Sally's Regime

Here is our daily routine.

The white board is used to keep track of Sally's chemo days. She takes her Leukeran every other day so I need some help keeping track of it. I also use it to note when she needs appointments for CBCs, ultrasounds, B-12 shots, etc.

The pill bottle on the left is the Leukeran (brand name for Chlorambucil). I have to wear gloves when handling it, especially when it's cut in half. It's a 2 mg pill and she takes 1 mg every other day. It has to be refrigerated to keep it in an inactive state. It's a carcinogen so it's vital to handle it correctly. The pill gun in the plastic bag marked "Chemo Only" is used only for Leukeran.

The three pill bottles in the center from left to right are Lasix (brand name for Furosemide), Diltiazem and Enalapril. These are her heart meds. She takes 1/2 tablet of Furosemide every 12 hours, 1/4 tablet of Diltiazem every 12 hours and a whole Enalapril once a day.

Diltiazem is our old friend. She has been taking it since she was 2. It is a calcium channel blocker that relaxes her heart muscle. Her Hypertrophic Cardiomyopathy causes the heart muscle to thicken and stiffen up, interfering with normal heart function. In Sally's case, it effects her left ventricle.

Enalapril is her newest med. Her cardiologist, Dr. Orvahlo, prescribed it for her after an unltrasound last May revealed mitral valve regurgitation. The mitral valve is where the blood re-enters the heart from the lungs. Sally's leaks. Enalapril is an ACE Inhibitor and, among other things, lowers her blood pressure to take the stress off her mitral valve. It has the unfortunate side effect of putting strain on her kidneys so that's why she has her kidney values checked every time she has a CBC.

Furosemide is a diuretic. It keeps fluid from building up in her chest. It was prescribed for her after her first episode of congestive heart failure last May. It works like a dehydrator so she drinks A LOT of water. It also causes her kidneys to work harder.

The small vial in the center is B-12. The syringes next to the bottle are very small. Her dosage is 1/4 cc. She was found to be deficient as a result of the thickening and layering in her intestines caused by her lymphoma. B-12 deficiency is serious all on its own and can make cats VERY ill. She now gets an injection every time she gets her CBC because I can not bring myself to do the injecting. Sally has no body fat and the shot needs to be given in a muscle. She's very tricky to inject. Dr. Hansche and some of the techs have had trouble with her too so I'm glad to know it's not just me!

The Cosequin for her arthritis is in the box. It's powder in a capsule so I sprinkle one over her canned food in the morning.

Next to the box is a pill cutter, her pill gun and her daily pill minder.

I give her a small amount of canned food every time she gets pills for several reasons. She can't hide them in the corner of her mouth to spit out later if she eats. Also, since she's getting several meds at a time, I figured it would be easier on her stomach if there was a little food in there too. She thinks she's getting a treat for being a good girl. She is actually very easy to pill, at least for me. We've just had lots of experience!

Dr. Hansche okayed giving a 1/4 of a Pepcid to help with nausea in the early days of her chemo. Before I could start giving it to her, the vomiting went away but we have it in case she ever needs it.

Sally can't have raw food or vaccinations because she's on chemo. Even though her red and white blood cell counts are normal now, her immune system is compromised because of the Leukeran. A little repsiratory infection could potentially turn into pneumonia so we have to be careful that she doesn't get sick.

Sally only gets filtered water. She drinks a lot because of her kidney disease and Oceanside's water is very very hard.



Here is her dry food. I buy a 6 lb bag of Royal Canin Prescription Limited Ingredient Diet Duck and Green Pea and mix it with a 4 lb bag of Prescription Diet K/D. They are both low in protein to help relieve some of the strain on her kidneys.

All of these things help us manage her lymphoma, HCM, CRF, mitral valve regurgitation and arthritis. Some days I don't know how I keep it straight but it's all vital to keep my little girl alive and healthy.

RC - $35 per bag
K/D - $18 per bag
Leukeran - $53 for an 8 week supply
Furosemide - $9 for a 60 day supply
Enalapril - $4 for a 30 day supply
Diltiazem - $4 for a 90 day supply
B-12 & syringes - no charge (thanks to Dr. Hansche)
Cosequin - $20 for 80 capsules
Pill gun - $8 each
Pill cutter - $10 each
CBC - $120 every 3 months
Cardiac Ultrasound - $495 + $75 office visit once/year
Abdominal Ultrasound - $395 + $75 office visit once/year

Healthy & happy cat in remission - priceless!

Finding Our Groove

Just because Sally is in remission, it doesn't mean that the fun ends. Not by any means!

After her ultrasound, Dr. Richter recommended CBCs every 8 weeks. Her kidney values were still a concern and just because she had been tolerating the Leukeran well didn't mean that things couldn't change. Fortunately they could be done by Dr. Hansche because Dr. Richter was comfortable with flow of information between the two offices.

I had been researching cat food online, looking for the optimum brand that would meet all her needs. IBD dictates a high protein/little or no grain diet. The common belief among owners of lymphoma cats is that carbs feed cancer so little or no carbs is best. Heart issues need low sodium. Ideally she should be eating canned food but Sally always has been a grazer. You simply can't leave canned food out all day - especially the fish flavor they like - without your house smelling to high heaven! So after weeks of looking, I settled on EVO dry. I figured I'd run it by Dr. Hansche to make sure it was okay. No way Jose. Dr. H said that cats with kidney disease need as low protein as possible.

Okay, back to square one. The K/D dry she was already eating is the lowest with 21%. The Eukanuba I was mixing it with was 34% so that had to go. Do you know how hard it is to find a food that means all of her requirements? Next to impossible! But I did find one that seemed to meet every point. Royal Canin Limited Ingredient Lamb & Green Pea. A novelty protein, no grains and only 30% protein. I convinced Dr. Hansche to write her a prescription for it.

Opinion is divided on how protein effects cat's kidneys. Several members of the IBD and CRF groups I belonged to on Yahoo told me I was making a mistake. But hey, Sally LOVED the taste and it couldn't hurt her so I decided to go with my gut instinct.

CBC done September 30th. Weight stable at 8 lbs 4 ozs. Dr. Hansche is VERY pleased with how Sally is looking. He called with the results the following Wednesday. RBC and WBC normal. Kidney values DOWN for the first time in three months!!!! Her creatinine had gone from 3.4 in August to 2.8. Normal is 0-2.4 so she was getting closer! Ah, I love being right!!

We discussed her wobbly legs again as she seemed to be getting more unsteady on her feet. Dr. Hansche felt that it was arthritis which at her age wouldn't be unusual. Unfortunately, the normal treatment for it is Prednisone so that only left us with doing nothing or giving her pain meds. I didn't feel like her legs were keeping her from moving around, she was just very stiff when she first got up. We decided to just keep an eye on it and see how things progressed.

For the next two months, things seemed to be pretty stable. Her next CBC would be just after Thanksgiving. But before then, a very important day. Sally's 14th birthday! I made chicken and dumplings for dinner that night because she just loves to eat the chicken out of it. She gave me a wonderful present that morning and did something she hadn't done in a very long time. She jumped to the top of her barrel and wanted to look out the window. She was pretty wobbly and for a minute I thought she would fall, but she found a good spot and got stabilized and wound up sitting there for quite a while. I almost wanted to cry. I couldn't remember the last time I had seen this sight.


I picked out a thank you card to send Dr. Hansche and told him how grateful I was for the care he had given Sally and Emily over the last few months. I thanked him for giving me the chance to have Sally for another birthday. I don't think a day in her life has had as much meaning for me as November 3, 2008.

Thanksgiving came and with it a foil wrapped package from grandma. Mmmm, turkey!! Sally ate a huge pile of it as soon as we came home!

Next CBC November 25th. Things still good but now almost positive that the wobbly legs are arthritis. The weekend before this appointment I had picked Sally up right after she got up on Saturday morning and she growled at me. She has NEVER growled at me. Ever. It scared me at first but then I realized that I had picked her up on her right side and it seemed like her right leg was weaker than the left. Unfortunately, we just have to watch her and if she seems to be painful, pain meds are about the only option. CBC results - Creatinine now down to 2.7. Way to go!!

The weather started getting very cold (at least for the southern California coast), barely climbing out of the mid 5o's during the day. Sally started spending more and more time on our bed, getting down only to eat and use her litter box. Legs very unsteady and also noticing that her wrists are unstable and look like they won't lock up and support her. I talked about it on Catster and had several fellow seniors recommend Cosequin, a glucosamine supplement made especially for cats. I'm not a big believer in supplements and herbal remedies. I think they can be helpful in certain situations but not enough is known about them and their interactions. I had gotten a lot of recommendations and suggestions of all different kinds of things to give her for her heart, kidneys and cancer but didn't trust any of them. The suggestions for Cosequin came from sources that I trusted very much, like Sally's guardian angel kitty's older sister and a 20 year old Siamese that helped run the "Olde Furts" group that she belonged to on Catster. I asked Dr. Hansche about it and he said that it couldn't hurt her but warned that it took a good 8-10 weeks to see results. I found some online and started giving it to her shortly before Christmas. There were 80 capsules in the box. I'd see how she was doing at the end of the box and if I didn't see any improvement I wouldn't order it again. In the meantime, we started leaving the electric blanket on for her, much to her delight!

A new year. A grateful mama and a happy kitty. What more could one ask for?

February 7th and another CBC. A little disappointed that for the first time in 6 months, Sally's weight is below 8 lbs. She's at 7 lbs 15 ozs, but with her diminished activity during the winter because of her arthritis, Dr. Hansche wasn't overly concerned. The good news is that the Cosequin seems to be helping. While still wobbly, Sally is now moving easier and less stiffly. She's even been caught galloping around at night when she thought no one was watching. A full panel wasn't done this time so we don't know her kidney values but her RBC and WBC are still perfectly normal.

We seem to have found our groove. Now we just have to maintain this delicate balance!

Where Do We Go From Here? Up, Of Course!

So, two episodes of heart failure (5/2/08 & 5/19/08) resulting from fluid retention first caused by Prednisone and then Methylprednisone. Visit to Dr. Richter (internal medicine vet) and Dr. Orvahlo (cardiologist) on 5/23. The verdict: 3 month break from all steroids, continue with Leukeran, B12 shots, diuretic and start on half dosage of Enalapril for newly discovered mitral valve regurgitation. Check kidney function in 3 weeks. Follow up in 3 months. If cardiac function improved, then Budesonide can be tried as a replacement for Prednisone.

I brought Sally home, along with a tiny sliver of hope.

Thank god that Sally's been taking pills as long as she has!! Trying to poke 1/4 and 1/2 tablets down a 7 lb cat's tiny little throat is nearly impossible without the aid of Greenies Pill Pockets (which she won't touch) or a pill shooter (which has been my best friend since 1996).

We went back to ABC in 3 weeks for her follow up. This would be her very first CBC since starting Leukeran and Enalapril and I was a nervous wreck. If her white blood cell or red blood cell counts dropped, she would have to stop the Leukeran and all hope for her survival would be gone. If her kidney function was elevated, she would have to stop the Enalapril which was helping her battered little heart work better.

Finally! The first good news in 2 months!! Sally gained 6 ozs! Doesn't sound like much but it is when you're as small as she is. Yaay! All the hand feeding turkey 3-4 times a day was working! Dr. Hansche gave her the last of the four weekly B12 shots and drew blood for her CBC. Dr. Martin called the next day with the results. More good news!! Her white blood cell count dropped from the high of 26,000 to 16,500 (only slightly above normal). Red blood cell count normal. However, her BUN and creatinine levels were both elevated so Dr. Hansche would follow up with Dr. Richter to see if she should stay on Enalapril or not.

Mid week, Dr. H called to say Dr. R said to stay with the half dose for another 3 weeks and then re-check. 3 weeks go by with Sally continuing to vomit bile virtually every morning between 2-5 am. I had heard through the Yahoo Lymphoma group that cats can be given small doses of Pepcid to help with nausea and vomiting. I asked Dr. Hansche at her next follow up and he green lighted her for 1/4 tablet as needed. Another 3 ozs gained!! Dr. Martin called the next day. WBC down to 15,000 and RBC still perfectly normal. BUN and creatinine were still elevated but at the same levels as they had been 3 weeks prior. Dr. H followed up with Dr. R who said to try increasing Enalapril to 3/4 dose and follow up in 3 weeks to see how her kidneys were doing.

At this point, Sally had been on Leukeran for almost 8 weeks exactly. I had heard over and over that cats with small cell lymphoma took longer to show improvement on Leukeran, usually 8-10 weeks. As if by magic, right at 9 weeks, Sally turned a major corner. The daily vomiting stopped. Her energy level was better, she was interested in all her favorite things again, she began grooming herself again. She was now up to 7 lbs 13 ozs from her low of 7 lb 1 oz much to everyone's delight. I was starting to catch glimpses of my old girl again and nothing made me happier!

3 weeks and another CBC. Dr. Hansche was pleased at how much better Sally was looking. Another Sunday and another call from Dr. Martin with test results. WBC now 13,500, RBC normal, kidney function still elevated but still stable. Dr. Richter said to go for the full dose and check in 3 more weeks.

It was time for her 3 month re-check with Dr. Richter. With some anxiety, I scheduled her appointment for August 30th, the day before Emily's birthday. We were his first appointment that morning. I filled him in on her improvements and accomplishments. He wanted to do a follow up ultrasound to see how her intestines looked. He gathered her up and headed upstairs. I went out to the waiting room and held my breath.

About 20 minutes later, Dr. Richter came out with a look of complete surprise on his face. He uttered the words I couldn't have imagined hearing just four short months before: "No evidence of active cancer." Translation = REMISSION!! The layering and inflammation that had been so obvious in April were gone. All of her lymph nodes were normal. Pancreas normal looking. Kidneys looked about as expected for a cat with elevated values. But overall, he was amazed at how well she'd done on just Leukeran alone. He said that every trial he had ever seen had used a combination of a steroid and Leukeran and that the steroid proved to be the key component in achieving remission. He was frankly dumbfounded by her remission, but was pleased as could be with the outcome. He said she could now go to having her CBC done every 8 weeks and that she needed a follow up with Dr. Orvahlo to make sure her heart looked good. Obviously, no steroid was needed. She was to stay on Leukeran indefinitely.

I pratically ran out to the car. Who would I call first with the good news? Dorian? My mother? I sat in the car with her on the seat next to me and laughed and cried at the same time. I couldn't believe it! All of my hard work, tears and stress and Sally's determination and strength had paid off. My prayers had been answered! She looked at me as if I'd lost my mind. No one gives dirty looks better than a cat! Hers clearly said, "Stop that foolish noise and take me home!!"

So we headed home with something that had been absent for the last 6 months: hope for the future.

From Bad To Worse

Armed with a new prescription for Methylprednisone, I crossed my fingers and hoped for the best. The first three doses were uneventful but the morning Sally was due for her fourth dose, her breathing seemed a little off to me. My husband stayed home sick that day and promised to watch her so I prayed that I was overreacting, gave her the pills and headed off to work. All I could think was, "Please god, don't let this be a repeat of how she reacted to the Prednisone." Throughout the morning, he kept telling me that she was doing okay. By the afternoon, he said that I should make her an appointment to see Dr. Hansche to make sure everything was alright. By the time I got home, she was struggling to catch her breath and gasping for air. I gathered her up and jumped in the car. It was rush hour and the traffic was horrible. I just kept telling her over and over again that she'd be okay if she could just hold on, but the look she had on her face scared me to death. I was so afraid that I would lose her before we got to ABC Vet, but we finally got there and I rushed her in. They took her back to the oxygen cage right away and Dr. Hansche told me to come back in an hour.

It was the longest hour of my life.

When I went back, Dr. Hansche was waiting for me. He brought my baby girl out to me all wrapped in a blanket. He set her down gently on the table and kissed her head. Her breathing was better but still very raspy. Worried how she'd make it through the night, I had her care transferred to the same emergency vet she was at less than three weeks earlier. The ER vet was very negative about her chances. She used the phrase "gravely ill cat" and told me to prepare myself for the worst. Seeing her in the cage and having to say goodbye just tore me up. I cried so hard on the way home, I had to pull over on the side of the freeway because I couldn't see to drive. This was it. I was losing my girl.

With an emergency vet, no calls = good news. I called at 5:45 am to check on her and she was resting comfortably. I hadn't thought to bring her meds with me so I stopped by on the way to work to drop them off. They had Sally on the counter in a little plexiglass cage and she looked at me as if to say "get me out of here!!" Unfortunately, they had tried to wean her off oxygen and she didn't do well so they were keeping her on it for a few more hours. Later that day they had their cardiologist look at her and an echocardiogram showed some major structural changes. Sally got to come home that night around 9 pm.

Coincidentally I had a follow up appointment scheduled with her internal medicine vet the next day so we headed back down to VSH. Dr. Richter was pretty concerned about what condition her heart was in after two episodes of heart failure in three weeks. He took her upstairs to the UC Davis vet school to have their cardiologist do an ultrasound. While her heart looked better than they thought it might, he did notice that she had a leaky mitral valve. The medication she needed to take for it (Enalapril) was cause for concern because of the negative effects it has on the kidneys. Sally's kidneys had already taken a knock from the diuretic she was taking but we decided to try her on half the usual dosage to see how she'd do.

As far as her lymphoma went, Dr. Richter was not very optimistic. The steroid component of the chemo was directly responsible for remission and without it, Sally didn't have much of a chance. The Leukeran would slow the growth of new cancer cells and give her a couple of extra months but remission on Leukeran alone wasn't possible. The only chance she did have was a specialized steroid called Budesonide that is only absorbed by the intestines so would have a minimal chance of causing fluid retention. But first, she needed a three month vacation from ANY steroid to let her heart have a chance to recover and gain strength.

During the month of May, it broke my heart just to look at Sally. She was so skinny and frail. Her fur was dull and greasy and missing on her front legs, chest and stomach from where she'd been shaved for her many tests. You could see her little hip bones jutting out when she walked. (The picture at the top of this post was taken shortly after her second episode of heart failure.) She spent most of her time curled up on her birdy blanket. Every morning I was so afraid that I might find that she'd passed away during the night. About 6 weeks into her chemo, she began vomiting bile every morning between 2-5 am. My friends kept telling me that she was suffering and that I need to do the kind thing and let her go. But yet, as sick and weak as she was, she managed to wake up every morning and struggle through the day. I'd been warned by people in an online lymphoma support group that Leukeran took a long time to show results, usually 8-10 weeks. I know that people say you will "know" when it's your pet's time to go, but I think it's more that you realize that you've exhausted every avenue of treatment and you can't save them. I was right up to that point and didn't know what to do. I didn't want to take away her chance at remission because I was too impatient to see results. However I didn't want to string out her suffering and struggling because I couldn't bear to let her go. I always knew this choice would be difficult with her, but I had no idea HOW difficult it would be.

The Last Thing I Wanted To Hear...

Aside from her heart trouble, Sally has had a relatively healthy life. She was never officially diagnosed with IBD, but I kept her on chicken free food just to be on the safe side. She was always a "puker", sometimes once a week, sometimes once a day. It never seemed to cause her any harm or discomfort so it didn't raise any red flags in my mind.

At the beginning of February last year, I took Sally in for her yearly "senior" check up. I was pretty upset when her lab results came back with an elevated white blood cell count and blood in her urine. Dr. Hansche figured it was a UTI so she was prescribed an antibiotic and I was told to bring her back in a couple of weeks to have the tests repeated. I took her back three weeks later and while her urine was clear, her white blood cell count was exactly the same. Since she seemed to be doing well overall, we decided to give it a couple more weeks and then re-test her. So in mid April we went back again and yet again her WBC was unchanged from the previous two tests. Also troubling was the fact that she was down to 7 lbs 1 oz from 8 lbs in February. When you only weigh 8 lbs and lose a whole pound in 8 weeks, something is wrong. Dr. Hansche recommended further tests to see if it was just a stubborn infection or something more serious. I made the appointment for Wednesday of that week. Sunday and Monday she was fine. Tuesday we got home from work to find she had vomited. Nothing odd about that, except it had an unusually strong smell. She vomited again later that night and after following her to the litter box, I realized she was constipated. She vomited again over night and twice in the morning so I began to worry that her bowel was blocked. I took her to ABC for her tests. X-rays and an ultrasound were inconclusive so Dr. Hansche said she needed a endoscopic biopsy. They would check her blood work to make sure everything was okay and then do the procedure the following day.

Dr. Hansche called me Thursday morning to say that Sally's clotting time was very slow and that he was nervous about her developing a bleed after the procedure. ABC doesn't have 24 hour care so she'd be alone and unwatched if she stayed there overnight or, worse yet, she could develop one at home with me. He strongly suggested a specialist for the biopsy and gave me two choices: an internal medicine vet in San Diego that he'd worked with a lot or one in Carlsbad that he wasn't as familiar with. I chose the San Diego vet and managed to get an appointment the next day. Dr. Hansche was worried that she may have lymphosarcoma and wanted her to be seen as soon as possible.

We spent an hour with Dr. Richter at VSH on Friday and he agreed with Dr. Hansche's hunch. He repeated the ultrasound and was 95% sure but wanted to be 100% sure so he would do the biopsy to confirm. A specialized blood test showed that Sally was deficient in vitamin K so they gave her an injection before the procedure. The biopsy went well and we brought home a pretty weak kitty the next day. Dr. Richter said that they'd have the results in a couple of days.

I realized after a couple of days that Sally also managed to catch a URI during one of her overnight stays so I called Dr. Hansche for some antibiotics while I waited for the biopsy results. Then came the call I'd been dreading. On April 23rd, my worst fears were confirmed. Sally had small cell (or low grade) intestinal lymphoma. Instead of having one solid mass, she had cancer cells throughout the walls of her intestines which had caused significant thickening and swelling which interfered with her body's ability to get the vitamins and nutrients she needed from the food she was eating. It caused her to lose weight and to be vitamin B-12 deficient. It also caused the vomiting, diarrhea and constipation because the walls of her intestines were no longer smooth and food wasn't passing through as easily. After two months of wondering, it was good to finally know what was wrong, but why oh why did it have to be cancer??

Dr. Richter wanted her to start her chemo right away. She'd take Prednisone every day and a chemo drug (Leukeran) every other day. She'd also get vitamin B-12 shots weekly for 4 weeks and then once every 4 weeks. Because of the URI, Dr. Hansche told me to delay her chemo for a couple of days to give the antibiotics a chance to work. I figured the Prednisone wouldn't be as risky so I started giving it to her and figured I'd wait until she got her first B-12 shot to start the Leukeran and everything would be okay.

Not so.

After just four doses of Prednisone, Sally's lungs filled with fluid. We came home from work one night around 11:30 to find her breathing rapidly. I knew in my heart was wrong (although I didn't know why) so I rushed her to the nearest emergency vet. They immediately put her in an oxygen cage and started her on a diuretic. The ER vet warned me that she was very sick: pulmonary edema, congestive heart failure on top of lymphoma was a lot for a little kitty to handle. She was not very optimistic about her chances but said they'd do their best.

By 8 am the next morning, they started weaning her off oxygen. She improved to the point I was able to bring her home that night. She still had a raspy sound to her breathing and was pretty weak but had the sparkle back in her eye. I was told to discontinue the Prednisone, go ahead and start her on the Leukeran and to keep her on the diuretic.

I was scared silly of the Leukeran. I didn't think twice about it until I read the label and saw that I had to wear gloves when handling it so I looked on the internet and was horrified to read that it was a carcinogen and could cause me to get cancer if I didn't handle it correctly. I was going to poison my cat! I was sure of it! I kept putting off starting her on it until Dorian put his foot down and made me give it to her. I sat on the floor with her and just sobbed because I was so afraid of what it would do to her but yet I wanted her to have a shot at remission. So I gave it to her and waited. She slept a little more than usual the next day but didn't seem the worse for wear. Maybe this would be okay.

The first couple of time she took it, Sally slept a bit more than usual the next day but didn't seem to have any other negative side effects. Dr. Hansche conferred with Dr. Richter and they decided to try her on Methylprednisone, which is the metabolized version of Prednisone and would have less of the fluid retention side effect which had caused her pulmonary edema. I got her prescription filled and started her on it and hoped for the best.

If I thought the first three weeks of Sally's life post-diagnosis were rough, I was in for a rude awakening.

Heart Trouble

Shortly after her spay, Sally began vomiting frequently, up to 3 or 4 times a week. She was also extremely gassy and had some litter box issues. I took her to the vet who said that it was either a food allergy or irritable bowel so I needed to change her to a dry food that didn't contain chicken or chicken by-product. Ha!! There was only ONE dry food I could find that fit the bill and thankfully she liked it.

Several weeks after that, Sally caught a respiratory infection from one of our other cats. My mom took the two of them in for antibiotics. She was prescribed Baytril which gave her explosive diarrhea so I took her back three days later thinking that I'd just ask for a new RX and that would be the end of it. Not so. Dr. Neimeic asked me a question that would change Sally's and my life permanently.

"Has anyone ever mentioned that she has a rather loud heart murmur?"

My heart just sank. NO! NO! I can't lose her!! She's only 8 months old!!! Dr. Neimeic told me that she needed to have blood work, X-rays and an ultrasound to determine the exact defect, what kind of damage there was and what her treatment needed to be. There was a visiting internal medicine vet who could do the ultrasound and Dr. N would do the rest. I was only working as a part time teller and couldn't afford everything so I started working nights to earn the extra money I needed for the tests. Shortly after her first birthday, I scheduled the appointment to have everything done. The verdict: hypertrophic cardiomyopathy. It's the most common form of heart disease in cats and in Sally's case it meant that the walls of her left ventricle were stiff and thickened which interfered with her heart's ability to pump blood efficiently. Fortunately, her disease was pretty mild so Dr. Slusser said that she didn't need meds yet, but that he would check her again in a year to see how it was progressing.

The year that followed was full of trips to the vet for non-heart related things. She got stung by a bee and her paw blew up. She got a wicked dose of colitis. She had a bad reaction to her vaccinations. Another URI. Typical cat stuff. At the one year mark, I drove her down to Mira Mesa to Dr. Slusser's office for a follow up ultrasound and hoped for the best. This time, the thickening was much worse and he felt that without meds, she wouldn't last more than a year. Sally was put on twice daily Diltiazem and I quickly became an expert in giving a tiny pill to a small cat with a tiny mouth. God bless the creator of the pill popper!!

Amazingly, she improved. Dr. Slusser was flabbergasted. The Diltiazem was only meant to stop the progression of the HCM. Over the next couple of years, her heart function improved to the point where you almost couldn't tell there was anything wrong. Sally acted like there was nothing wrong and thoroughly enjoyed her life begging to be let outside to chase lizards, lying in patches of sun on the floor, playing with my make up sponges and capturing my heart more and more with each day.

When she was 6, I came home from work one day to find her breathing rapidly and stretching her neck out like she was trying to clear her throat. I rushed her to the vet and was told that her lungs were full of fluid and she was in congestive heart failure. They upped her Diltiazem to every 8 hours and put her on a twice daily diuretic and gave her a 50/50 chance of recovering. The increased meds made her very nauseous and she lost her appetite. She even turned her nose up at the deli sliced turkey my mother bought for her. Out of desperation we went back the to vet and she was given an injection to stimulate her appetite. After two hair raising days, she started to improve. After two weeks, you'd never know that anything had happened, except for the little yellow pill stamped "LASIX" that she had to take twice a day. Once again, she beat the odds and we went back to business as usual. This would continue for the next 6 years.

Little did I know what was lying in wait for the two of us.

In The Beginning

I've been thinking about starting a blog for Sally for a very long time but frankly never had the time to. Now that I've decided to start a family blog, I think I better go ahead and start one for her too because I can see her quickly becoming the main subject in the one meant for ALL members of our family. Not just because she has so many issues, but because she is so important to me.

So, from the beginning....

I got Sally as a birthday present in January 1995. Right before Christmas the relationship I was in had ended (rather badly) and I felt adrift, unloved and totally alone. I didn't realize it at the time but I had sunk into a major depression with a side order of wicked insomnia. I dropped out of school, stopped spending time with friends, stopped going out. In short, I became an emotional hermit and shut out virtually everyone and everything. That was back when Jennifer (my childhood friend) was going to school at CSU Northridge. She came home every weekend so we made plans to go to dinner the weekend after my birthday. I had told her that I wanted a three month old male kitten, preferably black, for my birthday. January is not the height of kitten season so when she told me she wasn't able to find anything to fit my particular requirements, it didn't come as a surprise. So that Saturday, she arrived right on time to go to dinner but she had her sister Catherine with her. Jennifer was carrying a small bag of kitten food, a small box of litter and a small litter box. Catherine was carrying a cardboard carrier. Smiling, she handed it to me and told me "Happy Birthday." I held my breath and opened the box.

My heart stopped. I was looking into the biggest, most frightened green eyes I had ever seen. Everyone thinks kittens are adorable furry little things. Not so. This one had huge ears, a pipe cleaner looking tale, was scruffy looking instead of fuzzy and looked at me as if I was the Angel of Death. That night she managed to bite my mother bad enough to require a doctor's visit the following Monday and scurried under the bed and wouldn't come out.

Over the next couple of days, I tried to get her to come out from under the bed. When I let her go, she disappear right back under it. I had to put her food and water under it so she would eat. She was extremely private about using her litter box and would stop whatever she was doing if someone walked in on her and go back under the bed so I quickly bought her a covered box.

Every day when I came home from work, I'd lay on the floor with my head under the bed and talk to her. Not baby talk, but talk like I would to another human. I'd tell her about my day, what I was thinking and feeling. I never tried to make her come out from under the bed. I wanted her to feel comfortable and safe with me. She was born wild and was rescued at approximately three months and then she was segregated from the other cats because she was so small. Her life had started out so traumatically, I just wanted her to have some peace and security.

After three weeks of her coming to live with me, I heard her purr for the first time. She was under the bed and the lights were out and she purred to let me know she was feeling more comfortable. She started playing at night and at 2:00 am every single toy seemed to have a bell! I would go sleep on the couch so not to disturb her play. Two weeks later, she came out from under the bed to greet me when I came into my room. I had to help her get used to the rest of the house (much to her dismay) but she soon became the queen of the castle.

Everything seemed fine. I took her to be spayed about two months after I got her. It cost $30. That was the last time she had anything normal...