Canary # 5, the Toughest One

(Image by Henri Gustave Jossot, 1903)

Brutus was a rescue from Hamilton Animal Services. He was on the the euthanasia list. His history was completely unknown, and he was scheduled to die to make room for another cat, who would also probably be unclaimed within 72 hours, who would also be euthanized.

He reminded me of a cat I had once known, a great cat, so I spoke up that I would foster him for a rescue group. The group sent emails with photos of all the tragic cats on death row, several times a week. Their only chance at survival was to get “pulled” from the shelter by an individual or rescue group. Brutus turned out to have several medical issues that were an impediment to an easy adoption, and I got too attached during a particularly brutal period in my personal life. Brutus became a permanent member of my household in 2009.

Brutus’ death row photo from Hamilton Animal Services, 2009

Brutus was difficult to figure out. He wasn’t very social with me, or conventionally affectionate. Things that scared other cats, like a vaccuum cleaner or noisy power tool didn’t upset him at all. He was extremely food motivated. Even as a rescue from the shelter, with grimy, stinky fur, he wasn’t underweight or skinny. His body was wide and stocky, but short. His tail was short, and his feet were huge. Had he been someone’s pet that got left behind ? Was he a semi-feral cat that was used to being around people, but never had much friendly interaction ? He seemed to like being around other cats okay – but he was never close to any of them. I suppose he was kind of an introvert, as personalities go. He liked to hang around with me, but wasn’t a cuddler. Brutus just WAS.

Brutus faced a variety of life threatening challenges – from his first brush with hemobartonella – a blood parasite transmitted by fleas that can cause severe to fatal anemia. Shortly after, his digestive issues asserted themselves and he was diagnosed with mega-colon – a condition where the nerves in his gut don’t communicate properly with his brain. For the rest of his life, his food intake had to be supervised, with an additive to all foods to keep him properly pooping.

When he felt bad – he felt HORRIBLE. The hemobartonella apparently causes the spleen to swell painfully – and he really let me know how much it hurt. If he was touched the wrong way he would bite, HARD, and he was pretty scary. I navigated my way through dealing with an indifferent vet who didn’t diagnose him properly. The vets that followed got several pages of printouts to explain his complicated medical history. With the proper treatment the hemobartonella receeded, and his guts felt okay.

Brutus was pretty easy to please. Once in awhile he would astonish me with his former alley cat ways – like when he ate all the skins from a roasted squash I meant to compost. He really couldn’t be trusted around anything food-like. He learned that if he pushed the metal cannister where the dry cat food was (that he wasn’t allowed to eat) off the counter – that the lid might open. If he was lucky I wouldn’t hear the loud metallic smash as it hit the floor, scattering food. He would gorge himself until he was discovered, then would have to endure a day of enemas at the vet to remedy this indulgence. I couldn’t leave a sandwich halfway prepared as he would lick all the mayonnaise off and eat half the bread. He was driven by his food lusts.

Despite his chronic conditions, he was a normal guy.

Less than a year after the renovated gas station opened, he developed sudden acute liver failure. This happened during a month where I experienced THREE horrible gas vapour infiltrations inside the house. Even though his bloodwork showed the highest liver values my vet had ever seen – he didn’t seem that ill. He responded to medication for a presumed infection, and made a complete recovery that no one expected.

Fourteen months later, Brutus suddenly couldn’t raise his head. Bloodwork revealed very low potassium values, which were odd as he was fed a commercial diet and didn’t have other health issues like renal failure. It took awhile to put the puzzle pieces together – very low potassium plus extremely high blood pressure – again – the highest my vet had ever seen. The high blood pressure didn’t seem to be responding to the regular blood pressure medication dose, nor increasing amounts. It was only after he was tested for Hyperaldosteronism – with very high results that confirmed this condition – that his blood pressure was under control with another medication added. Hyperaldosteronism is caused by tumours on the adrenal glands. No one is sure what causes this. In ten years of being a vet, my vet had never diagnosed this condition. There wasn’t a lot of information on treatment or outcome, or even basic life expectancy for cats. My vet sadly toldly me that the medication regieme would be palliative.

As always, Brutus defied expectations. Within weeks of starting the proper medications he seemed completely fine, like normal Brutus. A year later, his bloodwork still looked good, and his blood pressure remained under control. His appetite was good, and his somewhat plump weight held steady. I searched and searched online, but couldn’t find more information to tell me what might happen. Senior cats have several health conditions that are pretty common – chronic renal insufficiency, and hyperthyroidism, for example. There are online groups where members help strangers understand and manage the common symptoms and treatment, how to decipher bloodwork results, and so on. I couldn’t find anything for cats with this condition. I read medical papers written by vets, and regular human doctors. In humans this condition is usually treated by surgery. However, cats are much smaller than humans, and a cat’s adrenal gland is about the size of a small green pea. Because his results were so high, this indicated that he had tumours on both adrenal glands, so was not a candidate for surgery. Surgery is very expensive, and must be done by a specialist veterinary surgeon, so this wasn’t an option in a smaller community anyway.

Brutus needed a very high dose of potassium to maintain his levels within an acceptable range. The prescription medication was generic, and a local human pharmacy was able to order it for me. Because Brutus had experienced so much veterinary interaction during all of his troubles, he became an easy and tolerant patient. He was easy to pill, and was happy to get meals throughout the day as his medication had to be given with food. In the last couple of years of his life, he endured a minimum of 8 pills every day. He became a good pill spitter, too, but he wasn’t very discreet. Brutus seemed indestructible.

December 2021 was overshadowed with my worries about Honky, as his unknown cancer made him feel worse by the day, before we came to the end.

Throughout the winter of 2022, I noticed that Brutus seemed less active, and was spending most of his time sleeping in the cardboard box he claimed, next to the warmest heat register. He started to get picky about eating – but the other cats were often refusing to eat the same canned food, too. A couple of the other cats were also colonizing Brutus’ box when he left it, so I made a second box next to it. I felt like Brutus was feeling less well, but there weren’t any new symptoms to address.

When the slippery slope starts for an ill cat – it can be acute – like for Rumpy – or a long subtle decline.

I had a stockpile of prescribed cat medications. I really couldn’t tell why Brutus was picky about the food. I tried changing foods, which made little difference for him OR the other cats. I wondered if he was in pain from his arthritis or a bad tooth ? Gabapentin knocked him out into complete immobility, even with a quarter of the dose, and he definitely felt no relief of any kind. I tried a couple of anti-nauseants – in case something going on was making him queasy, even though he was seldom vomiting. They made no difference. I tried the appetite stimulant – but that had no effect, even after several days. His gums looked pale. His bloodwork had always been on the cusp of anemia – but he was not showing any signs of a hemobartonella flare up, like a very painful belly, or extreme lethargy. It seemed like he felt better one day, then less good the next, then better the day after that. On good days he would make the trek down the flight of stairs to sleep on the bed with me. He was definitely losing weight from eating less.

I felt that he was on the slippery slope, and doubted there was much to help him.

Xrays revealed two large masses in his abdomen – probably the adrenal tumours. Each was the size of a large peach pit. There was an area of possible metastasis. I didn’t bother with bloodwork, as the tumours and possible, probable cancer were obviously what was making him decline. I didn’t have Xrays to compare it to, so I have no idea how large the adrenal tumours were at the time of original diagnosis in May, 2020. I suspected that the tumours were displacing his organs, and making his stomach feel full, even when he was hungry. I knew that his time was running out. His heart looked enlarged, but without any fluid build-up. The vet agreed that he looked very pale. Anemia is a SYMPTOM of a bigger issue. Had the tumours infiltrated his kidneys, which was causing the anemia ?

Despite this, Brutus showed me that he wanted to keep going. His world was getting smaller and smaller as he weakened. He enjoyed a few warm spring days in the yard. He walked around a little and settled in a sunny spot as the other cats raced around. I could tell he felt tired, but that he wanted to remain present.

Subcutaneous fluids helped him feel better, a little. As he ate less and less, he had less strength. If he was able to walk down stairs last week, he could now only move about 25 feet before he had to rest. The next day it was only 5 feet before he needed to rest. He refused all food that I offered him. I knew that we were at the end. I emailed the clinic to schedule his euthanasia. I assumed it would be the next day.

Even though he was feeling very frail, he walked to the back door to let me know he wanted to go outside. It was a little above freezing, not the nicest day. I carried him around to the spots I knew he liked, and set him down so he could smell the earth. He liked to sit in one spot with his head stuck under the privacy cloth, to watch the cars on the busy street. I showed him everything that I knew he enjoyed. I sat and let him move around at his new slow pace. Eventually he settled down in the spot I thought I would probably bury him, next to Honky. This made me feel terrible.

I brought him back inside, and put him in a warm spot. The clinic called, and asked if I wanted to bring him today ? I hadn’t considered this as a possibility. I really didn’t want to take him in at all, but I knew that his life, what was left of it, probably would not have a simple or painless end, without intervention. I knew that I would have an awful, sad, anxious night, and I doubted his would be much better.

At the clinic, in the euthanasia room, I held him and talked to him about what a good pal he had been, in his Brutus way. The vet tech came, and took him to the back to insert the IV catheter for the euthanasia procedure. I sat alone for what felt like a long time. The tech rushed in and said they thought he was starting to die on the table – did I want to be there ? I followed her. He was stretched out gasping. I crouched in front of the table so he could see me, and pet him and talked to him as he died. I don’t know if the sedative injection pushed him over the edge, or if he was already so close to going that he started to die on his own terms. The euthanasia drug was administered anyway, and his heart was confirmed to have stopped.

In human medicine, it is well known that dying people often hang on when their loved ones are in the room – but when the loved ones leave for a drink or a bathroom break – that is when the person can let go and die.

Brutus was no spring chicken, and I knew that he would die, someday.

In context of the chronic, intense gas vapour infiltrations – and all the unusual presentations my other late cats had – would he have had this condition with NO exposure ? I have never met another person OR cat with this condition.

Euthanasia killed him, it is true, but this condition brought him to the end.

The following week, my routine bloodwork had an abnormal result that suggests that I am in the early stages of kidney disease…

Brutus, euthanized March 22, 2022.

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