Today is Tuesday, 25 April 2000.  Liz and I just returned from the hospital where we visited with Zener, and made the decision to try to let him live for a few more months.

A week ago, Liz asked me if I thought that he was acting funny, or rather, not acting at all.  I thought that he didn't seem too different than normal; he didn't move much all day, but that was his style.  Shows how observant I am.  By Saturday, though, we both new that something was definitely wrong with him.  He wouldn't eat, and he wouldn't play with his favorite toy.  At midnight Saturday, we rushed him to the emergency room, for we didn't know what.

The doctor's didn't know what either, upon first examination, but suspected anemia.  They asked that we leave him, and they'd take a blood sample.  The doctor called around 2:30 (we were still up; Liz working on her school project, and me on work).  He told us that Zener's Pac Cell Volume (PCV) was low.  40% is normal, 20% is cause for concern, and 10% is life threatening.  Zener was at 11%.   This required an immediate blood transfusion.

Sunday morning Liz called, and Zener was a little better, but still not eating.  They had eliminated three of the four usual causes for anemia.  The fourth was waiting for an outside lab to conduct tests on the blood.  We brought him home Sunday evening, as he didn't need to be at the hospital, and they thought that he would be happier at home.  We were to take him to our usual vet on Monday morning, and the hospital would fax over all the reports to them.

Monday morning we dropped him off at our vet.  They would watch him and take a couple blood counts throughout the day.  I got a call around 3 p.m., and the vet said that Zener was doing better.  They still hadn't gotten the clinic's results on the blood tests yet, but his PCV was up to 18%.  He seemed pretty miserable there, and he wasn't eating, so she thought that he'd be happier at home.  They had a couple of medications that we were to give him, and  I could come pick him up around 4:30.

When I arrived, things had changed.  His PCV was down to 16%.  She was concerned that he was relapsing, and thought that we should take him back to the hospital for overnight care.  She would give us the info to take to them.  She suggested that I take Zener home for a few hours so that he could relax a little and maybe eat something.  Apparently he still wasn't eating.  I brought him home and put him in his favorite spot in the closet, with some food and water right next to him, and his litter box just outside the door.  He just lay there.

We brought him down later that evening to cuddle with him.  Finally we decided we had to take him back to the hospital.

The doctor came into the room, looking over the papers from the vet that I had given him.  He looked at us and said that it appeared that the vet hadn't gotten the last report that he had faxed them.  I had picked up Zener before they had gotten the fax.  The fax was the results from the blood-work clinic.  It showed that Zener's blood had no immature red blood cells, and a high white blood count.  This was Liz's first tip off that there was something cancerously wrong with him.  That meant that the rising PCV was just the fresh blood from the transfusion, and the ensuing decline was that fresh blood dying off.  Zener's own body was not creating any new healthy blood.  

There really is only one cause for this, and it is the cancer leukemia.

Leukemia the virus is common in cats (to which Zener had been vaccinated), but it is not the same as the cancer except in name.  The cancer is not pretty, and essentially incurable.  When I started to really realize what he was saying, I started to get faint.  I'm sure I was pale.  I heard Liz looking at the report and asking questions.  "How could she be so coherent?"  I wondered.  He left for a bit, and we just cuddled with Zener and cried.

They took him in the back so that they could monitor him, and we left.  We were to call in the morning and talk to their specialist.

All of a sudden it had turned from a serious, but curable sickness to a terminal one.  We were stunned.  I had to concentrate hard to drive home safely.  We cried for hours.  The poor little guy -- he doesn't understand what's going on.  He's miserable, and we just poke him and prod him and take him to big, scary places with lots of other unfamiliar animals and loud dogs.  He's so shy even in his own house... he must be so scared...

This morning we talked to the specialist, Dr. Zanger.  Zener's PCV had diminished even further to 13%.  Her prognosis was that a bone marrow test needed to be done to determine the type of leukemia.  There are two main types, lymphoid and myloid.  If it's lymphoid, then chemotherapy can be administered.  This would be mean bringing him to the hospital one day a week for an all day treatment and i.v., and giving him pills and other medication daily for the rest of his life.  The average life expectancy is two to four months.  Average.  The doctor has had one patient last a year and four months.  We asked about quality of life.  We don't want him to suffer just for our selfishness of wanting him to be around.  Her answer was that unlike in humans, where the concern is to get rid of the cancer, in cats they just try to make their life good for a while.  So the doses are smaller.  Zener will likely lose his whiskers, and maybe his hair on his ears.  But hopefully he'll be mostly his normal self for a bit, and happy.  We told her that we'd talk it over and let her know soon.

What do we do?  We don't want to make him suffer more, but it seems unfair to at least not give him a chance at feeling better.  We decided to go ahead with the bone marrow test.  We are still torn, though.  Is this selfish?  Are we just prolonging his pain?  Will he really feel better?

We went in in the early afternoon to visit with Zener and talk with Dr. Zanger.  We got to visit with Zener for almost an hour.  We took a ton of photos, which are on the following pages.  We also got him to eat a bit.  It took quite a bit.  He would only eat if he were safely tucked into one of our arms, and the other popped it in his mouth, almost like pilling him.  We did get a decent amount of food in him that way though.  His PCV had gone up to 14%.  Not much, but in the right direction.

They should be doing the bone marrow test today, and pending the results, conduct the first round of chemo tomorrow.  We're still both faucets, crying at the slightest thought of our poor baby.

Thursday, 27 Apr 2000.  Zener is home.  

Yesterday was, like the days before, tough.  First we'd like to thank each and every one of you who sent emails of support.  They sure help.  It's amazing how many of you have been in similar situations with similar diseases.  We received a lot of advice, often contradictory, and all of it seems right.  That's what makes it so hard.  If only he could talk and tell us how he feels.

Yesterday, I talked to Dr. Zanger, and the bone marrow results had been inconclusive, most likely because he had already had some treatment that could kill the cancer.  We were left with the option to treat it as if were lymphoid or put him to sleep.  Dr. Zanger seemed quite sincere that if it were her cat, she'd try to treat him.  I also agreed with that.

Zener's PCV had dropped over the night from Tues to Wed to 12%, but had been holding steady since then.  He hadn't eaten Wed morning, but had quite a bit last night after the bone marrow test.  One of the drugs used for the anesthesia is valium, which has an effect of stimulating a cat's appetite.  So that was good, as at least he'd eaten something since we left him on Tues.

Dr. Zanger also said that he had been spending more time at the front of the cage than just staying at the back, so he seemed to be in better spirits, or just getting used to the surroundings.

So Zener started chemo yesterday.  We were able to pick him up at 5.  We are to give him some pills, one for the cancer, and another to stimulate his appetite.  He did eat some baby food after Chemo, another good sign.  We made an appointment to take him back on Friday.  If he's doing well, he'll come home in half an hour, otherwise she wants to watch him all day.

We brought him home and put him in his favorite place, our closet.  He lay there for quite a while.  Later Liz brought him downstairs, and was holding him there.  Then he got down and threw up.  It was mostly a hair ball, but not completely.  He then just backed up a bit and lay down with labored breathing.  We were of course concerned, and called the hospital.  They're getting to recognize our voices.  We took him in, not really sure if we should or not.  The last thing that we wanted was to take him back to the scary hospital and have him poked and prodded again.  

The doctor looked at him, and said that when an animal is that sick, just the act of vomiting can kill it, so he'd like to watch it.  We were quite hesitant to leave him overnight again, so he said if we could wait for half an hour or so, he'd see how Zener's PCV was and how he was doing.

We've spent quite a bit of time in the waiting room, and seen some pretty interesting things, and some pretty sad things.  Last night was no exception.

About 45 minutes later out Zener came!  His PCV was up to 16%!  That's not great, but much better than we had hoped!  So we brought him home and made him comfy in the closet again.  We went to bed shortly thereafter, all of us quite tired.  However, we decided to sleep in the closet too, just to keep him company.  Thank goodness it's a pretty large closet!  The night went fine, except that Liz rolled over and almost squished him.  

We both stayed home to take care of him.  My boss is the best, and his understanding and giving me the time off has reduced any additional stress.

Today has us questioning the quality of his life.  He's weak and drowsy.  These are symptoms that the doctor said we'd see, but that doesn't make it any easier.  We moved one of the kitty boxes right outside the closet door so that he didn't have to go too far to use it.  The other cats sure found it, but this morning Zener walked right by it and stumbled all the way into the kitty room to use one of the other boxes!  

We both agree that if he doesn't show progress soon, we can't keep him going like this.  This is not the happiness that I had hoped for him.  We don't want him to be put to sleep in a hospital, but would rather have him just fall asleep at home in his closet.  But I get ahead of myself.  He's only been home for 20 hours now.  After tomorrow's check up we should be in a better position to evaluate his future.

Note: I made an error in what PCV stands for below.  It correctly stands for Packed Cell Volume, not Pac Cell Volume.  It is also known as hematocrit.  A good explanation can be found here.  Another site with great information on cancer in pets can be found here.

four new photos

Saturday, 29 Apr 2000.

This is not what I had been hoping to post.  

It's been a day now since we lost him.  Is it any easier?  Maybe yes, or maybe we just can't really accept that he's not coming home, that he's not just hiding, and will come out any second now, wanting to play.  (I apologize now for the fact that this is not going to be cheery.)  

He was our sweet boy, our youngest.  He wasn't supposed to be the first.  He was the only one of our cats that we got to raise from a kitten.  We originally named him "Butter" because he just melted into you when you held him.  It didn't really seem befitting of a boy, though, and we changed his name.  (The vets insist on calling him "Zenner" though, for some reason.  Insisted, rather.)

He was such a big, strong boy.  His toughness didn't serve him well in the end though.  He was so tough we didn't know he was hurting.  And he didn't give up when he should have.  We were hoping that he would pass in his sleep on Thursday night, but he was too tough, fighting to breathe.

Thursday was not good.  We had him home, and he rested.  We hoped that he was resting and his body was creating all the new necessary red blood cells.  He just sort of lay with his head down, sometimes just up, watching us.  The time he seemed the most interested was when Liz was playing with Ophers -- his head was up, and his eyes seemed clear, watching them.  It was so painfully obvious that he wanted to go join them, but his body just wouldn't respond.  This is not what we wanted for him.  This was not quality.  I hoped that underneath he was getting better.

However we couldn't get him to eat.  I gave him the appetite stimulation pill in the morning, but it seemingly had no affect.  I laid out all his favorite foods in front of him, and four flavors of baby food, some water and some cat-friendly milk.  He had no interest.  I tried to get him interested by dabbing some of the baby food on his nose to make his tongue work.  He got some that way, but very, very little.  The same happened in the evening.  Liz even went and got some ground beef and fried that up with some small chunks of rice in it.  Again no interest.  We sort of force-fed him a little, because if the drugs were actually working, they couldn't help him if he didn't eat.

We tried to keep our spirits up around him, to comfort him. 

When I would play my guitar on the landing, he would sit at the top of the stairs and watch me.  So invariably I would start to sing him songs to and about him.  Now I tried to sing him those songs, and I just couldn't.  This certainly wasn't keeping spirits up.

Liz held him for quite a while in the evening, and he seemed the most at peace all day.  He just closed his eyes and slept, all cozy in her arms.  Then he woke up and had a big burst of energy.  He got up, walked under the table, walked around the living room, then lay down.  He lay there until we went to bed, when we took him back up to the closet.

He got worse in the middle of the night.  We woke up because he was crying.  I tried to see if he needed to go to the bathroom, or if he were hungry or thirsty.  Neither.  So we just caressed him and talked to him.  He quieted down and fell asleep.

We both hoped that he wouldn't wake up, that he would peacefully go in his sleep.  But in the morning, he was still breathing, and his eyes were alert.  We gave him his pills again, but he still had no appetite.  Our appointment with Dr. Zanger was soon.  We had both decided that if and when we had to put him to sleep that we wanted him at home, safe and cozy in his closet, not in some hospital.  So we even debated taking him to the appt, hoping that Dr. Zanger could just give us a painkiller pill and the "put-to-sleep" pill.  But we decided we had better take him in, in case this was a normal response, or his body really was working under there.  We definitely didn't want him poked any more, though, if it weren't clearly evident that he would survive.

They took Zener in back for a quick check.  His PCV was down to 9%.  It was evident that nothing was working, and now the answer was clear.

There are no pills to do the put-to-sleep, so Dr. Zanger gave us referrals to vets that do house calls.  On the way home, as I promised Zener that this was his last car ride, he started really crying.  Should we just turn back, and put him out of his misery?  Then as I turned around, he calmed down.  (For all these trips, Liz just held him in her arms.  He never struggled.  Even when he was a kitten I could drive him to the vet with him on my lap, his head burrowed into my stomach.)  So we continued home.  I called the recommended vets while we were driving home, and left messages.  We got home and put him up in the closet, making him as comfy as we could.  We cried and cried and cried, telling him all the things we loved about him, and all the things we would miss.

How we're going to look for him behind my shirts in the back of the closet.  How we're going to expect him to come begging us to get the orange string out when we brush our teeth.  How we're going to want him to swarm us during breakfast, waiting for our leftover milk.  How I'm going to expect him to be sitting at the top of the stairs when I play my guitar.  How we're going to miss him stomping on us while we're still in bed, stomping on our chests and reaching out and poking our faces with his razor-sharp claws.

The vets didn't call.  I called again, and discovered that none of them would be available that day.  We had tried to make Zener as comfy as possible, but he was just suffering.  We had to take him back to the hospital.  I had lied to him, telling him that he would never be in the car again, and that he wouldn't have to go back to the hospital.

We arrived, and asked that we be with him.  They took him in back and inserted an i.v. in his leg.  Dr. Zanger brought him in, and put him in Liz's arms.  Then she asked if we were ready.  We had already said our goodbyes, and we couldn't prolong his suffering.  His eyes weren't alert anymore.  We said we were.

Dr. Zanger took out a syringe and inserted it into the i.v.  Slowly she pushed the pink liquid into the i.v.  Zener didn't react at all.  He was gone in a second, his eyes still open.  We cried (more, we already were crying), and petted him.  Dr. Zanger left us for a bit with him.  My poor boy.  Such a sweetie.  It's all over now, baby.  

We cut a lock of his hair, and took his collar.  The hospital will arrange to have him cremated and return his ashes to us.

We slowly returned home.  Stunned and tired.  We lost him in less than a week.  Just six days ago we thought that he was fine, and just four days ago still thought that he would be fine.  Now he's gone.

We'll miss him.

(look for a celebration of Zener's life here later)

Photos are here.