Chapter 6, In Which Life is Ironic

3/18/97

Even though we had increased Austin from 2 to 4 units of insulin a day at Feb 20 vet visit, his glucoses were all over 400 this time. Very frustrating. He has gone to 6 units a day and is very playful and the PU continues to improve (no every other day dumping of the entire box of kitty litter!).

I concentrate so much on Austin, that Eugene, his brother, tends to get ignored. Paul told me last week that Eugene hasn't been sleeping next to him and seems to be losing weight. I took a closer look and noticed that Gene isn't grooming and is very skinny. Paul is frantic because Gene is his special buddy. Unfortunately, Paul is out of town and I took Gene to the vet this morning and got some very bad news.

Gene has lost 2.4 pounds, down to 10 lbs. He has a very large tumor in his abdomen. Dr. Remcho wanted to do exploratory surgery this week. She said there is a distinct possibility that the tumor will have spread too far and can't be removed so we will need to decide if we will want to let Eugene go during surgery if that is the case. Since Paul is out of town and there is a possibility that Gene may not be with us after surgery, I have asked for the surgery to be postponed one week. Paul has to have some time with Gene. So do I.

I am shocked. I ignored Eugene. Why didn't I notice his symptoms earlier? Why did I ignore him, thinking Austin was the sick one? I guess this is one of life's ironies that is so typical: I have been preparing myself for losing Austin and now I may not have little Gener in only one short week. Guess we'll skip that bath I was going to give Eugene tonight! And as soon as we got home from the vet this morning, I opened a can of tuna for Gene. He can have non-stop tuna if he wants for this next week! All of you with cats know how hard this is. I hope this tumor is operable or something we can treat with chemotherapy. Let's all hope.

3/22/97

True to his nature, Gene is a bit livelier since he is getting "on demand" tuna. He probably thinks that he has already died and gone to heaven! He has surgery on Thursday and my husband and I are spending a lot of tearful moments with Eugene. Unfortunately, Eugene doesn't feel well enough to want much attention, so we are trying to respect that.

Austin, on the other hand, is doing great. He still has a little PU/PD, so I expect he will have to have more than 6 units of insulin soon, but he looks fantastic. He has put on a little weight, his coat is thick and shiney, and he is very playful. I am concerned that tuna on demand (Austin gets a tiny share when Gene gets his) will affect his diabetes adversely, but it's only for a few more days until Eugene has his surgery. Strangely enough, Austin doesn't even like tuna, but with Eugene crying so much for it, Austin gets caught up in the frenzy.

3/24/97

Paul called Dr. Remcho yesterday to ask if we could talk about Eugene. Even though it was Sunday, her day off, and she had houseguests, our vet had us over for coffee to discuss Eugene. She seemed much more encouraging and even expressed the opinion that if the tumor is inoperable, that she should sew Gene back up, keep him in the hospital a couple of days and then send him home with us for whatever time he has left. Apparently, when she previously mentioned letting him go on the table, she only meant that was an option if we wanted it.

We also discussed cremation and apparently her vet practice (4-5 very busy vets) routinely offers individual cremation with return of the "cremains" or ashes. In fact, as she told us this, she pointed to a box on a bookshelf and said, "That's Misty." Misty was her greyhound who died recently. Dr. Remcho and her husband are going to plant a tree for Misty this spring and put Misty's ashes in the hole. Isn't that cool?

Anyway, Eugene has his surgery on Thursday, March 27. He seems better the last couple of days, probably because he is eating better with the new "tuna on demand" policy. He even made an attempt to stalk a bird this morning. We feel much calmer about the upcoming events. We will do what is best for Eugene, and not be so hysterical about hanging on to him at all costs. That is selfish. As long as Eugene is not in pain and shows interest in life, he is here with us. And he will always be with us even after he dies.

Austin is getting bored by the whole thing, especially "tuna on demand." He wants to know why it can't be "yogurt on demand!"

Eugene looked so great yesterday morning. He played a bit, had me rub his head for ages, ate a lot. Then in midafternoon he refused to eat, became very lethargic. Around 4 pm I called the vet and she wanted to admit him to the hospital right away. Paul wasn't home, so I waited. Paul came home briefly then left for 2 hours to play tennis. Anyway, right after Paul left, Gene ate a little bit and I thought he was doing better. I went up and surfed the net for about an hour. Why didn't I stay with Gene? Paul came home and said Gene looked terrible. Yeah, yeah, I said. But I went and looked and Eugene was flopped out on his side (you know that death flop animals do as they die?) and very weak. His belly was a little bloated and he cried when I pushed on it. Signs that his tumor is totally blocking his intestine, an emergency. We called the vet immediately and she met us at the hospital.

Gene as Paul found him

Gene was so cute on the ride over. Paul wisely decided not to put him in his carrier. Instead we used a cardboard box with one side cut out, and put some of Gene's used towels in it. Paul held him (in the box) on his lap as I drove us to the vet. Gene put his little head up and looked all around in amazement. It has been years since he has been in the car when he could see out. Even better, he put his little paw across Paul's arm and held on to him as he looked about.

The vet immediately said Eugene looked terrible. She said he had lost a lot more weight since last week and that "he doesn't even look like the same cat." I felt awful. I thought he looked better. Isn't denial a wonderful thing? She said his lungs were clear, he wasn't in shock, but very dehydrated. Poor Gene just laid there in his box, not caring about anything. I didn't know whether I was more upset over Eugene or over how bad Paul looked. We finally said goodbye to Eugene and let the vet take him. I literally drove home blind. Fortunately no one hit me when I stopped at that red light then immediately drove through it. I cried for 4 hours and finally took a benadryl so I would go to sleep.

Gene is scheduled to start surgery right about now. (Written at 11 am 3/27) I have lost my hope that the operation will cure him. I don't even know now if we are doing the right thing by putting him through surgery. Maybe we should have let him go last night.

When we got the cats, I wasn't too crazy about either of them (cats, yuck) but I REALLY didn't like Eugene. For weeks I wanted to send him back. Too runty, too unfriendly, too stupid. I wanted to name him Dim Bulb. And then he grew into this comic and curious cat that everyone seemed to love. Especially Paul. Amazing how attached to an animal you can become in 12 years. You know, I have always wondered (but have been smart enough not to ask!) if Paul loves Eugene more than me!

So I am heartbroken. All part of life, dammit. I am going to go visit Eugene this afternoon. The vet had reluctantly said I could come in during surgery, but I thought it would be better not to see little Eugene in that state. Hopefully, he will be back home in a few days.

2 pm 3/27

Eugene is out of surgery. We are going to go see him in an hour.

Eugene's bowel had perforated so he has peritonitis, or a generalized inflammation in his abdomen. They took out about 7 inches of his small bowel. Unfortunately, the cancer is in the lymph nodes, so metastatic. The liver didn't look normal but they didn't find any discrete tumors in it. Part of the pancreas had to be removed which is very bad news, mainly because this puts him at very high risk for pancreatitis now, which is usually fatal in itself.

So, the next 48 hours will be critical. If he survives 48 hours, he still may not be well enough to come home. If he is well enough to come home, it will probably be for only a few days or so before he dies from his cancer. (Or we have him put to sleep.) As you could tell from my email this morning, I knew this would be the outcome. Still...

Well, Gener was a damn good cat. Never believed Austin would outlive Gene. Austin, by the way, has been pouting in the window for the last hour. I just went to him and he was purring in a very, very loud and guttural way. Guess he is feeling bad now for all those times he wished he were an only cat!

So, I am going to go see the Big G now, maybe for the last time.

Bye. And thank you, friends, for listening. It helps.

3/30/97 Chapter 8, In Which Eugene is One Tough Bunny!

GENE LIVES!!!!!

We have visited daily and Eugene proves once again that he is a tough little cat! Yesterday he ate and when we came to visit, he got up walked around, asked for hugs and acted like our little Gener! He is pathetically thin though. Dr. Remcho says we still have to see if things work; that is, he has to not throw up and have bowel movements. If so, he may be able to come home next week!

Many people have emailed their concern for Gene and this has helped Paul & me so much, and even Eugene, I am sure. I am so grateful for this. Now we are sure Eugene will come home. There is no way to tell how much time he has left. Hopefully, months and months. But if he can come home even for a few days and feel great, we will be pleased. Of course, we haven't seen the vet bill yet! :-)

Chapter 9, In Which the Darkness Lightens 4/12/97

Austin is getting awful fat and sassy with all the attention and food around here lately! Eugene is home, with bowel function intact, a long incision with staples on his shaved belly, and a very silly looking shaved front leg. We're thinking of all sorts of new insulting names to call him! Austin had another day long glucose curve done and Dr. Remcho says his glucose went down to 40 at one point. She said this didn't seem to bother Austin any but it bothered her, so we are cutting back to 5 units of insulin a day. Glucose levels will be rechecked in about two weeks.

Gener shows off his wounds

Gene had his staples taken out; he beat Dr. Remcho to the task on several of them. The pathology report came back and Eugene has lymphoma. We are ecstatic because this is treatable with chemotherapy. Unfortunately, this does not mean Eugene will be cured, but we hope to provide him with some extra months of quality life. The prognosis is still only months to maybe a year to live, but I will take that anyday. Dr. Remcho assures us that this chemotherapy regimen is tolerated very well by cats. Gene will get the first few days of chemo in the hospital and then the rest at home, in pill form. Chemotherapy for lymphoma does the most good in cats who are feline leukemia negative, so Eugene will have a test for this first. Gene has gotten regular leukemia vaccines since he was a kitten, but the vaccine is only 90% effective and Eugene spends a lot of time outdoors so has had lots of opportunity to become infected. We know his time is limited, but this really is good news. He will also be helped knowing that he has so many other people and cats rooting for him. And he thanks all of you again (but wants to know exactly how he can open that virtual tin of tuna from the UK!).

Eugene got his virtual can opener, thank you very much! He has had one round of intravenous vincristine on April 15 and had oral cytoxan at home on April 17. He seemed very tired the day after the cytoxan and even skipped his normal 4 a.m. awakening of me. (Usually he just wakes Paul, but Paul is out of town again.) He was very playful during the day, even scampered up the dogwood tree. His appetite was a bit off and he had one pretty violent vomiting episode. He woke up vomiting during the night, refused even tuna the next morning. I cooked a chicken breast for him but he didn't want that. Then I noticed he hadn't been drinking any water.

Dr. Candace was off for the weekend, but good Dr. George took a look at Eugene and decided to keep him for rehydration and antacids. Gene had to stay in the hospital until yesterday evening, but he came home just in time to greet his dad returning from his trip.

In fact, Eugene is yowling right now for me to stop this nonsense and take him outside, so later!

Eugene went in to the vet on Wednesday, April 23, expecting to have round 2 of chemotherapy. I was horrified that his weight was 8.8 lbs. I weighed him on Saturday, when he had to stay in the hospital for dehydration and he weighed 9.8 pounds then. A pound of weight loss in 4 days. This is awful. And then he couldn't have his chemo. His white blood cell count was up to 21,000 with 18K being the upper limit of normal for a cat. Eugene was sent home with antibiotics and we will try again next Wednesday for the chemo.

Eugene has seemed much perkier. He had the crazy dashes yesterday, doing an impressive lightning run from the back yard to the front, banked off the dogwood tree about 2 feet off the ground, and then dashed to the back yard and up into the maple tree! I laughed and laughed to see him so frisky and so NORMAL. He was pretty tired after that though and went to bed. Today, we worked in the garden, which meant Eugene laid on the compost pile, soaking up the warmth. He did play with me and I chased him around the yard some. It is so good to see him play. His hair hasn't even started to grow back. Guess the chemo didn't help that, but it just makes him look sick. He is so skinny that the sutures that were used to close the peritoneum (the tough lining of the abdomen that is under the surface of the skin) are starting to poke through his skin.

Paul and I had a long talk about the weight loss, lack of hair growth, persistent intermittent vomiting, etc. We want to be realistic. Eugene is not going to get well. We even agreed that we think he will be dead within 2 weeks. I am just happy that his quality of life is still pretty good. Paul is out of town again (Yes! Again!), just for the weekend, and Gene has been so sweet snuggling close to me at night, always sleeping with his head or paw in my hand. I sent a photo of Gene and a clump of his fur to Memphis with Paul so he wouldn't miss him too badly.

This is so hard. So much harder than I thought. I am horrifyingly depressed over this. Partly because of Paul, who fell asleep crying the other night, partly because I love little Gener so much, partly because I don't know that I have ever had a pet (since I was little) that has died, and a lot because it brings back such bad memories of my mother and my best friend dying of cancer. I want this all to be over, but the second it is, I will feel guilty for wishing that, and want even 5 minutes more. Poor little Boney Maroney Gene. He is like a little feather he is so lightweight. Austin weighs 11.2 pounds, very light for him, and he looks and feels like a giant next to Eugene. I am so depressed over this.

I told my sister, Nancy, about struggling so much with this cancer in Eugene and wanting it to be over. Nancy emailed me, saying, "Remember in Terms of Endearment when Debra Winger dies, and Shirley MacLaine says "I was so stupid - I thought it would be a relief when she died!" - that pretty well sums it up. It's easy to be philosophical about death when it's an abstract theory, but when it's a person or animal that you love, all logic and reason flies out the window." That's a good sister I have.

And just to make me worry more, Austin hasn't exactly been a peach lately. Two weeks ago he had a glucose curve done and his blood sugar went down to 40 at one point, so he was cut back from 7 to 5 units of insulin once a day. Austin went back in on April 22 for another glucose curve and this time his glucose dipped down to 40 and then later to 31! They had to give him a supplement to bring his sugar back up. Last year, when Austin got down to 32, he went into a coma and had seizures. The vet then said a glucose of 25 is "consistent with death." So Austin is down to 3 units of insulin once a day. I am so worried about him. Yesterday he had trouble jumping into my lap while I was sitting in the kitchen bar stool having cereal. It is a routine for Austin to jump up and share my cereal every morning. This morning, he didn't even want to try but sat there and cried. I taunted him and got him to jump up, but he failed miserably and I think he hurt himself falling. What a rotten mom I am. He was scared to try and jump in my lap later when I was in a regular chair, but he did make that, with difficulty. So, now the dreaded back leg neuropathy. He only weighs 11.2 pounds, quite skinny for him, despite pigging out on all the tuna and wet food I give Eugene. I thought Austin was getting fat; unfortunately, Gener is just so pathetically skinny that Austin seems fat even though he is losing weight, too.

Guess these two cats, brothers/littermates, share a genetic pool that says 12-13 years is their life span. I was kind of hoping for that 17-20 year range. I wonder what has happened to their other littermates.

I feel tired. I wake up all night long, checking to see that Eugene hasn't died and that Austin isn't in a coma. Thank goodness I have all my Feline Diabetes friends to encourage me and distract me. Thanks, guys.