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emergency vet :-( WARNING: this is going to be LONG...

A little backstory...last Monday, Leo started being less interested in food. I wasn't terribly concerned--he's usually TOO interested in food--but I was keeping an eye on what he ate. By Thursday, he was only eating a few bites. On Friday, he had several of the squeeze ups he loves but not until after I called his vet to make an appointment (he couldn't be seen until this Wednesday) and on Saturday, he refused everything but a single squeeze up. He threw up water on Saturday but I assumed it was from the muddy puddle he'd drank out of earlier in the day when he was outside. But on Sunday, when he threw up water again, I knew he needed help.

Leo is the first pet I've had where I was the one responsible for his medical care. Dad and I also have zero experience with emergency care, so I called the closest emergency vet to see what I needed to do other than bring Leo in. A woman answered the phone and immediately put me on hold. After 20 minutes, the horrible (jarring electric guitar) music switched to a phone ringing but after 20 rings, nobody answered, so I hung up. I called back twice and got no answer so I called another place--let's call it "EV" for "emergency vet"--35 minutes away and got a lovely person who told me to bring Leo right in.

So I did, and we were immediately escorted into an exam room where we waited. And waited. And waited. And waited. At one point, a receptionist popped her head in and apologized, saying they were terribly busy and it was a "crazy" morning. There were only a few cars in the parking lot, so I was a bit skeptical. After an hour, she popped her head in again and asked if I needed anything. I asked for some water for Leo; he's not been eating right but he IS drinking plenty of water. At this point, I'd let Leo out of his carrier, and he was wandering around the small room meowing. A half dozen times, he hunched and tried to poop on the floor, but either there was nothing in his system to poop out or he was too much of a gentleman to defecate outside a litter box.

Around the 90 minute mark, I texted bff to tell her what was going on. I mentioned that I'd not eaten yet that day (it was now around noon) and had only had a small dinner the night before and nothing after and she, being the awesome bff she is, told me she was on her way with some lunch. Shortly after that, the vet tech ("VT") came and took down some information. I mentioned Leo was barely eating but was drinking well. I said he was in stage 3 kidney disease as of last October and I was concerned he might have another mouth infection. He got them frequently when he was my bff's mom's cat, and he's been to the vet twice for either a sinus issue or dental issues since he's been with me. I also thought his breath smelled a little stinky, and not from cat food. VT wrote everything down, took Leo (who'd walked right up to her and was content to be held--a sure sign he's not feeling well as normally he barely tolerates me holding him and won't let anyone else do so), commented on what a handsome kitty he is and, after putting him in his carrier, whisked him away, telling me I could wait in the large waiting room while they ran tests. Her appearance was well timed as *I* was about to soil the exam room floor.

After about 30 minutes, VT came and took me back to the exam room. She informed me that Leo was in stage four, aka "end stage", kidney disease and they'd also detected a heart murmur, which he's never had before. She told me they could keep him for three days and run a continuous IV that "might" buy him a few months or I could choose to have him euthanized. This was the news I'd been fearing I'd hear all week. I have been crying on and off since at least Thursday, sure this was the end of the line for Leo. VT assured me I could be with him as they put him down, holding him the entire time, and I shakily agreed, so she went off to get me the paperwork to sign.

At that point, bff walked in with a bag of McDonald's. I was crying by then, and she asked me what was wrong, so I told her. She couldn't believe it. She's known Leo since he was rescued from her friend "B's" porch 7 years ago and she knows he has mouth issues and kidney disease. She's even given him subcutaneous ("sub-Q", or "SQ) fluids before when he was dehydrated. She kept telling me it was my decision but at the same time, she thought she could bring down his horribly high creatine number and BUN number (tech-y talk for values assigned to kidney function) with more fluids, since dehydration raises those numbers, and more importantly, she was willing to come to my house every day if need be and give him the SQ.

Honestly, at that point, I had no idea what to do. I have never been in that position before, to be the one to decide if it's time to end a pet's life. I don't want him to suffer, so I was leaning towards euthanasia but at the same time, if there was anything (reasonable) we could do, and I didn't do it, I'd feel horrible about "killing" my cat. Bff was pushing for SQ at my house so when a receptionist came in with forms asking permission to euthanize Leo, bff peppered them with a bunch of questions about certain numbers and alternate treatments. They couldn't answer them (obviously) and said they'd send VT back in. So VT came back in bff asked for the lab values. VT left and came back with the printout. Bff asked if SQ would be acceptable...VT didn't know, so she went and talked to the vet. VT came back and said no, probably not. At that point, I asked how much a 3 day stay at EV with continual IV would cost, so VT left AGAIN and came back with more forms saying it'd be roughly $5000.

$5000.

Both bff's jaw and mine dropped. I told VT I couldn't afford that. Bff again suggested she could give Leo SQ; she's convinced if he was less dehydrated, he wouldn't be considered in stage 4 kidney disease. I don't know...Leo's been drinking plenty of water all along, so I'm not sure dehydration is a problem. VT left for one final time and came back a lot later, telling me they'd given Leo a single IV (thought that wasn't good enough) plus an antibiotic (they didn't ASK me if they could and VT had told me his white blood count was high so he shouldn't have needed an antibiotic) and said I could take him home, providing I signed an AMA. I did, and as VT went to collect Leo, the receptionist handed me a bill for $852.63.

I have several issues with the service I received yesterday...

1. At no point did I actually see, or talk to, a vet.
2. Everything done to Leo was away from my sight, so I only have their word that they gave him an IV plus an antibiotic.
3. I understand that the fee for the visit to the EV was going to be more than a visit to the regular vet (2 and 1/2 times) but I'm not sure I understand why the same bloodwork done at the vet for $250 was $375 yesterday.
4. I got a copy of the AMA and it's...a little accusatory. Basically it implies that I should've just put Leo down yesterday at the EV and by taking him home, I'm just prolonging his suffering.

I'm beginning to suspect just that.

Once Leo got home, he still refused to eat, and he wouldn't take the appetite stimulation pill the vet prescribed. He also seemed a little...lost. He was restless, wandering from water bowl to my lap to the garage to the front door in an almost endless circuit, meowing a little, and when he did finally settle down, he looks content, but he's barely dozing, not really sleeping. He's not curling up to sleep like he usually does.

Today, bff came by with her friend B (the one who initially found Leo, or rather, he came to her door looking for help) to give Leo a SQ, and will do so again tomorrow. B also crushed up a pill and gave it to Leo via syringe in his mouth. Bff has had a half dozen animals since adulthood, and B, along with her husband, are the original "crazy cat people", at one time owning, and taking perfect care of, 13 cats (they're down to 3), and both were nurses who know a lot about biology and medical treatment for animals, and I (usually) trust their judgment. After his SQ, Leo looked "so much better" according to bff and B but I didn't agree. I think he looks about the same as he did yesterday, plus he's only eaten one squeeze up today (I'll try again later) and has been just kind of lounging about. The two of them discussed future treatment and think it's possible Leo has pancreatitis, which can lead to weight loss (Leo is down another pound and is practically skin and bones) and lack of interest in food but which is treatable. They're thinking Leo's going to go to his vet Wednesday morning and get a glowing report and get treatment and come home and live another 3, 4, maybe 5 years. I think he's a 16 year old cat (plus three months) and is just...done. He didn't have an easy start to life, which can lead to a shortened life span. I can't even be hopeful about Wednesday. I think I'm coming home Wednesday without a cat and bff and B are going to be disappointed (and possibly a little mad that they did so much to help him).

Because this didn't fit anywhere else, B asked me if I thought maybe Leo had a stroke. I don't THINK so...he's been a little weak, especially in his hind legs, and there's the wandering, plus when he drinks, he dribbles, which he's never done before, but he's not been shaking his head or seizing or anything. I just don't know...and the not knowing is the second worst, right after Leo not being 100%.

Sorry if this was a bit rambling...