Wednesday, September 30, 2009

Day twenty nine


Today was Houston's last day.

After my post yesterday things definitely took a turn for the worst. He hadn't had much to eat all day, and his balance continued to get worse.

He had a pretty restless night, he was finding it hard to get comfortable.
We all had a pretty restless night.

He didn't wake up again and ask for food. I got up and he was passed out on the lounge. He then demanded to be taken outside to sit in the sun.
That afternoon when I got home he came and met me at the door and I opened it and allowed him to go out (without his harness or leash!) and he tentatively went out, awkwardly managed the few stairs (was very unsteady) and after about three minutes he headed back up the stairs to go inside.
He spent the rest of the afternoon asleep on his pod.

Although he seemed very much like himself - he'd answer to his name, he appeared to want food and want to go outside - he wasn't enjoying himself and he didn't seem happy.
We knew we had made the right decision, and we also knew we couldn't wait another day.

So, exactly four weeks to the day (and possibly the time?) of his initial consultation, we took him back to the hospital (Sydney University Veterinary Hospital have been amazing during this past month) and had another consult. We were all sure that this was it. Any further tests or drugs would only be delaying the inevitable, and for us that just wasn't good enough anymore.

We had our final hugs and kisses, and then we said goodbye.

I still can't believe that we won't see him again, and we miss him already.
To others he may have just been a cat, or our pet. But to us he was our family and we loved him.

Rest In Peace Houston

Tuesday, September 29, 2009

Day twenty eight

Houston out the front

Exploring under the car

Today Chris and I had another long chat about Houston and his quality of life.

He is still enjoying going out first thing in the morning; but he no longer gets us up. He waits til we get up and then goes and sits near the back door. So he has no hunger and it's hard to get him to eat anything. Today I steamed a chicken thigh for him and he could only eat a few mouthfuls.

He is also sleeping a lot; and his balance is not so great.

He was busting to get out the front earlier this afternoon, but I had to drop Chris off to pick up his car, so he had to wait til I got back. By then he was passed out, grumpy and groggy, and after only a few minutes (and a wee!) out the front he stood at the front door ready to come inside.

I called the vet and she was not happy with his progress and has asked us to consider saying goodbye to him soon.
I will call them again tomorrow for an update, but Chris and I will definitely take him in for a checkup on Thursday. We know that Houston may not come home with us.

Monday, September 28, 2009

Day twenty seven

Houston having a late night snack of lamb and chicken Twisties

Sunday, September 27, 2009

Day twenty six

Houston's big adventure out the front

Licking his lips

Today Houston has had a brilliant day.
Yesterday wasn't really touch and go; but it wasn't a great day.

He is being really picky with his food - apparently only lamb and smoked turkey is good enough for him now!

Houston use to go out the front all the time but we had to put a stop to it after he kept trying to escape when we were coming in the front door! He has been limited to the backyard, under our supervision after an escape into the neighbour's yard, for more than a year now.
But it's one of his few pleasures in life, so today we found his old leash and harness and we took him out there for a little adventure.

He is now all tuckered out; passed out, sleeping, on our bed!

Saturday, September 26, 2009

Day twenty five

Flashback: Doing what he does best, 2nd November 2007

Friday, September 25, 2009

Day twenty four

Enjoying his ice cream!

Well, haven't we had a lot to think about these past 24 hours!

Yesterday was very emotional; there were a lot of tears (mine) and Houston was inundated with hugs and kisses!

Today things are a bit more real. We have had to come to terms with the fact that we are looking out for any signs of discomfort in Houston, and that when we do see it that we then have to take him to be euthanised. How unfair is that!!!

As for how Houston is today, well he has had a brilliant day!
He got Chris up at 6am for breakfast, he didn't eat a lot though.
He then was waiting (patiently) for us to get up a bit later so he could go outside. He roamed around outside for a good hour. No sleeping in the sun today!

He had a morning tea of some ice cream (as per his daily photo) and then in the afternoon when I was preparing dinner he had some raw lamb. He then had some cooked lamb while we were having dinner.

So, what are we looking out for, in terms of his discomfort and quality of life?
  • when he's sleeping too much, and not enjoying any part of the day
  • when he's not eating for fun
  • when he's not eating
  • when he's stopped drinking water and weeing
  • when he appears to be in pain
  • excessive vomiting
It is certainly not a fun time for us.

Thursday, September 24, 2009

Day twenty three

Houston's first drive in a BMW, on the way to the hospital

Houston being a good boy and waiting for the vet to come back

He was so well behaved!

Having his temperature checked, he really didn't like this!

Today was the day that we were hoping would not come for many many months.

We took Houston to the hospital for a check up (as he still hadn't pooped and he had a lump in his stomach) and unfortunately that lump is his kidney filled with cancer.

We were given a few options.
  1. continue as we are and hope for the best - that is the most expensive option; and also the one that would make him sick after each dose
  2. get the doctor to email a network of oncologists to come up with another plan for his chemo, to tackle his individual needs
  3. continue giving him the prednisolone and losec and waiting til his quality of life has deteriorated
  4. euthanasia today
We have chosen option 3.

Chris and I are, as I'm sure you can all understand, devastated. I'm sure I made the doctor very uncomfortable with my crying.

So we're home now. And we're going to be making Houston's last days as comfortable as possible.
He's already had some prawns today; and Chris just tried to give him some squid but he wasn't interested.
Tonight he'll be having some ice cream!

Today's consultation (which included a shot of maropitant citrate) $83.69

Total vet bill to date $3034.31

Wednesday, September 23, 2009

Day twenty two

Houston more orange than normal outside during the dust storm

Houston is doing a lot better today.
No more struggling to go to the toilet; but he's still off his food a little and sleeping a lot.

Today we bought him a treat - some white bait!!! And he is loving it!

Tuesday, September 22, 2009

Day twenty one - part two

Hiding in the coffee table

Things got worse today for Houston, since my earlier post.
He'd been straining to pee (or poo) all over the house and he vomited outside.
I called the vet and she asked that we bring him in.
We got all ready and then Houston did a poo outside and then fell asleep in his hat bed.
I called the vet and they were OK with us waiting to see if he feels better tonight/tomorrow.

I'd rather take him in today, but he hates the car and I'd like to give him the benefit of the doubt (and a rest) and not put him through that.

It's so hard.

Day twenty one - part one

Houston licking his lips after a drink outside

The last few days haven't been great for Houston. He's been spending a lot of time sleeping and hasn't been eating a great deal.

He still really hates his tablets; it's always a struggle. I always start off patting him softly and telling him I'm sorry but I have to do this for him to get better - but it always ends up with a bit of a fight and me saying "don't make me hurt you!!!" LOL - of course I never would! But it's so frustrating for the both of us!

He still loves going outside in the morning. And yesterday he ate a chicken neck!

Monday, September 21, 2009

Day twenty

Another flashback: Houston out in the front garden, with his harness and lead, 13th August 2008

Showing his displeasure at Chris' help climbing the tree!

Sunday, September 20, 2009

Day nineteen


Houston at his grumpiest, after his medication

Houston was generally pretty good today, his energy level was quite low, although he did jump and try to catch a butterfly outside in the morning. His appetite was quite low too, although when he did let me know he was hungry he was ravenous. He also vomited this afternoon, the first time he has done that since we took him to hospital. We're hoping it's not a bad sign, just one of those things cats do, as any cat owner will know.

Saturday, September 19, 2009

Day eighteen

Chillaxin' in the yard this morning

Grumpy on the bed this evening

Poor Houston. He's been really down the last couple of days. I know it's just a reaction to the chemo. But that makes us question whether we are doing the right thing or not (a familiar/constant theme here.)

Since we're now giving him 3 tablets in the morning; and another one at night (the antibiotic is given twice a day) he is really starting to avoid us throughout the day (me mostly!) And that is hard on us. We're trying to make him feel better and to give him a good quality of life; and he just seems really unhappy.

We're hoping he'll pick up tomorrow.

Friday, September 18, 2009

Day seventeen

Today's photo is a flashback: it was taken on 30th December 2003

Thursday, September 17, 2009

Day sixteen - part two

Deep asleep after his hospital visit

I was able to pick up Houston at 1330 this afternoon; I was told he was a model patient and no sedation was necessary. Fantastic news.

He's been placed on a broad spectrum antibiotic in case it turns out that he does have a parasite, however we won't know the results from the blood test til next week.
He's still taking the prednisolone and the omeprazole (losec) everyday.

Today's chemo bill cost (including the extra blood test to check for a parasite/immune mediated disease) $633.90

Total vet bill to date $2950.62

Day sixteen - part one

Waiting for his treatment this morning

Enjoying the view (or looking for an escape)!

We dropped Houston off at the hospital this morning before 0800.
It is his first day stay visit for chemo and it's also the first time in 10 days that he is being examined by his doctors.

His medicine specialist, who is coordinating his chemo, called me a little while ago to say that the results from his first blood tests this morning are back. She said his kidneys appear to have stopped over producing enzymes - last time it was 350 and now it is 200 (normal is 180). So that is great. They can stop treating him as if he also had kidney failure.

He is however still low in red blood cells, despite his bone marrow keeping up with producing new ones (there was a chance it'd be affected by the chemo.)
So, the doctor thinks there are two reasons why this is occurring.
1. He could have an autoimmune disease which is attacking the red blood cells;
or 2. he could have a parasitic blood infection.
They've asked to do another blood test that will test for both. I have agreed to this. I'd prefer to know what we are up against considering we are doing all we can to fight the cancer and make Houston feel better.

The good news is that the tumor in Houston's stomach can now no longer be felt during an examination; and his kidneys have mostly gone back to their normal size and structure (the right one is still a little larger).

He is having his chemo injected today (hence the need for the day stay) and will be home this afternoon.

The doctor also mentioned that his response to the chemo so far (so well) has promoted them to lower the dosage of one of his agents; and he'll be skipping treatment next week. Which will be a well deserved break for him since he goes off his food and sulks for two days afterwards.

Wednesday, September 16, 2009

Day fifteen

Houston's new favourite position for sleeping

Tuesday, September 15, 2009

Day fourteen

Happy Birthday Dad!

Today is Chris' birthday and Houston couldn't wait to give him his presents (Fly by Michael Veitch; and a Polo by Ralph Lauren polo shirt).
In all honesty Houston has no interest in gifts unless they are for him, he's a bit selfish like that...

Monday, September 14, 2009

Day thirteen

Happy to have his Mum home

Today I got home after two nights away. Chris had kept me in touch via daily phone calls; photo messages and I was, of course, reading the blog.
So I knew Houston wasn't doing too well, but I also knew that it was just him suffering the effects of the chemo treatment. It's not ideal. And it's really hard for Chris and I to witness.
We had a brief talk last night about whether we were doing the right thing, and will bring it up with the vet this week when we take Houston in for his next (first) out patient chemo therapy treatment.

But he was doing a lot better today. He was running in to the kitchen when we asked him if he was hungry; he also ran away from me outside when I tried to give him a cuddle!
He's still tired and even though he's excited when you mention food he's not eating that much.

Sunday, September 13, 2009

Day twelve


Highlight of his day

Houston could best be described as patchy today, he had a few good moments and ate a small amount of food, but mostly he was grumpy, moped around the house and drank a good deal of water. His coat looks scruffy, his eyes are a bit dull. I just found him hiding under the bed in the spare room, which is not a good sign. Hopefully he will have a better day tomorrow.

Saturday, September 12, 2009

Day eleven

The day after his first home chemo treatment I could tell Houston was feeling unwell. I was cooking chicken soup and ordinarily he would be driving me crazy in the kitchen. Instead he wandered in occasionally, seemingly more out of habit than anything else. I tried to tempt him with three different kinds of chicken, out of a tin, raw and grilled and although he sniffed and licked all three I doubt he ate more than a spoonful of any of them. He even refused fried bacon rind, and I once had a tug of war with him over bacon rind.

Next it was time for his medication and taking some tips from Kirrily I successfully gave him his two tablets. This made him even grumpier and he spent the rest of the day either avoiding me or barely tolerating my presence. Even when I made him a little bed out of hats.

Friday, September 11, 2009

Day ten

The tablets and the gloves you have to wear to touch them!

Houston is such a little trooper!

Today he had his first at home chemotherapy treatment. It was very disheartening having to give him a tablet (well, a capsule) that I was only allowed to touch while wearing gloves.
And Houston is getting better every day at trying to avoid the tablets. Today I actually had to chase him around the house and carry him into the kitchen - I have no idea how he knew that it was tablet time!

After the three tablets had been successfully swallowed (two of them needed two attempts) Houston went and laid on our bed. He was sulking big time. After about 10 minutes he let out a cry - which both Chris and I found very distressing.
Every sign of Houston's discomfort has me wondering if we are doing the right thing.
We thought me might vomit so we moved him out in to the kitchen and closed the door. I then left Chris to look after Houston but told him to keep me updated on his condition.

Thirty minutes later he sent me this photo! He was outside sunning himself and he was fine!


He hasn't gone off his food yet either, in fact he has eaten more today than he has any other day this week. So we really hope that continues!

Thursday, September 10, 2009

Day nine

Houston enjoying the sun

Wednesday, September 9, 2009

Day Eight

I wish I could say I had as easy a time with Houstons medication as Kirrily did.

We both woke up early in the morning around 0230 with food poisoning. Houston was asleep on the lounge and took the opportunity of me being awake to ask for some food, which of course I gave to him. I went back to bed. I woke up again at a more reasonable hour with Houston curled up beside me. When he realised I was awake he walked around me, alternately curled up and then walking up and staring into my eyes. He jumped down at some point and started rifling through Kirrily's magazines. This is usually what he does when he is hungry, but this mornings effort was much more subdued. I got up around 0900 and went out to feed him. His bowl was still three quarters full. I threw it out and put some fresh food down for him, a tin of the expensive stuff. Which he wolfed down and then licked the plate clean. It turns out we now have a cat that will only eat the dearest cat food available.

I did some study and watched him through the open window after letting him into the back yard, he explored different napping positions. I had taken his water bowl out and I noted how frequently he was drinking.

Eventually he sat at the door, waiting patiently for me to let him in. He went straight to the food bowl and licked the plate. I saw this as my opportunity to give him his medication. A small piece of beef mince was offered and accepted. The next piece of beef mince concealed the first tablet. He managed to suck all the meat off it and spat that tablet out on the floor. Same with the second tablet. Plan B was enacted which consisted of me shoving the tablet into his mouth then holding his mouth closed until he swallowed it. Mouth prised open, tablet popped in, mouth shut, hand clamped over jaw to prevent ejection of tablet. He looked at me. I looked at him. Five minutes pass with us in this position. Surely he's swallowed the damn thing by now. I release him. He releases the tablet onto the floor.

On the plus side, he doesn't seem annoyed by the experience, but victors rarely are.

Tuesday, September 8, 2009

Day seven

Houston curled up next to me in bed

Enjoying the sun

Sneaking in another nap outside

Houston's first night home was completely uneventful - thankfully.
He spent a lot of time asleep on the bed and when Chris and I joined him, he took turns cuddled up next to both of us.

This morning I got up at 7am and he was drinking some water, so I gave him half of one of his small Dine tins and he ate about a half of that.
We then both went back to bed for a couple more hours.

When we got up I tried to entice him to eat some more of his breakfast, he ate a few mouthfuls and then I took him outside to sit in the sun.
He ended up falling asleep out there!!!

When he came inside I decided it was probably time to give him his first two tablets as part of our at home care.
He's going to be taking one tablet of Prednisolone (an corticosteroid) at home every day for the next seven weeks. He's also taking Losec, which will reduce the amount of acid that his little stomach produces.
Houston, like most cats and dogs, hates taking tablets. We usually try to make the process as easy on him as possible. We usually try and sneak the tablet in some food (usually mince) but sometimes it takes a lot of times being spat out of his mouth to get it eventually to where it should be!
I thought today might be harder since he's had so much medicine these past seven days, but he ate the two tablets inside the mince without even hesitating!!!

Good boy Houston!

Monday, September 7, 2009

Day six

Houston with his bags packed and all ready to leave hospital!

Back at home in his new favourite spot

Houston is home!!!

And we are beside ourselves with joy! It is so great to have him back, and he is slowly getting back to his normal self, before he was sick.

This morning at 0900 I called the hospital and spoke to the specialist. She said that the checkup had shown that he was doing well, he was starting to get interested in food, and, best of all, the lumps in his stomach and kidneys had shrunk a little! All fantastic news.
We made plans to pick him up at her earliest convenience which was 1430.

The day went pretty long for us, we were clock watching til we could go and see him let alone bring him home!

He wasn't in great spirits, he certainly didn't jump up when he saw us, but he was looking a lot better!
While I was paying the bill he meowed at me to hurry up and that is a typical Houston grumpy bum attitude - I don't thin he appreciated us just laughing at him!!!

He was so well behaved in the car, I hope he continues to do so since he'll be making fortnightly visits to the hospital.
When we got home I put out a special tin of food for him and he ate it straight away! He then ate some raw chicken and a little bit of mince.
He then took up residency on our window sill, and then had a nice nap on our bed.

The hospital had given him all the medications he needed today, so his at home treatment begins tomorrow.

Today we settled the rest of Houston's bill.

Chemo (including 2 overnight stays and the IV setup and maintenance) $1229.92
Balance from initial consultation (including 2 overnight stays, blood tests, ultrasounds etc) $836.80

Total vet bill to date $2316.72

Sunday, September 6, 2009

Day five

Houston sleeping in the ICU

Enjoying some chin rubs from his Mum

Today's visit was really emotional for me.

When I got there they informed me that he wasn't to be moved from the ICU and my hopes of a happy visit diminished pretty quickly.
He was tucked up in his little box in his cage and he didn't move too much when the nurse lifted the box out and on to the table.

He wasn't responsive to my visit at all and I was quickly in tears.
Just before I'd left home my Mum had called to say that we seriously needed to discuss ending Houston's pain if he wasn't too much better today. I understand where she is coming from, I hope I am not in denial for my own selfish reasons. However I really do believe that Houston wants to be alive and home with us.

It's so hard to know what the right thing is to do.

After a little while the vet came in and told me that his lack of appetite and enthusiasm was very normal after a first chemo treatment. This made me feel a bit better.

And then Houston started to pick up a bit. He started rubbing his face on my hand and purring - and that made me smile - he definitely was happy to see me!

I had taken in some fresh mince and some raw chicken. At first he was a bit interested in the mince, enough to sniff it, but that was all. Getting him to eat will be a big sign of recovery and it was something I was really hoping would happen today.

So I spent the next 20 minutes patting him and I was going to leave and thought I'd try the food one more time. This time he was a bit more interested. And then he licked the mince! I was beside myself!!!!
I could see he was interested in eating it now, so I tried giving him smaller pieces and putting them on my hand, the towel and then the lid of the little Tupperware container I had taken the mince in in, and then success!!! He was eating it off the lid. So I kept putting more on and he kept eating it!
You could not wipe the smile off of my face!

Some very poor mobile phone footage of Houston eating the mince!

After a little bit of eating the mince, he then rested his head on the lid and that was that. He ate no more food and he spent the rest of my visit with his head down and me patting him.

After another full examination tomorrow we will find out if he can come home.

Saturday, September 5, 2009

Day four

Houston and I today

Poor little Houston.

One of the common symptoms of chemo in cats is a loss of appetite for the first couple of days after the treatment. Houston has only had a small amount of food of his own accord since yesterday's first injection.

Chris and I just got back from visiting him again and we took in a selection of his favourite foods: ham off the bone, a can of Dine and some McDonald's (nuggets and the meat from a cheeseburger).
Unfortunately Houston wasn't interested in any of it.

I am going back tomorrow to try again.

The food we took in for Houston

Houston clearly not interested in the food

Friday, September 4, 2009

Day three

Houston after his first chemotherapy treatment

We got the results back this morning and Houston has lymphoma. This a very common form of cancer in cats and apparently responds really well to chemotherapy.

I then spoke to the medicine specialist about what we can do - our options.
She said there were three options:
* Chemo - a 70-80% success rate; a survival rate of 18 months at best, and 7-8 month average
* One drug - 2 week survival rate
* and euthanasia

The decision took two hours. It was NOT an easy one. The second option was definitely out; and there was no way I was making the decision to euthanise. However the chemo is going to cost us $7k approx. I know that that is a lot of money, but it wasn't my upper limit of what he was worth to me.
The big issue was how he was going to handle the chemo, if there was going to be any discomfort or pain.
Both Doctors informed us that there are very few side effects with chemo in cats; so hopefully he can have a good quality of life for the time he has left.

After talking to both Chris and my Mum (she is giving us some money toward the therapy) we decided to go with the chemo. I will gladly give up my New York trip to have Houston with us for another year, and of course there is a chance it will be longer than a year!

After telling the hospital what we had decided it all moved very quickly and Houston had his first chemo treatment at midday. The Doctor said he handled it all very well.
He will now have the treatment once a fortnight in hospital and once a fortnight at home for 17 weeks; and then that will change to once a month. That is all dependent on him responding well to the treatment - which we should know after two or three treatments.

I asked the specialist during my visit this afternoon how we should expect Houston's death to eventuate. After this huge shock I felt like I should be prepared. She said that they will be monitoring him very closely and will not hesitate to tell us that treatment isn't working, that Houston is uncomfortable and that euthanasia is the only answer. I found this information really comforting. Of course it's not something I want to think about or want to happen anytime soon; but it's nice to know that they have a plan AND that they have Houston's best interests as their top priority.

Thursday, September 3, 2009

Day two

Houston at the hospital when we visited

The Dr called me this morning and said Houston's bloods were OK, except for some unusual kidney function. So pretty much what we expected. I thought this was good news.

She then informed me that the lump they had found the night before was still in the same spot, the same size and density. They wanted to go ahead with the ultrasound. She offered the ultrasound at a reduced cost (half price) and I gave them the go ahead (though I would have regardless of cost.)

After the ultrasound she called me again and said that it looks like the lump is a tumor.
It also looked like his kidneys were bigger and distorted than they were last year. She thinks he has cancer in there too.
They took some cells off the tumor and kidneys during the ultrasound and we will get the results from that tomorrow.

Chris and I visited him after his ultrasound and he was looking a lot better, but he was happy to just sit in his cage.

I spent the entire afternoon in a daze, crying and stressed. I am so worried about him, and also how I am going to deal if we have to say goodbye to our baby.

Wednesday, September 2, 2009

Day one

Houston watching me get into the car this morning

Today we took Houston to the hospital.

He'd been a bit lethargic the past few days and was off his food and drinking more water than usual.
We thought he might have had some form of kidney disease as he had been born with a small left kidney.

It was decided he would need to stay in overnight to be rehydrated and have some bloods taken.

During the initial examination the Dr also found a lump in his stomach. They asked if they could ultrasound the area. We were a bit reluctant as the last time we visited with Houston they said they had found a lump, however it was never found on the ultrasound OR X-ray. All we were left with was a huge bill. We didn't want to compromise Houston's health, but we also wanted to be sure the procedure was justified.

So it was decided that we'd wait to see how the lump was the next day, and also what the blood tests revealed.

We had to leave a $250 initial payment for his stay.