Pippin, My Beloved Kitty, Is Gone Options

[Pippin's Mom Kel]

It seems odd to be writing this more than a month after Pippin died. I thought I was okay. Well, I'm okay, but I need to talk about it. It still hurts, and I still have moments of near-blinding grief. They're fewer than they were, but - well. I need some support.

Pippin was my seven year-old tuxedo cat. My husband and I brought him into our family when he was just eight weeks old. The first thing he did to DH was bite him (and that's about how their relationship went, LOL! Not a mean bite, but Pippin liked to chomp my husband. It was how he showed his love). My first cat Cleo had died that summer, suddenly from cardiomyopathy and heart failure. We lost her over the course of an evening. Of course she had been sick for much longer, but with her being our first cat and only being 6, we didn't realize how sick she was, and how stoic she was being. We lost Cleo the week we moved into our first house, in a new city. The vet was an all-new vet, and over the years, we've become close to them - they only saw Cleo the once, before referring us to Tufts, which is where she died. Our vet's office manager mentioned on the phone, the day after Cleo died, that when we were ready for a new family member, to let her know and she'd help us find one. And then she mentioned she was fostering an adorable grey kitten - and she told me his story. A state trooper had pulled someone over on a local 4-lane highway, and when he got out of his car, he and the speeder saw the kitten dart up under the speeder's wheel well! So the cop and the speeder both got out and rescued the kitten, who then dove into the cop's car and hid under the seat. He couldn't get the kitten out, so he came to our vet and basically said: Help! Ha. So, this little kitten was named Robert after the cop that found him, and our vet's office manager was fostering him. As it turned out, we brought him home the next week, renaming him Horatio Robert. About a month after bringing Horatio home, DH and I felt he needed a sibling, because boy, was he tiring us out! We mentioned that we were looking for another kitten to our vet's office manager, and in a week or so, she called us. A rather troubled teen in a troubled family had found a kitten. The family was about to have their dog euthanized because they were "tired of it." The family had a history of not taking great care of their animals, and so our vet talked them into surrendering the dog and kitten instead of euthanizing the dog and doing who knows what with the kitten. I believe the dog found a new happy home shortly thereafter.

And so Pippin came to live with us at the age of eight weeks. We had a few scares at the very beginning, with him vomiting and having diarrhea, and getting terribly dehydrated, but we brought him to the vet quickly and they nursed him back to healthy. We lost his brother Horatio at the age of two, over the course of a weekend, to FIP. It was awful. He, too, died at Tufts. We were heart-broken, but carried on. Fast-forward to this past October, when DH and I went to my younger brother's wedding - we were away for the weekend, so we left out dry food for them. Pippin was quite overweight (he loved his noms!), so we'd been trying to get him to lose weight for over a year, with less success than we would have liked, and thus, we didn't give him dry food. We're pretty sure, given the amount we left and the amount that was gone when we got home, that Pippin must have gorged himself. The other three cats probably ate some of it, but... well, Pippin loved his noms, as I said. :-/ A few weeks later, at the end of October, we had a terrible snowstorm that knocked our power out. We noticed Pippin acting off. Not eating as much, acting a little lethargic, not moving around as much. Finally, on Halloween, we took him to the emergency vet - ours didn't have power! After a workup, we found he had developed diabetes and pancreatitis! Oh no! But I'm a nurse. I had perfect faith that I could manage this. He stayed in the ICU for a weekend while they got his sugars under control and gave him fluids.

Pippin was a trooper about blood sugars and insulin injections. He grumbled a little about the pawsticks, but he quickly returned to being his old self, running and playing and being generally happy. Two weeks later, he was sick again. Back in the ICU with a flare-up of his pancreatitis. A month after that... we were still having trouble regulating his blood sugars, increasing his insulin... and we found he had a bump in his kidney numbers. Pippin was in mild renal failure. Say what?! A seven year old cat with little prior history in renal failure? So we saw the internal medicine specialist, who did an ultrasound and thought he had pyelonephritis, a bad kidney infection. We put him on antibiotics and fluids again, and he appeared to bounce back again. We worked closely with the IM vet to try to get his sugars under control. Poor Pippin was still being such a trooper! Still happy, still eating, still playing and running around like a kitten. We had Pippin home for Christmas, and had a wonderful Christmas together - my DH, Pippin, the other three cats and me. I had to leave to go to my other brother's wedding, while my husband stayed home and took care of Pippin. At this point, our lives revolved around him and trying to keep him healthy and get him better. I thought Pippin was doing wonderfully.

And then after the New Year, another bump in his kidney numbers, so we took him to our IM vet, who did an ultrasound to find his kidneys were big again. So now it's time to do a biopsy to see if he has lymphoma - we'd already gone through the agony of a needle aspirate to check for it, and the waiting and waiting to find out. So again, we put poor Pippin through another procedure, and he does okay. In the meanwhile, we've started SubQ fluids daily. But that Friday, he starts vomiting. Back to the IM vet & a few days in the ICU with pancreatitis flaring. My poor baby! Every time he was in the ICU, I visited him before and after work. I work 3-11, so I'd go and sit with him in an exam room and play with him from 1-2:30, then spend a couple hours with him after work at 11. I did that this time, too. And so Pippin came home after a day in the ICU this time. Great, we think! They send us home with some injectable anti-nausea meds, just in case, and more SubQ fluids. Our ENTIRE existence is now revolving around our baby Pippin. He is our life, trying to get him better. And then, on Monday January 23, DH and I went to Petco to pick some things up, and come back to find Pippin has used the litterbox. Now, off and on throughout all this, Pippin has had chronic diarrhea, either from the antbiotics or pancreatitis, or a combination. We look, and holy cow! It's the first normal BM we've seen from Pippin in months, hurray! But then I look more closely and see he's vomited. So we give the anti-nausea med, which we'd had to give a couple times since we last had him in. It doesn't help. He still is acting nauseated. He goes and hides in his litterbox, just sits there. That terrified me, because he never does that.

So after multiple calls to the emergency vet, we take him at 1 AM. They look him over, say he looks okay, and by then he didn't look so nauseated. I asked them to do labs on him, so we'd be able to talk to the IM vet in the morning about it. They do, and the ER vet comes out with a very sad look on his face. His creatinine, which had never been above 3.5, was 9. It had been 2.6 eleven days before that. At this point, I know we're going to lose him. But Pippin's looking at me with those big yellow eyes, and he tells me with that look that he still wants to fight. (At least, I really hope that's what he was telling me.) So we admit him, start fluids and talk to our IM vet in the morning - not that my husband and I slept at all after we got home. She suggests bringing him to Tufts, because she really isn't sure what's going on. I was terrified. Even more terrified than I had been. We lost Cleo and Horatio there. This can't be happening, I thought to myself. But we took him to Tufts.

A wonderful team followed Pippin while he was there. He stayed from Tuesday AM until Friday when we let him go. We tried continuous dialysis, after a long talk with the attending specialist, and a long hard look at Pippin to see if he was ready to give up. He looked like he didn't feel well, but he still held his head up. He still purred and rubbed our hands. We talked with our IM vet, who knew Pippin and us so very well by now. She said that she wouldn't say this about most cats/in most cases, but if Pippin were her cat, she'd try it. So we decided to try it.

It was a roller coaster. He was in a little heart failure, so they put him on a lasix IV and another med to help his heart and kidneys work better. And that didn't work so they did put him on dialysis. And then he started making some urine. And then he stopped. And then he started again. And then there was blood in his bladder, since they did another renal biopsy to try to figure out what the heck was going on, and he was on a blood thinner on dialysis. And then his blood counts dropped, so he got multiple transfusions. And all this time, I'm looking at Pippin, still trying to decide if he wanted to give up. Wednesday night, I visited him and he ate from my hand. What a blessing that was. What a precious, precious memory, now. He kissed my cheek with his little sandpaper kisses. So I knew he stilled loved me, and that he knew we were just trying to make him better. And we thought he was making urine, so the dialysis was helping his kidneys. The next day, he was worse. I called out sick from work to go be with him, and I sat with him from 11 AM until 11 PM. They let me sit with him in dialysis, and I am so very grateful to have had that time. Friday morning, they call and let me know he's stopped making urine again. The attending began trying to seriously pursue transplant as an option, since Pippin was so young and we were willing to try it. DH and I rushed to Tufts to be with him, and we discussed the options. Euthanasia was an option, but so was trying him off dialysis, seeing if his kidneys started doing some work on their own, since his numbers were back to normal.

Again, we talked to our IM vet, who advised us to ask ourselves if we'd be able to live with not giving him that 24 hours off dialysis trying. So that was the plan - try him off dialysis. I looked at the heart monitor, though, and since I'm an ICU nurse, I recognize that he's in ventricular tachycardia, which I point out. So my husband and I, terrified, step back far enough to let them get to him. The doctors ask how much we want them to do. I look to my husband, because he wasn't in the same place I was - he wanted them to do everything. Suddenly, his heart rate drops, and Pippin cries out. The doctor gives three chest compressions, and his heart goes back into a normal rhythm for a kitty. DH and I call out, "Pippin, we love you. We're here, and we love you." They bring in the ultrasound to look at his heart, and draw blood from the dialysis line and find his potassium is sky-high on dialysis - a very bad sign, and I don't need anyone to tell me how bad, at that point. I know. I hate being a nurse and knowing. I don't always want to know. They give him a fluid bolus, and we go back to sit with him, petting him and telling him how much we love him. And then the tech takes his blood pressure, which is 40. Incompatible with life, I know in my heart. I tell my husband, "Honey. Pippin's body is telling us he's done fighting. We have to let him go." We have a talk with our IM vet, who is as kind and wonderful as always, and who agrees that Pippin is done fighting.

We took Pippin off dialysis, and held him. On top of all this, I called out sick to work for the weekend. I'm the sort of person who NEVER calls out, even on my deathbed, but I knew I couldn't take care of patients safely if we were losing Pippin. My boss calls me and insists on speaking to me. He asks how the kitty is. I tell him - a fellow nurse - that we took him off dialysis, and we're about to let him die. He proceeds to tell me that he and I need to have a meeting to talk about my calling out and future expectations. So at the moment I should have been most focused on my family, he's distracting me with that. I was so angry. But I refocused on what was important - Pippin and my DH. We settled Pippin in my arms, wrapped in a blanket, and we held him and talked to him. We told him how special he was, and how loved he was, and we would never ever forget him. We told him how much we were going to miss him, and petted him. We called my mother, who told Pippin she loved him and goodbye over the phone, and she told him she'd see him again someday. I think we held him for about an hour and a half. He was comfortable; he'd been on a narcotic IV, so that was still in his system. He was calm, restful. And then, we let them give the injection to help him die. DH and I stayed for at least another hour with him. It was so hard to let him go - to give him to tech and doctors. He fought so hard to stay with us. I loved him so much. I would have done anything for him. And then, we went home... January 27th. My baby was dead. My soulmate was gone.

No Pippin. Even with three cats, the house is quiet. Pippin was the one who was always hanging out at our feet. Letting us know when it was meal time. Letting us know when it was playtime. He was the one that slept on my hip. He was my baby. And he was gone. I explained what had happened to the other cats, and that Pippin wasn't coming home this time. I don't know how much they understood, but I do know that his sister Willow wouldn't look at me for a couple hours, after I explained things to her. For days, the other cats kept looking for him. He was the one that herded them into the kitchen for meals. Our Karma kept looking for him at mealtime. Strider was dejected. They've started to heal now, and we have a new family member, Earl Grey. It's beyond the scope of this post, but I'm fairly certain Pippin led us to him. And Earl is fitting in well - yet of course, he doesn't replace Pippin. I think Pippin would have liked him, though.

Most of the time, I'm okay. I go on with life. I hate being at work now, after the way my boss treated me while I was losing a family member. My mom says this is a gift from Pippin - a motivation to find a new job that's closer to home, where I'm happier. She's probably right. She usually is. (At 36, yes, I can finally admit my mother's right.) The other cats - thank goodness for them. Loving them helps. Being around DH helps. Distracting myself with decorating and craft projects helps... but none of it brings him back.

I know how this goes. I've lost pets before. I lost my dad when he was 49. I know it hurts like crazy, and that some days are good days, and some days are bad days. But today's not a good day. I haven't told the full story all at once yet, like I did here. Thank you for letting me share it.

Kel

[moon_beam]

Hi, Kel, thank you so very much for sharing with us how you're doing, and your beautiful love letter to your beloved Pippin. The angel-versaries are very hard particularly during the deep grief when all we desperately want is to hold them one more time, to look into their eyes one more time, and on and on and on. The truth of the matter is is that our earthly journey with our companions is never long enough - - for we will always want just one more minute, one more hour, one more day, - - one more lifetime with them.

This grief journey is both a physical and emotional adjustment to the physical absence of our companions. It helped me to hold something that belongs to my beloved companion when the physical ache to hold them became very unbearable during the deep grief. I slept with their collar under my pillow and held tightly onto a blanket or toy when the waves of deepest sorrow would overwhelm and consume me. No, it can never replace the blessing of holding their precious physical body in my arms - - but it served as a bridge to hold something that belongs to them in my arms that ached to hold them. Eventually as the deep grief eases so will the physical pain of separation. Some folks are afraid that when this happens that they are forgetting their beloved companion. Please let me try to reassure you, Kel, that it will be IMPOSSIBLE for you to ever forget your beloved Pippin, for he is forever a part of you. Not even the dimming of our minds with age can we ever forget our beloved companions.

I hope today is treating you kindly, Kel. Thank you so very much for sharing your and your beloved Pippin's 2 month angel-versary with us. Please know you are in my thoughts and prayers, Kel, and look forward to knowing how you're doing.

Peace and blessings,
moon_beam

[Pippin's Mom Kel]

Hi, Kel, thank you so very much for sharing with us how you're doing, and your beautiful love letter to your beloved Pippin. The angel-versaries are very hard particularly during the deep grief when all we desperately want is to hold them one more time, to look into their eyes one more time, and on and on and on. The truth of the matter is is that our earthly journey with our companions is never long enough - - for we will always want just one more minute, one more hour, one more day, - - one more lifetime with them.

This grief journey is both a physical and emotional adjustment to the physical absence of our companions. It helped me to hold something that belongs to my beloved companion when the physical ache to hold them became very unbearable during the deep grief. I slept with their collar under my pillow and held tightly onto a blanket or toy when the waves of deepest sorrow would overwhelm and consume me. No, it can never replace the blessing of holding their precious physical body in my arms - - but it served as a bridge to hold something that belongs to them in my arms that ached to hold them. Eventually as the deep grief eases so will the physical pain of separation. Some folks are afraid that when this happens that they are forgetting their beloved companion. Please let me try to reassure you, Kel, that it will be IMPOSSIBLE for you to ever forget your beloved Pippin, for he is forever a part of you. Not even the dimming of our minds with age can we ever forget our beloved companions.

I hope today is treating you kindly, Kel. Thank you so very much for sharing your and your beloved Pippin's 2 month angel-versary with us. Please know you are in my thoughts and prayers, Kel, and look forward to knowing how you're doing.

Peace and blessings,
moon_beam

Moon_beam, thank you so much - as always - for your kind words and empathy. I actually have a stuffed version of Pippin that I sleep with every night. A couple years ago, my mother visited and we were shopping and saw this rotund, stuffed plush tuxedo cat, and we laughed and thought it looked just like Pippin. She went back, when I wasn't looking, and bought him for me. When Pippin was in the ICU (as he was so many times, my brave boy), I would sleep with the stuffed version of him and think of him. I sleep with him every night now, and even though I'm terrible about kicking covers onto the floor, losing pillows on the floor, no matter what I've managed to lose on the floor overnight, "Pippin" is still in my arms. It's not the same, but it does provide some comfort. And I'm tearing up and crying as I write this, oy.

I actually was able to laugh and smile, with my husband, last night about Pippin. I struggled during the three months he was ill about whether we were doing the right thing or if we were torturing him and should have just let him go. I sat down and sobbed, so many times, "I can't do this anymore." And now I feel terrible for saying that, and I hope Pippin didn't hear me and decide not to stay because of it. Logically, I know it wasn't his choice, but I still can't help but ask - did he leave because he thought I didn't want to take care of him? I only meant that I just wanted him not to be ill. I wanted him to be stable, and not in and out of the kitty ICU every 2-3 weeks. I wanted his blood sugars to stabilize so he could be happy and feel good. I didn't mind any of the care I had to give him: blood sugars, insulin injections, pills, subQ fluids, making sure I was home at midnight after work to give him his insulin, and making sure he ate and didn't vomit afterward, giving him his anti-nausea shots when he needed them... I didn't mind cleaning up the chronic diarrhea from the pancreatitis and then the antibiotics he was on, and I didn't mind when he had accidents because he couldn't quite get into the litterbox fast enough. I didn't mind any of it. I just wanted to stop worrying that he was going to die. And then he did. I feel so, so, so guilty.

But yesterday, I remembered that those three months, even if he was in and out of the ICU, he was a happy cat. He started playing again, in between all the treatments. He ran around with his tail up, all perky. He mrrted at us and begged for play - he even did jumpy play, which he hadn't done in a while before we realized he had diabetes. He got to eat all his favorite wet foods, especially near the end when we just wanted to make sure he was eating - and eat he did! He was happy, playing, eating and loving us the very morning of the day we took him to the emergency vet for the last time, before his stay at Tufts. I had gotten the day off work because we didn't have enough patients and I wasn't needed, and I spent the afternoon playing with him. I guess, if I had to lose him, I couldn't ask for more. This is what my husband and I were talking about - how happy he was for those three months, and how he acted like he did when he was healthy. Not only that, but Pippin adored the staff at the animal hospital he went to, and they were all head over heels in love with him. I don't know if I've mentioned this before, but they'd do their morning and evening rounds in the ICU with Pippin in their arms, paws over their shoulders. One doctor, Dr. Silk, was his girlfriend. I'm pretty sure he had a crush on her, and she adored him. And Liz, the nurse who took care of him with the internal medicine vet we worked that, was in tears when we took him from there to Tufts and told him she loved him, and emailed me a couple times during his few days on dialysis to tell me she was praying for him. I made sure that in his last moments in his arms, I told Pippin that Liz loved him too. Even at Tufts, they adored him. And I know they're supposed to say that, but we got three whole cards with hand-written notes from the residents and dialysis techs and vet students who were taking care of him. You could really see, as they were all saying goodbye to him, that they felt a genuine affection for my little guy. He talked to them while he was on dialysis, and they talked back - they had conversations. I know I'm a kitty parent and I'm supposed to think this, but I really feel like Pippin touched so many lives, even if only for a few days. I suspect I'm not the only one who won't forget him.

I'm crying right now, but I'm also smiling. I guess that's a step in the right direction.

Thank you for listening.