My cat, Isaac, died on Monday. He never did anything like a normal cat, and that includes the manner in which he died. He went from no symptoms to multiple organ failure in less than a week. We’ll come to that in a moment.
Cats like Isaac are the reason people own cats. If he were a person he’d be a hard-living, hard-drinking kind of guy, never afraid to tell you what he thought but ultimately with a heart of gold. He loved being handled and had no sensitive spots. Cradle him like a baby in one arm (not so easy to do considering his weight) and rub his tummy and he was a very happy cat. And you could always tell when he was happy, because his purring sounded like an earthquake.
He was a bit more svelte when I first got him:
When it came to food he was pretty much a bottomless pit. I controlled his diet as much as possible and only fed him dry, low-calorie cat food. But there was only so much he would accept with equanimity, and there was a limit to how miserable I was willing to make him to get his weight down.
So what happened? It all started last Wednesday. It was around 5:30 in the morning, and I was getting ready to go to sleep. (What can I say? I’m a single guy with tendencies toward vampirism.) I walked into my bedroom and saw Isaac sitting calmly on the floor. I knew immediately that something was wrong. For one thing, he was not sitting in any of his usual spots. For another, he did not acknowledge me when I entered the room. This was a considerable departure, since he had been fine the night before.
I bent down to check him out, and quickly noticed that his right eye looked like this. There was also some ugly looking discharge running from his eye down his nose. His third eyelid was up, which, as it happens, is often a sign of illness. But I didn’t know cats had a third eyelid. I thought he had somehow injured his eye, and that the discharge was eye juice running down his nose. He also seemed a bit dejected, and barely responded when I pet him.
My vet’s office opens at 7:30. I stayed up until then, called them as soon as they opened, and had him there by 7:35. I told them there was something wrong with his eye. As an afterthought I mentioned that he seemed a little lethargic. The technician I spoke to explained to me about the third eyelid. I left Isaac at the vet’s office and went back home.
A few hours later I got a call from the vet. She told me that he seemed to be doing OK, but had a mild fever and some respiratory symptoms. Most likely it was an upper respiratory infection. When I picked Isaac up later in the afternoon she gave me some antibiotics. She also mentioned that he had lost a pound since his last examination in January. That was the last piece of good news I would ever receive about his physical condition. As it turned out, a more accurate diagnosis would have been dead cat walking.
Over the next few days I dutifully gave him his pills. Now, I had no prior experience with getting a cat to swallow a pill. So I looked for helpful videos on the internet, like this one. It seems there is a trick to it. With one hand you grab his head from above, placing your thumb and forefinger on the sides of his mouth, at the joint connecting his lower jaw to his upper jaw. You tilt his head back and apply gentle pressure to open his mouth a bit. You then place the pill in the thumb and forefinger of your other hand. With your middle finger you pry open his mouth wide. With his head tilted back like this he has little strength in his lower jaw. Then you place the pill on the center of his tongue and slide it back as far as you can. Close his mouth, hold it closed, and massage his throat until he swallows. Then follow him around for a minute to make sure he wasn’t fooling you. It all looked terribly simple on the video. That cat seemed positively delighted to swallow his pill. No doubt that is how a normal cat reacts.
But we are not talking about a normal cat. We are talking about Isaac. The problems started early in the process. His head was enormous. I do not think I have especially small hands, but it was like trying to palm a basketball. And once my fingers got near his mouth? Fuhgeddaboudit. Suddenly he had plenty of energy. There is some crap up with which he will not put. Still, clever cat though he was, he never really understood about futility. I was well-supplied with band-aids, and this was one battle he was not going to win.
There was little improvement by Saturday. I was getting concerned, but was far from panicking. He did not seem to be getting better, but he also wasn’t getting worse. He was sluggish and wasn’t eating, but a powerful infection will do that to you. My vet has Saturday morning office hours, so I called them up and calmly made an appointment for Monday morning. My thinking was that I would give the antibiotics to the end of the weekend to work. I considered it a real possibility that he would turn the corner that night and then I would end up feeling silly for having been worried.
It was on Sunday that everything turned into an episode of House.
This story is about to get even more depressing, so let’s fortify ourselves. Here’s a picture of Isaac from happier times, engaged in one of his favorite activities:
Sunday afternoon he had a new symptom. He was having trouble walking. He seemed unable to get his hind legs centered beneath him. About two hours later he had a seizure. It’s funny how you react to such things. My precise thoughts were very Spock-like. “So that’s what a seizure looks like. Fascinating.” Probably because it was so clear what needed to be done, I was completely calm. After the seizure abated I placed him gently in his carrier. (He did not resist me at all. Very bad sign.) Went out to the car. Drove him in a brisk but safe manner to the 24/7 animal hospital roughly twenty miles from my home. He had another seizure in the car.
The vet at the hospital did a full blood work-up. It was all bad news. His blood chemistry was all wrong. There was clear evidence of both kidney and liver damage. The prognosis was very grim. He asked me questions like, “If he goes into cardiac arrest, do you want us to perform CPR?” We talked seriously about euthanizing him right then, but I was not quite ready to do that. I did not want him dying in such a stark facility, far from his home, surrounded by people he had never met. Somehow I wanted to hear from my own vet that the situation was hopeless.
I had brought with me the examination report my vet had given me when I first brought him in on Wednesday. The emergency vet told me he would have suspected an upper respiratory infection too and that he was at a loss to explain how things had gotten so bad so fast. He suggested a toxin of some kind and asked me if it was possible that he had swallowed some antifreeze. Not unless he literally crawled under the hood of my car. In the end Isaac spent the night at the hospital being pumped full of whatever drugs and fluids the vet thought could do him some good.
I had some bad moments on the drive home. I couldn’t imagine what toxin he could have gotten a hold of, until I remembered that I had recently sprayed some weedkiller. Isaac was almost entirely an indoor cat, but he did occasionally ask to go outside. Then he would mostly sit on my patio. Could I possibly have let him out on the patio the same day I had sprayed the weedkiller? Did he then start chewing on one of the few small weeds that I sprayed near the patio? Did I somehow get some on my shoe and track it into the house? Holy crap, did I do this to him?
But the more I thought about it the less likely the weedkiller theory seemed. For one thing I clearly remember thinking, as I was spraying, that I had to remember not to let Isaac outside that night. For another, the time course of his symptoms was wrong, since it had already been more than two weeks since I had done the spraying. The clincher was that consuming weedkiller would almost surely have led to vomiting and diarrhea, and with everything that was wrong with him those were two symptoms he did not have.
After a sleepless night at home I was back at the hospital a little after seven the following morning. The fluids had done him some good. Isaac was alert and looking around and bitterly protesting his captivity. That’s my boy! There was a different vet on duty, and she told me she had looked over Isaac’s case. She confirmed that he was in very bad shape. I asked her if she had any idea what could be causing this. She shrugged and suggested a tumor.
I brought him back to Harrisonburg and dropped him off at my vet. A bit later they called. To his burgeoning list of symptoms you could add some nebulous damage to his intestines. Neither she nor any of her colleagues had much to offer in the way of a diagnosis. Options were few. Exploratory surgery was one, but in his condition the anesthesia alone would probably have killed him. There is apparently a facility near Virginia Tech that has every diagnostic tool under the Sun, but that is a long drive and it was not at all clear Isaac would survive it. In the end she suggested that his chances of survival were under ten percent. From the way she said it I took that to be a euphemism for, as we mathematicians like to say, nonzero but less than epsilon.
I pointed out that even in the best case scenario these options would only give a diagnosis. It sure sounded like the internal damage was so severe that treatment was no longer possible. I said I would empty my bank account to have him back the way he was, but that I wasn’t going to put him through more suffering in the service of a losing effort. I said I felt it was time to put him to sleep. She didn’t argue with me.
I went down to the vet’s office to say good-bye to him. In the cage next to Isaac there was a small white dog who seemed to be in decent shape. His tail started wagging when he saw me and he walked to the door of his cage. He seemed happy to see me. Not Isaac. I don’t even think he knew I was there. His eyes were half-open and glassy. He did not acknowledge me at all. The only way I could tell he was alive was an occasional flick of his tail or twitch in his ear. He looked so sad. I pet him in just the way he always liked. He didn’t respond.
I asked the vet to perform a necropsy. I had Isaac’s sister, Emily, at home, and I wanted to know if whatever happened to Isaac posed any danger to her. She’s also a good cat. Here she is thinking about all the terrible things she wanted to do to whatever small critter she was looking at:
I got the results of the necropsy that evening. (If this really were an episode of House, then we have reached the last ten minutes.)
Isaac had a condition called uroabdomen. This means that urine was collecting in his abdomen. It is not really supposed to do that, you know. This condition is not so uncommon when the cat suffers some external trauma, like, say, falling out of a tree. This can cause the bladder to rupture. In this situation it can usually be treated if it is caught immediately. The bladder can be surgically repaired and the errant urine can be suctioned out.
But in Isaac’s case there was no external trauma and his bladder was just about the only one of his internal organs that seemed to be in good shape. In his case the culprit was a punctured ureter. In such cases the surgery to repair the damage is far more difficult and dangerous. The cause of the puncture was almost certainly a failed attempt to pass a kidney stone. As a result of the puncture, toxins were being released into his body. This set off the cascade of symptoms you have already heard about.
The bottom line is that by the time he was showing symptoms there was already substantial internal damage. Even if it had been diagnosed immediately he almost certainly would not have survived an attempted surgery. The other bottom line is that, as crazy as all this is, it is ultimately natural causes and not anything that poses a threat to Emily.
Have I mentioned that Emily is very cute? Here she is sitting on her favorite bookshelf:
Monday night was a bit brutal. I kept noticing all the little things that would be different now that Isaac was gone. For example, I normally feed the cats around the same time I sit down for dinner. As it happens, on this night I forgot to put food in the bowl. I did not realize it until a few hours later. Emily is very mellow about such things, but Isaac would never have tolerated it. If he was supposed to be fed at 7:00 then by 7:01 he would have walked over to me, planted all four of his pudgy little paws, stood up ramrod straight, and meowed his head off until he got some justice. I’ll miss that. I cried off and on through much of the evening.
But you know what? By Tuesday I wasn’t crying anymore. On Tuesday I went into my office and had the best session of writing I have had in some time. Tuesday night I slept like a baby. And by today I was visiting the website for the local SPCA. (Bad move. They had a number of cats, and suddenly I want to adopt them all.) I will probably let a few months go by, but eventually I anticipate adopting another cat.
For six years I got to share my home with one of the world’s great cats. But now he is dead. It is very sad, but what can you do? Life is for the living and all that. Our bodies are ridiculous Rube Goldberg machines. It is incredible they ever function properly. Isaac was the victim of rotten luck and that is all. There was no meaning or purpose in what happened to him. It was not part of some grand cosmic plan and it was not ordained by God. It was just one more example of the general cussedness of things. I can live with that. Not easily, of course, but what exactly is the alternative to moving on?