December 2, 2007

The death watch

Ok, so maybe that title's a bit melodramatic, but that's how I felt at 2:00am this morning.

The cat I've lived with for the past ten or so years is sick. He's been diagnosed with chronic renal insufficiency, which basically means that his kidneys are pooping out on him. Once a hale & hearty part-Maine Coon/part-Labrador Retriever, he was 19lbs of attention-hogging affection and appetite. Ironically, the vet had me put him on a diet just a year ago. Over the last couple of months, though, he's lost over half of his body weight and spends most of his time huddled in a little ball with a woe-be-gone expression on his face. Trying to pet him causes him to either pull away, or to let out pitifully sad squawks that pass for meows. I also get to hear these squawks in the middle of the night, when he wakes up feeling poorly and gets right up in my face to let me know about it. He's gone from being a big, goofy goombah of a cat to a furry, miserable little bit of skin and bones.

Treatment of CRF is tons of fun. His usual vet went for minimal treatment: special food (which he won't eat), one medication, and subcutaneous fluid therapy to help maintain his hydration level. After three members of her staff couldn't hold him still long enough to give him one full sub-q treatment, I knew there was no way I was going to be able to do it alone. There's no experience quite like holding onto a squirmy, agitated cat that shouldn't be stressed with one hand, trying to insert a needle under his skin with the other hand, and then turning on an IV drip with your non-existent third hand. Toooonnns of fun. I gave it up on the first attempt without even poking him once.

So, when he continued to lose weight and the usual vet continued to insist that "some cats with CRF can live up to a handful of years", I took him in for a second opinion. While being examined, the goombah collapsed. The new vet immediately put him on oxygen, and collected lab samples once the cat had stabilised. He finally came out to the reception room to announce to me that "That cat is going to die!" My response was a stunned pause and then "Uhhh, yeah, I already know that. What are you really telling me?" I finally gathered that there's no way to predict how long the cat will hang on, but that he's in worse shape than the previous vet had led me to believe. His increasing weakness and dehydration has apparently contributed to a heart murmur, and the stress of being at the vet set it off and caused the collapse. The new vet prescribed a more aggressive treatment of six medications: three pills, two liquids, and a gel, each to be administered twice a day. So far, I've been able to get no more than one or two medications into the cat at a time. If it's in his food, he won't eat it (and he's barely eating to begin with). If I try to give any of them to him orally, he puts up a hellatious fight for such a weak little thing, and I'm paranoid of stressing him and having his heart give out. In addition to the six meds, the new vet also strongly recommended sub-q therapy. Surprisingly, this has been much easier than expected. The new vet installed a GIF-tube, which is basically a catheter, into which I can insert the IV tube with no needles involved. The goombah looks like a little Franken-cat with the thing sticking out of the back of his neck, but so far he's been amazingly good about allowing me to remove the cap, insert the IV tube, turn on the IV, then everything in reverse. He freaks a bit when the fluids begin flowing under his skin, but it's over fairly quickly.

The big question at this point is how long all of this is going to last. The cat keeps wanting to pry open the kitchen cabinet and curl up amongst my extra plastic grocery bags and cleaning supplies, and this gives me unhappy visions of sick animals searching for a solitary, quiet place to die.

The other spot he seems to like is a corner of my computer room. In the middle of the night, I woke up to find him gone from the bed, and got it into my head that I should try to get him to eat something. I found him in his little corner and gingerly carried him out to the kitchen, where he licked up a few bites of food. He then wandered back to the computer room, staggering a few times, and straight into the corner, where he huddled up into a ball, staring at the floor and occasionally shivering. I sat and watched him and convinced myself that every twitch he made was the beginning of the end. The big thing I wonder about is how I'm going to handle it when he does go, considering my phobia about dead things (can't recall whether I've already written about that or not). Will I freak and not be able to touch his body? Would it be better to have him put to sleep? And, if so, at what point? I've always believed firmly in quality of life over quantity, so my main concern at this point is that he be comfortable. If he deteriorates to the point that he's in pain or constant distress, I would have no qualms about putting him to sleep. It'd be devastating, but so would watching him die slowly or coming home from work to find him lifeless. I'm gonna be sad as hell no matter when he goes, so it's the how that has me agitated.

At 3:00am or so, I finally tucked a couple of fleece blankets into the corner around him and went back to bed. At the moment, he's huddled down there next to me. Every now and then, he'll curl up like normal and go to sleep with the tip of his tail wrapped over his nose, which is a relief to see. And I've written way more than I intended to. My intention for this blog was to briefly say that my cat is sick and his care is taking up a lot of my time, and as a result I'm going to be slow to respond at length to communications. A few brief posts or comments here and there are all I'm going to be able to manage for a while. Unless, like today, I have a bunch of mental or emotional crap that I need to unload.

The silly goombah:


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