Update on Puddy; she's gone*9/29* see post #421

[zippy-kat]

{{hugs}}

You are always so supportive in your responses. I wish that I had eloquent words to instantly comfort you. Regardless, please know that you are in my thoughts and prayers.

You will do right by Miss Puddy. I know it's a heart break either way but you will do right by your girl. And we will support you in your decision(s).

{{hugs}}

[sasvermont]

Mary, the one thing we CAN do for our pets, when it is time, is to allow them to leave this world in a rather comfortable state. We cannot do that for humans. If it is her time, and only you and Puddy know that, then allow her to have peace. She doesn't sound happy to me. I could be wrong.

Anyway Mary, we will all support your decision. You have my nod to allow Puddy to be at peace with her illnesses. We are all going to go.... it may be her time.....

(((((((((((((((((Mary)))))))))))))))

[shais_mom]

I too like the other have nothing to say that will take the pain away. A magic pill that heals them either.
You are so caring and sweet to everyone, I'm so sorry you are going thru this.
You will do what is right for you and Puddy.
you are very strong.
I wish you luck and lots of hugs and love in your decision.

[carole]

Mary part of loving her is knowing when to let her go in peace and you will know, you really will,i realize how heartbreaking this is for you and i feel your pain, it is around the corner for me too, take comfort in knowing what a wonderful meowmie you have been to puddy and you know you are amongst friends who care for you and understand 100 per cent, giant gentle hugs to you both, and hang in there Puddy girl,if you can.

Mary i just wanted to add something, what helps me with my Ash is knowing that he has had a really good life, i know i have given him the best care, love i possibly can, it does not make it any easier, and when his time comes i will be heartbroken as you are,but it helps me deal with it, i know i am not there yet, but i am preparing myself for the inevitable, don't be so hard on yourself and remember just what a great kitty mum you have been to her and what a great life she has had, that is all any kitty can ever ask for, again i am thinking of you, and sending you hugs and love.,and i hope this can bring you some comfort at a time that is unbearable for you.

Mary it was my mother who made me think this way, sometimes i would discuss with her how i cannot bear the thought of either my mum or dad leaving me on earth, and she would always say to me, remember we are elderly and we have had a good life, keep that thought in your mind when the time comes, so i have adapted that way of thinking with my Ash, i hope you can with Puddy.

[Emeraldgreen]

Mary, I had planned to post again to offer support and to say that I too hope that you know that we are all here for you if you decide that it is Puddy's time. You will know what is best for her. But I stumbled across something tonight and I want to tell you about it. I've gone through this whole thread and I don't think it's been mentioned but please forgive me if it has.

Tonight I was researching online for ways to help make Jimmy healthier and I ended up on an IBD site that led me to another site with regard to B12 deficiency. I am so interested in this as I think Jimmy may very well be suffering from this but I was even more interested in what I was reading because Puddy popped into my mind instantly.

I will include the link to the sites but will also include some quotes below that I think could be relavent for Puddy.

What can cause deficiency of Vitamin B12 in cats? Anything that causes excessive drinking and/or urination (diabetes, hyperthyroidism, kidney disease, etc.) can deplete B12 and the other B vitamins as they are “washed out” of the body. Giving sub-q fluids could deplete vitamin B. Chronic diarrhea can also deplete B12 as most B-12 is lost in fecal matter. Cats with an inflamed gastro-intestinal tract (such as cats with IBD) may not absorb B12 properly as it’s absorbed in the intestines. Vitamin B12 deficiency can cause anemia, neuropathy, other neurological issues, etc.

Puddy falls into two of these categories with kidney disease causing excess drinking and the sub-q fluids she receives.
And the last sentence about B12 deficiency can cause anemia and neurological issues it seemed like it could fit.

Those quotes above came from this site.

Cobalamin (Vitamin B12) is a water-soluble, cobalt-containing vitamin with an important role in biochemical processes referred to as single carbon transfers. During these reactions, functional units such as methyl groups (-CH3) are transferred onto or between biologically important compounds. Cobalamin is a co-factor for at least three enzymes that carry out these types of reactions, acting as a transitional carrier of the single carbon group. A typical reaction catalyzed by a cobalamin dependant enzyme, methionine synthase, is illustrated in figure 1. Single carbon biochemistry is an area of great interest in the human population, as deficiencies in the activity of these enzymes may be associated with hyperhomocysteinemia. Hyperhomocysteinemia is a recognized risk factor for cardiovascular disease. Deficiency in cobalamin may also be associated with demyelinating neuropathies, dementia and megaloblastic
anemia (Pernicious Anemia) in human patients.

I'm not certain if this last sentence is saying that the dementia is associated in humans or both animals and humans. But since Puddy seems to have this, it was another red flag.

Cobalamin is non-irritant and may be given subcutaneously or intramuscularly, most clinicians deliver it subcutaneously

Vitamin B12 is stocked by all vets in injection form and is often prescribed to promote appetite, and help with anemia where a deficiency of vitamin B12 is the suspected cause.

And from the first site, I read that it is an option to inject the B12 into the bag of Lactated Ringers so a cat can receive it when they get their usual sub-q's. And from what I've read, it's not expensive.

The above quotes came from this site.

It's a bit harder to find symptoms for cats with B12 deficiency than people so I googled just B12 Deficiency symptoms and found these symptoms among many: (p.s. the below info came from this site.)
Nausea, insomnia, depression, dizziness, hallucinations, loss of memory and inflammed tongue! These all make me think of Puddy. She is awake all night, lying on that cool sink countertop, maybe because she is nausceous or dizzy. Her weird behaviour could be dementia or loss of memory and hallucinations. And the inflammed tongue is what really made me interested since she keeps sticking hers out. Maybe she is trying to 'cool it off' by sticking out of her mouth.

I wish I could look up more stuff but my hubby has kind of put a curfew on my computer time! LOL I feel like I'm 12. But I have been spending alot of time online lately so I promised to be off by 10:30 tonight.

I support you in any decision you make and pray that Puddy will be comfortable soon, in whatever way possible. I don't know if any of this info is of any help but I wanted to pass it along. {{{Hugs}}}

[Kirsten]

Poor little Puddy, and poor you, Mary!!!

Maybe a test for B12-deficiency would really be worth a try?

Keeping the two of you in my thoughts,
Kirsten

[Medusa]

I apologize for not posting lately about Puddy. So many of you have been so helpful and encouraging, I don't want you to think for a moment that I'm ungrateful. I know that I've been remiss in extending birthday well wishes and prayers for those who have suffered tragedies and are experiencing pain in their lives and I apologize for that as well. I've just been physically and mentally exhausted, so much so, that I fell down the stairs the other day and got bruised up pretty good. I keep a baby gate at the top of the stairs in order to keep Puddy isolated from the rest of the Fur Posse. I can't put the gate at the bottom of the stairs because there are posts in the hand railing that the cats can squeeze through and go upstairs anyhow. Well, I always lift my legs over the baby gate rather than unlock it and remove it because I felt that was safer to do. I was wrong. I was so exhausted that I was careless; my foot caught on the gate and down I went. Fortunately, I only went half way down because I managed to grab onto the railing but I hit my back and ribs and the baby gate hit me in a very delicate area, if you get my drift. (It got caught between my legs.) It hurts a little to breathe and it's now painful to go to the bathroom, so Puddy and I make quite a pair. Plus I've been dealing w/this painful jaw and my surgeon told me that I can do one more round of antibiotics and, if it doesn't work, then we have to reassess. I know what reassess means: surgery.

I was nearly to the point of having Puddy PTS; I even called my local vet to talk to her about it because, even w/a shortcut to Dr. Lee's, it's a good 45 minute drive which will seem an eternity for such a task as I would be doing and I would probably lose my resolve. When I called to talk to Dr. Lee about it, I was told he's on vacation again and won't be back until Monday, so I talked to my next favorite vet there and he told me something that startled me. He said that the Selegiline usually takes 6-8 weeks before it starts working. I said "What? Dr. Lee said 10 days." He paused and said "Well, I guess he was thinking of the best case scenario and it's possible, I suppose, but really, this is a 'big picture' drug. You have to look at things long term". I was in my car when he told me this and I started crying so hard that I had to pull the car over. If Puddy didn't have chronic renal failure while operating on one kidney, anemia, gingivitis and a growth growing near her spine, I'd say that 6-8 weeks isn't that long. But she does have all those things and 6-8 weeks is terribly long. It isn't like Dr. Lee not to be a straight shooter, so I'm willing to give him the benefit of the doubt. He may be exhausted, too, and I don't begrudge him a vacation. I left a message for him to return my call early Monday morning and I'm going to mention the B-12 shots to him and if I detect anything in his response that doesn't sound right to me, then I'll know that Puddy's time has come.

Having lived alone for 12 years now, I've learned to carry burdens w/out complaint but things are so much easier to bear when you have a partner, even a roommate who can share your sorrow or, in this instance, look at Puddy and say "Yes, Mary, you're making the right decision" or "No, Mary, I'd wait". I'm having to use my best judgment and trust my instincts, which have never failed me before, but then, I've never observed senility in any of my pets before. This is by far the cruelest of conditions because animals can't talk and let us know if our definition of quality of life meets their definition. This is what has caused me so much inner turmoil, wondering whether I should wait just one more week or one more day and agonizing if I'm putting her through misery while waiting.

So. If after talking to Dr. Lee tomorrow I feel worse rather than better, then my decision will have been made. I spoke to my son on the phone yesterday and he said "Mom, I've talked to you 6 times in the last couple of weeks and all 6 times you've cried so hard. You can't keep going like this and neither can Puddy".