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The Ache of Not Knowing What to Do

Since my cat, Bob was diagnosed with having a 5cm mass on his right liver lobe, I've been feeling very confused about what to do next. I keep asking myself, “what is best for Bob?” What would HE want? What is humane to DO to him? Is it worth carving him open to give him more time? If so, how much time? A month? A year?

Dismayed by Roofers.jpg
©2006 Robin A.F. Olson. 2006. Just after Bob came to live with me.

Bob means the world to me. He's the Ambassador-the head “greeter” when I walk in the door. He's the boss. He slaps around the underlings. He's an old orange Tom with crystal green eyes. His purr has a musical, squeaky, quirky quality to it and he's quick to get that motor running. He loves everyone he meets and everyone loves him.

I don't know how old Bob is. My Mother, the intrepid photographer who documented every second of our lives, had photos of him that went back to 1999. I know he was an adult when he first showed up as a stray, at my Mother's back door. She always left out food for any hungry cat.

Bob, we guess, is around 14 or 15.

Bob has FIV+. I just re-verified it using a Western Blot test. There is no way I'd mess with wondering if Bob's previous snap test was a false positive when his health is in such jeopardy.

That said. Bob eats ravenously, though he is losing weight. We've checked his thyroid and that is working fine. Bob still grooms himself and continues to have good litter box manners. He even plays with little Blitzen from time to time.

According to the ultrasound, most of Bob's internal organs are operating normally and within limits. I see some very big words that I tried to look up...they basically say “cancer”...maybe. It reads: “There is a nodular cluster in the area of the mesenteric lymph nodes which represents mesenteric lymphadenopathy.” So, does Bob have cancer that has metastasized or is it just an infection brewing or is it from the liver problems?

Beautiful Bob.jpg
©2009 Robin A.F. Olson. 2006. Bob, last year.

Thing is, I'm a GRAPHIC DESIGNER. I'm a WRITER! I'm NOT a Vet! I'm a loving mom to lots of cats. I just want to know what to do and no one seems to be able to tell me. They say I have to decide. My options suck.

I met with Dr. Ann Hermans, a homeopathic Vet. Dr. H has been helping me try to cure Gracie's mysterious rash. She's had it over for 2 years. Nothing has really helped, but Dr. H has given me some treatments for her that have soothed her anxiety a GREAT deal and, in turn, helped to calm her skin down and she no longer “barbers” her fur, nor does she vomit those clumps of fur every few days. This is meaningful. Does it translate into they type of care that could support or even help Bob be stronger-a better candidate for surgery? Some people say it's tomfoolery, but I trust Dr. H. She has a degree from Cornell. She knows her nutrition in ways I wish ALL Vets did. I brought Bob up to see her a few days ago and I left feeling hopeful. That with some adjustments to Bob's treatments and nutrition, I would fortify him so he would be more ready for what may come next. Would we cure his liver mass this way. No. But there is a respect for how the body heals itself without beating it up by pushing drugs into it that cause bad side effects.

I wanted to leave it at that. Take a few weeks. See how Bob does. See if we can put some weight back on him. But last night, I started to worry. I found out that this mass could rupture and Bob would die in a few hours. It could also start to cause fluid to fill up his abdomen. It's also HUGE and we need to remember it's NOT going to get any smaller.

Perhaps the time to act is NOW while Bob is still BOB. Before he starts to slip into a weakened state where I have no options to help him other than give him a peaceful farewell.

BUT...with the liver, you have to do a “wedge” biopsy. This is SURGERY. You can't get a good liver sample using a guided ultrasound needle biopsy. The cat has to be carved open and they get a chunk out. DO they take the entire mass out at that time? Maybe. I don't know. Do they look inside and see what ELSE is going on? Look for more signs of cancer? Yes. Will they potentially see that Bob cannot be saved or helped..that it is too far gone and too severe..that it would be CRUEL to wake him up out of sedation and better to let him die on the table?

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©2010 Robin A.F. Olson. Last week. Bob enjoying catnip pillow.

I can put my foot down about some things. I can tell them that under no circumstances are they to let that cat die on the table, but it's serious, expensive surgery and the recovery has to be considered, as well...and the fact that Christmas is coming and that means Vets and their staff may be tougher to come by during the recovery process. Is it better to wait until after the Holidays or get to it NOW while Bob is at the best place in his health, he can be?

I know so many of you have faced a situation like this. There is no clear cut answer. There is no knowing if what is done will help your cat in any way. There is no way to know if it will significantly shorten the life of your cat, too.

There is just no knowing...and that is a heartache no one should have to bear.

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I am so soryy you are going thru this. Ihad a cat with Pancreatic CA (that means cancer, I'm a nurse).
You need to possibly consider (asI am sure you are) the quality of life he will have or length of time after the Sx. (surgery), the COST, (A BIG consideration for me), the recovery/pain time he will be in.
The fact he is FIV+ AND 15 yrs. old or so....well, I might just let him go as long as he is comfortable, eating, drinking, etc....when he is in pain, we take thatlast visit to the vet.
I have never used homeopathy on my animals myself, but could be valid~why not? (I have 8 cats, 3 dogs, 3 birds)
so I uinderstand what you are dealing with, as many of your readers will.

I wish you the best of luck in your choices, they are never EASY. YOu will do the right thing for Bob, but whichever you choose,DON'T feel guilty after the fact. Bob knows you will do the right thing, and he will tell you when he is done.

All the Best!/VIctoria

I am an infectious diseases doctor who sadly gets to see families deal with this question for their loved ones every day. Sadly, far too many of them can't/won't deal, and with humans we have to therefore break out the technology to keep the body alive.
I also have a senior cat, age unknown, (although not FIV+)who has obstructive cardiomyopathy. There will come a day when he wont be there to greet me at the door, and I will become absolutely useless (something the non animal-loving head of my group will never understand). I truly feel your anguish, and wish I had an answer, advice, crystal ball, anything to help. The only thing I can say is that as long as Bob is not suffering, and is able to give and receive love and attention, Nature will let you know when it is time to say goodbye and cry,
In the meantime, your work saving other kitties from never having a chance at this love is to be commended and continued. The other cats need you as much as Bob. He will always be special, but somewhere out there is another cat waiting for the same love that Bob was blessed with as well

Robin, my heart aches for you. As the servant to many many Cats I've had to make the call three times, the rest Kitty was able to tell me it was time. How fast is this mass growing? I think your vet owes you some plain english answers to your questions. You would want no less for any other family member, human or furry.
I can tell you this; I've never regretted saying "it's time". Sometimes, especially when your pet is young, it's VERY hard, but given their lack of comprehension of WHY they hurt and the upset of their beloved routines, and the fact that they are soon to go from the disease, I made the choice. I DO regret waiting too long. I did this once and I see now that my kitty suffered longer than she was supposed to.
Having said that, the call is yours to make. I think you're safe to wait a few days, adjust, get some answers, and say your goodbyes, if that's what you decide.
I send you and Bob my love. He sounds like a fine, fine Cat.

reading about your situation Robin. I'm so sorry. It's so hard with animals b/c just like with small children they cannot tell us what they want and they don't understand the "why"...why sometimes we put them through pain to help them...that's what makes it so torturous. I think you must at least think about how lucky Bob has been to not only have as loving a parent as your mama, but now YOU! You have given him a second wonderful home in his life. He is truly a beautiful kitty.
If this thing bursts, will it be a painful end for Bob? or will it happen quickly? they might help you decide?

My mother's dog had bone cancer, and although she did surgery and chemotherapy, she still questions if she did the right thing or did enough.

Our pets are members of our families. We try to do everything that we can for them. Unfortunately we need to make these decisions without their input. It would be so much easier if they could tell us what they want.

Here are a few questions that you can ask yourself to help make the decision a bit easier:

*How long has Bob had this growth? Is it something that is growing quickly and needs attention immediately?
*Does the growth interfere with his everyday life?
*What are the chances that it is cancer? If they are good, what are the chances that it has/will metastisize?
*How long is the recovery process from the surgery?
*Is Bob in pain now?

Whatever decision you do make, know that you are making it with love.

I hope that Bob pulls through this quickly and that you are able to spend many more happy years together!

He's so handsome! My thoughts are with you in your time of decision. Living with many animals this painful situation can't be avoided in one or two, and in my case the decision was different in each, regardless of what I knew how to do or not do at the time. One thing I've observed is that cats nearly always deal with their own internal pain, regardless of the source, so extremely well that you wonder how they go through normal daily living as they do, but as soon as you do something invasive that causes pain from an external source it throws them off balance and they seem to fail from not being able to manage their own pain. Homeopathy is not tomfoolery; this is where traditional medicine fails animals and alternatives are of the greatest assistance. If surgery is the decision and they can get some pain assistance, especially naturopathic such as acupuncture and support with reiki or t-touch plus homeopathics to strengthen the areas of need, he might do well. Even if there is no surgery, he will be experiencing increasing pain, and these natural supports will help him. If the mass ruptures there's not much anyone could do. Start with your practitioner and that may be all you need to do. Let us know how he does.

I don't know what to tell you except a story about two cats. One was Thumper, a lively cat who took ill one day. Her cat-mom (my housemate - M.) could not let go of her even though she was old and very sick. One day I came home to find M. force-feeding Thumper baby spinach. This went on and on until Thumper was taken in her sleep one night, and I sighed in relief. I could not stand to watch M. drag that poor cat through hell.

I vowed I would not do that to my cat when the time came. It came almost three months later than Thumper's passing. I picked up Koala (my kitteh) and noticed she had lost a lot of weight. I took her immediately to the vet, who told me she was anemic from fleas (which I did not even notice she had), had a mass on her liver, and a colon blockage. We both agreed to take her home and make her as comfortable as possible.

I pilled Koala as much as I could, but she rejected her medication and stopped drinking or eating. I could tell she was ready to go, so I took her into the vets the next day and had her put to sleep. All I could think about was poor Thumper, who just wanted to die with dignity and wasn't allowed to. I won't even tell you the horrible hell M. put her dog through, and how they both suffered uneccesarily.

If you know Bob as well as you say, he will let you know somehow what he wants. Just listen to him and let him go when he is ready.

I'm so sorry to hear about Bob's illness & I know what's its like to wrestle with these decisions. I had a kitty who had cancer & I couldn't afford the big expensive surgery, nor would it have given him much time. I made the decision that it was better to put him to sleep before he got really sick. I called an in-home vet who came out, but when she held my kitty, he kept jumping away from her. Finally she said to me, i don't think he's ready yet & we need to listen to him. She asked me why i wanted to put him down now & i said that i didn't want him to be in pain or have a poor quality of life (of course, i was sobbing this whole time). She said she understood, but that my kitty was clearly not ready to go & that maybe he needed these next few months to understand what was happening to him. So, we did homeopathic care and acupuncture, as well as antibiotics + probiotic support to keep the bacteria around his nasal tumor under control for the next 8 mths. The next time i made the call, my kitty laid very peacefully on his bed & let the vet stroke him & talk to him about what was going to happen. She pointed out the difference to me & i could see that he really was ready this time (I wasn't, but he was). after he was gone, i sat with his body so my other cats could know what had happened to their friend. the thing that surprised me was that they already knew; they didn't look around for him or cry. maybe those months inbetween let them understand what was happening too. i don't know if this story provides any kind of comfort at all, and what my kitty needed may not be what bob needs, but trust bob & trust yourself. you obviously care for him so much & he knows that. try to take as much comfort in that love as you can & know you are not alone in this. keep reading, keep talking to experts, but also listen to your heart and to bob. i am wishing you peace and wisdom.

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