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verushka70So yesterday my cat started having problems breathing. I knew this would come eventually -- she has cancerous nodules in her lungs, where her basal cell carcinoma metastasized to. I had hoped the chemo regimen she was on was working -- a month+ ago, her chest X-ray was, the oncology vet told me, no different from her initial diagnostic chest X-ray.
But I had to bring her in. She was breathing like 60-70 times a minute (normal is 15-30) and really heaving. I hadn't noticed at first how bad it was getting, because after she started the prednisone a month ago, she started pulling out her fur. The vet had told me to get small dog clothes and put them on her to block her access to her own fur. (The cat really, really didn't like wearing doggie shirts, but she did put up with it. Although then she just denuded both her front legs. Sigh.)
But she wasn't acting right; she was completely quiet (and normally she's extremely vocal), and she was still as a rock (whereas normally she follows me around) and she had this look that was a cross between mad and scared. I took her shirt off and then realized how much trouble she was having breathing. At least she wasn't mouth-breathing; that's a really, really bad sign.
I took her in to the vet Sunday afternoon at almost 5pm. They did an ultrasound, which showed no fluid around her lungs, so they thought that was a good sign. They didn't do a chest X-ray because we already know she has cancerous nodules and patches in her lungs.
After a few hours in an oxygen cage and some steroids, she seemed to do better. So they discharged her around 10pm and I brought her home, with her new albuterol inhaler with kitty-mask and spacer. (I am still easily floored by how many medications we humans have in common with pets, or vice versa. I have my own inhaler with a spacer, and it's the exact same dose of the exact same drug! Fortunately I hardly ever have to use it; my Singulair keeps my asthma controlled very well.)
Unfortunately, within only a few hours of getting her home, her respiratory rate was increased again and she was having to work hard to breathe. I tried using her inhaler -- and Kako is normally very feisty, so the fact that I didn't have to lay on her to hold her down while holding a mask to her little face was clear evidence that she really wasn't feeling good. But after two uses of the inhaler, each 20 minutes apart, and no improvement, I had to bring her back in around 3am. They kept her in an oxygenated cage all night. During the day they did X-rays, and her metastatic lesions in her lungs have increased in size.
I didn't know what to think or do. The 2nd vet she saw last night, at 3am, said to me more than once that we might be at a point where "we're out of options," and that her quality of life might be permanently negatively impacted, which would mean it was time to think about euthanizing her. I certainly don't want her to suffer. The weird thing was, she was fine -- her normal vocal, follow-y little self -- on Saturday. I had no reason to think she was getting bad. But the 2nd vet who saw her Sunday said cats are very stoic, and they don't show distress until they've completely decompensated (lost all ability to compensate for illness).
Also I think the weather has been total shit; my own asthma's been bothering me the last several days. So I was hoping that had something to do with it for Kako... because if that had nothing to do with it, it's just the cancer.
So when I came home at like 4am last night (early this AM), my heart was very heavy, because I thought I'll have to put her to sleep if she can't get any better. She did get better, the first time, but she got worse again so soon. I really had the feeling that this was the end.
Now I'm really confused. Her regular oncology vet took care of her today. And she has a totally different outlook. She seems to think that if we increase Kako's prednisone to twice a day (and make it injectable, rather than oral, which the cat often spit out or drooled; she hated getting it, and I have the scratches and scars to prove it), and that if we add this new drug, Palladium, to her regimen, that she still has quality time left... as long as the Palladium works.
So now I don't know what to think. Last night, I thought I was going to have to euthanise her, just because I don't want her to suffer or live a life where the quality of life is just crap. I have asthma; I know how stressful and scary it is when you can't breathe right. I don't want to put her through that.
But her regular onco vet seems to think this is just a bump in the road. I gave permission for them to go ahead and give her the new med, and they tried to wean her from the oxygen cage this evening, but it didn't really work. So they're keeping her another night, "to give the meds time to work," the onco vet said.
So now I'm like, did I do the right thing? I mean, even if she does have to be euthanized, I want her to be as normal as possible -- and able to breathe without difficulty -- up until she is put to sleep; I don't want her to die in distress, and I won't prolong her life if it's going to suck, just so I can still have her around for *me*. I very much want to keep this about *her*, and when it's the end of the road, and there's no way for her to go but down, to put her to sleep before she is suffering much.
But it came on so suddenly. I am an RN, and I didn't see it coming on (although they explained that cats kind of hide their sickness and just keep on keeping on until they can't, so it's hard for non-animal workers to tell). I admit that because my experience is with humans in the ER, I'm probably not looking for -- or seeing -- the right things, because while I know what a really sick person who's about to crash looks like, I have no idea what that looks like in a cat.
I spent most of the day just paralyzed and worrying. So much for the Adderall! Apparently, all I need is a flood of stress hormones, and that knocks out all the stabilizing, motivating, focusing dopamine in my brain.
But tomorrow I will pick her up -- if she's been weaned from the oxygen and she's doing okay -- and hopefully we'll both get back on track.
My lingering worry is, how will I know when it is time? I don't want her "time" to be when she's really in distress again. But that would mean I would have to catch her on the downward trajectory, but *before* she gets too bad... and I don't feel confident that I'll know what that looks like, because I didn't know that's what it was yesterday until I took her little shirt off and saw fully how much harder it was for her to breathe. I feel so stupid. So much for being a healthcare professional.
Also the vet from the 2nd/final visit last night has really given me pause. I definitely don't want Kako to suffer. The whole point of all this medication and ability to treat is so she *won't* suffer, so she'll have a good quality of life. The initial estimate they gave me, when she was diagnosed, was 6-9 months of extension of "good quality of life." Yesterday didn't seem like good quality. And I know she hates being in the hospital, away from home. But the hospital is where she needed to be. So doesn't that mean it is time? And yet Dr. G---- today seemed to think this was all treatable and deal-able with.
I don't know what to do. I guess I will see what happens tomorrow.
I knew she must be feeling really badly when I held her, all the way to the vet's, in my arms while driving (I know, not the best thing, but in her carrier, I couldn't see how she was doing). Normally, within seconds of picking her up, she's a little purring machine. Yesterday -- on the 1st trip to the vet -- she didn't start purring until I was getting of I-88 at the exit for the vet. It took her like 40 minutes of air conditioned air in the car to breathe easily enough to purr weakly. I felt so bad.
I guess it's that feeling of helplessness, that I can't do anything, that is really upsetting me. It really wasn't so long ago -- this time last year, for sure -- that I had the same feeling with my mother, every time she started to have trouble breathing. When I would come home from work at 4ish AM in the morning, I would go through my mother's apartment to make sure she was breathing and sleeping okay, even though it was hard to hear over the incredibly loud sound of her oxygen concentrator.
While I was driving home alone from the vet around 4am this morning, I thought about Nikita dying a few weeks ago, and now Kako seemingly being taken from me, and I wanted to shake my fist at the sky and say, "Stop taking people I love away from me!" But there's nothing to be done. It was Nikita's time; my mother, although her cancer was being treated and she'd lived a whole 3+ years after a diagnosis of lung cancer (VERY GOOD odds), was in a hypercoagulable state that led to her pulmonary embolism that killed her last June; I know that cancer will take Kako, too, because that's what cancer does.
But, dammit. Just dammit. It's the way life goes -- everything dies -- but why so soon, one after the other? I don't know how people who've lived through wars, disasters, fires -- who've lost everyone in their families -- I don't know how they go on. I know I will go on, too. But right now, it seems like, how? How can I? I'm tired of being so stressed out I feel like I'm losing my mind or I feel like the people in the marijuana PSAs, just completely inert and deflated. I feel like I've been that way since 2004-5 when my dad deteriorated into dementia and eventually died... and then my stepdad's cancer in 2005 worsened until he died in 2007... and then my mom last June, although at least she was okay and not in distress (she did die fast, at least). It's like, fuck. Fucking hell. Fuck me.
I'd ask why, why, WHY, but I know there is no answer. I wish I could do that whole Buddhist letting go of my desires and attachments -- my desire to have my loved ones with me, still; to remain attached to my loved ones, I guess -- but I can't, even though I think I am well acquainted with the first tenet of Buddhism: that life is suffering. But having no attachments seems like such a drifting, lonely type of life. So how can you let go of desires and attachments without cutting yourself off?
I don't want to be the crazy old animal lady, but my cats and dog were all cast-offs from other people, really... my little Kako was a kitten one of my employees couldn't keep when he moved back home in '96; Kailin was an alley cat; and Linus was my sister's dog until my nephew turned out to be allergic to him and to have terrible asthma. Sure, I get a lot from them... but they got something from me, a second chance at a decent life. It's not just one way, it wasn't just for *me*... I may not be the perfect pet mommy, but I like to think I'm better than none or than no-kill shelter life or, worse yet, than the end result of kill shelters when you can't get adopted.
Although both remaining cats probably would have been adopted because they were young when I got them... as opposed to the dog, who was already 5 years old when I got him; and it always seems like no one wants the older dogs from shelters. I'm trying to convince my older sister, who has been contemplating getting a dog, to consider older dogs. She's been eyeing a mixed breed puppy, who is admittedly very, very cute... but the Anti-Cruelty Society has dogs that are 3, 5, 7 years old... and still have more years to live.
But I had to bring her in. She was breathing like 60-70 times a minute (normal is 15-30) and really heaving. I hadn't noticed at first how bad it was getting, because after she started the prednisone a month ago, she started pulling out her fur. The vet had told me to get small dog clothes and put them on her to block her access to her own fur. (The cat really, really didn't like wearing doggie shirts, but she did put up with it. Although then she just denuded both her front legs. Sigh.)
But she wasn't acting right; she was completely quiet (and normally she's extremely vocal), and she was still as a rock (whereas normally she follows me around) and she had this look that was a cross between mad and scared. I took her shirt off and then realized how much trouble she was having breathing. At least she wasn't mouth-breathing; that's a really, really bad sign.
I took her in to the vet Sunday afternoon at almost 5pm. They did an ultrasound, which showed no fluid around her lungs, so they thought that was a good sign. They didn't do a chest X-ray because we already know she has cancerous nodules and patches in her lungs.
After a few hours in an oxygen cage and some steroids, she seemed to do better. So they discharged her around 10pm and I brought her home, with her new albuterol inhaler with kitty-mask and spacer. (I am still easily floored by how many medications we humans have in common with pets, or vice versa. I have my own inhaler with a spacer, and it's the exact same dose of the exact same drug! Fortunately I hardly ever have to use it; my Singulair keeps my asthma controlled very well.)
Unfortunately, within only a few hours of getting her home, her respiratory rate was increased again and she was having to work hard to breathe. I tried using her inhaler -- and Kako is normally very feisty, so the fact that I didn't have to lay on her to hold her down while holding a mask to her little face was clear evidence that she really wasn't feeling good. But after two uses of the inhaler, each 20 minutes apart, and no improvement, I had to bring her back in around 3am. They kept her in an oxygenated cage all night. During the day they did X-rays, and her metastatic lesions in her lungs have increased in size.
I didn't know what to think or do. The 2nd vet she saw last night, at 3am, said to me more than once that we might be at a point where "we're out of options," and that her quality of life might be permanently negatively impacted, which would mean it was time to think about euthanizing her. I certainly don't want her to suffer. The weird thing was, she was fine -- her normal vocal, follow-y little self -- on Saturday. I had no reason to think she was getting bad. But the 2nd vet who saw her Sunday said cats are very stoic, and they don't show distress until they've completely decompensated (lost all ability to compensate for illness).
Also I think the weather has been total shit; my own asthma's been bothering me the last several days. So I was hoping that had something to do with it for Kako... because if that had nothing to do with it, it's just the cancer.
So when I came home at like 4am last night (early this AM), my heart was very heavy, because I thought I'll have to put her to sleep if she can't get any better. She did get better, the first time, but she got worse again so soon. I really had the feeling that this was the end.
Now I'm really confused. Her regular oncology vet took care of her today. And she has a totally different outlook. She seems to think that if we increase Kako's prednisone to twice a day (and make it injectable, rather than oral, which the cat often spit out or drooled; she hated getting it, and I have the scratches and scars to prove it), and that if we add this new drug, Palladium, to her regimen, that she still has quality time left... as long as the Palladium works.
So now I don't know what to think. Last night, I thought I was going to have to euthanise her, just because I don't want her to suffer or live a life where the quality of life is just crap. I have asthma; I know how stressful and scary it is when you can't breathe right. I don't want to put her through that.
But her regular onco vet seems to think this is just a bump in the road. I gave permission for them to go ahead and give her the new med, and they tried to wean her from the oxygen cage this evening, but it didn't really work. So they're keeping her another night, "to give the meds time to work," the onco vet said.
So now I'm like, did I do the right thing? I mean, even if she does have to be euthanized, I want her to be as normal as possible -- and able to breathe without difficulty -- up until she is put to sleep; I don't want her to die in distress, and I won't prolong her life if it's going to suck, just so I can still have her around for *me*. I very much want to keep this about *her*, and when it's the end of the road, and there's no way for her to go but down, to put her to sleep before she is suffering much.
But it came on so suddenly. I am an RN, and I didn't see it coming on (although they explained that cats kind of hide their sickness and just keep on keeping on until they can't, so it's hard for non-animal workers to tell). I admit that because my experience is with humans in the ER, I'm probably not looking for -- or seeing -- the right things, because while I know what a really sick person who's about to crash looks like, I have no idea what that looks like in a cat.
I spent most of the day just paralyzed and worrying. So much for the Adderall! Apparently, all I need is a flood of stress hormones, and that knocks out all the stabilizing, motivating, focusing dopamine in my brain.
But tomorrow I will pick her up -- if she's been weaned from the oxygen and she's doing okay -- and hopefully we'll both get back on track.
My lingering worry is, how will I know when it is time? I don't want her "time" to be when she's really in distress again. But that would mean I would have to catch her on the downward trajectory, but *before* she gets too bad... and I don't feel confident that I'll know what that looks like, because I didn't know that's what it was yesterday until I took her little shirt off and saw fully how much harder it was for her to breathe. I feel so stupid. So much for being a healthcare professional.
Also the vet from the 2nd/final visit last night has really given me pause. I definitely don't want Kako to suffer. The whole point of all this medication and ability to treat is so she *won't* suffer, so she'll have a good quality of life. The initial estimate they gave me, when she was diagnosed, was 6-9 months of extension of "good quality of life." Yesterday didn't seem like good quality. And I know she hates being in the hospital, away from home. But the hospital is where she needed to be. So doesn't that mean it is time? And yet Dr. G---- today seemed to think this was all treatable and deal-able with.
I don't know what to do. I guess I will see what happens tomorrow.
I knew she must be feeling really badly when I held her, all the way to the vet's, in my arms while driving (I know, not the best thing, but in her carrier, I couldn't see how she was doing). Normally, within seconds of picking her up, she's a little purring machine. Yesterday -- on the 1st trip to the vet -- she didn't start purring until I was getting of I-88 at the exit for the vet. It took her like 40 minutes of air conditioned air in the car to breathe easily enough to purr weakly. I felt so bad.
I guess it's that feeling of helplessness, that I can't do anything, that is really upsetting me. It really wasn't so long ago -- this time last year, for sure -- that I had the same feeling with my mother, every time she started to have trouble breathing. When I would come home from work at 4ish AM in the morning, I would go through my mother's apartment to make sure she was breathing and sleeping okay, even though it was hard to hear over the incredibly loud sound of her oxygen concentrator.
While I was driving home alone from the vet around 4am this morning, I thought about Nikita dying a few weeks ago, and now Kako seemingly being taken from me, and I wanted to shake my fist at the sky and say, "Stop taking people I love away from me!" But there's nothing to be done. It was Nikita's time; my mother, although her cancer was being treated and she'd lived a whole 3+ years after a diagnosis of lung cancer (VERY GOOD odds), was in a hypercoagulable state that led to her pulmonary embolism that killed her last June; I know that cancer will take Kako, too, because that's what cancer does.
But, dammit. Just dammit. It's the way life goes -- everything dies -- but why so soon, one after the other? I don't know how people who've lived through wars, disasters, fires -- who've lost everyone in their families -- I don't know how they go on. I know I will go on, too. But right now, it seems like, how? How can I? I'm tired of being so stressed out I feel like I'm losing my mind or I feel like the people in the marijuana PSAs, just completely inert and deflated. I feel like I've been that way since 2004-5 when my dad deteriorated into dementia and eventually died... and then my stepdad's cancer in 2005 worsened until he died in 2007... and then my mom last June, although at least she was okay and not in distress (she did die fast, at least). It's like, fuck. Fucking hell. Fuck me.
I'd ask why, why, WHY, but I know there is no answer. I wish I could do that whole Buddhist letting go of my desires and attachments -- my desire to have my loved ones with me, still; to remain attached to my loved ones, I guess -- but I can't, even though I think I am well acquainted with the first tenet of Buddhism: that life is suffering. But having no attachments seems like such a drifting, lonely type of life. So how can you let go of desires and attachments without cutting yourself off?
I don't want to be the crazy old animal lady, but my cats and dog were all cast-offs from other people, really... my little Kako was a kitten one of my employees couldn't keep when he moved back home in '96; Kailin was an alley cat; and Linus was my sister's dog until my nephew turned out to be allergic to him and to have terrible asthma. Sure, I get a lot from them... but they got something from me, a second chance at a decent life. It's not just one way, it wasn't just for *me*... I may not be the perfect pet mommy, but I like to think I'm better than none or than no-kill shelter life or, worse yet, than the end result of kill shelters when you can't get adopted.
Although both remaining cats probably would have been adopted because they were young when I got them... as opposed to the dog, who was already 5 years old when I got him; and it always seems like no one wants the older dogs from shelters. I'm trying to convince my older sister, who has been contemplating getting a dog, to consider older dogs. She's been eyeing a mixed breed puppy, who is admittedly very, very cute... but the Anti-Cruelty Society has dogs that are 3, 5, 7 years old... and still have more years to live.