Anticipatory Grief

[Umbran]

If you don't want to read about sadness, maybe take a pass on this one folks.

Today was... not a good day.

One of my cats has clearly not been feeling well, as she hasn't been eating much. While my wife is a veterinarian, she's in hospice and palliative care, and generally doesn't need or have the bigger diagnostic systems, and doctors shouldn't treat their own family members anyway. So, I took our cat to the best clinic around, to get some blood work and maybe an X-Ray...

And the results of that weren't clear, but also weren't comforting, so I spent the rest of the day at an even bigger clinic that has radiologists around on the weekend for an ultrasound...

... and then a biopsy.

Full diagnosis isn't in yet. But cancer is the most likely. And, for the better form of that, if she tolerates chemotherapy... she has maybe a year. We can hold it off for a while. We can keep her comfortable. So, maybe it can be a mostly good year, a year worth having. But... it probably won't be a great year, and it probably won't be much more than a year.

Other than her care, the important, and kind of hard, thing is now to not allow knowing that to ruin the year. We have to soak up her goodness, and give her as much joy as possible, before she's gone. Allowing our grief before the fact to get in the way of enjoying that limited span, or otherwise seep into our lives and tarnish it, would be a travesty.

But, holding that anticipation at bay, not focusing on it, not letting it lead to bad decisions or fouling the time we have, can be hard. Knowing that grief before passing happens, however, is one key to managing it. So, here I recognize the potential, so I will be more capable of handling it as it comes.

 

[MGibster]

Knowing that grief before passing happens, however, is one key to managing it. So, here I recognize the potential, so I will be more capable of handling it as it comes.

I've sometimes wondered whether it's better to experience a sudden death or be forewarned. I'm morbid that way I guess. The advantage of being forewarned is you get an opportunity to say your goodbyes, make plans, and come to terms with what's going to happen. It gives you some time to manage everything, grief included.

The most difficult part for my wife and I was deciding when it was time to let our dog go. His physical health was deteriorating, but he could still get around well enough, enjoyed his food, and on occasion still wanted to spend time with us. He appeared to have dementia and it just kept getting worse to the point where we figured he was no longer living a good life. It was tough to decide where that tipping point was and I'm not 100% sure we got it right.

I'm sorry about your cat. I'm frequently amazed by just how much joy our pets bring to our lives and how much it hurts when they're gone.

 

[Autumnal]

That’s very hard, Umbran. Deepest sympathy and condolences from here.

 

[Dannyalcatraz]

I’m so sorry to hear that Umbran. You never know how much time you have with anyone in the world, but sometimes you know it’s not much more.

We’re kind of in the same boat ourselves. Our grrrl will make 14 in January…if she makes it that long. She got sick a few months ago, and we thought she was weeks away from death. But she got better.

Still, she’s got vision and hearing issues, and it’s clear to us that she’s experiencing mental decline as well.

 

[Alzrius]

I'm very sorry to hear what you're going through. I have a sick cat myself, so I can empathize with how heartbreaking it is to watch a beloved pet slowly slip away.

 

[Warpiglet-7]

First of all, I am very sorry to hear this.

Several months ago I had a sick pet.
The vet said he was sorry when we had him examined but he lasted longer than anticipated.

Over weeks I watched the breathing and activity and personality change. And then he did pass away.

I cried a lot. Probably daily. Leaving for work I felt Guilt while he was still sick.

I coped by trying to visit as much as he could tolerate. Tried to give special food and so forth. We had some very special moments before he passed. Be strong and allow those to happen. They are as real as the moments when he was not sick.

Anticipatory grief hurt more than I would have thought but resolved more quickly than i would have thought after his passing.

None of us truly know how long a pet has.

I say try to have some good moments. When they happen in the lifespan is not as important as long as they happen. I connected to my pet and he did some uncommon things seemingly showing his attachment to me specifically.

Hang in there and very sorry. I love my pets more than people usually understand sometimes more than my family understands.

Your pet needs you so let that help you do what you need to do. The rest does take care of itself. In the meantime, just show love. It’s important for you both.

 

[aco175]

Sometimes things suck all around and strangers, or quasi-strangers might be better or worse to talk to. When my do got cancer a few years ago, I told the wife that we spend hundreds of dollars on the dog and thousands on the kids. Sometimes ones financial situation is taken into account when talking about care and comfort of an animal. I'm not one that feels the pet is one of the kids in my family so there is that as well.

Mostly things come down to the animals quality of life and its pain and suffering compared to your wanting to keep it around. If things are managed, them fine, but at some point...

 

[Umbran]

Thanks, all, for your thoughts. Several of you have shared your own stories, and be sure, at this moment, I can sympathize and empathize with all of you.

I'll likely to use this thread to jot down some bits over this time. Nobody's obligated to check in - I'll be doing it mostly for myself.

I've sometimes wondered whether it's better to experience a sudden death or be forewarned. I'm morbid that way I guess.

Nothing morbid about it. Grief is complicated.

It was tough to decide where that tipping point was and I'm not 100% sure we got it right.

My wife has to handle folks asking that question every day. If the owner waits until is is blatantly clear that it is time, that means maybe they waited too long. But if it isn't blatantly clear, they're left with the question if they did it too early. There's no way to know if you hit perfection.

But it is part of the responsibility we take on when we get pets. They can't manage their discomfort on their own, and they need us to help. All we can do is the best we can for them. The hard part is doing what it best for them, and not what feels best for us.

I'm frequently amazed by just how much joy our pets bring to our lives and how much it hurts when they're gone.

Psychologically, they can take on places in our emotions just like family members. And part of the problem of love is that it means you can, and occasionally will, feel loss as well.

I coped by trying to visit as much as he could tolerate. Tried to give special food and so forth. We had some very special moments before he passed. Be strong and allow those to happen. They are as real as the moments when he was not sick.

Yeah. We are trying our best to make sure she gets some more of those. Today, one of my jobs is to hunt down a few things for the house that should help her enjoy her favorite things and places a bit more - like a set of stairs to make it easy for her to get to to one of her favorite snoozing spots.

Sometimes things suck all around and strangers, or quasi-strangers might be better or worse to talk to.

Yep. To quote Spider Robinson's book, Callahan's Crosstime Saloon: "Shared pain is lessened, shared joy increased." The act of laying things out can help one process.

Spoiler: The medical stuff

The biopsy came back, and she doesn't have "the good kind" of cancer. To summarize: with basic palliative measures, she's probably got one to three months. With chemotherapy, it is like one to ten months.

The first step, though, are basic palliative meds - anti-nausea and appetite stimulants. This all will be over quickly if we can't get her to eat. I've been tracking food intake over the past few days, and yesterday, there was a slight uptick, but still not enough to sustain quality of life.

Next will be steroids. The compounding pharmacy that can make what we need was closed for the weekend, but I should hopefully be able to pick them up today. We are going with transdermal formulations of everything we can. Cats typically hate oral meds, because they all taste sooo bad. And poking her with that many needles would be traumatic. But transdermal meds are absorbed through the skin - so you can just wipe them like, inside her ear. She actually seems to like the contact, so that's a win. Steroids can slow the advance of cancer a bit, and help her feel better in many ways - while they may interfere with some forms of chemotherapy, without them, she may not make it until we can get her into the next possible step.

Then, as soon as we can finagle a consult with an oncologist, we will discuss chemotherapy. Chemo for animals isn't like it is for humans, because the goals are typically different. In humans the goal is generally to blow the cancer back into remission, and we are terribly aggressive in pursuit of it, and poison the patient to just short of dying, hoping that they are tougher than the cancer. In animals, the goal is improving quality of life, and we don't count misery of chemo as much different from misery of cancer. So, we won't poison her until her hair falls out, or the like.

But chemo may force us into some hard choices. Many of those are chemicals you can't administer at home, even if you are my wife. So, we may have to weigh how often she has to go to clinics (which is a miserable experience) against how much time we can buy her.

Let's talk support structures.

I have the great benefit that my workplace allows us to take sick days not just when we are sick, but to support others - if someone has to spend a day running around getting meds and going to doctors, that's okay.
The people around us have been wonderful. We were at some hazard of basically sitting at home staring at the walls wallowing in the situation. But one pair of friends came by Saturday night to have pizza and watch Babylon 5 ("Sic Transit Vir" and "Late Delivery from Avalon", two great episodes, just happened to be up next). Another couple came by Sunday for a cooperative board game (Legends of Sleepy Hollow). So, in both cases, we got a chance to not over-focus, which is actually better for processing the whole thing.

Our next door neighbor, as part of her weekly grocery shopping, also put together supper plates for us, so last night we didn't have to cook.

We have plans to have people over for various RPGs on Tuesday and Thursday. Grief has a tendency to make folks fold in, but we're doing what we can to stay engaged with the world.

And then a bit on grief.

I find I am a mixture of very sad and kind of angry, which isn't surprising. The sadness just kind of sits there whenever I'm not really engaged with something else - which is also not surprising. Sadness and grief has physiological elements to them, much like depression, so they kind of carry with you all day, regardless of what you are doing. Some forms of distraction can help alleviate that for a while, which is why social contact while processing such things is important.

Normally, I'm pretty solid in equanimity. If someone in my family needs something, I get it done. There are moments that are really hard, though, when nobody really needs anything. Like yesterday, I went grocery shopping, and I stopped in the pet aisle to pick up some cat treats, because, well anything that will get some calories into her is probably a good thing right now. And I'm standing there, holding these stupid bags of treats, feeling hopeless, and trying like heck to not cry in public. Not that I actually care what random people in the market think - if they want to think weird stuff about a big middle-aged Viking looking dude crying over cat food, that's their issue. But having folks I don't know try to engage in that moment would have not helped me in the slightest.

 

[Morrus]

I’m so sorry. I know how hard this can be.

 

[Meech17]

I sorry to hear your news.

My partner also works in the veterinary field as a tech. It seems like such a challenging field to work in.

Pets are such a strangely special thing. They are so impactful on our lives, despite only being part of them for a relatively short while. I'm sure you've given your cat a wonderful life, and I hope their remaining time with you is equally wonderful in spite of the illness and brevity.