8/10/00 – the beginning of the end

When Sandi came down with Toxoplasmosis, it was sudden and terrible. She greeted me as usual in the bathroom as I readied for work. Sneezing three times (she was not prone to sneezing), she left the room and sneezed three more times in the hall. I thought, "that’s odd, hope she’s not catching cold". Cats do not handle upper respiratory infections very well. Then I fed all the guys and gals and went off to work. She wasn’t much interested in food, also odd, I thought.

Maryann normally works at home, but sometimes must go out for a meeting or delivery/retrieval of work, and today was one of those days. She left about 10 and came back at 2. As she tells the story:

A rush to our regular vet pronounced her as having pneumonia, so he put her on antibiotics and administered subcutaneous fluids. There had been no blood-work or x-rays done. He kept her overnight. The next day, she was some better, but not very alert at all. The fever had come down and he sent her home. We set up the guestroom as a "sick room" and made her as comfortable as possible for the evening. She tolerated being handled, but was not at all interested in snuggling.

Saturday morning, she seemed even worse. Temp was back up to 106. A quick call to the vet said, "bring her back in!" and he would give her an IV over the weekend. Since there would only be occasional "drop in" rounds on Saturday and Sunday and we all agreed it would be better if she were closely monitored, at noon we transferred one very sick kitty to the local emergency pet clinic nearby. By this time it was obvious something was seriously wrong. She had not eaten in days, and could not stand up, just crouch. Her head was cocked at an odd angle, her pupils were very dilated, and she was not aware of much of anything.

The Emergency Clinic is a fairly familiar place to us, and a very nice facility. It is clean, modern, well staffed and has up to date equipment. Rightly, it is not cheap. The staff is very knowledgeable and caring. The vet on duty this day takes a history and carefully notes the fact that Sandi is an avid hunter and loves the outdoors. Symptoms include lethargy, anorectic, depressed, lack of coordination, head pressing, difficulty in chewing and swallowing food, heightened sensitivity to touch, and signs of a neurological involvement. All of sudden onset.

While there is obviously upper respiratory involvement, X-ray shows Sandi’s lungs are clear. Routine blood work shows anemia: very few indicators are within normal range; most are very low.

At this point, her best guess is Toxoplasmosis. There is no time to do the antibody titer. Sandi’s chances are 50/50 of surviving the night. We agree to move ahead based on a working diagnosis, and begin administering Antirobe to counteract the Toxo. "If we can get her past this point, and we need to, we can do further tests." The outlook is grim because of the all-pervasiveness of the T-Gondi organism, and it’s destructive effects on nerve tissue, particularly the brain. No one seems to know what "switches it on" and the estimate is that 80% of all cats have it in its dormant state. The cat’s immune system has learned how to keep it dormant. Sandi may have been so run-down from all her activity and lack of sleep, that her diminished immune system let it wake up.

Sandi shows signs of brain damage already. The long-term question is not "whether", but "how much?" Our minds and hearts are in a tailspin. We love this critter very much, but to what extent? Do we take "heroic" measures? Can we sustain the financial hardship? What would Sandi want us to do? We are face to face with a specter we have never encountered, a tiny organism, our own fears and sense of loss already looming their ominous heads. We opt for the heroic. We cannot see our living with ourselves if we don’t give this magnificent creature a shot a beating this terrible affliction. We cannot imagine our house being a home without her. We only pray that Sandi does not suffer long and painfully. We pray that we have the strength to care for her long-term. We pray for wisdom to be making the right decisions. 

Sandi improves a little the first day, and is finally able to stand up. She is still holding her head at an angle like she has a really bad headache, and begins to circle around her cage that night. This pulls the I.V. from her foreleg, but that is okay. The catheter remains and is immediately flushed, sealed and bandaged over. 

The next morning (a Sunday), Maryann and I visit at the vet’s request. We are hopeful Sandi is ambulatory enough to take home. Sandi agrees, by being the most responsive she’s been since Thursday. She shows a little interest in the feather we brought, but seems to lose it from sight quickly. She circles the floor of the examining room and takes a taste of the food we offered (key to home care), as we try to re-assure her she’ll be okay.

Armed with lots of special food and medication, we quietly head for home, all together again. At least for a while …Dickens greets her on the bed in the hastily set up sick-room with a hiss, his hair standing on end when he sniffs her and sees those wide open pupils. Not a good CAT scan result, eh Dickens? He rightly avoids her and the room for the duration but is showing signs of distress. He stands vigil at the door whenever we’re not in there with her and is otherwise withdrawn.

Maryann assumes the role of primary caregiver, and neither of us have any idea how hard it’s going to get as Sandi continues to get better each day. If that sounds like a paradox, it is and it isn’t. This is what makes this so hard. As she continues to respond to the meds, Maryann is doing some heavy bonding. What if Sandi gets back to almost normal health, but her brain is dead? How will she deal with the very poor eyesight that has her vexed and depressed already? What kind of emotional expense will there be the longer we hold on if she doesn’t make it? We know we are not alone in these tough decisions, many people have been faced with these same bad times. We just need some support, and have already done a lot of research and talking to our cousin’s wife who is a vet tech. She has been a rich resource and so understanding.