Sunday, July 13, 2008

The Letter

In my previous post today, I mentioned the letter I wrote to friends and family about Tucker. I am posting here the actual letter. I'll tell you what I told them---thank you for reading it.

"If you notice me being out of sorts for awhile, then you'll know why. I'm heartbroken, and I don't know that I've ever felt sadness quite to this depth before. I took today off of work because I'm an utter and complete mess, and I'm not able to do anything for anybody today. This has completely debilitated me today, physically and emotionally. I've cried so much that my eyes are swollen. The skin around my eyes is raw and red from all the wiping and rubbing. I've cried so deeply that there are times I feel like I'm not going to be able to catch my breath. I've cried so loudly that I wonder if I worry the neighbors.

I got home from work last night, and everything was fine. Tucker met me at the door, as he's done everyday for the past 14 years. His behavior was completely normal until around 7:45 p.m. I heard a strange noise and realized that it was Tucker struggling to breathe. He was panting rapidly, making a LOT of noise while he was doing it, and his tongue was hanging out. He couldn't stand up, and he was crawling around on his belly, struggling to find a comfortable position. It came on so suddenly, I figured something was caught in his throat. I swept his throat with my finger, but there was nothing. I scooped him up, and I hauled ass to the After Hours Emergency Vet Clinic in Hickory. He was yowling and thrashing around the carrier. He was terrified and obviously in great physical discomfort.

I hurried into the clinic, and the technician behind the desk smiled and asked if she could help me. I put Tucker on the countertop, and I said (with tears forming), "About 30 minutes ago, my cat had a sudden onset of respiratory distress...I think he's in a lot of trouble." She took one look at him, and the smile dissipated from her face. She grabbed him up and hustled immediately to the treatment area---no questions, no "fill out these forms", etc. She came out a few minutes later and told me they put him on some oxygen while awaiting an examination room. I then filled out the forms and gave his medical history, which was very brief. He had just had his wellness exam a couple of months ago, and he got a great report, as always. His docs have always marveled at healthy he was, especially for a kitty his age. While I waited in the lobby, I checked my credit card balances so that I could see how high I could go before I had to start bargaining for a payment plan.

They called me back into a room and Dr. Ewing told me that she could hear a lot of fluid in his chest, and she suspected he was in congestive heart failure. His blood pressure was low. She tried to listen to his heart but she couldn't hear it because of all the fluid. She asked if he had a heart murmur or any history of heart trouble, and I told her no...that he had just recently gotten a good report from his vet. I told her how suddenly the problem came about, and she was puzzled since the symptoms of CHF usually develop progressively. They gave him some Lasix (a diuretic) and placed him in an oxygen chamber. The plan was to wait until they got some of the fluid off and got him a little more stable, and then they would get a chest x-ray to have a better idea of what was going on. Dr. Ewing said that though they could probably resolve this episode of CHF, they couldn't fix his heart, and it would be a terminal condition. He'd probably have to be on Lasix for the rest of his life, but that was fine by me...I'd learn to give him his pills, no question about that. She let me go back and visit him for a few minutes. He looked better...she said she was pleased with his response to the oxygen chamber. He was no longer panting or breathing through his mouth. He wasn't using his hindlegs yet, but he was able to pull himself up. He was meowing because he wasn't happy to be there, but we were feeling more optimistic about his chances. Dr. Ewing suggested that I call back around 11:30 p.m. for an update; hopefully, they would have a chest x-ray by then. I hugged him and kissed him, and then I left.

On my way home, I prayed out loud for God to be with Tucker and to please get him through this, because I wasn't ready to lose him yet. But, if that wasn't part of the plan, I asked that He make it known to me when it was time to let Tucker go, because I didn't want him to suffer because of any selfishness on my part. I called around 11:30 p.m. They hadn't done the chest x-ray yet, but only because they were crazy busy. The tech said, however, that Tucker was resting comfortably in the oxygen chamber. I told her I'd call back in a couple of hours, and she said that would be fine. During this time, I had been Googling cats and CHF on my computer so that I could start educating myself about how I'd need to care for Tucker from now on.

About half an hour later, my cell phone rang, and I could see that it was the vet clinic. My gut
started to scream. It was Dr. Ewing. She said that Tucker had apparently thrown a blood clot, and it had cut off the circulation to his hindlegs, which were now permanently paralyzed. He panicked when he could no longer feel his legs, so they sedated him to keep him calm. She said
that when it got to this point, she recommended that he be euthanized. Out of desperation, I asked if there was a way to dissolve the clot. She said she could,but his heart was functioning so poorly, he'd just keep throwing them. She said he was experiencing pain now in his front legs, and that "this is really no kind of life for him." Of course, I knew she was right. I realized that this was God answering my prayer...He was making it known to me, just as I had asked. I wept and wailed and cursed after I hung up, and then I got dressed.

I drove the 20-minute drive back to the clinic. I was crying off and on, though I was also struggling with trying to grasp the reality of what was happening. It was feeling surreal at this point, and there were moments when I literally wondered if I were dreaming. It didn't seem real. I walked into the clinic, and a very sad-looking tech asked if I was Tucker's mommy. I told her yes, and she said she would let the doctor know that I was there. I sat down in the lobby and started to cry. They called me back to a room, and I signed to authorize the euthanization. The very kind technician asked if I wanted to take Tucker home afterwards or to have him cremated. Since I have no place to bury him, I told her that I wanted to have him cremated and that I wanted the cremains to be returned to me. I have no idea what I'm going to do with them, but I know that I need to have them back. This happened so quickly that I've had no chance for any kind of closure. I had no idea that my last time holding him was going to be my last time holding him. I couldn't bear the thought of leaving that place and that being it---no connection with him ever again. I never thought that I'd be a person who would keep their pet's cremains, but now I fully undertand why people do it. I don't know if I'll keep them or maybe sprinkle them somewhere.

After all of that was worked out, they brought Tucker in so that I could tell him good-bye. Seeing him then confirmed for me that euthanasia was the only alternative. This was not the same cat I had seen 4 hours earlier. He was awake and responsive, but I could see that he was already dying. He was yowling in pain and trying to stand up. He had "the stare". It wasn't a "i'm doped up on sedatives" stare. It was a stare that I've seen thousands of times since working at Hospice. It's the stare that a dying creature develops when he or she is mentally disconnecting from the environment. His hindlegs were motionless, and the paw pads were dark blue. The insides of his ears had a bluish hue, as did his lips. He was starting to pant again. I realized that now he was out of the oxygen chamber, he was growing increasingly uncomfortable and that I shouldn't drag this out. I hugged him and kissed him, and I told him it would be okay...that this was going to end soon. And I thanked him for everything. I told him that I loved him very much. Dr. Ewing came in and asked if I had any questions. I wrapped my arms around him, and he rested his chin and front leg on my forearm (which is something he has always liked to do). Dr. Ewing injected him, and I felt him go limp literally about 2 seconds after she started to push it. This confirmed for me that he was already dying...he didn't need much help to leave this world. Before she euthanized him, Dr. Ewing cradled his face in her hands and said "You look like you've had a very good life." It was nice to receive that validation from an objective 3rd party. Dr. Ewing was wonderful. At the bottom of my invoice, she wrote "We are so sorry for the loss of your companion and friend."

In spite of everything else, the Lasix had been effective in pulling much of the fluid from around Tucker's heart. Dr. Ewing said she could hear no heart murmur, so she doesn't think the
primary diagnosis was CHF. Because of the sudden onset, she thinks something went terribly wrong with his heart suddenly and with no warning. We suspect he had what's called a Saddle Thrombus ( blood clot) in his descending aorta. It had apparently kicked loose and started to move when Tucker's symptoms started. Sometime between 11:30 and midnight, the clot manifested itself when it became lodged in the branching vessel into the femoral arteries and blocked the flow of blood to those arteries. All circulation to his hindlegs was cut off, and they became paralyzed. Everything went downhill from there. It's my understanding that a Saddle Thrombus usually forms as a result of some kind of underlying heart disease that is often undetectable.

The routine things have been very hard today. Tucker has always followed me to the bathroom...always. In the past 14 years, I think I've gone to the bathroom alone maybe 3 or 4 times. Tucker has always shown up. He sat on the edge of the tub keeping me company, or he sat between my feet---looking up at me, chirping and purring. It became routine for us. No matter where I've lived, I've always always always kept the under-sink cabinet door open. For some reason, in every apartment we've lived, Tucker has always adopted that space as his own. He was terrified of thunderstorms, so the under-sink cabinet also served as his safe place during storms. So the rule has always been that the cabinet door remains open so that Tucker can enter and exit at will. When I'd have friends check on the cats for me while I was out of town, part of my direction was that this cabinet door should remain open at all times. For the first time in 14 years, I shut the cabinet door this morning, and I cried. I cry everytime I go to the bathroom; I find myself putting it off until I absolutely have no choice but to go. I haven't been able to bring his kitty carrier from the car yet; it's still in my backseat with a piece of tape on it from the clinic that says "Tucker Adams". I wept the whole time as I was feeding Gus and Jasper hurts to only be filling 2 bowls today. All day long, I've had moments when I allow myself to be distracted, and then I suddenly "remember " that he's dead, and I feel like I've been kicked in the stomach, and I cry. I really really miss him.

I've been trying to think of things for which to be grateful. Obviously, I'm very grateful to have had such a wonderful little guy in my life for the past 14 years. He truly had one of the gentlest and sweetest souls I've ever encountered in any living being. I'm grateful that his suffering was minimal. The clinic staff got him comfortable very quickly, and they kept him there. I'm grateful that his death occurred only hours after the onset of his illness. I'm grateful that I was able to come home to two affectionate kitties rather than to an empty apartment. Gus is starting to figure out that something's wrong...he's anxious and sniffing around a lot...and pacing. He's been pretty clingy with me, and he looks at me and taps me with his paw the way that he does when he needs something from me. Jasper seems a little bewildered everytime I start to cry.

I'm attaching some of my favorite photos of Tucker. The one of him on the loveseat is my
favorite. His facial expression shows the essence of Tucker.

All of this being said, I do want you to know that I'll be okay. I think all of this is a process that I have to go through. I guess it's part of the deal when you love a creature whose life expectancy is
markedly less than your own. The depth of my sadness is the same as the depth of my love for him.

Thank you all, again, for reading through all of this. Mostly, thank you for all of your support and your encouragement.


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