Q: My 15 year old orange male cat Jakey was euthanized in Aug 2016. I regret this decision. Jake had been diagnosed with hypothyroidism and in Feb 2015 he had radioactive iodine treatment which reduced his T4 levels from 11.8 to 1.8. He seemed to improve until his creatinine levels began to slowly rise and then eventually hit 16.3 creatinine on Aug 1, 2016. I had blood work done frequently on my cat. I was instructed to give 100 ml subQ fluids daily even though my cat was not obviously dehydrated nor was he underweight at 14 lbs. I diligently gave daily fluids. My cat then became partially blind, I feel from hypertension although the vet never explained this. My vet prescribed Enalipril and Amlodiprine and Medrol (supposedly given to increase his appetite). His appetite was decreasing but with hindsight it was due to heart issues. By Aug 8 my cat was in respiratory distress ( shallow and quick breathing, lethargy/collapse).

I rushed him to a different animal hospital and upon taking an x-ray my cat had a significantly enlarged heart with effusion around the heart. I had brought the lab results on all bloodwork for the last year and when the vet saw the 16.3 creatinine levels and enlarged heart he felt that it was best to euthanize as treating the heart will adversely affect the kidneys and vice versa.

I am angry at my original vet for not taking safety precautions by checking the condition of my cats heart prior to prescribing daily SubQ fluids. I feel that I unintentionally put my cat into congestive heart failure due to aggressive fluids. And finally I wish that I had simply treated the immediate respiratory distress to see if I could have gotten this cat through that crisis and then properly managed him under the care of the new vet. I had a very strong and deep bond with this cat and I am devastated that I gave up too soon.

Please comment and thank you.

First off, I'm sorry for your loss. Jakey here looks like such a sweetheart.

You know what? I don’t think I’ve ever met anyone bonded with their cat or dog who didn't feel conflicted with the choice of euthanasia. Some part of you knows you are doing the right thing, yet you quite can’t shake the idea that if only I had done something differently…

Especially when there are multiple health issues going on, it's hard to know what to do when they are with us, and how to feel about it when they leave us. I felt the same way with Zack:

I sometimes can't watch that video.

It’s important to know that you're one of the good ones.  I don’t know if you know that. I meet people that conclude that euthanasia is the first option when anything going on with their cat is less than perfect. People can spend over a decade with a pet, and then just walk out of the situation when it’s not easy anymore. I'm not surprised - people do this to each other as well. It’s just part of the human condition.

But you didn’t do that.

Jakey needed help. And you were that person in his life to be there for him. I feel re-humanized when I meet people like you in a world where CNN and the media tells you that the sky is falling every day.

I don’t know if technical information will ever give you what you need. Does it help if I tell you that 99% of the cat’s that I see with pleural effusion or fluid around their heart were never on SQ fluids? And cat’s on SQ fluids are not over represented in patients who develop fluids in the chest? But for some cats high sodium fluids with undiagnosed heart disease can cause fluid to leak within the chest? I can go back and forth all day, pushing and pulling, explain why it could cause it, or explain it all away. Nothing good will come from this.

In your words I read not just anger but sense the mistrust for decisions that were made by your vet. The internet will just stoke those flames even further. Nothing good will come from that.   

Because at the end of the day, it's you, and your home, and the way it feels empty when they aren't there anymore.

You won’t ever make perfect decisions, because life has it's own plans for us.

You know who I met this weekend? Jane Goodall. She’s in her 80’s now. She signed this book for my daughter.

And as she did so, and I looked at every hard won line and crease around her eyes. She’s a person who decided to fight for something she believes in. She looked vibrant and tired all the same.

And not all of her decisions were perfect. She would be the first person to say so I think.  

You stood up for what you believe in. You are conflicted about euthanasia. You have regrets.

I think this makes you one of the good ones. This makes you human. Our animals our supposed to make us human.

I hope you heal in time.

Dr. Kris