Fate

 

At about 7 pm on an otherwise peaceful Sunday evening I was treated to a blood curdling howl from the hallway. Upon arrival my 15-year-old senior cat Porkchop was flaked out apparently immobile. Upon a cursory inspection, I noticed by virtue of a keen medical eye, that he was paralysed in both of his back legs. Well that can’t be good I figured. I  pick him up and while holding him in my lap, as he hyperventilated at 80+ respirations per minute in obvious pain, I googled the issue.

What I concluded  was a diagnosis of FATE. An aptly named feline arterial thromboembolism.

In med school I learned that embolism was never a good thing to acquire and usually meant that the angel of death approacheth nigh. Fate is also referred to as saddle thrombus….

 

 

Saddle thrombi are seen almost exclusively in cats and are usually an indicator of serious underlying heart disease; one chamber of the heart enlarges due to disease and blood tends to pool there. The pooled blood can form a clot inside the heart, which can then break off spontaneously and travel down toward the legs, carried along by the flow of blood. When it hits the split in the blood supply to the legs, known as the aortic bifurcation, the clot lodges there, draped over the division between the two femoral arteries and blocks blood flow. “One minute, cats are sitting happily at home, dreaming of taking over the planet. The next, they’re writhing in agony” So it was with Pork. He obviously  had  acquired ” hypertrophic  cardiomyopathy” read his heart is enlarged and pretty much worn out.. Old age. Imminent heart  failure. His old pump was  clocking  in at 200+bpm. Not a healthy situation.

Considering he never smoked, suffered hyperthyroidism or obesity , had loads of exercise and only ate high quality kibble and duck pate from Pet Smart, this came as a surprise. However despite good genes, quality living and nutrition, Pork was clearly in his twilight years. He had  had a good life of pampered love and adventure  visiting neighbours in Northern Ontario  for pets  and treats. In Belize he did much of the same plus chasing lizards, climbing mango trees and generally doing cat stuff, like bringing home dead vermin to crunch in the kitchen.

He would go for walks on ocean side back roads and socialize with the locals who had never before seen a white fluffy, friendly cat.

They were not used to cats being so humanized but quickly became fond of his quirky attention seeking antics. Local children would call to visit with him.

Pork was born in 2001 and was a going concern, a ball of long-haired white fluff originally named Crash. I adopted him in 2008 while residing with my future wife who was his adoptive mother and so I became his adoptive stepfather. Over the years we became very close. I looked forward to his nighttime bedroom antics of hide and seek and swat the human face.

He and Karl eventually tolerated each other. Karl who is 10 cats larger got into his face one day and received a claw on the snout. Since then there is mutual respect.

And now Pork, it appeared was clearly ready to cross the rainbow bridge.

Having trained at McGill in the 70’s we were taught that death was the enemy and must be driven back with gusto and determination. However my vet experience was limited to sat mornings in Kansas helping my vet friend in the OR.

I decided not to bring him to the local vets (it was Sunday evening) who specialize in wallet biopsies and in any case  the prognosis seemed to be really grim and it was either  euthanasia or extensive hospitalization with IVs and clot buster agents with an uncertain  outcome. If it was to be the end, I wanted him to die at home.

I spent an hour or so reading everything available  on FATE and learned that 2/3 cats don’t make it beyond  the initial 48 hours. Furthermore most ultimately don’t make it beyond 1 year.

However I decided that death wasn’t  going to win this time and I started with 50 mg of amitryptiline to induce sedation and help with pain control. It’s not like I had access to morphine, which was the recommended approach.

I kept him warm and checked his vital signs. I did not detect the gallop rhythms of heart failure or pulmonary edema.

I gave him 40 mg of baby ASA as  clot preventative and kept him comfortable.

He made it through the night fitfully with panting and grunting respirations. I charted his vital signs every two hours.

Next day I gave him water through an eye dropper and comforted him. He slowly came around and after 36 hours his cold hind paws warmed up, the left more quickly due to better blood supply and perhaps collateral circulation. I stuffed salmon pate on his tongue and carried him around on a padded plywood board.

However on day 4 he began howling while urinating, an obvious feature of a urinary infection though due to the extreme stress I thought it might be interstitial cystitis.

But as a precaution I stuffed  cranberry juice at first then capsules down his gullet.

So on day 5  he was less weak and fatigued, his breathing was normal as was the pulse, he began eating a bit on his own and hobbling along on 3 and 1/2 legs….

 

 

 

Death  lost this time. But the long-term outlook is for his demise within a year or less due to eventual progressive heart failure.

At least there is time to prepare for the loss  and provide him a bit more quality family time  as he approaches life’s sunset.

But he won’t be climbing mango trees anytime soon. Day 6……

 

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One Response to “Fate”

  1. Claude Francis says:

    It is truly amazing that with a bit of research and doctor smarts that you were able to intervene and give him relief and bring him back from the brink. I remember coming home from being away to find a very lethargic cat, my old buddy Brutus who was normally very active and a big strong cat. Not being sure what to do and not knowing how long he’d been this way I decided that he should at the very least be hydrated. I gave him water through an eye dropper regularly and forced coconut oil into him as a source of fat and calories. This went on for three days. On the fourth day in the morning, he had made his way up the stairs from the basement and greeted me with a healthy sounding meow.
    He was back to his old self in no time, eating and and chasing critters as if nothing had happened. I’ll never know what the problem was and I suppose it doesn’t matter.
    So glad to hear that Porkchop will be with us for a while longer and hope that he doesn’t have a relapse. I think that cats are a good judge of character as he seemed to warm up to me on some of my visits. Hope he’s with us for a good long time to come.

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