Many of you have been very kind to me, regarding the passing of my cat, Hegel.
You have been reassuring to me, about my guilt.

I just can't seem to shake it. I can't even think about the nearly 11 years of loving
care that I provided to him. All I can think of is the horrible, unforgiveable fact
that I didn't take him to the vet sooner. I have since recovered a memory of him
slipping outside unnoticed. He was out about 20 minutes. We recovered him
easily, and of course I scooped him up kissing and hugging him.
The skin sores that he had around that time, now make me suspicious. Did another
cat attack him while he was outside? The only reason that I was complacent at
all about skin sores, is the fact that he had been a "scabby kitty" for years. He
had feline pempigus, and flea dermatitis. He was itchy quite often. He would sometimes bloody himself up, around the ears, or neck. I kept prednisone tablets
from my vet, and if the itching was really bad, I would give him some. I used them
sparingly, as pred is hard on anyone long term.

For some reason, I never made the connection to the slip outside, and the sores.
I can't say for sure that they are connected. The week that happened was the
second week of November, and we were without heat and water. I remember that
I called my vet for an appointment, and they didn't have any when I wanted one,
due to me having to be home for workmen. I said I would call back. I never did.
His skin sores healed, he was still just a little itchy. Now I feel so very stupid.
There just wasn't a big red flag that he was sick, until December 6th. I found
those sores around November 7 or 8th. I know he was eating regulary, I know
he played in my son's high chair box that we bought on November 19th. I know that
he and I played for some time on November 22, and me looking at his neck, thinking
all was well. I remember that date, because of talking to my neighbors out a window while holding Hegel. I started housesitting/pet sitting for them the following
day, which is why I remember the date.
He slept a lot, but he was chunky, and he was nearly 11. Every morning, me, Hegel
and my 7 month old son hung out in bed together. It was our little morning routine.
Thanksgiving week, I gave him 3 tablets of pred for itching, Mon, Wed, Fri, as is
usual for pred for him. On the 29th of Nov, ( I have the receipt) I bought him
a bag of Hill's Skin and Coat formula, thinking it would be good for the sores, and
he always got a little dry and flaky in the winter.
That week, I got very involved in my son's first Christmas. I didn't pay as much
attention to Hegel. I know he was hungry that week though, excpept for Friday
night. That weekend, he was very sleepy, but again, nothing unusual for a big
fat housecat.
Then Monday, bam, no appetite, dizzy, pupils glazed. That was December 6th.
My vet found an absessed lymph node on him, and a high fever. He was dehydrated.
The lymph node turned out to be an absessed salivary gland, and shrank with
antibiotics. His bloodwork indicated very bad anemia, and she sent me to an
animal hospital with him. I told the hospital about the sores. Of course by
this time, there weren't any sores. They asked me about the possibility of a fight.
I said no. I never made any connection to that "getting out" incident.
They missed a heart murmur at the hospital, and sent him home with me after 5
days with antibiotics. He made little progress at home, and had to be taken
back. That is when they did a chest x-ray, and said that the infection had gone
to his heart. It's called bacterial endocarditis, and it does irreversible heart damage.
He developed pulmonary edema, and could not breathe well in an oxygen tank.
My baby was gone on December 21st.

And now, I blame my husband, who let him out, and I blame myself for not getting
him to the vet sooner. I feel like this guilt is going to destroy me. I can't reconcile
in my mind how I could have been so complacent with someone that I loved so much?

I know that all of you understand how much I loved him, as you all loved your babies
dearly. Hegel and I had little ritual, where i would whisper in his ear, "Mommy promises I'll always take care of you." I let him down. I spent about $1600.00
trying to save him, when $20 worth of antibiotics, most likely would have saved his
life 2 weeks earlier. Now I know I will never know if that is true or not, but that
is how I feel. I told the doctor in the hospital the day that he died, that if
he could save my cat, if it was just a matter of money, tell me, I'll get it. He
said there was nothing he could do about a damaged heart valve.

I feel like I'm drowning in my grief. I am trying so hard. My infant son needs me.
I am vacant.
I appreciate everyone who reads/listens to this.
I want my little family whole again, and it can't ever be. And worst of all, my husband
and I are to to blame.
I AM SO SORRY HEGEL!!!!!!!!!!!!!!!!!!!!!!!!!11

Let me help you a little here.

I'm a medical researcher, working mainly on neurological diseases, but I did come up with something for pemphigus a few years back that is just now being talked about more widely.

Pemphigus, if people don't know, is one of the most dreadful diseases (I don't know about feline, only human). Prior to steroids, like prednisone, it was invariably fatal in a few years. It causes ulceration of the mucous membranes.

Prednisone stops the ulceration by suppressing the body's immune response. Thus when one is on it the risk from infections is greater.

Five days on antibiotics is never enough - us scientists in the field rail against the insurance companies for promoting this idea. In fact the well publicized problems of antibiotic (abx) resistance and probably more to do with short courses than overuse. A really bad concept is the "Z-Pack", five days of Zithromax. It should be off the market. It didn't matter when you started the antibiotics, simply a few days is far too little.

So what happened to Hegel is quite clear. The prednisone limited his own ability to fight the infection, then a too-short course of abx allowed a streptococcus (probably) to invade the heart. The abcessed salivary gland was the source of the strep.

You have no fault here. Taking him to the vet sooner would have made no difference. Hegel passed because of the really appalling ideas about disease treatment that abound generally at present. Prednisone isn't dangerous long term, its *very dangerous* short term. Unfortunately sometimes there's no alternative and it has to be used. Not only should you not have guilt you should be proud that you did everything right, I can't see anything in your story that could be criticized. Its even difficult to make a diagnosis of bacterial endocarditis in humans and its a known complication of "strep throat", one thankfully less common now we have abx. I applaud you for making sensible, well thought out decisions for Hegel. Just stand in a vet's office one day and hear what other people advocate for their animals, it would make your hair stand on end.

In two humans - the only ones who have tried it so far - the effects of lysine were dramatic in solving pemphigus. Its not a cure, its like prednisone in that it stops the ulceration while you're taking it. It just doesn't have the problems of prednisone (lysine is available at health store no less!) One of the humans called me before Xmas and told me that w/ lysine she had been off prednisone for 3 years. I guessed lysine would be useful because the pemphigus sores look like herpes and lysine is very effective at suppressing herpes.

So, as Hegel's gift to the world, let's hope this &%^ysis does something for other animals and pet owners out there. Maybe a few vets will see the light about abx.

Thank you kitdad for your reply. However, I shouldn't have given him that prednisone without going to the vet. Of course, I had no idea that he had
an infection, but still.
The hospital sent me home with antibiotic tablets, Cephalexin. So it wasn't just
five days. What I now know is that he needed much longer on IV antibiotics;
however they didn't catch the heart infection.
The salivary gland absess puzzles me. That is why I fear that a cat claw or tooth
may have knicked him. I just don't know. Hegel had a weakened immune system,
and I don't think any of this would have killed another cat. My neighbors have
4 cats, down from 6. They are all indoor/outdoor. They get in fights occassionally,
and live to be quite old. They lost a 10 year old to kidney failure, and a 16 year
old to liver disease in the last year.

I do feel responsible. I shouldn't have given that prednisone. Like I said, with
his skin problems, I had become complacent about skin sores. I only used the
pred about 2-3 times a year, if that. I usually let him heal on his own. I only
gave this (and trimmed his back claws) so he would quit digging at his neck.
I feel stupid for not thinking that an antibiotic may have been necessary.
It's just that I thought of him as my son, and I feel the failure of mother/protector.

I did nothing out of malice. I wouldn't have harmed him for anything in the world.
I just feel neglectful. And the letting down of a promise made many times.
I look at my little human son, and I know that I can't always protect him from
everything either.

A mouth is a pretty good place for bacteria, warm & wet. Do any microbiology and you'll be amazed what's in there. I wonder if microbiologists ever kiss?

Just a small nick from dry food may be all that is necessary to set up a point source of infection.

I really can't see that you neglected Hegel. You did everything right. I personally would have done everything to avoid prednisone but then that's not the mainsteam view at present. Even then your instincts about prednisone were spot on, you used it very sparingly. I'm glad the vet gave you a course of cephalosporin to follow up, that was right tho' I'm not a great fan of those abx personally - they never seem to work as well in practice as they do in the lab. I still like the penicillins. A longer course of IV abx may well have caused more problems than it solved, Hegel would have started to develop diarrhoea and his gut flora would have been all messed up. If you hadn't taken action about the sores on his neck that could have turned into a life-ending condition. As to being outside for 20 minutes being the trigger for all this - I just don't think so. If he had been attacked by another cat you would have heard it I'm sure. No, my feeling that slip outside had nothing to do with it.

I mean what more could you have reasonably done? Hegel was no youngster and he had health problems. He had textbook treatment, even better than textbook - if only all pets were so well looked after. You certainly didn't let him down and I think your definition of "neglect" is far from what anybody I know would accept. You should be really proud. I'm sure Hegel is really proud of you.

I am crashing and burning.
No answer at pet loss phone lines.
Grief and guilt are unbearable.
Thinking of driving myself to the hospital.

Some of you know, that in a fit a grief, I took in a stray kitten on Jan 1st.
It's bloodwork was done today. FelV/FIV +
I wanted to "save someone" in Hegel's honor.

Dear Hegelsmom,
I'm so sorry for your loss of your dear Hegel. I had a cat for 18 years who I loved so much. I got her when I was 18 and lost her when I was in my thirties. She was the only thing I could depend on in my life during those moving around, college years. When I got married, my husband didn't want her in our bed. This was after she had slept under the covers, curled up against my stomach, for 15 years. I felt so guilty not letting her on the bed. It was horrible. When she died, I had a lot of guilt about other things taking priority. Like I had a toddler and twins on the way. But she had many years of my love and I know she knew I loved her. Hegel knew of your love too. I feel worried about you and the agony of your guilt. I don't think anybody can talk you out of it, facts don't matter. It's something you need to feel because it's part of your grief.

When my dog Kiva died, I felt so guilty about so many things. He had fleas and I didn't even know it. I didn't take him out for walks often enough. I didn't give him enough attention. But the fact is, I did the best I could. And that is true for you too. You did the best you could. You have a year old baby that needs you too. You gave your cat so much love for so many years. There is no way you could have known his true medical condition, you're not a super-vet. You came only from a place of loving and caring and you did take care of him the best you knew how, just like you promised. God and Hegel know your love for him and that is what counts. If you're still feeling so overwhelmed with guilt and it is affecting your ability to be there for your baby, maybe you should find a grief counselor. It seems like a really important thing to do for yourself and your family. Would you consider that?
Love, Mimi

Dear Hegelsmom,

You kept your promise to Hegel. You did not let him down. Please, please listen to kitdad: you did not neglect Hegel in any way. The guilt you're heaping on yourself is undeserved.

Your guilt seems to be centered on two things: not taking him to the vet sooner and having given him prednisone. Given Hegel's medical history, I wonder if the vet would have done anything different than what you did. If he was eating and acting normally, how would either you or the vet have had any clue that he needed different treatment? In fact, from what kitdad said, it doesn't sound like Hegel's sores were necessarily related to the infection. If so, he may not have even gotten the infection until after the 2nd week in November, in which case, taking him to the vet that week would have done nothing more than stress Hegel. (I'm assuming he didn't like going to the vet.)

Unfortunately, all of our beloved pets suc%%b to disease or accident or infection, no matter how attentive to them we are or how much love we give them or how much money we're willing to spend on their care. So much is outside of our control and so much is unforeseeable. To be sad when something bad happens that you truly can neither control nor foresee seems understandable; to hold yourself responsible under those cir%%stances seems like depression. Please listen to Mimi's advice and consider talking with a professional about your overwhelming guilt.

I'm sending hugs and positive thoughts your way tonight. Please let us know how you're doing.

Love,
Margie