Heidi had Exocrine Pancreatic Insufficiency. I now know more about it than I ever wanted to know. I know that even though it's rare, it probably isn't as rare as we think because the diagnosis is often missed.
While it's been a serious struggle over the past six to eight months, I suspect she may have had the condition far longer. Thinking back to when we first adopted Harry as a kitten (nearly three years ago), Heidi was a healthy 11 or 12 year old adult cat. We often called her "Tubbykins" because she'd become a bit pudgy. She started losing weight shortly after Harry arrived. Not a great deal of weight but "tubby" no longer described her. We just thought she'd lost some weight because she was chasing after a kitten. More exercise! All good! The idea that she might be ill never crossed our minds.
Then came the camping trip two years ago where Heidi decided to go back to being a feral cat. To this day I don't know how she opened the camper door. She lived rough for a week in North Little Rock before we found her and brought her home. We had her checked out by a vet in Arkansas before bringing her home and she'd lost a few pounds but it could be explained by the fact that she didn't have a steady, reliable source of food and had to rely on her hunting abilities. (She was a good hunter, but she was better when she was younger and quicker.) Again, she'd been checked out and we had no idea she might be ill.
But she never gained that weight back. She looked like she might be losing more but only going to the vet once a year, it was hard to say. Other than the fact that she seemed to be losing weight, she looked quite healthy. Her coat looked good and her eyes were bright and she behaved normally.
Then last July she wasn't well. Cats frequently "hide" when they don't feel well and Heidi was hiding under a table in the spare room. It turns out she had a bladder infection. After the round of antibiotics, she was feeling much better but seemed to be having frequent diarrhea. I got some feline probiotics to give her but they didn't seem to help.
She had a round of steroids. I know that we struggled with finding a diagnosis. All sorts of blood, urine and fecal tests were turning up nothing. We started experimenting with different foods. The weight loss continued.
Without getting overly graphic, let's just say that the diarrhea problem reached epic proportions. It was taking both of us hours to clean up the mess. The vet was in unfamiliar territory, as well. The elimination of just about everything else left us with the exocrine pancreatic insufficiency diagnosis. I read every thing I could find about it. It seems that roughly 60% of cats respond well to the treatment and about 10% don't respond at all. The rest were somewhere in the middle.
Heidi was somewhere in that group that didn't respond well. She continued to lose weight even though she was eating like a horse. She would be starving to death in the morning because she just wasn't getting the nutrition she needed from her food. She was on a special prescription diet (roughly three times the price of grocery store cat food) and two of her three meals had an enzyme powder mixed in. She didn't much like it, but it was critical for her to have it. She wasn't able to properly digest her food without it. She preferred the one meal where she got to have the probiotic powder mixed in instead of the enzyme powder. (A one month supply of the probiotics cost about $30 and a one month supply of the enzyme powder cost about $100.) But the real challenge with all of this was keeping her from eating Harry's food. And that wasn't easy. Being the food monitor was a serious job. Heidi was very sneaky and would take any opportunity to dip her nose into Harry's bowl if Harry walked away. And very frequently, the phone would ring and I would have to go into the office and by the time I got back she had polished off Harry's food. This would usually result in what came to be known as a "blow out" poo.
In the past when we traveled, Heidi would stay with friends. She'd been doing that all her life and felt as much at home with Alex and Jeannette as she did with us. (In fact, I think she liked them better until they got a dog.) But given her condition, I couldn't ask them to look after her while we were gone. Especially since in addition to their two cats and dog, they were also looking after a toddler. There was no time to be food monitor and no time to clean up the resulting blow-out if Heidi ate the wrong food.
The only option was to board her with the vet while we were away. I know they do their best there and get the cats out to interact with them. But I know this about Heidi - she wasn't big on that type of interaction. She saw herself as your equal. That meant you didn't pick her up and hold her. She would sit beside you but she didn't like to sit on your lap. (Harry, on the other hand loves to be on someone's lap.) There were no windows there for her to look out of and I know she hated going there. But it did solve the food monitor problem. She ate exactly what she was supposed to eat and there was no chance that she was going to get into another cat's food. But sadly, she had the blow-out poo anyway - at least once or twice a week.
We knew that this was a chronic condition and that she would be on the enzymes and probiotics for the rest of her life. I was okay with that. But I wasn't okay with boarding her when we were away. I'd hoped that she would respond to the treatment and stabilize enough to the point where even if she did sneak a bit of Harry's food, it wouldn't be disastrous.
But that's not what happened. She continued to lose weight and the disasters continued to happen and sometimes they happened even when we knew she hadn't eaten anything she shouldn't have. (They also happened while she was at the vet with her food intake carefully monitored.) She stopped going outside except for very short periods and she wasn't keeping up with her grooming like she used to do. And I was faced with boarding her for another ten days.
I was certain that we had done and were doing everything that could be done and her situation would only deteriorate. It would never improve. I wanted to hope that she would improve but was finally forced to accept that she would continue to waste away. It was so hard to reconcile that with the fact that she still wanted to be with us - still wanted her ears rubbed. And we were both with her at the end - rubbing her little ears until she slept.
No comments:
Post a Comment