One of the things they always tell you in vet school is “don’t go on gut instinct alone.” And this is a good point, because you can’t really practice sound medicine based solely on intuition. You get a hunch, then you follow through with science to prove or disprove your hypothesis.
Most of the time, though, you’re right, even if you don’t want to be. Like the time I was patting Nuke on his side and felt a mass pushing back on my hand. “Splenic hemangiosarcoma,” my mind spit out, and an ultrasound confirmed this.
As did the fine needle aspirate when Emmett had lymphoma.
And the radiograph when Kekoa had bone cancer.
So when I got home from the gym today and Apollo was down in the hind end, dragging his limbs, I didn’t even stop to do a complete exam, never mind jump in the shower or even change. I did enough to know we needed to go stat, and we went straight into the car, my sweaty self, my gym bag, my cat.
So many things pointing to a saddle thrombus, and one thing that didn’t. And because we cling to the one thing that is off, the chance maybe we’re wrong in our suspicions, I decided that I would go from the clinic to the specialty hospital, because we were not sure and I wanted science to disprove my hypothesis, very much. My sweaty self, my gym bag, my cat, zipping along to the next stop.
Saddle thrombus, for those who aren’t aware, is a not-uncommon condition in cats with hyperthroidism and/or cardiac disease. It’s a big blood clot that lodges right in the part of the aorta that splits down each hind leg, and it’s a very, very unpleasant condition. Even more unpleasant than how I must be smelling at this point, which couldn’t have been great. I didn’t care.
The internal medicine specialist, doing what internal medicine specialists do, came up with a nice comprehensive estimate of all the things we could do, anticoagulants and catheters and needles, should our suspicions prove correct. The cardiologist performed an ultrasound, and his heart was definitely enlarged. Apollo’s legs were cold, his pulses nonexistent.
“You can do all these things,” he agreed. “Or not.”
“I’m trying to be realistic about what is going on,” I said. “I’m not wanting to put him through a lot of intensive interventions for another month at home before this happens again.”
The numbers, when you lay them out starkly, aren’t great. “Miracles happen,” the cardiologist said. He saw one, once.
And what I saw was this: my children, crying the next few nights as they wondered if Apollo was going to live. Visits to the hospital, where he stayed, unhappy and scared, with a 50/50 chance of making it out. The kids coming downstairs one morning next month to find him down again, dragging his hind end and yowling. One miracle against this likelihood.
My husband said, “I trust your judgment.”
I tell myself this all the time, and it’s a very personal belief but one I hold strongly: Just because you can doesn’t mean you should. And my gut instinct was telling me loud and clear as a bell: Come home. Your sweaty self, your gym bag, your cat, in the car, home. And it stinks because this is a case where you don’t have the luxury of proving or disproving your hypothesis, because you don’t get to go back in time to redo something if you made the wrong decision. Sometimes gut instinct is all you have.
It’s what also told me “there is no way you can do this yourself, even though you have been doing this professionally for a very long time,” so my friend Dr. Benson kindly agreed on zero notice to come out to my house after the kids said goodbye, and help him cross on over to KevinVille. While I arranged this all and paid for our diagnostics at the hospital, I stood in my ever increasing stinkiness and ugly cried in the lobby. I am an ugly crier. There is nothing to be done about this. And even though I’ve been through it a bajillion times, I still ugly cry because, well, it still sucks every time.
There was a ton of traffic on the way home, my sweaty self, my gym bag, my cat percolating in the car, so I had plenty of time to think back to the lovely 15 years we had together. Apollo outlived Nuke, Callie, Mulan, Emmett, a betta, and a hamster. He was a relic from another era, my first vet school pet. I thought he would live forever.
He didn’t like being alone, so we got him a buddy. They were inseparable. He has a lot of friends waiting for him tonight in Kevin’s abode.
We bought that couch in the late 90s. Don’t judge.
He never meowed singly, it was always in threes: meh-eh-eh? The third eh rising like a question, every time.
Are you up?
Got any popcorn?
This lap taken?
I’m so glad superstition did not keep me from adopting him oh so many eons ago. He brought me nothing but good luck, the sweetest cat I ever knew.
My sweet Apollo died today, and I am sad. My sweaty self, my gym bag… an empty pillow.
Meh eh eh? I love you.
Pawcurious: With Pet Lifestyle Expert and Veterinarian Dr. V.