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Sandysmom

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Reply with quote  #1 
Hello, I just joined this evening.  I searched the forums first to see if this subject had been addressed and couldn't find anything previously posted, which doesn't mean it wasn't - just that I might have missed it in my search.

My 13-1/2 year old cat, Sandy, has terminal mammary cancer. Rather than go through our recent history of surgery and chemo, suffice to say that we decided to stop the chemo because the cancer had reached a point where any further intervention was useless. Even though she had no chemo side effects, the whole ordeal was just putting too much stress on her.  We knew once we received the diagnosis there was no "cure" just a desire to maintain her Quality of Life with us for as long as possible.  That's always been our priority.

We've experienced the loss of two of my other cats who we had for 18 years respectively.  Their illnesses were different and the 'decision' was made for us or we just waited too long which, in retrospect, was selfish and carries a guilt that I'll never lose.  I'm sure you can relate.  But now we must make the ultimate-act-of-kindness decision for our Sandy. We've discussed this with both her oncologist & reg. vet, plus because only we truly know her best, we know when it will be time. The was a huge dilemma on our parts: When?  They advised that if and when (most likely 'when') the hardened clusters of lumps begin to ulcerate...that it is time.  Why put her through endless antibiotics and more trips the vet when these ulcerations and possible infections will continue.  I won't do that to her.  I've already promised her: "No more medicines, mommy."

My question is regarding WHERE.  Originally we'd decided to take her to her reg. vet when we decide it's time.  He's only five minutes away.  But we are now considering having our goodbyes at home.  Despite the shortness of the drive to the vet, she has always been terrified there. She'd curl in a tight ball into the crook of my arm and press so close to my chest to hide.  When the vet or assn't. would move her, her little eyes would bug out with such fear.  Since she will most likely not be in as weakened a state as our other two cats were at the time, I fear (for her) she will react just this way even prior to giving her a sedative.

What I'm asking is: Has anyone had to make the decision of vet office vs. home procedure?  Did you use someone you knew or was it a service offered from a local hospital from one of their on-call vets?  (Sandy has been going to Red Bank Vet. Hosp. in NJ for her oncology and they have a Home Service which needs 24 hour notice).  Does it really matter if the vet is a 'stranger'?  I've talked w/the Service's dept. and they assured me the vet will comply w/our wishes as to how and where in our home.  

I'm sorry for this long introductory question, but since I haven't seen it addressed before, I wanted to give as much background info as possible and put out as many questions about it that I can think of now.

Thank you all for any advice, feedback, sharing or personal experience you can offer me.  

Inasmuch as the after-grief is devastating, the pre-bereavement anxiety and depression is almost as horrific.  

Sandysmom
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rbykrk

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Reply with quote  #2 
Sandy your last sentence is so very true. The anguish of knowing what is ahead is almost unbearable. 
I am truly sorry for what you are going thru right now but what comes across very clearly is your deep love and concern for your dear Sandy. You have put so much thought into this because you love her.
Where she passes is not as important as how and who she is with. You have addressed these issues very well and you will do what you feel is right for Sandy when it is her time just as you have been doing all along. To know you are with her and that you love her is what matters most to her.
You are considering at home and I think that is great. No stress for her, no trip to the vet. That would be my choice for my pets if it were available to me.
I hold you in my heart as I think about what you are feeling right now. I am so very sorry.


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Sandysmom

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Reply with quote  #3 
rbykrk,
Thank you so much for responding.  Every word and every gesture of understanding (real understanding) which can only come from another pet person who loves their fur babies as the family members they are...is a comfort to me and help. I appreciate all that you said.  I can tell it was from the heart.

Barring the always unforeseen, DH and I have decided on a home service.   After I posted here, I wrote to a bereavement counselor I had the good fortune to meet this past weekend.  Ironically, something I wrote in my email to her was very similar to something you posted:  I wondered if I wasn't putting too much emphasis on the "where" and "who", since it's the "when" that is the hardest to deal with.  

As long as we are with her, and I pray we are able to lessen her stress as much as we possibly can, that is what's truly important. 

I still would welcome anyone else's comments if they'd care to share as you have.  Thank you, rbykrk.
   
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ladysmom2

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Reply with quote  #4 
Sandy's Mom,

    Your love for your precious Sandy is very clear. She has such a loving mom. I know when the time comes you will make the very best decision for Sandy.

  I have never lived anywhere that a vet would come to the house for any reason. I have many times wished I had a vet that made house calls.  I can see where it would be less stressful on Sandy for the vet to come to the house, so I understand why you're considering that option.

   I agree knowing what's coming does not make it any easier but I know you're doing the best that you can.

   I will hold you & Sandy in my prayers.

   HUGS,

  lady'smom2

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Glory

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Reply with quote  #5 

There is no mountain I would not have climbed to find a reputable practicioner to make such a house call to my home. 

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Susie_Squillions

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Reply with quote  #6 
Dear Sandy's Mom,

I'm so sorry to hear about Sandy's condition, and also about your past losses.  Bless you for loving all of your kitties so well, and for striving to do what's in their best interest.

This topic has been discussed here before, but it was when the forum was in a different format, so you wouldn't have found those posts in your search.  It's clear that you are doing everything right, and that you are putting tremendous thought into this process to make it as painless and easy as possible for your dear girl, Sandy, and for yourselves.  There is never really any way to prepare for the end of our time together, but you are doing the most you can do.

It's absolutely a personal decision, but I agree with you that having the procedure done at home where Sandy is happiest is in her best interest.  I am of the firm belief that if something were to happen and you discovered while at the vet's office that she was nearing the end, she would absolutely understand if you had to say your goodbyes to her there.  We do the best we can to prepare, but sometimes there are other forces at work.

Please keep us posted on how you and Sandy are doing.  Treasure every moment you have wither her and take plenty of pictures while you can.

Now I want to address the feelings you mentioned about your other two kitties.  I hope you will be able to release the guilt of not making plans for the end of their time with you.  You are human, and it's our nature to be reluctant to let go of the ones we love.  You did nothing wrong by any far stretch of the imagination.  Yes, perhaps you could have prevented some discomfort, but you weren't in a place, emotionally speaking, where you could see that at the time.  That's O.K.  The important thing is that you loved your kitties and you took excellent care of them.  They knew they were loved, and they loved you too. 

Your angel kitties live in spirit and in your hearts forever.  They are pure love energy now, eternally young and healthy at the Rainbow Bridge.  They will surround you with love and understanding as long as you live.  When Sandy's time comes to join them, they will be there with you to guide her to her new realm of amazing beauty, and they will stay by your side to comfort your aching heart.

I will be keeping you, your family, your angel kitties, and your beautiful Sandy in my thoughts and prayers.



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My heart is battered and bruised, but I will not let it break. It holds such precious cargo, I must protect it now. (Susie Squillions)

"Memories of loved ones are like songs in our soul." Margaret Wakeley

T.J.'S RESIDENCY:
http://RainbowsBridge.com/residents/TJ006/Resident.htm

BUDDY GUY AYRES~LYNCH'S RESIDENCY:
http://www.rainbowsbridge.com/residents/Buddy128/resident.HTM

KING BING THE GOD CAT'S RESIDENCY:
http://rainbowsbridge.com/residents/BINGO009/Resident.htm

In one of the stars, I shall be living.
In one of them, I shall be laughing.
And so it will be as if all the stars were laughing when you look at the sky at night.
~ The Little Prince, Antoine de Saint-Exupery
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Sandysmom

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Reply with quote  #7 
It's very hard for me to respond now and say anything that is even remotely close to what's in my heart, because I am typing this through tears.  Tears of gratitude for all the words of love and support and kindness that all of you have put into your posts to me and about our girl from rbykrk, ladysmom2 and Glory.  Thank you especially Susie for speaking to my guilt over my other two babies. I understand what you're saying and logically agree.  But it will still take my heart longer to grapple with it.  There may never be any true closure for me on that, and I will just have to accept that.  

DH and I had another tear-filled talk while DH was lying on his side on the floor with Sandy on her side. She likes this position.  Nestled in the crook of either his belly or mine (like "spoons"), if we put one arm over her, careful not to rest it on her body, and hold her front paws, I think she feels very safe and protected that way. She almost always falls asleep or turns over on her back and does "bellies".

I am noticing slight changes in her and trying to be as objective as possible in determining the significance of them and if they are worsening.  Cats, as you all know, hide their pain too well making it very easy for their persons to assess if and/or how much they're hurting.  

I'm used to wearing my emotions on my sleeve and usually know when to put the emotions aside and think and act logically and objectively.  I think that 'mode of objective action' isn't even something any of us make a conscious decision to do.  We just ...do it naturally.  It kicks in instinctively.  Especially when it comes to caring for those who cannot care for themselves. Even though sometimes we may make the wrong decision, it may have been all we knew to do or were capable of doing at the time.  (As Susie so kindly and accurately wrote.)

Right at this moment,  that 'mode of objective action' is in play because Sandy also has Megacolon,  which we've been medically/nutritionally managing w/o surgery for over 2 years, and today is one of the two days a week I give her sub-q fluids.  I have to put aside my fears of hurting her w/the needle or not having the flow go fast enough because now especially that's the last thing I want: to contribute to her discomfort or stress.  Although she is used to the procedure by now and is such a good girl for it, it's still something I get anxious about and now more so.  

I started this by saying I didn't think I could write much.  But finding myself amongst people who can see into my heart at this time eventually made the words flow easier.  

I'd like to pose another question about pain med, but I think I should probably post it as another topic.  I still welcome anyone else's thoughts or experience with having a competent vet - even though you may not know him/her - come to your home.  
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jen_075

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Reply with quote  #8 
Hi Sandysmom,

I also agree that doing this at home may be the best thing for all of you.

I like that you posted a 'pre bereavement' topic because it is very important to make the plans, and, there is something called anticipatory grief, which you may be feeling. My cat was diagnosed 3 years ago with hyperthyroid and CRF. I was lucky his passing at home today was quick, because I had not made any plans, and was not sure what to do immediately after,  as I was in denial. So I think its great you are planning this, as painful as it is. I think you are very strong.

I am so sorry for what you are going through, and I know that you are doing everything you can to take good care of your Sandy.

Please take care of yourself too, and, just know, I get what you are going through, even if the circumstances are different.

All of you are in my thoughts and prayers,

Jen




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Sandysmom

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Reply with quote  #9 
Thank you, Jen, for your thoughts and prayers and sharing about your cat.  My cat before Sandy, Tyler, who lived to be 18-1/2, had hyperthyroidism for the last three years of his life and eventually developed CRF as well.  We treated him medically w/diet and compounded methamizole (Tapazole).  I was not so much in denial as he began to fail - just that I couldn't let go.  I'm not sure....maybe that's the same.  Either way, as I've said in previous posts, if I had been aware of home service, I may have ended his suffering sooner and calmer for him instead of rushing him to the vet at the very last instant. I will never know for sure and it will haunt me forever.  But also as I said before, I can't deal with that now because it's Sandy who needs all my concentration. 

This is the first night in weeks that she hasn't slept with me.  Perhaps that's why I'm up so late.  But she's resting in her bed and I don't want to selfishly carry her in here just so I can have her near me.  

I recently came across some literature on The Pet Loss Support page specifically addressing pre-bereavement or anticipatory grief as you called it.  It's here:



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rbykrk

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Reply with quote  #10 

Sandysmom,

 I am a member of this organization. They have a professional, weekly scheduled chat on pre-bereavement or anticipatory grief. I have an extra copy of the book that is referred to on the site and if you want I can send it to you. It discussed all aspects of pet loss including anticipatory. I found much comfort, understanding and resolution there.



 The Association For Pet Loss and Bereavement

http://www.aplb.org 


To your question, yes I would have my baby pass in my own home if that service was available to me.

Your love for Sandy is so evident in the words you write .My heart goes out to you. 



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"Never does a man know the force that is in him until some mighty affection or grief has humanized the soul."

Chucky...Forever Beloved.....May 13, 2007,
Rusty...November 30, 2007
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Vickie

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Reply with quote  #11 
Sandy
The best person to ask is your vet.I asked mine & due to Josie always going to them they said yes.I had no idea that 3 months later i would be making that call.My heart goes out to you.
Luv Vickie
    xx

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Sandysmom

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Reply with quote  #12 
I'm very grateful for the offer of the book, "Coping With Sorry on The Loss Of Your Pet", rbykrk.  But when I spoke w/the bereavement counselor from Red Bank Vet Hospital, just as you graciously offered, she gave me a copy of Moira Anderson Allen's book.  Like this forum, it's been of great help - when I can read it that is.  I can only read it (or post here) when my Sandy is in the other room or asleep. I have this sense of guilt doing those things when she is with me and alert.  Do you all understand that?  Somehow I think you all do.

As it happens, when I came across that page w/the pre-bereavement info on the Pet Loss site, I also entered their chat rooms at APLB on two occasions now.  Reaching out to like-minded people who have been through or are going through these terrible times has provided a kind of cushion for my feelings making it easier to express myself in places where I feel safe to do so.

Because Sandy has been seeing the same vet for almost five years , he was the first person I asked about when it might be time - what I should look for, etc.  and would he come to our home.  .  Unfortunately - very unfortunately - he doesn't.   When we last spoke w/him, we had decided to bring her to his office.  But since then after sharing w/so many other pet people, we've decided on the home service.  It would have been much easier all around if he could come here.   The vet who will come, however, will be one we've never met.  But as long as he/she is comforting, with a soothing voice for Sandy, and as others here have written, it really doesn't matter if it's her regular vet or this other vet from Red Bank Vet Hospital's Home Services (in N.J.) - as long as my husband and I are with her.  When I called Red Bank to get information about it (and even asked about it from her oncologist who works there), I was assured that whatever vet comes, he/she will accommodate whatever our wishes and needs will be.  


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Susie_Squillions

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Reply with quote  #13 
Hi Sandy's Mom ~

You are dong everything right every step of the way in this painful process. 

I would call the vet who is likely to be the one to come to your home when the time comes and see if you can make an appointment just so you can meet him or her.  It shouldn't require more than a 10 or 15 minute appointment (if that much), but at least you will know who you are expecting to arrive, and you will already have a connection.  It will also give you a sneak preview of who you will be dealing with so that if you're not comfortable with that person, you can look for another. 

I think it's best to meet these people as compassionate individuals first if possible, and not wait to meet them when they will appear to you as being "Dr. Death."  It's such a tough job they do, and I'm sure they would welcome the opportunity to meet with you ahead of time and to help you prepare for the procedure.

You are all in my thoughts and prayers.



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My heart is battered and bruised, but I will not let it break. It holds such precious cargo, I must protect it now. (Susie Squillions)

"Memories of loved ones are like songs in our soul." Margaret Wakeley

T.J.'S RESIDENCY:
http://RainbowsBridge.com/residents/TJ006/Resident.htm

BUDDY GUY AYRES~LYNCH'S RESIDENCY:
http://www.rainbowsbridge.com/residents/Buddy128/resident.HTM

KING BING THE GOD CAT'S RESIDENCY:
http://rainbowsbridge.com/residents/BINGO009/Resident.htm

In one of the stars, I shall be living.
In one of them, I shall be laughing.
And so it will be as if all the stars were laughing when you look at the sky at night.
~ The Little Prince, Antoine de Saint-Exupery
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jasminesmom

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Reply with quote  #14 
Sandy's Mom,

Believe me when I say-my thoughts and prayers are with you today. A decision like this is always very hard to do. I had to make that call 09-4-09 for my Jasmine, 13 yr old Peekapoo. But Jas had not eaten nor drank any water in 3 days-she was starving herself to death. She looked so sad and asking me 'what's wrong with me?'.
Your vet should agree to come to your home. Whatever decision you make will be the right one.

Cheryl

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Sandysmom

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Reply with quote  #15 
My first cat had a different vet because we lived somewhere else at the time, and the second cat (who we got after we moved to our present location) had yet another vet.  It was an emergency when both their times came and oddly enough, each cat's regular vet  was out of the office at those critical times.   So in both instances it was a stranger who put them to rest because there was no time or decision beforehand as to "who" it would be.  Perhaps it was a case of assuming their regular vets would be there when it was time.  Yet another reason why no one should ever assume anything.

Because of Sandy's condition,  more than likely, our goodbyes will be (God, I hate writing this because it sounds so cold):  By Appointment. Even if we went back to our original decision to take her to her regular vet's office when we decided it was time,  it would still have to be 'scheduled'. 

Jasminesmom, the grief in your words about your Peekapoo and that 'call' you had to make resonate very closely in my heart. You are absolutely right that Sandy's regular vet should come here.  But I am beginning to find out that most vets don't come to the home.  It isn't a rarity, but more the norm for most vets, which I obviously believe is a tragedy. I have to go back later this week to pick up some more sub-q fluids for her, and when I do, I'll either ask to speak w/him again or speak w/his staff.  I am not averse to pleading!  Not when it comes to any animal.  Especially when it comes to Sandy. 

I think the reason I was so indecisive about home vs. vet was that Stranger-Factor of a vet - who I had never met - coming here when we needed him/her since her regular vet doesn't come to the home.   I kept thinking: "Well, I know her regular vet, but I know nothing about who will come from Red Bank's Home Call Services". ( http://www.rbvh.net/services/housecalls.htm )  It wasn't until I began talking and writing to counselors/therapists and others facing the same dilemma that I stopped excessively agonizing over the "who".  The "where" of it became more of a priority for Sandy's sake. That's why we decided on keeping her at home regardless. The "when" is a whole 'nuther issue.  

Unfortunately, the Home Call GP Services at the hospital told me that they are recently w/o a permanent vet to make house calls and are currently relying on whichever of their own resident vets at the hospital are volunteering at the time to be on call. So it's not likely I'd be able to meet w/whomever would come.  

Susie, because of your post, however, I put in another call to the hospital to double & triple check if it would somehow be possible to meet beforehand.  Or at least - at least - if I could speak with that person on the phone before they come.  

No matter who it will be, it isn't about my comfort level. We all have felt that way. It's about our pets.  Just like any of you have done or will do, I'll do whatever physically can be done to prepare for that time.  I say "physically" because no matter how much I write in my diary to her each day (a practice one of the counselors suggested) or how much I try to talk it through, I will never be "emotionally" prepared.  I wasn't before, and I know I won't be now.  

I don't think any of us can honestly say that we are ever emotionally prepared.

LINDA


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