Saddle Thrombus and Euthanasia
Adina’s sudden onest of Saddle Thrombus and the sad end to her life.
When euthanasia goes wrong…
Adina, my dear beloved thirteen year old Blue Point Siamese cat was put to sleep on Saturday 26th November. Sadly her end was not a peaceful one.
On the morning of the day Adina was put to sleep, she was lying on top of my bed, when all of a sudden she stood up and staggered onto my pillow. I knew immediately something was wrong because she wasn’t walking properly and cried out, clearly she was in pain. I then coaxed her into bed to cuddle up next to me, but she couldn’t seem to settle and was shifting from one side to the other. She then got out of bed, flopped onto my pillow again and let out another distressing cry.
A couple of minutes later she went to cuddle up next to my other cat Lucca who also slept on my bed. I could see there was something definitely amiss with her hind legs. I shot out of bed to call the vet because my immediate thought was kidney failure. However, it was too early and so I had to wait until the vet opened at 8.30am before I could get an answer. There was only one appointment available at 10.50am and I said yes, I wanted to take it. When I came off the phone I immediately checked on Adina. She was now in her bed by the radiator so I decided to leave her rest there until it was time to leave. At 10.20am I placed her and the bed inside the carrier and that’s how she remained the whole journey, mewling all the way there.
Adina kept making distressing mewls in the waiting area so I removed her from the carrier and tried to comfort her. Then the receptionist came over to me and asked if I would I like to go into the middle room because she informed me a few dogs were due to arrive, which would obviously have made Adina more scared than she was. So my initial experience and the thoughtfulness of the receptionist was more than satisfactory.
After a few minutes wait, a young female vet came into the room. I expected her to perform the usual routine examination. However, as I was explaining Adina’s condition and asking if it could be related to kidneys, she was feeling around Adina’s abdomen. The first thing I mentioned was her more than normal thirst, which is a classic sign of compromised kidneys, but before I had time to tell her all the other symptoms, she said it could be thyroid and suggested blood work. I realised it could also be thyroid but no matter, I was more concerned about knowing what was wrong with her hind legs and the cause of her severe pain. So I then asked the vet if she would please get Adina on her feet and examine her back legs because, I said, “there is something radically wrong, she can’t stand on them without being in pain,” After standing her up she told me nothing other than to say, “yes, she is a bit weak on them.” She then switched her focus back to Adina’s abdomen and felt her ears and paws. Her circulation was poor because her ears and paws were cold, as well, she confirmed her kidneys had shrunk. So I was right about her kidneys.
The first thing every other vet I have ever been to, regardless of the problem, begins the consultation with a thorough examination while at the same time asking questions. This has included, placing a stethoscope against the heart, taking the temperature, shining a torch light into eyes, checking mouth, gums and breath and also the abdomen and glands.
So coming back to Adina…
Given the state of her kidneys and moreover concerns about the acute pain she was in, with no answers as to why her hind legs were like they were, I was left with my initial thoughts of kidney failure. I told the vet I didn’t want her to suffer anymore and so it was decided to have her put to sleep because no way could I take her home as she was. All she suggested was blood work.
Then began my nightmare experience…
The vet left the room and returned with a veterinary nurse. She told me she would sedate Adina to relax her (not that she was putting up any struggle) and commented it would sting a bit – I really wanted to know that!
She then left the room again and came back with the first injection. This was administered into the vein in Adain’s front leg but nothing happened, she continued to breath as normal.
She then left the room again and came back with a second injection, because, she told me, she had missed the vein.
Not good, I thought to myself.
After the second injection had been administered she assured me it did go into the vein.
Moments after Adina began to struggle. All four legs were kicking and she was trying to get up on her feet. As she did so the veterinary nurse pinned her down to stop her moving. At this point I was getting frantic with seeing Adina reacting like she was.
I glared at the vet and said, “what is happening to her, she should be going off to sleep not struggling!”
She remained silent.
I don’t think she knew herself what was happening or why it was happening.
I then pleaded with her, “please can you go and get a vet with more experience to come in and help, this shouldn’t be happening!”
She continued to remain silent and then left the room for a third time while I was left staring at Adina with the nurse still restraining her legs to stop her wriggling.
I was now beginning to think the second injection was not administered correctly either because why, I thought, was she struggling like she was. No way should that have been happening, she should have been going off to sleep not struggling.
The vet returned with yet another injection. All the time Adina was still alive and the nurse continued to hold down her legs. It was horrible to see and I was beginning to regret my decision, but it was too late.
This time she shaved some fur off one of her hind legs and began to feel around trying to find a vein. By now I was beside myself. I was beginning to feel like poor Adina was being slowly poisoned not put to sleep.
I couldn’t bear it any longer.
“Please,” I begged, “is there anywhere else you can inject her, I just want it to be over, why is she still breathing?” I questioned.
With that she told me she would inject into a kidney and so that is where the third and final injection was administered. Moments later, thank God, it was finally over. I couldn’t believe, why on earth at this point, she lifted up Adina’s lip and looked at her gums – what was the point in doing that now, I thought.
I have had cats all my life and so inevitably I have had to go through this dreaded ordeal with several cats and, although not easy, I have always been present with them up to the end. The only other traumatic experience I ever had was with one cat who developed a brain tumour and the vet ended his life by injecting directly into his kidney when he was fully conscious. As a result the last picture I had in my mind was that of my cat looking into my eyes and crying out in pain. Although it was over in seconds, it is not a very pleasant “final picture” and neither is it a painless way to end an animal’s life.
After that experience, I always requested to have the injection administered into the vein in the front leg and even although a few of my cats had poor circulation, which can make it more difficult to find a vein, each time it has been a painless and peaceful end. One cat in particular had advanced kidney disease with very poor circulation and even he passed away peacefully in my arms. Every one of these cats were given just one single injection.
Beforehand I explained to the vet the reason why I wanted the injection to be administered into the front leg and she assured me all would be fine. So I had a picture in mind of a painless and peaceful end for Adina too.
Had I known what was going to happen, she would have been back in her carrier in a nano second and I would have taken her straight to another vet.
In total she ended up having four injections, including the sedative. Why the vet even gave her a sedative I have no idea because she was a petite cat, a little sweety and was not putting up any struggle or doing anything to warrant a sedative. Besides, in doing so makes the vein harder to locate.
I have never had more than one injection administered into any of my previous cats. As well, I have never seen such a large syringe being used. Every other vet I have been to in the past always used a 1ml size syringe. This vet used a 5ml syringe and so in total Adina had 15ml injected into her body plus the sedative. I can appreciate the need to use such an amount with a large animal but, as I said, she was only a dainty little thing – smaller than your average sized cat. If 1ml worked for all my other cats, I really can’t understand why it didn’t for her. only that it didn’t because the vet kept missing the main vein.
The vet was young and so I have no idea what experience she had of handling such delicate procedures. She also didn’t know what was wrong with Adina, again possibly due to lack of experience.
In any case, I felt compelled to write to the top veterinary surgeon because I thought he needed to know what happened. I received a phone call from him the day he received the letter. He was very apologetic and also saddened to learn about my traumatic experience. Just from reading what I explained about Adina’s condition, he knew what was wrong. He told me all the symptoms pointed to a Saddle Thrombus (embolism). That explained why she was in excruciating pain. It is one of the worse things that can happen to a cat. There is no cure for it. It is a clot which lodges in one of the hind legs and causes extreme pain, which lessens over time.
However, what follows is even worse…
Due to lack of blood flow to the affected leg, it turns gangrened and the only solution then is to amputate the leg.
This is the dictionary definition…
Necrosis or death of soft tissue due to obstructed circulation, usually followed by decomposition and putrefaction.
Given Adina’s age and other health related issues, it would have been unfair and selfish to put her though such a major operation. Sometimes, no matter how painful, we have to do the right thing. Not what’s best for us but what’s best for our cat and there are occasions when it is kinder to let them go.
In Adina’s case, knowing what I now know, I did the right thing in letting her go. I did not however want her life to end in such an undignified manner. The disturbing ordeal lasted for fifteen minutes before she finally passed away, I only wish I could have had an appointment with the vet I spoke to because I am certain, in his experienced hands, Adina would have had a more peaceful end. I asked him why Adina was struggling like she was and he told me because the drug was circulating around her system and not in her vein it caused a stinging sensation.
But what’s done is done.
Finally… upon leaving the consultation room the vet said to me, “I’m sorry it took so long.” At least she had the decency to apologise, but no consolation to what I, and more importantly, Adina endured before taking her final last breath.
On the other hand, the vet who put Lucca to sleep on August 5th 2018, did so in a dignified and caring manner. His end could not have been more peaceful, which is what we all wish for our cats when the time comes to say goodbye.
My sweet little Adina is now at peace and free from pain, sleeping an everlasting sleep in her grave under a young Maple tree alongside her last cuddle buddy Lucca and also Rosie, my dear friend’s treasured cat. Her brother Cyrus is buried in the garden next door where I used to live.
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