Lucy and I Fought the Good FightPosted: July 25, 2010
A little problem
Normally I’d have a cat spayed at about four months, six at the latest depending on the circumstances. So much else was happening with the seniors in my feline family that I didn’t even think about spaying Lucy until—surprise!—she went into heat in early March. I applied to a subsidized spay and neuter program and had her spayed on what I presumed was her first birthday, April 1.
She was exactly six pounds at that time, tiny, lithe, active and social. I figured she’d always be a small cat if she was that small at one year.
A few days later I heard a noise in the basement, and Lucy seemed to be a little sheepish and subdued but otherwise fine. I was concerned, thinking she had fallen and landed on something or in a way that had injured her internally, especially so close after her spay. I called my veterinarian and described what I noticed and she described some symptoms of internal injuries for me to look for.
A week went by and I noticed that, though she hadn’t quite returned to her former activity level she was still social and affectionate, but she wasn’t eating normally. Then one morning exactly two weeks after she had been spayed she suddenly fell off the edge of normalcy and just lay on my bed in the morning, breathing heavily, looking scared and confused.
I called my veterinarian as soon as possible that morning. I think she knew just from my description what was happening, and in fact told me that there weren’t too many options for the labored breathing, lack of appetite, failure to thrive so suddenly in an otherwise healthy kitten, and FIP was at the top of her list.
We were on the phone as she drove to her first appointment, and she changed her offer of an appointment from later that day to right after the appointment she was headed to, apparently deciding Lucy was more critical than the next appointment; I could hear her shuffling things around and I knew she’d have to call others and rearrange her schedule. I was grateful to my veterinarian’s dedication to her clients—I wanted Lucy seen as soon as possible, but I’d wait for my veterinarian. And if it was bad news, I wanted it coming from my veterinarian, not a stranger.
I remember it was pouring rain that day, and after my veterinarian arrived and examined Lucy and told me to get her to a hospital right now, not later, one that could x-ray, tap Lucy’s chest if necessary, even do an ultrasound, I drove blindly through the rain and my tears thinking how unfair it was.
The hospital tapped a total of 200cc of fluid from her little chest, uneven amounts from each side, and just a look at the fluid, typically sticky and straw-colored, told the veterinarian the likely possibility. She ran a test, and also sent out a test, but we knew what it was. Lucy really did have FIP.
What to do next?
I was advised to have her put to sleep as soon as possible, even right there. There was very little chance she would survive effusive FIP for long, it was known to be fatal within a short period of time, and that time would likely be uncomfortable, even painful for her with the effects of the disease, her lowered immunity and her organs slowly deteriorating. The fluid had put a strain on her body already, and she was open to infections, her immunity quickly taken down.
I looked at Lucy, who looked frightened but determined, and we went home.
I called my veterinarian, who knew I’d put up an effort to at least keep her comfortable for a while, also that I’d firmly believe, at least for a while, that we could beat this. How else do you beat back the darkness, but by looking for the light?
What is FIP, anyway?
I had heard about Feline Infectious Peritonitis, or FIP, before then. With the overcrowded shelters of the 1980s and the awareness of Feline Leukemia Virus, or FeLV, in that decade, we had suddenly learned of a whole alphabet soup of diseases that could kill our cats, and there was no known cure, even the transmission wasn’t easily understood. We had actually gotten a grip on FeLV, FIV, Feline Aids and related diseases, but FIP continued, and still continues to, elude researchers in how it mutates into the deadly form, why some exposed cats seem to be immune, and how it can be treated, even cured.
FIP kills up to 1 in 100 cats under age 5, and cats coming from more crowded or stressful situations such as shelters or catteries are at five to 10 times greater risk of contracting and developing the disease. It is virtually 100% fatal, meaning no cats have been known to survive for more than a few months beyond diagnosis without symptoms, and while a vaccination has been developed it is hardly effective enough to make it worth the effort and risk, symptoms can be treated but the treatment is palliative, not curative, and so there is no treatment or cure.
This was not going to happen to my beloved, innocent little Lucy, the light of my life after losing my elders. She would stay with me as long as possible, and who knew, maybe we’d be the ones to win. So I had to learn more.
FIP begins as a Feline Enteric Coronavirus, or FECV. A coronavirus, in short, replicates itself by invading the actual cells of a mammal or bird species so that it replicates as a part of each cell and the host’s body may not recognize the infection and often doesn’t fight it. By contrast, a cold or influenza virus simply embeds itself somewhere in the body and begins breeding in tissue such as mucous membranes of the sinuses or lungs while the body sets up an immune response to what is clearly an invader. A complication is that the disease may sit dormant for weeks to years with only vague symptoms or no symptoms at all before it manifests.
About 90 percent of cats who come in contact with FECV have only minor symptoms or develop other diseases which can be treated. It’s what happens to the other 10% after the initial invasion of FECV that makes it the deadly FIP—the virus somehow—and that’s what’s currently being studied—somehow mutates within the cat’s own body into FIP, and the mutation is apparently different for each cat, even among siblings, which is what prevents setting up a standard treatment or formulating a vaccine. It’s currently suspected that a genetic factor causes or allow it to mutate into the deadly form.
There are two forms of FIP, referred to as granulomatous, or dry, FIP and effusive, or wet, FIP; the first has no apparent symptoms, the second form causes fluids to build up in the abdominal or pleural cavity, which is what I saw in Lucy near the end of the two weeks of symptoms leading up to her diagnosis. This fluid can be drained but will usually return, and the fluid itself puts a strain on the body’s function, as Lucy had trouble breathing and no doubt it put a strain on her heart, and on the immune system. The dry form has little to no fluids developing in the body, but lesions develop on the internal organs and these lesions variously affect the organ’s function and lead to secondary infection.
Whew. I looked at Lucy and she looked at me. That was a lot to take in. And it wasn’t looking very positive.
And the other concern: she had had siblings, her mother was still out there, and I had other cats in the house, all of them seniors, and Namir with his advanced heart condition. Who else was at risk? And how the heck did she get it? Where? And when? Should I confine her from the others?
I was relieved to find that FIP itself, because of the nature of the coronavirus mutation, wasn’t “laterally transmissible” from one cat to another, meaning she couldn’t pass FIP directly to another cat, so she hadn’t infected my household, though she could transmit FECV and I would have to observe the others to see if anything would develop (nothing ever has). The disease is only transmissible by contact with the feces from an infected cat, and it could be carried on fur and clothing, surviving for up to two weeks after the feces were passed, but because the disease could sit dormant for a period of time it was hard to tell where she might have picked it up. I have ten litterboxes in my house, and every so often one of the older cats, especially as they had come near their end, had had accidents. All my cats have been rescues, coming in contact with everything nature had to offer, any one of them could have been a carrier of sorts.
I don’t think I’ll ever know how she got the disease. I gave up trying to figure that out in the interests of finding out what I could do to help her in the moment.
Taking what measures I could
Once the fluids had been drained from her chest, she was almost back to normal, and for most of the next three months she really just seemed herself though I could see a decline in her appetite and activity level. We went to work making up for time we wouldn’t have later.
I always had my little kit of antibiotics, fluids, prednisone, vitamins, flower essences, homeopathic remedies and so on, and through the years I’ve variously used acupuncture, T-touch, reiki and other healing treatments, and I looked and asked around to see what others had done with allopathic and naturopathic medicine in the case of a cat with FIP. I was willing to try anything.
I immediately began feeding her a raw diet, though I noticed that she had trouble eating the meat or canned food that I also offered. I had to back off to dry food because she seemed to have some issue in her sinuses that impaired her breathing while she ate wet food, something I had occasionally seen with Namir during a bout of congestive heart failure as well. I still gave her little “treats” of raw meat, though.
Most veterinarians had prescribed antibiotics and I had her on B-complex injections and interferon.
I did my own intuitive test to see if a gem or crystal would help protect or heal her body, and I envisioned the color amber and a heart, perhaps because the fluids had been somewhat amber-colored and in her pleural cavity, but oddly enough I had a heart-shaped piece of amber on a satin cord that had come from a family member’s visit to Poland where some of the oldest and most beautiful amber is found. I tied this around Lucy’s neck to hang against her chest and she wore it without complaint until her last day.
There didn’t seem to be any other medication or treatment that would accomplish anything, and I really didn’t want Lucy’s time to be taken up with treatments and shoving things in her mouth. She seemed comfortable and relaxed at the end of April, so we just went on as if nothing was wrong.
Around the beginning of June at an animal event I encountered an animal intuitive I had known and worked with a few times before, Renee Takacs, and explained my situation with Lucy and Namir. She did a long-distance TAT, or Tapas Acupressure Technique, session for each of them and for both together. She mentioned that Lucy felt some blockage in her sinuses, way up inside there, and we needed to keep an eye on that. I remembered her difficulty eating, but it was impossible to diagnose at the time.
We went on about the same for the next month. I did what I usually do—took lots of photos, did a few sketches, and it was in this time when Lucy was always with me still being a kitten though a little subdued, that I began my sketches for her book, the ones I’m working with now.
An Okay Three Months
At the beginning of July it was clear that Lucy was having more trouble eating and swallowing both food and water, and she was losing weight and was dehydrated, and was also developing anemia, one of the side-effects of FIP. An exam and x-ray showed nothing encroaching in her mouth, but my veterinarian suggested it was in her sinuses (as warned above), and I imagined an infection had managed to get into her nasal cavity. Perhaps the amber had protected her heart as she never developed any more fluids in her chest, but the infection in her sinuses had likely been there from the beginning.
And I had just taken down the bag of subcutaneous fluids in the kitchen, but now I put one back up, beginning the tradition of always leaving one hanging in the kitchen to “ward off the evil spirits”. It seemed that I no sooner took the bag down than I needed one again.
I did my best to keep Lucy comfortable as she had increasing trouble eating and drinking for what would be her last week. She was quiet and blinked her eyes frequently, and I imagined a kitty headache.
On the evening of July 9, she and I had a little collision in the kitchen, I was turning on one foot with the other in the air as she came around the corner of a cabinet and we lightly bumped, my foot to the side of her face, and she seemed okay, though confused. A little later I was on the deck and heard a commotion inside, coming in to see Namir looking startled and concerned and blocking the doorway to the living room, then to the basement as Lucy reeled around the room.
Was it a seizure? Had I knocked her harder than I thought with my foot? Or had this started before that when she blindly came around the corner of the cabinet and simply grown worse in a few minutes?
I rushed her to emergency, and the reeling episode had ended but her eyes were oddly moving back and forth, reminding me of the silly cat clock where the eyes and tail move back and forth with the ticking of each second. Aside from telling me things I already knew about her general condition, the veterinarian couldn’t tell me much about this condition except it meant that the possible infection in her sinuses might be affecting her brain by adding pressure in her skull, or it may have even infected her brain. The eye movement was a form of strabismus, meaning that she had lost neural control of her eye movements and likely would not regain them. I have since learned that when the fluid collects in the pleural cavity, rare enough, it will also sometimes collect in the eyes and even in the central nervous system, rarer still, but this is likely what happened.
He sternly added that I could not leave her like this for long, and needed to consider euthanasia.
We went home, of course, and as I sat up with Lucy that night she had two more bouts of what now appeared to be vertigo. She looked frightened, and as we settled on the bed waiting for morning to call a friend for an opinion, to call Renee Takacs just for reassurance and then to call our veterinarian for “that” call, I could tell that Lucy accepted what would come. No doubt she had been holding symptoms off and dealing with her body the best she could for all for the past three months, and could no longer.
My veterinarian asked me if I was sure of my decision, but she made space in her schedule at 1:00 p.m., and I followed with a call to Chartiers Custom Pet Cremation. It seemed sudden to each of them who hadn’t seen the slow transition, then the previous day’s sudden change, and Lucy still looked healthy. I was almost heartened when my veterinarian looked her over and over, trying to find a reason not to have to euthanize a young kitty, but the eye rolling and vertigo continued and I knew Lucy was ready.
Namir paced nearby, then jumped up onto the arm of the recamier where I was laying with Lucy on my chest. They were buddies, and he was my comfort, so he cuddled above my head and purred and we sat quietly for a while as the others wandered by until it was time to hand her to Deb Chebatoris.
I slipped the amber heart from Lucy’s neck before I left and held it in my hand all the way home. On the sewing machine in my bedroom I have photos of family and friends and all the cats who’ve gone to the Bridge, gently lit at night by a small lamp. I would choose a photo of Lucy later after I’d had time to think about it, but for now I slipped the satin cord of the amber heart over the round finial of the lamp and laid it gently against the dark verdigris finish of the metal shade.
After an awful night’s sleep I awoke and looked at the heart, then later as I made the bed, without Lucy’s help, I reached over and cupped the heart between my hands. It was warm, very warm, and I knew that Lucy was home.
My own transition, and Mimi and her babies
For the first time in about 20 years, I had only four cats. From February 2006 to July 2007, I had lost five, more than half my household, all my oldest, then my youngest, and it was a transition for me too. Suddenly I just had too much time on my hands and too much time to think.
After that much loss, it was hard to imagine that anything lives long enough to love it, or that it’s worth the risk. I still had Peaches, Cookie, Namir and Kelly, aged 17, 15, 13 and 11, Namir with his HCM, the others senior approaching geriatric, and I knew that if I didn’t do something, and soon, they’d all become objects of fear and pain to me.
On July 11, the day after I let Lucy go, I was in my basement with the door open, Kelly sitting by the screen door, and I saw Lucy’s mom on the brick patio outside. She came near the door and she and Kelly had one of those cat conversations where they both crouch quietly and perfectly still and don’t look at each other, but you know an immense amount of communication is happening.
Later on my deck, I looked down and noticed Maia, her name then, waddling down the brick path and realized she was expecting—again. I need to take her in, I thought, and even as I dismissed the thought of taking my neighbor’s cat and kittens and the trouble and expense of raising them and finding them homes I could picture them inside and I pictured Lucy inside.
I didn’t run and grab Maia then, instead I called my veterinarian.
“I’d like to take in Lucy’s mother,” I said.
“O-kay…?” she said slowly, giving me time to explain.
“She keeps having babies, they’ll never get her spayed,” I said, “that has to stop. And aside from that, we’ll never know where Lucy got the FIP, but if her mom carries the genes to allow the mutation, and keeps passing it onto these kittens, the least I can do is get her and them off the streets and we’ll have that many fewer cases of FIP out there.”
“Yes,” she said, “I think that’s a good idea.”
I shook my head in disbelief. My veterinarian never agrees with me right off, at least she discusses things, and I was certain I’d get a lecture about keeping my numbers down and taking care of Namir and the older ones and so on. Maybe she felt sorry for me, maybe she agreed with me, after all she had been through each of the losses right along with me, but either way, we agreed that my household had already been exposed to FIP and it couldn’t get any worse, and getting Maia off the streets was a good thing to do. Scrub down the house, especially anything to do with cat litter, and that should take care of any traces. I’d ask around to see if there were any other risks associated with bringing in Maia with her next litter.
No one gave me any reasons not to, so I asked my neighbor if this time, instead of giving me the kittens to find homes, if she would just give me the cat. She said that would be fine.
No room in my house accommodates kittens well except the bathroom. I actually wasn’t sure what Maia would be like since she wasn’t particularly friendly outside, and I wanted to keep her in a situation where she couldn’t get out into the rest of my house. It took me a few days to clear out a space in my studio large enough to put a large dog cage and outfit it with basic stuff for birthing and babies, plus food, water and litter for Maia.
As it happened, the kittens were born before I was ready to take them all, but that’s another story I’ll tell one day soon.
I will say, though, that the day I brought them in, Lucy was in the room with us. More on that when I introduce the new family.
For more information on FIP I recommend several resources:
SOCK FIP, http://www.sockfip.com/, the official page of the genetic study of FIP at the University of California at Davis led by Dr. Niels C. Pedersen. This site explains as much about FIP as the researchers know and is regularly updated with information. They also accept DNA in the form of cheek swabs from cats who have FIP or who are related to cats with FIP, and the data gathered from the DNA is entered into the study. They are especially interested in freely-bred cats who pass genetic information randomly in addition to cats bred at catteries.
The Winn Feline Health Foundation, http://www.winnfelinehealth.org/, which supports and funds studies of all feline health issues. You can read through articles (http://www.winnfelinehealth.org/Health/FIP.html) about FIP, especially one published by Drs. Susan Little and Melissa Kennedy in January 2010, (http://www.winnfelinehealth.org/Pages/FIP_Web_2010.pdf). You can also donate to the Bria Fund for FIP research (http://www.winnfelinehealth.org/Pages/BriaFund.html).
The American Association for Feline Practitioners, http://www.catvets.com/search/search.aspx?Search=go&Submit=search&q=fip, has links to articles on FIP research and treatment as well.
Steve Dale features one-hour interviews with each Dr. Niels C. Pedersen and Dr. Diane Addie which you can access as podcasts (http://www.stevedalepetworld.com/print-archive/tribune-media-services/boxes/428-fip-update). Also search FIP on his website, http://www.stevedalepetworld.com/.
And well-known pet health and behavior author Amy D. Shojai has two detailed but easily understood articles on her website at http://www.shojai.com/articles-index.html.
These are the sources I used for this article, and also back when I initially researched FIP. From Cornell University’s Veterinary School to Tufts University and other research schools and programs in between, you’ll also find plenty of other information out there about FIP.