Merlin had always been a chubby boy. Perhaps we should say husky. Yes, Merlin had always been a husky boy. Juggling food between him and Houdini had always been a struggle, as Houdini is the absolute opposite. While Merlin was the wrestling champion in the heavyweight division, Houdini is the anorexic ballerina. So, after Merlin's physical in August when we received the report he had plumped up to a hearty 16 lbs, we decided to commit to regulating his food better, and providing Houdini more opportunity to eat while supervised.
By the middle of September, we thought that our plan might be working, because it had seemed like Merlin lost a little bit of weight. But by the end of September, we started wondering if he had lost too much. We started feeding him just a bit more, and he started leaving leftovers in his bowl. By the first weekend in October, we knew something was wrong - he had gotten too skinny. So, back to the vet he went, and it was reported that he had dropped 3 lbs since his visit 5 weeks prior. Even worse, on abdominal palpitation, a sizable lump was discovered. An ultrasound was scheduled for the upcoming Thursday, and we were sent home worried with a rather gaunt looking kitty. As we waited, we tried multiple new foods with Merlin, including cans of soft food, in the hopes that something would spark his once insatiable appetite again.
At his ultrasound, we received some of the most terrifying news: Merlin had 2 large tumors in his abdomen, 5x7 cm and 4x6 cm, and a tumor on each of his kidneys. The vet took fine needle aspirates of two of the tumors for confirmation, but did tell us that it looked like feline lymphoma to her. Lymphoma? My only knowledge of the disease was limited to the fact that it was a cancer, and therefore it must be bad. A text to my sister (a veterinarian) with the news yielded a very simple initial response: I am so sorry. That one phrase in itself told me the severity, and the grim outlook.
The weekend was a blur that was consumed by worrying about Merlin, as he had stopped eating by the middle of the day on Saturday. We did receive an appetite stimulant for him (mirtazapine) which apparently wasn't working. And by Sunday night, after more than 24 hours of not eating and almost no drinking, we were terrified. He began looking spacey and as if he were ready to check out of this world. The most heartbreaking part was that during the entire time, our cat that was once extremely food motivated would not eat a bite. He would cry for food, and run after you if he thought you were feeding him, but no matter what we found to feed him, he would just turn up his nose. We were terrified he wouldn't make it through the night, so we picked him up and took him to Penn Vet Hospital, in the hopes that it was not too late for him.
At Penn, we checked in and handed over Merlin, who was set up in a sizable, somewhat cozy hotel room which he promptly started voicing his discontent over. Apparently, he was informed that we would not be spending the night with him there. After a tearful goodbye, we departed, knowing that he was in hands far more capable than our own. He was to receive an IV of fluids overnight, and be transferred over to internal medicine in the morning. From there, he could receive treatment from oncology without formally being on their schedule.
Monday morning started out frantic. No real treatment could be rendered until we received the results from his aspirates, so I was determined to obtain them as soon as possible. Sure enough, once they came back from cytology, we had confirmation on what we already knew: lymphoma. The results didn't distinguish which tissue the lymphoma was diagnosed in, but it is likely that all tissue is involved. His end diagnosis was renal lymphoma (kidney).
After much deep thought and discussion (which took part in the days prior), we decided to start Merlin on chemotherapy. I will discuss our process to come to that decision in another posting, as it was not an easy decision to make. So, after his initial blood draw to obtain a baseline, Merlin received his first chemo injection of Elspar (L'asparaginase) and was sent home with a whole slew of pills: prednisone, ondansetron, metronidazole, and marbofloxacin. The first one is a steroid and a part of the chemo protocol. The next, an anti-nausea drug, and the last two are antibiotics (an anti-diarrheal and a broad-range).
I held my baby close and hugged him before putting him in the carrier to go home. I could tell he was scared, stressed out, and didn't get much sleep the night before. I told him, "I know buddy. Me too, me too." When we got into the car, he didn't put up a fuss at all (regularly, he'd question my motives with meows of discontent), so I tried to solicit a response by speaking to him. He never responded.
We drove home in silence, unsure of what the near future would bring.
