Connor

I took Connor for a chemo check-up yesterday. I know by now that if I bring the carrier into the room where Connor is, he will disappear like the Cheshire cat but without even the smile left behind. Instead, I scoop him up from the pillow he has claimed and carry him to where the carrier is stored and pop him in fast, slam dunk style - back legs first so he doesn’t see it coming. As soon as he gets in the carrier, he starts making a sound beyond meowing – a cat yelling – and he keeps it up all the way to the vet. At the vet he takes one symbolic swipe at Doc, a gesture of resistance, which earns him a four-paw nail trim. I have been worried about keeping his weight up since he doesn’t want to eat much on the days after his chemo pill, so I have been getting up before dawn to give him a second dinner before we both go back to sleep. This is not very good for my “sleep hygiene” but it’s working, the scale shows that he has gained a little bit of weight. I tell Doc about the sniffly nose that keeps coming and going, and he reminds me that he is immunosuppressed and viruses from his kittenhood might be reactivating. “I wish I could give him some of my donor antibodies,” I say, since the continual flaring of an old chicken box virus into repeated attacks of shingles was what made me decide to do the infusions. “Do they give immunoglobulins to cats?” Doc thinks about it – he’s a one man practice without the fancy equipment the rapidly spreading hedge fund animal hospitals have, but he keeps up with the research. “Maybe they do somewhere, but not generally,” he says. “How many donors go into one of your infusions?” “1,000,” I say, “because they are trying to include antibodies to as many things as possible.” “That’s one reason they don’t do them for cats,” he says. “What does it cost?” “Around $13,000 per dose,” I say. “That’s another reason, pet owners would be running from that.” He’s palpating Connor now, checking for lumps, while Connor tries to decide if his likes this strange new form of human touch. “They give immunoglobulins to foals,” he says suddenly. “When I was in vet school during the 70s, I worked on a research project where foals were delivered by c-section and kept in a sterile environment, and we had to bottle feed them. If a foal imprints on you in its first few hours, and you put your fingers in its ears and wiggle its legs, you will be able to do those things for the rest of its life. If you only do it to one side, it will only let you do that side after those first few hours.” “What were they like when they grew up?” I asked, wondering about the effect of this completely strange environment. “They were very docile,” he said. “They kept them in the study for the first couple of years, and then they sold them to people who wanted horses to ride.” By then he was up to the blood sample. I watched him deftly uncap the syringe and noticed that the skin on his hands was much less wrinkled than you would expect on a man his age. I wonder if spending his days constantly using his hands has had this effect. I pick up the carrier, put it on the table, and open the door for Connor, who decides the carrier is the lesser of the two evils and bolts in. Doc is talking about the appetite issue, and how we could lower the chemo dose but lose some efficacy. “What about mirtazapine?” I ask. Mirtazapine is Remeron, a psych drug in people but an appetite stimulant in cats. I know it will work, but this is the kind of situation where Socrates comes in handy. I once saved my own life using this technique. It was the first trump disaster, the multiple country ban, and my friends were rushing to protest at airports. I had been getting infusions of Rituximab, a powerful biologic agent, to stop my rogue immune cells from attacking my spine. Mr. Wednesday was still alive and taking some kind of pills. I popped one in his mouth right before bed and as I withdrew my hand I got a tooth nick on the outer side so small I didn’t notice it. I went to bed and woke up a few hours later simultaneously shaking with cold and sweating heavily. All the cats were on top of and around me, trying to warm me up. I turned on the light and saw my hand swollen into a lobster claw and a red streak from the tiny hole in my hand all the way up to my elbow. I headed to the ER, where my white blood cell count came back so low that when I read it to a doctor friend he said “total?” thinking I had read him just one type of cell. Stuck in reverse isolation to protect me from germs, in intense pain from the rituximab destroying the rapidly dividing cells that line the mouth, I knew my immune system needed a boost, and I knew the drug for that, neupogen. With my own doctors, I would have just told them, but these were strangers and medical professionals can have fragile egos. “Is there a medication that can increase white blood cells? I asked the young doctor with the tired smile. “Yes” she said, lighting up like a newly replaced bulb and rushing off to place the order. Back in Doc’s cramped exam room, he says “I should have suggested that,” with the smile people reserve for their favorite students. He has always enjoyed teaching me things – how to feel crystals in a cat’s urine with your fingers, how to spot ear mites mating under the microscope, how to remove a cat’s feeding tube when she broke the rigid plastic by scratching too hard. He was away at a conference at the time but he said, “you can do this, just cut the sutures and slide it out and bandage the hole,” so I did. And then I cut the neck off a tube sock and covered her neck to protect the bandage, a cutting edge feline fashion statement. I could never be a vet – I can handle pain and death in people, but I can’t even read about something happening to an animal in a book. I think books with content like that should have a warning. As a little girl, I had to be carried out of the Wizard of Oz because I was so upset when Toto got carried off. We still have to wait for blood results, but I am relieved that Doc thinks Connor looks good. Small cell lymphoma in cats is treatable but not curable, and I can’t let myself think about that or I will be drowning in a tsunami of heartbreak. We get home and Connor, never one to hold a grudge, takes a thorough bath to remove the fingerprints, and climbs in my arms for a snuggle.