Monday, December 31, 2007

There was an opening at the vet today and I took it. Katherine was re-evaluated after seemingly being under more distress.

They weighed Katherine and she'd actually gained a quarter pound. He made the caveat that the gain could be fluid retention. Her heartbeat had started to become irregular due to the anemia, so we talked about next steps. He believes there's an equal chance that Katherine has either cancer or an immune-mediated anemia. Even if we wanted to remove the spleen, she's not in a condition to risk such a surgery.

So, we started Kat on chemotherapy today. She also got a shot of Epogen to help boost her red blood cell count. The thought of chemotherapy had evoked images of a bald cat in extreme pain, but after reading the literature, it's clear there are typically little to no side effects in cats.

Katherine is back home now, a little groggy from the sedative, but seemingly more energetic. It could be my imagination, of course.

Sunday, December 30, 2007

Katherine's condition appears to have deteriorated a bit since her vet visit on Wednesday. Her movements seem even slower and more unsteady; and her mood seems more depressed. Despite all of it, she still sticks to many of her habits and continues to eat, drink and use the litterbox.

It is heartbreaking to witness what seems to be a classic set of diminishing returns in relation to her medication. I fear I'll soon be forced to consider what's truly in Kat's best interest: to keep her alive for the sake of being alive, with no hope of improvement, or euthunasia. For now, I feel there's still hope that Katherine will recover, given the ambiguous test results. Her symptoms first became apparent two weeks ago and, if nothing else, the steroids at least seem to be keeping her red blood cell count out of the really critical zone (a packed cell volume level less than 12%). But for how long?

Today, Katherine ate more deli turkey; chicken baby food; some Pounce treats, a small nibble of tuna; and a small portion of roast beef. I also tried to give her what I surmised might be the kitty equivalent to medicinal marijuana: catnip. Somewhere I'd read that catnip is often used to treat anemia, though I'm not holding my breath for an herbal remedy. No, my goal was to try to help lift Kat's spirits a bit. She slowly rubbed her face into the catnip, weakly mimicking her usual ritual when confronted with the herb.

I left a message with my vet to call me tomorrow, in the off chance that he's available on New Year's Eve.

Saturday, December 29, 2007

Katherine, fortunately, is still with us as the year winds down. She neither seems dramatically better nor dramatically worse. She still tries to do her normal routine, often cut short by her lack of strength and energy, which leaves me somewhere between encouragement and sheer depression.

I continue to administer the high dose of steroids, wondering if the medicine itself might actually be making her feel worse, given that it's a whopping 20mg a day. I've read that dogs typically should be given about 1mg per pound of weight, but have found no such guidelines for cats. Katherine last weighed in at 10.2 pounds.

When I arrived home from work, Katherine greeted me at the door. It was the first time she'd done so in days, though she had to stay there and rest a bit before mustering enough strength to follow me into the living room. Later that night, she weakly jumped up onto the plushy arm of the snuggler chair, meowing for just a couple licks from my bowl of ice cream. In healthier days, this was Katherine's custom, despite her lactose intolerance.

Her appetite still seems to be there, though I haven't seen her eat more than a couple pieces of dry food. Right now she's being sustained on deli turkey and roast beef, with the occasional bite or two from the tuna can. I've seen her drink from her water dish a number of times.

I still hold onto some hope that the oncologist's guess is completely wrong and that Kat will, in time, be her old self again. Still, I've been trying to prepare myself for the inevitable, whether that occurs a week or four years from now.

Wednesday, December 26, 2007

The test results for Katherine's spleen biopsy were frustratingly inconclusive. The oncologist still believes it's a good bet Katherine suffers from some type of cancer. She spoke to my vet and they both agreed it's at least a possibility. My vet, however, thinks Katherine looks better than the last time he saw her and finds it encouraging that she's eating and drinking. In fact, he still feels it isn't necessarily out of the realm of possibility that we're still dealing with an entirely auto-immune issue.

Despite his infectious optimism, which I surely appreciated, I was concerned that Katherine's PCV level had dropped 2% after her blood transfusion at the emergency clinic (now at 16%). If it's possibly all auto-immune related, why haven't the steroids had much impact?

"We've seen in some cats and dogs a delay in the body's response to prednisolone," the vet explained. "We've seen dogs, for example, take as long as three weeks before there's a noticeable improvement."

We talked about a number of possibilities, including Heinz-Body Anemia, Hemobartonellosis, vitamin supplements and the Epogen drug. In his more than 25 years of practice, he's never seen a documented case of Heinz-Body Anemia and finds it unlikely; Hemobartonellosis is also not likely given her blood work results. "There are some classic findings with 'Hemobart' that show up on a blood panel, and Katherine doesn't exhibit them," he told me. He confirmed for me that there had been at least two blood smears to look for the organism and nothing was found. As for Epogen, he felt it was too early to consider using unless, after about a week of observation, her condition warranted it.

Katherine's gums looked a little less pale to the vet and her hydration level seemed ok. After the examination, he demonstrated ways to better administer her medications, especially the pill-form. He gave me a bag of soft, salmon-flavored kitty treats that are hollow in the center, perfect for hiding a pill. "I wouldn't suggest hiding a whole steroid tablet in one of these, but it's great for the appetite stimulant," he said. I watched as Katherine ate three or four of them enthusiastically. He also provided me with a bottle of a bacon-flavored, liquid nutritional supplement similar to Pet Tinic called "Amino B+K." "A lot of cats really like the taste and you can sprinkle it over their food," the vet said. Finally, Katherine got a vitamin B-12 shot, which he said will also help stimulate appetite.

Katherine weighed in at 10.2 pounds --not as bad as I thought, though she's definitely bony to the touch along her spine and hind area where there was once muscle.

I'm trying not to think about the cancer end of things...the vet has injected newfound hope --however remote-- that Katherine will pull through and I'll be writing about her well into the new year.

Tuesday, December 25, 2007

It can be argued that I'm still in denial over the idea that my cat could be dying of cancer. Indeed, until I hear back about the spleen aspirate results, I'm still hoping for a more treatable and survivable cause of Katherine's severe anemia.

A couple prospects are Heinz-Body Anemia, which is a potentially severe form set off by the ingestion of onions or garlic. I had no idea that onions were so harmful, and it sickens me to think back on all those years in which I'd allowed my begging cats to have bites of people food, potentially heavily seasoned with all manner of onions. Both my cats are extremely big fans of tomato sauce, for example. In a way, I'm almost hoping that Kat's suffering from Heinz-Body anemia because at least that isn't a death sentence when treated.

Secondly, I still don't know for certain if Kat has been adequately examined for Hemobartonellosis. One vet told me it seemed from the chart that there had been a couple blood smears checking for organisms under a microscope, but I never got a definitive answer. If she is suffering from this disease, it's treatable with a one-two punch of antibiotics and prednisolone.

Due to the clinic's mishandling of Kat's liquid medication (they had failed to keep it refrigerated), I was forced to give Kat a pill form of the steroid, which is so much more difficult and traumatic an experience to administer. After finally getting her to swallow it, I tried to give her a half pill of Cyproheptadine, an appetite stimulant the oncologist had prescribed yesterday. I was only partially successful. By that time, Kat was already aggravated by the steroid pill and kept spitting out the now half-dissolved Cyproheptadine. So for the next few minutes, her mouth began to foam up with the stuff. I felt horrible.

But perhaps what little stimulant she'd ingested actually worked, because she ravanously chewed and licked into the tuna can twice today; plus she ate the last small bits of roast beef; and finally a spoonful of beef baby food. She also drank at her water dish for a few minutes. I'm hoping there were more episodes of eating/drinking that I didn't witness, as her weight loss is quite noticeable now.

Tomorrow, I will ask the vet about Heinz-Body Anemia; Hemobartonellosis; an anemia drug called Epogen; something called Pet Tinic; and the possibility of another blood transfusion.

Monday, December 24, 2007

Katherine's blood transfusion went smoothly last night. It's concerning to note, however, that the PCV test they performed post transfusion showed only a slight rise (18%). She has a long day ahead of her, as the oncologist plans to sedate her for the ultrasound and for a spleen needle aspirate (the bone marrow aspirate was too risky at this stage, the oncologist said).

I visited Katherine for the allotted half-hour time this morning. She was noticeably more active, walking around the room we were assigned and jumping up on chairs like her old self. My presence definitely brings out Kat's bravery and she seemed all around more comfortable and not so sickly.

When the technician walked in to take Katherine back to her cage, Kat hissed at her as if to say, "Go away, evil wench! Can't you see I'm spending some quality time with my Dad?"

At least five different veterinarians have invested time in Katherine's case: one of them is as far away as Rhode Island. All of them have looked at the numbers and, unfortunately, suspect cancer may be at play. The oncologist told me they will look to confirm or rule out a multiple myeloma or lymphoma. There is fluid in her chest and she has an enlarged heart...two things that could have been caused by the IV fluids themselves and would resolve once she's discharged; or it could be further confirmation of a systemic disease like cancer.

I'm worried about the tests they will perform today and the fact that she will be sedated. But I suppose the risks outweigh not performing the procedures, so I have given the oncologist the go-ahead. I should know more in a couple hours.

UPDATE (7:00 PM):
They discharged Katherine today, citing that she'd be more inclined to eat at home. Katherine and I probably have about five hours of combined sleep over the last few days, and I was upset when I discovered that the clinic technicians had neglected to refrigerate the liquid steroid medication I had been asked to bring in. So when they discharged her, they handed me a prescription for more liquid prednisone...late on Christmas Eve afternoon, when no pet pharmacies would be open. To appease me, they provided the drug in a pill form plus the prescription and offered to reimburse me for the cost.

The oncologist told me that the spleen biopsy results won't be available until the end of this week due to the holidays. The ultrasound revealed some fluid in her chest (which did not appear to be cancerous) and an enlarged heart. Her spleen was also enlarged and she took a biopsy for analysis. Judging on sight alone, the oncologist is 80% certain Katherine is suffering from lymphoma. If the results confirm her tentative diagnosis, chemotherapy might be in order. If Katherine responds to chemo (and only 50% of all cats do), she has about six months to live.

Frankly, at this point, I think the anemia would kill her before the cancer. I'm going to spend some time with her over the next couple days and then make a decision after the test results have returned.

Sunday, December 23, 2007

Katherine and I are both stressed out and exhausted today. Last night, a new, grimmer symptom seemed to be emerging, or perhaps I've only recently picked up on it. Kat seems to be breathless, taking more frequent, longer breaths. I've learned it's one of the classic signs of anemia.

Still, she continues to show interest and laps up much of the baby food I hold under her nose, one spoonful at a time. I force-fed her some of the Prescription Diet A/D food last night. I have not yet seen her drink from her water dish and she seems disinterested when I bring it to her.

The clinic she stayed at the other day was packed with holiday weekend emergencies and I got the impression that all they could really do for her was hook her up to an IV and wait it out until Monday amid a noisy, chaotic environment. Neither my normal vet nor the clinic could get her to eat while she was hospitalized, so I hesitate to return her there unless she dramatically starts to go even further downhill.

But given the breathlessness, I may drop her off this afternoon in preparation for her appointment with the oncologist tomorrow. I've also learned that there are a few more items she's inexplicably not been tested for: Feline Infectious Anemia (Haemobartonellosis); FeLV and FIV. I will ask for those tests when I drop her off.

It's been extremely taxing on both of us this past week. It's tearing me apart to be losing her like this, slowly, piece by piece.

UPDATE (7:20 PM):
I returned Katherine to the clinic this afternoon after witnessing the breathing change overnight and noting her white gums. They took another Packed Cell Volume (PCV) test and, unfortunately, the number had dropped from 17% to 14% (with the normal range being about 30%). She is now scheduled to have a blood transfusion, followed by bone marrow testing tomorrow afternoon. Her FeLV and FIV tests were negative.

Saturday, December 22, 2007

First of all, I want to thank all those who have sent us notes of support during Katherine's health crisis. We were overwhelmed by the emails and suggestions and we are very grateful for all our fans. Trudy, we thank you so much for your baby food suggestion: she is eating it!

Katherine had been back at home from her two-day hospital stay only 24 hours before my concern over her lack of interest in food and water prompted me to return her to the vet yesterday afternoon. They gave her a subcutaneous fluid injection, which is saline solution injected just under the skin for hydration. I watched as they performed the procedure and then, to my surprise, they handed me a bag of saline and some 18-gauge needles to take home with me. They also gave me a few cans of Prescription Diet A/D and a large, turkey baster-sized syringe. They demonstrated how I'd water down the food into a stinky, fish-flavored slurry, load it into the syringe and then force the food down Katherine's throat. I was dizzy.

The vet re-tested her Packed Cell Volume (PCV) levels and they had maintained themselves at 15%. A normal, non-anemic cat's PCV levels are twice that figure. Any lower than 15% and typically it's necessary for a blood transfusion. "There's been no change in the PCV levels since we last saw Katherine," the vet told me, "but it's good that it isn't dropping."

When we returned home, I continued to administer Katherine's dose of prednisolone. She wouldn't eat but a few nibbles of the tuna, so later that evening I force-fed her some of the Prescription Diet food via the syringe. She was very annoyed, but didn't put up much of a fight.

As the evening eroded into night, I grew increasingly agitated over her condition. How long does it take to see results and why wasn't I seeing any? Was there perhaps something else going on that was causing the anemia? My thoughts raced wild as I searched the Internet for clues. Finally, at midnight, I decided to take Katherine to another nearby pet clinic for a second opinion.

The vet there ran more blood work, took a couple X-rays and performed a physical exam. He concurred there might be some dehydration and also began talking about blood transfusions. Then came the one word I had dreaded: cancer. The X-rays looked fairly unremarkable, save for a slightly enlarged liver. Typically, anemia is secondary to some other condition, and since her kidneys appeared normal, the other most likely culprit was some sort of cancer.

My heart sank as I said goodbye to Katherine once again, leaving her at the clinic overnight for observation and further testing. She looked up at me from inside her new cage as if to say, "Please don't do this to me. Take me home with you!" She was surrounded by cages filled with many loudly yelping dogs and mewing cats. Was I doing the right thing? Was this in her best interests? When I arrived home, I tossed and turned all night, dreaming of a very thirsty Katherine drinking water from a faucet.

In the morning, the vet from the clinic called to say that some of the protein levels in her blood were suspicious for cancer. The good news was that her PCV levels did seem to rise overnight: they were now more than 17%, so perhaps the steroids were beginning to have an effect. They suggested I keep Katherine hospitalized until an oncologist could run an ultrasound and bone marrow test to either confirm or rule out the disease. But the oncologist wouldn't be available until Christmas Eve, more than two days away. Because the clinic wasn't having any luck getting Katherine to eat (and I was), I decided to have her discharged until the Monday appointment.

Now, Katherine's back home, just as lethargic as ever, though tonight I did get her to eat some Gerber chicken baby food (much thanks to Trudy for this wonderful suggestion). She's taken a few more nibbles of tuna and is trying to regain her strength. By Christmas, we should have a better picture of Katherine's long-term prognosis.

Thursday, December 20, 2007

When I called the vet today to check up on Katherine's condition and to possibly set up an appointment to visit her, she told me it would be a good idea to send her home.

"She hasn't been eating the last couple days," the doctor revealed to me. Their hope was that, when returned home to her familiar surroundings and routine, she'd renew her interest in food. The good news was that the steroids did appear to help a bit, so they sent us home with the drug in a liquid, tuna-flavored form.

My cats usually love lunch meat, so I bought some nice roast beef from the deli, a few cans of tuna and more kitty treats. When Katherine arrived home, she was able to eat a few of the Pounce treats I gave her and some of the tuna. Later, I sliced up some of the roast beef into tiny pieces and placed them in a serving dish immersed in a little water. Katherine wasn't interested initially, but when I picked up the little bits and placed them up to her nose, she'd eat pieces of the meat from my fingertips. I've seen her drink from her water bowl and use the litter box a couple times, so she's at least trying to keep in step with the usual routine.

But there's no denying Katherine is still very lethargic and unsteady. The vet told me she had lost 2 pounds during her two-day hospital stay, and it showed. A cat that for 10 years had been a sleek and muscular creature had been reduced to a tired, wobbly, sickly-looking kitty.

Her pattern today has been to sleep, attempt to move, but then she'll stop after a few feet and lie down to rest. I found her this evening lying just outside her litterbox in the basement; it took her a while to work up the strength to climb back up the steps.

Still, she does appear to be sticking to her habits. Despite the lack of energy, she still manages to jump up and down from my bed and she's as affectionate to me as ever.

I'm keeping a close eye on Kat and hope to see her back to her old self soon.

Wednesday, December 19, 2007

The vet called with an update on Katherine's condition. The blood work results showed that she's not suffering from renal failure after all. She's anemic.

"Katherine appears to be suffering from Immune-Mediated Thrombocytopenia," the vet said. It's apparently a condition in which the body's immune system tries to fight off a virus and in so doing, mistakenly begins attacking the cat's own red blood cells and platelets. This also explained the blood in her urine and the high protein concentration.

The vet will keep and monitor her over the next day or so as they administer doses of steroids. Their hope is to get her red blood cell count back to normal without having to revert to more aggressive measures, such as surgery to remove her enlarged spleen.

"Katherine's definitely feeling in better spirits today," the doctor said. But they'd have to wait and see if they actually begin to see improvement in her next round of blood tests.

Potentially, this is much better news than if I'd received confirmation of renal failure. Doing a complete about-face, the vet says the blood test results do not support any problems with her kidneys. That's good, because cats with renal failure almost always get worse.

I'm looking forward to my Christmas miracle. Get well, Katherine! Calypso and I miss you.

Tuesday, December 18, 2007

First Calypso was sick, and now Katherine. Only this time, I'm not sure Kat is going to survive past the holidays.

Over the weekend, Katherine very suddenly started to act lethargic. I was immediately concerned, but decided to adopt a "wait and see approach" since it still seemed like she was eating and drinking.

Nearly every night at bedtime, Katherine will jump up onto my chest almost immediately after I lie down. I'll pet her for a few minutes before she skitters off. It's been her way of saying, "good night" to me for more than 10 years.

But for the past two nights, Katherine stopped jumping. It seemed she would make a point not to travel very far, sleeping in the same spot for hours at a time. Still, she seemed interested in food, happily eating the tuna and cat treats I'd fed her.

I dropped Katherine off at the vet this morning so that they may run tests, and what they've learned so far doesn't sound very encouraging. There was evidence of blood in her urine and its protein count was extremely high; she was very dehydrated; and they were starting her on IV fluids. The vet told me they'd need to wait for some of the blood work results to get the full story, but it was looking a lot like renal failure.

She asked me if Katherine could have been exposed to something toxic like antifreeze but, of course, Katherine is strictly an indoor cat. The vet added that sometimes it "just happens" in cats over 10 years of age, though it's much more common in older cats.

X-rays on her kidneys will be the key to see if they are enlarged, but it was clear my vet was preparing me for the worst. I feel horrible, guilty, angry...and in shock. I simply can't imagine losing Katherine, not right now....not ever...but especially not during the holidays. She was my first pet after living on my own, and one of my best friends.

Here's hoping the vet can bring good news this evening.

Sunday, November 4, 2007

For the the last week or so, Calypso has been inexplicably vomiting shortly after eating. It doesn't happen every time she eats; indeed, there have been strings of days in which she seemed fine.

The bout started around the time I had fed her a piece of turkey pepperoni. Calypso and Katherine have both eaten "people food" for years with no problems. I usually limit their access to proteins like hamburger, chicken or fish, though they both have an unusual affinity for Spaghettio's tomato sauce. The pepperoni, however, proved too much for Calypso's little digestive system to take.

When we visited the vet yesterday, Calypso was quite stressed out, refusing to be coaxed out of her cat carrier.

"Good morning," the veterinarian said as she walked into the examination room along with her assistant.

"Good luck," I smiled back, pointing to Calypso's rump, the only part exposed from the cat carrier on the exam table. It took the vet and the assistant a few moments to fully extricate my screaming, wide-eyed cat.

Then came the Hannibal Lecter torture device.

With her assistant securing Calypso's writhing body, the vet slipped a black leather kitty muzzle over her head, tying it securely in the back. This seemed to placate Calypso in seconds. It was as if the darkness itself had lulled her into a more peaceful state.

Occasionally letting out a pitiful, muffled meow, Calypso held still while the vet examined her stomach and neck area, checking for swelling, bloating and anything else out of the ordinary. It all seemed normal.

After she was caught up on her vaccinations, Calypso was carried away to have blood drawn. Tests would be performed to rule out any pancreatic or other digestive system issues brought about by the pepperoni.

I should know the test results in a few days. In the meantime, Mr. Lecter has given me an excellent idea for a Christmas gift.

UPDATE (11/6/07):
Calypso's blood work proved unremarkable save a slight elevation in her white blood cell count. The vet attributed this to allergies since her stool sample was normal.

Perhaps a little too much information, but there you go.

Wednesday, May 30, 2007

We watched "Pirates of the Caribbean: At World's End" over the weekend.  In it is a character known as "Calypso."  Of course, we couldn't help but look at each other and smirk every time the word was uttered...

Friday, April 13, 2007

It's hard to believe, but Katherine turned 10 today. I adopted her three months later, and launched Pussycam soon thereafter.

Katherine has been a great companion over the years. She's not the friendliest cat to strangers; is frightfully scared of thunderstorms; chases and torments Calypso --but all in all, she's a good kitty.

The online experiment that is Pussycam has helped me document Kat and Calypso's lives like I never would have otherwise. And I'm thankful for that, as I am of my cats.

Happy birthday, Katherine.

Friday, April 6, 2007

Over the last 10 years, I've experienced recurring dreams about cats. I'm assuming this is natural for the average cat owner. Two primary cat-related dreams that I experience are as follows:

1. Invasion of the Cats
In this dream, as described in more detail here, hordes of kitties are desperately and aggressively trying to enter my home through every available crack and crevice. I anxiously attempt to keep them at bay, but eventually they manage to slip past my makeshift barricades.

2. Don't Have Kittens
This dream entails my acquisition of a litter or multiple litters of kittens. Typically, I realize in the dream that both Katherine and Calypso are spayed and thus cannot give birth, so I'm left wondering where the kittens came from and whether Katherine and Calypso would make good kitty "parents."

So what kinds of kitty dreams do YOU have? Use the Name That Caption form to submit your cat dreams.