When I was a kid, our cats didn't get sick. Minor cuts and scrapes, maybe, which would sort themselves out, but at the end of their lives, they'd just curl up to go to sleep and not wake up again. I naively came away with the impression that cats don't really get sick unless you're unlucky, somehow.
That impression changed when I lost two cats to cancer in quick succession in my twenties and learned three painful lessons along the way.
The first was that cats did in fact get sick, very sick, thousands of dollars worth of medical care sick. The second was that you'd probably miss the early symptoms or think that your cat would get better, so you'd take your cat to the vet too late and then feel like a horrible person when she handed down the grim diagnosis while you cried in the exam room. The third was that even when they're terminally ill, cats have a perverse will to live, and very few just go to sleep and don't wake up, thus forcing you to make one of the most dismal and awful decisions you will ever make.
Here's the thing about cats: It's not that they are conspiring against us (well, they are), but that they're some of the most stoic animals on Earth. They feel pain, they just don't say anything about it — unless you happen to be very, very watchful. And when it comes to symptoms of chronic illness, good luck.
They tell you to watch out for symptoms like sluggishness or sleeping in funny positions, drinking more water than usual or acting strange, hiding in odd corners or giving you the evil eye. Those are all pretty normal cat behaviors, so you don't really think there's a problem until you hit some kind of tipping point. And by then, it's annoyingly too late.
Kidney disease is extremely common in older cats (I maintain that 12 is not old, but apparently it is — cats only live 12-15 years on average), especially male cats. As they lose kidney function, they can't concentrate urine as well, they start drinking more water to compensate, and things can go downhill very quickly. Once that function is lost, you can't regain it. Wait too long and your cat goes into chronic renal failure — and your options are managing it with basic care or going for expensive hail marys like kidney transplants.
Acute renal failure, by contrast, can onset at any age, usually in response to exposure to a toxin — like ibuprofen, which can be very dangerous for cats, or contaminants in food. It happens so fast that your cat can get sick almost right in front of your eyes, and if you don't do something, it's over before you knew it.
Older cats tend to slow down a bit, so it didn't surprise me when Loki started sleeping more — "he's mellowing out," some of my friends said as they hesitantly petted him for the first time, and I thought it was a natural sign of aging. After all, that's what cats do. They mellow. Maybe he was being more affectionate than usual, but I was determined to block the memory of how snuggly Mr. Bell and Mr. Shadow were during the last few months of their lives, coiling around me in bed and worming under the covers, seeking warmth and comfort.
Loki's always played a little fast and loose with aiming for the litterbox, which is one reason I got him one with a bit of a moat to capture the overage. But in recent months, he'd been doing it more and more, and drinking more water than usual. "It's hot," I told myself. "Maybe I'm not refilling the bowl as much as I think I am."
There was always a reason, until my catsitter mentioned that Loki had been going through a bowl of water a day while I was gone, and that was when I knew it was time to take him to the vet.
He was suspiciously sedate while they drew blood to check his kidney levels, which was the ultimate sign for me: Something was very, very wrong. Loki is not a sedate cat with anyone except me, and even I would be hard-pressed to find a willing audience if I was jabbing him with a needle while two vet techs held him down.
I talked to him at the head of the exam table while I berated myself silently. I should have noticed sooner. I should have taken him to the vet sooner. They all know I'm the neurotic cat owner, it's not like they would have judged me for taking him in for nothing. I should have known he was sleeping more than usual. I should have thought it was weird that he wasn't growling at the gas man.
It took a day for the bloodwork to come back, during which I imagined every possible terrible scenario, and spent hours on the Internet. Maybe he had acute or chronic renal failure, I told myself. But then again, maybe he had a thyroid problem. Or a tumor. It turns out that there are a lot of reasons for cats to drink lots of water, and most of them are bad.
The vet told me that his levels were "a little elevated" but we'd caught them early, her bubbly voice attempting to reassure me as she told me we could probably control it with a low-protein diet for now. I panicked, thinking of worst-case scenarios and trying not to cite Dr. Google, DVM. Three days after the diagnosis, I was supposed to leave for Japan.
I wrote my catsitters a page-long note about his special diet, meticulously measured food, what to watch out for, telling them to call the vet if they noticed anything, I said, anything at all. The vet's office assured me that they'd handle anything that came up, but I spent the trip in a frenzy of anxiety — as, I'm sure, did my catsitters, saddled with the uncomfortable burden of fear over something happening. Intellectually, I understood that if he took a turn for the worse, it wouldn't be my fault or theirs, but the heart doesn't always follow the brain.
They wrote me regular reports, reassuring me that he was fine, sending me pictures. "He's eating his new food," they said. "He loves playing with the banana," they said, sending a photo of him tearing into the catnip-stuffed banana I keep in the living room. I bit my nails and read about feline kidney disease and life expectancy. Depending on who you asked, he was looking at a few months, or a few years, or many years. Words like "fatal" and "death" leapt off the page like they'd been bolded, scalding me with accusatory glares.
Loki's lying in his heated cat bed now, one ear flicked back to listen to me typing. The paranoid part of me is convinced that this means he's not feeling well, even though he's slept next to me while I work for most of his adult life. He likes his new food, he chases Leila around the house (still), he plays with toys.
He's a little slower than he used to be. Sometimes he moans in that dreaded senile cat meow that makes your blood run cold because you know what it means. At some point, I'll have to start giving him fluids — maybe it will be next month, in six months, a year. He'll probably need medication at some juncture too. Meanwhile, we monitor his levels and wait to see if his kidney function remains stable.
There's a lot of waiting, at the end, I wrote once in a piece for Longshot Magazine. I hope that we are far, far from the end, but I also know that I'll never shake the guilt off. Maybe I could have caught it earlier, done something earlier, known earlier, given him more time. Maybe I couldn't have, and everything would have played out exactly the same, but I'll never know, and I think about all the times I snapped at him or got frustrated that he missed the litterbox and I cringe.
Here's something I've learned about cats, as an adult: Sometimes it feels like every move they make is calculated to break our hearts.