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When do you "call it a day"?



 
 
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  #21  
Old April 22nd 09, 01:42 AM posted to rec.pets.cats.health+behav
dejablues[_4_]
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Posts: 110
Default When do you "call it a day"?

Eddy wrote:
I would like to know various people's views on when one should "call
it a day" when a beloved pet has a very serious illness.

If increasing part of the medication to maximum level will give the
animal good quality of life for a large part of the day though in the
end the side-effects of that large increase in medication will cause
additional complications, do you give the animal that extra
good-quality time and wait until the additional complications set in?

Do you say that it is good that increasing the medication has largely
removed the animal's suffering but while the animal is now in this
good window you should put him to sleep, rather than wait for the next
down-turn?

Or do you say that in spite of the increased medication the animal
remains below par, below normal health, and should therefore be
relieved of life without more ado?

Or what?

We are having a tough time here. One thing is certain. This fine
young cat could have been put to sleep a month ago when it was found
he had "very serious congestive heart failure" but since then,
because of the medication, and increases in his medication, he has
enjoyed some very happy days frolicking around in the sunshine,
devouring good food, and luxuriating in front of the fire.

Eddy.


"Frolicking" is subjective. "Luxuriating" in front of the fire is what every
cat loves, but a cat in chronic heart failure will have poor circulation and
will feel cold, so heat-seeking behavior, more than the average cat does, is
not a good sign. As long as he's eating and drinking, he's probably OK. When
he stops eating and drinking, it's time.
Please do not let your cat suffer and die at home, because it is a slow
death.

We bought our late beloved HCM cat about five more weeks with medication,
and sadly, he spent his last week in the hospital under heat lamps with IV
meds and nutrition, to no avail. I don't even want to tell you how much it
cost.
At least they didn't charge us for the euthanasia.


  #22  
Old April 22nd 09, 11:07 AM posted to rec.pets.cats.health+behav
Eddy[_2_]
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Posts: 72
Default When do you "call it a day"?

wrote:

Eddy,

A suggestion to help with medicine costs: have you checked pricing a
different place? Walmart and Sam's Club generally have cheaper
medications. Ask your vet for a prescription (if he's taking human
medications) and shop around.

A comparison: My vet charged $21 for 20 pills of turbuteline (a
broncho diolater). I was able to get 30 pills at Walmart for $17.xx.

You could potentially save a lot of money by doing this.


Thanks, "rschweitzer" for this. Bought another month's supply of drugs
yesterday for 30 US dollars, plus a further stack of tins of tuna and
pots of natural yoghurt to embed his medication, as well as the normal
tins of cat-food. Pricey indeed, so I appreciate the suggestion about
trying to get the drugs elsewhere. The thing is we're in a very
isolated rural spot here and the closest vet is a 20-minute drive away.
The next vet after that is 30 minutes drive away. So we couldn't really
chop and change vets in the future, if we wanted to, which we don't.
Our vet is genuinely concerned and very good. Her practice is not a
wealthy one. People in this area don't have much dosh. I think that if
we were to ask her to let us continue to consult her but not to buy the
drugs from her then she would not be too happy, and she might well then
feel she should charge us for chats and emergency phone-calls etc.,
which at the moment she is not. So I think we need to stick with our
vet and buy the meds from her at her price.

Eddy.

  #23  
Old April 22nd 09, 11:10 AM posted to rec.pets.cats.health+behav
Eddy[_2_]
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Posts: 72
Default When do you "call it a day"?

cindys wrote:
And for the medications that are not human or are human but only in
much larger doses, try 1-800-PETMEDS.

I get my cats' Tumil-K (potassium supplement) from Pet Meds: 100 pills
for $21 rather than 100 pills for $38 (at my vet). All orders over $39
are shipped for free.

The furosemide 2.5 mg and enalapril (can't remember the dose off the
top of my head) are about half the price the vet charges.

I was paying my vet $8 for 100 gelcaps, which are clear, empty
capsules (I combine the pills in one clear capsule so the cat is
getting one pill rather than four). At the Capsuline website, the
gelcaps were 1000 for $16. I am currently using size 2. IIRC, the
shipping was free from Capsuline as well.
Best regards,
---Cindy S.


Thanks, Cindy, again. Please see my reply to rschweitzer above. Can I
ask you how your vet reacts to knowing you are going elsewhere to buy
meds. Maybe your vet practice is in a different situation/context from
the one we have here, though I suppose we could always arrange to see
our vet, sit down with her, and explain that we are not in a position to
pay their prices and would she mind, even recommend, us buying
elsewhere?

Eddy.

  #24  
Old April 22nd 09, 11:25 AM posted to rec.pets.cats.health+behav
Eddy[_2_]
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Posts: 72
Default When do you "call it a day"?

Hi Cindy.

Thanks. You clearly believe so strongly in this that I will wait till
the coming month's meds run out and when returning to the vet to get the
next month's will broach the Plavix possibility - ask what they think,
do they supply, at what cost, etc.

Thanks too for the pill-popper suggestion. Have considered it before
but can see that it would be too stressful for us and for the cat - just
getting into position alone. The tuna and the yoghourt work
beautifully, despite the price.

Eddy.

  #25  
Old April 22nd 09, 01:54 PM posted to rec.pets.cats.health+behav
cindys
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Posts: 592
Default When do you "call it a day"?

On Apr 22, 6:10*am, Eddy
wrote:
cindys wrote:
And for the medications that are not human or are human but only in
much larger doses, try 1-800-PETMEDS.


I get my cats' Tumil-K (potassium supplement) from Pet Meds: 100 pills
for $21 rather than 100 pills for $38 (at my vet). All orders over $39
are shipped for free.


The furosemide 2.5 mg and enalapril (can't remember the dose off the
top of my head) are about half the price the vet charges.


I was paying my vet $8 for 100 gelcaps, which are clear, empty
capsules (I combine the pills in one clear capsule so the cat is
getting one pill rather than four). At the Capsuline website, the
gelcaps were 1000 for $16. I am currently using size 2. IIRC, the
shipping was free from Capsuline as well.
Best regards,
---Cindy S.


Thanks, Cindy, again. *Please see my reply to rschweitzer above. *Can I
ask you how your vet reacts to knowing you are going elsewhere to buy
meds. *Maybe your vet practice is in a different situation/context from
the one we have here, though I suppose we could always arrange to see
our vet, sit down with her, and explain that we are not in a position to
pay their prices and would she mind, even recommend, us buying
elsewhere?

----------
Well, I'm sure our vet would prefer that we get all the meds from her
(the ones she carries anyway), but when we don't, she doesn't say
much. I have never discussed it with her. I simply told the
receptionist that we would be getting the medications from PETMEDS
(where applicable). We are certainly not the only family who shops
elsewhere (the receptionist told me it was quite common for clients to
get meds elsewhere). A lot of people must be doing so, as 1-800-
PETMEDS is a booming business. When you place an order with them, they
phone the vet for you and request the prescription. Additionally, the
vet doesn't dispense everything, and it is not unusual for her to
write us prescriptions to be filled in a local drugstore. For sure,
she doesn't dispense Plavix. My cat is on the following meds (I've
indicated which ones I COULD be getting from her). The last three she
simply doesn't carry, and we couldn't get them from her even if we
wanted to:

Tumil K (available from the vet).
Enalapril (available from the vet).
Furosemide (available from vet).
Clear empty capsules (available from vet).
Plavix (she wrote us a prescription to be filled elsewhere). At my
request, the vet office faxed the prescription to the Canadian
pharmacy.
Diltiazem (she wrote us a prescription to be filled elsewhere).
Lactulose (she wrote us a prescription to be filled elsewhere, but it
is sold over-the-counter in Canada).

(When we had a cat who required Lantus insulin, we had to get that
from the drugstore as well).

Our vet practice is a very wealthy practice with multiple offices. The
veterinarians who work in each office are considered part owners.
(FTR, it's not one of the national chains. It's a local business that
simply grew over the years. The original vet retired and started
selling parts of the practice to the vets who worked for him.)

I don't feel bad about buying meds elsewhere because the practice is
wealthy and because we currently have four cats, one of whom is
currently elderly (i.e., lots of vet visits). We have had several
elderly cats in the past few years (two of whom had CRF and one who
now has the cardiomyopathy), so that's a lot of medical care. That's a
lot of checkups, grooming, dental procedures, x-rays, etc. This other
stuff more than makes up for the loss of profit on the meds.
Best regards,
---Cindy S.

  #26  
Old April 22nd 09, 01:59 PM posted to rec.pets.cats.health+behav
cindys
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Posts: 592
Default When do you "call it a day"?

On Apr 22, 6:25*am, Eddy
wrote:
Hi Cindy.

Thanks. *You clearly believe so strongly in this that I will wait till
the coming month's meds run out and when returning to the vet to get the
next month's will broach the Plavix possibility - ask what they think,
do they supply, at what cost, etc.


I promise you your vet doesn't supply it. But Cornell recommends it
(as did my mother's cardiologist). Aspirin is not just as good at
preventing clots. If your vet agrees you should try it (and why would
she object?), you will not be able to get it from her. The Canadian
pharmacy is going to be cheaper for you than anywhere in the USA.
(Plavix/clopidogrel is not available at PETMEDS either). Again, it's
because the generic is available in Canada but not in the USA, and
you'll be paying for this with cash out of pocket.

The only caveat is that you have described that your cat has required
thoracocentesis multiple times. This has not been the case for my cat
(after the initial crisis in December 2007). The Plavix will prevent
clot formation but can't do anything to prevent the fluid buildup in
your cat's chest.
Best regards,
---Cindy S.

Thanks too for the pill-popper suggestion. *Have considered it before
but can see that it would be too stressful for us and for the cat - just
getting into position alone. *The tuna and the yoghourt work
beautifully, despite the price.

Eddy.


  #27  
Old April 22nd 09, 02:05 PM posted to rec.pets.cats.health+behav
cindys
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Posts: 592
Default When do you "call it a day"?

On Apr 22, 8:54*am, cindys wrote:
snip

Tumil K (available from the vet).
Enalapril (available from the vet).
Furosemide (available from vet).
Clear empty capsules (available from vet).
Plavix (she wrote us a prescription to be filled elsewhere). At my
request, the vet office faxed the prescription to the Canadian
pharmacy.
Diltiazem (she wrote us a prescription to be filled elsewhere).
Lactulose (she wrote us a prescription to be filled elsewhere, but it
is sold over-the-counter in Canada).

-----------
I forgot to list the Pepcid (famotidine) which is available over-the-
counter in any local drugstore. The vet does not carry it. Just be
sure that you buy the regular stuff and not the "Pepcid Complete."
The cat requires only a very small amount (2.5 to 5 mg daily). Some
people will give their cats the Pepcid (famotidine) only every other
day.
Best regards,
---Cindy S.
  #28  
Old April 22nd 09, 05:42 PM posted to rec.pets.cats.health+behav
[email protected]
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Posts: 35
Default When do you "call it a day"?


Thanks, "rschweitzer" for this. * Bought another month's supply of drugs
yesterday for 30 US dollars, plus a further stack of tins of tuna and
pots of natural yoghurt to embed his medication, as well as the normal
tins of cat-food. *Pricey indeed, so I appreciate the suggestion about
trying to get the drugs elsewhere. *The thing is we're in a very
isolated rural spot here and the closest vet is a 20-minute drive away.
The next vet after that is 30 minutes drive away. *So we couldn't really
chop and change vets in the future, if we wanted to, which we don't.
Our vet is genuinely concerned and very good. *Her practice is not a
wealthy one. *People in this area don't have much dosh. *I think that if
we were to ask her to let us continue to consult her but not to buy the
drugs from her then she would not be too happy, and she might well then
feel she should charge us for chats and emergency phone-calls etc.,
which at the moment she is not. *So I think we need to stick with our
vet and buy the meds from her at her price.

Eddy.


Eddy,
I understand your concerns, as I grew up in a rural community myself.
FWIW, I don't see the harm in broaching the subject with your vet. A
good vet will respect your wishes and reasonable requests, and asking
for a script is certainly reasonable IMO. My own vet will happily
write me a script--and does not charge for phone chats/callbacks/
questions/etc. It's simply a business practice; nothing personal
against the vet.

Rene
  #29  
Old April 24th 09, 10:55 AM posted to rec.pets.cats.health+behav
Eddy[_2_]
external usenet poster
 
Posts: 72
Default When do you "call it a day"?

cindys wrote:
Well, I'm sure our vet would prefer that we get all the meds from her
(the ones she carries anyway), but when we don't, she doesn't say
much. I have never discussed it with her. I simply told the
receptionist that we would be getting the medications from PETMEDS
(where applicable). We are certainly not the only family who shops
elsewhere (the receptionist told me it was quite common for clients to
get meds elsewhere). A lot of people must be doing so, as 1-800-
PETMEDS is a booming business. When you place an order with them, they
phone the vet for you and request the prescription. Additionally, the
vet doesn't dispense everything, and it is not unusual for her to
write us prescriptions to be filled in a local drugstore. For sure,
she doesn't dispense Plavix. My cat is on the following meds (I've
indicated which ones I COULD be getting from her). The last three she
simply doesn't carry, and we couldn't get them from her even if we
wanted to:

Tumil K (available from the vet).
Enalapril (available from the vet).
Furosemide (available from vet).
Clear empty capsules (available from vet).
Plavix (she wrote us a prescription to be filled elsewhere). At my
request, the vet office faxed the prescription to the Canadian
pharmacy.
Diltiazem (she wrote us a prescription to be filled elsewhere).
Lactulose (she wrote us a prescription to be filled elsewhere, but it
is sold over-the-counter in Canada).

(When we had a cat who required Lantus insulin, we had to get that
from the drugstore as well).

Our vet practice is a very wealthy practice with multiple offices. The
veterinarians who work in each office are considered part owners.
(FTR, it's not one of the national chains. It's a local business that
simply grew over the years. The original vet retired and started
selling parts of the practice to the vets who worked for him.)

I don't feel bad about buying meds elsewhere because the practice is
wealthy and because we currently have four cats, one of whom is
currently elderly (i.e., lots of vet visits). We have had several
elderly cats in the past few years (two of whom had CRF and one who
now has the cardiomyopathy), so that's a lot of medical care. That's a
lot of checkups, grooming, dental procedures, x-rays, etc. This other
stuff more than makes up for the loss of profit on the meds.
Best regards,
---Cindy S.

Hi, Cindy. I think you've put your finger on why we feel reluctant not
to buy the meds from our vet: the practice is small, independent, and
there are certainly no signs in the humble little building they have
that they are raking it in. They also seemed worked off their feet,
what with the pets being brought in and all the other problems with
livestock - this area is all about sheep, cattle, and horses. So I
guess this is why we feel we at least ought to buy our meds from them,
in return for their good practice. But if they had all the trappings of
wealth, like yours, I think we would feel happy about shopping online.

Eddy.

  #30  
Old April 24th 09, 11:00 AM posted to rec.pets.cats.health+behav
Eddy[_2_]
external usenet poster
 
Posts: 72
Default When do you "call it a day"?

cindys wrote:
The only caveat is that you have described that your cat has required
thoracocentesis multiple times. This has not been the case for my cat
(after the initial crisis in December 2007). The Plavix will prevent
clot formation but can't do anything to prevent the fluid buildup in
your cat's chest.
Best regards,
---Cindy S.


Hi again, Cindy. It hasn't been necessary to mention it before, but
possibly I should mention it to you now: we are in the UK so the whole
business of getting meds through the post could be quite different here,
not so easy. Trying to buy ANYTHING online from the States or Canada is
problematical with regard to getting through Customs. I bought
something from Australia a while back, and the postman wouldn't give it
to me until I paid him a hefty Excise duty first!

Eddy.

 




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