BRBPR

That’s bright red blood per rectum.

A few days after my last post, I woke up to find a good amount of diarrhea produced by Hammett, including a bit of bright red blood. I carried him over to the vet in tears and was relieved when I saw his cat sitter standing out front on a break from work. She said that bright red blood is no big deal; dried brown blood would be the thing to worry about. I thanked her for talking me down, and she said, “You’re going to have to do that for yourself every day.”

Dr. Press agreed about the blood, saying it probably meant Hammett’s GI tract was inflamed. He prescribed antibiotics. (No blood seen since then, or diarrhea.) We had a discussion about chemotherapy and I decided to pay $300 for an oncology consultation. I asked if the cancer had likely metastasized already and Dr. Press said lymphoma is systemic (so, yes, by definition). I mentioned that Hammett’s bloodwork has consistently shown that his kidneys look great in the kidney failure sense and Dr. Press said that labwork cannot detect kidney problems until kidney function is 75 percent gone! This was news to me. Also, the methimazole he has been on for nearly five years for hyperthyroidism is an appetite suppressant. I never knew that, either.

Regarding chemotherapy, Dr. Press said the number-one objective would be for Hammett to thrive and feel great, so if he didn’t seem well after a treatment, that treatment would not be given again, or would be given differently. Dr. Press suggested that one approach would be for me to decide on my budget and we could offer treatment until that amount of money had been spent.

But it seems to me that if $10K might result in seven months of remission, spending one third of that might result in one third of seven months of remission, or even less, and then that would be spending what is still a decent chunk of money for not very much time at all. Also, I could easily see this being a slippery slope: If he seemed better after one month of chemo, I might well be tempted to pay for another, and then a third. Or if he didn’t seem better after a month, I might think that maybe a second month might do the trick.

And I also suspect that if Hammett did seem ill after a given day of treatment, I would be told that of course some fatigue is to be expected, or that I needed to give it a little more time for the chemo to kick in. That is, I think the thing about the number-one objective being for Hammett to feel great would prove to be ephemeral in practice. (That is, hogwash.)

But! What if he actually could have many months of comfortable remission? When I got the oncologist’s report, I saw that some cats actually live years after chemotherapy. I also saw that his suggested protocol was 22 weeks, not the 12-16 originally mentioned, meaning the whole thing would be closer to $15K.