Something woke me. I lay in bed, listening.
In short order I figured out it was Hugo. He was under the bed, coughing; a dry, heaving cough. I heard him scuttle a bit then come out from under the bed. I took a flashlight from the bedside table and turned it on. Hugo was on the area rug lying on his side, his breath gurgling in his throat.
I watched him for a minute, stroking him while he struggled to breathe, then woke up Gregg.
"Get dressed," I said, "We need to take Hugo to the emergency room."
"What's wrong?" asked Gregg groggily.
"He's having trouble breathing," I replied.
We got dressed.
Although I always put the cats in carriers when taking them to the vet, this time I just wrapped Hugo in a beach towel. I felt that he was in serious distress and I wanted him on my lap in the car. I needed to be able to offer comfort. When Hugo didn't struggle as I manhandled him into the towel, I knew that it was as serious. Hugo ALWAYS struggles.
As Gregg drove, I listened to Hugo's labored breathing, hoping that it would miraculously return to normal. It did not. The gurgling continued.
I tried to keep Hugo's paws wrapped in the towel but his front feet worked free. He reached out a paw and touched my neck gently. I expected claws but it was just a soft touch to make sure I was still there. I felt my breath catch in my throat. Tears were very close.
When we got to the emergency clinic, it wasn't there. We spent a frantic few minutes calling information and then our regular vet's emergency line to find out where it had moved. Luckily, it hadn't moved far.
At 2:30 in morning, we were the only ones at the clinic. The vet tech took Hugo away then came back to say that the vet wanted to do x-rays. We filled out paperwork while we waited.
After awhile, the vet came out and said that the x-rays didn't show anything obstructing his airway but that his lungs looked "busy" and his heart was slightly enlarged. Although she thought the gurgling breath was an odd symptom, based on the x-rays the vet tentatively identified heart failure as a possibility. She had sent the x-rays to the radiologist and expected results within the hour. She recommended that we wait. Meanwhile, she said, Hugo was being treated with oxygen and seemed more comfortable.
So Gregg and I waited.
The results came back fairly quickly. The radiologist said that it looked like heart failure. The vet laid out our options.
Hugo was to stay overnight in his oxygen chamber to see if he could be stabilized. He was given the drug lasix to get rid of the fluid in his lungs. He needed an echocardiogram to fully establish if it was indeed heart failure, but that couldn't be done until Monday. If he was stable enough the next day, we could take him home and then get the echo done later in the week. Otherwise, Hugo should remain under oxygen and observation and get the echo on Monday.
The vet went on to say that If it was heart failure, Hugo could be treated longterm by giving him the lasix three times a day, but that it would only work for six months to a year at the most, and a potential side effect was kidney disease.
When I started to cry, the vet said, "I'll leave you alone to discuss what you want to do."
After she left, Gregg said, "Well, we can't not do the echo, we have to see if it's heart failure and not something treatable."
"But, if it is heart failure," I said, "There's no way we can pill Hugo three times a day. We can't even pill Hugo once a day."
"I know," said Gregg.
Hugo is a bad piller. After pilling him, and being convinced that he has swallowed pills, I've found them under the bed, in the hall, in the garage, in the driveway, and on the front porch. And after two days of getting pilled, Hugo knows what you're up to and becomes the uncatchable cat. I've had cats my whole life and never had one as smart as Hugo when it comes to avoiding medications. I could not even imagine trying to do it three times a day for the rest of his life.
We both knew where our decision was headed.
After little discussion, Gregg and I decided that if it was heart failure, instead of putting him through months of multiple, daily pillings, Hugo would be euthanized.
We were allowed back to check on our good boy. He was cozily ensconced on a bed in a glass-enclosed oxygen cage. Hugo looked much more alert and his breathing seemed normal. The vet tech opened the door to the chamber so that we could say goodbye. We both gave him a pat and a kiss and told him to be good. The glass door was closed. Hugo looked at me and reached out a paw to touch the glass. I could see, but not hear, his mouth move in a meow. I was crying again.
The next day, we called the clinic at noon to check on our best boy. The vet told us that Hugo was still enjoying his oxygen and that his blood pressure had normalized. She was going to try to wean him off the oxygen and wanted us to leave him for observation. She asked about the echocardiogram and we gave our permission to have it done on Monday after another night at the clinic. We checked in again in the evening. Hugo was still on oxygen, still enjoying his bed, but had not eaten anything.
The next morning's progress report was the same. Hugo was improving. He was being weaned off of the oxygen but still had not eaten anything. It was the same at shift change when we got a call from the attending physician. But this time there was additional news; Hugo had had his echo and the heart failure had been confirmed. He was out of the oxygen cage and ready to come home. The cardiologist would give us a call with details and treatment instructions.
I called our regular vet and spoke with the receptionist to find out if they did in-home euthanasia. One of the vets did and would call me later in the day with details.
By the time we got to the clinic, we still had not received a call from the cardiologist. The ER vet met with us to give us a rundown of Hugo's diagnosis and treatment. As she was giving us a briefing on cat heart disease and congestive heart failure, I was reading the sheet she had in front of her. I smiled ruefully and shook my head when I saw the list of medications. The vet stopped talking and looked at me. I looked at Gregg.
Into the silence I said to him, "Did you see the list of meds?"
"Yes," he replied.
Besides the thrice daily lasix, there was pimobendan twice daily, aspirin twice weekly; then after a week add on spironolactone daily; after two weeks add on enalapril and plavix daily. Eight pillings a day. Nine on aspirin days.
"There's no way that's going to happen," I said.
"I know," said Gregg.
The vet looked stricken.
"Is Hugo a bad piller?" she asked. "I am so sorry. I have a cat that I can't pill. I know what it's like."
After more discussion and more waiting, we brought Hugo home.
Gregg carried him upstairs and let him loose in the cat room. Hugo walked over to the bed, ducked under it and collapsed on his side; his head was under the bed, his back feet sticking out.
I went over to pet him. He didn't move, didn't purr, just looked at me.
"Let's leave him alone for awhile," I said to Gregg, "He's probably really stressed out from the hospital."
Followed by Moonie, we left Hugo where he was and went downstairs to prepare dinner. I put some food in a dish and brought it upstairs, Hugo was lying next to his water dish drinking weakly. I showed him the food, stroked him a few times, and left him alone.
The cardiologist called.
"I hear that you have a bad piller. I had a cat like that, too," she said.
The cardiologist laid out a plan of attack; one pill of lasix and one of pimo per day; neither of them have much of a taste so put it in his food and see how it goes.
The next time Gregg checked on him, Hugo was still next to his water dish. And the time after that. The food was untouched. Gregg put one of the cat beds on the floor, lifted Hugo into it, and left him. As we checked on him periodically, Hugo never moved. Each time, Moonie followed us upstairs but wouldn't go into the cat room.
At 3:30 in the morning I woke to Ray's howling. I wondered if something had happened to Hugo, but he was still lying where we had left him. I put another bed on the floor, one that he could hide in if he wanted to. Moonie was nowhere to be seen. I went downstairs and found her sleeping in a tight little ball on the couch. I picked her up and took her to bed with me.
Gregg woke me at 6:00.
"Hugo wouldn't eat anything so I gave him his lasix," he said, "He's still in bed but he moved to a different one."
"Is it the other one on the floor?" I asked.
"Yeah," he said.
Gregg sat on the edge of the bed. We discussed our options.
"You know whatever decision we make, it's going to be the wrong one," I said.
"Yeah, I know," Gregg replied morosely.
As Gregg got ready for work, I headed to the grocery to buy some baby food. If Hugo would eat anything, it would be that.
When I got back, Hugo was collapsed next to his water dish again. I picked him up and put him up on the twin bed, moved his beds next to him, and put a dish of baby food in front of him. He wouldn't touch it. I went to get the pimo pill. I felt absolutely terrible pilling a cat that was too weak to put up his usual fight.
At 9:30, I called Gregg.
"Hugo isn't eating and isn't moving," I said, "Could you make the call to the vet? I don't want to do it."
Although I had held it together pretty well the day before, I knew I wouldn't be able to do it much longer.
"Sure," said my lovely husband.
He called back a short time later.
"The vet is coming at 3:30," he said.
I sent a message to Halle's grandma, Deborah, and asked if she could come and get Ray before the vet arrived and got back an affirmative.
I moved into the cat room with Hugo to spend his last hours with him. For awhile, he purred when I petted him, but it became too much of an effort. Every so often I would offer him water and he would drink but it also was an effort.
Gregg arrived home at two. We sat in the cat room, periodically kissing Hugo on his head and telling him what a good boy he was. The ceiling fan was making a noise as it spun around slowly, ticking off the seconds. Hugo remained immobile. The wait seemed interminable yet went by so very, very fast.
The vet arrived just after 3:30. As Gregg walked her and an assistant up the stairs to the cat room, I got up from the bed to meet them at the door. I heard a thunkthunk.
"Uh oh," said Gregg looking past my shoulder.
I turned to see Hugo's empty bed.
"He hasn't moved all day," I told Hugo's doctor as I got to my knees and looked under the bed.
I got up, moved to the far side, reached under and slid Hugo along the wood floor. He didn't resist. I picked him up started to put him down when he gave a brief struggle.
"I'm glad he's not going down without a fight," I said, but Hugo's struggle was over.
The vet laid him on his side in one of the cat beds. Gregg put his hand on Hugo's side. I held his head with both my hands, caressing his ears and telling him over and over that he was ok. The vet turned him to expose his back leg, hooked him up, and asked us if we were ready. We both nodded. I felt his head relax into my hands.
Our best of good boys was gone.
|Into the light|