The Treatment Juxtaposition. Why Your Pet Has Options You Don't

I am an eternal student. It is the price you pay when you are obsessed with what you do, and you can’t get enough of it.

I am constantly in search of the newest ideas, innovations, and treatments. Because of this I read each veterinary medical journal with baited, anxious breathe, and the hopes that tomorrows cases will benefit from today’s readings. I read, highlight, tear out, and save each journal article that I think can be a source for future patient care. I have boxes full of binders that overflow with “needed vital information.” It has begun to resemble a veterinary student driven to the brink of OCD. I admit it, I understand it, and still I am powerless to stop it. To prove my point on how vitally important these articles are I thought I would share my latest tear out.

Today’s article is from a favorite veterinary journal, “DVM Newsmagazine” November 2011. “AMC stem cell study to investigate intra-arterial injection for kidney disease,” written by Daniel R. Verdon. The article is particularly interesting to me on many levels. First, I lost another beloved kitty yesterday to kidney disease. She was the third in a row to have lost the battle against chronic renal disease. Of all of the old cat diseases I think kidneys wear the crown.  I remind my clients that cats and dogs have basically the same biology, so if humans get it, cats and dogs get it; cancer, heart disease, diabetes, kidney disease, etc. We all will die of some kind of disease and for many 2 and 4 legged beings it will likely be from one of these. But where the biology’s may parallel the treatment options diverge greatly. Much of this is based on cost, but where it may be available to humans the science exists for pets but society still largely views pets as disposable/replaceable so the options are limited.

Here is where it gets really intriguing and interesting. For humans if your kidneys are failing you start dialysis, and go on a waiting list for a transplant. Today transplants have become a common part of every large hospitals menu. If one of your parts isn’t working correctly, or you don’t like them anymore, and you are a human being, you can get it exchanged.  Transplants have been researched, tried and successfully done in pets also. The big dilemma is that unlike with human beings, a donor pet isn’t able to give consent to have their parts harvested. And in veterinary medicine we don’t have an organized transplant team. Instead if you need a new kidney for your cat another healthy cat is slain for their beans. It is a thought I can’t bear to think about. I know how much I love my cats but I can’t say that my kitties are more important than someone else’s. Even if that kitty wasn’t fortunate enough to have been dealt a lucky hand in life and landed in the loving arms of someone who understands and respects them. It is a hard lot to be born a feline. So kidney transplants are available to pets. The starting cost is about $40,000 and a conscious that will burden you. Dialysis is available, but unfortunately it is not an option in many parts of the country. That leaves you with a definitive death sentence when your kidneys start to crap out.

Then I read the article in DVM magazine. AMC (Animal Medical Center) in NYC is a forward thinking modern great American veterinary hospital that leads in almost every field of veterinary medicine. It is the premier think tank hospital that isn’t affiliated with a teaching hospital. If you live in or around NYC and you want, and can afford the pinnacle of veterinary medicine, than you and your pet go to AMC. The article describes a new novel study underway at AMC that will place stem cells via intra-arterial injection into the diseased and failing kidneys. The hope is that these stem cells will recreate a healthy environment in an environment that is dying. It is a hot topic in all fields of medicine. Stem cells represent the sort of magical but taboo medical treatment option. It is the point where religion meets pushing the edge of science. We appear to be too afraid to do it in human medicine but not veterinary medicine. Can you imagine the can of worms this will open? Can you imagine what will happen if we learn that we can stop, or even reverse disease? Can it be possible that we will be able to cure our pets but die ourselves of the same disease because our pets have treatment options that we humans don’t have?

The incredible juxtaposition to be a creature without any opinion on whether or not you were worthy of being treated has now turned into being able to take a sip from the fountain of youth.

Truth be told I won’t think of killing one cat to be able to transplant a kidney into one of my kitties, but sign me, (oops, I mean them), up for stem cells.

To read the entire article see page 20 of the November 2011 DVM magazine.

D.C.

This is the most personal story that I could write and share. It took me three weeks to be able to send it out into the world. Whenever an owner tells me how much they are grieving over their pet I think if how much I miss my cat D.C. I still can’t think of her or talk about her without crying. There isn’t a day in my life where I don’t think about her, grieve for her, and miss her like crazy. I understand how loss can profoundly affect your life.

To my kitty D.C; I say I love you, and I am so grateful for always helping me through the really rough spots of my life.

Here is D.C.’s story

I was looking for a kitty when I finally got my first apartment. I know most people get dishes and a sofa. I wanted a cat. Actually I wanted two but I told my roommates that I was only going to get one.  So I headed to where any responsible new pet owner would go for a cat, the pound. I, at that point, still considered myself a very knowledgeable, wordly, solidly standing in the “nothing shocks me anymore” veterinary arena. Suffice to say, I was so wrong. And I wasn’t just a little wrong. I was you aren’t even in the same galaxy wrong. I walked into the Baltimore City Animal Shelter with a plan and an air of confidence. As I crossed the threshold into the facility I was met by a foul smelling, disorderly, waiting room. There were a lot of people, I thought this was a good thing, I thought there were a lot of people there to adopt. Unfortunately I learned they were there for drop off and not pick up. Oh I was wrong on so many levels. I waited quietly and patiently to go in through the adoption rooms to find my kitty.

After some time I was escorted to the cat rooms. There were 2 at that time. They were the size of a closet. Lined on one side with cages, with just enough room to walk single file down the row piled three high of cages. There were maybe 30 cats in those 2 rooms. “Great,  I thought, there aren’t a lot of cats here they must have a high turnover.” Wrong again, they have a 5 day hold for these cats then they were euthanized. So all of those cats had been there less than 5 days, if they weren’t adopted or claimed by their owner, (which I swear never ever happened) they were euthanized on day 6.  I found out later that they routinely euthanized 70 plus animals a day. I spent a long time looking in those cages. This was a big decision and I wanted to make the right one. I had my boyfriend there with me. He picked out the small long haired cute grey kitten. She was almost irresistible. She was the obvious choice. I kept looking. In one cage in the second room in the middle of the racks of cages, there was a small, skinny  calico cat screaming. She had green snot pouring out of her nose and her eyes were all crusted shut. She was the cat no one would pick. I wanted her. I wanted her because she would meow and meow and meow. She wanted attention and she wanted a home. And I like anything that is assertive and demanding (no Freudian jokes! please?).  I asked the attendant if I could adopt her. she said she was too sick to be adopted, but I could put her on “hold”. If she was better she could be adopted. I was told that she had an upper respiratory disease that had turned into a lower respiratory disease and pneumonia. I filled out all of the forms and we left with one small grey kitten.

I called the shelter the next day. She wasn’t any better. I called everyday for the next 5 days. She was worse and not better. Finally on the 7^th day I went back to the shelter. I asked to see the manager. I explained that she wasn’t going to get better if she stayed there and I wanted to try to help get her better. I told her I would pay her adoption fee and take responsibility for her medical care. The shelter manager looked at me and I knew she was weighing whether or not she should break the rules for me and a sick cat. I took her skinny sick bony body home.

I spent the next months trying a lot of different antibiotics and running a lot of tests. She did eventually get healthier. She was always a petite cat, but she gained muscle and her coat got shiny and full. (I always tell my clients that cats get a poor coat within 1 day of being sick, so monitor coat quality closely). Her ocular (eye) and nasal (nose) green discharge also subsided with time.  But the one thing that never changed was her demanding meows. She would call for me every time I came home. It didn’t matter where she was. If she heard my voice she would scream for me. I always said hello to her cries, and she always came running for me. If I ever was upset, especially if I was crying, should would stand in front of me and meow until I stopped. More truthfully, until I focused my attention on her, but either way it always worked. Whenever there was an argument in the house she would stand between us and scream until we stopped. She really was my guardian and my most faithful companion.

I was so profoundly moved and concerned about the conditions at the Baltimore City Animal Shelter that I became their first official volunteer. I went to the shelter four times a week for 3 to 4 hours at a time to just walk the dogs and pet the cats. I was concerned because it didn’t appear that the animals were getting any attention from the over taxed overworked staff. After about 8 months I realized that I was really struggling with what I was seeing everyday. It was routine for them to euthanize 70 animals a day. I cried everyday I got home. I couldn’t carry this sadness and I couldn’t stop the death. I couldn’t help but get attached to these cats and dogs. I couldn’t bear not to see them the next day I came in. it burned a scar inside of me so deep that I changed careers at age 30. I spent 12 years in college so I could become a veterinarian. I bought my own clinic so no one else would ever have to tell me which pet gets a second chance and which one doesn’t.

D.C. died at the age of 19 in my arms, in my bed. She had struggled with chronic renal failure (kidney disease) for many years, and in the end she was too weak to stand. But she lay with me for two days and meowed every time I looked at her. It was so hard to say goodbye to her. Her fragile little body had lasted far longer than I ever would have guessed when I adopted her so long ago.

I went back to the Baltimore City Shelter a few years ago. I went into the room where I had found her.  I told all of the kitties there that I hoped that they found a loving home and that someone loved them as much as I loved my cat D.C.

For more information on chronic kidney disease in the cat please see the link below;

http://tinyurl.com/3bwedjy

If you would like more information on upper respiratory disease please see the link below;

http://tinyurl.com/3zelewn

If you would like more information on pneumonia please see the link below;

http://tinyurl.com/44jbebu