cannot see point of making her go through more procedures when ultimately, it won't change the situation as much as we hope. There as 25% change she wouldn't have made it after first op cos not all animals reacts well to anaesthetic, always a chance they won't wake up. I don't want to chance it again.
Stones will keep forming, no matter what. we are just prolonging her life but at what cost? Her life is going to be short enough, should I make her spend more time at vets she hates with 4 hrs in car she also hates??

I told the vet No to the exam, but told her I will be taking Coco to local vet every month to have blood test, that way if anything is going on with her kidney we can hopefully spot it before she crushes again. if she goes down hill, we will make the decision - have more op or let her go - when it happens.

I am now wondering, am I being selfish by not being proactive so she doesn't have to go through the unpleasantness that is invasive exam and possible ops? Or if we decide to make her have more op, am I being selfish prolonging her life artificially to have her with me longer but make her physically suffer more than necessary?

She is really special to me, I haven't been able to eat for last few days because I'm so upset. She is carrying on as if nothing has changed, that is the only blessing.

Sorry about the long post.