I think all vet offices have the same bench in the lobby and the same type of concrete floor. They all same the same too, like flea dip and pinesol. We were not the only people there. A lady in a publix shirt was with her cat, though I cant remember why... We got there at 12:25am and waited quite awhile. I sat outside smoking and chatting with Brian on the phone. He was working the night shift and was bored. I went back in at 1:15 and they where already back in the exam room. They had already taken urine and finished the initial exam, The rn came in and told us the doc waited to do some x-rays and urinalysis and see where that takes us. The was going to coast 295$. Ouch! Do it we both said. Sometimes you have to bite the bullent for your small fury children. They took Pookha to the back and we went for a smoke. I don't think either of us had a real idea how this was going to end. I really thought she might have developed feline diabetes or at the worst have some sort of throat infection that was making it painful to eat.
We waited in the exam room for the doc. She came in and brought the x-ray. I can vaguely interpret an x-ray if give some time...It didn't need to here. It showed a massive bowel obstruction from the lower GI to the epi-gastric area. The other thing was that it was as hard a stone. The doc had palpated the abdominal area and pelvic region, and though she knew something wasn't right...This blew her away. This 6.5 pound cat was 3.0 pounds of obstruction. The vet was amazing that she was still alive and that she wasn't showing any external signs of severe pain. The problem here was this. Pookha had been struck by a car two years prior. She healed well and seems to be back to normal in a few months. The regular vet thought everything was cool. What had happened was this. The trauma to her pelvis had caused a condition call Feline Megacolon. Here is a brief run down ...
Cat Megacolon is a bowel disorder. The colon of the cat is chronically dilated or enlarged because the nerves in the colon do not function properly. The causes of feline megacolon can be acquired through trauma for instance, congenital, or idiopathic(unknown). Clinical signs of feline megacolon in the cat can be simply chronic constipation. Other signs could be distended abdomen, not eating, weight loss, vomiting, nausea, straining to defecate(tenesmus), painful defecation (dyschezia), and rectal prolapse from constant straining. Megacolon usually shows up in middle aged and older cats but can appear in cats as young as three and four years old
Feline megacolon is a syndrome rather than a specific disease. Consequently, identifying the underlying cause of the megacolon, if feasible, and treating that cause, if possible, is important. Treatment of megacolon per se may include conservative medical therapy or surgery. Sometimes medical treatment alone is sufficient; however, in many cases medical treatment fails and surgery will be required to save the catÂ’s life. In some cases surgery is the treatment of choice,,,,Surgery involves removing most of the colon (lower bowel). This procedure is called subtotal colectomy.
What is megacolon?"If the nerves to the colon do not function properly, the muscles of the colonic wall will not contract properly. If this happens, the muscles stretch and the colon enlarges in diameter. In addition, the fecal material is not moved out of the body and severe constipation may result. This massive enlargement of the colon and the resulting constipation is called megacolon. The colon may have a diameter 3-4 times that of a normal cat. " "
Megacolon is a condition that is not uncommon in the cat. Most cases are idiopathic (a cause cannot be determined), and these seem to be a result of colonic inertia. Pelvic fracture malunions are the next most common cause and result in a pelvic outlet obstruction.
For cats that present with signs of gastrointestinal disease, obstruction is a primary differential. There are numerous reasons of gastrointestinal obstruction in small animals, yet there are several specific causes that are more commonly associated with the cat. These include linear foreign bodies, trichobezoars, focal intestinal neoplasia, feline infectious peritonitis, and megacolon. Clinical signs related to gastrointestinal obstruction consist of vomiting, diarrhea, constipation, tenesmus, anorexia, or weight loss. The course and onset of disease depends on the rate at which the obstruction develops and whether the obstruction is partial and complete. The diagnosis of obstruction is typically suspected based on clinical presentation and palpation of an abdominal mass. Diagnostics tools are used for definite diagnosis and determination of location within the gastrointestinal tract. Surgical treatment is dependent on the etiology of the obstruction and various techniques are employed to remove the obstruction and prevent recurrence.
There are many recognized causes of constipation in the cat and the management of the condition depends on the clinician's ability to recognize the appropriate aetiology in each case. Most surgery therapies for constipation in the cat are related to the management of idiopathic megacolon, although causes such as pelvic outlet obstruction, complications of neutering surgery, perineal herniation, and malunion pelvic fractures may also require surgical intervention. Currently, the surgical management of megacolon consists of subtotal colectomy with the recommendation that the ileocolic junction be preserved. The procedure, in general, is associated with a few life-threatening complications.
Pelvic fractures are commonly observed in cats after automobile-induced trauma and frequently affect other organ systems. An organized systematic approach should be followed in the evaluation of pelvic fractures. Common pelvic fracture patterns observed in cats include pubic fractures in combination with unilateral ilial fractures, unilateral sacroiliac luxations, bilateral sacroiliac luxations, and contralateral ilial body fractures. Narrowing of the pelvic canal may preclude normal passage of feces and result in megacolon.
Pookha's pelvic trauma had caused a pelvic outlet obstruction. This in turn had caused the lower bowel obstruction, which, after developing over the time since the accident, produced a excess of waste in the colon causing the megacolon, which according to the vet, most likely had swollen and pushed the remaining pelvic outlet closed. This complete closure had most likely occured only a few days prior, thus explainingg the sudden weightloss.
This was bad news. We sat speaking with the doctor for a few moments about our options. To begin she would need a unrinary and rectal cath. This would be to try to begin to remove the blockage. This would require two days of hospitalization. If the obstruction could not be removed via the cath, it would require surgery. Then, she would have to have the subtotal colonectomy, removing the greater part of her diseased colon and reconnecting the remaining portion to the lower GI. After that there was the possibility of having to reconstruct her previous pelvic trauma, which is to prevent a recurrence. Then came the bad news. Because of the amount of weightloss, the size of the obstruction, and the amount of infection in the colon, the vet advised us that the chances of her survival were not good. Even if she did somehow survive the possible three surgeries, Her quality of life would seirously decline. She gave us a few minutes to think in private.
I looked at mom, who was looking at the cat. "I don't think we should do this to her, she said. " "I don't want her to have to suffer." "What good is it to be a cat if you can't run around and play." she thought to herself." The tears she had been bravely holding on to, began to break through. I touched her shoulder and said ," you're right." This was not how I had seen night going. Mom sat with her till the doctor came back in. "We're not going to make her suffer." she said patting Pookha's head one last time. "I can't be in here for it" she said. Mom made her goodbye and left the room. I stayed in the room stroaking her head and talking to her. She was quietly purring and sitting very still. The RN came back in and I signed the order. The doctor was actually splitting time between us and surgery on a small dog. She had to finish suctureing the other animal, so it gave me a little more time. I kept her company, although I believe she somehow new what was happening, and was ok with it.
I know this will sound strange to some people, But I took out my camera-phone and took a picture of her. I don't know why I though of this, I just seemed like the thing to do at the time. We sat there for a while, long enough for me to think about going to get mom so she could spend a few more minutes with her. I descided against it, saying goodbye once was hard enough, having to do it again would be awful. The vet and an assistant came in. The doctor sat and said "This was a tough call...I'm sorry it had to go this way." "Yeah..Me too." I replied. Even though she wouldn't say it, I could tell by the look on her face that she was..Not to say happy..But glad that we chose correctly. I think that the doc was really afraid that we might cling to hope and prolong Pookha's suffering.
The assistant came over and held her gently but firmly. The doc cleaned and preped for a mainline injection. She had brought a three cc syringe in with her. The injection was a combination of phenobarbital sodium (anestheticc)and phenytoin sodium (anticonvulsant). This the actually a premixed drug called oddly enough "Euthanasia-3". It comes packaged in 100ml multidose vial. Each milliter contains 390 milligrams of phenobarbital and 50 milligramss of phenytoin. The recommended dose is one milliliter to ten pounds of body weight. The doctor made her stick and I saw the flash, I just kept stroking her head. It was over three seconds later. I closed her eyes and they took her to the back to be packaged for the trip home. I put her back in the pet taxi and we drove back to the house. Mom picked a spot to put her, in the garden near the Staghorn. I places some large stones over the site and we called it a night.
I think I will second guess the decision for a while. You can "what if" your self to death if you're not careful. During my search for the details of the megacolon syndrome I came upon an article that made me feela littlee better. In thatarticlel I found one small phrase that I think might possess both truth and beauty.
"Euthanasia can, if thought through and used as the last resort, be the most pure and unselfish way to say, "I love you." When an owner loves a pet enough to suffer heartbreak and say good-bye, to set their pet free of pain, that is love."
Sungod357...
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