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.