u/anthroleptic

Hi folks. Thanks in advance for your help. This post ended up being pretty long-winded and emotional, so I’ll summarize it in advance: TL;DR Last month, my cat started abdominal breathing and was diagnosed with a ruptured diaphragmatic hernia, which seems to have collapsed his right lung and displaced the majority of his organs into the lung cavity. The vet referred me to a specialist for more advanced imagining, but advised that it’s a pretty grim prognosis and I may have to consider putting him down because he’s probably suffering. That appointment is a month from now. Despite this, he’s acting perfectly normally. I don’t know what I should expect his future to look like. Is my cat dying? Do I have days left, or years? Can he survive in this condition? Thrive? Is he suffering? Any insight is so, so appreciated. Thank you.

Full details:

Background: Holmes is a 12yo maine coon mix I adopted at 7yo after his previous owner passed away. He’s still pretty active for a senior and has the breed’s quintessential dog-like personality. I love him to death. He’s a huge personality and a weird little freak and everyone who’s met him has fallen in love with him. I cherish the five years he’s been in my life, even though he loves stealing pencils to kick under the fridge and makes sure to jump up onto my bed whenever he’s feeling nauseous.

Medical history: His medical history is unremarkable, aside from stomatitis requiring full extraction ~2yrs ago. I’ll echo other cat owners when I say removing his teeth gave him a new lease on life and was the absolute best thing I could’ve ever done for him.

A few weeks ago, I noticed he was abdominally breathing so I rushed him to the ER vet. I knew whatever it was was bad and went in fearing the worst, so you can imagine my horror when the vet came back after xrays and tells me this “isn’t something as straightforward as heart failure.”

Radiology Report: Link

The ER vet referred me to a specialist for advanced imaging. She actually considered sending him over that night (bear in mind this was around 11pm), but called the specialist and asked if we’d be able to spend the night at home. Specialist said that was fine and the ER vet sent us home with gabapentin for pain management.

I asked what I should expect to hear from the specialist, and the ER vet was pretty frank with me. She told me that since there was no trauma to cause a hernia, it could be due to something more insidious that only started acting up now that he’s older. She also said that, since we don’t know how long this has been going on, it’s possible that his misplaced organs have adhered to the body wall and thus impossible to fix with surgery; and moreover, even if it was feasible to surgically correct, it’d be prohibitively expensive. She told me I should think about his age and make considerations for his quality of life, because it’s likely that he’s in a lot of pain. Naturally, this was devastating to hear (even just typing this post has me crying.) The next day, I made the imaging appointment with the specialist, even if only to obtain a second opinion and get some clarity about his QOL. However, the appointment isn’t until next month. I called up the ER vet to ask if that long of a delay was okay, and they told me it’s fine and I should just monitor his pain levels. Like, hold on, sorry, what??

I initially thought this was an urgent, painful condition that required emergency intervention if not euthanasia, but later I’m told it’s okay to let him walk around with his guts all up in his lung cavity for two months?? Moreover, he’s not acting sick?? He’s still abdominally breathing, but is otherwise… perfectly normal? He’s jumping on and off the furniture (much to my chagrin) and is playing with toys. He’ll still follow around guests slapping their ankles if they haven’t given him adequate attention. He’s eating and drinking normally as well, no changes to his litter box habits. Like, if you didn’t see the one sign of respiratory strain, you’d have no idea that his right lung collapsed and the cavity it’s supposed to be in is currently being occupied by his liver and kidney.

I know cats are good at hiding pain. I know I’m unqualified to make any determinations about feline veterinary health. But I’ve also seen him incredibly sick (the stomatitis) and know what he’s like when he’s hurting. I’ve also seen him more mildly ill after a mentally ill roommate poisoned him (story for another day), when I passed him a URI, when he got a botched medical grooming that tore up his skin. He’s not acting anything at all like he did then. To put it bluntly: he’s not acting like a cat who’s dying.

Prior to all this, I was confident we still had a few good years left together. Now, I have no idea whether it’ll be days or weeks or months before he passes. Is this condition something a cat can live with while retaining a good QOL? Is it imminently fatal? Is he secretly suffering in great pain when he comes up on my desk to knock off my pencils and sit on my keyboard? His appointment is still a good ways out and I’ve been an emotional wreck, not knowing if I should stay home to savor every moment we still have together, If I should feel guilty for going away to visit family for a weekend, or if I can continue to cherish him the same way as usual. Like, after I informed my ex partner about the news, he was planning to drop everything and take off work (as a surgeon, mind you) and fly out from the other side of the planet, just to visit Holmes and spend more time with him before he passes. My parents came to see him. Past roommates and old friends—people I haven’t seen in years—have come over to visit him, just to tell him how much they love him one last time. I’m so confused as to what Holmie’s future looks like. It’s like this daily emotional whiplash and it’s really messing with my head.

Sorry for how long this post is; I’d go back and trim it down if it wouldn’t make me start sobbing all over again, so I really appreciate you taking the time to read it. Any insight—literally any at all—is so valuable to me right now. Thank you so much.