Zack has lived a big, large life. He’s 20 years old. He’s outlived the rescue facility in Texas, which no longer exists (we looked — we wanted to see where his life began to turn for the better). He was ours when we were young and wild in our twenties. He’s now witnessed the birth of our two kids and as we close in on 40. People come and go in your life. Zack has been a constant. We can’t picture life without him because he has imprinted himself into our existence.
Until the day came that we began the process of saying goodbye.
We were at the kitchen table, when Zack lost the ability to walk in his hind end. Just like that. It’s called ataxia. I’m a veterinarian, so I try extra hard not to let my partner see the devastation I feel inside, because I know where this is going. I don’t tell her that he might not be coming home as I pack him into the car and take him to my clinic. There is a glimmer of hope in her eyes, and I am not going to be that guy — the one to extinguish it.
One thing is clear. We will not let him go without trying. He is part of our little tribe. He has earned our respect for just being who he his. So his age becomes irrelevant as we begin to figure out what to do. Old age is not a disease, right?!
The first thing, always, is to quickly gather basic minimum information. A physical exam, X-rays, and bloodwork. This is technical information designed to tell us if there are any red flags (catastrophic dysfunction or situations causing unmanageable pain) that is likely to cause suffering. Zack’s diagnostics didn’t come back perfect (they never do at this age), but we also didn’t see any “red flags” on his diagnostics. He was depending on us to put the right things in place for him. To give him a chance. To dig him out, when he was one paw in the grave.
Zack likely had a stroke within his spinal cord, causing his inability to walk. I developed a treatment plan, and decided to give Zack at least a week to see what his body and mind could do.
Zack’s 10 treatments are as follows:
Treatment 1: Adapt his environment
We took a trip to IKEA, and dressed our living room with softer surfaces and bright primary colors. We chose materials that were easy to clean and designs to boost everyones spirits. We customized an under-the-bed storage container from IKEA to make a large, easy-to-enter litter box. We put water and food close by for easy access.
Treatment 2: Involve the family
We wanted to treat his illness, but also to celebrate his life with us if this was going to be his last week. Everyone, even our three-year-old, helped with giving Zack his treatments. We wanted to teach our daughter that there can be dignity in old age, and even in death.
Treatment 3: SQ (subcutaneous) fluids
Giving SQ fluids to Zack rehydrated him, reduced nausea, and increased safety when giving multiple medications. It is a technique that anyone can learn. When you give them fluids, you give them a chance.
Treatment 4: Cerenia
This medication does not directly do anything for his ataxia. So why use it? Because it’s not just if Zack can get better, it’s also how he feels about it while we try. This medication eliminates nausea, vomiting, and can possibly reduce pain, improving how he feels while we try and address his ataxia.
Treatment 5: Pepcid AC
Eat too much pizza and you can’t handle gluten? Spicy indian didn’t go to well? Heartburn much? Yeah, it’s the same stuff in injectable form that we used for Zack. Just like with Cerenia, it doesn’t directly do anything to improve his ataxia. But it improves how he feels, which matters just as much.
Treatment 6: Metacam
This is a pain reliever and anti-inflammatory. This could directly improve the issue in his spine. It’s a sweet tasting syrup we gave him once a day. The SQ fluids and Pepcid AC make giving this safer to cats.
Treatment 7: A single dose of buprenorphine
This is a narcotic, and it helps ensure that he does not experience unmanageable pain. How do you know if cats are in unmanageable pain? They stop eating, show odd postures, breathe faster, have higher heart rates, or cannot focus on anything other than the medical problem causing them grief. Zack never experienced this, because we used buprenorphine. It can make them drowsy, though.
Treatment 8: Mirtazapine, nutrition, Vitamin B12
Mirtazapine is an antidepressant, which has the awesome effect of stimulating appetite. Sick cats have an increased requirement for food. They need protein to rebuild their bodies. If they go off their food, their condition can get worse, and their liver could get in on the act and create a new problem for them. So by using mirtazapine with high-quality proteins (I used Rayne GI) and vitamins, we help Zack helped himself.
Treatment 9: Gabapentin
This can relieve neuropathic pain. Neuro what? This is when pain comes not from your joints or muscles, but from your spine and nervous system. It is the worst sort of discomfort imaginable. This is when we wish animals could speak in full sentences, because it’s incredibly hard to definitively diagnose this without words — but we have our ways. I gave Zack the benefit of the doubt and used it.
Treatment 10: Laser therapy
This is designed to enhance wound healing and reduce pain or inflammation. I applied this over his spine. I also used it on all of his joints in an attempt to alleviate his ongoing arthritis. Pain can be accumulative. So, you treat ALL of their sources of discomfort to further become successful with their main problem.
We did all these things for a week. Win or lose, at least we tried. Yes, he is an old cat. Yes, he might not live that much longer. I watched Lilo & Stitch with my little girl when all of this was going on with Zack. Lilo says, “Ohana means family. Family means nobody gets left behind or forgotten.”
Six days later, Zack got up and walked
I could and couldn’t believe it all at the same time. He’s not as physically strong as he used to be. But the look on his face and desire to do all the things he once did tells us that he’s back. He just needed some help along the way. By eliminating the red flags, not treating old age as a disease, and respecting his place in our lives, we did the right thing. Win or lose.
Here’s a video showing Zack’s remarkable progress.
All photos of Zack and family courtesy Dr. Kris Chandroo.
About the author: Kris Chandroo is a veterinarian who lives in Ottawa, Canada, with two little humans, a big horse, 30-year-old turtles, and a cat. He shows specific techniques designed to help cats live longer, and writes regularly at I Will Help Your Cat. Sign up for his newsletter and follow Dr. Kris on Instagram.