That's our deaf cat Snowball, shown in better times. He had come to us a few years ago from a ghastly animal hoarder case, the conditions of which had made him chronically sick. Ever since he arrived we have treated him for stomatitis, an oral inflammation disease that is very difficult to overcome. He's been on steroids, had his teeth removed, and yet his stomatitis would continue to flare up from time to time, leaving his gums bloody and painful. When this happened, he wouldn't eat and he'd stop grooming himself because his mouth hurt. Our vets in Helena at Montana Veterinary Specialists came up with a special stomatitis drug "cocktail" to help treat this disease, and although it helped, he would still have relapses. It didn't help that his immune system was suppressed. This left him vulnerable to every bug the other cats might bring into the cat house; things that would be sub-clinical in them would make him sick.
A couple of months ago he spent a week at the vet clinic after a particularly bad stomatitis flare-up. Even then, our vet Brenda Culver said Snowball would stick his paw out of the cage to try and tap people on the head as they walked by. And through all his problems -- when he looked awful and felt awful -- he continued to be a loving, purring, affectionate guy. When I'd walk into the cat house, he'd look at me and meow. This meant, "Thanks for showing up, now please feed me." Because he was missing all his teeth he ate canned food, so Snowball ate his meals in one of our medical cages to keep the other cats away.
A few weeks ago he started to go downhill again, while he was on the stomatitis cocktail. Frustrated, I had called Brenda to ask what else we could do. She said, "You don't want to contemplate the alternative." We had discussed his quality of life many times, but we had always concluded that in the face of his enjoyment of eating, his affectionate ways, and his purring, that he still had a reasonably good quality of life.
But he continued to deteriorate, and he looked terrible. Alayne and I, as well as Jodie, talked about whether the time had come to let him go. Then last week, Snowball developed an upper respiratory infection, so I moved him to the isolation cottage and started treating him for that. (In a cat with a suppressed immune system, a simple URI can become deadly.) He hated the oral medication, Amoxicillin, and he was an ace at foaming up and then spitting out the pink fluid. Snowball's face would be more pink than white after I finished dosing him.
Last weekend he stopped eating, and he became dehydrated. Even after I got the URI under control, he didn't resume eating. I added fish oil to his food but he wasn't tempted. I left the food out with him all night, and the next morning, the dish would be sitting there, untouched.
Was he telling us he was ready to go?
If you looked him, you would think so. He seemed miserable.
On Tuesday afternoon, I had finished giving him his medications and stayed to love him up. I figured by then that this would be his last week, and I wanted him to remember me as the guy who loved him, not as the guy who kept squirting medications down his throat. He had been morose, but as I scratched him, he quietly started to purr ... and the little rumblings soon began to sound like an engine roaring to life. Then he arched his body, his way of telling me to scratch his back. I was leaning over him, scratching away, when he turned and reached forward to rub his head on my hat brim.
My heart stopped. I thought, this is not a cat who wants to die.
I called Brenda that evening and told her what was going on with Snowball, how he had continued to get worse, how he had stopped eating, and how we had been thinking it was time to euthanize him. But, I told her, "He's still purring! How can we give up if he's doing that?" I told her I was just worried that there might be something else going on with him ... maybe it wasn't his immune system, it wasn't the stomatitis, maybe he was dealing with something we didn't know about.
Too often we have treated an animal for one chronic disease, only to have them die of something totally different that we had never diagnosed ... because the original disease masked the symptoms of the later disease. For example, my most favorite cat in the world, Hoedad -- one I brought back to the U.S. from Sri Lanka many years ago -- had chronic renal disease, which we treated for a couple of years. But he died, unexpectedly, of lymphoma. We never knew he had it until the very end. That has happened to us so often, and yet we sometimes forget.
And even if there wasn't another disease at work, I wanted to give Snowball one last chance. We'd hook him up to IVs, Brenda was going to try an experimental viral drug, and we'd see if we could help him turn the corner. If not, at least we know we had tried everything. So that's why I took Snowball into the clinic yesterday morning. It was going to be our last effort.
When Brenda called late yesterday with her initial report, I almost wanted to cry. Brenda said her husband, Britt Culver, our board-certified internal medicine specialist at the clinic, had found fluid in Snowball's chest. That led him to do an echocardiogram of Snowball's heart. He found Snowball was suffering from hypertrophic cardiomyopathy, in which the walls of the heart muscle become thickened and enlarged.
That would explain why he felt and looked so bad, and why he had stopped eating. Britt told me tonight that many congestive heart failure patients become anorexic.
Now, ordinarily, this would be a devastating diagnosis to get. But considering that cardiomyopathy is treatable in the short-term with heart medications -- Britt has started Snowball on diuretics and beta-blockers -- and considering that we were contemplating euthanasia, this was like someone tossing us a lifeline at the last possible moment.
Don't get me wrong, there's no false hope here. Snowball's prognosis is not good ... already having fluid in his chest is a poor indicator. But at least we know what we're dealing with now, and we have a chance to make him feel better again -- at least for a while. We'll know in another 48 to 72 hours how well the heart medications are helping him.
The lesson we learned ... again ... is that in the face of chronic disease and a sudden downturn, we should always ask, "What else could be going on?"
Our goal now is to get Snowball to see another Rocky Mountain spring, so he can sit in the open window and soak in the sunshine and feel a warm breeze. Will he make it? I don't know. But at least we have a better chance today than we did two days ago.
What I liked about your story is that you paid attention to the what the cat was doing. A behavior that didn't sit right, it was a happy cat, not a given up ready to die cat and that behavior though very minimal to many was a signal to you. Good job Mr. Smith. Keep lovin' on Snowball.
Posted by: Mircat | January 22, 2008 at 01:55 PM
I hope Snowball feels the warmth of the spring sun again too; I'm sure he would love that! I'm so sorry he's been ill; hopefully the new medicine program will give him more quality days filled with louder purrs, a good appetite and lots of sunshine.
We send him our love.
Posted by: Boundforglory | January 21, 2008 at 07:18 AM
Snowball, I hope you feel better soon. Sending you lots of love and best wishes so you can enjoy at least another spring at the ranch!
Posted by: Nina | January 20, 2008 at 07:00 PM
Don't give up on Snowball yet. I have a cat with cardiac disease, specifically restrictive cardiomyopathy (if I have that right). He went through some problems with wrong diagnoses (hyperthyroidism when he wasn't), has seen numerous specialists and a couple of months ago had his fourth echocardiogram. But the results were he's not much different than he was a year ago (except now he really is mildly hyperthyroid so is on medication for that).
Sugar Ray has a pretty good quality of life. When I decide he doesn't, that's when I'll let him go.
So -- Snowball may very well have more time left. I really hope he does see spring in Montana. Thanks for going the extra mile for him.
Posted by: Mary | January 20, 2008 at 01:29 PM
I have a cat who was just diagnosed with Hypertrophic Cardiomyopothy. She's a rescue who I fostered for a year before adopting her. Three months later I found out she has a heart condition. Your post touched me. From what I can gather, Snowball's condition is much more advanced than Katies'. And I wish her all the best. After learning of Katies condition, I had to wonder, If I had known she was sick with an expensive to diagnose, treat and monitor disease ($1200 so far for two vet appts, a veternarian cardiologist consult and an ECG) would I have still adopted her. And the answer is yes. I'm glad that I wasn't influenced by the state of her health. I love her and will do everything I can for her. And now I think I can truly appreciate what you and Alayne do every day Steve. My thoughts are with Snowball
Posted by: Shannon | January 19, 2008 at 12:02 PM
Snowball had a horrible start with that awful animal hoarder but you can feel excellent that he knows what it is truly like to be cared for and loved. This blog is such a heartfelt way to stay connected to RDR. I wish I was there to love each and every one of these kitty kats!
Posted by: Shirley & James, Portland, OR | January 19, 2008 at 12:13 AM
I'm praying for you Snowball. You are a beautiful boy. I call purring in my cats their motors. So keep your motor running and see another spring. God bless Steve and Alayne and RDR. Hugs to Smokey & Charlie.
Posted by: Sonya Brooks | January 18, 2008 at 06:02 PM
I hope Snowball pulls through. You guys are the greatest! Thank you for sharing your stories with us.
Posted by: Libby | January 18, 2008 at 04:20 PM
This is a wonderful lesson for us to remember. Hoping that Snowball is feeling better and improving.
Posted by: Beth Thompson | January 18, 2008 at 03:34 PM
It's fantastic that you are so intiutive with the animals in your care. Even in times of them being so ill, you can think straight for the best care of each animal. I wish I could hug you in person for being such a wise person, Steve. Would you please ask Alayne to do it for me? With admiration & gratitude,
ginger, Tobias & Tlingit
Posted by: ginger & Tobias (the greythound) | January 18, 2008 at 01:26 PM
Stomatitis is a terrible thing. My cat Henry developed it a few years ago when he was eleven years old. The flare-ups didn't stop until all his teeth were removed. I hoped he'd be 100% again, but it's been difficult. It's hard for him to eat, even canned food; there's something affecting his tongue, so he can't groom himself anymore (I brush him often, but it's not the same); his sister, never the nicest to him on her best days, bullies him now because she's figured out he can't fight back. But he's still so sweet, and so happy to see me when I come home - okay, it's because he knows I'm going to feed him - he's telling me he's still glad to be around.
I hope Snowball enjoys the spring breezes.
Posted by: jeanne | January 18, 2008 at 10:33 AM
Thank you Steve for not giving up on Snowball. There is a wonderful lesson to be learned from your experience. My thoughts and prayers go out to Snowball and everyone at RDR. Bless you!
Posted by: Beverly | January 18, 2008 at 10:18 AM
Thank you Steve for not giving up on Snowball. There is a wonderful lesson to be learned from your experience. My thoughts and prayers go out to Snowball and everyone at RDR. Bless you!
Posted by: Beverly | January 18, 2008 at 10:17 AM
My heart goes out to you. It's such a difficult dilemna to know when the "right" time is--how do you balance possible future quality time against present suffering? If you take heroic measures, are you actually prolonging misery? How do you know if/when these resilient little critters will rally? You think they're on the way out, then they do an amazing turnaround. Just when you think you've gotten things figured out, another joker pops up.
The one sure thing I know about you and Alayne--your decisions will ALWAYS be what you believe is best for the animal, never based on selfish motives or money. They trust you and so do I.
May Snowball keep on purring.
Debbie
Posted by: Debbie Burke | January 18, 2008 at 09:55 AM
This story about Snowball is breaking my heart. What a sweet boy, to still be purring and so affectionate even when he is feeling so bad. I am praying for the meds to help him and keep him with us a little longer.
Posted by: KCBORRS | January 18, 2008 at 09:10 AM
I will really really be pulling for Snowball. The dedication of all of you is just wonderful. Will be following his progress and hoping for great news.
Posted by: bcdandme | January 18, 2008 at 08:54 AM
Every extra minute of life that you give our animal friends is worth a life time, and I know that Snowball will have more time being with the Ranch.
Peace, Snowball.
Posted by: Clay | January 18, 2008 at 08:14 AM
Wow...I know how you feel when they are still purring how can you give up. I think sometimes they are just saying how much they love you and thanks for taking care of me!! When you are contemplating euthanasia and you are with them at that time, they give you a sign that says yes I am ready to go, they even purr and we take it as no they aren't ready. I think more because WE aren't ready! But I agree Snowball's actions where hey..I'm not ready yet!! Enjoy him while you can and know as always, he is having a better life with you two then without!!!
Posted by: Laura | January 18, 2008 at 07:30 AM
Good luck Snowball - we'll be prarying that you get all better!!!
Posted by: Katy | January 18, 2008 at 07:16 AM
Snowball is beautiful! I believe there is still some fire in those eyes! He looks like my white cat I had for 21 years! She had one green eye & one blue eye! Hang in there snowball!
Posted by: Mary Young | January 18, 2008 at 06:00 AM
Stomatitis is a particularly miserable thing to live with...and adding the new diagnosis seems like adding insult to injury. Poor Snowball...all that and he still can manage to purr??? Amazing...though I know his time is growing short, I pray for his comfort. Thanks, kids, for the incredible work you do.
Posted by: Debbie | January 18, 2008 at 05:31 AM
Never has a blog entry been such an emotinal roller coaster. My heart was down, expecting the worst, then the new life line for Snowball made me smile again. I truly hope he gets that one last summer in the sun. Steve & Alayne you need not worry about when his time comes if it is the right thing to do. As the vet said to me about my old Springer Spaniel "you will know when the time is right." I am sure you have been through this before and know what I am speaking of. Some things just are and as sad as it will be you will know in your heart it was right. I truly am inspired by what you do.
Posted by: Andrew | January 18, 2008 at 04:32 AM
Dear Steve, my eyes are filled with tears, after reading your loving words about Snowball. Thank you for trying to have him see another Montana spring. What a touching image!
I will keep him in my thoughts and prayers, hoping the heart medications will help give him a good quality of life for at least a few more months.
God bless you all.
Posted by: Carla Polastro-Nigro | January 18, 2008 at 02:40 AM
oh, good luck, snowball! what a wonderful boy - he is absolutely adorable and i hope he turns the corner. hang in there, buddy...
Posted by: maggie | January 18, 2008 at 12:13 AM
I am a firm believer that the animals tell us all we need to know. We just have to sit still for a while and listen. Thank you for listening. Here's wishing all the best for Snowball - and another spring. How is Trooper doing? Warm hugs to all.
Posted by: bregda south africa | January 17, 2008 at 11:10 PM