Sunday, August 31, 2014

Smitty's Tale (In the Category of Want What You Have...Had.)

Attention comrades of the #wlf and all anipals. It is with the leakiest eyes that I must tell you that our sweet Smitty Kitty (@IAmSmittyKitty) has gone over the rainbow bridge. If you are reading this, Smitty was a pal to you, and this must be a shock. It all seems very sudden; hopefully this blog post will make things more clear. If you tweeted with Smitty, you know he was all heart. This was true in more ways than one.

At the beginning of May of 2013, Smitty developed a little cough. We were concerned that he may have had a chest cold or allergies so we took him to our regular vet for a check up and chest x-ray. The x-ray revealed that Smitty actually suffered from cardiomyopathy, a heart condition that results in an enlarged heart. It’s a genetic condition that can strike a cat at any age from 3 months to 10 years, although it is far more common in older cats. Smitty had just turned two. Our vet referred us to the Virginia-Maryland Regional College of Veterinary Medicine in Blacksburg, Virginia, or as we call it around here, the Vet Med College. We are blessed to live in the area; many devoted anipal staff drive for hours to bring their pets here.

An echocardiogram confirmed what the chest x-ray showed. Smitty’s heart had an advanced case of heart disease. The entire left side of his heart wasn’t working at all. Quantity of life was no longer an option. Quality of life was all we could shoot for. The note they sent us home with concluded that Smitty could die at any moment. Needless to say, it was a very dark day.

Please forgive us if we decided not to tell the pals on Twitter what was going on. Smitty didn’t realize he was sick, you see. We didn’t have the heart to tell him. We just let him be sweet, happy, silly Smitty.

Smitty was born to a mama cat that was either feral or homeless. Blacksburg, Virginia is a college town, and as such, it has a problem with irresponsible college students who adopt cats that they cannot afford to spay or neuter and then graduate or return home for the summer and abandon their “college” pet. Smitty’s mama cat taught him how to eat from a trash dumpster, weaned him, and then shunned him at around 12 weeks old. Smitty, ever a willful lad, decided he didn’t like to be alone, so he sat beside the dumpster mewing loudly for days until the girlfriend of the new tenant whose bedroom window was below the dumpster scooped him up and brought him in. (Thanks to Smitty’s song, they had not slept for two nights.) The boyfriend’s apartment did not allow pets, so she took the kitten to her apartment, snapped some adorable pictures of the little guy, and posted them on Facebook: Kitten Needs a Home.

That’s how we met Smitty. His rescuer was a friend of a friend, and that friend shared the photos on her Facebook timeline. I saw them there, and I knew at first sight that I had to play with the kitten. Had. To. I also knew what that meant, so I asked my husband if I could have him. We have an older cat, and I felt a companion kitten would put a bit more spring in her step. Plus, I had to play with the kitten. Had. To.

Admit it! You would have to play with this kitten too. Have. To.

My husband made me promise to take him straight to the vet for shots and a checkup, which I did. In addition to ear mites, Smitty had bad diarrhea, not uncommon, but in his case it was a serious overrun of Clostridium Difficile. The “C-Diff” bacteria can be found in rotten meat and rotten vegetable matter, the sort you would find at the bottom of a trash dumpster. He passed his feline leukemia test though (after a tense 30 minutes...I was already smitten with Smitty, but a positive test result would have ended his life that day). We put him on antibiotics to straighten out the tummy troubles and little Smitty thrived.

His tummy trouble did not immediately stop, though. The weeks of eating dumpster trash had wrecked his GI tract, and he had chronic IBS. We put him on a daily antibiotic. This need for a once-a-day pill resulted in Smitty, at a young age, becoming comfortable with being handled and pilled. His heart condition required more pills to be given, every 12 hours, and this allowed us to keep him medicated and comfortable for much longer than might be expected.

He took a pill to reduce his blood pressure, giving his half-heart a break from having to work so hard. And he took two doses of a diuretic, furosemide, every day, to relieve the build-up of fluid from around his not-so-spunky heart. The coughing stopped, and Smitty seemed to be doing well at first. He winded easily, though, and he quit being able to run for more than a few feet before he had to lie down and catch his breath.

Cats, like humans, can develop tolerances to medicine. Smitty needed to have the furosemide dose increased about every two weeks in order to keep it working properly. By the beginning of August 2013 he had maxed out the dosage he could handle, his breathing rate shot up to 65 breaths per minute, (18-20 is normal) and things looked bad. But then an anipal, @KendallKatz, suggested a different diuretic, torsemide. Kenny’s staff was able to provide a scholarly paper about its use in cats with cardiomyopathy that we sent to Dr. W., Smitty’s cardiologist. She agreed that we should try it, and after only two days, Smitty’s breathing was back to normal; he was running again! He even managed to take out a few birds – one he snatched out of mid-air with both paws! His form was truly restored.

Dr. W. found a pharmaceutical compounding company that would put the torsemide in a liquid suspension with a fish flavor. This allowed us to step up the dosage in very small increments. (And Smitty loved the taste! Meds were now a treat he requested!) But we were all in uncharted waters now. None of us knew how much a little ten pound kitty could tolerate before this new medicine quit working or his kidneys failed. We agreed that kidney failure was a less horrible mode of death than congestive heart failure. Kidney failure allows toxins to build up in the bloodstream, causing lethargy and eventually a coma. Congestive heart failure feels like drowning. One gasps and gasps until the heart quits. (This is true for humans as well as cats.)

Smitty developed a tolerance to torsemide less quickly, and he handled it well. We did not know for how long though, so we set out on a deliberate course to treat each day with Smitty as a gift. Smitty taught us not only to love unconditionally, but to savor literally every second of that love. Feel it, have it, for each precious moment, wallow in it. No eye blink should be taken for granted. Every breath, every sweet sigh can last a lifetime if we let them. Like magic, we made time stand still, for a little while.

We worried for his kidneys. His were young, strong, and healthy, but spending months pissing gallons, and I mean gallons of urine, takes their toll on even the youngest and the strongest. At the beginning of December 2013 we noticed that the amount of urine Smitty produced was starting to flag. Two days later, he stopped eating. He wouldn’t drink voluntarily anymore, either, and Dr. W. told us that was the sign. From there, his condition would deteriorate quickly. We scheduled the appointment to send him over the rainbow bridge (it’s a pretty euphemism). That night, Smitty began to drink again. Two days later, when we thought we would be taking him to be put to sleep, we gleefully cancelled the appointment. We called it a Christmas miracle. Smitty marched on.

In May 2014, we celebrated Smitty’s one-year-diagnosis-iversary with lobster (Smitty loved lobster). The torsemide had changed the game. Smitty’s heart still beat. The sense of sand slipping through an hourglass magnified. Every second of every minute of every day with Smitty became keen and precious. We stayed mindful of the moments. We wanted what we had.

Today, with a heavy heart, I finally finish this post to tell you he has gone. Sweet Smitty Kitty has gone away to a place where he doesn’t hurt anymore. A place where he can run as far and as fast as he wants to without losing his breath. Sadly, it is a place where we cannot follow.

In the true spirit of the comrades of the #wlf, Smitty has a new mission in the 10th Battalion. Smitty will go on to help other kitties with this same heart condition. You see, this heart condition is rarely diagnosed in living cats. Usually, the owners don’t know the cat has an enlarged heart until it just dies suddenly. Smitty’s cough was an unusual side effect of cardiomyopathy, one that vets rarely see in cats (it is relatively common in dogs with this condition). In many ways, we got “lucky” that Smitty coughed. It allowed us to treat the condition, and we got fifteen really great months that we otherwise would not have gotten.

It also allowed Smitty to become a member of an important collaboration that the Vet Med college has with another university in Italy. We have donated his heart to the Vet Med college so that more can be learned about the causes and course of this disease. We have also given them the extensive notes we kept after putting him on torsemide. We hope it will help veterinarians to better treat the condition using torsemide and increase the quality of life for cats with it. In the end, his kidneys did not kill him. We can’t be certain which, but either he threw a clot or his sweet little heart just stopped. We found him at his favorite napping spot in our bedroom. He did not suffer.

As for you, Smitty’s Twitter pals, I am so sorry to have broken your hearts with this news. Please know how much your Twitter friendship means to us. We do not yet know if Smitty will Tweet from OTRB or if Smitty’s Diddy will take up the account and the challenge to help anipals find forever homes and retweet to get help for Smitty’s friends, Lucy Liberte, the elephant and Tony the Tiger, who both need to find better homes than the ones they currently endure. For now, we are just going to try and make it without our “Boo Boo.”

Here are links to some memories of Smitty: (specifically the compilation at the top, and then the vidoes and pictures as you scroll further down).

*pawhugs* from Smitty’s Mama and Diddy.

31 August 2014

Saturday, August 16, 2014

Simple Pleasures (Stream of Consciousness) (In the Category of Be Where You Are)

As I write this, I’m sitting on my deck at a table with my husband. Train’s “Hey, Soul Sister” is on Pandora,” and I’ve given it a thumbs up. Pandora is still learning me, and maybe I led her astray when I added Floyd Cramer. Once in a while, his melodious piano playing soothes, but it’s a sunny Saturday, I live in suburbia, and we need something to drown out the sound of weed whackers. It allows us to pretend we’re the only ones here.

The neighbor dogs must be in because I don’t hear them. They bark shrilly if they see us sitting on our deck. Sometimes, if I say, “Hush Hoppy, hush Snowball, they will quiet down -- at least until Smitty Kitty appears. He likes to enrage the yip yaps by sitting at the corner of the yard, just inside our fence in their full view. Slowly, he’ll groom, washing ears and face, tail swishing in rhythm with their canine protests.

It’s a rare August day in the Blue Ridge Mountains – low humidity, a light breeze, sky as blue as the ridge line that surrounds my house. This is good tomato growing weather, and the garden has been bountiful. From inside my house, the scent of my fresh picked San Marzano tomatoes drying slowly in a low oven wafts out. It’s sweet and savory at the same time. I will pack them in extra virgin olive oil for future salads and pizzas. I’ve already put up a jar to take to my dear friend, Carol, tomorrow. These, now drying, I will keep.

Later today, we’ll fill the air with the scent of steak teriyaki, grilled to perfection on a bright blue Weber. Sauté the fresh wild mushroom mix we bought at this morning’s farmer’s market, roast corn shared from a co-worker’s garden. Simple pleasures – we want what we have.