Buprenex

A Saturday in mid-March was a gloomy rainy day. Hammett’s hind end was wobbling as he walked, he consumed virtually no food or drink, and his pupils were strangely large, but he seemed perfectly at ease and was able to hop up on top of the dresser in the closet to get to one of his beds that is in a darker, more secluded area. (Cats near death may hide, as they know they can no longer protect themselves from predators.)

In the afternoon, I checked online to see what the enlarged pupils might mean, and found it is not a good sign. I emailed back and forth with some school friends and began to feel that I was prolonging Hammett’s misery out of my dread of saying goodbye to him. I called his cat sitter, who is a vet tech, who advised me to try the after-hours line at the hospital; I didn’t know there was one. When I called, his own doctor answered, and when I described the symptoms, he said, “This is concerning. He is uncomfortable.” I concluded that the time had come to take Hammett to be euthanized. No fewer than three people—all chaplains—had offered to accompany me when this moment arrived, so I called one of them and she immediately said she would help, and asked when she should come over. I asked her to come in 30 minutes.

She was just wonderful. She took excellent care of us. She drove us over to the emergency vet, where Hammett was examined. I spoke with a vet who said that Hammett appeared to be pretty “lively” still, and how would I feel about trying pain medication and an appetite stimulant? I agreed to this. Hammett was indeed more energetic than he had been at home, nosing around the exam room.

The total for the exam and pain medication was $198. I was astounded. I said to the front desk, “I demand to pay more!” One of the workers said, “Usually people say the opposite.” Someone brought the pain medication over to us: to be given every 8-12 hours, as needed. I asked how I would know if there was a need. The young woman said I should give it if Hammett appeared to be uncomfortable. I asked what the signs of discomfort are, and she said enlarged pupils and rapid breathing. Grrr. That’s exactly what I took him over there to put a permanent end to.

I did learn a few useful things from the vet at the emergency animal hospital: that Hammett probably was not feeling panicked about his breathing—that when a cat really feels like it can’t breathe, it opens its mouth to breathe, which cats don't like to do.

Nevada drove us home again, and I gave Hammett a dose of the Buprenex and went to sleep.

When I got up the next day, I had a long chat on the phone with my father, as I do every morning lately and most evenings. Dad is my coronavirus buddy; he watches MSNBC and I scour the New York Times and SF Gate online, with periodic excursions to the Fox News website, to see what is being said there, and we exchange bits of news. After that, I had a long chat with one of my school friends who lives in Santa Fe. I had missed part of her presentation on Friday because Hammett began to vomit. She repeated the whole thing for me on the phone.

Then I arose—it was now probably nearing noon—to give Hammett his prednisone, appetite stuff, and pain medication, with water after the pills. The appetite stuff is a tiny little crumbly pill, so I tucked it into the pill shooter along with the prednisone. Hammett spat out the prednisone—I largely attribute that to my own amateur skill level—and then I saw that he was foaming at the mouth due to the appetite stuff, which he also spit out. The prednisone remained intact and I got it down him, but the appetite pill crumbled into mush.

Hammett began to moan in a way I’d never heard before, and to hiss, also an extreme rarity. I’m not sure if I had ever heard him hiss before. It was scary. I gave up and let him hop down. I was now angry at the emergency vet for encouraging me to prolong this terrible situation. I called them and expressed myself very directly, and they said they would respect my decision if I wanted to bring him in for euthanasia.

I saw a text from his cat sitter and summarized the situation for her. She offered to come over and administer Hammett’s pain medication, and refused her normal payment. I sort of didn’t see the point: what would happen that evening when I needed to give the medication again? But she pointed out that for him to cease being in pain would be a good thing, no matter what happened later, so she rode her motorcycle over and gave him the pain medication and appetite stimulant. It was very instructive to watch her technique for various things. She said that if he ceased to be in pain, he might feel like eating.

When she left, I offered her a squirt of hand sanitizer, which she accepted.

She texted an hour later to see how he was doing. I reported that his pupils were still huge and his breathing still rapid; she said the medication itself can cause both of those, and that behavior changes might be the only way to discern discomfort. In that regard, he seemed the same before and after the medication: low energy, but able to get around, including hopping on top of the dresser. His sitter also warned that the painkillers can cause dysphoria: a profound state of unease or dissatisfaction.

My father said what convinced him it was time to take Jack in to be euthanized was that he lost a lot of weight in one week and he made an alarming sound he had never made before. Even then, my father said, he could still hop up to high places, and he looked basically the same as always. I think the consensus in my family is that it’s better to let a cat go sooner rather than later. I wanted Hammett’s last day to be good, not crappy. The vet at the emergency place seemed to think that if a cat is still a bit lively, it’s too soon, but is the idea to wait until the cat cannot stagger to its feet?