Saturday, October 30, 2010

Friday Was Worth It

I dropped B.C. off at the vet Friday morning to have a couple teeth pulled and the rest cleaned. His teeth have always been bad, and I suspect it's because he doesn't actually chew the hard food, but swallows it whole (he only licks the gravy off soft food, so we don't go there). Also, bad pH balance, gingivitis, etc. Anyway we had also planned a chest X-ray because he's been wheezing and coughing very violently lately, and we thought it was best to check if there was a blockage or something, maybe asthma. He's been lethargic and losing weight rapidly the last 8 weeks and I thought it was because his teeth hurt.

His doctor called within an hour. "The X-ray is exciting. Not in a good way." And then she blew my world apart. Her words, not mine.

He had an abdominal hernia: the diaphragm between the chest and abdominal cavities just wasn't there. She couldn't tell from the X-ray whether it was a recent development or a congenital thing he's had his whole life that just now started causing him problems, for whatever reason. She thought probably the latter. What she could tell from the X-ray was that his intestines, liver, and most of his colon had moved up into the chest cavity, crowding his tiny heart and constricting his wispy lungs. When I saw the images and his two round kidneys floating in the abyss of his empty abdominal cavity (the stomach and bladder were there, but almost invisible), and everything else crammed up under the stark white ribs, I had to sit down.

The doctor said she'd seen the condition a few years ago, in one of her own technician's younger cats, and that surgery was the best thing, and soon, before any of his jumbled organs got pinched or punctured, killing him quickly and horribly. She didn't lie; the other cat she knew hadn't made it through the surgery, and there was the tiniest possibility that if this was a congenital condition it wasn't the problem with B.C.'s appetite; there might be something else wrong. Although I think we both doubted it. It was definitely the problem with his breathing.

She sent me to the local veterinary referral center, an emergency and surgical unit that specializes in extremes (there was also the veterinary department at U.C. Davis, 15 miles away, but she felt the people at the VRC were perfectly capable). A surgeon examined his X-rays and was certain it's a lifelong problem that only recently became volatile. I had a hard time digesting that: my big, substantial boy with such a mess inside, but come to think of it, he's always been odd; he was never particularly active like most young cats, and I have rarely seen him run (when he does it's an awkward lope, very brief) while even crotchety Kitty still tears around the house almost daily for 15 crazed minutes or so. Also the surgeon said the abdominal organs may have slipped in and out of the chest cavity over the years, especially since the hernia was so big. Her worry was that because it was discovered so late in life, some of the organs might have adhered together, making the separation difficult or impossible. There was no telling without going in.

At this point I had to choose: have my companion of almost 12 years -- his whole life and more than a third of mine -- put down right away, serene and dignified, instantly relieving what was probably severe discomfort, and avoid the trauma and pain and confusion of an intense, invasive surgery? Or do the selfish thing, putting him through this amazing ordeal just for the chance to have him around a few more days, weeks, months, years, simply because I love his presence in my life?

There were several scenarios with the second option: one, they'd open him up and find there was too much adhesion, too much organ damage, and they'd have to stop the procedure and euthanize, or other complications -- like reaction to the anesthesia -- would lead to his death on the table. Two, they'd get him sorted out and repair the diaphragm, he'd survive the surgery, but his lungs might collapse and possibly release a fatal amount of built-up toxins (depending on the length of time they've been severely constricted) into his system, shutting down his other organs and killing him within minutes or hours. Three, he could survive the surgery, his lung capacity increased and oxygenation improved, heart function improved and blood pressure reduced, abdominal organ function restored, and we might have a cat with a new lease on life and several good years ahead of him.

Terrible odds, numerous unknowns and frightening possibilities, exorbitant price.

You know what I chose.

He went in for surgery within an hour.

Later his surgeon, a brief woman with big eyes and an intense need to fix my cat, called. He had come through the surgery with flying colors. No adhesion of the organs, plenty of material to repair the diaphragm. His oxygen levels were way up and his blood pressure went immediately down. His lungs had partially collapsed, but there was no sign of toxicity. There was a slight mottled place on his liver, probably from being constricted, but she had taken biopsies of the liver and intestine -- which looked far better than expected -- and foresaw no problems. He would be in the ICU overnight and they would call me in the morning. Visiting hours on weekends are from noon to 2.

We -- and I should have been saying "we" all along, because I was on and off the phone with Brent the entire time and he graciously endorsed some serious capital outlay despite reasonable reservations and the very good possibility it was all for naught -- went to visit a while ago. Not only did B.C. survive the night, but he came out of the anesthesia remarkably well and the tech boasted that she'd had him purring and he'd even eaten a little. An I.V. fed him pain medication that made his pupils huge and his eyelids heavy, but he was clearly glad to see us, although he couldn't muster much more than a cheek rub and quiet purr. We should have him home by Monday.

There's no telling what his life -- however long it lasts -- will be like from here on out. He may not survive. There might be something else wrong: intestinal disease, cancer. He might not only make a full recovery but enjoy the kind of health and energy he's never had before. I tried, but can't seem to mentally shift the cost of the procedure to any other kind of benefit we could have gotten from those dollars in our life: a European vacation, the down-payment on a new car, even the security of food on the table and rent in the bank.* Nothing seems as valuable to me as that one cat's purring weight on the blankets at night, his long white hair on my black pants, his fluffy tail vibrating at the sight of me opening a can of tuna.

He is one tiny speck in the universe, no more or less than any other pet or, in the end, any other living thing, his life worth only what I am willing to pay for it. My life is only worth what an insurance company is willing to pay for it, after all, if something strikes me down. My life is finite, and I want the things I love for as long as I can have them, and we had the money. (I'm incredibly grateful for that, although I would willingly have gone into debt to accomplish the same means.) I can live with the guilt that I selfishly put him through something horrible that he will never understand, never even associate with any improvement it renders him. I am confident that in many ways he will forget it as soon as that improvement occurs, and I am confident that it will occur. And I am also confident that I would have bitterly regretted for the rest of my finite life not giving him the chance -- or myself the possibility -- of a few more good years together, even if the money turned out wasted. Everything so far indicates it is not.

Long story short, I can't put a price on love.

* (Side note: I also feel there are better ways of contributing to charity or causes than donating money, since most of the money donated in this country does not go where donors believe it goes. For instance: 23% or less of the money that goes to the Susan G. Komen Breast Cancer Foundation goes to research; the CEO of that foundation makes $450k a year. They channel funds into numerous other beneficial uses, of course, but they market the perception that they're funding the cure. And they're one of the most legitimate and responsible foundations out there. For this reason I generally donate time, appropriate materials, my limited knowledge, etc., but rarely money.)


Anonymous mister anchovy said...

cheering on BC!!

October 31, 2010 at 7:10 AM  
Blogger A said...

He's doing great! Four days later you would think nothing happened except for the gash in his gut. Also, his toes and nose are super pink, his purr is loud, he's groggy from pain meds but enjoying life. He recovered so well early on that they sent him home a day early. YAY!

November 2, 2010 at 1:52 PM  

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