10 minutes reading time (1909 words)

A Story of Broken Hearts: Cats and Cardial Hemangiosarcoma

I can remember the day that I brought Lothario, my first male kitty, home from the animal shelter. He was so small he could fit in the palm of my hand and had been weaned weeks too early. His mother, a mottled calico cat, was left at the shelter with her litter of eight kittens and the kittens, so much in demand in the spring, had been separated from their mother early to give them a better chance at adoption. I didn’t come to the shelter to adopt a kitten. My other cats, Pepper and Licorice, were well into their teens and had no desire to baby-sit. But Lo instantly captured my heart with his perfect pink paws and over-long whiskers. His ears and tail were so huge compared to the rest of his kitten frame—almost as if they anticipated the eighteen pound cat that he would one day become. I picked him up and cradled him against my heart the entire ride home and after a while I could feel him stop shivering and start to purr. 

For the next eleven years, Lo was my cat the one cat that followed me around the house when our little troupe of Divas had had their fill of me. Every night, Lo slept on the end of my bed twined around my feet--his distinct pigeon-sounding purr lulling me into dreams. Everything seemed fine. He had his check-ups every year, including a full CBC after he turned eight. His blood work was great. But the veterinarian always complained Lo could lose a few pounds. In late December, Lo started to limp a bit on his back right leg. His appetite was great—despite the fact that he was being special weight reduction kibble. The vet checked him out and diagnosed the beginning of arthritis—or possible a slight ACL tear. Lo was prescribed Cosequin and rest—a treatment that had worked so well with my dog, Lady’s ACL injury.

After a few weeks, Lo seemed no better. He had difficulty getting on to the bed and had to climb onto my curio chest to reach his coveted place among the pillows. But, other than his limp, Lo was his normal self. He purred, he played with his favorite feathered ball, and he pawed at the laser pointer’s red dot on the wall with glee. Still, something wasn’t quite right. Some small indefinable thing bothered me and pressed at my heart. After another week, I took Lo back to the vet. This time he ran complete blood work. There was no problem. Lo’s blood was perfect. The vet recommended that we wait a few weeks to let the Cosequin and rest do their job.

I moved Lo to my room away from the other cats and began monitoring his every move. There were no changes in his appetite, his play, or his bathroom schedule. Every night he climbed up to the top of the bed and said “Raow” before he returned to my feet for the night. But I could feel something was wrong. Lo seemed even more loving and happy. He never left my side. His eyes followed me everywhere and so did he. But, during the third week in January, Lo started to lose his appetite.

I switched him to his favorite cans—the ones banned by the vet for their high fat content. I fed him tuna and cream and kitten food. These treats Lo accepted, but he ate less of them. And, even though I took him to the vet once again and he had only lost a few ounces, Lo looked thinner now.

On Monday, January 23, I took Lo back to the veterinary clinic. He was weighed, poked at, and prodded. The vet determined he did have an ACL tear. He prescribed pain medication for the tear. Still, Lo was not eating as much I would like. But, he did seem happy and each night I dangled his favorite string of pearls for him to bat with his little pink paws. He slept by my side and purred and every now and then I could feel him move his feet as he dreamed.

The morning of Thursday, January 26th, I took Lo to the vet once again. He had eaten almost nothing the day before and it was wearing him down. That morning, before we left for the vet, Lo ate half a can of tuna and shrimp and played with his pearls. I coaxed him in his cat carrier and again, we drove to the veterinary clinic. This time, the vet asked to do x-rays. We could find nothing wrong with Lo, but there was obviously something we were missing.

Lo wrapped both paws around my arm as I sat listening to the vet. The x-rays would take an hour and a half. I sat in the waiting room and read while Lo was given full body x-rays. The news was not good. Lo did have an ACL tear on his back right leg—no doubt from jumping off the bed and landing badly. Lo had never been the most graceful cat. But, when the vet studied Lo’s full body x-rays he saw a small, perfectly round lump right under Lo’s heart. While I held Lo in my arms, the vet pointed out the circle, no bigger than my thumb, attached to the underside of the heart. It was what was making Lo tired. It was the reason for his lack of appetite. We began discussing aspiration to positively identify the mass as malignant, but the vet told me that he was almost 100% sure due to the symmetrical shape of the tumor. We discussed surgeons, specialists and options and all the while Lo lay in my arms and purred.

We had been talking about half an hour when Lo started to breathe raggedly. The vet immediately began working to restore his breathing, but it only became worse. I stood beside the silver table watching my tiny cat, my cat who had always seemed so big and invincible beside all my other feline friends, struggle for his life. I knew he was dying. I could hear myself saying, “Don’t die, Lo, don’t die.” But, I couldn’t really feel the words coming out of myself. Finally, I asked the vet if I could take Lo outside—he had always hated the vet’s office and I didn’t want him to die there. The vet followed me out to the grass behind our country clinic and Lo died in my arms, his head resting against my heart. I could feel his breath slow until there was finally nothing at all and after about another twenty minutes, the vet listened to Lo’s heart and told me he was gone. I buried him in the hills behind my parents’ house, where a childhood’s worth of cats, dogs, and hamsters lay in the earth.

Lo’s tumor was a hemangiosarcoma a type of cancer more common in cats than in dog and usually occurring in older to middle aged animals. Lo would’ve been eleven on February 14th. It is a cancer that doesn’t seem particular to any breed and can start in any blood vessel. Because hemangiosarcomas are vascular, they can occur on the internal organs or on the skin. The types that appear on the skin are usually quite visible and have a good chance of removal and remission. But, the internal hemangiosarcomas often have no symptoms until the very end.

A cardiac hemangiosarcoma, such as the one Lo had, can cause collapse and hind limb paralysis. Lo had neither of these symptoms. Because hemangiosarcomas start in the blood vessels, the tumors themselves are often filled with blood. When the tumors rupture, as the tumor did in Lo’s case, death is almost instant. And often the signs of the disease are only evident when the tumor begins to rupture. These ruptures can occur without warning and can cause (but don’t always cause) symptoms such as weakness, collapse, difficulty breathing, and fluid build-up in the abdomen.

I can’t overstate how hard this illness is to diagnose. Lo began visiting the vet for his leg injury in late December and died in late January. He was only “ill” for the last two weeks of that time period—and his sickness consisted only of a lack of appetite. He played, he purred, and followed me around the house. Although the symptoms for this type of cancer (as well as other cancers) include anemia, weakness, collapse, pale or white gums, difficulty breathing, fatigue, fluid build-up, masses beneath the skin (in the case of subcutaneous hemangiosarcomas), and pain in the bones, Lo only had difficulty breathing once the tumor ruptured. He was not anemic or weak, and his gums had no discoloration.

Only the x-ray revealed the tumor and, by then, it was too late. Had we not decided to do x-rays that day, Lo would have most likely died that night and I would’ve never known the reason for his death. These types of cancers can sometimes be detected by CBC (complete blood count) tests, but Lo’s was not. Serum chemistry and urinalysis tests for Lo were also indeterminate. Only x-rays showed the problem. Had Lo lived, we would’ve next aspirated the tumor (if possible) and ordered an ultrasound of the heart, as well as an EKG. Hemangiosarcomas can be treated with chemotherapy and with surgery.

Cancer is a growing problem in pets. Cancers develop in canine and feline population at about the same rate as they do in the human population. Often these tumors are undiagnosed. Never underestimate your feeling that something is just not right. You may be called paranoid, but you may save your pet’s life. One of my best friend’s cats, a fluffy Maine Coon named Mier, died of lung cancer only last year. He was ill for several months and despite chemotherapy and very aggressive treatment, he died. I am grateful that Lo was spared the pain of prolonged treatment. I am glad that he was happy right up until the time he died. Our pets cannot tell us what is wrong with them. I suppose, they, like ourselves, often don’t know. So, we have to be vigilant every moment.

Although Lo’s life was short—almost eleven years was much too short a time—he was very happy and he made my life more wonderful and complete. Now, my other pets and I mourn him. Nonny wanders the house looking for him and even though I brought home the sweater I was wearing when Lo died and let all the cats smell it, they’re still not sure that he isn’t coming home. Nonny searches the front yard every day and has run to the front door several times when she saw our neighbor’s yellow cat, Ryder, on the hunt in my yard. I suppose the only cure for grief is time—and even that is an incomplete cure.

From the time that I adopted Lo until the day he died, I carried him in my heart and I suppose I always will. Our pets are our friends. They are our family. I have always known this, but the unexpected loss of a friend, not to age or long illness, but to something so unexpected has reinforced these feelings for me. Love your pets. Take them to the vet for regular check-ups and never doubt your own feelings. You know your pet best. Trust yourself as your pet trusts you.

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Monday, 13 July 2020

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