What Matters Most
On Wednesday afternoon I called our shelter contact to tell her that Spike hadn’t improved since his visit to the vet on Tuesday morning. His breathing was still labored and he’d lost a little weight. We were still syringe-feeding him and injecting fluids every eight hours, so he was hanging in there, but the shot of Cephalexin he’d received at the vet and the Clindamycin he’d been prescribed weren’t helping yet. I told our contact that we thought Spike might benefit from hospitalization; if he could be put in an oxygen tent, maybe he could breathe easier until the meds had a chance to work.
Our contact consulted with the kennel manager, then called me back to say we could take Spike to a well-regarded 24-hour veterinary hospital in an adjacent county. It took me about an hour to drive Spike out there, since I had to contend with rush-hour traffic. Spike was taken back to the exam room while I waited.
When a vet came to see me, he said that Spike’s prognosis was guarded to poor. He didn’t have an x-ray to look at, but he could tell that Spike was quite congested in both lungs. All that congealed gunk makes it hard for the medication to reach the infection, which could be viral, bacterial, or fungal, he said.
“Really little kittens” like Spike rarely survive pneumonia, he said. I was struck by that characterization, since Spike weighed 2 lbs 9 oz, and to us any kitten over 2 lbs is big, with a reservoir of strength to draw on. So a minor red flag went up. The vet left to call the shelter and ask what they wanted to do based on his diagnosis.
He came back a few minutes later to tell me that after he’d discussed Spike’s condition with the assistant kennel manager, the shelter had decided not to continue care. The shelter would get in touch with me, he said, to discuss arrangements for euthanasia. He said that Spike probably wouldn’t survive even if he was hospitalized, and putting him in an oxygen tent with 24-hour care could cost over $500 per day.
I told him I understood completely; it’s hard to justify that expense for any one shelter kitten, let alone one with a poor prognosis. I went back to the waiting area and a few minutes later the receptionist gave me Spike’s paperwork. A tech came out with Spike in our carrier. I drove home feeling very sad.
A little after 8pm we got a call from our shelter contact, who told me that they had talked to the vet and that the shelter management had decided that Spike should be EU’d as soon as possible. I said I understood their decision, but asked whether it could wait until the morning. They said it was important to do it tonight, which made no sense to me. I asked again what harm would be done by giving him one more dose of meds and waiting until morning to see if he improved. No, our contact said. "We’ve decided to EU him tonight."
OK, I said, what would you like to do? We’re going to drive out there and get him, she said. What? Only after five minutes on the phone did I realize that the shelter thought I’d left Spike out at the hospital. Naturally, since they’d decided to EU him, they didn’t want to keep him out there with the meter running. I told them Spike was with us, and I was about to feed him.
Our contact seemed nonplussed. “They shouldn’t have given him to you,” she said. She said she needed to talk to her manager and would call me back. I went into the bunkhouse to feed Spike. When she called back, she spoke to Martha and told her I’d be expected to return Spike to the shelter the following day, preferably before they opened to the public at noon.
In the morning I sent e-mail to one of our 50K readers who we’d exchanged a few e-mails with. We’d learned that she lives about 30 miles away and has been fostering kittens for over 20 years. Her non-profit organization offers free care for the sickest and youngest kittens to a dozen shelters and 30 rescue organizations in three counties. She gets the kittens that are too young or sick for ordinary foster care, and she knows the people who wrote the book (literally) on shelter medicine. Based on our e-mail exchanges with her, we’d already concluded that she knew more about caring for the sickest and smallest kittens than anyone else we’d ever met.
In my message I mentioned the prognosis Spike had been given Wednesday night and the shelter’s decision to EU him. I asked whether I could drive Spike out to her house for her to assess him. I said I wanted her opinion on whether Spike was a lost cause, or whether she thought he could recover based on her knowledge and our care. I told her that if money was involved, the game was over for Spike. She gave me directions to her house and I drove Spike out there.
Her immediate reaction was “he’s a big kitten,” and I remembered how odd I thought it was to hear the hospital vet characterize him as “really little.” She also said “this is not a kitten I would put down”, and when I asked if she’d saved smaller kittens with worse symptoms, she said yes, many times. To her a “little kitten” weighed eight ounces or less. Spike weighed over 40 ounces. I recalled the vet saying that kittens with pneumonia rarely survive, and it occurred to me that it’s hard to survive if you’re EU’d.
I asked her what a kitten with pneumonia that was ready to be put down looks like, and she said that she knew it was time when the kitten couldn’t be held without thrashing around, and when she couldn’t get near it with a syringe. I described the piercing “death wail” we’d heard from Hobie and Drew, and she confirmed that that was another sign. Spike exhibited none of these signs of terminal distress.
She showed me how to use a nebulizer (which sends cool mist into a tented kitten’s lungs to loosen the congestion; by contrast our warm vaporizer produces larger droplets that don’t penetrate the lungs) and how to apply “coupage” to jar the gunk loose and stimulate the cough reflex. After the nebulizing and coupage, Spike was breathing easier. We fed him a little baby food mixed with A/D. She showed me a few tips on syringe-feeding and offered to loan me the nebulizer until Spike recovered. I thanked her and drove home, calling Martha at work en route to ask her to send our shelter contact e-mail explaining that we’d taken Spike to see an expert (at no charge) and that he was improving.
When I got home I put Spike back in the bunkhouse with his pals, opened the window and turned off the humidifier, and then sent a follow-up e-mail to the shelter describing my new-found optimism for Spike. I mentioned how lucky we’d been that this nearby expert had been willing to see Spike and give us life-saving advice at no expense. I thought the shelter would be thrilled to learn about this resource and hear that Spike could recover under our care without expensive hospitalization.
I was wrong. Within an hour I got a call from a shelter manager, who informed me that we had violated our foster contract. I didn’t argue with her, since I knew the contract had lots of restrictions on what we could do without contacting them.
She asked us to return all of their kittens as soon as possible, along with all their supplies. I said I’d call her back after I came up with a plan to do that. Ten minutes later I left her voice mail saying the shelter could send someone to pick them up anytime after 5:30pm. I nebulized Spike at 4pm, fed him, and then let him hang out with his pals while I collected and cleaned all our shelter supplies. An animal control van pulled up at 6pm.
I didn’t recognize the two officers but led them up to the bunkhouse to collect our six fosterlings. Their first reaction was “which one is sick?” They couldn’t tell from a quick glance at Spike; that’s how much better he looked.
They put him into a separate carrier, since they said they were planning on taking him to a hospital. When I asked which one, they said either the clinic a quarter-mile from our house (which we trust our own pets to and like a lot, but is rarely used by the shelter due to cost) or the 24-hour hospital I’d visited with Spike on Wednesday night, which had recommended EU’ing him and costs $500/day for oxygen support.
The van and our kittens were gone by the time Martha walked home from work. We spent a sad and frustrated hour cleaning all our kitten stuff.
Salem and Goblin are sleek, active and increasingly social black kittens who will soon weigh three lbs.
Dorian, Dierdre, and Dorothy are fat and happy tabbies closer to two lbs.
I’m not worried about any of them.
But I’m really worried about Spike, if he’s still alive. Who will syringe-feed him every four hours around the clock? How depressed will he feel in the hospital without us and his buddies? If he’s put in sick bay in the shelter, I think he’ll decline rapidly.
During the last week, Spike and I spent many, many hours together, both at home and on the road. When I handed him to a vet or a tech, he never took his eyes off me, as if he were continually seeking reassurance that things would be OK.
For a while I believed they would.
So we are finished with the shelter and have started the process of moving on. We invest time, sweat, and tears in the kittens we foster, and what matters most to us is that those kittens survive and thrive. We hope to find an organization where our efforts allow that to happen.
filed by: TS