Lola's fight with Oral Squamous Cell Carcinoma (I'm going to say goodbye to my cat)

Lola is beautiful.  

Thank you for posting pictures and sharing her with us all here at TCS.

You can see in her expression that she was tuckered out from the procedures but there is still that glimpse of curiosity and light in her eyes, so I'm not surprised that she's still with you.  You can tell she is a very loved kitty, and I'm guessing - she gets treated like a princess. LOL as she should.

It's a difficult road traveled when taking care of a terminally ill loved one, whether it be human or furry friend, it's emotional for all involved.

You are a strong willed person who knows exactly what his sweet Lola's needs are.  You and your wife also seem to know what Lola is thinking.  Your gut feelings will be your guide.  In the end, you will know exactly what she wants and when it's time, she will let you know, that was something that I was told daily, and I can tell you - it's the absolute truth.  Every time I thought Simon was on his last day, he'd wake up the next day and live life, on that last day, I felt it in my gut it would be our last and it was.  

Me and my husband decided to not take him to the vets and to pass at home.  He wasn't in pain and just wanted to lay on the bed looking out the window and that's how he spent his last day., in the window and in front of the fish tank.  If he was showing signs of pain, we would have taken him to the vets.

Enjoy every minute.  Sending you positive vibes from the States.

Warmest regards, Hope

Also, Buprenex (Buprenorphine) is also a liquid pain med.

The syringe is prepared by the vet and is administered in the cats mouth under the tongue or on the side between the gum and side of the mouth.  I swear it saved my boy.  And was suggested by member @Red Top Rescue  - because Simon  was in no pain he was able to eat and gain some weight, before life got very difficult.

I don't know if it's available to you in Italy but it's worth asking the vet.

We paid 4 US dollars per syringe and gave him one to two a day depending on his pain.  Which I could tell by behavior.

It's also the syringe that I ended up using for his food.  

thanks @Mia6   for triggering  my memory.

Hi everybody.
Yesterday, when I came home from work I found Lola in great shape and alert. One of the first things she asked me to do was to open the door and let her out. She wanted to explore the backyard and stayed out for nearly 45 minutes. I was watching over her, of course.
Then, as it was getting dark and colder, she headed for the door again to step inside the house where it's warmer.
We were ready for her dinner syringe when the phone rang and it was from the clinic where Lola had the radiation. The doctor calls me every 10-15 days to have updates. He feared to receive a bad news but when I told him that I was preparing Lola's food he burst in a laugh for joy. He said that they have never seen such a strong patient. All the signs and symptoms that I was telling him were great in his opinion. I told him that the only bad moments for me and Lola are when I have to syringe feed her. Lola's tongue has reduced to a short stump at the back of her mouth and it's totally useless and doesn't help her swallow. The food goes down by gravity and by some movement of her throat. It must be tiring and dreadful for Lola! He said that an option I could or should take into consideration is to restore the PEG. A PEG is a tube inserted straight into a patient's stomach.
Lola had it inserted in October, a few days before she began the radiation therapy. The radiations would have burned tha cancer under her tongue but tongue, palate and other parts of her mouth would be burned as well so eating would have become painful or impossible for some weeks. We used that tube with some concerns. Mainly because it would get easily plugged up by the food. The correct procedure was to push some water into the tube first with a syringe, so to rinse any remains, then push the liquid food down the tube with another syringe, and finally rinse the tube again. The tube had a screw cap to prevent anything going into or coming out. The last water injected would reach the stomach and remain into the tube so to avoid any food remain to dry up. This is the theory. The reality is that though I was extremely careful, the tube got plugged up three times and that was real panic!
Luckily I was able to fix the problem... I also would rinse the tube with Coke once or twice a week. The Coke is a perfect tube cleaner, it dissolves any crust or dry remain. The cat was all wrapped into bandages to protect the wound and to prevent the tube from getting hooked to anything in the house. Since Lola was peeing herself in her bed, I had to replace the bandage daily. The PEG is secured to the patient's body with a tag glued to the skin. Unfortunately the shaved fur kept growing under the tag and the tag eventually came off the skin after only two weeks with the result that the tube was kind of loose and needed extra precautions during the daily bandage replacement.
On a day one month later I came home from work and found the bandage undone and the tube hanging both sides!!! It had come off completely.
I ran to a vet ER but I learned that inserting a PEG isn't an everyday job and no vet around could do the job. After one night at the ER for observation my cat was sent back home without tube. Luckily enough she proved to be still able to eat on her own out of the bowl. We were happy of getting rid of that nightmare tube. Until shortly after last Christmas when Lola made a loud Meow during a meal, she started bleeding from her mouth and stopped eating.
I have syringe feeding her since. You know the rest of the story.
Now I wouldn't like to start all this over... but I don't know how to feed her properly. Today she didn't want to finish her syringe because swallowing her food must be a torture, I have to push her food at the back of her throat, she might think or fear I'm going to drown her.
If she doesn't receive enough food she could starve.
I'm so sad...

Well, this is a tricky situation.

While that PEG was a lot of work, if Lola is showing you signs that she still is interested in life and having fun, it may be your only other option at this point, sadly.

If you notice she's losing weight, don't take that option off the table.

From what you say, Lola wants to be around with you for a while.

Making these decisions for our furry friends is never easy, but again, if she's enjoying her time in the garden and is happy from what you see, I say go for it.

Again, as long as your vet thinks it's a good idea also.

Best to you, your wife and Sweet Lola.

2Cats4everLoved said:

Well, this is a tricky situation.

While that PEG was a lot of work, if Lola is showing you signs that she still is interested in life and having fun, it may be your only other option at this point, sadly.

If you notice she's losing weight, don't take that option off the table.

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Apart from being a nightamare due to all hassles involved, inserting a PEG is a complicated task, not many vets can do that and not many clinics are equipped to do it. The PEG that Lola had was inserted by a team of doctors in a clinic next to the one where we had the radiation therapy done. I asked the vets around here and none of them does or knows who can do it. I should travel back to the first clinic, over 200 miles from here.
Furthermore, the insertion of this tube needs an anesthesia and a surgery of not less than one hour. In the physical conditions Lola is, she wouldn't stand and survive it...

Antonio65 said:

Apart from being a nightamare due to all hassles involved, inserting a PEG is a complicated task, not many vets can do that and not many clinics are equipped to do it. The PEG that Lola had was inserted by a team of doctors in a clinic next to the one where we had the radiation therapy done. I asked the vets around here and none of them does or knows who can do it. I should travel back to the first clinic, over 200 miles from here.
Furthermore, the insertion of this tube needs an anesthesia and a surgery of not less than one hour. In the physical conditions Lola is, she wouldn't stand and survive it...

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Okay, I wasn't sure of all involved.  So sorry you are facing this decision.

My heart truly breaks for you as you enter this next stage of  Lola's treatment process.

Best to you all. xoHope

What a beautiful little girl. Sending prayers to you both 

Like the others, I'm also thinking about sweet Lola today.

Hope she is still enjoying herself.

Be well.  Update us when you can.

Best always.

Antonio,

Thinking of how darling Lola is doing.

Hugs,

Mia

Hi all and thanks for your support and lovely thoughts!

I wanted to wait till now to give you up to date news.

We had a bad couple of days.

On Saturday Lola was really fine and spent much time outside walking up and down along the backyard. I think she walked 300-400 meters. she was a bit slow but kept going.

I woke up on Sunday to a sleepy and weak cat in her bed on the couch. She was so motionless that the first thing I checked was her breath. She was breathing.

I tried to wake her up but she didn't respond, she was like a toy. I was scared, I was really scared. I pulled her up and tried to walk her, she started walking but was visibly wobbly. She made the round of the table and then went back to sleep. I managed to give her some food only two hours later. In the afternoon she was a little more active, but was slower than the day before. The warmth of the day (yesterday we had about 21°C / 70°F) exhausted her and she laid on the fresh tiled floor two times. Later on she enjoyed a walk outside but she soon felt weak and thought it was better to lay than walk.

At night I gave her the last syringe of the day but only half of it because she showed little interest in food.

This morning she was feeling a little better and ate the whole syringe (40 g). I also gave her some drops of Metacam as prescribed. At noon, two hours ago, she was worse than in the morning and I had to fight to give her 25 grams of food.

I don't think she doesn't want to eat, because she seems attracted by smells of other food, I think she doesn't want to be syringe fed, she hates the feeling of something that is pushed down her throat.

Her lower gums (front teeth and left side teeth) are swollen and redder than some days ago. It doesn't seem she is suffering, though, because I tried to touch them and she didn't react.

Probably these are just two of those bad days along this long path to the end...

Antonio,

Poor Lola. She is a fighter. She sounds very weak but wants to enjoy her last days. My Kirsten didn't like the heat when she was very ill.

Please hug and kiss her for me.

Hugs,

Mia

I am sorry to hear the last few days were not good... but in ways, they were days you had with her, and she spent them how she chose, so it is good, and I hope you feel that part of the good too.  Death is inevitable, for all of us... but dying, knowing you are loved, its not so bad.  At the end, Alex made the choice not to eat.  we would offer her favorites, and she would sniff at them... our hearts would soar, but she would turn away, and we accepted it for what it was.  When she lost interest in food, we decided to stop with the fluid treatments.  As the body shuts down, the pain diminishes... or so it seems.  For Alex, the haze just got stronger. She would reach out from the haze every now and then to reassure herself we were there.  IDK... hope you are able to find peace in these days and even if it sounds silly, I think you need to give Lola permission to go when its her time. 

You are not alone!  I had 3 weeks with my Rizzo before I had him put down.  Knowing that we were doing all of our normal routines the day/night before the vet came just broke my heart.  I could not cry because if I did he would go up stairs to be alone.  Having the vet come to the house is the best thing for a cat if you can afford it.  He has been gone for 2 years and I still think of him everyday!  Take care and talk to us!

Riley1 said:

 
 Knowing that we were doing all of our normal routines the day/night before the vet came just broke my heart.

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I think that this is one of the truest things I could read.

I don't know whether I am able to keep my routine running hours before the end. Having a vet home isn't expensive over here, not more than having that done at the clinic.

But I'm still hoping in a natural end....

MollyBlue said:

 
I am sorry to hear the last few days were not good... but in ways, they were days you had with her, and she spent them how she chose, so it is good, and I hope you feel that part of the good too.  Death is inevitable, for all of us... but dying, knowing you are loved, its not so bad.  At the end, Alex made the choice not to eat.  we would offer her favorites, and she would sniff at them... our hearts would soar, but she would turn away, and we accepted it for what it was.  When she lost interest in food, we decided to stop with the fluid treatments.  As the body shuts down, the pain diminishes... or so it seems.  For Alex, the haze just got stronger. She would reach out from the haze every now and then to reassure herself we were there.  IDK... hope you are able to find peace in these days and even if it sounds silly, I think you need to give Lola permission to go when its her time. 

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I am clinging to the idea that these are just those bad days and that more good days will come.

i know, though, that thise ggod days will be fewer and fewer.

Mia6 said:

 
Antonio,

Poor Lola. She is a fighter. She sounds very weak but wants to enjoy her last days. My Kirsten didn't like the heat when she was very ill.

Please hug and kiss her for me.

Hugs,

Mia

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Lola has always loved heat. She has always been lying in the sun. she's dark, so it got very hot when staying in the sun, I had to move her to a fresher spot every now and then. She's still looking for the warm radiator in the morning, but with the outside temperature around 20°C it won't turn on.

Yesterday she felt weak after some minutes on the window sill, but later in the afternoon she loved to bask in the sun in the backyard.

I'll give her your hugs and kisses! Thanks!

Hi everybody.

When I came home from work yesterday I found Lola rather bright and active. She asked me to get out to take a walk in the garden and backyard. We stayed out for half an hour then she started gently scratching my legs. This may mean two things, food or cuddles.

I gave her food and that was what she asked for. Then we had dinner. Lola sits on my legs when I am at the table, whatever I am doing she wants to sit on my legs. And during our dinner she showed much interest in some of the things we were eating though none of them was something she had ever eaten. She proved to be alert and focused.

Another portion of food right before we went to bed and then the lights went off.

This morning she was still bright and alert, though weaker than yesterday. She ate the whole content of the syringe but she took longer than usual.

Her lower gums are growing around her teeth and the left side of her mouth is slightly changing shape.

I'm sure she's not in pain, though, only annoyed by the syringe feeding and by the fact she can't eat what she wants or drink when she wants. She does drink from the bowl every now and then, but she bites the water and I don't know how much of it she can actually swallow. Probably nothing, but she loves the feeling of a wet and fresher mouth.