Farley passed away from us on Sunday, January 10, 2010 at 4:15pm.
He managed to survive through his sedation for an enema on the preceding Wednesday and again on Friday, but his blood tests revealed that he had become highly anemic, and his BUN and Creatinine levels were very high.
His ratio of red blood cells to plasma was 11%, where it should have been closer to 40%.
His potassium levels were too low.
He was dehydrated, which is what caused the constipation, and he had very poor muscle tone.
This result was very unexpected, because apart from the constipation, we felt he was doing fairly well. Our veterinarian advised us to euthanize Farley on Friday morning, but we were so shocked that we could not make that decision. We also felt that he needed to come back home before we could do anything like that.
After looking over his blood test results, I called another veterinarian for a second opinion. He was so forthcoming and helpful, even though he had never met us or Farley before. He reviewed the blood test, and his initial reaction was that Farley was dangerously anemic, but that he had a chance of rebounding a bit from his kidney failure. He advised us to take Farley to the Emergency Animal Hospital of Northwest Austin.
We immediately packed Farley up with blankets and a heating pad and drove him to the emergency clinic. They looked him over and repeated the idea that he had a decent chance at recovery from the anemia and we could monitor the renal failure through fluids. If we were successful, he would have a very good chance for a good, comfortable quality of life for a few more months. After thinking about this, we felt that we wanted to do what we could to give him a chance. He was still able to walk and move and urinate on his own, and we didn't feel like he was ready to give up the fight.
That night, we checked him in to the emergency clinic. They gave him a blood transfusion and began to give him fluids in an IV tube. His body temperature was very low, so he was put in a heated cage, and his IV tube ran through a heated block to keep the fluids warmer. We drove back and forth to the clinic to bring all of his medications for the weekend. They said that they would monitor him through Monday morning, and then we would take him to a normal vet for further monitoring and tests before we could bring him home.
Saturday morning, the emergency clinic called with good news. Farley's HCT count (blood cell to plasma ratio) was up around 30%--almost normal--following the transfusion. He had eaten that morning. They said the next step to try to encourage his body to produce its own red blood cells was to give him a synthesized hormone called Epogen. This would supplement the hormone production that his kidneys were failing to do on their own. Unfortunately, in time, his body would develop antibodies to the hormone, but he could have several weeks to a few months worth of success with it. Unfortunately, we had to go to our old vet to buy the Epogen. It was very awkward to go back there, because we were so angry with them for failing to properly test Farley before--even though we had brought him in SEVERAL times for blood tests for his kidneys and what we expected was anemia. The 2ml bottle of epogen was $109.
We delivered the epogen to the emergency clinic, and they started him on it. While we were there, we visited with Farley. We got to pet him in his cage. He was responsive and he rubbed his face against our hands when we touched him. We were thrilled and optimistic that he was doing so well so quickly--even though we knew all of this was just a "band-aid," and renal failure was eventually going to win. We just felt with these signs, he was going to make it.
Later Saturday night, around 9pm, we returned to visit Farley, and his potassium levels had returned to normal. He was on fluids steadily now, but unfortunately, he wasn't urinating enough. It was important for him to urinate to get the toxins out of his body. He was urinating some, but not as much as they expected. Even so, he was most responsive to us Saturday night. He even managed to walk around, and he climbed out of his cage into Jennifer's lap. We think he was just trying to escape, but it was so good to see him walking around and recognizing us. We left that night feeling very happy and with very high hopes. It was such a relief after just 24 hours.
On Sunday, we returned to see him around 12 noon, and everything was different. Farley was completely unresponsive. He was just lying in his litterbox. When I tried to pet him, he didn't move. When I tried to pick him up, he resisted, but he couldn't stand on his own. I called the vet over, and they immediately took him out to draw blood and test his levels. His potassium had shot way up, and his BUN and Creatinine had not changed at all. His body was swelling up with fluids, and he wasn't urinating enough to remove the fluids from his body. In other words, his kidneys really were failing completely, and his systems were shutting down. We were sitting on the floor of the emergency clinic holding Farley in our arms and petting him, talking to him, trying to get a feeling for if he had any fight left. We were crying and sniffling. His body was heavy and limp in my hands. He couldn't even hold his head up. They changed his IV fluids while I held him to take out the potassium supplements. As I was holding him, his body temperature dropped too low. It was down at 93F. It should have been up around 100-101F. I put him back in his heated cage and wrapped him in a towel. Sobbing, Jennifer and I went and sat in my car in the parking lot to try to come to terms with what was happening to our precious cat.
We had been so worried on Wednesday but he was better on Thursday after the enema. He didn't manage to pass any stool on his own on Friday, and our vet advised us to euthanize him while he was still sedated. We couldn't bear to do that, so we called for a second opinion and made one last final push to save his life. On Friday night, we had hope. On Saturday we felt like our hope was justified and our cat was going to make it through. On Sunday at noon, our hopes were gone. We cried and cried in the car. We decided we had to stop his suffering and we weren't going to subject him to more aggressive procedures. His chances for even a semi-normal life were gone.
We spoke to Farley's emergency vet, Dr. Chenault. She confirmed what we already knew in our hearts. She listened to us patiently and spoke to us very kindly. We had to fill out some forms and pay for the euthanasia. That part was very difficult. They took us back to a room and brought Farley in to us. He was still wrapped in a white towel. His head was out, his eyes were only partly opened, but he was breathing. He moved his head back and forth a couple of times to get more comfortable. We each took turns holding him so that we could whisper in his ears. We let him smell our fingertips. My tears fell on his head, and he flinched. I think we went through an entire box of kleenex. After we held him and stroked his tiny body. We pushed a button that told the vet we were ready.
She came in the room with the 2 syringes. Farley stayed in my arms the whole time. Dr. Chenault leaned over the table to reach Farley's IV line. I apologized for crying and told her I didn't want to drip snot on her. She said she was a vet who had kids, so it wouldn't be the worst thing that got on her. She gave Farley the first shot to sedate him. I got scared because he yelped at first and stood up in my arms. His eyes looked straight into mine. His pupils were dilated, he looked frightened, and I felt like I'd made a mistake. I petted him, and so did Dr. Chenault and Jennifer. Farley laid back down in my arms, and within a few seconds, I felt his head lie heavily in my palm. She gave him the second shot. And he didn't move. I asked her if that just took a couple of seconds, and she said yes. She put a stethoscope against his chest, and she nodded her head. She quietly told us that we could stay with him now as long as we wanted. She left the room, and we just sat in our chairs and cried. I looked down on him, and he still looked like he was sleeping. Two times, his body twitched and his lungs pushed his last breath out. We lifted his body up on the table, and covered him up in the towel. We pushed the button a second time, and Dr. Chenault came in. She delicately lifted Farley's body up in her arms, and held him close against her chest as she took him out of the room. We gathered up our things and walked out to our car.
We sat there in the car crying as I tried to calm down enough to drive home. I felt like I was in a fog the entire way. When we got home, we both fell on the bed and cried while the other cats came up and laid down with us. Our little family was incomplete without Farley there. It seemed so unreal and impossible after he showed so much promise just the day before.
That night, I went back into our living room. Farley had been staying in there since he came home from his first vet visit on Wednesday. We still had his bed and blankets and heating pad. His water bowls and food bowls were still there. His litter box was there. The little pieces of litter that he had tracked around the room were still there. His hair was on the blankets and the upholstery. His spirit still hung in the room. I wanted to hear his meow again. I wanted to pet his soft fur; to feel him raise his tail up as I ran my hand down his back, but he was gone. I slowly gathered up his bowls and set them in the sink. I gathered up his blankets in my arms and sobbed. I washed them and dried them and folded them in the chair where he used to sit and lie in the sun. I threw away his litter box and swept up the floor where the litter had been tracked around. I picked up all of these reminders of the last difficult days of his life.
But I still think he might be sitting on the kitchen rug or inside a cardboard box or sitting in a windowsill. I keep seeing the places where he would hide, and my heart breaks all over again. I keep feeling like he might be coming home someday. Lying in bed at night, I feel around on the blankets where he used to sleep before I fully wake up and realize he isn't there. We see lumps in the comforter and we have to put our hand on them to see if he is under there.
I don't think either of us realized how much he had become a part of our lives. We both work at home, and he was always here. He would sit in our laps or sit on our desks. He would get in the way while we tried to work. He would meow loudly when we were on a conference call. He would sit at the backdoor and meow to be let outside. And now, even with the other cats around, his absence is obvious.
There is a tiny, vacant spot where Farley belongs, and it keeps moving around the house. Reminding us that he isn't here. Reminding us how much we love him.
Little Farley, did you know how much we loved you? And how is it possible to have loved you so much? We didn't even know how much we loved you until you were gone, but we are so happy that we got to spend so much time with you every day.
