When I initially received Mort’s diagnosis I did what I do: research. And I didn’t understand the dearth of significant first hand accounts.
Ah, those halcyon days.
I understand now: Nobody writes personal accounts because nobody has time.
This has been the single most consuming endeavor of my life, and I’ve got two graduate degrees, three jobs, and two dogs. I’d write theses for a living at this point; just for the relaxation. Comps were a beach vacation.
The past three weeks have presented us with laughter, tears, hope, complete normalcy, heart failure, weight loss, hypokalemia, complete loss of hope, a little more hope, confusion, a complete review of every feline-consumable substance, and existential crises. What it did not present me with is even the remotest desire to spend any free time writing a blog post so long as there was sweet, sweet catatonia as a viable option.
After 2 chemo treatments, Mort’s tbili (total bilirubin) came down to almost normal range. 0.6, where the upper end of normal is 0.5. Everyone was pleased with his response: the cancer was obviously being beaten back and he was little worse for the wear. Still spending more time than usual under the guest room bed, but back to breakfast-demanding shenanigans and spending time in genpop during the social hours.
Yesterday, I was phoning euthanasia-at-home services. Because fuck cancer.
In between, after the second chemo treatment (cytoxin again, because the onco wanted to give his liver just a liiiiiiiiittle more time to recover) Mort woke us up on a Sunday.
This was not abnormal. His breathing, however, was.
We got up, went through morning routine, scrutinized his every move before determining about an hour later that, no, it wasn’t us being reactive. He was breathing hard. So, into the bucket he went and off to the vet we went . . . to spend most of the day.
Hours later, they confirmed that he had fluid in his lungs, and suggested he spend at least one night, preferably two, in the oxygen cage until they could consult with cardiology on Tuesday.
Tuesday because Labor Day!
It should be noted that the only other time I’ve ever had to call an emergency vet for Mort, prior to all this, was the evening he managed to eat an entire container of hairball treats. That was the Friday before Memorial Day. Watch your back around federal holidays with this one.
We were able to bring him home Tuesday with the addition of two diuretics and a diagnosis of congestive heart failure secondary to either undiagnosed hypertrophic cardiomyopathy (Nigel’s pathology of choice: twinsies!) OR the hyperthyroidism diagnosed concurrent with the lymphoma OR use of prednisolone in the treatment of said lymphoma OR some unholy combination of all of the above.
Because it was very minor, and resolved well with Lasix and Spironolactone (which, happily, had not completely wrecked his kidneys after the first couple days), and because he’d been doing well with the chemo so far, there was hope that it was the hyperthyroidism + prednisolone and that it would reverse entirely once his thyroid was controlled for a few months.
It was at this point that an an already cranked person with anxiety (that’s me) was instructed to count their beloved cat’s breaths on a regular basis. This is how obsessions are born, folks. This and the inability to consume alcohol for fear that cat shit will hit a cancer fan halfway into the second glass of wine.
So we counted, and we gave him diuretics, and we watched as he receded under the bed for longer and longer stretches while simultaneously increasing the length of time between meals and decreasing the amount consumed therein. All while maintaining perfectly delightful respiration.
By his third chemo appointment we knew something was wrong. I had called cardio the day before, enquiring about the potential for hypokalemia (low potassium) which is common in cats on diuretics and manifests in “drunk” walking, weakness, lethargy, and inappetence–all of which he was suffering. Our suspicions, and then some, were confirmed when his chemo day labs showed both very low potassium AND a spike in his tbili from 0.8 to 3.2.
The only explanation was that the refractory action of essentially drug-resistant cancer was beginning.
Because his liver was, once again, compromised, the Madison Wisconsin Protocol that we were using–the gold standard chemo treatment–was rendered off limits, as 3 of 4 drugs are metabolized by the liver and would likely have killed him right along with the stupid cancer. We were presented with 3 options:
- An overnight infusion of one new/different chemo drug, followed-up by oral chemo
- Oral CCNU
- Stop chemo entirely
The expectations were the same for all: either he would do well on the alternative chemo, or he wouldn’t. He already hadn’t done well on the best known protocol. And if he didn’t respond well (or if we chose door number three), he would succumb to liver failure, most likely in a few days. This all leads to a prognosis of “Guarded.”
How does that even happen? Huh? We went from normal to Fuck in like 2.5 seconds.
We chose to try the oral CCNU and bring him home, because he’d had such a tough time with extended hospitalization. He already wasn’t eating, and there was no guarantee anything would actually improve. We couldn’t imagine him spending his last days–or even a preponderance of them–freaked out in the vet hospital.
Since Tuesday, I’ve been at home obsessing over breaths and amounts of food not eaten and ounces lost and time spent under a bed and lethargy vs. comfortable resting and the difference between “not suffering” and “quality of life” and cremation rings and and and and . . .
And then, today, at the tail end of the “very critical” 48 post-chemo hours, he ate stuff. Not much: some Kitten Milk Replacer and some chicken and a little kibble and a few licks of high calorie malt gel.
And now, he’s hanging out on the couch with me.
And I have no idea how long this will last.
And I’m just trying to do what the vet tech told me to do, which was take everything one hour at a time.
And it all sucks complete ass but for now I have a cat that I don’t feel bad about keeping alive so I’m just going to enjoy as much as I can, while I can, because I literally have no idea what’s going to happen in the next 60 minute interval but I’m pretty sure I won’t regret *not* spending much time on a blog entry.
And that’s what you can expect with feline hepatic lymphoma, I guess. Everything. Nothing.