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Maryam | 2 months ago
Hello All, I Posted On Here Earlier This Year Asking For Some Advice About My Cat …

Hello all,

I posted on here earlier this year asking for some advice about my cat who had a very advanced cryptococcosis infection.
Her right lymph node (submandibular) was swollen the entire time, and the left one but to a lesser degree.

She developed anisocoria and horners syndrome, droopy right eye, and she had a mass that felt like bone on top of her eye.
The anisocoria disappeared after 3 days and her pupils were entirely normal again.

Things escalated last week. Her nose has always been blocked, to various degrees, since she developed the symptoms, 1.5 years ago, but it seemed like she was able to get enough air in with some gasping and mouth breathing. I didn’t know how comfortable she was, but I had to try the last recommendation the vet suggested: 150mg of fluconazole a day. She was on this massive dose for 3 months. (4 kg cat)
Previously, she was on 37.5mg for 6 months, her nose and lesions cleared up and she was able to breathe again (most importantly!)
But, in March, a big lump (cryptococcosis mass) exploded into an abscess. It wouldn’t heal. The vet performed surgery to remove it and other lesions nearby. It was an eyesore, I felt so bad for her. She had a cone on for nearly 3 weeks because the suture area got a bit infected. Raised her fluconazole dose to 75mg a day.

Last week, her nose got much more inflamed and distorted very rapidly. It began bleeding and ulcerating, drying up and then bleeding repeatedly.
She looked so uncomfortable and basically slept all day in various positions to keep her head elevated. When near me or when sleeping with me at night, she’d clamp onto my arm or neck with her teeth to keep her mouth open so she could breathe and fall asleep. I can’t fathom how difficult it was to sleep having to make a conscious effort to get air in through her mouth. I understand cats are not “mouth breathers” and can’t fully relax that way.

I took her in to see her vet, 11 days ago, after noticing blood on her paw, and no wound. The vet looked inside her mouth and looked said the fungus was pushing through her soft palate (roof of mouth) into her front teeth. She recommended euthanasia and said she was not going to “get better” in her professional opinion. And that my cat was suffering and it wasn’t ok, I asked outright if her quality of life was ok. She said no. My cat had lost 1 kg since her last visit. This also factored into the vet’s recommendation.

The vet was ready to put my cat to sleep at the time of our consult, but I requested some time to digest and take her home to say goodbye.
Then, 4 days later, I took her in for euthanasia. I wish I had canceled. Am I wrong to feel that she should have died on her own terms?
What she had was like a breathing disability, in other ways she was a strong and vital cat. She was still eating, though appetite decrease by 30 or 40%.
Why did her nose not clear up (while the cutaneous lesions cleared) and in fact get worse after 3 months on a higher dose?
I’m so devastated and confused and wish I could have done more to save her life.
I felt selfish for letting her live this way, knowing there was no hope and I’d just be prolonging the inevitable (probably suffocation).
I am in so much pain recollecting what’s happened.

I wish I had kept her at home and only taken for euthanasia if she had collapsed and refused to eat. Taking her in to have her put down when she still asked to be fed, showed playfulness in some moments, trotting around when it was food time, it felt hasty but also inevitable. I felt I was saving her from experiencing more suffering as the fungus grew.
But, I will never know how it would have gone if I left her. Maybe nature would have performed a miracle, and she would heal, or she would die without my intervention and without pain (like a quick heart attack). I feel so terrible for having made the choice to snuff out her little life when she was still very strong.
She fought the sedative the vet gave, they took her back to insert a catheter and didn’t bring her to me until 40 mins later, saying she was fighting the sedative.
It pains my heart thinking she was in terror during her last hour on earth. When they carried her in, sedated, she looked absolutely petrified and braced. I could see her spirit fighting with all its might.

The vet told me that she had a more thorough examination of her nose and that the masses had hardened/were like concrete all through her nasal airway and that she was breathing through a “pin prick” hole. She said she was never more certain that euthanasia was the right choice.

I am so heartbroken. I still feel like I took her life away too early. Why should it be up to me? I can barely trust myself now.

2 Responses

Comments

  1. Krista Magnifico

    Hello,
    Based on your description and the photos I feel about as confident as I could that this was a cancer in the nose/face/brain and that you did the right thing.

    No matter how much money you would have had, or how many specialists you could have brought her to she was not able to survive or get better with this.

    I am so sorry. I do believe you did everything you could have and that your cat was so lucky to have had someone who loved her as much as you did.

    Sending love and condolences.
    Krista.

    1. Maryam Post author

      Thank you for your input, Dr Krista!

      It never occurred to me that it might be cancer. She had a biopsy done last year (for the cutaneous lesions) and it came back positive for cryptococcosis. They didn’t want to touch her nose or interfere with it, since it was so sensitive. Once she was on fluconazole, her nose response (clearing up) was so rapid, within 3 weeks all the crust, nasal bridge disfigurement and inflammation had virtually disappeared. She was breathing well. That was on 37.5 mg a day.
      When she developed a big ulcer on her side, and then later her nose starting to inflame and ulcerate again, I felt so solemn about it all. Previously she was in what appeared to be a “stall” state with her nose. Upping the dose did not do a thing, imo. It continued to worsen.

      Could it have been fungal AND cancerous? My theory was the fungus developed resistance to the meds, and also was far too embedded to loosen its grip. In months past, I looked up nasal cancer to get an idea what that looks like but it didn’t seem to fit her. Also looking it up because I was so worried about her not being able to get air in, and whether this was humane, while we searched for a cure. Cryptococcosis cases in cats are not well documented online. I have not yet found one where the cat’s nose was so blocked up, from nostrils all the way up, like hers was.

      She was very loved, I am amazed at her resilience and that is what also hurts. She was so intense and sensitive, with immense all-round hardiness. It really felt that whatever was afflicting her was not going away.

      Thank you for your reassurance. I felt I took her life too soon, and also concerned she was not comfortable. It’s challenging to separate what I want and see her /the situation objectively and compassionately.