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Maceo Cat's Cancer Journey

Jul 19

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Wednesday 7/19/17

Today was Maceo’s big First Day of Radiation! Jose and I got up extra early to go to yoga at 5, back by 7:30 am, for an 8:30 departure for UC Davis.

Maceo did even better than usual in the car (maybe he knew it was his Big Day?), and set a shining example for poor kitten Charlie, who threw up viciously after getting car sick at the very beginning of the ride.

It’s only an hour and 20 minutes by car, but that can seem like forever to a little kitty!

When we arrived at Davis, we waited for a couple of hours before they took him in.

This was fine by us, as the waiting is always pretty peaceful there and they have good wifi (plus I broke the rules and gave Maceo a small snack at 4 am — they’re supposed to fast from midnight on. Long story short, it was fine.). As in previous visits, I was able to be very productive while there and even had a good team video call and sent an important email campaign!

Charlie had to wait with us too, and he seemed more traumatized than Maceo. I sure hope he never gets cancer, because he would make a terrible patient.

In the waiting area, we chatted with another kitty parent who was bringing her cat for her 11th radiation treatment (also out of 20, also for a fibrosarcoma). That kitty looked tired to the bone, and yet it was comforting to hear from another person going through a similar situation. Her kitty had totally clean scans, though, whereas Maceo has not just one by two little nodules in his lungs. Call us crazy, but we aren’t condemning him yet for those two nodules. No one knows for sure what they are, and many animals (and humans!) have all sorts of random growths inside them.

At 12:30, the radiation oncologist took him away to get started. At 2:30, a mere two hours later, we got the call that he did great and was ready to be picked up. Fast! We were told he could be there all day on his first day, so we were pleasantly surprised that we didn’t even get to have lunch before it was time to go get him again.

When we picked him up, he was one mad cat. The nurse told us that he was pretty angry at them, for whatever reason, but they had been able to give him about half of his food that I packed for his “wakeup” moments (apparently, they are hungry right after anesthesia because the drugs whet their appetite).

He has a wrapped catheter in his right wrist so that they don’t have to poke him every day (they can just unwrap his catheter to administer anesthetic drugs), and he has to wear an e-collar to prevent him from fiddling with the catheter. It’s so interesting that animals have to go to so much trouble for something like radiation treatment — which doesn’t hurt at all — simply because they don’t understand what’s happening and they can’t / won’t sit still enough for the treatment. Anyway, anesthesia, catheter, e-collar… it’s all just to get him to stay still!

During the 10 minute car ride back to our hotel, he wasn’t quite as calm as during our morning ride in to Davis. This time, he meowed angrily the whole way. Pretty stressful, and made the 10 minutes feel like half an hour.

Once we arrived in the hotel room, though, he became a different cat. His tail perked up, and he immediately went about investigating the entire room — every nook, cranny, and door. This was a complete 180 from the kitten Charlie’s reaction; upon entering the room, Charlie immediately ran under the bed and stayed there, so upset was he.

Maceo explored the room thoroughly, and then decided he wanted to explore the rest of the hotel. He told me this by standing by the door (which he knew led to something more) and looking at me expectantly. So we harnessed up, and took him on a brisk leash walk up and down the hallway of the hotel, and even outside by the walkway to the pool.

When he came back in, he was ready to eat! He ate well today, and it was a full supplement bonanza. Much better mood and appetite than at home.

We kept remarking that he seems much more cheerful, alert and engaged when he’s in these strange new situations — even clinical ones! This is completely opposite of what most cats are “supposed” to act like in new situations. At first, I thought it was maybe his way of showing stress. But… he does not seem stressed. He simply seems bossy, interested, and very curious. Good for him.

In the evening, he got lots of special treats, including a fresh catnip plant that he promptly proceeded to gobble down, a catnip worm, and some new baby food (for his daily supplement fest).

It’s almost 9 pm and he’s still not sleeping! If this were a regular day at home, he’d be pretty disengaged by now. But here, he is still poking around the room, eyes big and bright.

Well, that was Day 1 of 20… we are staying positive, but realistic that not all days will be this easy. Still, we’re hoping for the best and doing all we can to keep him strong.

With that, here’s his intake for the day.

Total supplement intake:

  • 2000/2000 mg Turkey Tail mushroom, 4 total pills
  • 2/2 pills Stamets 7 mushroom blend
  • 0/600 mg IP6 with Inositol (0 total pills) — didn’t bring this with us
  • 2/2.5 scoops Transfer Factor Feline
  • 1 pill (200 mg) Transfer Factor for humans
  • 0/2 tea pills of Chai Hu Shu Gan Wan (bupleurum)
  • 7 drops of CBD oil

Total food intake:

  • 1/2 blocks of Primal Chicken & Salmon (46 cals per block) — 46 cal
  • .5 blocks of Primal Venison (40 cals per block) — 20 cal
  • 0 cup Origen kibble — 0 cal
  • 0 cup homemade chicken bone broth — 0 cal
  • 0 tablespoon of raw pureed chicken liver — 0 cal
  • 1 jar Gerber turkey baby food — 80 cal
  • 3/4 can Wellness grain free cat food in turkey and salmon flavor (166 cal per 5.5 oz can) — 125 cal
  • Some treats

Total Calories: 271


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Jul 10

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Monday 7/10/17

Today was Maceo’s big day at UC Davis… his long-awaited consultation with their oncology department! We were fortunate to be able to pull in Dr. Michael Kent, who’s the radiation oncologist there, as well thanks to some string-pulling on the part of the kind surgical oncologist we spoke to last week here in San Francisco (normally that might be a separate appointment).

Well, it was a hot day out in Davis — about 100 degrees and we didn’t realize our A/C was on the Prius’ “eco” setting, thus rendering it totally useless against the blazing sun. Poor Maceo started meowing as soon as we got out of the cool foggy Bay Area and the car started heating up. His little paws were sweating, and they were hot just like him. Poor guy! He meowed not just because of the car ride, but also (or mainly?) because of the heat. When we finally fixed the A/C, he seemed to do better, but by then he was already at the end of a long day and pretty exhausted and fed up.

We left for the appointment at 11 am to arrive by 1 pm, since Davis isn’t terribly close to San Francisco. So, we were still able to have a pretty normal morning, with a morning walk, a supplement snack, and a full breakfast.

As soon as we got home, Maceo headed straight for the first food bowl he could see (Charlie’s, that we had to leave out in the morning as we were hurrying out of the house). So, it’s great that he was hungry, but after eating, he limped quite a bit and had no desire to go out for a walk. He’s typically always up for a walk, so this was concerning to me.

Tomorrow, the holistic vet is coming and promised to bring some pain meds (she’s a regular vet too!), so hopefully that will help tide him over till further treatment on the tumor.

The UC Davis Appointment

Totally contrary to the horror stories we read online, our experience at UC Davis was positive — aside from the long wait times. The staff were professional and nice, and clearly loved animals very, very much. Maybe more than any other veterinary staff we’ve encountered in our dozens of visits so far!

The oncologists at Davis seemed more empowered with knowledge and tools than any other oncologists we’ve seen so far (that’s four total besides the two we saw at Davis), and that’s probably because they’re at a world-class facility where they can actually do stuff, instead of just refer people to Davis.

They were pessimistic, or realistic, depending on how you look at things. They emphasized their concern about the nodule that was found on Maceo’s lung, and said that if it represented metastasis, then treating the primary fibrosarcoma via radiation and surgery could delay (palliative) treatment of the lung nodule using chemotherapy, with disastrous consequences for Maceo.

After much talking, and much more waiting (we waited about two hours total, separate from our actual appointment time), I basically bulldozed my way to a definitive radiation treatment for Maceo. When you are someone’s mom, you must be the last person to lose hope, and you have to be so strong in that.

I understand the doctors have a duty to tell me the median outcome, and to make sure I fully understand the risks of what we’re getting into. They don’t want another nasty Yelp review saying they don’t care and are just after the money, or that they “promised” a cure, but the animal died anyway. I understand them needing to be protective and conservative — even pessimistic — after the intense negative attention that’s come their way over the past couple of years. So that’s fine… but that doesn’t lessen my conviction or my belief in my strong Maceo.

(In the same conversation, the radiation oncologist told us about his own dog who had two nodules in the lung that they were sure were metastatic cancerous growths after another tumor appeared in the spleen. They operated on the spleen, found it to be benign, and did nothing about the lung nodules. When he died 5 years later, they autopsied him and the nodules were nowhere to be found. So, as that doctor said, we don’t want to “condemn him for the results of one test.”)

Anyway, there’s so much more to say, but in short we decided on the following action plan (again, bulldozing!):

  • CT scan on Wednesday July 12 to prepare for IMRT radiation treatment
  • They will also try to needle aspirate the lung nodule one more time from a different angle to see if they can get some of its cells and see if it is indeed metastasis)
  • If not, they’ll begin radiation on Monday July 17.
  • Radiation is 20 treatments, 5 times a week for 4 total weeks. My husband and I would temporarily move up to Davis so we could be with him daily.
  • If it IS metastasis…. well, I don’t know right now. We’ll have to cross that bridge when we come to it.
  • They probably can’t do chemo and radiation at the same time (the medical oncologist’s chemo drug of choice, doxyrubicin, doesn’t play well with radiation), so we really have to pick just one route at a time.

Long car ride home through traffic and 5 o clock heat, then home to rest. I took the day off work today, so tomorrow will be busy.

I’m extremely nervous about Wednesday and what tests will show. I have a lot of faith and show strength for my baby, but I also feel worried inside.

Here’s his intake today.

Total supplement intake:

  • 1500 mg Turkey Tail mushroom
  • 700 mg IP6 with Inositol
  • 4 scoops Transfer Factor
  • 2 tea pills of Chai Hu Shu Gan Wan (bupleurum)

Total food intake:

  • 3 blocks of Primal Chicken & Salmon (46 cals per block) — 138 cal
  • 1/8 cup Origen kibble — 50 cal
  • 1/4 cup homemade chicken bone broth — 20 cal
  • 1/2 Tablespoon of raw pureed chicken liver — 10 cal
  • 1 jar Gerber all chicken baby food — 100 cal
  • Some treats

Total Calories: 318

Jul 07

Friday 7/7/17

We started giving Maceo Turkey Tail mushroom. Today, we were able to get in 1.5 capsules (750 mg) of Turkey Tail, and 2 scoops of Transfer Factor, which also contains Turkey Tail among other mushrooms as part of its immunity blend.

Total supplement intake:

  • 750 mg Turkey Tail mushroom
  • 2 scoops Transfer Factor
  • 200 mg IP6
  • 100 mg curcumin longvida
  • 1 tea pill of Chai Hu Shu Gan Wan (bupleurum), prescribed by Dr. Lisa Pesch

Total food intake:

  • 4 blocks of Primal Chicken & Salmon — 180 cal
  • 1/4 cup homemade chicken bone broth — 20 cal
  • 1/4 cup Origen kibble — 20 cal
  • 1/4 cup raw pureed chicken liver — 50 cal
  • Spoonful of grain-free canned food
  • A couple of treats

Total calories: 270 cal

It’s been two weeks since we discovered the tumor. Yesterday, we saw a surgical oncologist, James Farese, to talk about surgical interventions for Maceo’s tumor. He recommended getting radiation first, so we are proceeding with the UC Davis appointment on Monday, but we also called the Veterinary Cancer Group of LA to have a backup and get a second opinion, given the extremely negative reviews of the Davis clinic.

He seems to be ok. He has been going out on the harness and leash for multiple hours a day, sometimes walking, other times just relaxing, and he even slept in the bed with us again the whole night. He didn’t just stay in his “sick chair,” the place where he goes when he’s unwell.

Charlie

In the meantime, baby Charlie seems to be feeling bad.

Yes, he is also a black cat. But unlike Maceo, he is goofy, clumsy and generally very clownish. He also has very mild cerebellar hypoplasia which makes him extra silly when he’s excitedly running around, and sometimes his back legs slip out from under him.

He started vomiting (multiple times) and generally seems to not feel good. We took him to a completely useless vet — Especially Cats Veterinary in San Francisco — yesterday for his wrist, and the only thing that came of it was 1) he got carsick and threw up in the car, inside his kitty backpack carrying case, and 2) we were told that by the vet that she had no idea, couldn’t successfully do a needle aspiration on his wrist, and that we should go and see an internal medicine specialist at VCA.

I’m not sure if I just have had too high expectations for how much veterinarians should be able to tell you, but I’ve been so disappointed every single time. We’ve taken Charlie twice to SPCA, once to an expensive dermatology specialist, and now once again to this cat-only clinic, and his foot issue is completely unresolved. We don’t even have one speck of knowledge more, and nothing close to a diagnosis. I guess it’s time to take things into my own hands with Charlie as well.

His wrist is so swollen that it looks like a boot. He’s drinking lots of water, willing to eat, but then vomits again. Poor thing.

Jul 04

Tuesday 7/4/17

It’s been 12 days since we noticed the lump.

Now, looking back, it’s crazy to think that we didn’t notice it before — it’s so bulbous and foreign underneath his velvety coat. But, it’s there on the shoulder blade, sort of like a football player’s pad on top of his regular bone and tissue.

“Wow, your cat is so friendly. But what’s that lump on his back?”

Thank god that our friend Ryan, with his fresh eyes, saw something and said something. At first, we thought maybe he’d been bitten by an insect while on his daily harness walk in the back yard. That was how sudden it seemed to appear. But no, it didn’t seem like a bite of any kind.


We took him to the emergency clinic the next morning, a Saturday. After waiting and waiting, he was needle aspirated and examined. He didn’t have an infection, which only left worse possibilities. I went home with Maceo, who had been patient in his carrier for the entire 3 hour visit — half of it without me — full of worry and apprehension.

The next day, Sunday, the vet called me at 8:30 pm at night. The initial results indicated sarcoma, she said, sounding awkward and robotic on the phone. I’m sure it’s tough news to deliver. We would get the official cytology results the next day.

My heart dropped into my stomach. I never thought I would be hearing this about my most special, most intelligent and most robust kitty. Maceo was the one who fought off fleas. Maceo was the one who never got sick except for his run in with calicivirus earlier this spring. Maceo bounced back from emergency small intestine surgery after just one day. This couldn’t be happening to Maceo… yet I knew it was.

I fought off nausea and switched into action mode. I started Googling everything I could, and started making appointments. Because it was the week before July 4th, I made about a dozen calls before I got him an appointment with an oncologist in Redwood City, 45 minutes away from San Francisco where we live. I also made him another appointment with a well-regarded holistic vet in Santa Rosa, an hour and 15 minutes away, and an appointment with 5 other oncologists later that week and into the following week. I also made him an appointment at UC Davis, which couldn’t accommodate us until July 10th. Why so many? You can never be too sure, was my reasoning, and it was better to stack up the appointments and then amend them, then have to wait again.

Maceo is strong and independent, and has been eating raw since I adopted him at 8 weeks old with his bonded ‘brother’ Spike. I sent them to live with my mother in Seattle when I decided to take a sabbatical from my busy life in San Francisco’s startup scene and live in India and Bali. Maceo and Spike were 6 and a half years old at that time, and had learned the ins and outs of apartment living with me. They knew how to open drawers, freezer doors, and cabinets in their insatiable pursuit of forbidden food. I used to ask myself, is this because I’m feeding them raw, and they’re not getting enough calories? But they were a healthy body size, especially Maceo, who was dense and muscular, though soft at the same time.

Those years away were crucial to my formation, but I sure did miss my kitties and now I sometimes wonder if it was really worth it to be away from them.

Can’t take it back though, so here we are.