For the Love of Nicky.

We trudge down this all too familiar path with weary legs. It started with something that was a little bit off with Nicky's behavior, then a blood test, then, ultrasound. Next step takes us to having exploratory surgery done on Nicky on Monday, at which time they'll do biopsies. We'll get some answers and have more questions. Based on finally reading the ultrasound report, it looks grim, but it could be worse. I fear Dr. Weisman finding a labyrinth of tumors inside Nicky's belly-that same belly we've rubbed and kissed, now full of growths that could take us from him far sooner than we could have ever anticipated.

If you looked at Nicky, you'd see a big lug of a cat with a sweeter than sugar personality and a high LOUD cry (only when he has to be in the car or is looking for his sister, Nora). Nicky doesn't look sick. He eats well, gets around the house without problems, his eyes are bright, his coat is good. He doesn't vomit or have the runs.

©2011 Robin A.F. Olson. Nicky chillaxin' yesterday.

I look at him and think I may see him waste away-just like I did with Bob. I don't know if I could bear to see that again. Bob was an old kitty. Technically, I suppose Nicky is, too, but 11 doesn't seem that old. Sam and I both thought that we had at least 15 to 20 years with our cats, especially now that they've all been on a much improved diet for many years. This just seems so out-of-the-blue. We're both shocked and I don't think the reality of it has completely hit me.

©2010 Robin A.F. Olson. Nicky, with sister, Nora, crammed into a cat bed even though there are two of them and the one next to them is empty.

Nicky could be weeks away from dying or not. I sure HOPE NOT!!! Some of you have been sharing stories with me about your cats who passed from lymphoma: one was only 5 years old...another a few years older than that. Some found out just before their cat had to be put down or died on their own. No, we don't have a confirmed diagnosis, but let's look at Nicky's ultrasound report. It's like reading another language. I have to wonder why they don't use simple words! I had to look up just about every word on the report. My comments are in italics.

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“There is no evident peritoneal effusion. (no fluid-this is good).”

“There is an apparent solitary, solid nodule of undetermined nature which measures approx 1.5 cm x 2 cm. The parenchyma appears hyperechogenic (I think this means the functioning part of the spleen- allows increased sound waves to penetrate it. What does this mean? I have no idea and I can't find into online, but I DO KNOW WHAT A NODULE IS-TUMOR?) centrally in the nodule and the remaining parenchyma of the spleen appears unremarkable.”

[paraphrasing here]: The liver appears unremarkable..lacks lesions...gall bladder OK

“There are multiple (4 to 5) hypoechogenic to mixed echogenic nodules in the mesentery. The largest is 1.5cm in size. The others are about 0.5-0.8 cm. The nodules closest to the root of the mesentary are likely the mesenteric lymph nodes (this is not good). The others may be the same but seem less likely to be so. The character of these is unknown but would include reactive noes or neoplasia. The iliac lymph nodes are not visibly enlarged (this is good).”

“Both kidneys have increased medullary echogenicity and consequent reduced corticomedullary contrast or distinction that would be consistent with mild inflammation or degeneration. There is no significant mineralization apparent. There is no visible renal pelvic dilation to support pyelonephritis (how about just say, NO INFLAMMATION in the kidneys, but I think the opacity of them varies in not a proper way! ENGLISH PLEASE!) at this time. The overall size of the kidneys are withing normal limits. Neither uretar appears dilated.”

[paraphrasing here]: Bladder is OK.

“There is diffusely prominent and mildly thickened small intestine...There is no visible focal lesions and this thickening appears to be in normal mucosal to muscularis proportions which would be more suggestive on non-neoplastic inflammation (I think this means the inflammation is not an inflammation due to swelling of a tumor). There have been reports by oncologists of low grade lymphoma that mimics this same appearance (this could be very bad news).”

[paraphrasing here]: Stomach and pancreas are OK.

Sonographic Diagnoses (the bottom line):

Splenopathy-solitary nodule of undetermined nature. (growth on Nicky's Spleen).

Renal Disease: Increased medullary echogenicity consistent with Interstitial nephritis-nonspecific inflammation or diffuse neoplasia such as mast cell disease or lymphoma (Inflammation of the kidneys...not good)

Mesenteric nodules of undetermined nature (this could be mesenteric lymphoma).

Mesenteric lymphadenopathy (Mesenteric lymphadenitis is an inflammation of the lymph nodes on the wall of the mesentery-the covering of the intestines).

Small Intestine: moderate, diffuse thickening more consistant with IBD than diffuse lymphoma (but...lymphoma and IBD go "hand in hand" so we're not off the hook).

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We've stopped in our journey to take a rest. This weekend will be “All About Nicky.” We cancelled our plans to have an outing on Saturday. Instead, we'll stay home and focus on Nicky-as we have been for the past few days. We'll also have to ramp up our care for Gracie. She still has a growth on her belly that may also be cancer. Right now we're to put warm compresses on it to see if we can get it to drain. It got smaller a few days ago, so I'm hoping this will be a non-issue...please...please!

I realize that if we're facing the last days with Nicky that no amount of attention this weekend will ever leave us feeling like we had enough time with him. After this weekend has passed, Nicky's life will be much more difficult, at least at the onset of the week. When the surgery is over, hopefully he'll recover and be like his old self again, but these few days may be the last we'll ever see of our ol' boy, as he once was.

No matter what path his life takes, we will always love Nicky.

A few folks have contacted me, asking me to post a ChipIn to provide donations towards Nicky's surgery on Monday. If you'd like to help him, the ChipIn is on the right sidebar. To those of you who have already been so very kind to donate, Sam and I appreciate the help so very much---more than simple words can say. Thank you.