Shadowlands

This is something that I almost didn't write but I need to write it to keep going here, so forgive me my sentimentality.

I won't lie - having the Secret Cat die last week was awful.  She was 19 years old, and although we didn't start to look after her until she was about 10, it still feels like a lifetime.

In the end, we had her put down by the vet.  She had been deaf and blind for about a year.  Surprisingly, she adapted well to moving into a new house, and she learned to find her way around.  Gradually though, she got sicker and sicker, slowly getting thinner and thinner and wasting away.  Part of it was arthritis.  She clearly was uncomfortable moving.  But part of it was the slowly evolving diabetes that we didn't know about.

Lots of people said we should have her put down, but we always thought that she was still enjoying life.  She'd find the sunny spots somehow.  She'd find her way to the kitchen when she could smell us cooking and ask us for some meat.

In the last fortnight though, things went downhill fast.  She got painfully thin.  She seemed to have trouble walking straight and seemed to get lost.  And she sometimes got very weak and couldn't straighten her legs out.  We would find her crouched on the floor in the morning, stranded in the dark for who knows how long, waiting for us to rescue her. 

A cat that can't or won't move is a cat that is suffering.  And we couldn't watch it, and there was nothing we could do to help her.  So we took her to the vet one last time. 

It was such a hard decision to make.  I knew what my decision was though, when I found myself hoping that she had died overnight so that it would be over for her, and for us.  At least this way we could be there with her as she died.  I think she deserved that.

I'm glad that we had her put down when we did.  Any earlier and it wouldn't have been right for us - we would have felt that we did it for convenience.  Any later and it wouldn't have been right for her - she would have suffered too much.

But it doesn't make it easier when the time comes.  It had never occurred to me that you sometimes need to plan these things.  There was no last minute call to the vet, begging for help in an emergency.  There was just an appointment made, a schedule to keep.

We walked out with an empty cage.  And she danced by the light of the moon, the moon, the moon - she danced by the light of the moon.

Heartache

The Owl and the Pussy-cat went to sea

In a beautiful pea green boat,
They took some honey, and plenty of money,

Wrapped up in a five pound note.
The Owl looked up to the stars above,

And sang to a small guitar,
'O lovely Pussy! O Pussy my love,

What a beautiful Pussy you are,

You are,

You are!
What a beautiful Pussy you are!'

Pussy said to the Owl, 'You elegant fowl!

How charmingly sweet you sing!
O let us be married! too long we have tarried:

But what shall we do for a ring?'
They sailed away, for a year and a day,

To the land where the Bong-tree grows
And there in a wood a Piggy-wig stood

With a ring at the end of his nose,

His nose,

His nose,
With a ring at the end of his nose.

'Dear pig, are you willing to sell for one shilling

Your ring?' Said the Piggy, 'I will.'
So they took it away, and were married next day

By the Turkey who lives on the hill.
They dined on mince, and slices of quince,

Which they ate with a runcible spoon;
And hand in hand, on the edge of the sand,

They danced by the light of the moon,

The moon,

The moon,
They danced by the light of the moon.

           - Edward Lear

In memory of Belle, 4 March 1992 - 22 July 2011

Olfactional heavies

While I was ironing my shirt last night I noticed a strange odour rising from the ironing board.  On closer investigation I discovered that the end of the board was redolent with the smell of feline urine.  It seems that leaning the ironing board up in the laundry where the cat likes to pee on the floor may been an unwise decision.

I sniffed my shirt thoroughly since nobody really wants to turn up to work smelling like urine, but I was about 65% sure that I couldn't smell it, and hey - 65% is good enough for a credit in the subject "Not Smelling Like The Crazy Cat-Lady 101".  Besides, the Hatchling vomits, pees or poos on me most days and if I start to care too much about that kind of thing we'll have three times as much washing to do, so I just let it slide.

If anybody queries me about funny smells, I'm pointing the finger at the patients.

Insomnia

Every now and then I have trouble getting to sleep.  Usually it's because I slept in really really late that day so I was only actually awake for 12 hours or so before going to bed again.  Sometimes it's because my mind is racing with something interesting or challenging or upsetting or disturbing that happened during the day.  And sometimes it's because the Secret Cat is stomping all over my face trying to make herself comfortable.  Regardless of aetiology, it's annoying.

So I've developed a great method for focusing my consciousness and getting myself off to sleep.  It seems to work well, for me at least.  If you have insomnia why not try it and let me know if it works for you?  Here's how it works:

1.  Visualize a sphere floating in front of you, about the size of a tennis ball at arm's length.  The ball is smooth and matte and shining against a dark background.
2. Now change the colour of the sphere from however it first started.  The colour you want depends on your current emotional state.  If you are angry, make it red.  If you are agitated, make it purple.  If you are sad, make it blue.  If you are happy, make it green.  And so on.  The colour doesn't really matter, the point of it is to identify your current emotional state and make the sphere an appropriate (for you) associated colour.
3. Just focus on the sphere now it is that colour.  It will probably try to change to a different colour or maybe even a different shape but just gently nudge it back to what it should be.
4. Now, visualize the sphere gradually changing colour to a pale silvery grey, over the course of several seconds.  Hold it there.  Feel your mind relax.
5. Repeat the previous steps in order about ten thousand times until either you're asleep or the goddamn sun comes up and it's time to get out of bed.

 If I get a positive response to this maybe I'll record some CDs of the instructions and sell them in hippy shops.

Chopper

I object to my cat being treated like a common criminal.  What's that, you say?  I'm raving like a madman again?  Let me explain.  Come closer.  Closer!  Let me whisper in your ear...

We took the Secret Cat to the vet a little while ago, and short minutes later we were pushed from a dark consulting room out through the back door into the sunlight, where we stood blinking and dazed, groping helplessly in our pockets for any money that might remain.  Once we got home we realized that we'd been given some tablets to give the cat.  (Actually, the vet originally said to us, "Oh, you're medical students?  Do you have any way of getting hold of amlodipine?", to which I replied, "I don't think that breaking into the drug cabinet at the clinic and stealing the drugs there to give to my cat would be a good first step down that pathway to Hell which is paved with good intentions", so he sold us the amlodipine at a vast markup instead.)

It was kind of cute, the box had a little label printed up just like for a human prescription.  Except the cat's name was in inverted commas, like this: "Chopper" Read  (My cat is not called Chopper Read, that was just an example of formatting).

See what I mean?  Hypothetically, if my cat was called Snowball, and hypothetically if my last name was Farkas, the prescription label would be "Snowball" Farkas.  It makes my cat look like a crook, and looks trashy and downmarket and entirely lacks the dignity and quiet majesty of Snowball Farkas.

Furthermore it doesn't actually make any sense.  The cat's (hypothetical) name really is (hypothetically) Snowball.  It's not a nickname.  If anything, it's my surname that should be in quotes: Snowball "Farkas".  It's not really a relative of mine, after all.  As the old joke goes, cats don't have owners, they have employees.

Trying

Doctor

Come in Mrs MacGillicuddy!  This is PTR, our medical student.  He's the only medical student I've ever known who wears a suit.

PTR

I'm not wearing a suit, I'm just wearing a jacket because it's cold in here.

Doctor

Just as well you're not wearing a tie.  Are you very tired?

PTR

I suppose so.  No more than usual though.

Doctor 

You look glassy-eyed.  You can go home if you want to.

PTR

No, I'll try to tough it out.  But this afternoon I have to take my cat to the veterinary ophthalmologist.

Doctor

Ha ha ha!  Why?

PTR

It has hypertensive retinopathy.

Doctor

How do you treat that?

PTR

Amlodipine

Doctor

No, what you need is the Green Dream.

PTR

That's a terrible thing to say!

Mrs MacGillicuddy

Good morning!

Case history

BB is a 17 year old Burmese female who presented with almost complete loss of vision.  Due to language difficulties taking a direct history was not possible but some collateral information was obtained from her carers.  They had been away for three weeks and during that time placed her in care. Upon their return they noticed that she was disoriented, distressed and her pupils were midriatic and unresponsive to light.

BB has a past history of mild kidney disease affecting her distal tubules causing her pass large volumes of dilute urine.  Her continence remains good.  She eats a low protein, low potassium diet prepared specially for her to preserve remaining kidney function.  Her carers believe that she may have an obstetric history including some births but are not certain of this.  Her hearing has been deteriorating over the last 6 months and she is now almost completely deaf.  Otherwise her history is unremarkable save for chronic coryza.

On examination BB was attractive, well-groomed and of lean body habitus.  Her carers report her appetite as good though she has been losing weight over the last 6 months.  She was anxious and difficult to settle.  She was afebrile, well hydrated, and mildly tachycardic.  Her intraocular pressure was estimated to be normal though not formally measured.  Her lenses were clear, but observation of the retinas was difficult due to her non-cooperative nature.  BB was referred to a ophthalmologist the following week.

On examination by the ophthalmologist, BB's retinas were detached with significant areas of haemorrage and scarring.  Her blood pressure was difficult to measure precisely, again due to her lack of cooperation, but was certainly above 200 systolic.  A diagnosis of hypertension, either primary or secondary to kidney failure, was given.

BB was prescribed amlodipine 1.25 mg/day and asked back for review in a month.  Some degree of vision recovery is expected if the retinas can re-attach, although the scarring is irreversible.  The ophthalmologist's view was that she was otherwise in excellent health for such an old cat and her prognosis was good.