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- Jun 30, 2020
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I'm going to try to keep this short, but Jonas has a long, complex medical history. Seriously, he's filled three files at the vet's office (and that's just his primary vet.)
Jonas came to me as a half-dead blind feral kitten. No one expected him to make it through the day (the actual plan was to euthanize him, but he woke up long enough to bite me and I figured he had some fight and deserved a chance.) He just kind of kept not dying, but throughout his life has had a number of health problems. He seems to have almost no immune system, which makes him very vulnerable to infections. Despite this, he's generally been a very happy, robust cat, with maybe one crisis a year that required a trip to the University or various specialty vets.
Over a year ago Jonas started having trouble with very bad diarrhea and low appetite. We try very, very hard not to sedate Jonas, as he had a cardiac arrest under anesthesia as a kitten. His primary vet won't touch him on the surgical table because of this. He also dropped a lot of weight very quickly and was very frail. The internal med. doctor did an ultrasound and found intestinal thickening that was suggestive of small cell lymphoma. With Jonas' condition being what it was, she agreed to presumptive treat without a biopsy. Jonas was started on Chlorambucil.
For quite some time Jonas did very well. He gained back much of the weight he had lost and was eating with enthusiasm. However, he would have occasional times where his appetite would drop off for a few days. He also still needed daily Cerenia or he would start vomiting. On a recheck ultrasound there was still some thickening, though it had markedly lessened. The vet opted to keep him on Chlorambucil.
About two months ago Jonas had a neurological event. Over the course of an hour he completely lost the ability to walk. After 14 hours at three different vets, it was determined he either had a brain tumor or had suffered a stroke. As he recovered slowly over the course of the next few weeks it was clear it was a stroke. His blood pressure was found to be high and he started on medication for it. On recheck it was normal. The stroke left him with some neurological issues in his rear legs, but he was still able to get around quite well.
It felt like over the last 3 months or so that Jonas' periods of low appetite were getting closer together. There were also some odd events. A month after his stroke I took him to the emergency hospital in the middle of the night because I thought he was head pressing and was worried about his pressure. It was normal, but it looked to me like he was head pressing and grimacing at times. He's had on and off congestion that no one is sure of the reasons for. Sometimes his rear legs seem worse, which is strange for a stroke recovery- normally recovery is consistent.
About a week ago Jonas had three days where he didn't want food AT ALL. He would actively run away from it. We started an appetite stimulate and scheduled an ultrasound, which took place today. For the past two days he's been eating much better, which is probably the medication kicking in. However, he seemed weaker and even got caught on the lip of his litter box.
The ultrasound showed what I feared, which is that the thickening has worsened. He had also lost over a pound in just one month. The doctor is no longer sure that it's small cell. She's not even sure if the chemo EVER worked, though I disagree since he did get better for a sustained period of time. The doctor is concerned that there is something else going on, and that it may not even be intestinal. Maybe there is something going on in his brain, or maybe there are multiple things happening.
At this stage, we have two choices.
Schedule an MRI and a biopsy. There is a risk he won't wake up. There's a chance they won't find anything, or that what they do find won't be treatable. Small cell is basically the best case scenario in terms of response to treatment, so if it isn't that it's likely to be something not good.
Or increase his steroid and just see if it does anything at all. Maybe it won't, or maybe it will give him a little more comfortable time, but this is basically accepting that we're going to lose him soon.
I am very, very torn. Every other cat I've lost, I've known what was wrong and how treatable it was. This would be the first time I'm stopping without knowing exactly what is happening and if it is or is not treatable. Part of me wants to move forward with the MRI and everything just so I'll know for sure and will have the comfort of knowing I did everything I could.
But part of me also feels that Jonas is a 15 year old cat who everyone expected to die as a kitten, and he's already endured so much in his life. If we do find it's a brain tumor or a more aggressive form of cancer, I'm not sure I'd opt to treat. And to be frank, the MRI is very expensive. I've done MRIs on Jonas in the past for various reasons, but he was younger and what we were looking for was more likely to be treated. I'm not actually sure where I would find the money right now. And I absolutely HATE that it is coming down at least in part to money, because I've never let that factor in before. With Jonas it has always been he gets what he needs and every other consideration comes second.
On the other, other hand...I know how blessed I am that Jonas has been with me this long. He's beaten the odds so many times. Even so, I'm not ready to say goodbye yet. I lost my mother two years ago after being her caretaker for most of my adult life, and honestly the thought of losing Jonas hurts worse.
Any advice or thoughts would be appreciated. This just sucks, really.
Jonas came to me as a half-dead blind feral kitten. No one expected him to make it through the day (the actual plan was to euthanize him, but he woke up long enough to bite me and I figured he had some fight and deserved a chance.) He just kind of kept not dying, but throughout his life has had a number of health problems. He seems to have almost no immune system, which makes him very vulnerable to infections. Despite this, he's generally been a very happy, robust cat, with maybe one crisis a year that required a trip to the University or various specialty vets.
Over a year ago Jonas started having trouble with very bad diarrhea and low appetite. We try very, very hard not to sedate Jonas, as he had a cardiac arrest under anesthesia as a kitten. His primary vet won't touch him on the surgical table because of this. He also dropped a lot of weight very quickly and was very frail. The internal med. doctor did an ultrasound and found intestinal thickening that was suggestive of small cell lymphoma. With Jonas' condition being what it was, she agreed to presumptive treat without a biopsy. Jonas was started on Chlorambucil.
For quite some time Jonas did very well. He gained back much of the weight he had lost and was eating with enthusiasm. However, he would have occasional times where his appetite would drop off for a few days. He also still needed daily Cerenia or he would start vomiting. On a recheck ultrasound there was still some thickening, though it had markedly lessened. The vet opted to keep him on Chlorambucil.
About two months ago Jonas had a neurological event. Over the course of an hour he completely lost the ability to walk. After 14 hours at three different vets, it was determined he either had a brain tumor or had suffered a stroke. As he recovered slowly over the course of the next few weeks it was clear it was a stroke. His blood pressure was found to be high and he started on medication for it. On recheck it was normal. The stroke left him with some neurological issues in his rear legs, but he was still able to get around quite well.
It felt like over the last 3 months or so that Jonas' periods of low appetite were getting closer together. There were also some odd events. A month after his stroke I took him to the emergency hospital in the middle of the night because I thought he was head pressing and was worried about his pressure. It was normal, but it looked to me like he was head pressing and grimacing at times. He's had on and off congestion that no one is sure of the reasons for. Sometimes his rear legs seem worse, which is strange for a stroke recovery- normally recovery is consistent.
About a week ago Jonas had three days where he didn't want food AT ALL. He would actively run away from it. We started an appetite stimulate and scheduled an ultrasound, which took place today. For the past two days he's been eating much better, which is probably the medication kicking in. However, he seemed weaker and even got caught on the lip of his litter box.
The ultrasound showed what I feared, which is that the thickening has worsened. He had also lost over a pound in just one month. The doctor is no longer sure that it's small cell. She's not even sure if the chemo EVER worked, though I disagree since he did get better for a sustained period of time. The doctor is concerned that there is something else going on, and that it may not even be intestinal. Maybe there is something going on in his brain, or maybe there are multiple things happening.
At this stage, we have two choices.
Schedule an MRI and a biopsy. There is a risk he won't wake up. There's a chance they won't find anything, or that what they do find won't be treatable. Small cell is basically the best case scenario in terms of response to treatment, so if it isn't that it's likely to be something not good.
Or increase his steroid and just see if it does anything at all. Maybe it won't, or maybe it will give him a little more comfortable time, but this is basically accepting that we're going to lose him soon.
I am very, very torn. Every other cat I've lost, I've known what was wrong and how treatable it was. This would be the first time I'm stopping without knowing exactly what is happening and if it is or is not treatable. Part of me wants to move forward with the MRI and everything just so I'll know for sure and will have the comfort of knowing I did everything I could.
But part of me also feels that Jonas is a 15 year old cat who everyone expected to die as a kitten, and he's already endured so much in his life. If we do find it's a brain tumor or a more aggressive form of cancer, I'm not sure I'd opt to treat. And to be frank, the MRI is very expensive. I've done MRIs on Jonas in the past for various reasons, but he was younger and what we were looking for was more likely to be treated. I'm not actually sure where I would find the money right now. And I absolutely HATE that it is coming down at least in part to money, because I've never let that factor in before. With Jonas it has always been he gets what he needs and every other consideration comes second.
On the other, other hand...I know how blessed I am that Jonas has been with me this long. He's beaten the odds so many times. Even so, I'm not ready to say goodbye yet. I lost my mother two years ago after being her caretaker for most of my adult life, and honestly the thought of losing Jonas hurts worse.
Any advice or thoughts would be appreciated. This just sucks, really.