Sunday, April 5, 2015

Too Close to a Nightmare I Couldn't Handle

***SEE NOTE AT END FOR FULL DISCLOSURE***

So what do you do if in the course of petting your fur-baby, you feel a lump that you are almost positive is not supposed to be there? For those of you who have checked out Momma Kat's Facebook page, you've already read bits of the saga of the lump I felt in Bear's back, just about an inch off his backbone, and a few inches above his tail. He LOVES to get a good back scratch on his backbone, just above his tail. And it has to be a scratch, a simple rub will not do. So I am fairly familiar with the territory and it was odd that all of a sudden, it was there.

My first thought (and nightmare) was a vaccination-related sarcoma. No one knows exactly why they form and the prognosis is fairly poor; though treatments have improved over the years, they are likely to grow back if removed. They are also fairly rare (my vet's seen 4 in his 40 year practice and online sources say 1/10,000 - 1/20,000 - but it doesn't really matter if your cat is the one in the thousands to get it). Sarcomas have been on my radar since I moved back to my hometown and took Bear to the vet I knew well. We got a newer guy in the same practice, and before doing any vaccinations beyond rabies (which is required in the county we live in), he made sure I was aware of the rare, but often dangerous sarcoma. In the moment I had to think about whether to get the additional vaccinations, I figured it was worth not having to worry about these other conditions, so I went along with the other recommended vaccinations. Despite making the decision, in the back of my mind, it was still there - I continued to think about what COULD happen. In subsequent yearly visits/vaccinations, the topic was never brought up again, and I continued to get the recommended vaccinations, though each year I thought about it and it settled into a simmer on my "back burner." 

Fast forward to Saturday, March 14th (Bear is 9 years old), when I felt the lump. I panicked and felt overwhelmed because my instinct told me something was not right. First thing Monday, I made an appointment for the afternoon and brainstormed questions, concerns and details about the lump. The lump was strange (as the vet verified, he wasn't entirely sure what was going on), because it felt rather hard like a marble (though a little bigger), yet it didn't seem like it was attached to underlying tissue - it could be manipulated in a circle with a couple inch diameter. He told me it was unlikely it was a sarcoma because they are usually more spread out and soft, and they are firmly attached to the surrounding tissue. Because Bear's lump was hard, he wasn't sure an aspiration would be conclusive (tiny needle inserted into the tumor to withdraw liquid for testing). His recommendation was to remove it sooner than later (especially because it wasn't attached to anything and should theoretically be easy to remove). While it all seemed so sudden and I usually like to think things over and make an informed decision, I scheduled the surgery for the next day. 

Poor Bear. He hates his carrier, is terrified of vets (and all people except for me) and usually just about has a heart attack smelling or hearing the other animals. He also is known to be loud when he's not happy - he "talks" and makes sure everyone is aware of whatever indignity he is suffering. If I had a dollar for everyone that's commented on his extensive and impressive vocal skills, he'd eat caviar at every meal. If it were anything else, I would have given in - but off he went (despite his meowing like he was dying a horrible, painful death). I seriously debated insisting on staying - at least while he was awake - because I know hearing my voice calms him down. When I spoke with the vet after the surgery, he started to waver on whether it was a sarcoma and told me that it was a "nasty" tumor - and because of what he saw, he took more than double (almost three times) what he'd expected - to make sure there was as wide a margin as possible. He also told me Bear was awake and watching everyone intently. No doubt, he was carefully watching everyone to make sure they were doing what they should. Mr. Overseer, making sure to keep an eye on his humans' "incompetence." 

When I saw Bear for the first time after the surgery (later that day, Tuesday), it was no doubt one of the hardest things I've ever done. The incision was about six to eight inches long and broke my heart. If it was in fact a sarcoma, that was likely to grow back, I couldn't imagine putting Bear through this all over again. Even worse, he was unsteady and wasn't himself (to be expected with anesthesia, especially since he got more than planned since the surgery was extended to remove more). I cried on the way home and panicked when I got him out of the carrier at home, because the incision started bleeding and he could barely hold himself up in the litter box. Thank goodness my vet is patient and was available to calm me down. No doubt he thinks I'm a complete nut, but in reality there are very few things (mostly people that I love or Bear) that rattle me enough that I doubt I can handle them. The vet suggested I put him in a dark room and close the door. But after I got off the phone, my momma instincts returned and I knew he'd want to be next to me and would tear up carpet if we were separated and he was by himself in a room (not good for the stitches). So I made us a nest of blankets on the floor (I was afraid he wasn't ready to jump on the couch and he's the kind of cat that if I'd picked him up to the couch, he'd have jumped down - maybe before he was ready or okay to do so). I also fed him some wet and dry food, which he gobbled greedily. The vet said wait an hour after I got home, but I know Bear - he'd have followed me around until I gave him something, and he didn't have any problems with the little bit I gave him at a time. 

Four hours of our nest snuggling (and a ridiculous amount of food) later, he got up and went to jump on the couch by himself (I know this means he needs his time alone). Still, he looked up to make sure I was around and came over every so often to get an ear rub - which made me feel good that my presence was reassuring and my momma instincts were working correctly. I was panicking in the back of my mind - but decided I would take this one day at a time. Instead of dealing with his appearance/behavior AND the consequences of what the doctor saw, I decided to deal with his state as a result of the surgery NOW and deal with the long-term issues when the histopathology report came back and we had answers (and theoretically, I'd feel better about his post-surgery condition and have better ability to cope with the rest).

By Wednesday, he was more like himself, though it took him closer to a week to get back to attacking the printer when it's turned on and various other "Bear" behaviors (being destructive for attention). On Friday the histopathology report came back - the tumor was benign. The tumor started out as a lipoma (accumulation of fat cells - harmless unless it becomes large enough that it interferes with surrounding nerves, tissues, etc - but it never turns into cancer itself), however, it somehow became infected. We're still not sure why because the vet said it wasn't usual for that to happen, but his best guess was that the tumor had outgrown its blood supply (makes sense given the presence of necrotic, or dead, tissue in the tumor), and the dead tissue triggered an infection. 

Two weeks after the surgery (March 31st), the stitches were removed and Bear was back to being Bear. The vet kept telling me that I should be happy and relieved, which I was, but it was just too close. Too close to something horrible. I know that over time, my reality will shrink back to normal, but I'm still struggling with believing every thing will really be okay. I'm not ready to let go of my awareness that something really bad could happen and haven't figured out how to live fully around that awareness. I don't want to get my hopes up even though the vet thinks this is "over." 

My announcement of my blog happened a few hours before I felt the lump and everything turned upside down. I wondered if I'd made a target of myself for being so proud of and loving Bear that I wanted to share him with others. Was I too prideful? If I'd never started the blog, would this never have happened? I also wondered if I was too complacent. I don't take Bear for granted (as the existence of my blog indicates), but I wondered if I became complacent about bad things happening in general in my life: if this was a reminder that bad things happen. I got mad at God and told Him off numerous times - mostly saying that if He had a problem with or an ax to grind with me, to hurt me, not Bear, who hadn't done anything. Of course, my language was more colorful - because Bear is my Achilles Heel. He is wonderful and the thought of him suffering because of my mistakes (in life in general or in his care) was just too much. I offered God deals that I would never have done for anyone or anything else. As I was dealing with all this, I wasn't sure where my blog fit in anymore - it seemed more important to be there for Bear and spend my energy appreciating him. This is why I haven't been posting as much as planned. I have more than twenty ideas for blog posts and a couple pages of notes, which I will get to eventually. 

Thank you for your patience as I figure things out and negotiate this new reality that was just TOO CLOSE for me to be okay any time soon. And I'm also struggling with the deal I made - maybe it wasn't realistic, but Bear is too important for me to mess it up. And if it would make a difference - then I will do it. Rationally, I know that in the face of something outside one's control, one grasps for anything that could possibly make a difference. Any situation is easier if you think there is something you could have or could now do to change the outcome - otherwise you are left with a life that is arbitrary and makes no sense. I also know that we are told that God is not punitive and doesn't "make" us suffer. I know all the rationalizations for the struggles and feelings described - but unfortunately, this is a situation where the feelings and potential loss far outstrip the powers of rationalization. I also recognize that even in the worst case scenario, there are much worse things in the world that people have to deal with. I "get" that Bear is "just" a cat - but I am not embarrassed that my deep capacity for love includes animals as well as other people. Some people might think that is crazy - but for me, I believe it to be a strength. Besides, I dare you to meet Bear and not love him!

Bear Back to Overseeing the Printer (incision is on other side - I don't feel right posting those pictures)


***NOTE FOR FULL DISCLOSURE:
Because a lot of issues have been made in opposition to childhood vaccinations, I want to be clear that I still believe the security of feline vaccinations far outweigh the consequences. Even if Bear's tumor turned out to be a sarcoma, I wouldn't have regretted making the decision to get those vaccinations (though I would have minimized future vaccinations if he'd shown the susceptibility for sarcoma). Today, vets favor giving vaccinations in the back legs (rabies on one side, others on the other) to try to manage the incidences of sarcomas - versus in the lower back as they used to (again, why I feared Bear's lump might be a sarcoma - it was precisely in the area of the back the vaccinations were previously given, and they can take years after the actual vaccination to form). I believe vaccinations are important - especially in multi-cat households or for cats that are exposed to other, unknown cats (cats allowed outside for more than a minute or two or cats who are boarded).

Most importantly, I am not a vet, nor do I have any kind of veterinary training. I hesitate to provide too much technical information because I can't verify it independently - but I also feel like it's important in some cases (like in saying sarcomas are rare), to give some kind of concrete range to allay fears and show just how rare it is. Any kind of technical data I provide is consistent across reliable sources (vet medicine groups), though there is no way for me to get information from every source, so you might find conflicting information elsewhere. Finding a vet you trust is worth more than any other resource because they are dealing with your cat specifically. Any concerns, questions or uncertainty should be discussed with your vet - it should feel like a partnership - with a common goal - the health of your pet. 

A good summary of the vaccination issues related to sarcomas can be found at:

4 comments:

  1. WOW! That was scary! I'm so glad Bear Cat is okay!

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    1. Me too! It's hard to believe it's already been a year since this happened! We both got really lucky for a second time. First time: when I happened to cross paths with a loving, homeless kitten who was willing to give me a chance . . . and now, that the worst was avoided in this case. I love my boy and I can't imagine my life without him.

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  2. I know the feeling of how scary something is when you discover something or something is wrong. I'm glad all turned out well for Bear. And Bear is not "just" a cat - he is family.

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