My Name is Leo

An adored cat deals gracefully with a jaw tumor while his owner quietly falls apart.

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Location: Philadelphia area, Northeast, United States

Thursday, September 28, 2006

Mixed Blessings

Leo's tumor has definitely gotten bigger over the past couple weeks...although it seems wrong to call it a tumor, since it's grown off into two separate areas -- the left side of lower jaw big round protrusion and the inside the mouth extravaganza (which seems to be at least two smaller lumps.)

The growth inside his mouth (popping up on the left side) had been pushing the tongue off to the side. In my last post I mentioned that Leo's tongue wasn't hanging out the side that day...

...and it hasn't hung out the side since.

Looks like the tumor must have grown, so now that it's not only next to his tongue, but also under his tongue.

Although that sounds bad, in fact, it has been very good. It's made his tongue move back more into its normal place.


Sleepy kitty! This photo shows how his tongue is back where it belongs. The arrow is pointing to where the tumor has also grown out on the side of his mouth.

When his tongue stuck out the side and he had to lap food up in a convoluted way from that side of his mouth. Now, he's back to lapping up in the front like a normal kitty.

Consequently, he's eating way faster -- and more! Maybe because it's easier now, he's just wanting to eat all day long.

Since the tongue moved back, I've been able to crush up pain med into mayo (yes, cats like mayonnaise) and let him lick it off my fingers. When I tried that with the side-tongue, I ended up having to just stick the mayo-mixture into his mouth and most of it ended up on his chin.

However, most of the time I'm still just pilling him the usual way, just to make sure it's all getting into his system.

On the negative side, his mouth was bloody this morning -- dark blood, so it was from overnight. He's hardly bled at all in the last few weeks since being put on the pain medication, so that was a surprise. However, it didn't bleed any more when I pilled him this morning or get any worse when he ate.

Also, yesterday I started back on the half-dose of antibiotic twice-a-day regime. Being a wily cat, Leo was managing to spit out quite a bit of the Clindamycin when given the full dropper's worth. This with me holding his head up, rubbing his throat and just waiting...waiting...until it seemed he must have swallowed the liquid. But he'd just be there biding his time with it pooled in the back of his throat and as soon as I'd let him go he'd shake the liquid of out his mouth.

So, at least with the half-dropper I can drip it in slower and he is getting most of it into his system.

Anyway, it's really all pretty good here, at least in comparison to a month ago. So much less slime drool! If I hadn't gotten Leo on the torbutrol (pain med) I don't think he'd be here today.

Sunday, September 24, 2006

Eight Month Mark

Yesterday marked eight months since the tumor was found on Leo's lower jaw.

This will be a short post, but I wanted to update on his medications and his condition.

The puffiness under his chin I wrote about earlier (a week and a half ago?) went away by itself (with the help of his regular ongoing antibiotic.) And he has been eating well (mostly just meat varieties of baby food.) In fact, some days he's in and out of the kitchen all day lapping at food.

He's probably eating about 4 jars of baby food a day. I try and get him to eat a little a/d food to get cat-centric nutrition, but at this point, I'm just happy he can eat anything.

About 10 days ago I started making the intervals between his prednisolone doses longer. This was not under his vet's directive, but my own decision...and a few days ago I changed the dosing on his antibiotic as well.

Regarding the pred -- it's now just 5 mg every other day. He has seemed much less jumpy on this regime. On the other hand, I'm pretty sure the tumor grew larger on the side of his mouth. And today, his tongue started hanging down in front (as opposed to its previous sassy hanging-out-the-side position.) I don't know if this is a new trend or just tongue position du jour.

He's got some bald spots on the right side of his face (non-tumor side) and underneath where the puffy spot was. The underneath part he scratched off himself(maybe it itched as the presumed infection healed) and the side bald part are mostly where I had to cut mats off his neck.

Anyway, it makes him look even more off-kilter, but he doesn't mind. He even likes me to rub where there is just bare skin. Actually, he's got a peach fuzz growing back in most of the spots.



Look at Leo's face (left side in photo) and you may notice his lack of fur on one side of jawline/neck.




Leo still looks pretty good from the back -- he even has a bit of a milk-mustache (beard?) going on here.

Regarding the antibiotic dosing: all along, the Clindamycin drops bottle states cat dosage as being once every 24 hours. For whatever reason, my vet had me giving Leo a half dosage twice a day. Maybe it is supposed to be easier on his system this way. I just started doing once per day about four or five days ago. It seems to be doing just fine in controlling any potential infection.

The rationale behind all this is multi-faceted, but I'll try and explain it in a way that doesn't make me seem irresponsible! Having to squirt/pill Leo five times a day was much stressful on both of us. So much so that I decided to eliminate as much as possible. With the new regime, we're down three meds one day and four the next.

The prednisone is meant to 1) control tumor growth and 2) provide pain relief. Since the pain medication (torbutrol) does a better job than the pred, pain relief wasn't effected by reducing his pred...and as far as #2 -- at this point, well, the tumor's been growing all along. And maybe faster is better than slower after eight months of this ordeal.

The benefits of reducing dosage: long-term steroid use isn't the best thing for any animal. All along it's been making him jumpy and he seems much happier in the last couple weeks and very affectionate.

And another side effect of pred is that it lowers the body's resistance to infection. So I am hoping that by reducing the pred I am reducing chances of infection in his mouth.

I was thinking of trying to get him off pred altogether, but the every other day seems to be working alright for us now, so I'm going to stick with that for a while.

Well...so much for a short post!

Saturday, September 16, 2006

Look Ma - No Drool!

Just a couple of photos taken today - hopefully, they show how Leo is looking much better since his pain medication (Torbutrol) has reduced his drooling and improved his eating.



It's all relative, but he looks pretty good to me. Not like his pre-tumor glamour days, but definitely an improvement from the Slime Machine of a month or so ago.

Leo's happy-cat-having-face-rubbed pose.

Thursday, September 14, 2006

Mea Culpa for the Cranky

Sorry if I was a bit cranky in my last post.

My kids are in the only school district in the nation - nay, the entire universe - that hasn't started the school year yet. And the parts for my non-functional washing machine have been "in the process of shipping" for two weeks now.

Anyway...

Yesterday I realized the Leo was really looking better. More like himself than he has in at least a month.

(This would be a good place for a photo, but I haven't gotten anything uploaded recently. Maybe tomorrow.)

Looking better aside, his sticky drool still has him smelling like a dank, damp, used handkerchief (if any of you reading this are old enough to remember when people used handkerchiefs instead of tissues and how bad they smelled.) His nickname's now "Mr. Stinky," although I mean it in the most affectionate way.

Smelly or not, Leo's been wolfing down meat varieties of baby food like...well...a really, really hungry baby that looks like a cat with a jaw tumor.

I've been offering a bit of the Hills a/d food watered down too - trying to get at least a little of the cat-specific nutrients into him every day.

So he's put on enough weight that he's more than just fur and bones.

And I can just plop the food in a bowl and he can eat without any assistance from me whatsoever and very little mess. So much easier than the Fancy Feast assisted-feeding routine that used to take hours every day.

And after two weeks since the addition of the pain med, he's getting used to the five times a day I have to insert stuff into his mouth -- he's been much less scared of me as far as the pilling (Pred and Torbutrol) and liquid meds (Clindamycin) are concerned. He knows he will get some sort of food afterwards, so that is his motivation for not fighting me as much.

Not that he still doesn't try and hide pills in his mouth and spit them out when he thinks I'm not looking...!

I also decided to wean him off his prednisone - down to 5 mg every other day. Started yesterday, and so far so good.

Whether the pred has been controlling the tumor growth in the past 7+ months - who knows? But I do know it's been making him a bit jumpy all along, and at this point I'm more interested in seeing if reducing the steroid in his system will make his last days/weeks/months? more comfortable.

We've had a good couple days anyway. Although most of the time I've got the Lisa Kudrow/Friends song "Smelly Cat" going through my head. Continuously.

Wednesday, September 13, 2006

33 1/3 Weeks Past Diagnosis

Over the weekend, I noticed a soft spot under Leo's chin. About the size of a marble.

It seems a pretty obvious sign of infection, as his tumor is very hard. He'll let me press on the soft spot, but not for long. I'm pretty sure there was already a growth there, so it's probably just puffiness on top of part of the tumor.

Anyway...he's already on antibiotics and pain med, so I decided to take a wait-and-see approach. And the soft area hasn't progressed in size and Leo's been acting like nothing's wrong (well, other than the ongoing so-very-much-is-wrong stuff, like having a giant lump inside his mouth...)

Lately, I've felt more than a bit defensive about some well-meaning input I've gotten from some certainly caring individuals who have given me advice. This advice has ranged from "let him go" to suggestions of alternative treatments that might cure him.

I find myself pretty skeptical regarding alternatives remedies...since all the stories ultimately end the same sad way. I don't need to stretch this process any longer than the 7 1/2 months it's already been stretched. And my wallet cannot afford a wild goose chase for a cure.

As far as it being the time to let him go...believe me, there is nothing that would make me keep Leo alive a second longer if I thought he was suffering significantly. And I'd like to stress that I am not carrying this on for my benefit...because although Leo is still a purring machine, I'm not getting much out of the relationship at this point.

If anything, caring for him is so hard for me mentally, so time-consuming -- trying to keep him (and the house) relatively clean and dealing with his odor...

But I feel like I owe him for 12+ pre-tumor years of maintenance-free love he gave me.

At this point, the only motivation I have is to not rob him of life when he is still energetic, eating, and purring.

That said, I have decided to not take any extra measures to drag this on. If this soft lump under his chin progresses into something more...well...the white flag will be thrown.

Wednesday, September 06, 2006

32 1/3 Weeks Post-Diagnosis

When I start using fractions in my post title, it's a sure sign I'm going nuts.

But in a good way now, I guess.

As I type this sitting on our family room couch, Leo is laying along the top of the cushion behind me. Just like the good old days.

Since my last post, the pain medication didn't seem to be doing the trick as well.

On Saturday, he went most of the morning without eating. It may just be that he's tired of the a/d food, but he didn't want any Fancy Feast either. But then he ate great that night...so it was off and on...

His body language told me he wasn't always feeling as good as he had been when he first started the Torbutrol. Again, it was intermittent -- so a call to the vet could wait until the end of the holiday weekend.

Yesterday, the vet upped the dosage to 2.5 mg twice a day (up from 1 mg.) I halve a 5 mg pill, so it's only 1 pill per day, which saves some money too. This Torbutrol is much more expensive than Leo's prednisolone, which is only about $8 for an entire month. I don't have the receipt in front of me, but think it was about $20 for the 10 Torbutrol pills they gave me yesterday.

Anyway, back to Leo. I thought maybe when I upped the pain med today he would go back to eating ravenously again. Nah. He only wants to lick up watered down food.

I decided to step back regarding feeding...I will provide food for him 24/7, but I'm not going to force-feed him. And when he doesn't want to eat anymore, that will be the sign it's time to let go.

The good news is that the pain medication has significantly reduced the slimey drool. My guess is that some of the drool was due to irritation.

This is a huge plus -- I no longer need to hover over him as he eats to pull off strings of drool sliming out of his mouth.

Don't want to make it sound too sunny. Leo still pretty much always has a gooey chin, but the long drool strings dripping down aren't a constant anymore, and that is a major positive.

And because he's only lapping up food, he doesn't do that hitting himself in the face while he's eating anymore.

And his mouth has barely been bleeding lately. And the jaw/mouth tumor hasn't grown noticeably recently.

On the downside:

I probably spent about an hour today cutting mats out of his mane (is "ruff" the technical term?) Leo kinda liked it (when a mat was released, he purred happily), kinda tolerated it (knowing it would eventually make him feel better), and definitely was looking for an escape route as it dragged on and on.

So there's still a giant lump of knotted fur between his front legs. I really want to get it out, because the mats end up pulling so hard on his skin that he's got a few bald spots.

In addition to my annoying grooming, being medicated 5 times a day has made Leo run away when he sees me coming. Growling is commonplace as I pill him.

I'll admit to shedding a few tears over this. The cruel twist is that I'm working so hard to prolong his life only to have my efforts make him hate me.

In reality, it hasn't come to that.

Still, if he didn't seem to forgive me...didn't still flop down at my feet to be petted...well, I wouldn't be able to stand the pilling and the drops.

I do feel Leo's a little confused as to why his (formerly) nice human is annoying him so much. But I always follow up the nastiness with food or milk.

Which is probably why he's currently lying behind me, with his fluffy tail draped across my shoulder, purring loudly. (A combination that I believe is Cat for, "Feed me, please.")

Friday, September 01, 2006

Update

I'm pleased to have some positive news -- Leo has been eating close to a normal amount the last couple days and actually doesn't feel skeletal at this point. Boney, yes. Skeletal, no.

He's been eating only Hills Prescription a/d food. Amazingly, he's not tired of it yet. I tried Fancy Feast yesterday, but he only gave it a half-hearted try.

The pain medication (Torbutrol) that he started Wednesday seems to get him a little high -- even at the low dosage of 1 mg twice a day. It's prompted him to push his nose into the food while eating, and kinda rest his face in the food from time to time....and he has seemed just the tiniest bit wobbly on his feet (a bit of sashaying while he walks) when the med first takes effect.

But he's jumping on and off things and going up and down stairs without any problems, so he's not too whacked.

Although he still doesn't seem to be sleeping his normal amount, he has returned to spending time alertly looking out the window. He hadn't done that for weeks -- which I didn't really notice until he went back to it again.

Anyway, for informational and amusement purposes (okay, just the first one is mildly amusing) here are some recent photos. Skip the last three if you're not interested in the inside of a cancer cat's mouth.

SATURDAY: HOPING TO START A NEW INTERIOR DESIGN TREND

We've got one nice piece of seating in the house. True, it's a hand-me-down, but a gently-used hand-me-down. Leo showed no interest in it since its arrival about 9 months ago, so the seating surface was unprotected.

THEN, about a week ago, I found drool evidence on both the seat and the throw pillows that suddenly he was liking the loveseat.

So, I covered it in junk (theoretically temporarily) to break him of the habit...evidently, even newspaper couldn't discourage our determined friend.



WEDNESDAY: WINDOWS ARE MORE FUN WHEN YOU'RE STONED

From this angle, he looks just like his old self...



ALSO WEDNESDAY: NOT LIKE HIS OLD SELF


This photo is included to show how Leo's tongue is pushed up and over on his right (your left) side of mouth by the tumor.


OKAY, HERE COME THE GROSS PHOTOS (WITH HELPFUL ARROWS, CIRCLES AND OTHER MARKINGS). AT LEAST THERE'S NOT MUCH BLOODY DROOL IN THESE:


TUESDAY


WEDNESDAY

I've included these simply because I've found very little in the way of pictures when searching for info on feline oral or jaw tumors.

Since I haven't had Leo biopsied, I suppose these are not as helpful as they would be if I knew if he had Osteosarcoma, Fibrosarcoma (vet thought it was one or the other) or whatever...

The only oral tumor that we can pretty much rule out is SCC (Squamous Cell Carcinoma) because everything I've read on that indicates that Leo would have been a goner by now. He's survived seven-plus months with this thing, and SCC seems to claim its victims in two to three months.