I was happy to find MySpace still had this blog from six and a half years ago. About ten years ago while I was still going through the heartbreak of being dumped by the woman I fully expected to marry some concerned friends of mine gave to me the greatest gift ever; my best friend of the past ten years. Boo is a black domestic short haired cat and only a few weeks old when he was given to me. I was a little naïve about cats when he was first given to me believing he was a female, telling people his name was Tabitha so it was a bit of a surprise when one day I found myself engaged in thinking that he had quite the pair of testicles for a girl. Fortunately to his face Id been calling him my baby boo so it wasnt too much of a transition for him when I changed his name to Boo. Ive always periodically lived with a cat or two and have mostly been good developing trust with cats but I still surprised me when the first night I had him he insisted on sleeping in my bed next to me. And the attachment only got stronger as time progressed. If I were to close the bathroom door he would sit outside the door and cry until I opened it, which did get me accustomed to using the bathroom with the door open. Even when I did keep the door open when I was in the shower he would sit outside the shower curtain and meow until he could see me again. Because we lived in the middle of the woods about two miles outside the small village of Johnson, Vermont I didnt mind letting Boo outside and be in tune with nature. My mother raised an exclusively outdoor cat to the age of 21 so I felt it relatively safe and would give him a happier, more fulfilling life. After a couple of years living outside any population center we moved onto Railroad Street which is right in the village of Johnson. Here Boo did experience some more injuries. Most were small with one or two requiring minor surgeries but one night, with 9/11 still fresh in the psyche of America he returned with his once proud, erect tail dragging limply behind him. As it turned out his tail was broken up in his hips about where your and my tailbones would be. This particular injury turned out to be life changing for him and not only because of the cosmetics of having him no longer having a tail but because of the damage to his spine this injury caused. He was no longer was able to feel how full his bladder was resulting in resulting in him being prone to accidental urination wherever he would relax. This I also feel led to the buildup of crystals in his bladder giving him a four night stay in the vets until this was cleared up. Of course, when they presented me with the option of amputating his penis I responded as most guys would and told them no way in hell and found myself with an obsession of protecting my own genitalia. While I these injuries cause me guilt and sadness and cost me a couple thousand dollars over the years, they still left me completely unprepared for what we are battling though now. A few weeks ago and a day or two after giving Boo some new medication for tape worm which you apply to the back of the neck like you would with a number of flea and tick medications I returned from work to find that his left eye was runny like he had an allergy. Initially I thought this was because he somehow got some of the medication in his eye perhaps while he was cleaning himself but the next evening he was walking around squinting. I was able to humor myself by imagining him with a pipe clenched in his mouth gulping down spinach because of the resemblance to Popeye but it concerned me enough to give a call to the Lamoille Valley Veterinary Services. The receptionist, after explaining what was happening with Boos eye, informed me that earliest they could get him in to examine him was two days later telling me I didnt want to pay for the emergency visit. The next two days the amount of time he could have his eye open became shorter and shorter so I was happy to bring him in to be examined by the doctor. The first thing she did was to give me a good lecture about how with eye injuries the animal needs to come in right away. She examined the eye and told me there were some spots inside of it that were concerning to her. I told her my suspicions about the medication but she appeared skeptical about that hypothesis. She felt this was an injury or possibly cancer. Neither of us was correct. I went home with a tube of some eye medication I applied directly onto his eyeball and a deep feeling of regret that I was so ignorant about eye injuries and pissed at the receptionist for telling me I should wait and not pay for the emergency visit. Normally I never spared the expense when it came to my cats health and happiness. My father and step-mother always made me feel irresponsible about how much I would spend for this constant and unquestioning companion; a friend who would come springing out of his hiding place in the tall grass whenever he heard the sound of my car pulling up into the driveway causing neighbors to compare his affection for me to that of a dog. After a week or so of applying the medication and seeing no improvement I scheduled another appointment with the vet. Over the next couple of days I noticed a few things about him. His eye appeared to be a little larger and swollen and it started to get a cloudy appearance to it. I also noticed that he was never hungry and there was a very slight cough. These last two observations were probably the most important clues that were overlooked by not only me but the veterinarians I took Boo too. I dropped Boo off at LVVS early in the morning as I was going to work and waited to hear back from the doctor. She called me back and told me that she wanted to get him in to an ophthalmologist and gave me the number of a doctor in Colchester. I made the phone call immediately only to be informed that the one pet ophthalmologist in the entire state of Vermont was out of country on a lecture tour and wouldnt be back for three more weeks. I immediately called LVVS back and explained the situation and we both agreed not to let Boos condition linger any longer. She gave me the number to Veterinary Emergency & Specialty Center of New England where I made an appointment for that Saturday with Michelle Willis DVM, DACVO. The next couple days I tried to prepare myself for what was becoming more and more apparent. Boo was going to have to have his eye removed. I spoke with whoever would listen about what was happening to him and what the possible outcomes would be but, and reading over the invoices from LVVS which is where I noticed that Boo lost a little over a pound in about ten days. While these activites helped me intellectually get me prepared for this eventuality, emotionally I could never be prepared. That Saturday Boo and I took the four hour trip to Waltham, MA where we met up with my friend Aimee who lent me some much needed support for the news I was about to receive. Dr. Willis did a thorough examination of Boos eye demonstrating to me that he had completely lost sight in the eye and telling me what I already knew, that he had developed glaucoma. She explained that while there was no visible injury to the eye what she saw resembled trauma to the eye either sharp or blunt likely caused by another cat. She also warned me that there was a slight possibility of cancer. To be sure she also checked Boos jaw because injuries like this in cats are often combined with a broken jaw but thankfully the jaw was fine. She also took blood to run some tests prior to the surgery. She then gave her recommendation, the very news I had spent the past couple of days trying to immunize myself against. It was in Boos best interest that the eye be removed suggesting just to be safe that I spend the extra $120 to have the eye biopsied. As it turned out this ended up being the best spent $120 of my life. I made the appointment to have the surgery that Tuesday and then walked out to the lobby hardly aware of my surrounding and feeling like my legs could barely hold me up. The feeling didnt get any better when my application for Care Credit, my one hope of financing this operation, was denied. While I was beating myself up for not taking the steps to correct my credit Aimee made the amazing offer to put her name on the application. My feelings then were anger at myself for not preventing this from happening and at whatever could have caused this amazing animal such harm even if it was an unfortunately placed stick he happened to poke himself in the eye with, sadness for the pain he must have felt over the past couple of weeks, grief over the inevitable removal of his eye and the loss of that which he treasured most, his freedom as there wasnt going to be anyway I would be allowing him outside any longer, and also shame for being the pet owner to allow this to happen and to be so visibly disturbed in the lobby of a hospital where there waited the owners of animals with what I thought was far more severe injuries and illnesses than Boos. I returned to Vermont with Boo simultaneously preparing our return three days later and to try getting myself into character for a movie that we were supposed to wrap up that night. Unfortunately in my grief I ended up getting completely lost on the way to it. The next two days were agonizingly long but it helped me get into a much better frame of mind in regards to the upcoming surgery. On Monday I walked into work and rather than asking for the following day off matter-of-factly informed my manager that I was taking the day off. She was very understanding and made no argument or appeal for me to do otherwise. Monday night after work I drove down to Boston listening to Jon Lester pitch a no hitter for the Red Sox. Listening to the announcers describe pitch by pitch how a survivor of lymphoma could return to make his mark on history. We arrived at the hospital just before midnight. The most helpless feeling in the world was watching the late night attendants carry his carrier to the back and knowing that was going to be the last time I saw him with both eyes. I wanted to be by his side the entire time to let him know I was always with him but instead I hopped on Interstate 95 and headed to Aimees apartment which practically sits in the shadow of the Boston Monument in Charlestown, MA for the night. It was an easier night than expected. I was coming to peace with what was to happen telling myself mantra-like how well Boo was going to adjust and how it would relieve the constant pain that was probably the reason he was no longer eating. To say I was feeling refreshed the next morning would be an overstatement but it was better sleep than I had gotten in days but I was still feeling restless. I spent the morning picking up a double latte and exploring around the banks of the Charles River just across from the TD North Boston Garden but even the decorations adorning Interstate 93 in celebration of the Celtics moving on to play the Detroit Pistons in the playoffs could get my mind anywhere else but on Boo. After an hour or so I couldnt be that far away from him while he was going through this. I could just feel the surgery had gone fine or so I was telling myself but I wanted to be right there when the effects of the anesthesia wore off. I hustled to my car and made the premature drive back to the hospital and waited at an outdoor table at the restaurant that shared the building with the hospital. Almost immediately I was given the message that the surgery was successful but they were going to hold him for a couple hours to make sure he looked fine while awake. A few hours later I was taking the increasingly familiar trek back to Vermont. After a quick stop to pick up some supplies to make this experience a little easier and maybe distract him from the Elizabethan collar he was required to wear we arrived home. Because they told me to keep him away from stairs for a night to make sure the anesthesia had run its course I had to lock him in my room for the night. Encouragingly the first thing he did when I opened his cage was to finally have a fair amount to eat. At the risk of sounding insensitive the noises in the middle of the night caused by a cat wearing a protective collar and lacking depth perception are actually quite comical and I woke the next morning almost feeling refreshed. I gave Boo his pain medication and headed to work making sure he had plenty of wet food for him to snack on and a multitude of bowls of varying shapes and sizes for him to figure out which the easiest from which to drink for him. When I returned I noticed he didnt have the same energy he had just that morning but I still in the afterglow of telling the doctor at LVVS how well he was doing and still feeling thrilled with how he was acting almost normal the previous night. It did seem that his breathing seemed a little labored. It didnt seem very serious but I made a mental note about this. Was he dehydrated from not being able to reach his water dish? The next evening I really started getting worried. He was having a much harder time breathing and wasnt moving at all. There was also a disturbingly constant purring coming from him even when I wasnt petting him. I picked him up from his perch on the steps where he liked to overlook the action happening in the kitchen and moved him to the couch so as my brother didnt come stumbling down the stairs and accidentally step on him in the middle of the night. The next morning I woke and immediately checked on him to find he never moved from the position I left him in and I knew there was more wrong than anybody realized. His breathing was even more labored and the only thing he had energy to do was to continue with that creepy purring. I tried to put him in his carrying crate but the collar around his neck made this impossible so I picked him up and held him in my lap while I drove him back to the hospital. To make things just that much worse it was also one of those moments when Boo couldnt feel the contents of his bladder and emptied it all over my lap. I dropped him off at the hospital not caring one iota about how much this emergency visit would cost me. The greatest companion I could ever ask for in life was in distress unlike anything Id ever seen him experience before. I dropped him off and made my way to work. The doctor on duty called me after checking his blood to inform me there was a high level of a particular protein that was consistent with the surgery but there was also an increased level of calcium in his blood that was an indication of either dehydration or a malignancy. This last word hit me like a sledgehammer. What a wicked twist of fate that would be to put me through all of this only to find out my cat had an incurable and fatal disease. I begged, pleaded, and cursed whatever god there might have been out there. How could a loving god allow this to happen to the most incredible creature to grace this earth? It was just too cruel to believe. She told me that she was going to run more tests to find out more about the calcium and which would give her a better idea of what was going on inside of Boo. A couple hours later she had called me back with the results of the latest tests. The calcium indicated it was a malignancy and when she X-rayed his chest she found nodes in both lungs indicating he had cancer in both lungs. I asked if she checked with VESCONE about the results of their blood test and she told me she did and that came back negative. It didnt make sense that suddenly cancer would just appear when about five days prior there was no indication of it. She told me that there was a drug that could possible extend his life another month and chemotherapy was a possibility but I couldnt justify either of those options. It just seemed like it would be extending what was only going to be an absolute miserable existence. She also told me what would be the most definitive evidence of what Boo was afflicted with would be the biopsy on the eye and we should wait for those results. I have no idea how I made it through the rest of the day and the following day was nearly impossible to get through. I was just leaving work when I got a phone call from the doctor. After initially being told it would take up to two weeks to get the biopsy results back the doctor explained the situation the doctor from LVVS explained the situation which got Dr. Willis personally got involved on her day off. The biopsy results came back and it was negative for cancer. He came back positive for blastomycosis. Blastomycosis, also know as Gilchrists Disease or Chicago Disease, is a disease caused by the fungus blastomyces dermatitidis. The spores are most commonly found near water in wet, sandy soil rich in organic material. Its almost exclusively found in North America and then its usually restricted to the Mississippi, Ohio, Missouri, Tennessee, and St. Lawrence River valleys, the mid-Atlantic states, and the Canadian provinces of Quebec, Manitoba, and Ontario. The doctors told me its extremely rare in Vermont and even rarer for a cat to catch it. Dogs are about 100 times more likely to contract it and even humans are approximately 10 times more likely than cats. This is why it wasnt even considered by two different doctors at two different hospitals. I was to learn later that Boo was the first case of blastomycosis that LVVS had ever seen. Normally an animal will get this disease by inhaling the spores into its lungs where the infectious spores change into the non communal yeast form of the disease as the body temperature of dogs, cats, and humans is the correct temperature range to encourage this transformation. From there it will travel throughout the rest of the body to infect a host of other organs such as the skin creating lesions, bones, lymph nodes, brain, testes, and, yes, the eyes. The eyes appear to present an extra difficulty as the medication does not penetrate into the eyes well with the removal of the eye or enucleation a strong possibility for a severely affected eye. They told me that they would prefer to keep Boo there for the start of the treatment as the first two weeks of what was going to be multiple months of treatment months was the most dangerous period for the animal as when the fungus starts dying in the lungs it loosens and causes respiratory difficulty which could prove to be lethal. They had my blessing and initially counted my blessings that he wasnt suffering from cancer in both lungs. Were I a little more knowledgeable I would have been a little more reluctant to start counting. Initially the vet recommended he stay there through the weekend and possibly come home Memorial Day or the Tuesday following that but for two weeks I spent time almost every night witnessing Boo waste away from not eating. Anorexia is a common symptom of blastomycosis and one of the first to manifest in Boo. Over the next two weeks I made a nightly visit to LVVS to give Bubba (one of my many nicknames for Boo) a bright spot to his day. Aside from the times I was by his side petting him, brushing him, and giving him reassurances the rest his days were spent lying in the back of his tiny metal cage with too little energy to move. The doctors and attendants had to force food into his mouth four times a day as he quickly dropped a couple more pounds and then they also had to give him is pills twice a day. While they were feeding him and giving him his pills they had to be sure they didnt excite him too much because exciting an animal at the beginning of treatment with the dying fungus loosening in the lungs would only worsen its condition with the potential of death. There are a few types of antifungal medications to treat blastomycosis. What was prescribed to Boo was itraconazole. A pretty strong indication of just how unlikely it was that a cat contracts this disease is how the doctor couldnt get it locally in dosages appropriate for a cat. They had to get it in gel caps that were appropriate for humans, open the caps, and repack the medication into smaller gel caps so Boo could take it safely. Too high a dosage could have been damaging to his liver. These pills are not cheap either. A two week supply costs about $61. That is for an 11 pound cat. One of the doctors revealed to me that with a large dog the cost for a two week supply is closer to $250. Of course the rarity of such a disease in this region led me to investigate it a little more. Was this something I could have brought into my apartment and infected Boo? Could I or my brother, Chris, who is also my roommate, be next to contract it? It is about ten times more common in humans than in cats. We will probably never know. The biggest indicators to whether or not you or another creature will be infected with blastomyces dermatitidis is the proximity to another creature that has contracted blastomycosis, proximity to water (a study of canine blastomycosis in Wisconsin showed that a vast majority of cases involved dogs who lived within 400 meters of a body of water at altitudes less the 500 m above sea level while another in Louisana showed infected dogs were ten times more likely to live within 400 meters of water than the control set), and it appears that being around construction or excavation sites also increase the risk. Unfortunately the times that its been isolated in the wild have been rare even after outbreaks of the disease occur. Not surprisingly in the northeastern United States and southeastern Canada the disease is more common from Spring to Fall but in Louisiana and other regions in the southeastern United States the amount of occurrence doesnt vary as much from season to season. The incubation period for this disease is anywhere from a couple to around six weeks meaning Boo was probably carrying the fungus around for weeks before that one evening when I noticed his leaky eye. Since Im right across the street from the Lamoille River which does have the wet sandy soil on its banks that the spores grow in that would be the most likely spot for him to have gotten infected but it was a very wet spring and the soil around this area is organically rich so its possible it was even closer than that but with it being almost imposible to isolate it in the wild its pretty much impossible to track down the source to destroy to avoid future contact for any creature. My brother who is also my roommate was rightfully concerned that it could be transmissible to one of us. I did explain to him that we wouldnt have to worry about getting it from Boo as it wasnt a contagious disease but it would be something that we would get from the environment. It appears that slight exposure to the spores is not enough to cause the disease as the average humans immune system is strong enough to fight off this attack. It requires a major exposure to the spores or a compromised immune system to actually catch the disease blastomycosis so people with AIDS or other such diseases or symptoms are at higher risk of catching it. In fact 40% of the fatalities from blastomycosis for people in treatment are people with AIDS. About two weeks into his stay at LVVS he still wasnt voluntarily eating. They were syringe feeding him and he wasnt very cooperative. Every time I would come to visit him I would have to brush the dried up balls of what was once wet cat food from his fur. Also because he was too weak to move and because hes unable to feel when his bladder was full he was usually covering in urine, too. It wasnt the prettiest of sights. I thought a change of scenery might be good for him so after getting lessons on syringe feeding him I finally got to bring my cat home. They were still concerned about the dying fungus killing him so they asked that I keep him in a cage for a while but instead I kept him in my room where he couldnt be jumping on things or exerting himself at all. He mostly his himself away for the first few days but slowly I could start to see some changes in him. It started with him eating on his own. I remember with tears in my eyes looking up to the skies and saying Thank you after a few days of him being home. This was the biggest step for him and the first sign that he was starting to win this battle where the odds were against him. I dont know how low his weight got down to but you could visibly see each vertebra and if you felt his belly you could actually feel his internal organs. Little by little he started to eat more and more and started to gain all that weight back. After three weeks of being home hes now almost back to his normal weight. Energy has also returned to him and he keeps trying to slip past my brother to get outside again which to us is a really good sign. Were it not for his removed eye and the missing patches of fur from where he was hooked up to an IV you would see nothing but a normal cat. Im not a wealthy man and the cost of this so far has been almost 10% of my gross annual salary it has been a major hit to me financially. Many people have told me how silly they thought I was for doing all this for him. Recently I bumped into an estranged friend who after telling him this story responded with Dude, its a cat to express how he felt about me spending so much money on what he was seeing as a lesser species but Boo is not a cat. Hes my cat; an animal thats shown me true friendship and loyalty for almost ten years and one for whom Im responsible with the chance for a full recovery. Hes also an animal that I love more than almost anything in this world and I really dont know how you can put a price on love.
Posted on: Wed, 17 Dec 2014 17:54:06 +0000
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