Monday, July 20, 2020

Pet Loss: When A Pet's Routine Surgery Goes Bad

If a cat spoke, it would say things like 'Hey, I don’t see the problem here.'  ~ Roy Blount Jr.

A reader writes: Three months ago, my dear cat passed away from cancer. I became very familiar with your online Loss of A Pet forum. It helped immensely. Now, I need advice.

I adopted two kittens shortly after my cat's death. They are now 20 weeks old -- got them at 9 weeks. Well, I took both of them in to get spayed and neutered. The neutering went fine, but one of my dear kittens is now blind.
At 5:00 p.m. the day of the surgery, I went to visit her and take home my boy. She was almost like a limp rag. They said that she was having a little trouble coming out of the anesthesia. So, the next morning I called. They said she was better, more active and alert. I went over on my lunch hour. I walked to the cage to see my girl. She was howling. She didn't recognize me. Her eyes did not follow my hands. I said, "My cat is blind." I asked to be put in a room and the doctor came in and talked to me. I was in shock and crying at this point.They never told me she couldn't see. Did they think I was stupid???

We discussed possible causes -- lack of oxygen, stroke, reaction to the anesthesia. She didn't look like a stroke because both sides of her body were essentially the same. Because I specifically asked that question, he told me that all during the surgery, no monitors gave him an indication that her oxygen level had dropped. He mentioned several monitors: O2-sat -- that's the only I remember offhand. Now she's on Prednisolone. I asked why that medication. He said for any possible inflammation of the cerebral cortex. I brought her home so she would feel safe. She did not feel safe at all in there. They didn't make me pay for the surgery. The doctor said he feels in his heart that she will get some vision back. I thought, Wow, that doesn't sound like medical advice, but I was in shock and still am.

The question I have is: I guess I know that nothing can bring back her sight, but are there any avenues I should pursue regarding this?? Should I lodge a complaint with some Veternary Society or regulatory agency? If so, do you know what agency? Should I check into this any more? I asked to see the chart, and the doctor came in and said there is nothing in the chart that he had not already told me. I don't remember the whole conversation, but he made a statement something to the effect of "I'm not lying about this - I would not do such a thing." I might have been accusatory, but being in shock, I'm not sure.

I took her in three days after the surgery, to get a second opinion. Doctors seem to stick together. This one didn't say anything negative about the other vet. Possible causes of her blindness: hypoxia (lack of oxygen), hypotension (low blood pressure), idiopathic drug reaction (drug reaction of no known cause???) and other....whatever that means!!!The new doc stated that when he took her back into the room to check out her eyes, she squinted when he shined a bright light in them. He said that indicated some return of vision. There is a slight.......very slight possibility that some of her vision may return. He told me if I see any vision coming back there would be signs within six months. That's a half a year.....So right now, I'm raising a blind kitten...........because of what looks like an anesthesia overdose!!!!! I HATE THAT VET--I HATE THAT VET--I HATE THAT VET!!! Nothing is going to change her sight, but I'm very angry. I've written several letters to that doctor and thrown them away. I want to leave a nasty message on his voicemail. I still may do that. He wants to examine her again tomorrow. Right, like that's going to happen. He didn't tell me she was blind in the first place. There's nothing that makes me think he would even apologize. That would be the professional thing to do. Even acknowledge that something went wrong. He gets off scott free, and mine and my kitten's lives are forever changed. Something's not right here.

My little kitten is acting like a trooper!!! I just feel so bad and guilty that such a routine surgery went bad. It's killing me to know that I took her in. Maybe on another day this wouldn't have happened. I'm in need of a little advice because I know that my head is not thinking properly right now. Any help would be very much appreciated.

My response: I'm so sorry to learn that this has happened to you and your kitten, and I can only imagine how shocked and upset you must feel about all of it. I’m sure your mind is filled with questions, medical and otherwise. Since I'm not a veterinarian, I'm not qualified to answer whatever medical questions you may have as to what went wrong in this usually uncomplicated surgery, but I certainly do believe that you deserve some answers, and I sincerely hope that at some point, when you feel in better control of your emotions, you will take your questions back to the veterinarian who operated on your kitten. To come to terms with this, you need information about what happened to this kitten that may have caused this blindness or partial blindness, an opportunity to discuss what went wrong and what might have been done differently, and reassurance that what happened was not due to negligence on your veterinarian's part.

It is certainly understandable that you are feeling very angry at your vet, perhaps even angry at yourself for asking the vet to spay your kitten in the first place, when (as far as you knew) there was nothing wrong with her to begin with. I don’t for a moment want to discount or minimize your feelings, and I think that under the same set of circumstances, any one of us would feel exactly the same as you are feeling now. But at a time like this it's important to remember that neither you nor your vet intentionally set out to bring any harm to your beloved kitten, and neither one of you would ever wish blindness on a kitten or any other animal. The sad reality is that there are always risks associated with anesthesia and surgery, including sudden death. We animal lovers sometimes overlook the fact that, like its human counterpart, veterinary medicine is not an exact science, and mistakes are always possible. It is also possible that your kitten may have had a congenital defect or some other pre-existing condition that went undetected until this anesthesia exacerbated it. Unfortunately, both you and your veterinarian are human, terrible accidents do happen, and neither one of you foresaw what was going to happen to your kitten during this surgery.

I’ve said elsewhere that anger is a powerful emotion that can be frightening, but feeling angry doesn't necessarily imply that you will lose control or take your anger out unfairly on others. Nevertheless, before you can get through it, let go of the intense emotions attached to it and move on, your anger must be admitted, felt and expressed, if only to yourself. When you simply acknowledge feelings of anger to yourself or to a trusted other (or even online in the safety of our pet loss forum) without actually doing anything about them, no harm is done, to you or to anyone else. On the other hand, if you suppress that anger and hold on to it, eventually you may explode, turn it inward and get depressed, or aim it at innocent others. I encourage you to find ways to discharge the energy of your anger through physical exercise, writing and talking. Then, after examining all the facts in this case you decide that your anger at your vet is justified, when you feel ready to do so, you can confront him constructively (in a letter, phone call or in person) with what happened and how you feel about it.

Please know that before I constructed my response to you, I consulted with a veterinary colleague, a highly qualified doctor whom I know to be a very caring soul. (She participated in the Pet Loss Support Group I facilitated in Phoenix and I have the highest respect for her.) I asked that she give me her objective medical opinion based on the facts as you have presented them to me. She said that although hypoxemia and hypotension are all very real and possible side effects with anesthesia, she has never heard of blindness as a result of anesthesia, and she would actually consider that this kitten had a congenital issue that may have been exacerbated by anesthesia.

As you say, regardless of whatever you decide to do next, you’re still left with the reality of living with your kitten’s vision impairment, but you may find that her reaction to her disability will surprise you. Animals have other keen senses that enable them to compensate when one of their senses is impaired. And one of the most wonderful things about our animal friends is that they tend to cope with disabilities with far more resiliency and flexibility than we humans do. In addition to all of that, your kitten is blessed to have you as her mom, and you are there to offer her all the acceptance, love and protection she will ever need.

A quick search on the Internet tells me that there are lots of articles and websites devoted to the topic of blindness in cats. See, for example, Eye Problems in Cats. In response to a reader’s question about sudden-onset blindness in her friend’s kitten, one veterinarian responded that, "I do not think that this kitten will have many problems if it is a house cat. We have several blind patients in our practice at any time and I suspect that most veterinary hospitals do. Pets that are congenitally blind or who experience blindness after a chronic degenerative process tend not to be particularly bothered by their condition. As long as your friend keeps the furniture in approximately the same places and the litterpans, food and water bowls and other of life's necessities in the same places the kitten will probably do fine."

Again, my dear, I'm so sorry this has happened to you and your beloved kitten, and I hope with all my heart that this information may be helpful for you.

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