My Heart Will Go On

WARNING: This blog contains graphic depictions of death, and raw emotions. Read at your own risk.

My cat, Holly, died this month at the age of 16. I got her as a kitten, so I have had her for more than half of my life. She was a constant companion. 4 years ago she was diagnosed with diabetes, but that is not what she died from. She had been doing fine until February of this year. I didn't know then that I was starting down a very long path from which I will never be the same.

In February, Holly's appetite declined and she was barely eating. Besides her appetite, she was fine. She slept on my bed all day, sunning herself. She would get up when I came home and go to the food dish (although she wouldn't eat.) I thought maybe it was her teeth, since she has always had trouble with them. I took her into the vet and he agreed that her teeth needed work. We scheduled the dental work. I dropped her off the day of the appointment and they started with blood work, to make sure she was ok to have the anesthesia. She was not. They discovered that she was anemic. They had trouble with the tests, which were also telling them that she had leukemia (cancer, not FeLV.) They sent out a CBC and the results were not cancer, but definitely anemia. The good news was that it was regenerative. So we took a wait and see approach. Subsequent CBC's showed no improvement, but no decline either. Something was destroying the cells at the same rate that they were being created.

After her second or third CBC, she had some sort of incident. (I now believe she had a seizure.) At the time I didn't know what happened - I was sitting at my computer and heard a thud in my bedroom. I got up and looked and found Holly on the floor next to my bed. She was trying to get up, but couldn't. I picked her up and put her on my bed, but she didn't stand, she immediately flopped over. I could not get her to stand. I was scared, I didn't know what to do. I stayed up with her all night, moving her around from my bed to the food bowl to the water dish and the litterbox, holding her up while she did her thing. By morning she was able to stand and walk, although not very well. She kept falling over onto one side. She could not get on my bed anymore, so I setup a bed for her in the living room, and took to sleeping on the couch so that I was near her and could keep an eye on her during the night. I told the vet about it when they called with the latest CBC results, and they didn't think much of it. Because she was improving, they decided to leave it at that. Later I brought her into the vet so they could see the way she was stumbling around. Stroke and arthritis were the possible conclusions that the vet came to, but again they did nothing about it.

With some further investigation, it was determined that Holly had Hemobartonella, which is a blood parasite. She was put on a course of antibiotics and steroids. (I should mention that she had steadily been losing weight, but was still eating.) After almost 2 weeks on the meds, she started to throw up. It was caused by the antibiotics, but she refused to take any more medications. So we took her off the meds. She improved, although another CBC showed that her count had dropped more, and was now 15%. We needed to continue the steroids, but she wouldn't take the pills. We were well into March now and the constant sleep/awake/sleep/awake nights were beginning to take their toll on me. I was tired. With the help of some objects used as stairs, Holly was able to get on my bed, but preferred to stay on her makeshift bed in the living room. Then one night I witnessed the most horrible thing I have ever seen - Holly was happily eating her dinner when suddenly she was on her side, her legs pulled up to her body, and everything was jerking. Then just as suddenly she righted herself, but she wasn't there. She stayed like that for several minutes before she started to respond to my touch and went back to eating. She had had a seizure.

We needed to get ahead of the anemia. Since she wouldn't take the pills, liquid steroid (prednisilone) is what we ended up using. Holly was not happy with me squirting it into her mouth, but at least she was getting the meds. After a week she started throwing up and had diarrhea. I stopped giving her the prednisilone and she improved. So I gave her the prednisilone again, and again she threw up and had diarrhea. I consulted the vet and we decided to halve the dose. That seemed to be ok for her.

My heart wrenched every time I looked at her. She was just skin and bone, she had lost all fat and most of her muscle. She did not react to my presence or voice. She could barely move around and she just looked like she was on death's door. I started giving her MB12. She immediately showed improvement - she was alert and aware of her surroundings, and was able to move around more easily. Hope fluttered in my heart. It was quickly dashed at the end of the week when I realized that Holly was constipated. She was constantly going to the litterbox, and straining so much I thought she was going to have a heart attack. I took her to the ER.

The ER vet hospitalized her to give her an enema and fluids. I signed a DNR. I have never hated myself more. I felt like I had paid for a hit. The next day they sent her home, saying she would be fine for home care. I took her home, but she was still constipated. 2 days later we were back at the ER so they could keep her comfortable until I could get her into my regular vet's office. The next day I brought her in. The vet looked at the CBC result from the ER, and gave me the grim news:

Holly's red blood count was now down to 10%, and was no longer regenerative. Her white blood count showed every indication that despite our efforts, cancer had set in. Her only treatment options were chemo and blood transfusions, neither of which she was very likely to survive, given her condition. I could not tell the vet to put her down, even though the vet's body language and facial expressions were screaming at me to do so. I felt like I would be murdering her. I couldn't do it. The vet told me she wasn't in pain, that she would probably fall asleep and never wake up, or go into heart failure. She said that Holly probably wouldn't survive the week, and it was ok to take her home. So I did.

Holly survived the week. And 2 weeks after that. I had stopped all medications, and she actually seemed to improve. She was walking around more, and eating and drinking like it was going out of style. She would go lay in the sun in my room (although she couldn't get on my bed anymore, even with the "stairs" there.) I spent as much time as I could with her in the evenings, holding her. I was still sleeping on the couch, waking every time she got up. I had sort of gotten used to the lack of sleep now.

Partly through the 2nd week I had to travel for work. She was ok when I left, and I hoped she would still be fine when I got home. While I was gone her kidneys failed and she started urinating wherever she was at the moment. She held on until I got home. I got home at 11:30pm and found the cat urine mess that was my house. I cleaned the worst of it, spent some time with Holly, then went to bed. When I got up the next morning for work, Holly was curled inside the cat condo. She responded when I touched her, so I gave her chin some scratches and then went to work. When I got home, I finished cleaning the house, mopping all the floors. When I was done, I set myself up on the couch to sit with Holly, as I had been. That is when I discovered it.

Holly was still in the condo, but she was no longer responding to my touch. She was not moving at all, except to breathe. I carefully pulled her out of the condo, and sat with her on the couch. She was not there, in the same way as she was not there after her seizure. I suspect she had one during the day, and never recovered. She had not eaten all day, so I used the syringe to put water into her mouth. She would not (or could not) open her mouth, but she did swallow the water. I fretted if I was making things better or worse with it. I cleaned her up and stayed with her. All night I stayed with her.

Around 11pm she had another seizure. I held her to me, to keep her from flailing off the couch, until it passed. Around 12am she had another. And another around 1am. And another around 2:30am. Around 3:30am she started having seizure after seizure. Her tongue was hanging out of her mouth and I was afraid she would bite it off. She was shaking so violently all I could do was hold her and cry. Finally she stopped shaking. And breathing. I thought that was it, she was done. Then she sucked in a gasping, watery sounding breath. Then nothing. After what seemed like an eternity she gasped again. I was praying, begging for it to just be over. Twice more she gasped in a breath. And then it was done. She was dead.

I was flooded with emotions. Relief that it was finally over, that my sleepless nights were gone. Grief that a longtime friend was gone. Guilt, a lot of guilt. Had I done the right thing? Had she suffered because of my choice? Resentment that so much of my life had centered around her health care. Anger at myself for the resentment.

The myriad of emotions has not gone away, but I hope over time they will fade. I have come to realize though that I would not have been able to accept her death if I had let the vet put her to sleep. I had to experience her death with her. I needed it, to accept and let her go.

Rest in peace Holly.