Thursday, September 9, 2010

Case of the Week: Margie

To start off Senior Health Care Month, our case of the week focuses on Margie, our clinic cat. I adopted Margie three and a half years ago, two weeks after we opened the clinic. She had been living at Save Haven cat shelter for years and her age and history were unknown. She was thought to be around twelve at the time and was definitely a senior cat. She did not like living with the other cats in the house and spent all her time in a cat condo cage. Even though the door to the cage was left open, she never left it and did not allow other cats inside. As I am partial to calico cats, I was drawn to her and she yelled at me to take her home with me.

Safe Haven let me borrow her cage to set up in my office so Margie would feel more at home. It took her a few weeks to start venturing out of the cage and then a few months to take her first step outside my office. She eventually became comfortable enough to hang out at the front desk and wander the clinic, although she will still only walk to the back of the clinic when it is quiet. She is a cranky old lady that will bite if feeling annoyed. But she loves to rub her face on shoes and lick my computer and hand while I type.

Her medical problems have grown over the years. She needed a dental cleaning when she first arrived. She has had on and off vomiting and diarrhea, which has required different diet choices. Two years ago I diagnosed her with early chronic kidney disease and we switched her diet to include some of the renal prescription diets. Routine abdominal radiographs indicated mild arthritic changes in her hips and we started her on Adequan injections to help her joints. She became livelier and even started chasing imaginary bugs.

Her kidney disease gradually worsened. Six months ago, her kidney values had increased to moderate levels and she was not eating well. We started giving her fluids under her skin to improve her hydration and help her feel better. We also started her on Mirtazapine, an appetite stimulant that is given twice a week. Her appetite picked up and she became more active.

In the past month, she has declined in her activity level. Suspecting her kidney disease was worsening, I performed another physical exam on her and found a mass in her abdomen. We called Dr. Greene, an internal medicine specialist, into the clinic to perform an ultrasound. He found multiple tumors through her abdomen. Dr. Greene aspirated the tumor, using a needle to select a small sample to send to a pathologist. The pathologist diagnosed Margie with sarcoma, an aggressive malignant cancer that has no treatment except for removal. However, because the cancer had already spread throughout her abdomen, removal was no longer an option. It was a disheartening diagnosis.

So far, Margie is in good spirits. She has good days when she eats well, talks to me as much as usual, and rubs her face on everything she can reach. And she has days when she sleeps on the chair in my office all day. Her abdomen is slowly filling with fluid and she is starting to have difficulty jumping onto the chair. We continue her treatments for her kidney disease, trying to keep her feeling as well as possible.

Having a senior cat is difficult at times but so rewarding as well. Many people are reluctant to adopt an older cat, wanting to raise a cat up from a kitten. Yet so many older cats are just like Margie. They can certainly be aloof at first, reserved and distant as many cats are toward strangers. But given half a chance, they can become devoted pets. They have endearing personalities and lots of love to give is someone will open up to them.

The day when we will have to say goodbye to Margie is fast approaching. She has been a joy to have here at the clinic with us and we will miss her cranky demands for food and treats. She has been a great clinic cat, and I think she has really enjoyed her time here. I have no doubt that the last few years of her life were better at her new home, and we are better for having her at the Scottsdale Cat Clinic.

Dr. Judy Karnia

1 comment:

Janet said...

Thank you so much, Dr. Judy, for telling us Margie's story. It is very moving, especially as I am reading it through her photo posted in Flickr, after she passed away. Indeed she was a darling cat, with a unique personality, as all cats have, and she obviously loved you and her life at the clinic, and you made her last years happy and fulfilling for her. Its very rewarding to adopt an older cat; we have done that in the past. They are very grateful for the love we can give, and its a joy to watch them open slowly out, blossoming like a flower, with a loving home and good food. Margie will be in no pain now, and she will be busy telling the other kitties in Kitty Heaven what a wonderful life she had with you at the clinic!