Now we have arrived at the reason I just put up so many posts in a row: because I needed to say this, and didn’t want to say it and then veer months into the past in subsequent posts. I took Hammett to the vet a couple of weeks ago because he lost a quarter of a pound in one week. His weight had been hovering around seven pounds for a year or so; all of a sudden, he weighed six and three-quarters pounds. I also told Dr. Press that his hind end had looked a little wobbly a few times.
Dr. Press suggested that we do bloodwork and urinalysis, followed by an ultrasound if the first two tests didn’t find anything. The first two tests didn’t find anything. Dr. Press said his bloodwork, including in regard to his kidneys, looked great. I scheduled the ultrasound, and then almost decided to cancel it. Hammett seemed to have perked up, and veterinary bills often seem astoundingly large. But then I decided that it’s just one of the rituals of being a cat owner to periodically pay a small fortune to find out nothing is wrong.
I was standing outside The Butcher’s Son (an all-vegan deli in Berkeley) waiting for a friend from school to join me for lunch when I got a call saying Dr. Press would like to talk to me. I was expecting only a call saying when to pick Hammett up after his ultrasound, so this was worrisome. K. and I paced up and down University Ave. while I waited for Dr. Press to come on the line. When he did, he said that the ultrasound had found two abnormalities: both kidneys looked abnormal, and Hammett’s pancreas was inflamed. It was the day Hammett turned thirteen and three-quarters years old.
“I’m worried that this is lymphoma,” Dr. Press said.
K. and I had an absolutely scrumptious lunch, and an interesting conversation. I was able to put Hammett out of my mind after sharing with K. what Dr. Press had said, but after she and I parted later, I walked to BART in tears and wept pretty much all the way back to the city.
When I fetched Hammett, I was given a bottle of prednisone, which Dr. Press said to start right away. It was in liquid form, and was a nightmare to administer. Hammett, a sick little cat of six and three-quarters pounds, fought like a champion wrestler to avoid it, and after I got it into his mouth, he foamed at the mouth horribly.
We went through the same ordeal the following morning, the following night, and the morning after that, while we waited for the results of a needle aspiration of his kidneys. By then, I was ready to euthanize that very day, before I had to put Hammett through taking prednisone again. The bottle said it had to be given every 12 hours, and the person at the front desk at the vet had said those instructions had to be followed precisely.
Dr. Press called that day to say that Hammett does indeed have renal lymphoma. I had been thinking that if it turned out Hammett had cancer, no way was I going to agree to chemotherapy for him, but that is precisely what Dr. Press suggested. He said only 10% of cats get sick from the chemo, and that it has an 80% chance of affording a remission of 10-12 months. Hammett would need to spend one day a week at the vet’s for three or four months, at a cost of $600-700 per treatment: $10,000 total, give or take.
Dr. Press said the prednisone does shrink tumors, but only for “several weeks.” He said that chemo would not be an option unless Hammett responds well to the prednisone. I said that if he did respond well to the prednisone but I was unable to spend $10,000 on cat chemotherapy, would he support Hammett’s being euthanized in that case? He said that he would, and that we could also discuss some cheaper options.
As for the prednisone, he said it comes in pill form, and that the doses do not have to be 12 hours apart. He said you can give them one hour apart if you feel like it. I went and picked up the pills, which are very easy to give Hammett using a pill shooter.
At the moment, he is doing fine in that he is eating, pooping and peeing, and seems reasonably content. He’d lost even more weight when I weighed him yesterday.
I have shed many tears since the day of the ultrasound, and even had moments of suffocating panic, for instance, when I picture the spot by the wall where Hammett likes to lie on a sunny day. It is a beautiful sunny day, but he isn’t there, because he is dead. The sweetest, most placid and most precious cat on earth has gone. I am trying to balance the natural and real experience of anticipatory grief with not terrifying myself with excursions into the imaginary future. It will be a future version of Bugwalk who sees that spot with no cat in it. It’s not happening right now.
I have mulled over the chemotherapy option. If I had to, I could come up with that money; I would be spending money I had planned to save. I love the thought of having ten or 12 more months with Hammett. Saying no to the possibility feels like I’m doing something bad to him, but that is not true. There will never be a moment when he thinks, “I’m angry that she deprived me of what could have been ten great months!” It’s all the same to him whether he has a peaceful death ten minutes from now or a year from now. He will not be able to judge the difference between those; he won’t be here to do it.
What he can tell the difference between is whether he’s snoozing peacefully in his little bed by the radiator or being stuffed in his cat carrier and hauled over to the vet. Even if he was going for a weekly spa day, he would not enjoy having to leave his house. Also, I have a gut feeling that he would be in the 10% made ill by chemotherapy and/or the 20% who don’t end up in remission. He has had a number of health challenges throughout his life. I wish he were going to live to be 20, but it’s wonderful that he made it to be thirteen and three-quarters. My mother’s favorite cat of all time died at just seven or eight years old. Dr. Press commended me for having taken “meticulous” care of Hammett.
Hammett has cancer. He is going to die. I understand from the Internet that chemotherapy is much less awful for a cat than for a human, but I have decided to embrace the inevitable and focus exclusively on his quality of life. Once that is gone, I will have him euthanized. If possible, his last day will be a good one, or at least not totally terrible.
I named this post as I did this so others in the same boat might find it. I have read so many posts from people who are glad they chose chemotherapy for their
cat that it made me worry that I am doing the wrong
thing. But working in palliative care, reading book after book about it,
and having just written a thesis about it have bolstered my feeling
that it is OK to make a different choice, as has talking with trusted
advisors, including Lisa C.; both of my parents; Hammett’s cat sitter, who is a vet tech; and, somewhat weirdly, the manager of my apartment building. There has been some strain between us since the flood in May, but after I texted her about Hammett, she immediately sent a warm and loving response, with many heart emojis, and told me to follow my heart when it comes to choosing care for Hammett.
I have found out what his own vet charges for euthanasia and cremation, and have also spoken with an emergency animal hospital that is always open, and with a vet that does house calls. (The latter said that if you arrange for euthanasia at home but change your mind by the time the vet arrives, they just charge for a consultation and go away again. I thought that was nice. That is precisely why Thelonious was euthanized at the emergency animal hospital: I couldn’t bear the idea of waiting for someone to come over to kill my cat. My mother kindly said, “You don’t have to do that. If it would be easier to take her somewhere, then it is fine to do that.” Tom came with me.)
I can clearly remember the day I adopted Hammett. I remember the first night he was here, looking fearfully over his shoulder at Tom, and crawling up into my armpit after I went to bed.
Here’s the first line of the medical log I have kept for him all his life:
Adopted on 10/14/06. :-)
How quickly it has gone.
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