Probably Cats: Dexter, declining

I wish the first time I actually fulfilled the “probably cats” part of this blog’s tagline was for a happier topic. It was something I’d do some day, thinking the perfect topic on which to cat-gush would strike out of the blue. I’d even thought I’d like to do an introduction post for each, such as “Meet Monty,” or “Meet Miles.”

So, Meet Dexter; I wish I’d gotten to this earlier.

Dexter came to us in the most normal of ways, through Lansing’s Capital Area Humane Society.  We adopted him as a kitten in May 2009, about a month after losing 14-year-old Thacker to renal failure. He instantly filled us with mirth and happiness, and though we were still grieving the loss of an amazing and devoted friend, Dexter began squiggling and biting his way into our lives; for almost a decade our homes had been defined by the presence of “Monty and Thacker,” and then it was awkwardly Monty alone for a brief time. Dexter restored the unexpectedly significant “and.”

Something strange happened as Dexter grew. I think our loss of Thacker – the first loss of a truly close companion animal either Jessica or I had faced as adults – took a long time to discharge, and that made us wonder if we would ever connect to Dexter the same way we had with Thacker and Monty. Monty, incidentally, was finding his own difficulties in moving from the status as the baby of the household to elder brother and living training dummy for a black poof of teeth and claws. Monty’s reservations for the newcomer were understandable, and I suppose our own were par for the course, too. Over the first few months of Dexter’s life with us, we enjoyed his company more and more, and began to feel assured that he was on his way to his own niche, but we never felt we were head-over-heels infatuated with him. He was a great kitten who was a ton of fun, but that seemed like it.

That changed when Dexter was about six months old, and in the oddest way. Jess and I briefly considered the benefits of having a house cleaner, seeing as we were feeling increasingly stretched for time and knew we weren’t keeping up as well as we should. That plan fell apart soon thereafter, but we did invite one particular candidate to our home in Okemos, so she could get the layout and specifics to get a better idea of what we would need from her. She brought her husband and toddler son with her, as they had planned to run other errands while in the area.

I’m not a kid person, as anyone who knows me can figure out. I’m not a child hater, as is often misunderstood by some; kids are unpredictable and I rarely find the things they do as endearing and funny as others. But this kid, this house cleaner’s little boy, is responsible for our seeing Dexter as he truly is. Within moments of the trio entering our house, Dexter and the boy had locked eyes and converged. It was genuinely cute, watching this child squeal with delight at Dexter’s friendly nuzzling and sniffing. It was, for Dexter, a moment that defined how we’d view him for the next three years. He was transfixed by the child, but just… friendly. He kept marching around the boy, his tail straight up in greeting, his front paws flexing in the kneading gesture cat people recognize as contentment or intense interest, and his purr loud enough for everyone to hear. For a few minutes, Dexter and the child contentendly orbited each other like a binary star system, sharing their common core of fascination, friendship, and bliss. The family left soon thereafter, leaving Jess and I completely stunned by his behavior.

That was when we stopped just liking Dexter, and fell in love with him.

Dexter is sick. We’ve learned in the past two months that it’s very common for neutered male cats to develop urinary tract blockages. The feline male’s anatomy for eliminating urine is poorly tuned, predisposed to infection, blockage, and pain due to its very narrow urethra. To help visualize, think of the female cat’s urethra as drinking straw, but the male’s as a coffee stir that still has to function after bending at a right angle.

The first event happened about one month after unpacking here in Atlanta. We awoke on the morning of August 30th to find him breathing heavy, curled up tight onto himself, and coughing strangled cries of pain. A nearby vet hospital was able to get him in immediately, thankfully, and we learned he was totally blocked and his bladder was distended. He was catheterized, drained, and flushed; we were told he was extremely lucky because we got him in before his bladder or kidneys were damaged. We also learned that Dexter was the proud owner of the world’s narrowest and thinnest urethra. He came home on the morning of September 1st to parents who were now educated and prepared to deal with a FLUTD kitty (Feline Lower Urinary Tract Disease). Special food, multiple points of access to flowing water, and close observation gave us some hope that we had avoided catastrophe and would be able to adapt to a special needs pet.

Dexter was back in the hospital by September 4, blocked once again. On the recommendation of his doctor, we decided to fast track the drastic measure we would have considered only if he blocked three times. A second blockage only three days after the first was cleared was obviously grave. Dexter underwent a surgery for a perineal urethrostomy. By removing his genitals, the urethra was significantly shortened, leaving the wider and less likely to be blocked portion behind. He spent almost a full week in the hospital and in recovery.

His at-home recovery was full of pitfalls. He had to have an out-patient catheter put in twice, both to ensure he was draining fully, and to correct a case of fatigued bladder muscles. He constantly dripped. He was routinely eliminating outside his litter box. He would sometimes urinate small (and occasionally not so small) amounts of blood. He developed an infection. He lost over three pounds – nearly a quarter of his body weight.

We had hope throughout because of a few crucial things. First, he was peeing regularly. Whatever else had happened, the urethrostomy appeared to be a success. Second, he was continuing to go about the business of living. He ate enthusiastically despite the weight loss, kept himself as neat as he could, given the messy condition he was in. Most importantly, and still the case today, is that the same happy, lovey, affectionate cat whose disposition is as sunny as his fur is dark is still with us. He wants to be the same. He still raises his tail straight up when you address him, and it still quivers with unrestrained eagerness when you reach down to pet him. He still marches in tiny circles when you prepare his food, something he’s done since he was a kitten. He still sticks his nose deep into my goatee, snuggles and rubs around against it, makes a tiny snerff sound when his nose is inevitably ticked by the hair, and finishes by ramming the top of his head into my chin. That Dexter wants to keep living the same cuddly, content, peaceful life he’s lived for the past three and a half years.

Wanting something is powerful, especially when it comes to wellness. Wanting to stay and fight keeps people and animals around instead of succumbing quickly to wasting diseases – we saw that with Thacker. Even as he dropped from 14 pounds to just six as his kidney failure progressed, he stuck around because he wanted to. He wanted to be with us, to grumble at us, to rub against us, and to end his day at our feet. That carried Thacker a full six months beyond his diagnosis before we saw the sign that he no longer wanted to stay. Wanting is powerful, but sometimes wanting just isn’t enough.

Dexter wants to stay with us, but he may not be able to. On Halloween, he began peeing large amounts involuntarily, leaving large puddles or spots where he slept. We took him in to the vet one more time. I can’t say if I knew the news was going to be bad or not, but I feel like Jess and I knew the other shoe was about to drop somewhere in our hearts. The doctor confirmed his bladder was distended once again, and proceeded to attempt a catheterization to clear it; it didn’t work. As far as she can tell, Dexter has developed scar tissue deep inside his urethra – possibly a byproduct of the earlier catheterizations, but certainly related to the trauma of the past two months. The scar tissue is preventing the doctor from actually entering his bladder to drain and rinse. Dexter’s stuck in a loop.  He gets so full that he begins to become extremely uncomfortable, he licks, rubs, and pushes to no avail. Finally the pressure of too much urine in his bladder is what dislodges the tissue blockage enough for a gush to pour forth, but never enough to empty his bladder. The bladder begins filling again, and the process repeats.

The options for Dexter are unpalatable. Another, more invasive surgery to place a catheter from inside his bladder offers no real chance that he won’t simply reblock again after it is removed; we’re not actively solving the issue, and his bladder muscles have also weakened again from being constantly stretched. Of further concern are the concomitant risks of significant surgery, infection chief among them. We could take a referral out for a specialist with different technology who may be able to place the catheter non-invasively, but that doesn’t address the same after-removal scenario.

We spent yesterday day scrabbling for something to give us a chance to treat Dexter one more time. We’ve found nothing. What we are faced with now is that, aside from some pills to help strengthen his bladder muscles, we can do very little for Dexter except keep him as comfortable as possible. We’ve decided not to pursue a second opinion because of the battery of tests and prodding that would inflict upon the poor little guy. In essence, we are out of options. We can keep our fingers crossed that somehow this suspect blockage resolves itself, but sometime very soon we may have to accept that Dexter shouldn’t keep going, no matter how much he wants it.

Jess and I wondered why this time felt different than with Thacker. We had Thacker for eight of his 14 years (adopt an older shelter cat if you haven’t yet; knowing Thacker stands as one of my most worldview-altering experiences). Thacker was an amazing friend who seemed so much like a person, and he died in a slow, at times very painful manner. Dexter’s probable fate feels like a much more savage wound in my heart, and I feel already that this one will take longer to come to terms with than did Thacker’s passing. Jess and I wondered why this was until we realized it was a difference of hope.

Even in Thacker’s most horrible moments – such as a rocky Christmas Eve in 2008 where we went to bed certain he was going to be gone when we woke Christmas morning – we had a reason to hope. We could hope for one more day, week, or month of Thacker feeling comfortable enough to stick around so long as he wanted to. That hope is missing in Dexter’s situation, and all we have to replace it is vague, directionless wishing for a miracle that’s all but impossible.

Right now, Dexter’s happy. He’s purring, he’s playful, and he’s engaged. In fact, he seems better than we’ve seen him in weeks. In his mind, the blockage isn’t a big deal. But it will be a big deal eventually, and probably sooner than later. Beyond all my ineffectual rage that it’s unfair that a cat of only three and a half years – practically a kitten! – is facing his probable end, I’m stricken with a sadness that Dexter won’t be able to make this decision for himself. If this moment comes, we’ll be putting to sleep a creature that is healthy in every other possible manner. A friend who has been so sweet, kind, and loving to virtually every other soul he’s encountered will miss out on so many more souls because of the tiniest little glitch in his body. It’s not just unfair.

It’s unfathomable.

EDIT, November 5: We said goodbye to Dexter this afternoon. As expected, he declined quickly until it was undeniable he was in pain, and possibly kidney failure. He was loved by everyone who knew him, and he loved in return. He will be missed more than I could ever hope to express in words.


2 thoughts on “Probably Cats: Dexter, declining”

  1. Just read this, Roger. So sorry about Dexter! We lost Joe at around 5 years old, in nearly the same way – it’s so difficult to see them in pain with no real options… I am sure that the life that he had with you and Jessica was awesome. Hugs to both of you.

    1. Hey, Renee. Thanks for dropping in!

      I do appreciate the kind words, and I’m sorry for Joe’s loss, too. It is total crap to lose a pet in such a way. Dex would’ve hung in there until the bitter end if we had let him. So small a thing to take down so healthy a cat.

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