Tumor / SCC: Defying the Odds with Hospice Care - Living with a Terminally Ill Loved One, I share w

Introduction:

The purpose of this thread is to give hope and comfort to others who have loved ones diagnosed with a terminal illness and facing the difficult decisions of treatments and euthanasia or Treatment vs. Euthanasia.  What to do?

The day Simon was diagnosed, I started a calendar/diary titled Simon's Diary:  "Our Bittersweet Journey...the long goodbye" I've logged his daily progress of eating, drinking, playing, grooming, sleeping, bathroom, etc. with pictures. 

Reading it back, I thought this should be shared.  If my experience could help others it would be help me during this process as well.  It's been a roller coaster ride yet rewarding.

I wasn't sure where to post this info, the Health Forum or Crossing the Bridge, he's in between and wasn't sure, but with the assistance of @Margd  and @mrsgreenjeens, we figured Health was the best place.  thanks again...

This will be a thread containing daily posts of Simon's Diary, info, experiences, pics etc.

So I won't get too wordy in this post, I'll just give you a quick background:

My 12 year old male Simon, soon to be 13 was diagnosed on February 11th with SCC.  I was sent home with Clindamycin and told he most likely wouldn't live to finish the med's.  Well, I'm on the 3rd bottle and a month later he's still enjoying life and all faculties are working, some better than ever.  

He has some trouble eating since the tumor shifted his bottom jaw to the left and he only eats RC Urinary SO Dry with his favorite snacks being lettuce greens, baby spinach leaves, if you hold them and wheatgrass  he can't grab them easily.  But I've made adjustments, and since he's terminal, I give him whatever he's interested in eating.  Yesterday it was bacon, 1/2 cup cereal milk, 2 table spoons of haagen dazs vanilla and about 1/2 cup of his dry food, along with lots of fresh water.  I also have his dry food liquefied which I give him often throughout the day with a syringe.

Until he can't eat and/or gives us signs that it's time, we'll continue to enjoy him as we have been since I found him at 2 weeks old.  

(the avatar above was his first night with us).

I look forward to any replies from those who have lost a loved one, experienced scc, cancer,  terminal illness, dealing with vets, giving meds, habits, etc.  I'll post the start of the journey shortly along with pictures.  

The threads below were ones I started when my cats first got sick.  Some background for those interested.

2  Cats  - 2  Problems - Kidney Meds Issues and Lump Under Chin soon to see vet.

2  Cats  2  Problems - UPDATE! LUMP UNDER CHIN TURNED OUT TO BE TUMOR No Cure!

Just to be clear, Simon has JAW BONE CANCER- Oral SCC .  He never had the black bumps under his chin on the outside that are common with the other.

The first sign which I ignored was the hard lump under his chin on the left side and If your cat is throwing up with no hairball to show for it.

If you notice this on your cat please take him/her to vet asap.  

Reason for oversight:  First, we were dealing with his sisters kidney issues and Simon's lump started as a pea size hard mass under his chin on left side which I thought was a lump resulting from him slipping off the bed and banging his chin which he has done on many occasions (he's a jumper/climber).  Since he only eats the Royal Canin Urinary SO, the vet told me that he's probably throwing up and constipated because that's all he's eating.  What could I do, he detests canned food and meats. Then the vet also told me that the RC Urinary SO was designed to limit the waste/stool so he shouldn't be pooping much. I've heard this about certain foods so didn't think it was cause for concern.  I wish I found this site years ago...

I got rid of that vet, and my new vet said those were signs and the old vet should have suggest I make an appointment.  And also said, even if we detected it earlier, there would have been nothing we could do.

In a way it was a blessing, because we've had so much fun with him during the holidays, and as soon as we found out  my behavior changed to, sad and anxious, which Simon is noticing.  

Next post will be the start of "Simon's Journey"  

It took me a while to get my thoughts.  Yesterday was difficult as reality smacked me and my husband in the face with the fact within the next week or two we will have to let go.  I thought I was strong, but  honestly I'm devastated.

Simon's Diary:  "Our Bittersweet Journey...the long goodbye"

Below are pictures of Simon on January 1st.  He was happy, playful, eating, sleeping, playing etc, no strange behavior. Pea size lump not noticeable to the eye, only to the touch.

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On February 3rd I noticed his behavior changed slightly, (now keep in mind, his sister was peeing all over due to her kidney issues and  thought that's what he's reacting to).  I noticed he'd smell the floor then look up with his bottom jaw slightly open with his tongue sticking out (as in pic below) I thought it was his reaction to Chestnut's odor. Then I noticed he'd drool a lot when eating his "crunchies"  bite them in half then flick out pieces, we thought he was losing a tooth or something, At this time he was set to visit OLD VET, on Sunday the 14th.  

    He continued those new patterns for the next month until February 9th  he started sleeping by my head, his saliva got slimy, breath smelled, the only way he would eat is if I laid out the dry on a towel.  He was still playing, eating, drinking and in good spirits but in a week the lump grew much larger. On the 10th, my pet store owner said that it could be a tumor not tooth, and recommended the new vet.  

On the morning of the 11th, he started scratching his chin like he was trying to remove his own tooth, at that time his mouth started streaming blood, I threw him in the cat carrier and took him to the NEW VET.  He gave me Clindamycin and said we had only days, feed him whatever he wants.  I was a bit surprised with the abrupt bedside manner but also appreciated it.  Honestly I was stunned...

I did speak to another vet later that night who said the same thing, his entire jaw would have to be removed, this was a progressive cancer. I felt guilty because we missed his vet appointment last year but she said most likely it wouldn't have been detected then anyway, so not to fee bad.  But I do, you can't help but wonder...what if.

I wasn't going to take this news lying down, we figured out some feeding tricks etc and we've been having a Last Hoorah.  fun yet bittersweet.

Simon's Diary:  "Our Bittersweet Journey...the long goodbye"

February 12th:   After a night of tears, denial and 2 doses of the Clindamycin, we woke up to an empty food dish, and this (picture below) LOL, Simon enjoying a moment with his "girlfriend".  At his point we knew we had more than just a few days.  

    This behavior continued from February 13th thru February 19th, the only difference was when playing with the Cat Dancer and Bird on a String Toy, he can no longer attack with his mouth so those proved frustrating for him, but he still enjoys catching balls. doing his flips catching mice and chasing the laser in the tub,   His eating was great, his bathroom habits were normal for the first time ever and he's gained a few pounds.    Changes I've made for him is a permanent spot on the bed by the window, with a towel where I can lay out his "crunchies" so he can eat them easily, and give him very wet brushing's to help him with this grooming.  His saliva at this point is still slightly slimy but his breath is odor free.  I have  always massaged him, but now more around his neck, I can tell he's stressed in that area and thankful he's allowing me to touch him there so I can keep an eye on growth process.   Since he's been on his meds, it seems the swelling went down slightly under the chin, but now I notice the actual tumor closer to the back of the jaw near his neck.  So far so good.

Reading this with much interest, and sending many vibes for Simon as well

TURN FOR THE WORST - started using the syringe to feed him.

Saturday morning, February 20th we slept in until 8 am, I saw Simon didn't eat any of the food from his bowl or off the towel (he started eating our of bowl again mid week). He was following me around and kept sitting in front of the fridge,  I held up a slice of american cheese which he loves  to lick and noticed his bottom jaw shifted to the left and his tongue was flapping and his bottom fang was digging into his top lip, very hard to watch.  I had to leave the room and cry.  He couldn't drink from his bowl or tub either and he loves his water.  

He tried desperately to lick and eat the cheese, with great difficulty he managed to eat some but couldn't figure out how to grab it, jarring and emotional to say the least.  I got out the syringe and gave him lots of water, also liquefied his RC Urinary SO and he accepted it, along with his doses of Clindamycin, he showed some interested in playing and very interested in looking at the birds outside on the fire escape, but mostly slept for the day.  I started looking up at home svcs for euthanasia.

The below pictures, show him trying to clean himself, with difficulty, he'd get into it then growl, it was an on going procedure, he's a cat that takes great pride in his appearance.  Our nickname is Mr. Kitty the Metrosexual Cat.  He comes to me for nail clipping, and ear cleaning.


After that he just slept and for the first time, Chestnut went up on the bed and laid by his side.  This convinced me, this was IT.  Every so often I took the syringe and fed him both the liquid food and water throughout the night and also massaged him gently and brushed him.  He seemed thankful but I still wasn't sure what I'd wake up to.

      

mrsgreenjeens said:

 
Reading this with much interest, and sending many vibes for Simon as well

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Thank you so much mrsgreenjeens.  We need all the vibes we can get. Thanks again, you'be been very kind and helpful.

      

Pictures above taken, February 20th I thought these would be the last photos of him. However,  much to our surprise, he was wide awake Sunday morning February 21st, he ate a cup of his crunchies off the towel, drank lot's of water, took his meds, All faculties are working smoothly.  I don't know who answered my prayers, but not only was he eating, his jaw managed to straighten out enough to let him eat his food, plus more. I still made sure he was getting enough water by giving him several syringes throughout the day.  

     These pics were morning of Feb 22nd, lethargic no more.  February 22nd thru February 29th he ate on his own (off the towel), drank, and continued to eat his favorites, ice cream, milk,cheese, bacon etc He did need help with grooming it was uncomfortable for him to move his mouth for too long.  He also had several bowel movements with no issues.  This was always a painful experience for him.  It seemed the Clindamycin side effects have a positive reaction on him.  I continued with our routine of grooming (very wet brush), massages and playtime.

At this point I started questioning if what I was doing was the right thing.  Was I doing this for me or him.  Was this really quality of life?  But then he starts to play, he's having fun and doesn't mind the meds or occasional syringes, so I guess all is good.

I never had to make this decision in my life, our dogs and cats growing up all died naturally in their sleep inside the house.  So this is new territory for me.

I have that guilt now thinking about all the signs he was giving us and we missed.

Unusual mischief - extra affectionate - the  excess drooling - throwing up - constipation - tossing his dry food out of his dish.  I'll think of more signs as I keep writing.  

I never thought cancer would be an issue, I was naive about how common this cancer actually is.  I'm dumbfounded by it all.  One thing the vet asked is if there were smokers in the home.  My husband smokes but outside and he washes his hands after.  I grew up late 60's/70's/80's my dad smoked as did every other parent on the block and none of our dogs or cats got cancer, they were all indoor/outdoor animals.  Worst case was hit by car, opossums or the 2 St. Bernard's up the block who'd terrorize the neighborhood.  They all ate the supermarket food none of this high end stuff.  So whats causing this, they have more informed vets, prescription meds,  high quality organic food etc but these cats seem to be getting seriously sicker by the minute.

If anyone out there knows what causes this, Please let me know.  I did find Simon outside my uncles house, and his cat who was a neighborhood stray, got cancer, a huge tumor on his side outside of the body.  Very sad.  Perhaps it was in Simon's bloodline.  Don't know.

So February ended as happy as could be.  I started to get excited, but read up on animals and their last days- it said they sometimes eat really well, get energy etc, before they take a turn for the worst.  Like my vet said, he'll let us know when.

to be con't.

Simon is a beautiful boy and you are a loving and wonderful cat guardian. [emoji]128149[/emoji] Following your journey and standing in solidarity during this difficult time. I think it's great that you are journaling this and letting others support you from one cat lover to another and vibes for many more happy days for you and Simon!

2Cats4everLoved said:

 At this point I started questioning if what I was doing was the right thing.  Was I doing this for me or him.  Was this really quality of life?  But then he starts to play, he's having fun and doesn't mind the meds or occasional syringes, so I guess all is good.
I have that guilt now thinking about all the signs he was giving us and we missed.

Unusual mischief - extra affectionate - the  excess drooling - throwing up - constipation - tossing his dry food out of his dish.  I'll think of more signs as I keep writing.  
 
Like my vet said, he'll let us know when.

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It's good that you are questioning if you are keeping him alive for YOU or for him....that means WHEN the time comes, you will be strong enough to let him go

From what you've written, I don't see the signs that he's ready to leave you yet.  I've had too many furbabies than I care to count that I've had to let go, and I'm not seeing the signs here yet, at least not in your journal so far. 

Thank you mrsgreenjeens, I suppose I'm questioning  syringe feeding, he's not giving me a hard time although there have been a few moments of doubt but he just bounces back, I'll post after I feed him.  

My reason for sharing this is, if I listened to the new vet, who is dry with no bed side manners, we may have jumped to the conclusion to put him down immediately, if I listened to my older vet, they would have had us going through every test under the sun costing $$$$$, knowing he wouldn't live much longer or even make it through treatments, in this case the only outcome would be jaw removal.  

I'm all for doing everything and getting proper care, but in Simon's case, besides the fact this is an extremely progressive cancer, he has a murmur and the stress of taking him out of the apt. would have caused his health to diminish within days, I know that in my heart, without a doubt.  He would never understand what we are doing FOR him, he would just know what we are doing TO him.  So to us this was a no brainer.

We took him to the vet for crystals when he was 5 years, he was in the hospital for 11 days, after he got home, it took him a few months to trust us with the door open, and he's like a dog that way, he rattles his leash to go out in the hall, LOL  so we put it on, wrap the leash handle around the inside door knob, and let him hang out by our front door, in the hallway.  He thinks he's hot stuff.  So cute.

I guess, when it comes to an animal, since they can't talk and let know what's going on, we'll always question whether we're making the right choice.

Writing this has been therapeutic.  I suggest anyone going through a similar situation, start keeping a calendar on health, progress & behavior.  You start to see patterns, which can help us as the "care giver" .

I'm going to feed and massage him now, then I'll post March's roller coaster ride.

LotsofFur said:

Simon is a beautiful boy and you are a loving and wonderful cat guardian. [emoji]128149[/emoji] Following your journey and standing in solidarity during this difficult time. I think it's great that you are journaling this and letting others support you from one cat lover to another

and vibes for many more happy days for you and Simon!

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Thank you so much, I wish this journey would lead to a happy ending, but If we can have fun leading up to the heartbreaking goodbye, I'll take it.  Thanks again for your kind words.  Much appreciated.

Hospice Care:  I read an article called- The "HHHHHMM" Quality of Life Scale  - Hurt, Hunger, Hydration, Hygiene, Happiness, More Good Days Than Bad Days,  0 to 10, 10 being the worst.  This article as well as this Site has been a terrific tool and one that's made a difference in Simon's Quality of Life.

Many thanks again to the Members & Guests for posting the most invaluable information I've ever read on our furry friends.         Thursday March 17th -  I made an executive decision out of desperation (I do not recommend this before you speak to your vet), I ran to the store and got  Pedialyte plain and Baby Aspirins, I started syringe feeding him the Pedialyte 6ml every hour, along with a 6 ml syringe of regular water, then dissolved 1 entire Baby Aspirin pill in 1 6ml syringe worth of water.  I fed him the aspirin in 3 doses 12pm, 5pm, 10pm.  I cleaned him best I could and let him be.  

In the morning I woke up to this.    The Baby Aspirin kicked in, he was wide awake and alert and didn't seem to be in pain.  He was walking wobbly and without eating or drinking it was a matter of days.  Simon slept in the tub Friday March 18th,  I left the water trickling for him - his favorite source of water.  March 19th - Saturday morning I picked him up out of the tub and placed him in bed to sleep.  I had no hope, I called the vet to inquire euthanasia/cremation etc.  He still had elasticity to his skin and was alert, but wasn't eating.  Later on, while I was making breakfast, he smelled the bacon and came out stretching as if he'd been asleep for years, he stood behind me at the stove.  I folded little pieces of bacon like tents and he figured out how to grab them.  At that point I gave him syringe's of pedialyte, water, he still wouldn't take the food. I left bowls of water all around the apt, and left the tub dripping for him, he was desperately trying to figure out how to drink.  He spent the day looking at the tub faucet.

  
Below are videos of his accomplishment, please be kind, with the sick cats, I've neglected my cleaning duties and my grout needs bleaching badly.

First Simon getting a shower and drinking, then taking pride in grooming ALL DAY SUNDAY March 20th.  

         

DO NOT USE ANY MORE ASPIRIN!!!  Read the link below.  I know he's dying but you don't want to poison him.  You just want him to be comfortable.  Maybe you can get some appropriate pain medication from your vet, like buprenex, it just goes on their gums or under their tongue, so no pill, no shot, great pain relief.

http://vetmedicine.about.com/od/veterinaryqa/a/cats-aspirin.htm

So as of Monday March 21st, I changed my strategy, I got baby food, Gerber Peas and beef Gerber which I added Blood Tea to, I no longer feed him in bed, I set up a staging area on the counter, so I can actually see the food drip from syringe.  I didn't want Bed to be associated with Eating or Sickness.  So far so good, this is my set up along with pictures of him today March 22nd, his ears are getting pink again and he's enjoying eating from the syringe and  grooming once again.  I added Royal Canin Urinary SO WET to the baby food.  I gave him a 1/4 of baby aspirin today and that will be it for now.  We've cut down on the dosage of Clindamycin to once a day, for the remainder of this bottle, 3 doses left.  I've read it burns the vocal chords and we have noticed that he isn't as Chirpy anymore.  


I suppose this will be our way of life for a little while.  It's amazing how he bounced back and what 48 hrs will do.  I'm glad I didn't make a rash decision Saturday.  Both Simon and myself have gotten much needed sleep and continue to forge ahead.  

*Blood Tea:  is when you take beef, put it in a mason jar with holes poked in the lid, boil the jar, every so often, take the jar out and press the meat to squeeze the blood out.  Continue until all the blood is drained.  This is something my mom used to do when I'd get anemic or sick.

Red Top Rescue said:

 
DO NOT USE ANY MORE ASPIRIN!!!   It is toxic to their kidneys.  Maybe you can get some appropriate pain medication from your vet, like buprenex, it just goes on their gums or under their tongue, so no pill, no shot.

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I gave him a quarter today, but that's all.  I will ask the dr. if he looks as if he's in pain.  Thanks for the advice.  Much appreciated.

Cats hide pain well, so if I were you, I would see if my doctor would let me have buprenex.  My vet will let me take home a 1 ml. syringe of it, and the cat gets 0.1 ml. twice a day.  That means a syringe lasts 5 days.  The other two pain relievers they have, Onsior and Metacam, are both NSAIDS like aspirin so you cannot give them daily or for a long time -- you have to be careful with the dosing.  The vet could tell you.  It all depends on the vet, since buprenex is in the controlled substance family.

I'm in love with Simon! What a doll [emoji]128525[/emoji]

I'm so happy that he's having some good days, he really looks good in the videos... Love watching him wash

Simon knows you love him and you are doing tremendous in the supportive care you are giving him, he seems happy and content and even if brief I know you are cherishing it! for more good days for precious Simon!

LotsofFur said:

I'm in love with Simon! What a doll [emoji]128525[/emoji]

I'm so happy that he's having some good days, he really looks good in the videos... Love watching him wash

Simon knows you love him and you are doing tremendous in the supportive care you are giving him, he seems happy and content and even if brief I know you are cherishing it!

for more good days for precious Simon!

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Thank you so much.  He was so cute, he spent all day Sunday in the tub and by night he came out of the bathroom soaked to the bone and just looked at my husband and I, as if he came out of a hot tub on spring break. LOL  I know the thing he hated most was not being clean.  Tomorrow, I'll try and feed him the Royal Canin and ween him off the baby food.  Thanks again.

I have finished reading this thread. I hope it continues for a while longer.

The love and dedication you have for Simon is overwhelming. He knows you love him and he is showing you his love back...

You are so intuitive and daring with your approaches.

I have fallen in love with Simon and you...

((hugs)))