This year’s been a time of ups and downs for Tucker. Fighting leukemia since at least 2005, probably since 2003, has lately been depleting his reserves; twice now this year we’ve seen the sharp and radical decline of a cat who’s gradually getting tired of fighting.

Leukemia – straight up leukemia, not “feline AIDS” – happens when the cat’s bone marrow is no longer producing red blood cells at a high enough quantity to meet his body’s needs. The pancreas will step up a bit to try offsetting the shortfall, but the pancreas’ ability to produce RBCs is supplementary at best. The pancreas swells up significantly as it’s overworked. The treatment is daily corticosteroids to stimulate the marrow, and strong antibiotics (because the steroids impair the immune system). That manages the problem, but doesn’t cure it. It only slows down the deterioration process. In our case, it slowed it down significantly: Tuck was given a three-month prognosis in May 2005. He’s now over four years into a three month death sentence.

Like I said, this year’s been hard for him. The first sharp decline came in March (we wrote about that here); he lost weight, slowed way down, rarely ate or drank, slept all day. The blood tests weren’t good and the vet said he probably had weeks left. So we kept him comfortable, found new tricks to keep him eating and drinking, and he started turning around. A few weeks later, he was back to his active self and gaining weight again.

The latest decline started at the beginning of July, the same thing again. Weight loss, sleeping all day, not eating. A steeper decline than the March one, steep enough for us to start having serious discussions over end of life issues. We decided to keep him eating and drinking, not forcing it on him but strongly encouraging it, and to see what happened. If he continued to worsen, we’d make the call. Otherwise, he’s been fighting his way back to life for four years – he might do it again. We didn’t want to count him out until we knew it was time.

And sure enough, the last few days he’s been gradually rebounding. Knock on wood, it seems we’ve bought another reprieve. With some luck it’ll be another few months or longer before we’re here again.

Part of the problem of tending a sick animal over a long period of time is that after he’s been acting normal for a while, you start forgetting that he’s sick. You’re still doing the twice-a-day meds and rearranging your lives to accommodate the illness, but it’s part of the everyday routine – the disease is managed again and you start lowering your guard. Then he takes a turn for the worse, and not only does it take a little while for you to properly recognize it, you also have to remember or relearn all the little tricks you used last time to turn him around.

This time I told Kristi that we needed to write a “Tuck Critical Care” sheet and put it on the fridge for the next time. She agreed and started sketching out what worked this time, and we recalled what worked back in March. I plan to type it up.

Many people, when that initial diagnosis comes down, decide right then and there to end it. I can’t blame them – the vet typically will offer up the worst case scenario (i.e., he’ll be dead in two weeks) rather than the long term possibilities, given regular attention and care. I can’t blame the vet for doing that, either. We and Tuck have been fighting his cancer for over half his life, a war that I’ve always known that we never had a chance of winning, a war that I never in my wildest dreams expected to last over four years.

I also don’t blame anyone for not wanting to fight that battle. It can be a long, hard, expensive, heartbreaking slog. I had my own reasons and I don’t regret fighting it – but I can tell you that it’s not for everyone or every situation. Responsibility comes in all shapes and sizes.

I just wanted to drop in here today and post what we’re doing, what we’ve been doing. If you have a sick cat, maybe it’ll help; I suppose it would also help with a cat reaching the far end of old age. If you have anything to add, feel free to comment. It’s all after the jump.

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