October 17, 2019
You get that feeling that you’ve heard this story before…
Almost two years ago–shy five days–I posted that Lazarus (the scruffy, orange fellow pictured above) had liver cancer. And then he didn’t. He had pancreatitis. Still, we were told he was going to die. Soon. And then he didn’t.
Two days ago, we were once again told that Lazarus probably had liver cancer, and we began mourning all over again. And now he doesn’t have liver cancer. Honestly, I think the boy’s liver was a gift from Loki, or maybe Anansi. It likes to f**k with us.
I also think that I’ve found cause to deny Harlan Ellison’s claim that “Let me help” are the three most important words in the English language, even up against “I love you.” I think “It’s not cancer” are those words for me. This is not the first or the second time I’ve heard them, about a cat or a human, and their emotional impact simply cannot be described.
Nonetheless, he’s not out of the woods as I write this. Just as it happened two years ago, the story doesn’t have an end, or even an ETA on one.
Last Sunday, October 6th, Lazarus threw up in the dining room. Now, understand, barring hairballs, Lazarus is not a puker. Never has been. But this time he left a day’s supply of cat food and more on the new rug. I cleaned it up and didn’t think a lot of it. Sometimes we all get sick to our stomachs. And I still didn’t think a lot of it, though I should have, over the next few days when my friend Lynda, who was staying with us following the memorial party for our friend Lew, commented that Laz was leaving food in his bowl. It was dry food, after all, and he usually eats canned. Our shipment of cans had been delayed, though, courtesy of some douchebag who stole my credit card number. So I figured he was just tired of dry food.
Then he threw up again early Thursday morning. Twice. By 10 PM that night, I was pretty sure he was dying. His paws were cold. He was very listless. He refused food. He was spending all his time in our back bathroom, the same room that he’d lived in for his first few days in our house as a kitten in 2003. I wasn’t sure if he was being nostalgic, or he just wanted to be near the tub, where the spout always offers a little water. Mind you, he has a very nice water fountain downstairs, but, for some reason, he was preferring the tub right now.
I did not call the emergency vet. The fact is that Lazarus is old. He has a thyroid condition which was being managed very well with diet, but which had suddenly spiked again in response to a bladder infection. He was on antibiotics and due for another blood test in 72 hours. All of his bloodwork was pretty normal, if you accounted for the fact that the thyroid and kidney function were being elevated as a result of the infection and my (all unknowing) purchase of a vial of catnip for him, which neither my vet nor I knew could be trouble for a thyroid patient. If he was suddenly dying, I didn’t believe there was anything that they could do to help him along that we could not. I texted his regular vet to let her know things were strange.
I took him to our bed that night. He usually sleeps in the laundry room, because his meows would otherwise keep us awake. Since the death of Oreo, our older cat, in January, he had taken to yowling all night long. The vet believed he had dementia. But he wasn’t yowling now, and I did not want him to die while I was in another room.
Surprisingly, though, he did not want to sleep with us. He jumped right off the bed and went to the door, and, upon its opening, headed down to the laundry room, where he likes to stretch out in the dog’s crate during the hours that he knows she won’t be coming to toss him out.
The next morning, I talked to his vet, the amazing Dr. Ward. I asked if his kidney numbers had really been normal four weeks ago when they were checked. She said they had. She was baffled that he was suddenly not eating and vomiting. She prescribed fluids, which I immediately began administering, and an anti-nausea drug which seemed to have no effect at all. Laz still wanted nothing to do with food. That Friday night, again, he seemed out of it and as though he were transitioning out of this life. But, again, he wanted no change in sleeping arrangements.
The weekend brought no improvement. I gave him daily fluids and offered him food. His canned food arrived, but he didn’t care. Saturday, I tried raw ground beef. I tried bullion, thinking maybe his teeth hurt. I tried cream. Nothing. Finally, Sunday, I bought Summer Sausage, his favorite, and cut it into tiny pieces for him. I think he ate one. In despair, I syringed cream down his throat, thinking he had to have some calories. To my surprise, after 2 mL of cream, he got off my lap and started drinking it out of the bowl.
Renee convinced me Sunday night to carry forward with our plans to spend a night and day at the beach. I was very afraid that we were leaving Lazarus to die alone, but I suppose I was even more afraid that, if we did not take a break from the routine and the responsibilities of caring for so many people and animals, we’d be going with him. So our son Christian came to take care of Laz and Kirby, and we went.
I was heartened when Christian texted me that Laz had eaten a little Sunday night. I was amazed, when we returned, that our sick cat met us at the door, meowing insistently, and accepted four pieces of Summer Sausage. No, not accepted–devoured.
And then, just a little while later, my hopes came crashing to the ground–indeed, crashed through the floor and into the subterranean depths–when we took Laz to see Dr. Ward later. Not knowing why he was so ill, she feared that there existed a mass inside him that she had missed on examination a month ago and again just two weeks ago. So he went in for X-Rays along with his dose of antibiotics. X-Rays showed that his stomach was not lying straight left-to-right, perpendicular to the line of his spine, but cocked on an angle–as if something was pushing it out of the way. That “something” appeared to be a shadow between stomach and liver. It was either a mass on the liver, or it was fluid in the stomach causing deformation, which meant a tumor in the stomach. In either case, we were looking at cancer, because a benign growth wouldn’t be making him this sick. We would know more tomorrow, after a radiologist looked at the images, and after his blood work came back.
“If it’s cancer,” I said, “we don’t have many options, do we?” I knew that he was too feeble to survive surgery, and that chemo wasn’t practical for feline hepatic carcinoma. Dr. Ward kind of winced. She loves Lazarus almost as much as we do. “Only to make him comfortable.”
So we bundled him up and took him home, utterly drained, resigned to care for him as best we could for what little time he would have left. Would he develop jaundice soon, I wondered? We had lost a cat to liver cancer before. Was he already in “the zone,” of being detached from reality? Would he continue to eat? Would we have to put him to sleep? And when?
He got his fluids that night and ate a bit more. He was finicky about breakfast the next morning, although we were encouraged that he was meowing for attention when we got up. That was a bit more of a return to normalcy. We waited all day for a phone call about the bloodwork and the radiologist. That evening, as we do, Renee and I went to exercise and to the Judges’ Bench for dinner and a drink. Our son Ethan joined us. Just as I was sitting down with my second Night Swell IPA of the evening, my phone rang.
At first, I though Dr. Ward sounded hesitant to speak. That would make sense, delivering bad news. But then she said that my initial guess about kidney function had been correct. Lazarus’s BUN and Creatinine numbers were suddenly very high–something like 125 and 4.6, if I remember correctly. Way up from where they had been a month ago. “I think the bladder infection was so severe that it just overwhelmed his kidneys.” She then explained that administering fluids to a cat with renal failure was equivalent to giving dialysis. I knew that. Our cat, Touchée, had spent quite a few years of her life with reduced kidney function. Fluids had helped her turn the corner, and a diet of raw ground beef, oats and carrots had kept her levels normal for years.
Dr. Ward cautioned me that we probably could not expect his kidneys to return to normal. But I asked if, all other things being equal, it might not be possible to compensate for the reduced function for some time to come. “That’s what I’m telling you,” she said.
“What about the mass?” I asked.
“Well, that’s why I’m so glad the radiologist looked at his plates. That mass is his pancreas. He’s a very weirdly shaped man on his insides. Don’t tell him I said that.”
“He’d probably be proud of it,” I said. “So it’s not cancer?”
“It’s not cancer.”
It’s not cancer.
We discussed diet. We discussed that there are still grave risks. His thyroid function is not what it should be. If we can’t coax him to eat, he’ll still die. That’s the battle with kidney failure and pets. The first job is the get them to eat.
I’m well aware that this story could still end the way I’ve twice feared it would. After all, we’re all going to die someday. The only questions are, how long can we hold out, and how much good can we fit into those days, months and years?
Right now, Lazarus is starting to complain more about the promptness of service, the state of the house and the staggering national debt. He jumped up on the couch last night and gave the corner of the book I was reading a good half-dozen head-butts. This time I didn’t tell him to stop. He made it clear that the needle in his neck which delivers fluids is not a welcome visitor. He ate dinner. Twice.
Tomorrow may suck. Tomorrow may always suck. But we’ve had 725 tomorrows with him since the first time we were told he was leaving us. For now, it’s amazing to get one today that doesn’t suck.