Dealing with loss of Lily due to saddle thrombus

[wiz.k]

I woke up as usual on Feb 2nd, got ready, and went downstairs to say hi to my cats.

They were both in the kitchen looking out the backyard door, a very typical scene in the morning. Lily greeted me with her sweet meows and let me pet her and I left.

Later in the afternoon I get a call from my mom, saying Lily is unable to move, and howling in pain. It took me 30 minutes to get home and another 15 to bring her to the ER vet. I wish I stayed to work from home that day.

Within 30 minutes of bringing her in the ER vet calls and says there is no blood flow to 3 of her little paws, which is why she was unable to move. What does this mean? What is the treatment? The ER vet doesn't really explain the treatment but says that it could be due to several reasons, but most likely due to blood clotting from underlying heart conditions, and that I will have to make a very hard decision today.

I begged the ER vet, please don't ask me to make this decision. How could this happen? She was fine. My mom said she was running around all morning before she found her howling. The ER vet explained that there is a treatment for the blood clots with the use of blood thinners, but it will only cause Lily more pain and that Lily may not even last the next hour. She also said that the treatment may prolong her life shortly but will still have a grave outcome.

Due to COVID, all the conversations happened over the phone. I had to call her back 4 times before I could tell her the hardest decision I ever had to make.

I don't know if there were any external reasons for the ER vet to push me towards euthanizing my cat. Was she busy? Did she have other more serious patients with higher chances of living and that's why she pushed me to euthanize? I did want to trust her but I wonder if the treatment could have possibly helped her?

Does anyone have experience with saddle thrombus? This sudden onset of symptoms all at once? I still don't understand why there weren't any prior symptoms. Looking for closure. My dear Lily was not even 3 years old yet. I wonder if I did right by her. The vet assured me that the alternative would have been a much more painful death, but at the moment I did not even have a chance to get a second opinion.

I did email my regular vet after, still looking for an explanation, and he said the same thing, that he advises against treatment and the cat will end up dying shortly after anyway. But where are the stats? Are they just saying from personal experience/observations?

I would love to hear from the community if you have any encounters with this ailment.

I'm still in shock that I had to lose her so suddenly and so young. She was a piece of my heart. The loveliest and gentlest of beings. A true angel on earth.

 

[neely]

Although I have never personally experienced this health condition in one of my cats, my heart aches for you. I just wanted you to know that I would have the same concerns as you and be asking myself all the identical questions. It is my understanding that saddle thrombus is very serious and even if treated the cat can have a repeat episode which despite treatment usually do not survive.

During this time of Covid it makes matters exceptionally difficult since we cannot go into the vet with our cats. I realize you were unprepared for this and did not have enough time to grieve. Therefore, when the time is right you may want to sit down and put all your thoughts/questions in writing then speak with the ER vet. Once again, my sincere and deepest regrets.

 

[gilmargl]

What a terrible shock for you! I'm so sorry that this had to happen. I have not heard much about saddle thrombus but know that it is a very serious condition in cats. If there was already no blood flow to three of her paws, even if she'd survived she may never have been able to run around and play as before. I hope that someone on this sight will be able to give you some more information.

I am fairly certain that if there were any chance of the vet being able to keep her alive without her suffering, he would have been more than happy to give you more time to make your decision. My heart feels for you. I am so sorry.

 

[wiz.k]

Although I have never personally experienced this health condition in one of my cats, my heart aches for you. I just wanted you to know that I would have the same concerns as you and be asking myself all the identical questions. It is my understanding that saddle thrombus is very serious and even if treated the cat can have a repeat episode which despite treatment usually do not survive.

During this time of Covid it makes matters exceptionally difficult since we cannot go into the vet with our cats. I realize you were unprepared for this and did not have enough time to grieve. Therefore, when the time is right you may want to sit down and put all your thoughts/questions in writing then speak with the ER vet. Once again, my sincere and deepest regrets.

Thank you friend. I was able to see my Lily when it was time for her to go, they let me in for that part. She was in clear distress despite being given pain meds. Yes you are right, I should put it down in writing and ask the ER vet for more information. I was given an option to do an autopsy, but we wanted to bring her home and bury her, and didn't want her being cut open. I just wanted to hold her for a few more hours until we buried her. Maybe the autopsy would have given me complete closure, but at the expense of not having my Lily back immediately. I understand our pets have to go sooner or later, I just did not have any warning signs for her death

 

[neely]

I was given an option to do an autopsy, but we wanted to bring her home and bury her, and didn't want her being cut open. I just wanted to hold her for a few more hours until we buried her. Maybe the autopsy would have given me complete closure, but at the expense of not having my Lily back immediately.

If it's any consolation I would have done the exact same thing. I think you got more closure by holding her in your arms the way you remembered her. Lily is at the Bridge now with all the other cats who have gone before her. RIP sweet angel.

 

[fionasmom]

I have lost two cats to a thrown clot. In the first case, the vet tech thought that he heard a heart irregularity when he listened to Eliot's chest but the vet said that it was nothing remarkable or serious. About a month later he fell over at my feet in the hallway. His last moments were walking oddly, lifting his feet in a way that cat so not, as if he was experiencing a lack of feeling in them. The second was an older, diabetic cat. ( I should have mentioned that Eliot was only about 6). Because of her diabetes and some neuropathy, I was in constant contact and observation with her, so I am sure that there were no real symptoms beforehand. We came home from a fructosamine test at the vet's and about an hour later she died.

I am so sorry for your loss. It is such a shock when you have no time to prepare as a longer illness might have given you....not that long illnesses are a good thing.

In the case of both of my cats, it was over in seconds. There was no chance of even picking them up and running for the car. It seems that you came home at a time when Lily was already in the midst of this and that makes it seem as if you have hope if you can get to the vet; however, the howling was not a good sign even at that point. The window for treatment is usually about 2 days in a cat who is diagnosed earlier and if an improvement is not seen there is usually no hope. A cat who is in pain, as Lily was, is in later stages of the thrombus.

I don't think that the vet gave you incorrect advice but I was not there so it is just what I am reading from your post. You want to have saved Lily, of course, but I don't know that it would have been possible. Again, I am so sorry for your loss. You were right not to do an autopsy....those take on a life of their own and don't necessarily make you feel any better or give you any further closure.

 

[Mamanyt1953]

I am so, so very sorry. Saddle thrombosis is a bear, and there are really no good, long-term outcomes. I believe to the depths of my being that you made the exact, right decision. You put Lily's well-being ahead of your own heartbreak. Again, I am so very, very sorry.

 

[wiz.k]

I have lost two cats to a thrown clot. In the first case, the vet tech thought that he heard a heart irregularity when he listened to Eliot's chest but the vet said that it was nothing remarkable or serious. About a month later he fell over at my feet in the hallway. His last moments were walking oddly, lifting his feet in a way that cat so not, as if he was experiencing a lack of feeling in them. The second was an older, diabetic cat. ( I should have mentioned that Eliot was only about 6). Because of her diabetes and some neuropathy, I was in constant contact and observation with her, so I am sure that there were no real symptoms beforehand. We came home from a fructosamine test at the vet's and about an hour later she died.

I am so sorry for your loss. It is such a shock when you have no time to prepare as a longer illness might have given you....not that long illnesses are a good thing.

In the case of both of my cats, it was over in seconds. There was no chance of even picking them up and running for the car. It seems that you came home at a time when Lily was already in the midst of this and that makes it seem as if you have hope if you can get to the vet; however, the howling was not a good sign even at that point. The window for treatment is usually about 2 days in a cat who is diagnosed earlier and if an improvement is not seen there is usually no hope. A cat who is in pain, as Lily was, is in later stages of the thrombus.

I don't think that the vet gave you incorrect advice but I was not there so it is just what I am reading from your post. You want to have saved Lily, of course, but I don't know that it would have been possible. Again, I am so sorry for your loss. You were right not to do an autopsy....those take on a life of their own and don't necessarily make you feel any better or give you any further closure.

Thank you so much for sharing your story. This really helped. I have spoken to a colleague and they had also lost a 4 year young cat to thrombus. I keep having flashbacks of her last months and weeks and wonder to myself what kind of oversight may have caused this pain. She was cuddlier than usual, but it didn't strike as odd behaviour as its cold in Toronto and I just thought she just wanted to snuggle up. She was always so full of love I just thought she was showing it more, coming out of her shell. I am still crying because I keep thinking maybe she was in pain for weeks/months and I couldn't tell? I wish I could take all her pain, not sure why she had to go first

 

[FeebysOwner]

RIP little Lily. No one can ever know for sure about what happened before her passing. But, we can know about afterwards. She is no longer in pain, even though your heart is. When you are ready, give Lily a place on this site to pay tribute and homage to her and to memorialize her with whatever stories and pics you want to share with us. She deserves that and so does your heart.
Crossing the Bridge | TheCatSite

 

[Bird]

I am so sorry for the loss of your furry loved one Lily to this horrible, unexpected blood clot. On February 8th, my 6-year old cat Mojo had saddle thrombus (arterial thromboembolism). Mojo had no symptoms of heart disease prior to the blood clot. We thought she was a healthy cat. On that night, she vomited up her dinner in multiple places around the house. I followed her while this was happening, and noticed her breathing rate was rapid. She even opened her mouth briefly. Then she rolled onto her side, and seemed unable to get up. I tried to stand her up, and she just rolled again. It appeared something was wrong with one or both back legs--loss of control, paralysis in the back legs. She was not meowing or making any noise during this event, until we put her in the carrier. Then she started meowing in a scared way (as usual with any vet visit, actually). We rushed her to the ER immediately, where we received a diagnosis of saddle thrombus. The ER vet said she was in pain and meowing loudly. We were given a very grim prognosis, and the option of euthanasia. What?? We were told by the ER vet that only about 30% of cats recovered, and recurrence of another blood clot was likely and the prognosis was bleak. I couldn't believe what I was hearing--I was sitting in the car in the parking lot, listening to the ER vet tell me this on the phone because we aren't allowed inside because of the pandemic. I could barely process what I was hearing. I told them to treat her--give her the best treatment money could buy. She was hospitalized for 2 days, receiving oxygen, blood thinner, pain killer. By the time she was discharged, she regained control of and use of her legs! Apparently the left back leg was worse than the right. After examination by the cardiac vet and an echocardiogram, the prognosis was still grim and poor. Mojo has HCM - hypertrophic cardiomyopathy that caused the blood clot, and early-stage CHF - congestive heart failure with minor fluid accumulation. Mojo was discharged from the hospital fully mobile, able to walk and jump, with only some minor weakness in her left leg. Two weeks later, I would have a hard time telling anything was wrong with Mojo, as she returned to her normal behaviors, just sleeping a bit more. But of course the grim diagnosis stands and I was informed that Mojo will not live long. The cardiac vet gave her, at best 6 - 12 months. It's still hard to wrap my head around that. I am going to do my best for her, and try to give her the best life I can. The numerous medications are overwhelming, and she hates being pilled, but each day is precious. (Emotionally, well, I am a mess.)

I have read multiple scientific papers on saddle thrombus at this point. I think the statistics may be misleading because so many cats are euthanized without treatment. Not all blood clots have the same severity of impact. Having fewer limbs impacted and having a higher rectal temperature seem to be a good indicator of recovery from a blood clot, but for the underlying condition that caused the blood clot (HCM), the long term prognosis is bad.

 

[wiz.k]

I am so sorry for the loss of your furry loved one Lily to this horrible, unexpected blood clot. On February 8th, my 6-year old cat Mojo had saddle thrombus (arterial thromboembolism). Mojo had no symptoms of heart disease prior to the blood clot. We thought she was a healthy cat. On that night, she vomited up her dinner in multiple places around the house. I followed her while this was happening, and noticed her breathing rate was rapid. She even opened her mouth briefly. Then she rolled onto her side, and seemed unable to get up. I tried to stand her up, and she just rolled again. It appeared something was wrong with one or both back legs--loss of control, paralysis in the back legs. She was not meowing or making any noise during this event, until we put her in the carrier. Then she started meowing in a scared way (as usual with any vet visit, actually). We rushed her to the ER immediately, where we received a diagnosis of saddle thrombus. The ER vet said she was in pain and meowing loudly. We were given a very grim prognosis, and the option of euthanasia. What?? We were told by the ER vet that only about 30% of cats recovered, and recurrence of another blood clot was likely and the prognosis was bleak. I couldn't believe what I was hearing--I was sitting in the car in the parking lot, listening to the ER vet tell me this on the phone because we aren't allowed inside because of the pandemic. I could barely process what I was hearing. I told them to treat her--give her the best treatment money could buy. She was hospitalized for 2 days, receiving oxygen, blood thinner, pain killer. By the time she was discharged, she regained control of and use of her legs! Apparently the left back leg was worse than the right. After examination by the cardiac vet and an echocardiogram, the prognosis was still grim and poor. Mojo has HCM - hypertrophic cardiomyopathy that caused the blood clot, and early-stage CHF - congestive heart failure with minor fluid accumulation. Mojo was discharged from the hospital fully mobile, able to walk and jump, with only some minor weakness in her left leg. Two weeks later, I would have a hard time telling anything was wrong with Mojo, as she returned to her normal behaviors, just sleeping a bit more. But of course the grim diagnosis stands and I was informed that Mojo will not live long. The cardiac vet gave her, at best 6 - 12 months. It's still hard to wrap my head around that. I am going to do my best for her, and try to give her the best life I can. The numerous medications are overwhelming, and she hates being pilled, but each day is precious. (Emotionally, well, I am a mess.)

I have read multiple scientific papers on saddle thrombus at this point. I think the statistics may be misleading because so many cats are euthanized without treatment. Not all blood clots have the same severity of impact. Having fewer limbs impacted and having a higher rectal temperature seem to be a good indicator of recovery from a blood clot, but for the underlying condition that caused the blood clot (HCM), the long term prognosis is bad.

Bird, thank you so much for sharing your story. It is almost identical to what we went through with Lily except yours had a much happier ending. I am so happy that your Mojo was able to recover in whatever way possible. Now I really wish I had pushed for treatment.

And this is exactly what I was talking about! I begged the vet to treat Lily in any way possible, but she strong retaliated and said that we could be putting her in more pain, and that there is a chance she will die overnight in their care. The vet also added "I doubt she may make it the next couple of hours, let alone overnight". This is what pushed me to make a decision to euthanize.

I truly do think they made a rush decision in a way because once we were allowed inside, I could see how overwhelmed the ER vets were. They were overloaded with patients. If Lily had not been given adequate attention, maybe she would have died overnight at the ER vet, instead of in my arms.

It's too late to change any decisions now. But your story has given me hope in a way that if we run into the situation again, I will push for treatment. If I could have my Lily back for even 1 more day without her suffering excessively, I would have done everything in my power to make it happen.

I wish the best for you and Mojo. I hope the time frame of 6-12 months does not get you down too much. Our family friend with stage 4 terminal cancer was given a prognosis of living for 6months - 1year and and yet she is still here 4 years later. Our doctors and vets may have an education that we don't but they are so focused in their technical/statistical knowledge they forget every being is unique and individual and one story is not the same as others.

 

[Bird]

I wanted to provide an update on Mojo. She had a good two months since her first blood clot, but she just went through a second saddle thrombus event, despite all the daily medication (including clopidogrel, which is a blood thinner). The second blood clot had symptoms identical to the first blood clot, but the paralysis in her rear legs did not resolve quickly this time. She was hospitalized for about 3.5 days for this second saddle thrombus because her kidney values shot up. It is now day 6, and her leg paralysis is the same—no improvement. She doesn’t want to eat, so we are syringe feeding her. This is a heart-breaking situation, but I feel compelled to keep trying and give her the best chance I can for recovery, even though she has a terminal heart condition.

Wiz, I didn’t mean to make you second guess your decision. Mojo‘s situation demonstrates how very tough this can be. I have no idea what will happen with Mojo now or tomorrow, but she got at least 2 good extra months. I am second guessing myself every day now. Am I doing the right thing for Mojo? Will she recover this time? Will she be able to walk again? Will her kidneys fail? I only have uncertainty and overwhelming sadness right now.

 

[wiz.k]

I wanted to provide an update on Mojo. She had a good two months since her first blood clot, but she just went through a second saddle thrombus event, despite all the daily medication (including clopidogrel, which is a blood thinner). The second blood clot had symptoms identical to the first blood clot, but the paralysis in her rear legs did not resolve quickly this time. She was hospitalized for about 3.5 days for this second saddle thrombus because her kidney values shot up. It is now day 6, and her leg paralysis is the same—no improvement. She doesn’t want to eat, so we are syringe feeding her. This is a heart-breaking situation, but I feel compelled to keep trying and give her the best chance I can for recovery, even though she has a terminal heart condition.

Wiz, I didn’t mean to make you second guess your decision. Mojo‘s situation demonstrates how very tough this can be. I have no idea what will happen with Mojo now or tomorrow, but she got at least 2 good extra months. I am second guessing myself every day now. Am I doing the right thing for Mojo? Will she recover this time? Will she be able to walk again? Will her kidneys fail? I only have uncertainty and overwhelming sadness right now.

Bird, I'm sorry I lost this thread for a while. I couldn't bring myself to think about Lily's passing away for the longest time and recently started thinking about her again. How did Mojo's treatment turn out? I'm hoping to hear all is well with her, even though I'm responding 2 years later. I'm glad you gave her treatment a chance either way.