Losing Alex

by Sherry Perkins

It is November 2, All Souls’ Day—the Feast of the Dead. And it’s the day after All Saints’ Day, and two days after Samhain, All Hallows’ Eve, or Halloween, the Cross-quarter day, "(halfway between autumn equinox and winter solstice): the seed now begins its time of gestation, the harvest is gathered, the fields lie fallow, and the gates of life and death are open."*

Yesterday, November 1, I lost my beloved cat, Alex. I didn’t lose her, really, but I had to give her back to wherever she came from when she entered this world as a kitten some 18 years ago. She wasn’t originally my cat. She was adopted as a newborn kitten by Liz, my former upstairs housemate, and this was long before I moved to the Northwest. Her son, Mark, was in third grade at the time. He had a crush on a little girl in his class named Alex, so that’s how Alex the cat got her name. (Now Mark is 27 and he lives upstairs with his wife and year-old son. He just told me the story last night about how Alex had gotten her name.)

Alex and I adopted each other about five years ago. She had been diagnosed with diabetes, Liz was moving to South Carolina to take care of her parents, and I had now said goodbye, in the course of two years, to two very old and ailing cats, Max and Baby. I was willing to take on the responsibility and expense of her insulin shots and periodic monitoring and blood work. She was delighted to be an "only cat," coming downstairs from a household where she’d had to share attention with a domineering male Siamese and a rambunctious Dalmatian.

Alex was an American shorthaired tortoiseshell. She was small, but very round when I got her. Over the years, she slimmed down, as her need for more insulin grew. A portion of her tail had been removed years earlier by a vet, due to a mysterious injury when she had disappeared for three days. This I also learned from Mark. She was absolutely beautiful, with her black, white, and caramel-colored face, dainty white feet, and dark body.

She was also very affectionate and smart. She loved sitting on my lap while I read or worked at the computer. Giving her insulin was no problem after we had an initial talk. I told her that her medicine was why she was feeling so much better, not having to be so thirsty and pee so much, and if she didn’t take her medicine she would feel worse and soon die. From then on, I would call her to come take her medicine, and she’d come and stand still for me, purring.

While she got the best food and care, over the years, her kidneys began to fail. I think this must be the most common cause of death in older cats. Max had the same problem. My vet, Dr. Tejinder Sodhi, a well-known naturopathic vet, urged me to give her subcutaneous fluids, but I couldn’t get her to sit still for that. It would turn into a big wrestling, clawing, biting match, the needle would pop out, saline solution would go all over, and I would give up. In spite of this lack of treatment, she lived on with increasing needs for insulin and increasingly high readings concerning her kidneys, still being her wonderful, affectionate self. I do not believe in allowing animals to suffer needlessly. If she had given me one look, to tell me that she was tired of it all, it would have been over.

But recently, everything came to a head. Her last blood work showed that her kidneys were in terrible shape. Dr. Sodhi was amazed that she seemed to feel so well. Then, last Tuesday, she went into insulin shock. I had given her her usual dose of insulin, but she hadn’t eaten enough food. By the time I realized she was not just sleeping, she was out cold. I thought her kidneys were failing and she was dying. I ended up driving her up to Dr. Sodhi’s clinic in Lynnwood, since he’s not in his Bellevue office on Tuesdays. Traffic was horrible and it took more than an hour to get there. During that time, she had two seizures. Then I knew it was insulin shock. They were able to get an IV catheter into her foreleg and start a glucose drip and warmed her up with blankets. By 6:00 PM she had come around.

She needed to be monitored overnight, so I drove her back to Bellevue, to Aerowood Emergency, where they continued to monitor her and give her glucose and fluids. I picked her up at 7:30 AM on Wednesday. Dr. Friedman told me she’d done fine, and had eaten like a little pig. I took her to Dr. Sodhi’s Bellevue office, where he monitored her all day Wednesday. I picked her up in the late afternoon, and they, too, said she had eaten nearly a can of AD. AD is a catfood that cats will eat when they won’t eat anything else. I bought three cans. We kept the IV catheter in, in case she needed more emergency glucose or fluids. She was glad to be home. Thursday wasn’t a very good day. She ate very little of her AD food. I have another cat, Tasia, that I’m keeping temporarily for a girlfriend who can’t keep her where she’s staying. Every time I turned around, Tasia had eaten the AD food, and once she’d gotten a taste of it, she refused to eat her regular food.

By Friday, I was feeling very put upon. Alex had eaten at the emergency clinic and the regular vet’s. Why wouldn’t she eat for me? I lost my temper at her and Tasia. I stormed out to buy organic chicken at Larry’s. She ate one small bite of that, but no more. Finally, I did get 100 ml. of fluid down her. The vet said I should force feed her with a syringe. That didn’t work either. He’d also prescribed Pepcid-AC and Mylanta, a half tablet and half teaspoon, respectively, twice a day. That seemed odd to me, but I’d bought it, and at least gave her the Mylanta.

Finally, on Saturday, I found a Web site that deals with feline chronic renal failure (CRF), Tanya’s UK Feline Chronic Renal Failure Information Centre. It’s written by someone in the UK who had two cats, Tanya and Thomas, die of this condition. What she (I believe it is a woman.) learned through her mistakes with Tanya she was able to apply to her treatment of Thomas. It is very comprehensive and well organized, and I consulted it countless times over the weekend to check Alex’s symptoms against what was listed there. It was a match every time. Things began to come clear for me, and I found new patience to work with Alex, and to deal with the very needy Tasia also. I so wish I’d found it months or years earlier!

I also found out something about myself: In the realm of science and health, when a treatment is prescribed, I need to be able to see the logic of it, why it’s prescribed, what it’s supposed to do, and what results are expected. If I don’t see the logic, and without all the facts, I tend to drag my feet on doing the treatment until I do understand. I’ve done this with my own naturopathic doctors, to their veiled annoyance, and at the risk of my own health. And I’ve done it with Alex, and earlier with Max.

What I did understand about CRF was that the kidneys no longer compressed the urine, which is why Alex peed so often and so much, wherever it was convenient. So I couldn’t understand how it would help to pump yet more fluids into her subcutaneously. What I didn’t understand about CRF was that the kidneys no longer filtered out toxins and excess levels of substances we either excrete or need in normal doses: blood urea nitrogen (BUN), creatinine, and phosphorus, and others. So the subcutaneous fluids were for the purpose of diluting these substances, and lowering their readings in a blood test. High readings of these substances are an indication of how badly the kidneys are failing. Had I understood this better, I would have worked out a way to get those fluids into Alex a long time ago, no matter what.

And why Mylanta? Dr. Sodhi had said it contains aluminum hydroxide which binds phosphorus, but that went right over my head, until I read it again on the site. I imagine the aluminum hydroxide combines with the excess phosphorus and turns into—something else? And that something either isn’t as toxic or can be flushed out easier. Makes sense to me now. And the Pepcid-AC? Dr. Sodhi had said that her stomach acids would be elevated, due to her dehydration, and I read the same thing on the site. And with elevated stomach acids, cats refuse to eat. The fluids she’d gotten in emergency and at the regular vet’s reduced the acids, so she ate for them.

So, Saturday and Sunday, I dutifully gave her fluids, medicine and food, but she just got weaker. I willed her to live until Monday, so that Dr. Sodhi could help me help her to the other side. Monday morning, she hadn’t moved from the warm blanket on the couch where I’d left her. I put her on a towel on my bed and lit a candle and read her a poem. She looked beautiful and peaceful in the soft light. I got ready, wrapped her in another soft blanket and took her in.

It was over very quickly, but my heart is still breaking, when I think of her. I saw no reason to spend any more time with her body. She was gone. She will be cremated and the ashes will be back in a couple of weeks. I tried to pay, but they said to forget it until later. I think they couldn’t get me out of there fast enough. It’s hard on them too.

Afterwards, I didn’t know where to go. Then I thought of the Bellevue Botanical Gardens. I’d never been there in autumn. It was a gray day, misting slightly, but the maples have never been more beautiful. They are at their peak right now, and it was a fitting place for me to find peace and beauty after such a loss. I got back to the car just as the rain began to fall in earnest. Lucky me.

*Earth Prayers from Around the World. Roberts Elizabeth and Amidon Elias. Harper Collins, 1991, p. 422.

Sherry has been a tech writer and has dabbled in short story and essay writing as well as environmental writing. She participates in workshops and spends way too much time on her journal.