This past week of tributes to Amber, and all the love, support, kind words and cyber hugs you’ve offered through your comments and notes, have provided great comfort for me during this difficult time.  Thank you, all of you, from the bottom of my heart.

Throughout this past week, I’ve been getting a lot of questions about exactly what happened to Amber.  Even though it’s difficult to write about it, I’m hoping that by sharing the sequence of events of her disease process, I may help other cats who may present with the same, or similar symptoms.  I am not a vet, and I’m writing this from my vantage point of being Amber’s mom – a mom who is still grieving.  Dr. Fern Crist has promised me an article on the calici virus which we think caused Amber’s illness.  It will run here on The Conscious Cat in the next few days, again, in hopes that it may raise awareness about this virus.

I’ve also gotten a lot of questions about whether I need to worry about Allegra getting sick, too.  While there are, of course, no guarantees, the answer is almost definitely no.  The most likely scenario is that Allegra might actually have been the carrier of the virus – chances are that she had a mild form of the disease when she was younger (her medical history is a bit sketchy, and she was also over-vaccinated, so who knows), got over it, and is now immune, but was or is still shedding the virus.

On Sunday, May 2, Amber was stilll fine.  She was starting to get to know her new little sister, who, at that point, had been with us for almost a month.  She had a full breakfast, and spent the day doing all her normal, happy Amber things – napping in the sunny spots, looking out the window, cuddling with me while I was reading.  When I offered her dinner that evening, she didn’t seem very hungry, but ate about half of her meal.  Later that evening, I noticed her making some gagging noises – as if something was stuck in her throat perhaps.  She was breathing fine, and she even purred for me, so I thought maybe some hair had gotten lodged in her trachea, and that she was eventually going to be able to clear it herself.  We went to bed that night, with Amber curled up in my arms, as she had been almost every night since she came to live with me on July 29, 2000.

Unfortunately, the gagging didn’t stop overnight.  She ate a few bites of her breakfast Monday morning, and then went to one of her favorite napping spots for her morning nap.  I called Fern to run these odd symptoms by her, and we both agreed that I would just continue to keep an eye on Amber.  If things got worse, Fern would come and take a look at her.  Things didn’t change much throughout the day, but the gagging got progressively worse throughout the night (why is it that anytime a pet gets sick, things always get worse overnight?).  I didn’t want to take her to the emergency vet.  I knew that her situation wasn’t life threatening, but I also knew that she was very uncomfortable.  To compound things, she also vomited a couple of times overnight.  By Tuesday morning, it became clear that she needed to be seen by a vet.  After examining her, running bloodwork and taking a series of x-rays, we still weren’t any closer to diagnosis.  Fern was hearing high-pitched sounds in the back of her throat, like her airway was constricted or partially blocked.  She also thought she saw some redness and swelling at the back of her throat, but without getting a closer look, there was no telling what was going on.  And in order to take a closer look, Amber needed to be sedated.  There’s always a risk with sedation, but the bigger risk seemed to be to not know what was going on, so I agreed.  The good news was that the exam revealed no tumors or foreign bodies, but her larynx was severely swollen, making it tough for her to breathe.  The treatment would require steroids and supportive fluids.  Normally, I’m not a fan of using steroids because of their longterm side effects, but in this case, something was needed to knock the inflammation down and make Amber more comfortable quickly, so again, I agreed.  Thankfully, I’m able to give injections and fluids myself, so she could come home with me.

She seemed to be feeling better on Wednesday, and I started breathing a bit easier.  Meanwhile, Fern had done some research on this odd presentation of symptoms, and thought this might be a variant of a particularly nasty strain of calici virus making its way through the cat community.  This calici virus was appearing in other cats that had similar symptoms:  laryngitis, followed by inflammation and swelling in other parts of the body, including pancreatitis.  The way to treat a virus like this is with supportive care.  We thought we were on the right track, and the virus just needed to run its course and work its way out of Amber’s system.

By Friday, she wasn’t any better.  Fern stopped by my house to take another look at her, and still didn’t see anything that would lead her to think that it was anything other than a virus.  We decided to see how Amber would do through the weekend with continued supportive care.

She had a quiet weekend, but she was clearly uncomfortable.  Every afternoon, she’d rally and have a brief period of renewed energy, which gave me hope that things were starting to turn around.  She’d walk around a bit, jump up on the back of the loveseat and look out the window, and then go back to resting comfortably on her favorite sunny spot on the sofa.

However, by Monday morning, it was clear that not only was she not getting better, she was getting worse.  That’s when we took her to the internal medicine department at the Hope Center for Advanced Veterinary Medicine.  Ultrasound and other examinations revealed that she had fluid in her chest and abdomen.  An echocardiogram showed that she was in congestive heart failure – an underlying heart condition we were not aware of complicated matters, and the steroids and fluids she had been given had pushed her heart too far.  She spent the next three and a half days in intensive care.  She was given intravenous fluids, concentrated nutrition through a nasogastric feeding tube, and antibiotics for a complicating bacterial infection.  Thankfully, I was able to visit her twice a day.  It was hard to see her so sick, but she responded to me each and every time I came to visit, and she even purred for me at times.   I tried to cling to the hope that she was going to get better.

Ultimately, the challenge of needing to treat her with aggressive fluid therapy without pushing her heart too far proved to be too much.  On Thursday morning, after she seemingly had a good night, she took a turn for the worse, and while there was more that could have been done, her prognosis was so poor that I decided to stop treatment and take her home.   Her wonderful doctor at the Hope Center agreed that this was the right decision.

Amber and I spent the next few hours together, just soaking up every last little bit of togetherness that we could.  For most of that time, she was curled up in my arms, in our favorite spot.  Fern would come later in the afternoon to help her make the final transition.

I was still having a hard time with my decision.  I knew the decision to stop treatment was the right one, given the circumstances.  I wasn’t so sure about my decision to euthanize that afternoon.  Perhaps there was still a chance she would get better on her own?  Miracles have been known to happen.  Maybe I could have one more night with her?  Fern told me that if I waited too long, fluid would continue to accummulate in her chest, and she’d die miserably, would, in effect, be drowning in her own fluids.  Of course I could not let that happen.  But Amber seemed so happy to be home, and she seemed comfortable.  She just didn’t seem that sick!  She walked around the house, as if reclaiming her space again, then settled on her favorite spot on the loveseat.  She seemed content.  She even purred for me!  When I went into the kitchen a little while after she came  home to open a can of food for Allegra, Amber jumped off the loveseat and walked into the kitchen, tail held high in the air.  I coudn’t believe my eyes.  I offered her some food, and she even sniffed at it, but then turned away from the dish.  Still, the fact that she was interested enough to come into the kitchen….  it seemed like a glimmer of hope.  A little bit later, a friend came over to say good bye.  She brought flowers for me.  I laid the flowers on the coffee table while my friend talked to Amber.  Amber jumped off the loveseat, then up on the coffee table, to inspect the flowers.  My friend and I were speechless.  How could she show this burst of energy when she was supposedly so sick?  Seeing her so interested in what was going on around her made it really difficult to believe that her body was being ravaged from the inside and that I needed to let her go.

However, as the afternoon progressed, her breathing became a little more labored.  She was still comfortable, though.  She climbed into my lap, and curled up for another nap.  She purred some more.  And yet, her breathing continued to worsen.  At around three o’ clock, I called Fern and asked her to come in a couple of hours.  Only two more hours left together.  My heart was breaking, and yet, at that point, I knew I had no choice.

I will always treasure those last two hours.  Gradually, I began to feel more at peace.  I got a sense from Amber that she, too, was at peace.  When Fern arrived, Amber was lying on my chest, sleeping lightly, and occasionally lifting her head to look into my eyes.  Since she still had her catheter from the hospital, we didn’t even need to disturb her.  Fern gave her the final injection, and Amber passed peacefully, looking into my eyes until the last moment.

26 Comments on Amber’s Last Two Weeks

  1. Pingback: Watch and Wait, or Do Something? « The Creative Cat
  2. Hi, I am desperately sorry to hear about your cat! I know how you feel as when one of my cats was run over last year (fortunately he survived but now has a manx tail and a permanent limp). It was touch and go for about a week as he couldn’t use his back legs and the vet thought he might be paralized. He was in a cage in my room and everytime I spoke to him and looked at him, all I could think of was “what happens if he doesn’t make it). To make matters worse one of my great cat friends told me not to cry in front of him. I don’t know how I got through it. I haven’t read your story as I know I will be crying for the rest of the day. Mty very sincere condolences to you.

  3. Sending out thoughts to you as you go through this difficult time. It is great that you have a way to express your thoughts about your time with Amber. Thank you for sharing the story of your decisions and Amber’s illness. I hope someone else out there can learn from it. Hugs.

  4. Ingrid, I am so saddened to learn of Amber’s transitioning. My heart goes out to you. You were a wonderful, loving caretaker of Amber and she loved you dearly. Her spirit has not left you, and she will always love you.

  5. When and if I ever need to make that end of life decision for one of my treasures, I am now 100% sure that the last face they see before they close their eyes for the last time, will be mine and it will be at home.

    Quality vs quantity is my theory and suffering is never an option. You knew her better than anyone and made the right decision for her and I’m sure she communicated, in her own way, what she wanted.

  6. Thanks for you beautiful words, Tamar, and for all your support. I do draw quite a bit of comfort that at least she got to come home, even if only for a few hours.

    Thank you for your support, Esme. It will take time for the emotions to become less raw – it’s still so fresh.

  7. I am crying just reading this and appreciate you sharing the story with us. While I am sure you never know if you are making the right decision when you choose to let a pet go to another place you are when you are putting their needs above yours. Amber is fortunate to have had you as a mama and to have been loved. I know it takes a long time to get over these emotions and I hope that you can find some peace. Thank you for stopping by.

  8. I am in Spain as I read this – can’t sleep – and am sobbing. I can’t imagine how difficult writing this post must have been, and the decision to let Amber go. How wonderful she was able to pass not only in her own home, but with you snuggling her. Sweet baby. I’m so sorry for your loss and how hard the last few weeks must have been. Just think of all the love she brought you and how lucky she was. You will see her someday. It must be hard to know/think that Allegra could have given her something but you can never know these things. You have clearly been an amazing mommy, and are a caring warm sensitive person. Thank you for sharing your story.
    T

  9. This answered a lot of my questions. Every bit of feline vet info is useful. It’s the hardest thing to know what action to take with ill pets who can’t speak. You not only did the right thing, but to have those two precious hours in the comfort of your home and not a hospital was the best call in a terrible situation.
    (((hugs)))

  10. Bernadette, thanks for the reassuring words. It’ll be a while before I’m at peace with this, but writing about it did help. I’m glad to hear Kelly is doing better.

    Teri, thanks for sharing that writing about your husband after his death helped you. I don’t know that I would have vaccinated against VS-FCV even if I had known about the vaccine prior to what happened with Amber. It’s such a tough call, and with a mutating virus, there are no guarantees that a vaccine can protect 100%, either.

    Laura, thank you for your beautiful words – they bring great comfort.

    Daniela, thank you for your support.

    Cindy, I’m so sorry about your Noelle. Go hug your babies extra hard for me.

  11. Oh Ingrid, I’m heartbroken for you. Sitting here with my two sweet kitties I’m remembering losing my wonderful sweet girl Noelle about this time last year. My girl fought a valiant fight like your Amber but died in my arms looking in my eyes. It was that moment that sustains me and I know it sustains you as well. Thank you for writing so honestly about Amber’s struggle with the calici virus (I’ve never heard of it) and am looking forward to more info about it. Hugs and peace from me, Coco (a shelter rescue) and Sophie (found abandoned in the road).

  12. Omigod, Ingrid, I can’t imagine your pain writing all this. I’m so sorry, my dear. My heart is broken.

    And about the euthanasia, I’m sure you made the right decision. You are so caring and loving with your cats, and you also have the knowledge and sensibility to make this decision.

    Be in peace, my friend. You did everything you could for her.

  13. Ingird-
    My heart trembles for what you have just gone through. I know how excrutiating your pain is and all my love is with you. Your words are a comfort to so many. You truly have a special gift as did Amber in being a muse for you.
    Lots of love and hugs always,
    Laura

  14. Ingrid,

    Writing this, to help others, shows the true love in your heart for Amber, too. After my husband passed away, I knew there where people who were reluctant to ask what happened, and so I wrote it all down and emailed and put it on my blog, too.

    In a way, it was one of the most difficult things to do, so close to his death, but I also in a way, thought I was maybe helping a few people ‘learn’ and also helping them heal in their grief.

    I knew about FCV and VS-FCV, and heard from some of the pharmaceutical reps that come through out clinic of losses at other practices, but had never ‘known’ a cat who had the virulent strain…til Amber, and because of her book and meeting you, I do feel like I knew her!

    Breeding cats, as well as working in at a feline only cat practice, and always surfing the web for info to help both myself and our clients, I am torn between vaccinating for VS-FCV or not. I am not attending cat shows any longer and I have a ‘closed’ cattery, so am not bringing in new cats and some of those decisions are based on concerns about disease.

    UC Davis has a great website and info on ‘shelter medicine’ which I am certain you know of, but your readers may not be. And as I always say, the best pet owner is an educated one.

    http://www.sheltermedicine.com/portal/is_vsfcv.shtml

  15. That last glimmer of hope makes the decision agonizing, but Amber let you know it was the right thing to do and that she welcomed it. She even acted as normal as possible that day for herself and for you, glad she could be with you when she knew this day would be her last; she wanted your last memories of her, and her last memories of you, to be the things you loved most about each other. I remember how cathartic it was for me to write about Namir last summer, and I’m sure this helped to ease things just a little for you. And it’s happened to me that a cat I chose to foster apparently carried a disease that took one of mine, you just never know.

    I’m also glad you could compose yourself enough to write about it in a way we could understand. I wanted to hear more about the calci virus, and I look forward to Dr. Crist’s article. This past Sunday morning (yes, the timing thing), my Kelly evidenced the same symptoms with a 104 fever and I started her on fluids and antibiotics but it was Tuesday morning before she ate anything. She’s apparently fine now, but I also noticed a slight gagging response in her swallowing and I’m still keeping an eye on her. No new cats or even visitors, but I was at the Sheep and Fiber Fest on Saturday communing with all sorts of farm animals. A few others of my cats have come down with other viruses through the years that they could only have contracted through me in a similar way.

    Our thoughts are with you.~Bernadette and family

  16. Thanks, Mason.

    Marg, I’m glad I was able to answer some unasked questions for you. Hopefully, Dr. Crist’s article will answer some more.

    Tammy, thank you. It just always feels like there should have been more I could have done.

    Linda, thank you for your beautiful words.

  17. Oh Ingrid, I can barely see the screen. My heart is just aching for you. Yes, Amber is at peace but I know how tortured you feel. You did do the right thing, you couldn’t let your precious girl suffer. It was so quick, it’s so scary. I’m so sorry that you had to go through this and that your heart is so broken. As I say to people at the clinic who are there for their kitties final moments “this is the right thing for her but it sucks for you”. You did the most loving and unselfish thing that anyone can do for a beloved pet. God bless you for giving her the freedom to move on to a more comfortable and pain-free place. She will always be in your heart and how happy that day will be when you are all connected once again.

  18. A beautiful, honest piece, Ingrid –you did everything you possibly could for your tortie girl and then some. The fact that Amber kept her eyes fixed on you till the end says it all.

  19. Oh gosh, I don’t know how you wrote that. I sure had a hard time reading it. It is all so sad. But I am so glad you did write it because I sure want to know more about this virus. I am looking forward to Dr.Christ writing about it.
    I truly do feel like you did the right thing. We all know looking into the cats eyes just how they feel. I am sure coming home for Amber just lifted her adrenalin for a short time and that is why she was walking around. It sounds like she was ready to go.

    Glad to hear that Allegra cannot get it. I was worried about that too.
    Hope you can have a good week end.

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