Thank you.  DH and I have been crying, talking, and researching
together, and while we haven't made any final decisions, I think we
will probably choose to keep her at home with pain meds and steroids
for as long as she feels well.  For a variety of reasons, I don't
think chemo will work well for her.

There are veterinary oncologist departments within an hour and a half
of here, but I think instead we're going to see the internal medicine
specialist about 5 minutes away.  The e-vet says that internal
medicine is another three years of school, and oncology is basically a
concentration within internal medicine.  She also gave me the names of
a few vets who do house visits.  If at all possible, I don't want to
take her to vets anymore.  They can come to her.  She deserves to be
comfortable, especially at the last.

Thank you.  I've spoken to my aunt, my parents, and several other
people -- the main theme I have heard is, almost everyone who's had a
pet has had the experience of wishing they hadn't waited so long to
let them go.

My family has a very strong ethic when it comes to pets -- one, they're
your responsibility, you don't abuse them or neglect them.  Two, your
most important responsibility is that when it comes to the end, you
choose what's best for them, not for you.  As my aunt said, "With pets
we can avail ourselves of options we don't have with people."

Oscar is still doing pretty well.  The pain med for her, Buprenex, is
absorbed directly, so she doesn't have to swallow it.  After we gave
her it last night, she felt well enough to play with her cat dancer,
even jumping around a little.

This morning I stuffed her chili pepper toy with catnip, and she has
been enjoying it, rolling around, licking it, holding on to it -- the
usual.

So I know that she is still with us, and at this point she still seems
alert, interested, and able to enjoy the little things.  She is eating
well, drinking, and eliminating.  But I can also tell that she's
slower than she was just a few months ago, that some things hurt her,
that even being pet is sometimes too much.

It crossed my mind that it might be kinder to her to let her go while
she's still well -- before she starts to suffer.  But I don't think I
could do that, even if it would be a kindness to her.  The best I can
do is to spend as much time as possible with her and be honest with
myself about how she's doing.

Thank you.

Thank you.  It is heartbreaking, but the pieces of the puzzle are
starting to fit together -- her EGC, the fact that she's had three
infections in her paws in the last year.  I think her immune system
may have been busy doing other things.

At the moment I'm not sure where I put the file with her oldest
medical records; I would like to check if they tested for FeLV / FIV
when I first brought her to the vet's.  I imagine they did, but I
can't actually remember.  And now I'm wondering about when Eros
briefly lived in the house -- could he have brought something in that
compromised her?  Regardless, if she has either, there's nothing we
can do about it now.

Although -- while FeLV is associated with some sorts of lymphoma,
typically the type Oscar has is not one of them.

Thank you.

Thank you.

My therapist wasn't making any recommendations.  It just happened to
be that the time I was supposed to call the vet's was also when I was
at my appointment.  Glad it was, actually, and glad I called then
rather than waiting.

Thank you.

Oscar clearly wonders what's up -- DH and I were bawling last night,
and she acted like we were aliens.  "Mom, you are *weird*."

Thank you.  I'm doing better today ... I have a plan of sorts.

Thank you.  Oscar would like me to tell you that she's a girl -- her
vet told me otherwise at her first exam, and by the time I caught on,
she already knew her name and didn't want to change it.

Thank you.  Wouldn't it be nice if she could talk to me?  Tell me if,
where, and how much it hurts, and what she thinks about the risk vs.
reward?

Thank you.  We came up with some questions last night and talked to
the e-vet.  We're still going to talk to an internal medicine
specialist, but ...

Here's where we are.  There is no such thing as a cure for this
disease, in humans or cats.  Only remission.  Oscar hates vet clinics
and won't eat if she's staying there, so hospitalization isn't really
an option.  Chemo pills must be swallowed whole -- we can't even get
her to eat most foods (even before she got sick).  Any medication
involves chasing her around the room, forcing her out from under beds,
etc, and forcing things into her while she fights and shivers.

Her symptoms include vomiting (which she hasn't done for a while now)
and nausea.  Side effects from chemo include vomiting and nausea, and
reduced appetite.  Oscar is already an extremely picky eater.

She has had several infections in the last year.  Chemo trashes the
immune system.  Oscar's reaction to antibiotics is liquid diarrhea,
with painful-sounding gurgling tummy, and that's assuming we stick to
the regimen and force-feed a frightened, fighting cat this liquid that
she definitely doesn't want.

So if we did chemo, it would involve (probably) four days of chemo
pills, 21 days off, four days of pills again, etc for several months.
In addition to other medications.  And then there would be the nausea,
the loss of appetite, potentially diarrhea, and the risk of further
infection and illness.  And force-feeding.  Which she hates, and gets
all over her fur. There are still mats in her fur from last week that
I need to cut out (I've gotten a few of them).

All of that is for a 60% chance of a remission that might last a few
months, and during which we'll have to continue to medicate.  For a
lucky 15% *of those cats who ever go into remission* it buys 2 years,
knowing that cancer *will* hit again, and when it comes back, it hits
hard.  (I've seen different percentages in different places.)

If we do this treatment, Oscar won't know that we're doing it for a
sliver of a chance of a few months of health.  All she'll know is that
we're chasing after her, forcing things down her throat, when she is
already feeling miserable.  Quite likely given her sensitivity, she'd
get diarrhea that smells so bad that she keeps trying to cover it up,
and if I'm not there to do it for her, she'll keep doing it till she
gets it on her paws.  If she has to wear an e-collar she'll get litter
and diarrhea on the collar.

Oscar has been sick several times this year, and DH and I have had to
force treatments on her, treatments she hated.  Now, when I thought
these were isolated events, and that she would just be fine, of course
I did this.  But when there's no cure -- when it's just for a sliver
of a chance of getting some more time for her -- I just don't feel
like that's the right choice.  If she were easier to medicate, if she
were an enthusiastic eater, if she hadn't had so many health issues in
the last year ... maybe I would see it differently.  But that's not
the situation we have.

I think we will probably end up doing pain killers and possibly
prednisone (need to talk to the specialist about how that relates to her
immune system and the infections in her paw, because given what I now
know about the time she has left I *will not* put her through antibiotic
treatments again), and treat her like a queen until it's clear that we
need to let her go.  And I have the names of a few house-visit vets so
that we don't have to take her to a clinic anymore.

Thank you.  I have to say, having someone who's trained to say just
the right things there when I got the news was a godsend.  Actually,
that's shortchanging her -- she's an incredibly compassionate and
insightful woman.  And she just lost a cat a year or two ago, and has
another elderly one, so she well understands.  She recommended
something I hadn't thought of, getting a vet who will do house calls.
It turns out there are a lot in this area.

I love that one, too.  I just wish it wasn't so blurry!

Minor nit: Oscar is a girl.  I didn't find out until I brought "him"
in to be neutered ("We can't neuter your cat" "Why not?" "Because
she's a girl!").

Looking at all these pictures makes me realize how much weight she's
lost.  Partly that's because she really was getting a bit chubby, and
I switched her from dry food (which she adores) to wet food (bah).
But a lot is a week of not eating, and her shaved belly.  Both her
arms are shaved for IV last week, which makes her front paws look
really weird.  Still, we are trying to get plenty of pictures.

I'm so sorry.  It *is* hard.

Thank you.  I don't know if I will join any groups for this, but I
appreciate the links.  Fortunately I do have my husband, and we are
doing this together, so I am not completely alone.

Thank you.

Thank you.

Thank you.

Yes.  The vet said that she was shocked at the lab report, because
when she'd been in Oscar's belly everything looked pretty good.  Maybe
that means we caught it early ...

Perhaps.  There are a lot of reasons that I'm not sure chemo is right
for her.

Thank you.

Thank you.

Thank you.

Purrs for Newton.

{{{{{{{Eileen}}}}}}}}}

Purrs coming for Newton

Purrs also for Newton

Lesley

Slave of the Fabulous Furballs

I'm so very sorry to hear that.
Lots and lots of purrs,
Polonca and Soncek

I'm so sorry.  I found out Friday night, and DH and I spent the whole
night crying together, while Oscar looked on in puzzlement -- "Dum
hoomins, quitcher bitchin and play wit me!"

May I ask -- how did your vet determine that Newton has small cell
lymphoma, and how is Newton feeling / acting / looking?

The way it happened for Oscar is (warning: massive text ahead, but I
hope this will help anyone searching on feline small cell lymphoma ) --
she had been eating unusually well for about a month, finishing her
meals and still begging for treats.  Perhaps I should have questioned
that, but I was just happy she was eating regularly.  (She loves dry
food, but I wanted her to eat wet food for health reasons, so that was a
constant struggle.)

Anyway, Saturday morning 10/27 she finished her plate; after that she
didn't eat anything.  At all.  Sunday evening and Monday morning I saw
her throw up clear, slightly foamy fluid.  I called our vet and she
said it was probably a hairball, and to get her some hairball treats
to help it pass.  She said, don't worry as long as she doesn't throw
up food.

So Monday evening, we fed Oscar the hairball treats; she wolfed them
down, then threw them up within 10-15 minutes.  We went to the emergency
vet; they took x-rays and blood work and gave her fluids.  X-Rays didn't
show anything; nothing in the blood work.  We took her home with some
pain meds.  The e-vet pointed out that her paw looked infected; they
cleaned it out while she was sedated for the x-rays.

By Wednesday, she still hadn't eaten anything and I was freaking out.
No litterbox offerings since Monday morning, either (I don't know
before then because I cleaned it out Monday and hadn't been monitoring
before that).  I made an appointment at our vet's, but our regular vet
wasn't there, so another vet did the exam.  He wasn't too concerned
still; just wanted to wait it out and see if she would eat on her own.
I started getting upset and he said, well, maybe we can do a Barium
series if she hasn't eaten by tomorrow.  Keep offering her all sorts
of food.  He did give us antibiotics for the paw.

Wednesday evening, Halloween, we put one treat in front of Oscar's nose;
she started heaving and threw up.  I freaked out -- how could I possibly
get her to eat when she threw up just at the smell of food?  I felt
certain that this was not just going to resolve itself, and if I kept
waiting, she would pass the point of no return.  DH and I also discussed
the idea that if we waited too long, even if she needed surgery, her
vitals might be too poor to do it.  I called the emergency vet and ended
up bringing Oscar to the e-clinic.  

At the e-clinic, another set of X-rays showed one anomoly (turned out
to just be her intestines showing at a weird angle), but no smoking
gun.  Oscar has been known to eat string and other inappropriate
objects that don't show on X-rays.  The e-vet was concerned: Monday
night, Oscar had fought like a hell-kitten when getting X-rayed;
Wednesday night, she just sat there, like she'd given up.  The e-vet
also felt that a Barium series would be either worthless or
impossible: she felt that Oscar would never sit still long enough to
do it unless she were anesthetized, and if she were anesthetized and
force-fed, it wouldn't be a good representation of her digestive
system, which is the whole point of doing that test.  And it still
wouldn't necessarily show the problem.  We decided, if she would need
to be anesthetized anyway, let's go the full monty and do exploratory
surgery.  At that point I felt like that we would end up doing that
sooner or later, so let's do it sooner so that she has a better chance
of recovery.

So Halloween night, Oscar went into surgery.  DH had gone to play ice
hockey (with my blessing -- he had offered to join me at the clinic, but
I wanted him to play his game), so I visited with a neighbor until he
came home.  I asked if we could please go out with his friends, as they
often do after the game, to keep me occupied.  We did that.  Around
midnight, as the wing place was closing up, I got the call that Oscar
had made it through surgery just fine, that they had taken biopsies
that would be sent to the lab, but that everything looked fine.  Her
liver was a little mottled, which the e-vet felt was from not having
eaten.  She hadn't seen an obvious problem.  There had been some
unusual material in Oscar's colon -- possibly hairball, possibly cloth
-- that was removed via enema, but the e-vet wasn't convinced that was
really the problem.  I, on the other hand, felt that having a huge
mass of something rough could account for all sorts of unpleasantness.

Oscar stayed the night and the following day at the vet's, where she
was miserable and peed herself and wouldn't eat (typical -- she hates
staying at the vet's), but she got IV fluids the whole time and she
did poop on her own (yay!).  At that point the vet felt that Oscar
would be better off recovering at home.

So, Thursday and Friday, Oscar stayed home, getting pain meds and
antibiotics, generally trying to avoid us.  We kept her in our bedroom
so that we could monitor her inputs (none) and outputs.  We saw her
pee several times, in the litterbox, but no poop -- our daytime vet
felt this was normal, given she still hadn't eaten since Saturday.

At some point, I offered her food and she threw up some brown liquid,
which freaked me out.  I called the e-vet and she assured me that this
was probably blood from the biopsies and no big deal; possibly it was
causing Oscar nausea (blood in your tummy is not pleasant), so maybe
it was a good thing to have it out.

Anyway, Friday evening, Oscar was still listless and seemed dehydrated
again.  And still wasn't eating.  I called the e-vet and, in addition
to more pain meds, asked for anti-nausea shots and to be shown how to
do subcutaneous fluids.  I also started force-feeding her using a
syringe.  This didn't get a whole lot of food into her system, but at
least it was some, and the idea was to stimulate her appetite.

Saturday was full-time cat care.  It was a hellish day.  Also happened
to be my 30th birthday.

Sunday morning, Oscar ate!  DH and I were thrilled.  At some point in
the next day or so, she pooped, and a day or two later I actually
spied her drinking water.

The week passed.  Oscar was eating progressively more every day, and
while she was taking it easy, she seemed pretty good.  I figured the
worst was over.

Friday evening, I found out that the preliminary biopsy report showed
small cell lymphoma.  We were devastated.

So, that was the course from beginning of symptoms to diagnosis.

Purrs for Newton en route.

Blessed be,
Baha

I'm so sorry. Purrs for Newton and his Meowmie on the way.