These Are Not Tears, Smoke Is In My Eyes

Though it seems as if it’s been months, it’s “only” been five weeks since the morning I came out of our bedroom at 8:00 am and instead of being greeted by Smokey, our bouncing grey basketball of fur, I found him lying in a heap in the hallway, motionless and too ill to stand. Since then there’s been a lot of lap-time and tears, because I know he’s in pain, and I’m tired, and hoping that all I’m doing will help him survive. 

It was sudden, at 2:00 am he had insisted on going for a run in the long corridor that serves the wing of the building we live in. He thundered down the long run, stopping to sniff at the doors of those units where other cats and dogs live. When we got back to our own door he took off and ran down to where the wings intersect and ran down an adjacent wing and back, scampering like a kitten.  

Mr. Smokes on a better day

Our vet’s office starts taking calls at 8:30, and as soon as we were able to get him into the office we had him there. She examined him and noted that while he had no fever he had extreme jaundice. His ears, eye membranes, and gums were a deep peach colour. When his blood tests came back we learned his bilirubin level was over 100, when it should have been no higher than 3.  The question was “Why?” 

She prepared us for the most likely and worst possibilities; feline leukaemia, feline HIV, liver cancer or possibly gallstones, which could be treatable with surgery. When the leukaemia and HIV tests came back negative the next step was to seek the opinion of a specialist who could do an ultrasound looking for a liver mass and/or gallstones. This was quite a trip (45 km), with Ian doing the driving once and me doing it the second time, but from the ultrasound we learned that he had almost certainly had had a gallstone which he’d managed to pass, probably overnight, but which had backed up horrendous amounts of bile in his liver and body tissues. They’d shaved his belly for the ultrasound and his normally pink-white skin was absolutely the colour of an over-ripe peach. 

More ominously the ultrasound revealed he had hepatic lipidosis, a frequently fatal liver condition in cats. Hepatic lipidosis happens when an abnormally high amount of fat accumulates in the cells of a cat’s liver. Even though there is all this fat in reserve, a cat has no ability to convert these fat reserves into energy when it does not eat. When a cat doesn’t eat for 24-48 hours its liver can begin to fail, especially if there are other factors going on, like a gallstone, which has filled the liver with bile. 

Smokey, who is usually a chow hound, ate very little on Saturday, and almost nothing on Sunday. He had slept a lot and seemed a bit lethargic, but then on Sunday night, or early Monday morning, he ran up and down the hallway like a kitten. In retrospect maybe he was in pain on Saturday and Sunday, and that running and jumping was an attempt to dislodge the gallstone blocking his bile duct.  (Apparently it worked!)  

Once we had our diagnosis the treatment plan was clear, but the outcome was not guaranteed. Many cats do not survive hepatic lipidosis. We came home with medication to stimulate his appetite, because getting food in him was to be his only chance at life. My job was to feed him a half-teaspoon of food made into a slurry, so he could just lap it up, every hour around the clock. This was as big a challenge as having a newborn.  

We were back to the vet’s for medication for vomiting, for IV fluids, for more appetite stimulants, for probiotics, to have him weighed. 

After two weeks we moved to feeding him a teaspoon of food every two hours. Profound gratitude.  Now I feed him at 2:00, Tony feeds him at 6:00 and I feed him at 8:00, so I can actually get some sleep. 

Five weeks and we’re still not out of the woods. One day in three or four he eats well, the others I have to take the bowl to him, wake him and urge him to eat a teaspoon of food. He may eat only two or three teaspoons of food on those days, and I fret all over that we’re going to lose him. Recovery from hepatic lipidosis can take months. He’s still jaundiced, his ears look waxen and his poor little naked belly is the soft, fuzzy yellow of apricots. 

Hobbes the little brother, has stuck to Smokey like a burr. He was very upset when Smokey was away at the vet’s. Now when Smokey lies down Hobbes will soon snuggle down beside him, and the two sleep contentedly side-by-side, for the better part of the day, and night too. 

It is not yet the end, because it is not all right yet.