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Bob's Battle with Lymphoma: The Next Big Hurdle

Considering what's on his plate, having half a liver, lymphoma and a URI, Bob's doing well. He's no longer confined to a pen and last week he got his staples removed. A soft, downy fuzz is already growing on his belly. With winter here, I hate that his belly is so bare. I have heated cat beds for him to rest on all over the living room to keep him warm. Through all of the discomfort and pain I've put him through, it's tough to ask him to bear more. My goal is to keep him as content as possible.

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©2010 Robin A.F. Olson. Dr. Weisman removes the staples. YIKES!

I'm so proud of Bob. I wish I could tell him that. I'm proud of him being a good sport about riding in the car for the long trip to the surgeon and I'm so amazed that he's been climbing two flights of stairs to come to bed at night. This morning he was ON the bed, which is a tough climb for him, yet somehow he did it. He even picks on Petunia-STILL...which for now, I'll let him be a bad boy since he only scares Petunia and that's about it. It's a sign of him being normal and I know that won't last forever.

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©2011 Robin A.F. Olson. Bob just LOVES riding in the car. Okay, maybe not so much.

Tomorrow afternoon I'm driving Bob to Wappingers Falls, NY to meet Dr Impellizeri, a Board Certified Oncologist. There we will discuss treatment options for Bob. Are there any? I've been lead to believe there are, they are well tolerated by cats and that if Bob does well we can, at least, hope for a remission for some duration.

In a way, I can't wait to get Bob on chemo. I truly believe it will help him. Although he's eating and resting a lot, he's still losing weight and I know every day we wait, the cancer has more time to grow. I want to kick that stuff in the ass and make it leave my boy alone!

As with this entire journey, there are lots more unknowns ahead. I find myself deeply appreciating every little thing, being so gentle with Bob and so loving to him. I want every day to be as good for him as I can. I know I'll have to say good bye to him one day and it could be soon or we may get six weeks or six months.

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©2011 Robin A.F. Olson. Nora (left) and Bob (right) enjoy nap time. By the way, Nora weighs 23 pounds so Bob isn't a tiny cat!

We'll see. In the meantime, Bob will go on, not knowing what's wrong with him and probably not too worried about it, either. How does an animal feel as it ages? Do they know their time is drawing to a close? For some reason, I don't think they fear that at all. I think they just take it day by day and if they live, that's great and if not, then that's okay, too.

Maybe they're more evolved than we are about such things?

Bob's Battle with Lymphoma: Next Steps

Bob's been home for almost a week since he had surgery to remove the right lobe of his liver. We found out it was cancerous, but now removed, it could be considered to no longer be a threat to his health. Of course many of you know, they also biopsied one of his mesenteric lymph nodes, where they found he had lymphoma. As in humans, the amount and severity of cancer is rated. In humans, they call it “stages,” and in cats, it's called “grades.” Bob's cancer is “low grade,” which means we may have caught it very early on in the game. Dr. Weisman said it could be a blessing in disguise because if she hadn't done the surgery, the lymphoma would have grown unchecked until it was probably too late.

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©2010 Robin A.F. Olson. Bob a few days after surgery.

At least Bob has options and I'm glad I didn't wait another month to see how homeopathy would work for him. He just would have gotten sicker.

There are two great candidates to help Bob with the next phase of treatments. It's ironic that they are almost exactly the same distance from here-about 50 miles. Dr. Post was referred to me by Dr Weisman and the other, Dr. Impellizeri, who runs the Vet. Speciality Center of the Hudson Valley was glowingly referred to me by Dr. Larry as well as Super Deb-who used to WORK for this Vet. I have appointments with both Vets, but am leaning towards Dr. Impellizeri.

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©2010 Robin A.F. Olson. Enjoying freedom from his pen and a nap near my space heater.

I'm really grateful to live in a place where I have choices and don't have to drive Bob hundreds of miles for treatment. It's important to me to be careful about what Bob must endure and the value of the stress on him versus the beneficial results. I find myself treating him as gently and lovingly as I can. He feels like he's made of glass.

It's been a long week, but Bob continues to recover. He's eating well and some times looks perky, though he is tired and sleeps a lot. He loves his heated bed and his dehydrated chicken treats. His belly turned black and blue from the surgery, but that is starting to fade. Tomorrow we visit Dr. Weisman to have his staples removed.

What is very frustrating is that Bob caught Nora's upper respiratory infection. I gave Bob some homeopathic treatments and he seems less afflicted. I certainly hope that this is the case. The last thing Bob needs is to be sick with something else.

Last night, I let Bob out of his pen. He was glad to be free from confinement and went right back into his old routine. He sits quietly, in “his spot” and waits for meals to be served. He sleeps in his favorite places, too. He gave me a real thrill by climbing the stairs to our bedroom, then not only did he sleep in a cat bed next to my side of the bed, in the middle of the night he climbed into the "human" bed and slept with us all night. At one point I got up to see if he was on the floor and was surprised to see him flanked by Spencer and Blitzen at my feet. I didn't want to go back to sleep. I wanted to just watch him and have the joy last of seeing Bob surrounded by his family, resting comfortably, maybe even happy.

He's a good boy, that Bob.

The Good News & The Bad News

Dr. Weisman called. Biopsy results are back already. The mass she removed was a type of cancer, but with it gone, goes any worry about that type of cancer coming back. It's nice news, but...

Sadly, the biopsy of Bob's lymph nodes shows that Bob has Lymphoma. I guess it's common in cats that are FIV+. How I hate my Mother for not getting him neutered when she could have. This never would have happened. Now I have to face taking Bob to an oncologist and chemotherapy. Lymphoma, I am told, has an 80% remission rate. It might give Bob a year or two, or...well, we don't know.

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©2010 Robin A.F. Olson. Bob under the half built Christmas tree. He can't wait to celebrate what may be his last holiday with us.

Merry Christmas...my heart is broken.

An Update on My Dear Bob

WARNING: THERE'S A GRAPHIC PHOTO OF BOB'S STAPLED UP BELLY AT THE END OF THIS POST.

Bob made it through the first night after the major surgery to remove the right lobe of his liver. It had a 5cm mass on it and it needed to go. Fortunately, Dr. Weisman was able to remove the entire mass, but because the rest of Bob's liver didn't look so great, she had to biopsy a small part of that, as well. She also biopsied some lymph nodes. The pathology will take FIVE DAYS. This means that with the holdiay upon us, I'm guessing I won't know a thing until next week. For now, the goal is to get Bob to perk up, start eating and use his litter pan.

This morning I was told that Bob was not eating. He's on pretty serious pain meds right now and between that and the operation, he must feel like Hell. I offered to come see him and try to get him to eat, since I know all his favorite treats. I figured, if nothing else, I had the dreaded dry food to give him if he wouldn't eat anything good.

I couldn't get up there fast enough, but I admit to being one of the many people who stayed up late the night before to (attempt to) see the Eclipse. It was too cloudy here and though I hoped the stupid clouds would move out of the stupid way, they did not. I watched some of the “show” online, but it felt phony and awful. I went to bed and got a few hours of sleep, but felt hungover when it was time to get up.

Sam wanted to see Bob, too, so we ditched whatever plans we had and grabbed some raw food and treats for Bob. We stopped at the store and I bought a small container of chicken liver. Gross, but yes, Bob LOVES it. I don't give him much of it, but I had to arm myself with everything I could, in case he would eat for me.

We got to VCA Cheshire in the early afternoon. They told us they weren't busy and to come over. Just as we got there a family got ahead of us. They were there to see their dog, so we had to sit and wait for them to stop visiting with the dog so we could see Bob. My blood started to boil. Why they couldn't put Bob in an exam room was beyond me.

The minutes ticked by. After 30 minutes I was about to spit fire. Then, out of nowhere, was Dr. Weisman. She came over and explained what was going on, that it was very busy in the back and that they were going to put us in a room with Bob. At last! As we stood up to walk to the room, I saw through a window in the door to the hall. A tech was holding BOB in her arms!!!!

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©2010 Robin A.F. Olson. Oh, Bob!

I asked for a towel for him so he wouldn't have to sit on the cold steel exam table and she brought out two. Bob seemed like Bob. He didn't look near death's door, but he wasn't very perky, either. We gave him pets and kisses. He started to purr faintly.

Bob has the best purr. I have an audio recording of it that I must figure out how to share one day.

Bob was clearly in pain. He didn't move much and his head was almost always down on his paws. He was wiped out. What did I have done to my boy?

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©2010 Robin A.F. Olson. Get some rest, my sweet boy.

We began putting different food combinations together. We brought out all his treats. He ate nothing. He was fine if I rubbed something against his mouth. He even licked at it a bit, but we thought he throat was hurting from being intubated, along with everything else. He wouldn't eat raw, or dried chicken treats or dried salmon treats. I opened the container of chicken livers. I had no way to chop them up so I washed my hands and just ripped up little bits. I put them right under his nose and he licked a few off my fingers. It wasn't much, but it was something. I tried over and over again, to encourage him to eat something more, but he refused.

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©2010 Robin A.F. Olson. We will be strong for you, Bob and keep those prayers and good wishes comin'!

I didn't want to push him too hard, so I let it be. I washed his face and he purred for me. We pet him and talked to him, told him to get better. I wanted to see his belly, but I didn't want him to exert himself by having to stand up or roll over. I wanted to sit on the floor and hold Bob on my lap until he felt better again.

I ran into the Doctor again. We talked about Bob. She wasn't too worried about him not eating. He's on an IV, so that's good. Her concern is she wants to see Bob perk back up. Have some twinkle in his eyes again, then he can come home-even if he's not eating. That surprised me, but she knows best. Instead of coming home today, our next hope is that he will come home tomorrow NIGHT, at the earliest. She said if we had been through what he had, we would be in tremendous pain and not want to eat, either. On a good note, Bob DID use his litter pan and had a good pee. He wouldn't use their tiny pan, but when they gave him a big one, he went for it and made a big mess, splashing the litter all around! How unlike Bob to make a fussy mess! Maybe he still has some “Bob” left in him?

The tech came to get Bob and I gave him another kiss. She lifted him in her arms and that's when I saw it...his belly. My heart sank. I knew the incision was going to be long, but I wasn't prepared for what I saw. My Bob looked like franken-kitty!

I could only think about how badly that incision must HURT and on top of that, what's going on inside his body right now? My poor, sweet boy. I am so sorry I had this done to you, but I know it was your only chance of getting better. To know I made my cat suffer so much...well, it's a very uncomfortable feeling. If I think about it too long, I'll start to beat myself up. I made this choice for him-his one chance. Now he has to heal and show us he can make it and I will do everything I can to help him get there.

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©2010 Robin A.F. Olson. Franken-Bob. :-(

All I know is, Bob has survived the surgery, now he has to survive the recovery.

I love you, Bob. I hope you can come home, soon.

A Pebble in the Stream

During the course of your life, you probably don't often know ahead of time that a particular day will hold any meaning. Then, something occurs that marks that day forever. It could be a surprise marriage proposal or the sudden passing of a dear friend. You didn't expect either one and now each year, on that day, you'll think about those events all over again.

August 16, 2006 was the day after my Mother died and the day I took her cat, Bob Dole, home with me. I didn't intend on keeping him. I had six cats at the time and felt that was my limit. I had plenty of family members with just one cat or none, who could have taken him, but no one stepped forward. As Bob's many medical issues came to light, I realized I wouldn't feel comfortable with him living anywhere but with me. Who would care that his teeth were bad or that he had become diabetic? And also, Bob was my last link to my Mother. He needed to stay with me.

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©2006 Robin A.F. Olson. The day Bob arrived.

I remember bringing Bob home from the Vet. We had to have in shaved down. His coat was badly matted. He seemed sad. He really did. He lived in my foster room, what ended up being for three months. I wanted him to be healthy and ready to meet my cats and have them be ready to meet him. The introductions were done slowly, a bit at a time and when Bob left the foster room, he never looked back. He became the Ambassador of my home, the first one to greet a visitor and “The Boss” of the other cats.

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©2008 Robin A.F. Olson. Bob in 2008 after being in intensive care for 12 days.

In May of 2008, I had a bad scare. Bob's health deteriorated. He was hospitalized for two weeks. I did everything I could to find out what was wrong. The diagnosis was pancreatitis, but because it's tough to diagnose without doing exploratory surgery, we never found out for sure what it was. My friend, Jennifer, got me an appointment with an animal communicator in hopes that Bob would tell us something. All I found out was that Bob wanted to come home if that could happen, but he was okay with dying. He wasn't afraid, but he was in a lot of pain.

It's almost December 20, 2010. That will be a day I mark in my book as the day Bob had his surgery. It will be the day we find out more about this 5cm mass that envelopes his right liver lobe. We'll find out if tomorrow is Bob's last day on Earth, or if that day is fast approaching. We find out if Bob has another life left of his nine-that perhaps, we'll be lucky and the mass will be removed and Bob will feel better than he has in a long time.

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©2010 Robin A.F. Olson. Bob this past summer.

I want to prepare myself for what is to come. I want to be able to control things. I want to tell myself if I am positive in my thinking or if I pray or if I hope or if I make some sort of bargain, that I can make Bob be OKAY, but I know I can't. Being a Buddhist reminds me to not cling to anything, that a life is like a pebble in a stream, bouncing along, getting stuck against other pebbles, then getting unstuck for a time and moving along, then getting stuck again and so on. There's something beautiful and bittersweet about letting go and just moving along with the flow of life. But I wish I was better practiced at doing so, because I want to make a bargain. I want Bob to be all right, but in the end it's already happened. What's going on inside Bob's body has been going on for some time. Tomorrow we mark the day of knowing, at last, what it is, if it can be removed or if it means the end of the road for one very special, very lovely orange tomcat named, Bob.

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Bob's surgery is tomorrow, Monday, at some time in the afternoon. I'll know at noon (EST) what the exact time will be. By this time tomorrow, I'll have the answers whether I like it or not.

Prayers, good vibes, whatever you got, is welcome...bring it on, for Bob.

Not on My Watch: I Just Can't Do Nothing

I've got five foster kittens headed my way. They'll be here in an hour. My dear cat, Bob is having very serious surgery tomorrow to try to remove a mass from his liver. He may not survive. He may have a belly full of cancer. Christmas is in less than a week and I am nowhere near ready...

...yet...

I can't look away from this poor girl sitting at Henry County. She's been in quarantine for almost ten days without any vet care after being injured when she took refuge inside a car engine to get warm. I just have to help her.

This is Noelle. She'll be staying with our best foster mama in the world until she's ready to come to CT and join us at Kitten Associates. Because she's injured and may have to have part of her tail amputated, we're going to start fundraising for her right now, even though we don't know what she's going to need. If we need less than I'm asking for, I will change the ChipIn widget. I will only ask for just what we need and no more. Hopefully we can get the job done. She'll be seeing a vet, tomorrow. No more waiting, silently in pain.

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Merry Christmas little one. I hope we can help you find your confidence, love, a warm loving home and a pain free life soon. Bobby's coming to get you tomorrow. Hang tight!

Please help spread the word so we can get the funds we need to provide Vet care for this baby! THANK YOU SO MUCH!

Bob Dole, Surgery Bound.

Anxiety plays out in my stomach most of the time, but today I could feel it in my chest as my heart beat hard and fast-“thump, thump, thump!” It was time to pack Bob into his cat carrier and drive to Cheshire, the town name I find rather ironic and/or amusing. There we would meet Dr. Weisman at the VCA Cheshire Vet Hospital. As much as I needed to get this meeting to happen, I struggled with wanting to go to bed and stick my head under the covers. I didn't want to know how she felt about Bob's prognosis or whether or not he'd make a good candidate for surgery.

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©2010 Robin A.F. Olson. Bob circa 2008. This is why we love Orange cats!

I was pretty sure, after talking many times to Dr. Larry, that I'd hear: “Well, Bob is a senior with FIV+ and the mass is large and, you know, he probably wouldn't even survive the surgery and maybe it would be best to just send him home to be loved and let him go to The Bridge.

Dr. Weisman was surprising. She was upbeat and listened, she is quick to understand a situation and she explained things clearly. Bob IS a good candidate for surgery! Yes, he has a liver mass, but his other organs, including his heart and lungs are working normally. His blood test is really quite GOOD, if you don't count the glaringly sky-high ALT value.

She didn't want to do the surgery to prove anything. In fact she said she's not a “hero.” She's not going to go in and try to remove the biggest liver mass ever seen. If it's dangerous, she's not going to do it. She said a few times, she is there to do what is BEST FOR BOB-NOT what is BEST FOR ME, HER, ANYONE. I really admired her for saying that and appreciated it. That's all I want.

She told me she'd open him up, take a look. If he was a mess, full of cancer, she would close him up, send him home to spend his last hours or days or weeks with us. If he wasn't full of cancer, if the mass is on the part of the right lobe (there are THREE lobes on the right of the liver!) she thinks it's on, it would be something she could remove. If it's NOT and too risky to remove she may biopsy it to find out if it's benign.

As it has been since we found out Bob had a liver mass a week ago, there are no firm answers, only the okay to go to the next step. We've reached the place to decide and in the end, there really was no decision to be made. Bob will have a better life without the mass. If it can be removed, we will have that done. If not, we'll at least know what we're dealing with and Bob will have the best, most comfortable end-of-life we can provide for him.

If we did nothing, Bob would slowly decline further and further and die. If we do something, Bob can have quality of life. We did not talk about how much MORE life, but it will be more...

And it's going to cost. It's going to cost a lot of money. Between $3500-4500. Sam and I aren't having Christmas this year due to our lack of finances, but we will find the resources we need to make this happen for Bob. It's not foolishness. It's not "just a cat." It's a living creature who is in pain. If we have the ability to do this for Bob, then we will. Money will never be something that is more important than LIFE. That is just wrong.

At the end of my own life I never want to look back and feel like I didn't do right by my cats because of fear and because of a buck. If I have to go without some things, that's fine. I will still have a roof over my head and food in the panty. It will be okay. It will suck to have to spend this money, but so be it.

Sunday, the foster cats arrive from Georgia. My house is going to be full up with craziness. Monday Bob has surgery and hopefully by Wednesday he will be coming home to recover. It may mean Christmas Eve at the ER Vet. It may mean a sleepless Holiday, but hopefully it may end up meaning, that what I really wanted for Christmas, I have a chance at getting. I just want Bob to be well and to stay with us for as long as he can manage. We're not ready to say goodbye and I think he still has a lot of life left.

Bob Dole proved it to me as we were about to leave the Hospital. We walked past another client who was bringing his Golden Retriever into the waiting room. Bob took one look at the dog and HISSED LOUD!

THAT'S MY BOY!

Sifting Through the Pieces

I'm trying not to think about Bob...24 hours a day. I'm trying to remember to not loose my footing, to stay calm, to try to breathe. I don't want to make a rash decision, but I also don't feel like I have a lot of time to think. With the Holiday crush upon me and with Polly and her family and MacGruber about to arrive, I need to get things ready, but all I want to do is lie down next to Bob and just be with him.

I know I can't take enough photos of him. I can't pet him enough times. I can't listen to his crazy purr long enough. I got up at 5am, went downstairs and just sat with him and petted him. I can't take one second for granted. I can't assume he will be here tomorrow. Sure, that's true for all of us, but when you KNOW the sand in the hour glass is running low, is there any way to prepare?

I've made a few more decisions. I took Bob to get a blood test to check to see if his blood will coagulate properly. If it does, then he is a better candidate for surgery. If it does not, then we'll stop here and just let Bob live out whatever days he has left. If he's OK to go ahead, then I'll meet with the surgeon. She is VERY well respected-certainly one of the best. I'll only have a consult with her, that's it. If she says we can go ahead, then I have to make a very difficult decision. Dr. Larry told me that if we did open Bob up and they find that he has cancer, to wake him up out of sedation is unkind. It would be asking so much of Bob-to have him wake up, then face painful recovery, only to die a few weeks or months later in even more pain from the cancer spreading.

“You have to prepare yourself now for being able to make that choice for Bob, if it comes to that.”

There goes my heart, breaking into little pieces. I can't put Bob through Hell, but there IS a chance it is benign, operable, can be removed and he can live for a few more YEARS. How can I not take that chance? My head feels like it's going to explode.

I ordered a new cat tree a few weeks ago-before all this mess with Bob. I bought it on a lark, thinking it would give another one of my cats a place to go if she got stressed out. The box just arrived a few days ago when I was hormonal (why do cat trees show up when I have PMS? If you want a laugh, read THIS and THIS). Sam and I weren't on great terms (still). Somehow we still managed to put the thing together without killing each other.

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©2010 Robin A.F. Olson. Blitzen, the parts inspector arrives.

In a way, it was nice to do something that got my mind off things. The simplicity of tightening down a bolt helped me stop obsessing. Seeing the parts scattered across the floor, while my cats excitedly inspected every piece made me break with tradition, as of late, and actually smile.

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©2010 Robin A.F. Olson. Bob helps with the inspection, but as usual, Nicky fails by smelling Bob's tail, instead of the parts of the cat tree.

Blitzen was fascinated. He sniffed and climbed on everything. Bob and Nicky joined in, but were soon bored and went back to taking a nap. Blitzen, began to scratch on the sisal posts just seconds after they were in place. Lock down a sleeping platform and he was on it having a field day.

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©2010 Robin A.F. Olson. Bob!

Blitz was certainly test-driving the cat tree and it was a good thing he did-he's about the ONLY cat that will actually FIT onto or into most of the damn thing!

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©2010 Robin A.F. Olson. Bratty boy “helps.” (we're still building the cat tree at this point)

It's small. This is not a cat tree for full grown cats, save for the main platform that's big enough for any cat to lie on, but the rest of it is tiny. One piece was so small we didn't even bother to attach it. Honestly, this will be GREAT for my foster kittens, but my guys will not be able to enjoy this very much.

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©2010 Robin A.F. Olson

Of course, tell that to Blitzen. He loved it. There was only one problem.

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©2010 Robin A.F. Olson. Blitzen gives this cat tree a 1-Belly Up!

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©2010 Robin A.F. Olson. Bucket o' Blitz.

“Someone” is not big on sharing.

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©2010 Robin A.F. Olson. Spencer was investigating the top of the cat tree when Blitzen reminding him whose cat tree it was.

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©2010 Robin A.F. Olson

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©2010 Robin A.F. Olson. Not sure which end of Spencer you're seeing in this photo.

I admit that Blitzen is good for cheering me up when I'm feeling down, but it makes me feel guilty, too. Blitz is, in some ways, much like Bob. Blitz has a crazy purr and it's obvious he shares a resemblance with Bob, though Blitz is very light in coloring. Blitzen is all things joyous and fun-full of promise and magic. He has decades ahead of him, most likely. His story is just beginning.

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©2010 Robin A.F. Olson. King of the Cat Tree (for now)

Bob was like Blitzen once-a long time ago. I never knew Bob in his youth, only as an adult. I bet he was a handful when he was a baby. I find myself wishing that I COULD have been his “mama,” from day one. I could have prevented him from getting FIV+, he'd still have all his teeth and most likely, he never would have gotten a mass on his liver in the first place...but I can't get a “do over” to put Bob back together again. I don't have the right tools and I'm pretty sure the instructions are written in Chinese.

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©2010 Robin A.F. Olson. Bob, enjoying his heated cat bed.

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?

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©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?

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©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.

When the Going Gets Tough

I know this road. I've walked it more times than I care to recall. It's the moment at which I realize the time I have with one of my cats is coming to an end. The road is full of hopeful moments that will ultimately lead to despair and to the final choice we must make for our cat, one day.

I hate this road more than I can say. It eats at my heart and taxes my reserves. I try to prepare myself, but there is no preparing for death. It comes, as it does for all of us. We either accept it and find peace or fight and have the same end, no matter what.

On Saturday I got Bob's blood test results. His liver function, one test indicated by his ALT, was stratospherically high. A normal value would be 10-100. Bob was at 1240.

Other liver values were also very high, save for his Bilirubin, no it's not a sandwich, it's a blood test. That test result was normal. This is a good thing.

From Cat World, Australia, I found this description of Bilirubin:

Bilirubin: This is a major breakdown product of red blood cells. When red blood cells wear out they are trapped in the spleen and destroyed, releasing bilirubin into the blood. This type of bilirubin is called unconjugated. This bilirubin is transported in the blood to the liver, where it is taken up & conjugated (joined with glycuronic acid). This conjugated form may either be stored in the liver cells or excreted into the bile. Bilirubin levels are increased in cats with liver disease, gallbladder disease or have excessive destruction of red blood cells (known as hemolysis).

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What do these numbers mean? See THIS web site for some helpful guidelines.

Then the kicker came today. Bob had an ultrasound done of his heart and abdomen. I thought I was going to be able to sit in during the ultrasound, but Dr. K said it would be quicker if he was on his own. Super Deb assured me she'd be with him and answer any questions. I kept thinking about this and that thing I wanted to make sure he knew, but in the end, nothing I was worried about mattered.

I took Super Deb's dog, Jayne for a walk, instead of twiddling my thumbs in the waiting room. It was freezing cold outside with a bitter wind. I tried to shake off the fear of what I would find out in a few more minutes. I tried to not cry thinking about it. I know as any good cat-parent knows-something is wrong, I just didn't know what it was. I didn't really WANT to know.

When I returned to Dr. Larry's office, grabbed a magazine about celebrities and their fabulous lives and pretended to look at it. I saw Super Deb. She wouldn't make eye contact with me. Then Dr. Larry arrived to start his day. He didn't even look towards the waiting room. Maybe it was not a big deal that he didn't look, but it seemed like no one wanted to even give me a hint as to what was going on.

Sam arrived with Petunia and Nora. He sat next to me, but we didn't speak. It's been a common thread here for a very long time. We only speak when necessary. Something is going on with Sam. I can guess, but he won't talk to me about it. Instead he hides in his office in the basement and plays his guitar. He mumbles this and that. He helps out around the house, in silence. Each day I grow a little more resentful, more angry. I am shut out and alone. I didn't do anything wrong. I can't wait forever for his life to be in a place where he feels like being a partner to me again. I'm still suffering from the car accident, in tremendous pain, but he does nothing. No comforting. No nothing. With all the stress I have about Bob, he only taps my shoulder or brushes my hand. When I need him most, he is the furthest away. I have to ask myself how many more years can this go on? What happened to having joy? Companionship? Even a dear friendship? For so long I have tried to encourage him to trust me, to talk to me, to give him guidance and support, but I am tired of trying.

So, Sam is there, but not there. I am there, but wishing I was somewhere else.

Petunia is getting a dental. One of her molars has a HOLE in it! Was THIS what was causing her to go on a pee-storm throughout the house? Fight with the other cats? Did she also have a urinary tract infection or impacted anal glads? While under anesthesia we'd be finding out. Maybe after all these years, I'd finally have a true end to the inappropriate urination going on in my home.

Nora was there to check her foot. We thought she had ringworm, but turns out she did not. She has some sort of fungal infection on one foot. It hasn't spread. We've treated it and it's getting better. But what about BOB??! Will someone please TELL ME what is GOING ON?

Dr. Larry took a deep breath. That was all he had to do. I knew it was bad news and he was preparing himself to speak.

Bob's heart is normal, which is very good, but...

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Fun with ultrasound results.

As you can see, above, the many LONG words that I can't make heads or tails of spell out that Bob has a 5 cm mass present in the right lobe of his liver. It is not possible to tell if it's a cancer or if it's a benign tumor that could be treated or removed surgically.

With FIV+ and being a senior cat, Bob may not be a good candidate for surgery. He may have cancer and if they do the surgery they will open him up, then say they have to put him down. That it would not be fair to wake him up when he will only live a little while longer, anyway. It's a big crap shoot.

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©2010 Robin A.F. Olson. Bob ponders his future (on his new blanket from Jennifer)

Thanks to one of my readers who works with FIV+ and Feline Leukemia positive cats, she told me something shocking:

...for any kitty that has been tested since the beginning of this year with the new IDEXX 3-way test (FIV/FeLV/HW), you cannot trust ANY positive result on the FIV or FeLV component: incredibly high rate of false positives, confirmed by retests with the western blot for FIV or the IFA for FeLV. the true positive rate on retest is the normal, VERY LOW, percentage. (and, of course, the FeLV component only tests for EXPOSURE, and most cats are able to process the virus out of their systems, which is why retesting is imperative. usually, the retest should be done 90-120 days after last exposure, but with the nationwide problems on the new test, we-who-get-the-panicked-calls-to-place-these-cats are advising that cats be retested immediately. (IDEXX does know about the problem, and will admit it to vets; however, tho they've asked for the names and contact info for those who have stats--national rescues, and special-needs sanctuaries--they've never followed up when they were provided with same.

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©2010 Robin A.F. Olson. Blitzen and Nicky try to cheer Bob up.

Even though Bob was tested years ago, this is the time to make SURE he is FIV+ because that will effect his ability to get a surgeon to take on his case. Because he was not neutered at an appropriate age, he got FIV. This is my Mother's fault and I will never forgive her for not caring for her cat. His life would have been so much better if he'd been neutered sooner and not left outdoors to get into fights with other territorial males.

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©2010 Robin A.F. Olson. Blitzen decides to lick Bob's head while Nicky is...Nicky.

I started to cry when I got the news...big, shaky tears. I tried not to cry, but he knew I couldn't hold back. Dr. Larry rubbed my arm and told me about a woman whose dog had the same thing Bob does. That he opened the dog up and saw the mass and called the owner and said he should put the dog down. The mass was too big. The dog would die anyway. She was going through a bad divorce. The dog was all she had. She demanded he cut the mass off-so he took half the liver. The dog lived...another two and a half YEARS. But Bob's not that dog and Bob could have cancer and Bob has FIV+ and he's a senior...blah blah blah...

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©2010 Robin A.F. Olson. Blitzen being cute, as usual.

I just wanted to fall over, curl up in a ball and weep. But that won't help Bob get better or live a bit longer, at least.

So I asked a few questions, then left the exam room. The first thing I saw was Moonpie's face! His new owner, as promised, brought Moonie and Patty to meet Dr. Larry now that they are adopted. I couldn't have been happier to see their friendly faces. I took Moonie out of his cat carrier and held him. He sat comfortably in my arms. Both cats meowed furiously at me. I hope they weren't asking me to take them home. I wanted to, but they will be happy in their new home one day. Right now they're doing well, but are still scared. Their new owner says that each day the calm down a bit more and become a bit more cuddly. With three young boys to play with, it's a big change for them. I told her to give it a month and that I'm always there for her whenever she had a question. She told me to come visit them any time. It would be too tempting to sneak them back home with me, but it was really GOOD to see them again.

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©2010 Robin A.F. Olson. My boy, Bob.

We loaded Bob into the car, alongside Nora and drove separately home. I got Bob fed and gave him his liver medicine. He ate well, then went to his heated bed for a nap. It was just like any other day, completely unremarkable, save for the part that I know there may not be many more such unremarkable days ahead.

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