Austin's Final Chapter

Chapter 18, In Which Austin Becomes Critically Ill
February 18, 1998

We had a very nice dinner last night, all sitting at the dining table, and Austin insisting on sitting in the center of the table. He usually sits in Paul's lap at dinner and is not allowed on the table, but he looked so cute we all let him stay there and petted him and commented on how good he was looking the last few days. My brother even cut up some of his meat for Austin and let him eat it directly off his plate and we all laughed about how spoiled Austin is and were amazed that he would eat meat. We made sure Ripley was asleep on the sofa so she couldn't see this outrageous behavior.

I stayed up late, fighting off sleep, disturbed by something I couldn't put my finger on. Finally, I went up to bed a little after 1 am. Austin was sleeping quietly on Paul's ankles and when I got in bed, as usual, he came to snuggle in my arm pit. He stayed only seconds before he got up and moved to the pillow next to my head. He couldn't calm down though, constantly changing position and after a few minutes of this, bolted off the bed, into the hall, and under a piece of furniture.

Since he has recently changed insulin and has not been well-controlled, my first thought was hypoglycemia. He then started having trouble moving his back legs at all and I ran for the honey. He did not improve after a few minutes and began panting. I called out and woke Paul, who paged the emergency vet. Amazing how slowly the minutes pass when you are waiting for that phone call back from the vet. Just to do something, and in case Austin was dehydrated, I begin subcutaneous fluids on him and continued the honey to his gums.

Unfortunately, on call is the one vet we do not know in the group practice but he meets us in 15 minutes at the clinic. Before we leave, Austin begins panting harder, his breathing rate goes up to to almost 100/minute (yes, his respiratory rate, not his heart rate), and he begins a type of gurgling deep in his chest.

If you have ever heard a person or animal in pulmonary edema (fluid on the lungs) you will never forget this horrible sound. I immediately went into denial and think, "Oh, he has inhaled some of the honey and it is blocking his airway." Austin begins yowling loudly. Obviously, his airway is not blocked.

At the vet, his blood sugar is off the scale high and his breathing worsens. The vet, who is very nice but somehow fails to give either Paul or me a feeling of confidence, confirms my fear of congestive heart failure and pulmonary edema. He gave Austin Lasix, a diuretic, to try and take the fluid off, some digitalis to help his heart beat more strongly, and put him in an oxygen filled cage.

Austin was pathetic at this point, trying to drag his little back legs around, flailing around wildly and yowling in panic. I suggested a small amount of sedation as we do for humans but the vet said this was too dangerous for a small cat. We had to watch him flailing in that glass enclosed cage, scratching wildly at the door, using up what precious oxygen reserves and heart muscle he has. I put my lips to the door and whispered to him, which quieted him for awhile. Finally, we realized that we had to leave or Austin would never be quiet. Although the vet didn't want us to, I took Austin out of the oxygen "tent" and Paul and I held him together between us. Austin loves to be held like that. We said good-bye, not knowing if Austin would live through the night.

After we got home, I found Paul back in his office, head in hands, crying over Austin. I used to worry that Paul loved only Eugene.

The vet tells us that it is common for cats in congestive heart failure (CHF) to form blood clots that then go down their aorta (the main blood vessel leaving the heart) and get stuck where the aorta splits to go down each hind leg. This blocks the blood flow and causes paralysis in the legs. This is not a typical presentation of CHF in humans and I am a bit confused by why this would happen. Dr. Candace is back on the case this morning, though, and I will have her explain this later.

Austin was breathing better by 5 am the on-call vet told me this morning. Someone brought their dog in at that time with congestive heart failure also, so the vet was back at the clinic. I had wanted to stay with Austin, knowing this vet would leave after watching him for a short time. (There wasn't anything he could do but look at Austin, and that isn't a reason for him to lose sleep. And I don't mean this unkindly, but quite sincerely.) If Dr. Candace had been on, she would have let me stay, but I didn't want to put this vet on the spot. He has never met me or Paul before. Or Austin, for that matter. I was so afraid that Austin was going to die alone, flailing around in that cold stainless steel cage. The vet was not hopeful about Austin's recovery.

We are waiting for EKG, xray, and lab results at this time. Candace is being very agressive, giving Austin blood thinners to prevent formation of more clot (why didn't the vet start that last night?) but she fears this paralysis is permanent. If Austin does have a damaged heart and the paralysis does not show improvement soon, Paul and I have agreed that we will put Austin to sleep. I almost had the vet do it last night. You should have seen the suffering that little cat was enduring. Candace says he is calm now, appears to be in no pain, breathing well. And she says he has to get better because, "He's my boy." Now that is the vet you want taking care of your precious pet. Austin does love Candace, so I am sure he is much better already. Poor Dr. Bob, the vet from last night, to get a patient he has never met, and a patient with two very aggressive parents! If I had thought about it, I would have made sure that we had met him previously. Oh, that wonderful hindsight.

Paul and I are being realistic and we fully expect to have to say our final good-byes to Austin within 24 hours.

I am looking now at that previous sentence with an image of Paul sitting in his office this morning, head in hands, crying over Austin. Of us holding each other in bed, shivering, after we got home from the vet this morning. Of Austin with his little paws around my neck, hugging me. Of our sweet boy, our last boy, going to join his brother at Rainbow Bridge. We always knew Austin would do this within six months of Gene dying, but we hoped he would live forever. Gene passed away 5 1/2 months ago. Guess he is lonely up there without his brother, but I don't know how we are going to bear it. Looks like Goofy Girl Ripley is going to have to shoulder a lot more responsibility.

I can't believe this is happening so fast.

Austin gives mom a big hug

3:OO pm 2/18/98

The vet just called. Austin is in pulmonary edema still but much improved, has an irregular heartbeat, and very high potassium. This is from his diabetes being uncontrolled. I am feeling very bad about not buying that glucometer that I have been planning to buy for two weeks.

Austin definitely has an aortic embolism, a large blood clot blocking the flow of blood to his hind legs. His legs are cold, blue, and paralyzed due to lack of oxygen to them. Strangely, he no longer seems to be in pain. Dr. Candace says he is very calm. He is on blood thinners to try to prevent more clots and in an effort to restore blood flow to the legs. He will be treated for 3 days but if no improvement by then, there will be no hope. Dr. Candace has only had 3 cats survive this. Austin has pulled through the impossible before. Please let him again.

Ripley actually came up on the bed to my lap this afternoon and let me pet her and she purred loudly. This only lasted about a minute, but it was wonderful. I really needed some cat comfort. We'll keep working on her and soon she will be a snuggler, too.

3:15 pm 2/19/98

Went to see Austin yesterday and he looked terrible. Eyes so dark and dull. I took his little Dino with me and rubbed it on him and talked to Austin for awhile and finally he picked up his head. He seemed much better when I left.

Paul went to visit Austin last night and swears Austin moved his tail!

This morning Paul talked with Dr. Candace and Austin has been moved out of the oxygen tent, his blood sugars and potassium are back to normal levels, and he shows some signs of increased blood flow to his rear legs. No movement but some improved color in the nailbeds.

Paul has had to go out of town for 2 days, so I am flying solo. I hope Austin holds on. I am terrified that I have to go to work tonight and there will be no one in town for Austin for almost 12 hours.

People on the Muffin mailing list and on the Message Board have given me so much sympathy, support, and information. It is wonderful. Cindy phoned from New Jersey this morning and told me the latest issue of Cat Fancy has an article on this very problem that Austin has.

Paul and I slept on a towel last night that I will take to Austin for his cage so he can smell us instead of the vet's towels. He needs frequent towel changes, but at least he will be able to smell us for awhile. I am off to visit again as I head off to work.

4:45 am 2/20/98

Austin's glucose and potassium are under control but his heartbeat is still irregular. He has been started on a medication, Diltiazem, to control the heart. He is out of the oxygen tent. His back legs are warmer and pinker now but still paralyzed and he is still on blood thinner.

When I visited him yesterday evening, he looked awful, with his head down in a pool of saliva. I had brought in a towel with our smells on it and so I folded it and put it under his head. I rubbed his little dinosaur on him and petted him, but he never even lifted his head up in the 30 minutes I was there. Dr. Candace told me he was better during the day.

He looks awful. His eyes look like Eugene's did right before he died. I cried and cried while I rubbed and kissed him. I asked Austin to stay alive and promised him he can come home tomorrow. I told him we don't have to make any decisions until Sunday at the earliest. Dad will be home tonight.

We stop the blood thinner later today and he should come home tomorrow. I hope we don't have to put him to sleep, but I think we will have to. I keep telling myself that, but in the back of my mind, I keep telling myself that it can't possibly happen.

Austin is the first cat I ever loved.

Chapter 19, In Which Austin Comes Home


Paul and I went to see Austin yesterday morning and his head was up and he looked so alert! He still wasn't eating on his own but was swallowing syringe fed food. An EKG showed the heart beating properly. His intravenous heparin had been stopped and he had been switched to oral coumadin with a bridge of subcutaneous heparin shots until his blood is properly thinned by the coumadin.

I scooped Austin out of the cage into my arms and he buried his head in my armpit and began purring. We sat for awhile, with Austin peeking out occasionally, seeing he was still at the clinic, and re-hiding his head! He smelled absolutely terrible despite daily baths since he can't clean himself or move himself away from his urine or bowel movements. We love him even when he stinks.

We finally went home, with lots of medicine, and three very happy campers. Austin and I sat on the sofa in front of the fire all afternoon, reading and napping. Paul played Beethoven CDs for us. The weight of the world seemed to fall from Austin's little shoulders. I had to go to work at 5 pm, but I whispered to Austin that he should do whatever he had to do. That if he had to go, he should do it, but we were there to help him as much as possible.

I went to work with a much lighter heart. It all seemed possible.

Austin's last photo alive, 2/21/98
Austin at home

Paul called me in tears at 2 a.m., just as my shift was finishing. Austin had just died. I have never had a longer hour drive home. I kept telling myself Austin was not dead. And as I got a few blocks from home, I suddenly didn't want to be home, as if that would keep Austin alive.

Earlier in the evening, Paul had made up a bed on the floor of the living room, afraid to take Austin upstairs to the bed for fear he would fall off. When I finally got home, Paul was there crying, a notepad beside him. Before he had gone to sleep next to Austin, he left this note for me:

Becky Bob:

Austin & I (& probably Ripley) are sleeping on the living room floor. He slept most of the day, but did prop his upper body up & move around a few times.

Austin had all his meds with no trouble. He had some food & water (both X2) with my help. He ate yogurt by himself (X2) after he figured out what it was. I was ecstatic about the yogurt!

Tex, Austin, & Ripley

P.S. Patrick gave Austin yogurt first.

Apparently, Austin was asleep with Paul's arm wrapped around him. Austin twitched and woke up Paul, reached out a paw and touched him, then gave a big sigh and died. It was 1:50 a.m. EST, 2/22/98.

I called Dr. Candace around noon and told her. She was shocked.

This was so unexpected. We had no time to prepare. I can't even continue this now.

  Our last time in the sun, 2/22/98
The morning Austin died,
we shared the sun on the bench
one last time.

Wednesday, March 4, 1998

Two weeks today since Austin became ill, 10 days since he died. I felt that I was doing pretty well. People have been very sympathetic and many touching emails have arrived, along with virtual and real bouquets, cards, and gifts. Our vet, Dr. Candace, and her family gave us a wonderful children's book called Cat Heaven by Cynthia Rylant. On one page, God is walking in his garden with a cat on his head. The garden is reminiscent of Gene's Garden I put in last fall. Ripley, however, absolutely refuses to ride on my head! As a compromise, she is on top of the scanner which is on top of the tall file cabinet and she is peering down at me now.

Once we took Austin for cremation, I started to feel a bit calmer. Then last night my brother mentioned how much he was missing Austin and all the raw hurt came flooding back. If I could just turn back time and have my precious, loving buddy Austin back. I miss him so very, very much. He and Gene are on that garden bench in cat heaven right now though, and I can guarantee it isn't cold and snowy there!

Tuesday, March 10, 1998

I dropped Ripley off at the vet clinic this morning for a glucose curve and picked up Austin's ashes at the same time. Sitting in the kitchen later, all alone in the house, I set Austin's cremains by me so we could have breakfast together, per our routine. While eating, I was sure that I heard Austin's meow on the back porch, demanding that the door be opened for him. I laughed, looked at the cremains, then got up anyway and checked the back porch. Empty. I sat down again, but then heard the distinctive jingle of Austin's tags on his collar. This time I just smiled and told Austin that I love him, too.

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