Moon's Graden

(I'm posting this without my name to try and avoid flame e-mails)

My SO and I have decided not to treat our (hers, actually) 18-year
old cat which has just been diagnosed with Diabetes.

Unfortunately, she would not take well to the daily (or twice-daily)
insulin injections that are required, so (it was a VERY tough
decision) we decided to just make her as comfortable as possible
until we had to put her down.

Our vet seems to think that she has about a month of quality life
left and we were wondering exactly what happens at "the end" of
the diabetic cat's life...does the deterioration happen quickly
(hours?) or will she be miserable for weeks.  The last thing we want
to do is have her suffer needlessly.  It will be a very sad sad day
when we have to put her down but if we have some warning, we can
prepare and perhaps have the vet come in to the home rather than
transporting kitty (which, for this one is not a pleasant experience).

Anyone with any experience with a diabetic cat, please post here.
(alt.support.grief.pet-loss or rec.pets.cats)

Thanks
I hope that I haven't offended anyone with this posting since I
am new at this.

Don't be scared. There's nothing you said that was the least little bit
offensive. You sound very loving and its a really hard decision.  If your
cat is 18 and hates needles, why bother her? She should have the choice to
refuse treatment, just as we would want the choice. When my elderly cat
needed subcutaneous fluids I tried giving them to her. She *hated* getting
them. We had a long talk. I explained that if she didn't get them she
would probably die. She told me she didn't care, she was old and sick and
was gonna die anyway, and it didn't matter to her whether it was a little
sooner or later, but that it *did* matter very much to her whether or not
she had to undergo a procedure she hated or whether or not I violated her
will. I withheld treatment and she had a peaceful death about a year
later.

It's hard to predict when a cat will die. One vet once gave my cat a few
days to live and she lasted another 1-2 years, apparently enjoying much of
the time.  I don't know much about veterinary medicine, but I can tell you
about diabetes in humans.  The course of untreated diabetes in humans is
very variable, depending on the type and severity of the diabetes.  Some
people live relatively healthy for decades and die of unrelated causes.
Some die of complications of diabetes, like heart attacks or renal
failure.  Extremely high *** glucose levels will cause people to slip
into a coma and die peacefully, although some may develop nausea and
vomiting in the early stages.  The complications of diabetes are
unpleasant, but they only develop in people who are diabetic for a long
time. In the short term, untreated diabetes, even if it is severe, is
generally not unpleasant unless the patient is suffering from nausea.
Nausea from diabetes is generally associated with ketoacidosis, which
causes the breath to smell fruity and can also be detected using a urine
dipstick you can get in any drug store.  

I would think the course of diabetes in cats would be similar, but check
with your vet to be sure.  If she just developed diabetes, she may not be
at risk of getting the vascular complications, since she's old and would
probably die of something else soon anyway.  Then you can just watch her
and put her to sleep if she seems to be getting uncomfortable and seems to
die.  She may even live peacefully for a while and then decide to die
peacefully on her own.

Please feel free to e-mail me if you want to talk about it some more. I
empathize with you.

I hope that the time left is one which is spiritually enriching for you.  Stay in touch
with your cat - if you're really tuned in to her, she'll probably let you know when
she's ready.

Peace,

Lee

I would never flame you for your decision. Our cat, Jason, who lived to

be 21, had some diabetes (in addition to his arthritis and kidney
failure). We, too, elected to deal with the kidney failure and to let
the diabetes alone. It's painful enough to be losing a cat you love
without having to worry about being judged for how you decide to treat
your cat at the end of its life. We all make our decisions based on the
best information we have and by following our hearts. I'm terribly
sorry for you and for your cat and wish you the very best. The vet
advised, with regard to Jason, that we add pedialyte to his water to
help keep him hydrated. Since he was on K/D, dietary restrictions were
already in place. In the end, we had to have him euthanized because of
the kidney failure, not the diabetes.  Best, Phyllis

~ My SO and I have decided not to treat our (hers, actually) 18-year
~ old cat which has just been diagnosed with Diabetes.
~
~ Unfortunately, she would not take well to the daily (or twice-daily)
~ insulin injections that are required, so (it was a VERY tough
~ decision) we decided to just make her as comfortable as possible
~ until we had to put her down.

Are you sure? Did you try?  Lots of RPC folk have diabetic cats-some as
old as 17 yrs. and they all say that their cats don't even notice the
shots because the  needle is so tiny?

--
8 cats 1 d*g and 1 hoomin so far...
[Colette, Lily, Frau Freya, Leon, Burt, Leify, Simba, Puffy, William(a d*g),
& Kathy(a hoomin)]

We made a similar decision with Tut last New Years.  Although he had been
sick the past summer, it was never diagnosed and he seemed to recover.  He
suddenly went down-hill after Christmas.  I knew that whatever we did
would only prolong him a short time.  He went to sleep overnight & is
remembered often.

Sympathy, Cheryl

Hullo.

I'm not a vet, just a vet technician, but I can address some of the questions you
ask.

First off, let me say that I have a great deal of respect for the two of you. I know
that this was not an easy decision to make, and it was not one made in haste.  
Treating a diabetic pet is an all-or-nothing type of commitment, and not without it
own additional problems. The insulin injections are usually not too much of a
problem for most animals; the syringes used have very fine needles, and the animals
hardly notice the injection. More problematic, especially in cats (as they tend to
eithr be fed free-choice, or do not eat scheduled feedings all at one sitting), is
the necessity of maintaining strict dietary control.  Inuslin must be given in
conjunction with a meal for best effect; if the cat doesn't finish it's meal, then
you're left with trying to decided whether or not to give the entire dose, or just a
portion of the dose.  Diabetes also tends to bring on cataracts, and accelerates
kidney failure, despite management of the disease with insulin.  Cats are also
somewhat difficult to get regulated, which means repeated visits to the veterinarian
for *** sugar testing and adjustments to the insulin dosages.  For an 18 year old
cat to undergo this regimen would be a tremendous stress to the animal.

Diabetes, left untreated, will take her to the Bridge in one of these ways:

She could go into a diabetic shock and then progress to a coma; if not given insulin
to counteract this, she will pass on while still comatose.

She will lose weight, drink copious amounts of water and urinate seemingly
incessantly.  If everything else about her is okay, she will eventually begin to
show signs of starvation, and become weakened as a result.

She may also succumb to kidney failure.  The signs of this are refusal to eat (the
build-up of toxins in the *** as a result of the kidneys not functioning properly
will cause her to feel nauseous, and food won't taste right to her, plus her
appetite will decrease sharply), disorientation, increased *** pressure, rapid
heartrate and increasingly labored breathing.  The disorientation, to the point of
hallucinations, is also a result of the toxins in the ***.  Once the kidneys shut
down, and the uremic poisoning reaches its peak, she'll become comatose.  While in
this state, she will experience heart failure, and will ultimately cross the Bridge.

Kidney failure, I've been told by a renal specialist and an infectious disease
expert, is not the worst way to meet death.  There is virtually no pain involved,
and once comatose, death usually occurs within 48 hours.  I went through this
experience last year with my brother, who decided to stop dialysis for kidney
failure due to *** he had been taking for an AIDS-related eye problem.  From the
time he made this decision until two days before he died, he was alert, responsive
and was in no pain.  His final two days he was comatose, and when he passed it was
quietly and with no sign of any discomfort.  He simply ceased to be here any longer.

Until she reaches a point where she's clearly in distress, just keep her happy and
comfortable, and savor every moment she is with you.  When the time comes, you'll
know, and you can fulfill that final responsibility we all have to our pets--to
provide a dignified, peaceful passage.

You have my sympathies.  Think of this time not as a death watch, but as a life
affirmation.  There'll be time enough to mourn her later.

Regards,
phyllis rayca

I am very sorry you decided not to treat her.  I couldn't tell if it was
for medical/monetary reasons or if you just couldn't handle the
treatments .  

If the last: please reconsider!  It is *not* difficult and the cat
*barely* notices the injections! (I say this from 2+ yrs of experience
and from seeing so many others post in rec.pets.cats with the same
comments!)

If she can't tolerate insulin or the testing involved or it is beyond
your means to pay, I understand- it is very sad, but that happens
sometimes.  Just be sure to euthanize her before she is suffering (it is
hard to tell sometimes, if a cat is in pain.  They don't necessarily give
great outward signs, so pay attention to the little changes!).

I am so sorry you are going through this.  I did it at the beginning of
this year and know how painful a process it is.  Please accept my
sincerest sympathies.

Amber

Since November, my cat has had some problems, and I can honestly tell you
that I will fight like hell to keep that little boy alive - but he's only
three years.  You are talking about an 18 year old cat and one that
require a lot more care than the ocassional care that mine requires.

And, I know how hard it is to have to let go of a long time friend.

My only advice to you would be to prepare to do so before the cat begans
to suffer.  You do it for the cat's sake not for yours.

I had friend whose dog got cancer.  When she brought the dog home, if she
had to leave I stayed with the dog.  We use to lay on the pillow with
this dog - it seemed to be what she wanted.  When she wasn't happy to see
us any more, it was hard to do, but I convinced her that at that point it
wasn't fair to try to keep her that way anymore.  

As hard as it may sometines, the main thing is to try to do what is best
for the animal.

Jolyn

We also want to assure you that no one in this group would offer you
anything but sympathy in your situation.  When the treatment is as bad
as the disease, the choice is difficult but many of us humans have
made living wills to forgo heroic medical measures when fatal disease
strikes.

Wishing you and your furfriend as many happy and peaceful days as
possible.

Ray & Rashida

Manga: DM G+W Y 1 Y+ L W+ C+++ I++ T A- E++ H V- F- Q- P B++ PA+ PL++
Dudu: DM B Y .10 Y L W- C+++ I++ T++ A+++ E- H V++ F- Q+++ P B PA PL
**********************************************************************
and the staff: Ray & Rashida Girven, Nanaimo BC, Canada

To the anonymous poster:

I doubt if you will get any flames because of your decision to let
your cat die peacefully. Many of us have had to make similar decisions
in the past, and it is never easy. You are making the choice you think
is best for you and your friend, and while you will certainly grieve,
you have no reason to feel guilty. You can expect to receive sympathy
and understanding, but I doubt very much if there is any cat-lover
here who will feel you made a wrong decision.

You have reached  the moment when you know that it is time to let go.
Accept it, and enjoy your memories of a dear friend without any guilt.

Beth