Isaac, 2004-2010

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?

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My sympathies. I went through similar things with two cats and it hurts so much I don't want to have any cats anymore. One of them died suddenly and I thought he must have gotten into some household poison -- I had the autopsy done, as you did, and it was that he had some kind of congenital heart damage. The other cat, years later, died more in the way Isaac did.

It is easy to blame yourself for all of this. I did. But I did it partly because I was treating my cats too much as humans. You have to let them be what they are. They won't tell you where it hurts and they will fight you if you try to take them to the vet. And they just don't live as long as we do.

I bet you get more responses to this than to blogs about math. I was a math major and I read your blog sometimes but this is the first time I commented on anything.

By W P Gardner (not verified) on 24 Jun 2010 #permalink

I lost a cat a couple of weeks ago to a car... They didn't stop, of course. She'd been my kitty for over 10 years.

There's no alternative to moving on, and when I think of years of couch-cat and wake up-cat and mole hunting-cat, the grief is soothed by the happy memories.

No regrets here. Once I'm in a more permanent residence, I'll be getting a new cat.

By Zach Voch (not verified) on 24 Jun 2010 #permalink

I'm sorry you had to lose Issac in such a dreadful manner. I'll be losing a kitty soon myself, to old age, and I dread the day that will come.

I like cats, but I am terribly allergic. I rather like to breath on demand, so cats are out of the question. I have dogs, my last dog died 3 years ago of old age and cancer. his nickname was 'the perfect dog'. I only lasted 2 months before adopting another rescue dog. The house was simply too quiet. I still cry over him. Did I mention that your article made me cry too? My condolences for your loss..

Really sorry for your loss. I'm a cat lover also and I know it can be very close to losing a child. My cats are getting up in age and I fear the day, dealing with what you're dealing with.

At least you have other cats to keep you company while you recover. It might not seem like much of a door prize, but it definitely helps compared to the alternative.

By Uncle Bob (not verified) on 24 Jun 2010 #permalink

wow, I swear when I saw isaac's picture I thought I was looking at my own cat! He seems much like yours - an attitude and a love for sleeping on my backpack. I can't imagine losing Shorty and I am very sorry to hear about your loss.

You had this 37 year old red blooded male in tears with your first sentence. My deepest sympathies. I've been there with one cat, and given that my four current cats are now getting to the 8-10 mark, I'll have to face it again pretty soon - certainly sooner than I have any desire to.

The little buggers take over your life and you can't imagine what it was like without them - but as W P Gardner says above, they just don't live very long compared to us apes.

So it goes.

Will Emily be alright?

Thank you, Jason. This was a lovely, touching post.

By Peter Beattie (not verified) on 25 Jun 2010 #permalink

Jason, I am so sorry about your cat. When they die it's like losing a member of the family. Hell, it IS a member of the family!

I had a similar experience--took my cat in for what they thought was constipation, and when I went to pick him up, they said it was advanced lymphoma instead; on advice I decided to have him put to sleep on the spot. I had ten great years with that hard-drinking cat.

RIP to Isaac and best wishes to Emily.

Jason, give Emily a hug from me.
Emily, give Jason a hug from me.

So sorry to hear the news, Jason. But for poetic reasons, I do appreciate "the general cussedness of things."

Could be a name for a second blog.


We lost our beloved cat a little over a year ago in similar circumstances. She was fine... until she wasn't, and her entire system collapsed within a week. Kidney failure, basically, leading to blockage, not eating, and a shutting down of her entire digestive tract. And I went through the same process of blaming myself with a series of What Ifs: What if I'd been more observant? Would the treatment then had worked? But in the end, as you say, it's natural causes. The last gift we can give to a beloved pet is to not let them suffer more than absolutely necessary.

My thoughts are with you guys...

Am so sorry, Jason. You have my condolences for losing a dear member of your family (I agree with Jerry's sentiments.). Thanks for a poignant, most moving, post.

By John Kwok (not verified) on 25 Jun 2010 #permalink

Not even gonna read the post... I'm coming up on the 1 year anniversary of losing a cat that was my first real pet that was only my own, who also went directly from perfectly healthy to multiple organ failure... only it was in one day, not in a week. She was 8.

i know just how you feel. in the last 8 months i have had to put down a cat (kidney failure) and a dog (too old). your animals are a part of your family--but for far too short of a time, even when they make it to old age.

My sympathy, Jason. I hope you find good ways to remember him and ways to comfort yourself.

I am very sorry to hear of your loss. He was not an old cat... and he was not very very fat.

You will have to keep one of his toys in a box of junk, with his name on it...


By Kevin (NYC) (not verified) on 25 Jun 2010 #permalink

I'm sorry to hear about your cat, Jason. Losing a pet is horrible! I had a few cats growing up that died by car. That was always hard. But, last September I lost one of my own cats by car, and this time didn't have my dad to take care of her. My husband was out of town, so it was up to me to pick her up and bury her. It was really hard, yet somehow cathartic. She was a good and loving cat, but SUPER stubborn. She liked to prove to us that she really didn't need us humans, she just stuck around because she wanted to stay. Which, was fine with me. I had her from the moment she was born (we were adopted by a stray who had kittens. We kept the stray momma and two of her kittens), so losing her was really hard. Anyway, I hope Emily does okay without her brother and accepts a new friend well.

Condolences, Jason, on the loss of your feline companion.

By Owlmirror (not verified) on 25 Jun 2010 #permalink

Jason, you have my deepest sympathies for your loss. Isaac seems to have been quite a wonderful companion.

Also, thank you for writing such a wonderful post about your beloved pet; not only is the illness discussion a good public service for cat owners, but the post as a whole is a marvelous eulogy for Isaac. I'm glad that you have such good memories of him to treasure, and that you still have another feline friend around so you two can help cushion the grief somewhat for each other.

Take care, Jason.

~David D.G.

By David D.G. (not verified) on 25 Jun 2010 #permalink

Hey Jason - long time no internet converse... (Carnival of Evolution)

I have 3 cats, one of which is epileptic. I most definitely understand your pain. Witnessing a seizure alone is enough to traumatize a person. I dread the day when we will face the same as you with our three furry family members.

Thanks for all the kind words. It means a lot to me.

John Farrell - I should probably mention that the line about "the general cussedness of things" is not actually mine. It comes from a mystery novel by Carter Dickson (aka John Dickson Carr). He had a series character named Henry Merrivale who used to say it all the time. I thought it was a memorable line also.

Kele - Emily also really likes sitting on that backpack. I don't see the appeal. There's always some stuff in it, so it's not exactly an even surface. And there are things like zippers to poke them.

Yeah, it's tough sometimes. I think back on the cats and dogs we've had over 44 years and how many times we've grieved for one and wonder why we get yet another one or two or three...

Speaking of which, we managed to capture and spay and neuter 7 of the 9 ferals who showed up over the winter after our big old (neutered) tomcat Ernie got hit on the road, but we couldn't catch two females until it was too late. So we've got 5 really cute kittens left. Free to a good home! :)

We have a cat, and have had only one at any time. 10 years ago we had a white, deaf cat. Great mouser. But she liked to eat with us. You get the idea. Not acceptable. Another developed of feline lukemia, so we had her put down. Our current cat, Nermal (per Garfield's antagonist), seems anything but. We often call her abnermal. When we picked names, I had food on my mind. Taco, fajita, entre, and other similar names came to mind. I wonder why nobody went along with me on these option. :-) Still, she sits on my lap. I scratch her behind the ears while I recall various episodes of Alf.

Sorry to hear about your cat.

So very sorry, Jason. I've lost a dozen or more cats and one dog over the past handful of decades; it never gets easier. And it shouldn't.

Isaac looks very like my Zach, and Miss Emily like the "nephew" he spoils, Mr Peavey, so this hit me doubly hard. I hope that another fur person helps patch the hole in your heart as soon as appropriate.

As with everyone else, my condolences.

On a more positive note, I have a theory about the backpack lying desire. My cat (coincedentally named Emily) and her former hated step siblings sat on every transitory storage device they saw.

I believe that after a time or two, they associate bags(backpacks, luggage, duffels, lunchbags) with what normally follows their appearance: their human going somewhere. I think it goes something like this. "Hey! You put stuff in this contraption, and then you go somewhere. I'll sit on it, and you won't be able to find it, or if you do, you won't be able to leave because you can't put stuff in it."

That shows learned behavior, but what about the first times they see a new bag? Why would they lie on it then? Well, cats sit on changed stuff. I move a footrest or stool 12 inches, and Emily will be on top of it within 30 seconds checking out the new sightlines. She'll also be in every corner of the modified room silently judging my decorating ability and complaining with her eyes about how her world is not the same and how she needs treats. All cats are OCD mothers-in-law with fish cravings.

I mostly lurk here, but though I'd pop out long enough to express my condolences. I've been through this with two cats, who helped me get through some of the toughest parts of my life. Good on ya for making the compassionate end-of-life choice. It gets better, eventually.

Our sympathies, since we went through the same thing. Each of my two children had adopted a kitten from my parents' cat, my daughter picking a brindled male whom she named Milo, and my son choosing a Jellicle cat and naming her Sweetie. Five years later (2000), we were getting the household loaded to move from one city to another, and Milo began acting lethargic. In the general hub-bub, my daughter was the only one to pay attention. When we got to our new town (on a Saturday night, of course), Milo was just a rag doll. We took him to the closest vet on Monday morning, but he was too far gone. Same thing: Urinary problems. A week later, we got my daughter another brindle kitten (Mina, a female). (Sweetie died just this summer, of a tumor. Her urn is next to Milo's on the mantle.) The fur-bearin' critters are part of the family.

By CortxVortx (not verified) on 29 Jun 2010 #permalink

I shed a few tears after reading this. So sorry.

By aratina cage (not verified) on 29 Jun 2010 #permalink

So sorry to hear about Isaac.

The memorial was very touching, though. He sounds like he was a cool little dude :)

I am sorry for your loss. I lost a cat 2 years ago to lymphoma, my cat actually looked a lot like your Emily. And my Texas would also let me know at 7:01 if it was dinner time. I missed that too after he was gone. You wrote a wonderful memorial for Isaac.

I've been reading this blog for a while, but I've never commented before. I just wanted to tell you that you have my sympathy. This post was very touching and I'm sure that your cat had an absolutely wonderful life with you.

I'm sorry to hear about your cat.

Our friends just had their cat put down today. It was a similar story to yours. We'll miss him, too -- we were his step-parents and cat-sat him regularly the past 5 years.

Professor Rosenhouse,
Just wanted to send my absolute condolences. You are a wonderful professor and mentor, keeping your family in my thoughts.