It was a Saturday morning, on a bank holiday weekend. I was just putting my suitcase in the car, heading away for a break, when I got a phone call from a good friend. Her kitten was not well.
Mimi, an adorable kitten aged four months, had gone off her food. She had been an enthusiastic eater, but for the past 36 hours, she had turned her head away when food was put in front of her. She had also lost interest in playing: she had stopped playing and had no energy: she sat in one place, quietly watching the world go by. She seemed very well in other ways, passing urine and faeces, and responding in a friendly way when she was approached. My friend was worried about her, so I said I would call around to take a look.
When I examined Mimi, I was very worried too. The signs she was showing were ominous. If a kitten loses interest in all food, and becomes dull, then it’s very likely that there is something very seriously wrong inside.
The most effective diagnostic tool that vets have is the simplest one: the physical examination. This can be done quickly, it doesn’t need the latest technology, and a large amount of information can be obtained. So I spent a careful ten minutes checking every tiny aspect of Mimi. Her eyes were bright, she was alert, the colour of her gums was a healthy pink, her temperature was normal, her heart and lungs sounded clear: there was a lot that was still very healthy about her.
It was when I examined her abdomen that I grew concerned. Normally, a kitten’s intestines can be felt through the abdominal wall, like a bagful of slippery eels. And kittens don’t mind you palpating their abdomen in detail. When I gently prodded at Mimi’s abdomen, she did not seem happy: for the first time in the examination, she miaowed. And while I could feel the slippery feeling of lots of normal intestines, I found there was one area where there was a thickening. It felt firm, like my pinkie finger, mixed in with the rest of her intestines. And when I gently squeezed this thickening, she miaowed again. I felt fairly confident that I had identified the source of Mimi’s problem.
There were two main possibilities, and the most likely was a so-called foreign body. Kittens love playing with small objects, and sometimes they swallow them. Their intestines are narrow, and many objects can lodge half way down, causing an obstruction. I asked Mimi’s owner if any toys or other items had gone missing, but she was certain that this was not the case. So what else could be going on?
The second possibility now seemed more likely: a condition called “intussusception”. This happens when one part of the small intestine is enveloped by another part: it’s similar to a situation where you hold the lower part of the sleeve of a jacket and pull it inside the arm of the jacket, as if you are beginning to turn it inside out. When this happens, one piece of the intestine goes inside another piece of intestine, and all sorts of terrible consequences follow. The blood supply to the affected intestines is disrupted, and the affected area starts to die off, like gangrene.
Unfortunately, this was a surgical emergency: without a prompt operation, Mimi would rapidly deteriorate and she would not survive more than 24 hours. I would need to refer her to the after-hours emergency clinic for the help she needed. She would need a thorough diagnostic work up to confirm this was definitely the problem, with bloods samples, xrays and ultrasound. She would need a full surgical team operating for several hours, and then she’d need intensive care follow up for 48 hours.
There was a risk she would not make it: up to 50% of cases do not survive, and even if she did there was a high chance that the same problem would recur. The cost would be up to €2000.
Her owner looked at me, in tears: she could not afford even a quarter of that. She was living on a static pension.
I offered the best options available, including payment plans, and cutting all costs to the most very basics, but however it was arranged, this was always going to be a pricey problem, and there was never going to be a promise that Mimi would come through it.
Her owner made the toughest decision: she asked me to give Mimi a sedative, and then to give her that final injection to let her go. I could not save Mimi’s life that day, but I was able to ensure that she did not suffer pain or distress.
These decisions are the most difficult ones that I have to make as a vet. The bitter hard reality of money is something that we would all love to dodge. I wish I could give every sick pet the best possible care, regardless of what an owner can afford, but it’s just not economically viable to do this. Mimi is just one of many similar cases that we see at my clinic every week, and while we always do our best to help, without funding, medical and surgical procedures are not always possible.
There is an answer: pet insurance. Mimi’s owner had planned to put this in place soon, but she had never expected a crisis to happen so soon, in such a young healthy animal.
Pet insurance should be part of the budget you put together for your pet: it can be a life saver.