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...