Cleo’s morning and keeping her comfortable

I’m afraid I do not have any good news to share.

Despite giving her the Mirtazapine, Cleo did not have any appetite this morning. I even steamed fish for her, thinking that the change of food and flavour might encourage her to eat, but she merely licked a bit of it.

Cleo’s hind legs are also wobbly now and she has trouble walking though she tries.

I woke up at 5am this morning so that I had sufficient time to start with Gabapentin (for the calming effect), followed by Sucralfate and Famotidine to coat the stomach lining and prevent gastric problems. Then I let her rest while I fed the rest of the clan.

Later on, I offered three types of food but she wasn’t interested in any of them. So I had to force feed some food so that I could give her her medicines for the morning. She did not really fight back as much as she would have in her hey day. Today I could even pill her. But how much of the food and paste went in, maybe only an optimistic 75%, I think.

Later, I also saw she spat out some of the food. That means she kept some of the food in her mouth to be spat out later. I know, she doesn’t want to eat anymore.

But without force feeding some food, I could not give her the medicines.

I am clearly reminded of the time when Pole was terminal, in her final weeks. When cats are ill, they simply do not want to eat anymore. But yet, I had to force feed her so that I could give her the medicines and also because I did not know how much longer she would live, and I didn’t want her to die of starvation and thirst. But it came to a point when the force feeding was too stressful for Pole (and also me) and I asked a senior vet for advice.

He is a very, very compassionate and experienced no-kill vet. He advised me to stop all the medication and just let her be and to go naturally on her own when the time comes. Let her be peaceful and comfortable. He also explained that at that stage, the body probably cannot absorb nutrients anymore too, so force feeding food and medication does little to help.

When it came to the very last few days, he even advised me to stop the subcut but I didn’t have the heart to do this as Pole did not object to the subcut and I did not want her to die of thirst. So I continued the subcut until her very last day.

It is so difficult when it comes to palliative care for a pet with a terminal illness. When do we stop giving medication? How do we know nothing helps anymore?

Here’s where a compassionate and honest vet helps very, very much.

I’m so glad Cleo has such a vet. I just texted her for advice. She explained that some owners want to do everything because they are not ready to bid farewell to their pets. As a vet, she can try to buy some time as per the owners’ requests, but how much of this is quality time?

What our vet says rings so true indeed. Buy time, but is it quality time? Time for who? Time for our pets or for us? More often than not, it isn’t quality time for us nor for our pets.

Yesterday, we discussed the possibility of blood transfusion. How much can this help? At best, the surge of oxygenated blood might make Cleo feel better for a few more days, then the blood PCV is going to drop again. And to achieve this, Cleo has to be subjected to an invasive procedure and one of our cats has to donate the blood too. And in some cases, like in Heidi’s where Smurfy donated blood, the blood transfusion did not help at all. Heidi passed away the next day.

So as it stands now, seeing how fast Cleo is deteriorating, the blood transfusion option is off the table.

As our vet so compassionately advised, what Cleo wants is to be home with her loved ones, to spend her last moments with us, not to be in an unfamiliar environment with strangers. I totally agree with this.

That is why I wanted to bring Cleo home as fast I as could. The day when her blood pressure dipped, I was so worried all night that she might not pull through, but she did and I managed to bring her home yesterday.

Cleo is staying home, where we will do everything we can to make her as comfortable as possible.

I’m asking the vet which medicines can be omitted. I don’t want to stress her too much by feeding her medicines. We will just do the bare minimum (because feeding meds is stressful for her) and prioritise giving her comfort and serenity.

Updates: The vet says the two medications that can really help to keep Cleo comfortable would be Gabapentin (can be up to 4 times daily) and Mirtazapine (anti-nausea effect), both are transdermal creams (luckily!). If it’s too stressful to feed the rest, they can be omitted.

The subcut will continue, to give her hydration. She doesn’t object to it at all.

I cannot play the Kalimba yet, so I played some Kalimba youtube music for her and sat with her.

Together with you, Cleo.