Bitey Update: Thursday,March 2nd 2006

Another day off from work. Can only picture colleagues gathered around water cooler..."Where is she? A cat? Really?"

Great.

TMI ALERT
Anyway, I take Bitey out of his cage at around 6:30 am. I lift him up by his front half and hold him in my arms. Oh, Gravity, you fickle mistress. Bitey, who has really had no trouble in the "Number Two" department, shits all over my exposed leg.

One hour later.

I take Bitey to the local vet to have his bladder expressed. I really have to learn this skill. While Bitey is being squeezed, I glance over at Winky, who is occupying a top level cage in the hospital area. Winky is my favorite orphan cat. Found under a building, he has one horribly red and infected eye. Today however his eye is stapled shut, and he looks even more like the Terminator. Winky is young and alive and happy. It's nice to see.

A few hours later we are on our way back to West LA to see the specialty oncologist.

When the doctor comes into the room, Bitey hisses at him. This is the first time Bitey has ever hissed at a vet (unless of course the vet has his finger up Bitey's bum). The cat must be really tired of doctors. Doc tells me the options, tries to diminish my expectations, and then describes what he will do to attack the mass choking Bitey's spinal cord.

Bitey will receive four radiation treatments, one every Thursday. He will also be started on a chemotherapy protocol. (Promise, names of drugs this weekend!)

Since no pet hospital is large enough for a giant radiation emitting device, the vet takes The Caravan of Cancer Cats over to UCLA. It's like a radioactive field trip.

So the doctor takes Bitey, and I am told to return at 4pm. I spend the time wandering around the Century City mall, then return to the kitty hospital.

The doctor brings Bitey back into the room. He is sacked OUT. This is from the anesthesia needed to keep Bitey perfectly still while he is irradiated. I can just picture this perfect row of anesthetized cats outside the radiation chamber.

One in, ZAP! One out, another in, ZAP!

Anyway, the doctor takes extra time with me to try and teach me how to express Bitey's bladder. He draws diagrams, explains the theory, places my hands in the right place, and is generally extremely patient. (I guess there are bad vets out there somewhere, but I have yet to meet one.)

After being assured that it would take a lot to burst the bladder by over squeezing, and that it wasn't likely I would mistakenly grab hold of a kidney or a spleen, I started feeling around my cat's gut. After much exploration, I am briefly able to grab hold of the squishy round thing that feels like a water balloon. I squeeze, hard, and a little dribble of pee comes out the other end.

It's a start. The vet expresses the rest, and we call it a day. Next appointment is one week from today. Round 2 of radiation and chemo.

We drive home in hellacious traffic, Bitey curled up in a nest of towels on the floor of the car. When we get home, he stays awake long enough to eat. He's not really drinking water with great enthusiasm, so I have to work on that.

tomorrow, I attempt expression!

J

Bitey Update: Wednesday, March 1st, 2006

I picked Bitey up at 9am from our local vet. He was quite alert, and immediately began trying to push his way out of his carrier. I know how I would feel about being crammed into a small black bag all the way down to Orange County, so I decided to let him spend the drive on the passenger side floor. This isn't something I would let a healthy cat get away with on a freeway drive, because it's not the safest mode of travel. But this is not a healthy cat, and I'd rather have him comfortably nested in a towel on the floor, licking his paws than going stir-crazy in a carrier for fifty-three miles.

We got to Irvine way ahead of our appointment time, so we took a little field trip to Newport Beach. (More on that later.)

Then we re-arrived at the kitty neurologist office. She re-examined Bitey, and told me that he wasn't feeling anything in his back paws. Which is bad. She also saw that Bitey was leaking urine, something I had already smelled on the drive down. This also concerned her, because it means that the mass may be spreading "south."

Then the kitty neurologist showed me Bitey's MRI films. It was chilling to see the cross sections of his spine. You could see where the "mass" was surrounding, then choking Bitey's spinal cord. Everyone is assuming that it's lymphoma, although without a biopsy there may never be a 100% positive diagnosis.

Then they took Bitey away for his first major treatment, a shot of allspar (?) The tech who brought him back said Bitey weighed a little over 14lbs. Is it possible that he's lost almost 2 pounds in two weeks? Part of the weight loss is muscle atrophy in his back legs.

We drove home. I brought Bitey into the house, the first time he'd been home since last Thursday. He was so deliriously happy to be home, purring like a maniac.

Later in the afternoon, I took him back to our local vet. After seeing his joy at being home, I was really resistant to the idea of leaving him there another night, but I know he needs their help with his bladder.

Fortunately, the vet agreed. He expressed Bitey's bladder as much as possible and told me to take him home. And that's where he is now. Tomorrow, a new doctor, who was praised by a friend as the "cocky, aggressive kitty radiologist." Will wonders never cease.

Decision Making Philosophy

Throughout this ordeal, several people have echoed a dilemma I've been struggling with for some time. "If only you knew what Bitey wanted," they say.

I've thought about that a lot lately.

Bitey and I communicate on a basic level. He lets me know, with different meows, when he's hungry, happy, or disgruntled. If he's angry, or in pain, he'll hiss. On the flip side, I let Bitey know verbally when I'm not pleased with him (like the time he made off with an entire turkey carcass after Thanksgiving...although I clearly sent a mixed message because I was also laughing so hard I thought I might pee).

Bitey also has a vast array of subtler facial expressions, but the meaning of these are unclear. I know he's thinking something, but what?

So it took me until yesterday to realize that I did, indeed know what my cat wanted.

Bitey wants to eat (cat food, tuna, turkey carcasses, broccoli, butter). Bitey wants to sleep (on the back cushion of the sofa, in our bed, on the warm cover of our non-functional hot tub). Bitey wants to look at birds, and make that weird predatory "ack, ack, ack" noise. In short, Bitey wants to be at home, living his normal life.

Obviously, only some of this is possible now. But thinking about Bitey's simple pleasures helped me figure out which treatment option (see previous post) to choose.

Option 1) Putting him to sleep just doesn't seem right...yet. There's still too much life in his eyes, too much lust for food. That time may come, and soon, but it is not today.

Option 4) Surgery to remove the mass. This option was very tempting to a girl who likes to clean, clean, clean. But the post-op hospital stay is 3-7 days, and real recovery could take weeks. It just didn't seem to be a good way to spend our potentially limited Bitey quality time. Also, when we asked the kitty surgeon what she would do if this was her cat, surgery was not her choice.

That left Options 2 and 3. Option 2 was steroids combined with a shot of the kitty cancer "wonder drug" whose name I promise I will learn at some point (allspar?) That's what we did today (see next post).

Option 3 is chemotherapy and radiation. This is what we will do tomorrow.

And, in keeping with the theory of "what would Bitey want", our cat is finally home, at least for tonight. Bitey is laying at my side as I type, purring.

Bitey Update: Tuesday February 28th

TMI ALERT first two graphs

Monday Bitey went for his MRI in Orange County. Boyfriend and I picked him up at the local vet's around 7:30am. He was in better spirits, having solved his "excretory issues" the night before, with a "helping hand" from both the on-call vet and her lab tech.

(How different is your life when the best news of the day comes from a kind vet tech, calling you at 7pm on a Sunday to tell you that your sick cat has pooped prodigiously?)

End TMI ALERT

So Boyfriend, (I'd call him Comedy Guy but I worry the Sports Guy might litigate) took Bitey to Orange County ahead of a massive rainstorm.

I went to work.

Several hours later we got the results. Boyfriend called from the doctor's office, and the phone on speaker. This is what I heard.

...arge mass...inside spinal...umn but...side...

So that didn't work too well.

Later I got the translation. Bitey has a large mass inside his spinal column but outside of his spinal cord. The mass is putting pressure on the cord, creating the paralysis. The mass was consistent with feline lymphoma, although they still didn't know for sure.

Bitey, sacked out from the anethesia, went back to the vet. He lay on the cold metal table oblivious as our family vet tried to gently gauge our readiness for Bitey's further decline. Then I carried him back to his cage, stroked his fur, and left.

Here's a picture I took Monday night, taken on my cell phone. Bitey is resting his head on a small stuffed chicken. He likes it because it's at just the right angle for his head.

---------------

Tuesday's first piece of information was that Bitey was negative for toxoplasmosis. You think?

Later I got a call from the kitty neurologist. She gave me the first really detailed set of options. Here they are in order of, well...

1) We could put Bitey to sleep. Every vet I talked to has told me that no one would think poorly of me if I did that...he's in that bad shape. More on that later.

2) We could treat Bitey with a steroid and a "wonder drug", the names of which I keep forgetting. It's the simplest option. Combined, these drugs are supposed to reduce lymphoma. You find out in a couple of days whether it's working or not.

3) We could embark on a full course of chemotherapy and radiation with a kitty oncologist. Kitty chemo is not as bad as human chemo. The dosages are less. It's still not easy. Lymphoma apparently responds well to chemo.

4) Then, there is the surgical option. The kitty neurologist would open Bitey up and do her best to relieve the compression on his spinal cord by cutting as much of the tumor out as she could. If Bitey made it through the surgery without complications, he would spend 3-7 days in the hospital and then need several weeks of recovery, and possibly chemo and radiation post-surgery.

And finally, the worst news. Whichever option we choose, it is very likely that Bitey will not live longer than four more months.

After all this news, I left work. I took Bitey's films over to the West LA Surgical Center for a second opinion. All the way west and all the way back east on Santa Monica Blvd, I thought about the four choices. I worked myself up into a pretty good state. I hadn't planned on visiting Bitey until later, but my car took the right turn automatically.

The moment I turned the corner into the hospital section Bitey started meowing. I opened the cage door and sat down on the floor. Bitey looked so much more alert than the night before. Own his own accord, he stood up, bearing his weight on his two front paws. He hasn't done that since last Friday. He started eating the food, as if to show me he still had an appetite. Then he dragged his useless back half out of the cage and onto my lap. This was a deliberate show of strength. For good measure, he peed all over my jeans. What a cat.

We sat for a while, both watching as a large black and white dog was put under anesthesia. We listened to the whimpers of the small terrier in the cage above, who fell out of the window of a moving car. We sized up the French Connection; three sad-eyed cats named Cleo, Shaquil, and Paris. And then I left, to think.

Which treatment do we choose? Which one is the most likely to give us the most time with the least discomfort? These are tonight's questions.

You may wonder...

...if you have read enough posts, does this young lady have a life? Why, yes, yes, I do. I am a moderately well-adjusted pre-30 year old with a good job, a great guy, and a gorgeous cottage in Los Angeles. On any given day prior to the start of this odyssey, my cat was one of many things I was thankful for in life, but I did not sit home on weekends staring into his magnificent amber eyes. I traveled a lot for work, rode my bike, saw lots of movies, tried to make brunching an art form, and occasionally indulged my desire for high-priced electronic gadgets.

For the first two years after his FeLV+ diagnosis, whenever my cat did something particularly smart or funny, I smiled, but the same thought always bubbled to the surface of my brain: How long? Often it wasn't even a consciously worded question...I would just feel my smile twist a little. After we moved to the cottage, the question was still there, but it was silenced for long stretches by his continued good health.

Until two weeks ago, when the question resurfaced with renewed ferocity. How long? How long? How long? I'm writing now because posting kitty anecdotes to the web is cheaper than paying a therapist $130 dollars to talk about my cat. Or turning into the weeping cat lady at work. Because that would really be too much.

The Great New Jersey Adventure

In August of 2004, my comedy writer boyfriend got a job in New York City writing for a television show. This was a big deal for his career, but had the inescapable side effect of moving to New York for an amount of time to be determined. As I had successfully escaped the city of my birth, I stayed put in Los Angeles. We were long distance couple once more.

Since I also travel a lot for my job, I needed a lot of Bitey sitters. This is rarely a problem, as we live in a house with 500 satellite channels, a PS2 and the baseball package. The only time I hit a wall is Thanksgiving and Christmas. That's when all the East Coast expats I rely on for catsitting make the pilgrimage home. I've never called early enough in the year to board Bitey or get a professional sitter, so when I go home for the holidays, so does the cat.

Bitey is a pretty good flier. He (barely)fits under the seat, doesn't need to be drugged, and has learned to prevent Deep Vein Thrombosis by stretching, half-in, half-out of his carrier every hour. One time we were even upgraded to business class, only to end up next to the one neurotic East Side cat-hater on the whole plane. She hissed so loudly about cat hair and passenger rights, and I became so shaken and upset that the flight attendants were one step away from implementing the 'dangerous passenger' plan. In the end, Bitey and I sipped champagne and enjoyed moist towelettes; she was moved to coach.

But I digress. In November of 2004, I took Bitey east for a triple purpose visit.
1) Visit Boyfriend, who had been sleeping on a couch in Brooklyn for the past three months;
2) Celebrate my birthday, which was the week before Thanksgiving;
3) Spend a classic 'divorced child' Thanksgiving with both of my parents. (This, by the way, is magic trick that involves a car, a time machine, and many helpings of turkey).

Bitey and I arrived the night before my birthday. My mother picked us up in her silver Mustang at Newark Airport. By this time Bitey has been in the travel bag for over eight hours. He is at his limit, and we still have a long drive to my mom's new lake cottage in wilderness of Northern New Jersey. So I let him out of his carrier. Bitey promptly disappeared under the passenger seat of the car and took a piss on Mom's mail.

An hour later we arrived at my mom's cottage. I opened the car door to try and coax Bitey out from under the seat, but he was one step ahead of me. Bitey leapt out of the car, and sprinted off through the snow into the woods.

I was horrified. My mom lives in bear country. I couldn't believe I had lugged my cat 3,000 miles across the country only to have him turn into some lumbering bear's midnight snack. Poor boyfriend had been living like a hobo for three months, and now, instead of kitty comfort, he would be faced with kitty carcass.

We searched the neighborhood, yelling his name. We looked under the house, in the woods, even down by the lake. I cried. I called boyfriend and cried some more. My birthday would be here in four hours, and I had let my cat escape into a cold unfamiliar environment. I sucked.

Eventually my mom convinced me that Bitey would come home eventually. She went to bed. I grabbed a blanket, sat on the sofa and looked out at the front yard. Nothing. I opened a window, despite the cold, so as to better hear any noise.

Eventually, exhausted by tears and paranoia, I drifted off. Some time later, I awoke to the best noise possible; a plaintive and confused meow just outside the open window. I opened the front door quietly, and there was Bitey, sitting below the window boxes. I grabbed him and went inside. As I settled under the five layers of blankets with my cat on my pillow, I looked at the clock. 12:10 am. Happy Birthday. J

This is Bitey in the closet of my room at my mom's house. He loves closets, and used to be able to jump quite high to reach them. (And no, I have not read War and Peace).










Here is Bitey in our closet at home.

Bitey Update: Sunday February 26th

The local vet is closed today, but they are kind enough to let us visit. We ring the doorbell, and a kind woman named Judy lets us in. I lead Boyfriend back to the room where Bitey is staying.

I look for my cat in his regular cage and see 'Paris,' the sad little tabby who makes no noise and moves very little.

"We put Bitey in the great dane cage," says the on-call vet. "We thought he might like it." I look down to see my cat lounging in the largest cage in the whole building. It's practically a kitty condo. I open the cage and pick Bitey up. He howls. I'm immediately concerned because it's not his usual "Why am I here, and where have you been" query, but a howl of real pain.

We pet him, but he continues to howl and I can see the muscles that run along his spine rippling, even as his back legs lie useless beneath him. I look at his eyes, which are fixed on a far distant location. Aha.

(Warning: All but the most devoted cat people should do themselves a favor and skip to the next few graphs. In other words, TMI ALERT)

The dignified yet absent look on Bitey's face is the one you see when you catch him in the litter. It says 'I know you're looking at me while I'm going to the bathroom, but I'm to going to pretend you're not."

The vet confirms that while Bitey's bladder is being 'expressed' several times a day, his bowels have not 'expressed' anything lately. So she straps on a latex glove and well, checks things out. I would imagine it is not easy to keep your dignity when some lady is rooting around in your behind, but somehow Bitey manages.

When the worst is over, the vet strips the glove and pets my cat. "I'm sorry," she says "don't worry, you're still the most spoiled cat in here." Bitey is returned, still in pain, to his kitty condo. He spends most of the rest of our visit still trying to 'express himself.'

(Okay, normal people, you can come back now.)
Usually, I leave these visits feeling better than when I arrived. Not today. My cat is in pain. I can't do shit and neither can he. Tomorrow, Boyfriend will take Bitey to Orange County for his MRI. I hope they find something, although I constantly remind myself to be careful what I wish for.

And if by chance you feel it is silly to put a cat in a Great Dane cage, check this out.