Back to the vet

A week has gone by without a word - a humbling testament to how quickly time marches on when we are busy living it. Last Tuesday Fig went to the vet for the blood panel needed before he could receive his next chemotherapy medication. I hate to stress him by taking him there, but this seemed necessary. They drew his blood and we waited...and waited...and waited for the results. In that instance, time crawled as I worried about Fig's stress level, about what the results would be, and what our options would be. At last the doctor came out with a dizzying array of colorful charts that essentially told me:
1) Fig's kidney function is continuing to deteriorate due to the cancer (it is still growing)
2) His liver function and white blood cell count are still good (he can have more chemo)

I caught myself feeling disappointed that the chemo wasn't stopping the cancer. He looked and acted so much better than before we started it - he has an appetite, his coat is still glossy, his eyes still clear, he is still alert and even plays after having some catnip. How could he not be getting better? Ah, the human proclivity for hope and denial!

Then we discussed options. I asked about the more aggressive chemo approach. Sadly, I learned that it would require weekly hospitalization for hours while an IV dripped the chemicals into him. This is where the quality of life issue comes in, since Fig would be miserable spending one whole day of each week he has left on earth being at the vet with a tube stuck in him. He might even have another seizure or stroke, and become debilitated or even dead as a result. Clearly, this approach does not seem an option for Fig. So we opted to take another capsule home. The pharmacy technician gave me a pair of blue latex gloves with the capsule - just to drive home how toxic is the substance I am putting in his body. I feel like a poisoner, but shove the capsule down his throat and wait until he swallows. I continue to hope that he will outlast the vet's prediction of 1-4 months left.

I have been wondering if, on some level, Fig knows that he is going to die. He wants to spend nearly all of his time on our front porch, watching the birds, cats, and neighbors; it's as if he wants to soak up every bit of experience and stimulation possible, making up for years spent indoors. And even in food, he wants constant variety. I have to mix wet food of different flavors and dry food with the bonito flakes to tempt him. These days I have 3 or more tins of different cat food flavors open in the refrigerator at once to accommodate his need for diversity in meals. One night my friend and I took him for a short walk - it was a mild evening and the night sky was sparkling with stars. After a block he ensconced himself on the warm asphalt and regally watched the bats flying overhead, listened to the crickets, and quietly enjoyed our company. I am glad that we are able to spend these moments together. Glad, too, for the miracle of technology that allows us to capture his moments and antics on video - memories of Fig that will outlast his all-too-brief passage on this mortal coil.

Hard Truth

I took Fig to the vet today. They wanted to do a blood panel before dispensing his monthly chemo capsule. It's not hard to get him into his crate these days - he seems to think of it as his sanctuary - but at the other end, it can be difficult to get him out of it. Especially after he's been spooked by hearing a myriad of dogs barking and trotting by us. This time I had to upend the crate and pour him onto the stainless steel table. One woman held him while I rubbed his head in a vain attempt to distract him from the needle being inserted in his neck to draw blood. We all got through it, though, and he was happy to scramble back into his crate afterwards.



Then we sat in the lobby to wait for the results. Isn't it odd how anxiety distorts time? It felt like days passed before the vet came out with a sheet of colorful graphs comparing his baseline tests to the ones done today. His kidney function is somewhat worse, due to the cancer, the vet said. The good news is that his white cell count, his liver - all are fine, which means that he can continue with the chemo. I asked how long she thought he had, acknowledging that there are no guarantees. She said that renal lymphoma moves quickly, and that he probably doesn't have more than 2-4 months, although it's possible he might live another 6 months.



Now I wonder if I asked the right question, for what do I make of the answer? He will die of this disease well before the 5-8 year window I thought we had before he got sick. So does the amount of time he has left matters? Or is it the quality of time he has left that is important? How does a cat value its life? For Fig, perhaps, the answer lies in the number of birds and other creatures he observes from his post on our front porch, or the amount of bacon we give him from our plates in the morning, or how long we gently rub his cheek in just the right spot. Yet I truly don't know.



I was disheartened by the vet's report, though. Since Fig has seemed better since we started treatment (more of an appetite, more normal activity levels, etc.), I was thinking that he might be a candidate for the more aggressive chemo treatment than the one we are using. I've been told that treatment hits the cancer harder than the capsules do, so he might have more time with that treatment protocol. But the vet explained that it would require Fig to spend whole days at the hospital on an IV drip. Given how stressed he gets by just a short visit to the vet, it doesn't seem that given a choice, Fig would choose that treatment for himself; it doesn't feel right to make that choice for him, just for the possibility of extending his existence.