The Enumerated Suck of the First Week: Lymphoma Suckhole Pt. 2

This is Part 2 in an ongoing series about Mortimer, Original Critter, who has been diagnosed with feline hepatic lymphoma. Read more about that whole pile of shit here and here.

The first week sucks so bad.

I’m technically only on Day 5 of the first week, and it’s already been the longest and crappiest that I can remember in recent times. And that stands to reason: my cat is a walking time bomb. Of course that sucks. What’s surprising is the numerous, often excessively banal, ways in which the first week of a lymphoma diagnosis is a horror. So, without further ado, let’s just jump straight into this flaming shitpile with both feet.

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Shit Begins: Lymphoma Suckhole Pt. 1

poop

This is Part 1 in an ongoing series about Mortimer, Original Critter, who has been diagnosed with feline hepatic lymphoma. Read more about that whole pile of shit here

That’s how all this started: With poop. How else would it start in my house?

Technically, that’s not true. It was the absence of poop that got this ball of suck rolling downhill in highly uncontrolled fashion.

The following is as condensed a timeline as I can give, from weirdness that I now understand to be relevant to diagnosis. It’s probably very dull–it’s a goddamn timeline of my life over the past couple weeks. But if there is one thing I hope it can illustrate, it’s that the symptoms of this horseshit can be extremely subtle. I pay such close attention to my critters that you could reasonably accuse me of helicopter pet parenting and not a single (probable) early symptom couldn’t be easily explained by normal circumstance of life. So if you have a cat with lymphoma and you feel like the biggest asshole of all time for not picking up on it earlier, I am here to tell you that this shit does not play fair.

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*unintelligible swear words*

This is a terrible picture because this has been a terrible week.

 

Mortimer, Original Critter, has lymphoma.

That’s why he looks very angry above: he was, at the time, 12 hours out from his first chemo, had significantly diminished liver function, hadn’t eaten in 3.5 days, and was suffering mild encephalopathy.

Fuck cancer.

I’ve decided I’m going to chronicle whatever the hell happens from here on out mainly for people who, like me, take their cat to the vet for some vague weirdness only to be told, after several hours and multiple bags of chips that, actually: lymphoma. And especially for people who then frantically wipe the grease and crumbs off their fingers to google “cat lymphoma prognosis” and wind up with far more depression and confusion than they had while trying to wrap grey matter around the understanding that time with their kitteh is now finite in a painfully specific way.

 

I’ll do a couple background posts and then, hopefully, post many updates over the next few years.

If you’ve come across this in your Googlage and are wondering how to proceed, let me state right up front that I have no idea or recommendations beyond strongly suggesting that you consult a veterinary oncologist. I can only share what we’ve decided, why we decided it, and how everything plays out.

So, the following are relevant to our specific situation, based on discussions with our veterinary oncologist:

Mortimer:
12yo neutered male domestic shorthair. Former barn kitten. Has lived the spoiled life since 8 weeks of age. Indoor only. Fed only the fancypants-est food. Grain free for the past 10 years, raw-fed (prey model home, prepared frozen, and prepared dehydrated) for the past 3 years. Sees a holistic vet for yearly checkups. Gets only rabies vax. Has been the picture of health, if a bit on the portly side, his entire life.

Diagnosis:
Hepatic Lymphoma with super giant intestinal lymph nodes and a shitty liver. I believe that is the highly technical terminology. Will also accept: Fucking shit. That’s what we have.

Options:
Chemo, or imminent death from liver failure.

Decision:
Chemo. Madison protocol. That’s 2 months of weekly treatments as an outpatient, followed by 4 months of treatments every other week.

Prognosis:
Since liver failure is a pretty significant complicating factor, prognosis is uncertain and depends entirely on:

  • Mort’s ability to tolerate the chemo
  • The responsiveness of the cancer to the treatments
  • The ability to return the liver to somewhat normal functionality.

In general, cats tolerate chemo in this application quite well. Lymphoma in cats cannot be cured, therefore treatment aims to improve quality of life and, ideally, achieve remission. This means that side effects are kept to a relative minimum and this treatment protocol cannot, in any regard, be compared to the level of sickness commonly induced by chemo in humans. If remission can be achieved, then Mort could get a couple quality years. Median survival rate is 1.5 years.

I cannot stress this enough: The goal of treatment is to use the chemo to make Mort feel better. Not to make Mort violently ill in the short term, with long term hopes of beating the disease. Since the  disease cannot be beaten, there is no point in causing suffering.

I do not intend to present as any sort of authority on the subject. I am just a seriously freaked out person with a very sick kitty and if anything that we (Schmoop, Mort, Other Critters, and I) go through in the course of whatever is to come can provide any sort of comfort then I might as well share it.

Blog will remain blue for the forseeable future, mainly because making it all black (LIKE MY SOUL) would be super hard to read.

Fuck Cancer.

Read Part 1.

Kitten Curtain Deathmatch and Other Pleasantries

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The kittens have the sort of relationship that would make Dr. Phil raise an eyebrow. One minute they love each other and are snuggling adorably,the next minute they sound like a small herd of rabid elephants stampeding through the house on a murderquest. Rabid, quacking, yowling, screaming elephants.

Occasionally, they use props. Mortimer really liked it when we were painting the dining room, and a plastic tarp thrown over a kitchen island-turned-buffet created an amenable murderers cave. He would hide beneath the buffet–behind the tarp–and wait for an unsuspecting Puppy, Nigel, or human to walk past, greeting all with the ninja paw, or sometimes even a full kitten lunge-and-retreat. By the time painting was complete, the tarp was shredded. In times without painting projects, though, a bed, human, or piece of furniture will provide suitable cover for whichever kitten is on the offensive. They take turns being the aggressor.

Yesterday, they used the delightfully old timey window treatments left by the previous homeowners, which we have been reluctant to replace because critters destroy everything, as staging for their battle royale. For ten or so minutes they alternated hiding behind the curtain, and deathmauling the curtain hider, while I watched and giggled and calculated the survival rate of whichever kitten crashed through the window and onto the driveway.

As usual with kitten shenanigans, it’s all fun and games until someone gets a claw stuck on some fabric. In this case that someone was Mortie, at which point Nigel became bored and left the striped cat to sort his dilemma alone. Brute force prevailed, and I now understand where the mystery tear on one of the other panels came from.

To the neighbors wondering if this is some sort of crack house with the torn and lopsided window panels: not my fault! *points frantically at nearest kitten*

To the commissioners who want to raise my property assessment: this is totally some sort of crack house!

To any police who might have read the above and are now planning a SWAT infiltration and DEA bust: just kidding! (Unless a commissioner happens to be reading over your shoulder.)

***

In Karmann news, the vet confirmed Addison’s based on cortisol tests, and then did a full blood work up only to discover some things which supported Addison’s, and others that were exactly the opposite of what they generally expect. Given that she is my puppy and I have been informed by two physicians, independently, that various anatomical bits are “not exactly where the anatomy books suggest they should be” this is not particularly surprising. I grow ever more convinced that we somehow share DNA, or are swapping places. I have not personally had any interaction with a Zoltar machine lately, but who knows what Karmann gets up to when she isn’t busy pooping every 20 minutes.

Since “supportive” outweighed the “huh?!?” We are treating her with a short course of a low dose of prednisone and observing her closely. If she improves, we will take that as confirmation. If she doesn’t, I suppose there will be a considerable amount of head scratching. Either way, she’ll have another blood test at the two week mark.

So far, on day two of the prednisone, I can’t see any improvement. I can, however, see a lot of pee–increased urination being a known side effect of prednisone, albeit one I don’t recall her having during treatments in the past. And she doesn’t seem to get much warning, either.

KARMANN: *sleeping*
(15 seconds pass)
KARMANN: ohmygodtakemeoutNOWWWWWWWWW!!!
*pees on stoop*

I assume she’s just trying to not pee until the next regularly scheduled pee, but then realizes late in the game that that isn’t going to work. And unfortunately, when it happens in the middle of the night or at the ass crack of dawn she is thwarted by humans, who require things like pants (and the half asleep, blind, bumbling location thereof) to go outside. Natch.

She still seems off, to me–like she’s agitated not in the sense that she’s cranky, more like she just doesn’t know what to do with herself. Which makes me sad. Because I tell her we are going to get her better but it’s taking a really freaking long time and she just keeps feeling weird in the meantime. But then I suppose I need to give the prednisone more than 36 hours.

I hate being patient.

***

I also hate port-a-potties.

Which is why, if you are reading this and thinking, “Ehhhhhhhhhhhhhhhhhh maybe I’ll donate to this broad’s fundraiser for the Animal Rescue League . . . Or maybe not. I mean, she’s kind of funny-ish. At times. I’m getting, like $.50 worth of entertainment out of this. Can I donate $.50?” I am here to tell you I’m sorry, I’m off my game, and YES YOU CAN! You can certainly donate $.50. And if 70 of you donate $.50 (that’s a total of $35 for my fellow MFA’s out there) between now and April 1 I will be entered into a drawing to win one of seven VIP passes for the marathon and a VIP pass means NO PORT-A-POTTIES!

It also means private changing rooms. Very swanky.

Granted. If I do not raise $35 by April Fools Day–which is also Calvin’s birthday, no pressure–I will still run, and I will pee in a wee plastic hut, and I will change in a giant room with hundreds of other sweaty females while averting my eyes.

I WILL DO THAT FOR THE CRITTERS. I will publicly undress for them. I will do that.

All you have to do is give $.50.

Bad Hair Day

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It’s not the most flattering cut, if we’re being honest.

My sad, half naked, slightly clipper-burned puppy is *thisclose* to a diagnosis and, thus, to feeling better.

Addison’s Disease.

Probably. Her ultrasound yesterday found wee itty bitty adrenal glands. The vet sent out some bloodwork, and we should have confirmation/more information on Monday.

While I’m not thrilled by the likelihood that she will have to deal with chronic illness requiring somewhat finicky medication and management, the prognosis for well-maintained Addison’s is a normal, full, and happy life. Which is awesome, and also the prognosis that I required from the universe. I thank it for complying.

In a nutshell, her adrenal glands are freeloaders. They just sit there at the top of her kidneys, sucking up space and refusing to do their damned job–which is secreting cortisol and aldosterone to manage electrolyte balance as well as metabolism, and biochemical stress response. As a result, she develops all manner of symptoms–urinary, gastrointestinal, muscular, neurological–while her adrenals hang out all, “lalalalalalalalala life as a gland is grand lalalalalalalalala!” And “What, me worry?” And “Think I’ll have a nap now! Doing absolutely nothing useful is exhausting!”

Bastards.

If confirmed, The Nut will be maintained on daily steroids, and will possibly require prednisone “boosters” during periods of stress, either good or bad. And I will therefore have to learn what happy things are systemically intolerable and adjust meds accordingly, since even things like happy fun playtime can stress her slackass adrenals.

I am so mad at those stupid glands right now, threatening to make my girl’s social events unpleasant for her. But I am also over the fracking moon at the prospect of finally having a diagnosis and a course of treatment, because the last month of sickness and not knowing and helplessness has SUCKED EPICALLY for every living creature in this house, most especially my Karmie Monster.

Who is super adorable, naked tummy notwithstanding.

*squish*

Sometimes it’s Really Hard to Be a Puppy.

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It’s hard to be a puppy when kittens steal your bed, for example.

And it’s really hard to be Karmann lately, as something in her gut just ain’t right. She’s been on meds for her intestinal irritation while the vet makes it through a drop-down menu of tests to find out what is happening to make her intestines intermittently fill up with gas. The latest was a fecal exam for parasites, which was negative.

We spent a chunk of last night’s witching hours at the emergency vet due to another episode of gastric distress. Same as last time, except no traffic, and no Paczki for me as it was 4am when we returned and also I think they are extinct due to Lent. I am once again sitting on the couch putting off the cleaning of vomit from my car’s driver’s side back seat latch. Say what you will about Karmann, the girl is consistent and her aim is spot on–what didn’t make it into the seat latch she rather kindly deposited in the back seat storage pocket. I stuffed both with Clorox wipes last night before dragging my be-Benadryl’ed butt to bed. Are those things absorbent at all? That would be nice if they were.

Her regular vet is now lining up an ultrasound. Hopefully quite soon. The emergency vet last night said it could be any number of things, from IBD to Addison’s Disease to parasites that don’t show up in fecal exams (whipworm, anyone? Mmmmmmm!) to cancer.

This will bring our household Critters With Ultrasounds percentage up to 50% and my sleep quotient down to None Of The Sleeps.

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Sad panda Snugglepuss is finally resting comfortably–if a bit dejectedly.

I Am Eating All the Paczki.

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A Paczki. Shortly before I ate the crap out of it.

That awkward moment when you’re like, oh I think my dog may be dying.

That moment was at 7 this morning, when Karmann woke me up by freaking out: air licking, frantic pacing, refusing to sit or lie down, trying to eat the whole yard when we went outside, finally puking up mucous and foam.

Oh shit. She’s bloating. Is she bloating? FUCK. Fuckfuckfuck. She is. Oh. Is she? Surely, this isn’t happening.

So I called my preferred emergency vet, playing it cool, all, “oh, hey, I’m trying to figure out if I have an emergency . . . ” and was told in no uncertain terms to get her to an emergency facility as quickly as I could in the interest of caution because yes, it sure does sound like she’s bloating. Is she a big dog with a deep chest? Bring her in. Definitely bring her in.

It was rush hour. It was snowing. There were three known emergency vet options: my preferred place–the one I called–which is on the other side of the city, another place I trust also on the other side of the city, and there is a small, national chain place quite near my house. I’m not a huge fan of the latter. I have nothing against them, and no reason to distrust them, I just have considerable anecdotal reasons to trust my preferred place implicitly.

I made the decision to tackle traffic. My thought was that, if she really were bloating I KNEW they had the facilities to handle it. Thinking ahead to worst possible non-death outcomes, I was more confident in their surgical/stomach tacking abilities.

It was a stupid decision. 45 minutes later, stuck in un-moving bumper-to-bumper traffic I was still many miles from the point I expected traffic to clear, which was itself still 15 minutes from the vet center.

And Karmann was not doing well. She was crying, pacing, roaching, licking, and puking up more foam. As soon as I was past the center barrier I pulled a U-turn and headed back toward the small place closer to my house.

While I was in the middle of playing Pittsburgh Drift on snow-covered roads, Karmann farted.

And farted some more.

And then she burped.

Very sad Karmann in a very gross car says no Paczki for her right now, thank you.

Very sad Karmann in a very gross car says no Paczki for her right now, thank you.

By the time we got to the emergency vet, she was substantially improved. Which meant that I got to run a gauntlet of vet techs telling me how fine she was and how happy she looked and how no, of course she wasn’t bloating, and was I sure I still wanted to see a doctor when my dog was so obviously well?

To those techs, I extend my heartiest fuck you.

We saw the doctor and he confirmed that he could feel a lot of gas, but no distention or blockage. He also confirmed that she was likely epically nauseous. So she got IV anti-nausea meds and a shot of Pepcid.

And once Nutter was ready to go home he suggested that we both take a nap. Apparently 45 minutes in traffic, bawling at your dog not to die, please, leaves one a bit worse for the wear.

I’m sure there are myriad inappropriate ways to act toward or around someone who has just spent their morning assuming their puppy was nigh to perishing. From experience, I can list a few–just in case it helps any baby techs out there:

1) Don’t act as though the woman with the anteater eyes and hoarse voice is a lunatic when she walks in, talking about how her dog has been in awful distress until just 10 minutes ago. Don’t laugh and tell her her dog is “happy.” Whether or not her dog is actually happy, I assure you that she is not. She is imagining your head on a platter with an apple garnish, and considering kicking you in the shins.

2) Consider waiting until aforementioned woman is checked out and on her way before two of you launch into an awkward conversation that flips between your torrid attraction to the vet and the effects of probiotics on your colon.

2a) Scratch that. It’s probably never an awesome idea to flip back and forth between the hotness of your boss and the state of your intestines. It’s almost certainly not productive, in any event.

I still feel like I spent my morning in the Twilight Zone.

On the way home, Karmann resting, finally, in the back, I stopped for Paczki. Because near death experiences demand fat and carbs in gross quantities. I immediately shoveled in a custard, and when I remembered the foam puke I still needed to clean out of my car’s seat latch, chased it with a chocolate buttercream and a nap.

And when I woke up from the nap I cleaned up some water yack, which reminded me of the foam puke that still needed cleaning. So I ate a bagel and drank a root beer.

All your carbs are become mine.

Bed-lam.

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Karmann recreates the floating door scene from Titanic

Calvin has been living better through chemistry since his vet added as-needed Trazodone to his regimen of daily Prozac to help his separation anxiety. But while it seems to make his time alone far more sufferable, he still gets nervous when he knows he’s about to be left alone. And so it came to pass last month, as I prepared to leave on errands, that he scaredy-peed all over the grossest of the living room bolster beds. The bed that had been with Karmann almost as long as Karmann has been with me, and which had been washed so many times in its first four years of life that the cover had become mangled and shrunken to such an extent that it had been un-removable (and therefore un-washable) for the last three years of its service.

Truly icky. It was summarily tossed, and not without a bit of rejoicing.

Since The Peeing we have been dutifully carrying one of the bedroom beds downstairs every morning and back up every evening whilst I sought an ideal, long term living room bed solution. My criteria: 1) attractive, 2) easily de-furred between washings, 3) entirely washable cover and pillow, 4) bolster-free (see also, criteria #2), and of course 5) cozy for pups.

When, last week, we forgot to bring down a bedroom bed and entered the living room to find Cal snuggled into the remaining living room bed, with Karmann on the floor, plastered against it, we knew we had to act. And I was developing neck strain from carrying a giant pillow up and down the stairs while also herding dogs and cats.

I checked Orvis and found a very excellent bed that met all of my criteria PLUS my favorite, nondelineated 6th criteria: SALE! We ordered two.

And so we have come to the point of this meandering post. Orvis. I direct your attention to the picture above. In that picture you will find my 53lb dog DESPERATELY CLINGING to your large (accommodates dogs up to 70lbs!) bed, turning herself into Superpuppeh in an attempt to stop her ass end from sliding off the back of what is–let’s be honest–a very nice, high quality, king size human bed pillow.

That cotton square accommodates dogs up to 70lbs??? What? Did you only test it out with morbidly obese English Bulldogs? Or perhaps morbidly obese Lawng Legged Baygles? Because Calvin, the 32lb wonder fits into it perfectly–and really, it’s about 32lbs of Karmann that fit comfortably. The rest hangs over, dangles off, and otherwise clings in quiet desperation. I mean, look at my poor girl’s face! Resigned, confused, trying really really hard to like it but falling short and, pretty clearly, feeling very bad about her failure to be excited about the newest bed hotness, all while Calvin (out of frame and looking somewhat aghast)–substantially less than 70lbs-worth of Calvin–is curled up comfortably, with the excess bedding smooshed out to the sides so that he can rest his little chin.

Calvin: Relaxed. Supported. Happy of chin.
Karmann: *I won’t let go, Jack! I won’t let go!!!*

Orvis made my puppy sad. 😦

It also made my Schmoopie somewhat nuts. Because there ensued a surreal 10 minutes or so of back-and-forth in which I pointed and laughed while he kept exclaiming, “It fits up to 70lb dogs!”

ME: That is pathetic.
SCHMOOP: It fits up to 70lb dogs!
ME: She is falling off.
SCHMOOP: It fits up to 70lb dogs!
ME: She’s literally–like, in the real, dictionary definition of literal, literally, and not in the ironic amplification sense–hanging on for dear life.
SCHMOOP: It fits up to 70lb dogs!
ME: It’s the size of a pillow. She is longer than the bed.
(Karmann readjusts so that she is lying diagonally across the bed, clinging to a corner)
SCHMOOP: That is the picture of comfort!
ME: That is the picture of sadness and disappointment.
SCHMOOP: Well . . . it’s supposed to fit up to 70lb dogs . . .

I may have taken some creative license there, but you get the point.

So the beds are boxed for return because looking at the sight on the daily will hurtle me into a deep depression faster than my incurable unemployability. And yes that’s beds, plural, because about the only thing Karmann shares readily is her bedding, and the pups have worked out some sort of amenable, complicated exchange system, such that returning just one bed for a larger size would ensure that Karmann was still forced into undersized bedding about 50% of the time when Cal takes over her plus-sized pillow.

I just assume that the giant, more expensive beds will no longer be on sale. Dammit.

Comfortably Numb

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Karmann, summing up all our feels about this eye situation

Anesthesia stories.

1) When I was 14 I went in for my one billionth set of (ear) drainage tubes. Being that I was 14 I was, of course, *super* cool and, after receiving whatever magical feel good elixir they put in the IV pre-op, I led the surgical team in a truly awful rendition of Pink Floyd’s Comfortably Numb (because HAR!) as they wheeled me to the OR.

That is my primary association with general anesthesia. Well, that and being about 5-ish and headed in for maybe my second set of tubes and being asked what flavor anesthesia I wanted and choosing bubblegum and then experiencing the end of my childhood as I inhaled the rubber-scented gas, thinking “those fuckers lied to me.” In more 5-ish year old vocabulary, albeit. Not that I’m still bitter or anything.

THERE ARE NO GODDAMN FLAVORS YOU INCREDIBLE ASSHATS!!! WHY ARE YOU EVEN IN PEDIATRICS IF YOU THINK KIDS ARE SO STUPID??!? UGH YOU’RE PROBABLY ALL RETIRED BY NOW BECAUSE IT WAS FOREVER AGO!

Ahem.

2) Getting the phone call that Karmann, who I’d dropped off in the morning for dental scaling with general, was ready for pick-up. This was basically my first solo experience with critter anesthesia–indeed my only anesthesia experience since being an ultra-cool 14 year old Floyd fan–so I insist I should be forgiven for enquiring as to whether she’d be up for the one mile walk back to my apartment. I was told to drive.

The critter that I picked up resembled my Karmann only tangentially. She was dopey, uncoordinated, sluggish, and clearly unhappy. And about an hour after we got home, the awful pooping started. Every half hour I had to run her outside for an emergency. Even though she quickly exhausted all intestinal contents, she continued to have cramps and dry heaves and every single half hour, all night, into the next morning, and well into the afternoon, we frantically ran outside so that she could do a futile poop dance and cry. And then I would bring her in and she would flop onto the floor and proceed to lie perfectly still for the next 29 minutes. I sincerely wondered if she was going to make it.

She apparently gets stress colitis, and we’ve gone through a variation on this routine each time she’s had to be sedated for a dental. Which is why, after the last one, I resolved to NEVER EVER DO ANESTHESIA AGAIN (save for emergencies–basically, no dental. Superficial cleaning only. And good maintenance.)

So when I took her to the vet this afternoon, I went from:

Oh my god my freaking puppy has freaking pink eye! WORST DAY EVER!!!

To:

*blink, blink, blink* *human stomach cramps*

When the vet said that no, not pink eye. Benign, pre-existing eyelid cyst is growing in toward her eyeball and irritating the crap out of it and it has to be surgically removed and hey, since she’ll be under, why don’t we also do a dental and make sure you’re totally broke and also covered in liquipoo–is Wednesday good for you?

So much pro-biotic and eye ointment and wine in my immediate future.

*hugs puppy*

Full Moons, Head Trauma, and . . . PINK EYE??!?

This month, the Full Freaking Moon brought to me:

– 2 critters who are questionable for this week’s big game due to head injury. Mort sustained a knee to the head as I flopped about in bed, trying to get comfortable, and Karmann got bopped when she shoved that giant, adorable head of hers under the dishwasher door as I was lowering it.

Oh sure, at face these may seem like accidents or, quite possibly, even, maybe, you might perhaps wonder if I were not to blame as I merely scapegoat the moon. But the moon makes me creepy! And discombobulated! I cannot be held accountable.

– Pink eye. ARE YOU FREAKING KIDDING ME DOGS CAN GET PINK EYE?!?? I noticed green gooey eye gloop yesterday, as I was kissing Karmann’s nose in apology for the Moon braining her with the dishwasher (*shakes fist* MOOOOOOOOOON!!!) This morning her little eye is red and swollen and she’s rubbing it (generally on me) and just seems displeased with her current condition.

She was also doing her routine puppy hork to clear the scarf’s worth of her own fur that she swallows every day and it sounded notably less resonant. Like somebody carpeted her sinuses. So we’ll be headed to what has become our weekly vet visit tomorrow.

Unless I freak out and think she has become terminally sadpants in the middle of the night and hike her off to the emergency vet for a puppy cold because oh my god a sick puppy is the saddest thing ever. And also, I’m a little reactionary.