It was a crisp, cold night and the sky was already black when we received a call about a cat, Stella, who wasn’t doing so well. Her owner, Pam was worried that it was time to say goodbye so we re-directed our route through town. Although, we were somber we couldn’t help but notice the sprinkling of early Christmas lights twinkling along the way.
Pam greeted us with tears in her eyes. She was visibly upset so we gave her some time and just held space.
“Stella is everything to me”, Pam said. “My husband passed away a year ago this week. I’m not sure if I can let her go just now, but of course, I don’t want her to suffer.”
Stella had multiple concerns and had been hospitalized for a week. She had seemed to recover some but when she came home she gradually went downhill. She was barely eating and drinking and wasn’t leaving her comfy bed for much more than to go to the litter box. She was usually a very active cat, snuggling with Pam on the sofa, going for walks, watching the neighbours from the upstairs window seat and playing with her toys on the main floor. One of her favourite things was to cuddle up in front of the fireplace but she wouldn’t even make the trek downstairs. Her quality of life was very poor at this point and Pam knew she couldn’t continue to watch her as she was but she was worried that she was making a decision too soon. “Maybe my judgement is being affected by the anniversary of my husband’s death, but maybe not, I’m just not sure. Is there anything I can try while I work on clearing my head?”
We discussed palliative care as well as hospice care and how it wasn’t considered to be curative care. We discussed all of the options available to Pam and Stella and went over what the expectations and commitment would be for each option.
The options that we presented to Pam included
- Referral for potential curative care
- Medical care with us or her referring veterinarian including more diagnostics and treatments
- Palliative treatments at home to support Stella and treat her individual symptoms for a short time to see if it would improver her quality of life.
- Hospice Care through natural death. Supporting her and preventing pain and adverse symptoms until death occurred.
Pam was adamant that she did not want hospice care with natural death for Stella, but she was hopeful that we could improve her life for a short time with symptomatic palliative care before saying goodbye.
We left Stella to rest and the four of us sat down at the kitchen table to come up with a plan for Stella and her family. We discussed Pam’s fears and expectations. We talked about her limitations. How much nursing care could she provide? How difficult was it to get medications into Stella? How much time and money could she provide to care for Stella? Once we had the answers to all of these questions we formulated a plan that addressed all of Stella’s needs.
The plan was extensive and included:
- a nutritional plan
- a hygiene plan
- environmental adjustments and enrichments
- safety considerations
- nursing care
Over the next few weeks we stayed in very close contact with Pam and we made some nursing calls to help her out. Pam was an excellent caregiver and by the second week there was some improvement but not a lot and Pam decided that she did want us to perform some diagnostics after all. We went to their home performed an ultrasound and drew some blood and were pleasantly surprised that her pancreatitis had resolved and some of her other values were also showing improvement. We adjusted some medications and other treatments and Pam kept up her excellent care of Stella.
Over the next month, Stella gradually improved. She started eating enough food to actually gain some weight and she was becoming more active and playful. By spring she was back on her walks with Pam and they had gone on a road trip or two.
We made several adjustments to Stella’s treatment plan over the months and by the time that summer had rolled around, Stella was back to her old self. Pam was so happy: “She is perky and playful and chasing the chipmunks in the backyard again! I can’t believe how well she is doing.” Her blood tests were checked again and although they confirmed that she had did have chronic disease conditions they were much improved from when we first met her.
Now, one year since we first met her, Stella is still doing very well and planning her winter get away with Pam and some friends. She is still on a palliative treatment plan and will remain on one with tweaks and adjustments here and there as her condition improves or declines. We are so proud of Pam and the hard work she did to take care of Stella and to improve her quality of life. They are both rock stars in our opinion!
We are so grateful that we are able to guide Pam and Stella on their journey.
“The greater the obstacle, the more glory in overcoming it.”
Author: Janet Henderson DVM, CHPV