It’s been a month since I lost my oldest cat, Cara. I rescued her when she was a very small palm-sized kitten, her little flagpole tail sticking up everywhere she ran. She nearly died then due to an upper respiratory infection that was spread around the shelter. Due to the kindness of the man who (almost forcibly) adopted her for me, she got treated just in time – such infections can be deadly for kittens. She became Daddy’s girl. To me she was a sweet, loving, insightful companion. To others she was a holy fucking terror. She didn’t like people much. She didn’t like other cats either. In fact, Cara didn’t like most things. But she loved her Daddy.

A cat named Cara
Daddy’s Girl

When she died, Cara was somewhere between 14 and 15 years old. We think she was born in August, based on her approximate age when I adopted her. She was diagnosed with angiosarcoma. Right up until her last few weeks, several veterinarians had commented on how healthy she was. With only a mild case of arthritis in her hips in the last year, she was running up and down the stairs and remained the reigning queen just a few months ago. Really, she remained the reigning queen right up to the end – any other cat would be wise to steer clear of her regardless.

She was very much her own person. On several occasions, she acted as Attack Cat against those who she perceived were threatening the household. This was a surprise to them, since they weren’t really threatening but just playing. She’d always be right there with the same “I got’cher back, Daddy” look any time Matt and I would wrestle, too.

Angiosarcoma is messy and untreatable. While not directly painful, it’s a cancer of the blood vessels, which causes their structure to break down over time. Hers started on her belly, causing blood serum to leak, then eventually a lesion to form as the surrounding tissue became starved for regular blood flow. Over time, actual blood will drain from the internal parts of the lesion. Inevitably, it metastasizes elsewhere in the body – typically the lungs, heart, and brain. Usually a natural end can be as gentle as simply “dying of old age”. Usually.

Sometimes not.

Rallying After Surgery

After she was diagnosed, we knew we would be in hospice mode. In Matt’s experience as a veterinary technician, he’s met some interesting people. We called upon one of his interesting ex-coworkers, a vet by the name of Dr. Furie. She’s amazing with animals and visibly emotionally invested in their wellbeing. She kindly accepted our request to be our home hospice vet for the remainder of Cara’s life.

We asked her very frankly what to expect and whether we should euthanize my baby girl. Dr. Furie explained what would happen and that, if Cara were her cat, she wouldn’t euthanize unless Cara showed signs of distress. We could have a few good weeks – maybe even a few months – to say goodbye. Our goal was to keep her comfortable with an oral pain medication if she appeared to need it, hydrated with subcutaneous fluids, and eating (sometimes with a topical appetite stimulant applied to the ear).

Over the next few weeks Dr. Furie came and checked on her patient, assessing her condition and giving us frank updates. At no point did she feel it was “time.” Cara had a few ups and downs in terms of energy and apetite. Over time, she stopped jumping up on the bed to sleep with Daddy, a sign things were definitely not right. Her leaking became a problem for furniture and carpeting, and she wanted her privacy, so we set up the cat tent (meant for safe outdoor fun) on an electric blanket and put her own litter box, food, water, and bed inside. She willingly stayed inside most of the time, even with the flaps open. At night, I’d drag the tent into the bedroom and zip it up so she could be safe and unbothered while being at least near Daddy.

In the last week of her life, her belly was looking raw but she tolerated having it prodded and cleaned. It couldn’t have felt good but it didn’t appear to bother her. The occasional blood alarmed us more than her. That Monday, Dr. Furie showed concern only for her apetite and, like us, thought she’d probably have another bounce-back. She still seemed okay. Except that she’d stopped even playing “SEND-THE-STRING-BACK-TO-HELL”, her favorite game.

Things started to go downhill. By Tuesday, I started having doubts and fears. It looked for all the world like she was giving up. I struggled into Wednesday, when she appeared to be restless and looking for an alternative hiding place to her tent. By Thursday, she looked uncomfortable and would occasionally complain.

Drugged & Tired

I went to bed Thursday night very worried, wrestling with the decision. Around 4 AM, Cara woke me with a few forceful, attention-grabbing meows. I turned on the lights and looked over the edge of the bed. She was sitting facing me with a very purposeful “give me attention” look. I crawled out of bed, opened the tent, crawled in and pet her. She turned around so I could stroke her back as she kept the uncomfortable part of her belly off to the side. She purred very hard, luxuriating in my attention. After awhile, she got up and crawled back into her bed.

Then she loosed a sad yowl. I started to cry (again – I’d been crying several times a day every day for nearly a month by that point). I looked her in the eyes and asked her, “Are you telling Daddy goodbye, baby?” She seemed to know something was very wrong. Her out-of-character behavior and purposeful attempts to get me to notice and comfort her couldn’t be more obvious.

I crawled back into bed and cried some more, leaving her to rest. I told myself if that was her goodbye, then she probably wouldn’t be there in the morning. After what seemed like forever, I fell asleep. When it was time to wake the next morning, I lay there afraid to get up, afraid to look over the edge of the bed. Finally, I gathered my courage and looked. She was laying in the middle of the tent breathing but she had “the thousand-yard stare.” I decided to work from my bed to be by her side.

As I sat there in bed with my laptop, I admit I didn’t get a thing done. I couldn’t concentrate. After a few minutes, she started yowling. She appeared not to be able to get comfortable no matter how she laid. The tone of her crying hit me hard – my heart broke as I realized it was time. By that point, it didn’t seem like she was going to have an easy end and, against my own long-held convictions, I decided to make the “assisted suicide” decision on her behalf.

In tears, I called for Matt and told him to call Dr. Furie, that it was time. Cara was vocalizing regularly. I went out to listen to the conversation. By the time I went back to the bedroom (less than five minutes), Cara was breathing heavily and crying. I cried with her and tried my best to be soothing.

Then something awful happened. For sensitive readers, I think it’s best you stop here. Seriously. I have to write about it for several reasons but I have to warn you: it’s brutal.

Cara couldn’t get comfortable and was visibly distressed. I hoped for Dr. Furie to arrive quickly, but I strongly suspected we didn’t have time even to drive Cara to the vet’s office and she’s always been freaked out by that. I wrestled with myself.

A minute later, she began to crash. She staggered into her litter box. I thought she was just trying to use it but she laid in it. Cats will surround themselves with their own smell when they’re truly insecure. Cara has never been insecure in her life. She doesn’t get scared, she gets angry and fights.

Maybe I shouldn’t have, but my human side prompted me to lift her gently back out of her litter box. I told her I wasn’t going to let her die there. I brushed her off and kept petting her. By this time she was crying regularly.

Then it got worse.

She knew exactly how to get out of either of the two flaps in the cat tent. Yet she got up and tried to bolt through the tent wall. Several time she headbutted it in a blind panic. I got out of the opening and guided her toward it. She wanted OUT. She dashed under the bed and wailed. I took one look at her eyes and yelled, “Matt, she’s going!”

Her pupils were completely dilated. Her eyes were swiveling back and forth like a dizzy person. She was clearly anoxic. She was panting heavily but no oxygen was getting into her system. I was beside myself with grief and terror but somehow a calm came over me. I laid head to head with her, telling her it was alright to let go, that she’d been a great friend, that I’d remember her and love her forever.

By this point, she’d taken on a Cheyne-Stokes breathing pattern. It’s a very distressing thing to witness. It comes in cycles. Recovered heart attack patients report no pain from it specifically, and untreated, severe apnea sufferers do it every night, but in a terminal patient, it’s the final spiral. It couldn’t have been more than two minutes but it felt like I was serving out a long, agonizing prison sentence. It shifted to an outright agonal breathing pattern.

Then it got even worse.

She jumped up, ran in a half-circle, and ended up under the middle of the bed. She rolled on her back and screamed several times. She rolled to her side and let out what I can only describe as an agonized moan. It was heart-breakingly pathetic sounding. Her back was arching and falling, arching and falling. I’d pulled myself under the bed and was petting her, still trying to be a soothing voice, to let her know Daddy was right there with her. Matt was watching from the side of the bed and asked through his tears, “Is she gone?” Because of her movement, I hadn’t realized it. The pathetic sound she made was her dying breath. I put my head on her little body and listened. No heartbeat. No breathing.

It was the morning of Friday, January 6. Cara was gone.

I gathered her little body into fetal position so I could pull her out. The floor was wet – she’d voided her bladder. Through my grief, I noticed the oddest detail: her tail was completely limp. I’d never felt a cat’s tail with no tension in it, especially not Cara’s. Some cats are easy with their tails being handled, others aren’t. Even the easiest cats carry some tension in their tails. It was the first time I ever felt a cat’s tail so limp. That detail has stuck with me. Vividly.

I pulled her out and put her on my lap. I didn’t care about the mess. I sat holding her for awhile. Matt asked me to close her eyes but they wouldn’t close. After awhile I took her out and put her in a towel on top of the old shower curtain we’d been using under the tent to prevent anything leaking through to the carpet.

Without a word we began mindlessly cleaning up. We called Dr. Furie to let her know what had happened and to ask if she would pick up Cara’s body for cremation. I’d picked out a beautiful copper urn and a small urn necklace some weeks before. It was my way of coping with her death sentence. I cut a bit of her fur – she’d always had a beautiful, well-groomed coat – and set it aside for the necklace.

When Dr. Furie arrived, all she had was a cardboard box. Seeing my baby girl for the last time, curled up and lifeless at the bottom of a cardboard box was yet another detail that hasn’t left me. I don’t know what I expected – a gilded rickshaw carried by holy eunuchs? Nothing would’ve been enough.

We received her ashes the following Wednesday. I opened the bag and pulled out an impossibly-small wooden box. I slid the lid off it and pulled out a felt bag. I opened the felt bag and there it was – a plastic bag with what looked like … sand. Beach sand minus the rocky components. For a moment I felt robbed – duped. A flash of anger stole over me as I imagined I’d been tricked. This couldn’t be her remains.

Then I came to my senses. All that was left of cremation was broken down bone. I held the bag and a thought came over me, crushing me down in a split second: it was the first time in 14 years I was able to hold her in the palm of my hand. I wept hard as I opened her urn and placed her remains inside. I sealed it and sat over it for awhile. Then I got up and placed it on the shelf I built for it over the bed. She’d sleep by Daddy’s head like she always had.

I’ll spare you the details of the numerous things I did to build a shrine to her. I only stopped when I remembered my thoughts of her being in a cardboard box: nothing would ever be enough.

I spent the past month learning everything I could about what happened to my baby girl. I learned cats often vocalize when dying. Even when euthanized “kindly.” I never wanted Matt to tell me about the euthanizations in which he’d taken part but suddenly I needed very graphic descriptions – anything he could remember. Believe it or not, it helped immensely. It seems the ultimate cause of death was metastasis in her heart and/or lungs. The same seepage from her belly was occurring in her chest cavity. Her chest (not her lungs) filled with fluid. Blood loss and chest cavity compression put her into cardiopulmonary distress and ultimately her heart failed. Dr. Furie had said it was just plain bad luck – that this kind of cancer usually takes them more peacefully. Just bad luck.

During that time, I felt immense guilt. I still do, just not as harshly. I blame myself for waiting too long, for not recognizing it wasn’t going to end easily for her (even though I was told by several professionals there’s simply no predicting it). I blame myself for her suffering. I relive her desperate, screaming, fighting death all-too-regularly. I have many nights of fitful sleep. I’ve decimated many boxes of tissues.

Ultimately, the consensus of all those in the know are counseling me in a simple truth: she knew I loved her. She sought me out for comfort the night before – me and nobody else. She was treated like royalty for 14 years. Her end was awful but it was a few minutes of pain and panic – like many dying people experience – but it’s a tiny fraction of a lifetime of comfort, love, and pampering. She went out fighting, true to her lifelong nature.

After a month of reflection and a rather substantial medication increase (which has served as a good pressure relief valve), I’m finally able to look fondly at photographs of her and laugh about stories and her personality with Matt without crying every time. I have good days and bad. Some days I’m perfectly fine all day long; then I might have one, two, even three days in a row where I’m depressed and crying constantly. The medication has helped me to calm down and face my grief without getting to a point of hyperventilating … it was that bad.

It was the first time I witnessed the death of a loved one and it was a hard death. It’s my first real battle scar in that respect. I’ve always been emotionally strong (though I hadn’t realized it until the last few years – I’d always felt weak). Like a strong brick building having survived its first earthquake, I have cracks and crumbles that’ll never be entirely whole again. I’ve never in my life experienced grief as deep and debilitating as this. Her death changed me.

I’ll never again be dismissive about people’s need to keep the remains of their loved ones. I’ll never again be dismissive of people’s need to “spare no expense” for the memorial of a loved one (though I’ll always hate the Funeral Industry’s predatory nature). I’ll never again doubt there’s something that can emotionally bring me effortlessly to my knees and completely overwhelm me for weeks.

I love Cara deeply. I miss her smiling eyes, her coos and trills, her fiery, angry, royal opinions about damn near everything. I miss her odd need to accompany me to the bathroom for toilet or for bathing. I miss her comforting purring as she jumps up on the bed and settles down right next to my head. I miss how excited she’d be to do so during the middle of the day during the rare occasion of a midday nap. I miss her sleeping contentedly under my desk as I work.

In a photo album I made, the last page is a very brief letter to her. It ends: “I hope you loved your life. – Your Daddy

Special thanks to Dr. Michael Karg for taking such good care of Cara the last few years, to Dr. Wendy Furie for her compassionate hospice care, and for the staff of Frederick Emergency Hospital for allaying my fears of her blood loss early in her diagnosis. You’ve all been wonderful and I thank you from the bottom of my heart.

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