I Lost Phoebe Last Night . . . msg

[Laurie and Tasha]

I am so sad right now - my heart is breaking. She was in severe kidney failure, and reading Susan's post about Belle was eerie for me, because it sounded exactly like what Phoebe was going through. She was diagnosed with diabetes in February, and I gave her insulin injections twice a day, as well as checked her blood sugar levels frequently. Within the last few days, she gradually stopped eating and looked awful. I made an appointment for last night, knowing that something terrible was wrong. I was thinking cancer. She was actually diagnosed with GI lymphoma 2 1/2 years ago. We put her on prednisolone for 16 months, and I am sure this is what brought on the diabetes. My vet and I now think this was a mis-diagnosis by the pathologist - she never really had any symptoms other than a short bout of diarrhea and vomiting. We did the biopsy because she was having surgery to remove bladder stones. At the time, my vet said he was surprised at the diagnosis, because her intestines "did not look that bad."

She had lost almost two pounds since her diabetes diagnosis in February and was very weak yesterday. I thought it was because she wasn't eating, but it turns out she was very anemic - her hematocrit was around 17. Doc said 15 was time to consider a transfusion. Her kidney values were so high, they were not measurable. I was offered the option of putting her on IV fluids for 48 hours to see if there would be improvement. But she was such a tender soul, she did not do well at all whenever she had to be hospitalized. And I wondered - to what end? I would have to give her sub Q fluids at home, she would still probably feel terrible, and we would be right back there in a very short period of time. So I said goodbye. I had her since July 5, 1996. Even with the 3 other cats here, the house feels very empty.

Traci and Sue, I am so sorry about Cotton and Belle - Hope they are with Phoebe and showing her the ropes. I send you both (((((hugs))))).

[Tina B and crew]

I am so sorry about your loss. It seems so many of us here have experienced in the last year and a half or so. Sweet and gentle journey dear Pheobe....((((hugs))))

[Traci]

Laurie, I am so terribly sorry, my heart is so breaking for you! I remember when you brought sweet little Phoebe into your heart and home, it seems like only yesterday.

This is so strange, particularly with the bladder stone surgery (Cotton had to have stones removed too, months earlier), and it seems Phoebe's renal values were fine just like Cotton's were at that time. Months later, chronic renal failure, I just don't get it. Did you monitor Phoebe's bloodwork after the bladder stone removal, or were you strictly focused on the diabetes only? (Cotton also had diabetes, but we ceased his insulin to treat the renal failure). Since the vet knew Phoebe was on prednisolone for so long, she should have insisted her bloodwork be checked on a regular basis (not just because of diabetes), and knowing you, you probably did. Even so, I am finding that it is not uncommon anymore for renal failure to develop rather suddenly, despite regular bloodwork, it is so frustrating. That said, it is however, quite common that in one primary condition, secondary conditions are more common.

I wish I could find the words to comfort you, I know just how heartbreaking this has been for you. Know that my heart and prayers are with you, and I know that you did everything you could possibly do for Phoebe, she knew that, and she knew how much you loved her.

Safe and gentle journey, sweet sweet little Phoebe, you are so missed

(((((((((((HUGS)))))))))))

[Laurie and Tasha]

Traci . . . just to let you know, Phoebe's bladder stone SX was 2 1/2 years ago. At that time, they did the biopsy of her small intestine and we got the diagnosis of GI lymphoma. We put her on the prednisolone, and kept her on it for 16 months (gradually decreasing the dosage). My vet and I finally felt (as she really was having no symptoms whatsoever), that we had gotten a misdiagnosis and stopped the pred altogether. She was only getting 1/2 tablet every third day by that time, anyway. Everything was fine for about 8 months, and then in February, she started eating, drinking, and peeing a lot. She had diabetes. We checked her blood values every 3 months or so while she was on the pred, but not during the 8 months she was off of it, before the diabetes developed.

Because of some major health problems I have been having myself since February (Parathyroid surgery and diagnosed with a pretty bad case of degenerative disk disease), I did not have her blood checked. I was checking her glucose values twice a day, and talked myself into believing that was sufficient.

Now that the initial shock of losing her is gone, I am doing the "What If?" game - what if I had taken her in sooner - could something have been done? Or would I just have said goodbye to her sooner? Cats are so good at hiding when they are sick. Every morning when I came down to give her the insulin shot, she was at her usual spot - looking out the back sliding glass door and teasing the dog next door. She came whenever I called her to eat, and enjoyed licking the empty can from canned tuna and chicken. She still came by for her nightly pet and head scratch before I went to sleep. It was only Wednesday that she started not to eat very much, and Thursday that she stopped eating altogether (even though she seemed interested in eating) - when I put the bowl in front of her, she just sniffed and walked away. Even though she was strictly on canned food, I tried tempting her with some crunchies on Thursday afternoon. She looked like she wanted to eat, but walked away. That was the point at which I decided to make the appointment. I thought the reason she was so weak was because she hadn't eaten very much for two days. Little did I know she was so anemic.

Thank you for your kind thoughts, you always know the right thing to say to me.

[Traci]

Bloodwork should have caught it, but it's hard to say how progressed it might already have been before bloodwork indicated it. Cotton was evaluated frequently, twice-a-year bloodwork (plus frequent BG checks and fructosamine levels) and it wasn't caught until around 6 months from latest bloodwork. I contributed his age (although he was only 12 or 13) and the diabetes as a contributing factor.

The anorexia is common in renal patients, it is most often caused by dehydration or nausea or excess acid in the stomach - meds and altering the diet temporarily to something palatable and easy on kidneys is sometimes all it takes to keep them comfortable and get them eating again (of course the addition of regular fluids maintenance is a must). But, sometimes in very progressed cases, this may not be enough.

With Cotton, he had a bad tooth that couldn't be pulled due to not being a good anesthesia candidate, so that was a bit prohibitive. He was on pain meds though, and I pureed his favorite canned foods, and used the coffee grinder to powderize his kibbles and added water. Cotton ate well all the while, but his renal function just progressed more quickly than I had imagined. I was in denial the entire time, having as much hope as I could muster but I knew that I could not predict how long he would be with me and therefore focused only on his care and the time we had together.

Even when you know you're doing all the right things, the what-ifs will always rear their ugly head, and I try not to focus on that, but rather, having given my babies everything I've got, and being grateful they were in my life and gave me so much in return. I know you, Laurie, you're a fantastic mom, you have always gone above and beyond for your babies, and even had the renal disease been detected earlier, there is no way to predict the outcome. You didn't cause this by the previous false diagnosis nor the pred usage, renal disease occurs in a great many cats, and even in cats we consider as otherwise healthy.

I hope you can be comforted in knowing that Phoebe knew you would, and did, everything you could possibly do. The utmost love, care and concern you had for her, she knew and felt that.

((((((HUGS))))))))