Kofi

October 15, 2007

This is a loosely organized collection of things I wrote to various people when my cat Kofi died. I haven't tried to organize this into a coherent narrative, and probably won't. I just wanted to keep a record of what I was feeling at the time.

I had to put Kofi to sleep today. Everything seemed fine until Friday, when he threw up a bit during the day. Then I came home from swimming that evening to discover he had completely lost his lunch, and was hiding under the bed and didn't want to come out. I figured I'd leave him there, and during the night he joined me in bed, but later got up and threw up some more - this time nothing but bile. I woke up in the morning to more retching and he looked awful. I rushed him to the vet, and they didn't seem too concerned but suggested I admit him. They said they'd call me if they needed me to authorize any treatments and they never did. I couldn't call them because their regular office wasn't open. But when I talked to them this morning they said he had gotten a lot worse, and they had been unable to feed him. I went in and the vet showed me x-rays from Saturday and from today. Saturday's didn't look too bad but today's showed his chest completely full of fluid - "hydrothorax". I asked if we could drain the fluid, which was possible but the vet said there was a 90% chance he'd die under the anesthesia, of a heart attack due to the already high stress, and that anyway we'd probably just delay things a couple weeks, and keep him in pain during that time. Although I hated to leave an option unexplored, he was clearly in pain and I didn't want to prolong that if the chances were good he'd still die anyway. So I authorized them to put him to sleep. I hated that he didn't get to die at home, and that he died in pain, both of which were situations I always wanted to protect him from. At least I was there with him, but I don't know if he was able to appreciate it.

Of course I'm now second guessing myself and wondering if there was anything I could have done to prevent this, or if if I had more information I would have thought the prognosis was good enough that it would have made sense to treat this more aggressively. There are any number of causes of this condition, including trauma and something he ate. But we went through the list of possibilities in that area and the vet doesn't think any of those are likely. He says it's most likely a virus that Kofi had all along, that just chose this time to make itself known. They had drawn blood to do some tests, but canceled the tests once it was pointless. I could still have the tests run, the question being if $200 to run tests that won't save his life and may or may not set my mind at ease about what I could have done differently is worth it. I also wonder if a different vet would have given me a different prognosis, or if, had they done x-rays on Sunday, they would have caught it with a better chance to do something constructive. The vet doesn't think so, and there's no point second guessing the vet now, but I do wish I was confident that all options had been explored as early as possible.

About 2 months ago it seemed to me that Kofi was depressed. I decided that he really needed feline companionship, because we had just had another small tiff about the fact that he can't play with me the way he would with a cat (with teeth). In retrospect, it's also possible that this apparent depression was actually an initial symptom of the condition that eventually led to this. So about a month ago I brought another cat home from the humane society and have been going through the process of introducing them. Kofi wasn't all that thrilled to have a new guest, but was starting to relax somewhat around the new cat. The new cat was definitely trying to be dominant over Kofi, and there were certainly some power struggles - though I would interfere when Kofi was losing too badly, and I had only started allowing them to be in the same room together full time for a few days. But I wonder if the stress of the introduction played any factor. I hate the idea that something I did, expecting it to be in Kofi's best interest, could have worked the other way around. I asked the vet if the new cat could have brought in any disease, or if the fighting itself could have been a factor, but he said no. But I supposed I can't know about the stress angle.

So there are a lot of unknowns to me about why this happened and if I should have done anything different. I have always felt extremely responsible to Kofi and didn't want to fail him. Bringing the new cat home also made it really clear how attached I was to Kofi - I felt more attached to him than ever when there was another cat to which I wasn't yet really attached to compare. The good news is that, in spite of the stress of the new cat, I made sure Kofi and I had lots of "us" time in what turned out to be his last month of life. So I can hope that, all things considered, Kofi was reasonably happy up until these last few days, and hope that the decision to minimize the amount of pain he was to experience was also right.

This is my first adult experience with loss and the suddenness of it. In that, I guess I'm on the whole lucky. I haven't lost any people close to me, and no pets since my teenage years, and none for whom I felt wholly responsible as I did for Kofi. I always knew I would have to lose him sooner or later, and hated the thought, but certainly never expected it would be this much on the sooner end of that scale.

So now I have to deal with the "life goes on" side of things. I don't feel I want to emotionally engage with the new cat right now. I'm thinking of asking someone to look after it for a bit, though on the other hand maybe it's better to not have a completely silent apartment. Dunno. I certainly would never have chosen to get a new cat for quite some time after losing Kofi, and am kind of stuck with this situation now.

I'm still doing a lot of thinking over whether there was something I should have done differently. For instance, if I had taken Kofi to a 24 hour vet instead of his regular doctor, would they have been more likely to check in on him more closely on Sunday and caught the hydrothorax in time to do something meaningful? Or if what I took as depression was in fact the (only) symptom of a viral infection, could I have diagnosed it earlier and put him on some medication what would have helped?

I'm also wondering if the new cat could have bit Kofi and caused this - online searching says that can indeed be a cause of hydrothorax. I know the cat got its jaws around Kofi's neck, but I don't know how hard it bit. Certainly it didn't draw blood, as I checked for that, but could the pressure have damaged something internally? The vet said his trachea was narrow in his neck but didn't know the cause of that. And, I'm also wondering if the stress of introducing the new cat could have been a factor - as a primary cause, or accelerating something else that was going on, such as the progression of a disease I didn't know he had. The long and short of it is, Kofi died within a week of my introducing the two cats full time to each other, and I can't help thinking that was an extremely bad decision on my part.

When he died, there was no sense of "release" - neither the impression of a soul leaving the body, nor even the impression that he got to experience a grateful moment free of pain before he died. Everything simply stopped. As I stayed with him, he was frozen in the last moments of struggling for breath. I could see his tongue turning blue and realize that the cells of his body were still alive for a while, but that the collection of processes that made up my Kofi had ended. So putting him to sleep ended his suffering, but did not create a state of non-suffering.

I got Manji 3 weeks before Kofi died, with the intention of having a playmate for Kofi. Those 3 weeks really made it clear to me by comparison how deeply I was attached to Kofi; Manji was just a guest. To have Kofi up and die was really devastating. I still don't know for sure what happened. I can't rule out that Manji brought a virus, though the vet thinks that's probably not the case. It's possible Kofi was getting sick for the couple months before this; I thought he was depressed, which was why I got Manji, but it could have been that he was getting sick then. There were no physical symptoms though until the last weekend, so there was nothing for me to ask a vet about. I really hate thinking that I failed him - I'll never know if there was something I could have done if I'd been more alert, or if it was just his time. I also hate that he did not die peacefully, he was in pain for the last three days, and he was away from home. I was with him when we put him to sleep but I couldn't tell if he appreciated it.