The Brad Hole

It's been almost a month since we took Ian in and discovered his cancer, and the subsequent surgery to remove the tumor under his tongue. Initially we were concerned about his appetite, but he's taken to Beech Nut stage 1 chicken baby food and has been eating and drinking pretty regularly.

A few days ago, his drooling started to become excessive again, much like it was when we brought him in before we knew about the tumor. Within the past few days, he's been pretty much constantly drooling, with ropes hanging out of his mouth most of the time he's awake, and build-up on his chest when he sleeps. As well, he didn't eat much Wednesday or yesterday, so I hastily scheduled a vet appointment for 8:15 this morning.

The good news: he's up to 13.6 lbs, which means he has gained a half-pound since surgery -- although he's not back up to his pre-surgery weight of 14.1 nor his "Pavarotti" days of 15.5 lbs. I was honestly expecting worse given his lack of appetite the last few days. Also good news: the vet was pleasantly surprised that he's held up so well for so long.

The bad news: the tumor has grown back under his tongue. It's not as large as it was before, but when the vet showed us the area, it was easily visible and irritated. It was a little larger than I was frankly comfortable with, but I never saw the original tumor so I don't know how the size compares. The diagnosis is feline squamous cell carcinoma which is known to be fast-growing and fast-spreading, so although it's a deep disappointment to see the tumor again, it wasn't a total shock.

Beth and I decided long ago that we're not going to subject Ian to surgery again for several reasons. First, he lost a full pound of weight last time his mouth was operated on. Second, the vet says it won't really do much - the cancer will continue to aggressively grow and spread and is likely already in his lymph nodes. Finally, it'll be very expensive to boot (it cost roughly $750 for surgery last time) so the vet believes we'd just be wasting money and effort only to be rewarded with heartache. He said he wouldn't talk us out of surgery but the payoff in quality of life for surgery on these types of tumors is typically great for the first time, and markedly less so each successive time.

At this point, we're essentially doing cat hospice care. We'll make his remaining days as comfortable as possible. In the short term, the vet may have us give him regular subcutaneous injections to keep him "above water"; dehydration will cause him to deteriorate more rapidly and with his mouth/tongue difficulties that will be a factor. When he's strung together enough "bad days", then it'll be time. The vet cautioned that there won't likely be any one indicator - weight, attitude, appetite and drooling will all factor -- and he'll give us his opinion if Ian's quality of life has crossed the line and he believes we're unnecessarily extending it for purely emotional reasons, which I greatly appreciate.

My belief is that the drooling issue has already caused him to have trouble eating as much as he'd like, so he will probably continue to lose weight gradually. Right now he smacks his mouth a lot and when he shakes his head, you get wet if you're nearby. From an attitude standpoint, he hasn't had a "bad" day since recovering from surgery but I think we're probably looking at a week or two tops before his inability to eat and the tumor growth cause more difficulty. The vet guessed that Ian has probably a month left due to the aggressiveness of the cancer, but that's not an exact science by any means.

I'm still not sure what to make of it all. I work from home and Ian is always in my office, so to say this is a distraction is an understatement. It might be easier if I didn't work from home and didn't have to watch his decline from so close a view. There are times when It's very hard to focus on anything else. I don't mean this to sound cold or unfeeling, but there's a part of me that hopes this will end sooner rather than later because it's very emotionally draining - more than I would have ever guessed.