Higgins Case Study  

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Other Diseases/Conditions: Galloped heartbeat Story: Higgins came to our family at 5 months old, having been a feral kitty in a nearby town. A woman had noticed him wandering around and had been putting food out for him. One day, she decided to try and pick him up as he ate, while she had her dog on a leash in her other hand. Of course he completely freaked out and bit the woman which led her to call animal control. They managed to trap the little guy and he spent 10 days quarantined to make sure he wasn't rabid before he was shipped off to the local animal shelter. That's where we found him two days after he had arrived, and though we were warned he would be the cat to nip your ankles when you got out of bed at night, he seemed to be the cat most interested in getting out of that place. So my husband and I took him home and hoped we would be able to handle such a feisty kitty. He was definitely a rambunctious little boy, getting into everything and leaving us with more than a few scratches. Higgins is 10 now, and has settled into his very comfortable life with us and our other kitty, Claudia but is still a handfull. While he is quite affectionate with us and tolerates people he knows, he runs from anyone he doesn't know and will become aggressive if someone tries to handle him. His yearly check-ups have become known to my husband and I as his "Alien Abductions", since he needs to be anesthetized and awakens disoriented and grumpy for the duration of the day. Other than a bout with a blocked urethra (male cats are proned to this) Higgins has been a healthy, fairly active cat. It was this past winter that we noticed he was losing weight, but chalked it up to him becoming a senior. His appetite was fine and so were all of his other behaviors. Only as of this June did he start to look as though he was much too rapidly losing weight, so I set up a vet appointment and we braced ourselves. Getting Higgins to the vet is a project...it usually begins with luring him with a treat of some sort into a room that is closed off and then as he eats we drop a rubbermaid tote over him and slide the cover we have fashioned with airholes underneath. Once we know the lid is secure, we carefully right the tote and apply duck tape to the handles. Oh yes, he can get out of the tote otherwise, we found that out. And then try getting him back in... It was in the few days prior to his appointment that we started to really see a change in his behavior. He usually sacks out on the couch or in the middle of the floor wherever the sun is, but he started going to a corner of our screened porch under a table. He just didn't seem himself and became increasingly lethargic. We also started to become concerned because we weren't sure if we were imagining it or did his color seem off? Our vet confirmed he was in fact jaundiced and that his liver was extremely enlarged, and yes had lost too much weight. His ideal weight, being a larger framed cat, is 10-12 pounds. He was just under 8. Also, he had a galloped heartbeat, probably due to the stress his body was under. We were told that we were most likely dealing with cancer, and should do a needle aspirate biopsy. We agreed and left the vet quite shaken after the appointment with a prescription for Baytril, Denamarin (a liver supplement), a new diet of Hill's AD and the knowledge and equipment to administer sub-q fluids. We both balled our eyes out when we got home at the thought of losing our little man, and faced with the daunting tasks of pilling and hydrating such a difficult cat we worried we wouldn't be capable of providing his medical care. I think it was only through sheer luck, the grace of God and some careful planning, that we were able to do both, at least for a while. After a few days we finally got a call with our cell cytosis results. They had found no cancer, only inflamation and an extremely elevated white blood cell count. They believed it most likely to be hepatitis, curable with another round of antibiotics after we finished our present one, and we were to also start giving him metronidazole in addition to his current regimen, in case it could be another infection of some sort. We scheduled another appointment at the end of his first antibiotic run to do a CBC and make sure he was responding. My husband, Mark & I were elated! What a scare! Thank God its not the "C " word!... As it turned out, he wasn't responding at all, in fact his WBC count was still climbing, Higgs was still losing weight, and at that point we were told to finish up our second course of antibiotics and were referred to a specialist. By the time we got to the specialist, we were all really worn out - it was becoming quite difficult to hydrate him and he was catching on to us that his pill pockets weren't just a treat. He wasn't obviously declining, but Higgins wasn't making any marked improvement either. Not knowing if anything we were doing was making a difference was really taking its toll. He had an ultrasound, which really showed nothing except the inflamation we already knew about. We were advised to do a biopsy where tissue was actually removed, and exploratory surgery was put on the table as an option as well. They weren't sure that the biopsy would necessarily give us any insight into Higgins condition. Surgery would be invasive and costly, then there's the chance a cat in condition might not recover well, and if they found out he was really a mess in there, would we want to wake him up at all? We decided on the biopsy, we didn't want to put him through surgery unless we knew exactly what we were looking for. At this point, antibiotics were on hold and we started Higgins on 10mg of prednisone a day in addition to his denamarin. Two days ago, 7/16/08, we got the biopsy results. It was stage 4 lymphoma. Words cannot express the images of fear and sorrow that flashed through my head and heart when I was told. I couldn't believe what we were being told. His prognosis was that with aggressive chemo for up to 48 weeks, we might be able to extend his remission time 6 months to a year, if he responded well. Otherwise, we could keep him on the prednisone and it might be weeks to months. We had some serious decisions to make. We asked all the questions about side effects, the frequency of visits,the costs associated with chemo, and did the end justify the means? Were we just going to prolong the inevitable, and to whose benefit, ours or Higgins? We struggled with this and questioned ourselves over and over. We have decided to keep him on the prednisone. Actually, our vet recommended we try a depo medrol injection, as he will respond quicker to it and it will be more aggressive in extending his time with us. We just can't put him through the stress of a chemo regimen...it's too much for him and he's too difficult a patient. And yes, it kills me to say it, but its too expensive. We want Higgins to be as happy and comfortable as he can be in last days. From here in, he gets anything he wants and as long as he's not in pain and still continues to eat and drink and have his facilities about him, he can stay at home and we'll do whatever we can for him for as long as we can. He's an integral part of our family, and we just don't want him to be miserable or to suffer. We'll hope the depo medrol does well by him and I'm sure he'll let us know when its time. Outcome: Updated July 22, 2008 - So very sad to be writing this today, we had to let Higgins go. The past few days he started to decline... Sunday we had a very difficult time coaxing Higgs to eat and he seemed less interested in goings-on than usual. His breathing had become very heavy and he seemed much weaker and tired. Monday morning we awoke to find he had diarrhea and a few accidents through the night. We tried to get him to eat, even offering deli ham which he turned down, and he then went to hide under the bed. This was quite unusual for him, and my heart sank. When Mark & I arrived home from work, the house was a mess - Higgs had been sick several times and had a few accidents. He did not get off the couch to greet us - we knew it was time. We called our vet and struggled through the night, was this the right decision? It was heartbreaking today, but our vet was very kind and reassuring that what we were doing was the last, best act of kindness we could bestow upon our little man. It was best to end his suffering before it became too great, for him, for his companion Claudia, and for us. The decision was clear, quality, not quantity and we know he did his best and so did we. We love Higgins very, very much and I can only hope his story helps others faced with what we've done and been through...See you on the other side, little man. God bless. Outcome: We'll keep him comfortable and happy for as long as he wants us to. He's a trooper - he's hanging in there. - By Michelle Higgins Mom -

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