In August of 2012, I got a terrible diagnosis on one of my beloved cats, Clide. Oral Squamous Cell Carcinoma. In the world of feline cancers, this is one of the worst. In addition to cancer, Clide had always been diabetic, and I had learned how to treat feline diabetes through the grace of his patience. We lost Clide on March 5, 2013 after a good fight. It was time, and we had done everything we could do for him. He was a little over 16 years old. Many people had followed Clide's journey on Facebook, and I believe I even wrote about him here.|
So it was somewhat not surprising to get a phone call from my friend Harry in May of 2013. Harry was the adoption center coordinator for a local nonprofit rescue, and managed the center in a PetSmart in Northern Virginia. It seemed there was this 8 year old cat who had been boarded at PetSmart while his person was on a cruise who had started showing classic symptoms of feline diabetes. The boarding manager took him to the Banfield vet in the PetSmart for a quick blood sugar check, and sure enough, he was off-the-charts diabetic. His glucose was over 600 (for the uninitiated, normal glucose in a cat ranges from about 60 to 120). They couldn't reach the owner, so the boarding manager brought in insulin (Lantus) he used on his own diabetic dog, made a call to PetSmart Charities to cover the veterinary care, and they started the cat's treatment. When they finally reached the owner, she told them to just euthanize him. His name was Henry.
Henry had so charmed the staff at the boarding facility and Banfield that they did not euthanize him. But the clock was ticking. They reached out to Harry and asked if he knew anyone who would foster or adopt a diabetic cat. Because Harry knew that I had lost my diabetic two months prior, he called me and asked if I would take Henry. Honestly, I felt like Clide sent Henry to me -- that it was an alignment of my skills and my love, and one that would ease the pain of the loss I had experienced. What started was about a 10-day negotiation to get the owner to sign over Henry to the rescue, and then I officially adopted him and took him home.
Henry was always a character. He was a big short-haired Maine Coon mix -- his healthy normal weight was between 13.5 and 14.5lbs. The first thing I did was start getting him used to home testing. Again -- for the uninitiated -- you can glucose test a cat with a simple, fast prick to the outer part of the ear with a lancet, and then use a commonly available (and affordable) human glucometer to start getting a handle on blood sugar at home. Lucky for me, Henry was a snap to test. Knowing that I could monitor his blood sugar, I then set about switching his diet. Cats generally and diabetics specifically should be fed a low carb, wet only diet. It is biologically appropriate for the species, and it's better for all body systems, not just natural insulin production. To start, I switched him to Fancy Feast Classic pates. Each of those are grain free with a whole protein as the primary ingredient, and all are 5% calories from carbs or lower. He LOVED Fancy Feast (I refer to it as "crack for cats"), and within two weeks of coming home with me, he was off insulin entirely and completely diet-controlled.
The age estimate I was given on him when I adopted him was that he was 8 years old (ish) when I brought him home. Once he was off insulin and had put on weight, he went for dental surgery to have 24 (!!!) of his 30 teeth removed. No need to get his diabetes under control just to let him languish with bad, painful teeth amirite?
After these two big things, Henry's winning, charming personality really came into full bloom. I mean, it makes sense, right? He felt better, so he was free to just be Henry. So here's what we started seeing:
- Henry LOVES hair ties (ponytail holders). It was a regular occurrence for me to be sitting and working to have him come up, spit a hair tie at my feet, look at me and then meow as if to say "you know what I want. Get on with it." I'd toss those hair ties and he would do a feet-high standing vertical leap and come down with it in his mouth -- nothing but net.
Allow me to digress a bit. I do a lot of rescue, and like most cat rescuers, you develop a specialty of sorts. Some people are extremely experienced bottle-feeders for orphaned kittens. Some have a penchant for blind cats, or for tripod cats, or for wobbly cats who have cerebellar hypoplasia (a painless, non-progressive condition caused by in vitro exposure to distemper affecting fine motor coordination). When people would ask me where my rescue passion was, I would tell them: "Old, broken cats." So basically, my soft spot is for at-risk older cats who also have one or more chronic but treatable conditions (most often, diabetes) who are highly unlikely to get adopted by a "normal" family. I care for them with a passion and skill I have developed over the last decade. It's even grown to where I assist a national nonprofit, Diabetic Cats in Need, by going out and giving hands-on training to people who contact them for help on how to home test, what to do about diet, and how to safely administer insulin to a cat. I've learned to be really observant and focused when it comes to these older diabetics -- I am extremely proactive in their medical care, and I'm very, very lucky that I have a job that frees me financially do what I need for them. I'm always grateful for that. Just keep in your mind as (if) you read on -- there's not much I won't do to keep one of my cats healthy and happy, and I'm proactive about it. Always.
In addition to diabetes and bad teeth, Henry had a bunch of other intermittent chronic but manageable conditions. He was prone to unspecified allergies -- grass would cause him to break out around his mouth (I used to walk him on a leash and harness until that happened). He started showing signs of GI issues back in 2014, so we switched him to a low carb novel single source protein. In 2016, he had a mild asthma attack (which we thought was probably related to his allergies) and treated him with Flovent and Albuterol inhalers. Nothing was serious on its own, but it heightened my already borderline-obsessive tendency to watch him like a hawk health-wise.
So last Sunday, December 17 2017, it was remarkable that Henry did not immediately eat all of his food. That's a warning sign that something is up with him. On observation, it appeared to me that his respiration was faster than it should be, so I timed it. Yup. He was about 50 breaths per minute, where 40bpm is high normal. So, we went to the vet first thing Monday morning, December 18th. But seriously -- I wasn't concerned anything super bad was going on. Because of his allergy history and his asthmatic history, I figured it was likely that he was having another asthmatic event. His vet did chest xrays, and they didn't look great, but we were still in the asthma lane. I took him home and started him back on the Flovent and Albuterol.
By Tuesday night December 19, however, his breathing hadn't improved enough to where it was becoming a serious concern for me. Of course, it was after hours -- but rather than wait for my regular vet to open the next day, I took him to the ER and had him admitted for respiratory distress. They put him in an oxygen cage and he immediately felt better (although his pulse-ox always showed well-oxygenated blood). We discussed kick-starting the healing by putting him on a steroid, prednisolone. Again, for the uninitiated -- steroids and diabetic cats usually don't go together. But, because I can handle the increased blood sugar that steroids would drive, we decided to go that route. he was discharged on Thursday December 21 and I brought him home.
By Saturday morning, I have to say -- I was scared. I told my husband that there was something else going on with Henry driving his respiratory issues and that we needed to quickly get to the bottom of that or else my fear was everything -- all of his issues that were manageable in isolation -- would aggregate and then snowball. I felt like we were standing on a precipice, and we were either going to get it together and under control or careen off the edge into oblivion.
So, back to the ER we went. Because the steroids and the inhalers should have been having an effect on him if an acute asthma attack was the only thing in play, and they weren't. Repeat xrays interpreted by a radiologist yielded a possible diagnosis that any pet-lover fears: it looked to the radiologist like it was some kind of neoplastic thing going on in his lungs. Shorthand of that adds up to cancer.
But even then, I didn't panic. I discussed with the vets that I wanted them to treat him and keep him protected and stable until I could get him to the oncologist on Tuesday morning (today, December 26). The stupid Christmas holiday -- which I HATE in the best of circumstances -- meant that it had to wait until after the holiday. Henry was kept on oxygen, his steroids were upped, and they started him on an IV and antibiotics, in addition to his inhalers. We visited multiple times a day and he was hanging in there until....
Christmas Eve's visit, 9pm. Despite the oxygen and steroids, his breathing was not substantially improving. That said, after grilling the vet, we determined that he was neither frightened nor in pain. His demeanor was good, he was eating for them (though not as much as usual), and was at the front of his ICU cage looking for attention whenever any random human was nearby. Henry was good that way -- he never got freaked out in those situations as long as he felt safe and acceptably ok.
But then, Christmas morning. Cursed, horrible, forever blighted Christmas morning. We came for a visit, but we wanted to talk to the vet first. Remember -- the goal was to maintain him to get him to the oncologist the day after Christmas. Because I mean -- he was literally FINE a week and two days earlier, doing Christmas Henry things and Dickish Henry things, snuggling in, purring, walking around, fucking with shit. Status quo Henry stuff. Suspected cancer isn't a good thing in anyone's book, but this isn't my first rodeo and I know that some cancers respond very well to treatment, and that cats tolerate chemotherapy very well. I had first-hand experience with that fact. But Christmas morning, in our discussion with the vet, one terrible new thing was addressed. Somewhere between the time that we left Sunday night and return 12 hours later on Monday morning, Henry had lost the ability to blink/close his left eye. Further, the critical care vet's examination yielded that the entire left side of his face was numb and without feeling. She didn't think it was a stroke, but more like Bell's Palsey in presentation. But the clear implication was that IF they suspected cancer (they did) and IF that cancer was not a more treatable cancer that responds well to steroid therapy (it wasn't) then it was likely a more aggressive cancer that -- wait a second while I burst into tears here -- was likely involving his brain. The eye and face were neurological symptoms.
Let me tell you a little bit about how I view euthanasia with pets. I'm for it. When I bring these cats into our home and family, when I agree to love them completely and do the very best I can for them, that agreement includes absolutely sparing them from pain and fear. And this vet -- kindly but firmly -- just told me that without being able to be certain, she had to fear that there was some metastasis or spread of whatever it was to his brain. I was no more than 24 hours from being able to get him to an oncologist. As luck would have it (and as a funny aside), when I had been a client of my oncologist back in 2012/early 2013, I discovered that he was a raging liberal and we frequently exchange outraged personal emails about the Trump administration. So I had emailed him and knew that I could get Henry in to see him today.
But none of that would come to pass. There was a serious risk that Henry would have a seizure, a stroke, or an aneurysm or something else equally as awful. He would be frightened. He would be in pain. I always had the power to spare him from that. And in 15 minutes, we made the decision to help Henry move to the next thing. We spent some time with him in the "Family Room" (a nicer setting than an exam room specifically for euthanasia procedures). Before they brought him in, I told my husband to calm himself and rid himself of any grief or anxiety, that Henry didn't know anything other than that this was a visit, and that we didn't need to be telegraphing our grief and fear through our demeanor or body language or tone of voice. I told Henry I loved him. I scratched his neck and chin, and I kissed him. I told him what a joy he was, how grateful and honored I was to have him in my life. He was still Henry on some level -- and that was hard. It's hard to let them go when they're still themselves to some extent. But what's the alternative -- wait until he's so out of it to spare me a hard choice? NO. When we had given him a lot of love, the doctor came in. He already had an IV catheter. She gave him a sedative and I felt Henry relax. I kissed him again, and then she gave him the euthanasia drug. In seconds, he was gone. It was peaceful. He was with us. He wasn't frightened -- he went permanently to sleep.
When they took him out afterward, I let it all out. I had held it together, as I should have. But I fell to my knees on the room and released what my husband described as a soul-wrenching wail. I don't even remember that.
Yesterday was hard. Today was worse. I'm doing that thing that anyone who has loved a cat or dog and who has to make that decision does -- I'm second-guessing myself. I'm going back through pictures I've taken of Henry over the years to see if there's anything there that I should have noticed, some care I should have gotten him that I failed to do. I can't find anything, really. So that's good, I guess. But then I've moved onto whether or not he had cancer; whether or not I should have waited that 24 hours and gotten him to the oncologist. I mean, seriously -- I've had hospice cats that didn't go downhill as quickly as previously-healthy Henry did. In less than a week, and really -- in about 48 hours from Saturday morning to Monday morning -- he went from basically ok to near death. I'm conflicted and grief stricken, and unable to do, well, much of anything. This sucks on a level that makes everything else I ever thought sucked completely inconsequential.
So now that I've bummed you out, let me tell you something. Put aside my guild and grief -- I'm going to have to reconcile myself with how this played out, and I'm going to have to get through my grief by going through my grief. No way around that. But even with all of this, I feel lucky and grateful to have had Henry in our lives. I took him because not many people would have, and because I knew that whatever effort I gave to him to see him happy and healthy would be returned exponentially. He was a joy in our lives -- truly enriching. That's why it's so shocking and painful that he's not physically here with us any longer. Even knowing what I know now about how this would all play out, I would do it again. I would take Henry again and love him and baby him and let him know he's adored all over again. No regrets -- just grief. The residue of a life cherished.
When not crying, I've spent today getting all of the pictures and video I have of Henry organized into an electronic folder. There are LOT, and I'm grateful for that. I've been able to go over particularly the videos, some of them very recent -- and reassure myself that there wasn't something I missed. And even more than that, to see and remember that every second of this cat's waking life he was babied, kissed, scratched, brushed, cuddled, played with and loved. Truly.
The hole in my heart with his loss is profound, and it's different than with the others I've lost. With them, I knew what they had. I pursued treatment, and when treatment wasn't working, switched to palliative care and prepared myself for the loss. With Henry, the fabric of who I am has been torn.
I posted about his passing on Facebook yesterday, and the response has been overwhelming. So many kind notes, phone calls from those I know in real life, condolences and reassurances. But one, from a friend of both my husband and I in real life, stand out. She gave us a poem that I think perfectly captures the glory of love and the agony of loss:
The Once Again Prince
We who choose to surround ourselves
~Irving Townsend, Separate Lifetimes
Exactly so. I'm deeply grateful to my friend for providing me with that.
Thanks for reading. I wrote this to honor one of my best friends, Henry, and to publicly mourn his loss from my life. I am enriched he was there at all, and eviscerated by his leaving.