About a month ago a sick cat was brought to my office. He had suffered from a day of lethargy and poor appetite. The person caring for him had become concerned as he gradually stopped moving.
The cat’s condition was very poor. He was profoundly lethargic — to the point of collapse — and dehydrated. His temperature was low. His bladder was massively distended and turgid. Even gentle palpation of the bladder elicited a pitiful groan of pain. The tip of his penis inflamed and covered with crystalline debris.
The diagnosis was immediately evident: The poor cat was suffering from urinary obstruction. Urinary obstruction is easily one of the worst things that can happen to a cat. It is linked to a condition called feline idiopathic cystitis, or FIC, also sometimes called feline lower urinary tract disease, or FLUTD. FIC is a mysterious condition that results in episodic inflammation of the bladder and the urethra. In all cats the condition causes substantial pain and suffering. But, due to their anatomy, male cats with FIC can suffer an even worse fate: Their urethra can swell and crystalline debris or mucus can block the urethra’s outlet. This makes it impossible to urinate. The result is agonizing pain, followed by kidney failure and electrolyte imbalances that rapidly lead to death.
The treatment for urinary obstruction involves placement of a urinary catheter with several days of hospitalization while the inflammation subsides. The treatment is intense and expensive — in large metropolitan areas it costs several thousand dollars to do it properly. Without treatment death is nearly certain.
I explained all of this to the person who had brought the cat. He needed treatment immediately. I don’t like to pressure people, but this case was urgent. Time was absolutely of the essence. And then came an unfortunate wrinkle in this already unfortunate case. The person who brought the cat was not his owner. She was a pet sitter. The owner was in Hawaii. She dialed his number and it went straight to voicemail. Twice.
This put the pet sitter in an extremely difficult situation. The cat was literally dying as we spoke, and an immediate decision was necessary. She would be on the hook for both the decision to treat and the expense of the treatment.
Such situations are frustrating and common. In fact, they’re frustratingly common. Cats get sick while under the care of pet sitters with incredible frequency. This type of scenario occurs at least once per week at my job. The pet sitter elected to move forward with treatment. Although she didn’t say it, one question was clearly on her mind. Was this situation her fault?
The answer, unequivocally in this case and in the vast majority of other similar cases I’ve seen, was no. Pets suffer from illness and medical crises at much higher rates while under the care of even the very best pet sitters. The explanation is simple: stress.
Stress is a risk factor for virtually every every serious veterinary problem known to science. Cats are generally creatures of habit. Mere separation from the owner can provide a camel’s-back-breaking straw to any brewing illness; it sometimes can be the only necessary trigger for an entirely new problem.
For instance, stress is a well known risk factor for urinary obstruction. Cats with stable kidney failure often go into crises shortly after their owners leave town. The insulin needs of diabetic cats change with stress; the result can be a ketoacidotic crisis. In dogs, dreaded syndromes such as gastric dilatation with volvulus (GDV, also known as bloat) and hemorrhagic gastroenteritis are highly linked to stress.
The pet sitter in the case in question opted for immediate treatment. Everything went well. The cat recovered; the owner, when he finally got cell service, was grateful that treatment had been performed and happily paid for it; the pet sitter’s guilt was assuaged.
But, with the summer travel season coming up, you do not want your cat to find himself in such a situation if at all possible. There are several steps that I recommend.
First, even if your cat has a medical problem, don’t feel that you need to be a hostage to your pet. You’re entitled to take a vacation.
However, even if your cat is perfectly healthy, understand that veterinary emergencies are common during owner absences. Of course you should make sure you choose a responsible, competent pet sitter. Confirm that she can recognize a situation that requires urgent veterinary attention.
Communicate your desires to your pet sitter. Tell her if your pet has been suffering with chronic kidney failure for years and you do not want to put her through major treatments. Conversely, she also needs to know if you want everything possible done for your cat.
Make sure your pet sitter has a contact number. Keep your cell phone on, and answer it regardless of the hour. Actual live contact with the owner is always best when dealing with veterinary emergencies.
Let your vet know that you’ll be out of town. Give the vet your pet sitter’s information and confirm that she is authorized to make decisions in your absence.
Put important things in writing. Leave a note with your contact information and a description of your desires. State that in your absence you authorize your pet sitter to make decisions on your behalf, and that you will not hold the pet sitter or veterinarian liable for competently performed procedures that fail. Provide a credit card number. Don’t leave the pet sitter on the hook for the expense of treatment.
Finally, don’t lose touch with reality. Although pets are more likely to get sick while their owners are out of town than under normal circumstances, remember that the overwhelming majority of cats — even those with pre-existing medical conditions — left with pet sitters do just fine. Plan for the worst, but hope for (and even expect) the best.
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