Monday, September 14, 2009

Doing Too Much for the Dying


Merly knew she was dying before we did, and she didn’t care. She made her peace with it before we did. Because we couldn’t accept her decision, we kept her alive another month and I don’t think it was a good month for her. I feel bad about that.

Merly’s life was eat, sleep, sit in the sunroom and look out the window. When there was an opportunity to go outside, she went out to eat grass and roll on the warm cement. Then she was ready to come back in. Sometimes she wanted her head scratched and would head butt you until you rubbed her. She liked being brushed. She did not like being picked up. She never had a bath. She did not like riding in the car so only went to the vet when it was absolutely necessary. She lived in four different houses and she adapted well to each one.

She did not socialize with the other cats in her last few years, or very much when she was younger. She kept to herself. Because of her size, all she had to do was hiss and the others would scatter. No one pestered her.

She was no trouble. She ate whatever food was available. I can’t think of any food that was her favorite. It was all good. She didn’t like missing a meal so often sat on the dining room table so she would be first. I suspected she ate all the leftovers, too, even if they were a day old.

She liked splashing her paws in the water bowl. She liked jumping up on the breakfast bar and sitting on the bills whenever I had them all spread out. She would rub her face against my pen when I was trying to write checks.

All that was her total life, and when she no longer felt like doing any of it, she had no reason to live anymore. In cat years, that happened when she was 13, which is 73 in people years. I guess that is a good life, but she seemed so healthy right up until the last 60 days, we didn’t think about her being old.

Merly was seriously overweight starting soon after we had her fixed when she was about a year old. At her heaviest, she might have been 17 pounds. Her stools were the largest and smelliest of all the cats, and she didn’t bother to bury them. Around 2005, four years before she died, I noticed there was sometimes blood in her stools. We took her to the vet about it, but their cursory examination didn’t find anything. I researched bloody stools in cats on the Internet and couldn’t find anything alarming about it. To discover if this was an early sign of what would eventually kill her would have cost hundreds of dollars in uncomfortable tests, and then what? If she had been a human, we would have done it, but she was a cat. She didn’t seem bothered by any digestive problems. We didn’t worry whenever the blood appeared on her stool like a garnish.

Four years passed. One day she was sitting on the bills on the breakfast bar and when I moved her off, I noticed small droplets of liquid stool on the envelopes. Why was she dripping? That was the first sign something bad was happening, but it didn’t happen again, so I didn’t do anything. I feel bad about that, but it may already have been too late.

In the middle of May when we took her to the rabies clinic at the fairgrounds – where she mournfully expressed her distress at being in the car – she seemed to be her normal weight. At least that’s what we remember. When you’re not looking for signs, you don’t really notice when they begin.

But soon after that we couldn’t help but notice she was getting thinner. We thought it was a good thing. Maybe she wasn’t eating as much and was finally slimming down to normal cat size.

By June, we could feel the bumps of her spine along her back. She was losing muscle weight, too. She wasn’t jumping up on the breakfast bar anymore, or the dining room table. It was time to take her to the vet. She didn’t like the car ride.

The vet felt a mass in her abdomen. I blame the vet for being too tactful with us. He was certain she was going to die sooner than later and this mass was not a good thing, but he kept offering things we could do. We could leave her for the day so they could put her on an IV and rehydrate her. We could bring her in the next day for another day on the IV. We agreed to both. Merly didn’t appreciate the two days in a cage at the vet’s. Her choice, if she could talk, would have been to skip the rehydrating and stay at home. She didn’t care about living an extra month. To do what?


I can understand that people want to do something for their dying cat, so vets make offers of various things, costly things, futile things, that humans can do to make themselves feel better. The cat, on the other hand, doesn’t want to do any of it. They just want to die quietly, soon, and on their own terms. They are not going to miss you. They aren’t going to miss being alive. They aren’t afraid of death. All they know is they don’t want to hurt or feel even a little uncomfortable and strange, and if they don’t feel like eating anymore, if they can’t eliminate without messing themselves, if they’re too weak to jump up on the table and look out the window at the birds, then why live? They don’t care about living. Or dying.

Merly wasn’t looking out the window anymore. She wasn’t interested in eating unless I brought it to her, and then she only took a few bites. She couldn’t climb into the litter box anymore, and so sometimes she had accidents, even after we got her a box with a door open to ground level. We’d have to clean her up with a damp washcloth and she didn’t like the bath. She looked at us like we were just annoying her with all this attention.

She had already picked her place to die, on the floor by the side of the bed. She liked the bowl of water we kept there and drank often from it, although she had to tip her head to the side and got half her face wet. And she was too tired to dry herself, so she just sat there with a wet face. That upset me more than anything. I should have known that was the end. We were done. She was done. When she felt especially bad, she’d creep halfway under the bed, too tired to make it all the way.

But I kept pulling her out, kept trying to get her to eat. Trying to dry her face for her. I even tried force-feeding her with a syringe. If she had the strength, she would have slapped me away. If she could talk, I know she would have said, “Leave me alone!”

I agreed to x-rays, and the mass was clearly visible and growing rapidly. We declined the offer of exploratory surgery because the only point of it seemed to be to tell us what was going to kill her. No vet would offer even the possibility that they could cut the mass out and she’d be good as new. We feared we’d get a call while she was still on the operating table that it was indeed cancer and there was too much of it and the best thing to do would be not wake her up. We didn’t want her to die that way, although in the end, even that would have been better than the way we finally let her die.

The best choice, of course, would have been to do nothing. She knew it was time. She was good to go. She picked her spot next to the bed and she was waiting it out. I think she would have passed by the end of June if we had given her that privilege. By not eating or drinking, she would have quietly euthanized herself ahead of the mass getting too big.

After Merly died, my husband’s aunt told me stories about how her cat and dogs had died. Both just disappeared into the woods behind her house and were never seen again. They never found the bodies. Her other dog kept moving out to the driveway, which is as far as he could get. She’d carry him back to the garage, and he’d drag himself back outside again. They want to die outside, away from people, away from everything, by themselves. Goodbye. It’s been nice. Time for the woods. Or under the bed.

The couple of times I took Merly outside during the last couple of weeks, she walked slowly to the edge of the yard and then sat down with her back to the house. The first time she had enough strength to roll over on her back and let the warmth of the sun touch her one last time. Watching her, I prayed she would die right then. It seemed like the perfect moment, but she didn’t.

The next time was a disaster. She was in such a weakened condition, with her stools leaking, that flies were landing on her. They left maggots in her, which meant another trip to the vet to pull them out of her anus. He tried to make it sound like a good thing. “Maggots eat the diseased tissue,” but how can having maggots in you ever be a good thing? So that was the end of her going outside. By that time, Merly was really fed up with our interfering with her death.

She had chosen the date – end of June – and the place, under the bed. Here it was the middle of July, and I was carrying her around the house, wrapped in a towel to catch the anal seepage, because I didn’t want her to die alone. 

All she wanted to do was die alone and I was getting in the way.

I feel bad about that now.

Maybe if I had not rehydrated her, had not kept forcing her to eat, not kept squirting water down her throat with a syringe, she would have died peacefully before the tumor got as big as a sweet potato, according to the vet the last time we took her in. Maybe she wouldn’t have had the seizures, or at least would have died after the first one. But no, I had fortified her body to keep going, and it took eight seizures to weaken her to death. And even then I couldn’t bring myself to rush her to the vet and have her put down. She didn’t like riding in the car. She didn’t like the vet. It was the middle of the night. I kept telling myself all these excuses. I wanted her to die at home in my arms.

But that had not been her choice. She wanted to die alone under the bed when we were sleeping, and she wanted to go before things got too bad.

I feel guilty that I didn’t let her.

After the first seizure, she never really looked at anything like she was seeing it, or made any noise, so she might have been only technically alive those last hours, but even then, she waited until I finally left her alone for a minute to go to the kitchen and get a donut. The short time I was gone, that’s when she died.

That’s all she had ever wanted, to be left alone.

I feel so bad about what I did to her, which was I did too much when she wanted none of it.

Thursday, September 03, 2009

Regrets of a Multi-Cat Household

Ever since Merly died, there's been a disturbance in the force -- the cats are behaving differently. For instance, Arbee, who had lived with Merly the entire time she's been with us, seems liberated all of a sudden. She's no longer hidden somewhere in the house. She's often out in plain view, even making contact with the other cats.

Did Merly intimidate her for a decade and I didn't know?

Merly's death has given me a lot to think about regarding the disadvantages of having too many cats. We were slow to notice her weight loss. Although I suspected the foul smelling stools, sometimes flecked with blood, belonged to her, I could never be sure. I did take her to the vet because of them four years ago, but there were no other indications of a problem then. The one time I noticed she had some anal leakage, I didn't do anything about it because it didn't recur. I wonder now if Merly had been my only cat, if I would have acted sooner on that.

The problem, is testing animals to find out if something is amiss is very upsetting to them. They don't understand and you cannot explain what is happening to them or why, that if you leave them with the vet, you're coming back. Because I give my cats feelings and thoughts which they probably don't actually have, this prevented me from seeking medical help sooner.

Also, I could not monitor her stools, her vomiting, or even if she was eating normally because with seven other cats, you don't know who is doing what unless they do it in front of you.

So we let her lose almost half her body weight before we took her to a doctor. The other problem was because she had always been obese, at half her body weight, she looked like a normal cat. I should have known something was profoundly wrong when I felt the lumps of her spine on her back -- that meant she was losing muscle mass as well. I let things get too advanced.