|Poor baby! with IV fluids, feeling crummy.|
$510.00 later, the picture was looking like "feline acute supperative choleangiohepatitis" Which is an impaired liver due to bacteria that have ascended her bile ducts, invading the ducts into the liver. the immune cells that are attacking the bacteria work somewhat like a landmine, and cause indiscriminate damage with inflammation- this kills the bacteria, but the healthy liver cells are collateral damage. This will cause her bilirubin to rise, and the skin of her ears was turning yellow (jaundice). This could possibly lead to liver failure, which can be fatal. Because the local vet would not be open Sunday, and Polly needed more care and monitoring, they referred her to an 24 hr emergency vet, or Kitty ICU. That doesn't come cheap- $475 for the continued care plus $150 per day just to be there. They also recommended a $450 ultrasound to look at her liver to better understand the type of problem she was having. Being in medicine, the vets and nurses and I could shop talk, and it was fascinating to see how processes I understand in people play out in cats.
Rob and I agree that vet care is something we budget for. But we have set the limit at $500 per episode, and the condition has to be reversible, not progressive. So I had to decline admission to the kitty ICU and the imaging. Instead, the emergency vet and I worked out a plan- I would give her subcutaneous fluids at home, as well as oral antibiotics twice daily (liquid, at least. Giving a cat a pill is a Herculean task!)And we would try and get her to eat.
|Homemade Kitty ICU. Polly is getting fluids subcutaneously. After getting antibiotics down the hatch. She is definitely NOT a happy camper, but she is starting to perk up a bit.|
The debate about refusing pet treatment due to financial constraint can be a heated one. Some call it "economic euthanasia". The vet did give me a rather expectant look when she gave me her quote. I'm sorry, I won't be handing that kind of money over, but Polly is not ready for the Euthanol yet. We will give this a chance to work itself out with supportive therapy. I did some digging in the literature regarding feline cholangiohepatitis. Apparently even if correctly diagnosed and treated, there is a 50% mortality rate in the first year. The remainder will usually live from 1 to about 5 more years, and a fraction will have normal lifespans. So there we are. I will do what I can to help my kitty, whom I do love. But I will not spend a fortune diagnosing something just to know what it was that killed her or that we didn't need to know because we took care of the symptoms and it went away (granted, in people, I JUST WANNA KNOW!). I am also unwilling to fight an expensive losing battle in which she suffers for no good reason. Two excellent opinion articles at Salon called "What I wouldn't do for my cat" and "How to say No to your vet" lays out the controversy and echoes my feelings pretty well. Except I don't think most vets are inspired by money. I think they are inspired by what is now possible to do in order to help an animal get better. And I admire that. They deserve to be paid for their work, too.
So here's hoping Polly will pull through.