Update on Kia: New Fork in the Road

Kia will be one week post-procedure tomorrow. She's been doing extremely well since I brought her home last Friday night. She's eating constantly (and driving me crazy by waking me up at all hours of the night, asking for more food). The prednisolone seems to be doing its job. She's keeping everything down with the exception of Sunday afternoon and yesterday afternoon, when she stole food from my plate while I wasn't looking. That all came right back up. But, she immediately resumed eating her special kitty food and that stayed down just fine. It's a lot of extra work grinding up her pills into powder and mixing her food up into a pate-like consistency. Her food is very expensive, too. I went from spending 50 cents a can to $2.39 a can and will likely have to keep doing that for the rest of her life. But, of course she's worth every bit of it. I'm thankful every single day that she's still here with me, and I waste no opportunities to tell her so.

The vet from VIMP called me yesterday with her biopsy results, saying they were "interesting." Apparently, everything in her stomach was unremarkable but her intestines showed some inflammation of her lymphocytes. From the looks of things, she appears to have Inflammatory Bowel Disease, which could be what caused her to vomit violently enough to form a stricture in her esophagus. So, there's at least one more piece to this mystery puzzle. However...IBD and intestinal lymphoma look the same under a microscope. The only way to tell them apart is by a phenotype test where they stain the sample with a special dye and check to see if there's many of the same cell (lymphoma) or a bunch of different cells (IBD). Well, that test costs $500. HSFC has already invested several thousand dollars into her care, so what are the chances of them paying for yet another diagnostic test?

Well, VIMP called them to ask them that very question and called me back later with the answer. They said yes, they would cover it... HOWEVER... since they've spent so much money on her in such a short period of time, this would likely be the end of them covering her expenses. Another option VIMP presented me with was foregoing the test and just treating her for lymphoma anyway. This involves a powerful chemotherapy drug which, while inexpensive in and of itself, would require constant monitoring of her red cell count and frequent visits to the vet to keep an eye on her condition during the course of treatment. So, either way, it would add up to a lot of money for the entity paying for it. A third option would be to not do anything and just gamble on the fact that it's probably just IBD and not lymphoma. I'm not much of a gambler, especially when the health and well-being of my animals is involved. If it were my money and price were no object, I would choose to have the type test done. But, I need to be sensitive to the fact that this is not my money and, if done, would leave me with very few options if the results were bad. Therein lies my dilemma. The downside to all of this is that she almost definitely will need further treatments in the future, whether to re-dilate her esophagus or to monitor her blood work or even just to make sure she's still doing OK on her new diet and not losing any more weight. I'm not banking on getting much more funding from HSFC, so I'm not sure what's going to happen if and when this further treatment is required. It's highly unlikely I'll be able to afford it myself.

So for the last day or so, I've been weighing the pros and cons of each option. Do I go for the definitive answer that spells the end of my financial assistance, do I play it safe by going for the less expensive treatment and put her through a round of chemotherapy that she may not even need, or do I do nothing and risk it coming back to haunt me later if it turns out she does have lymphoma? I traded calls and visits with vets all afternoon and evening, trying to figure out what to do. I even emailed Janice this morning to ask her advice as someone who's footing the bill for all of this. I was leaning towards doing nothing because my gut instinct is telling me it's not cancer, but I know I will second guess myself every single day. Well, Janice called me this afternoon and told me she had already authorized the type test. She also said she didn't mean for it to come out sounding like they wouldn't do anything to help me in the future, but that they would just need to give it very careful consideration from here on out. She asked me Kia's age and about her general health, probably as a guidance point for their higher-ups. I told her she had just turned 11 a few months ago and had been the epitome of health up to this point. She never went to the vet except for her yearly dental and had never been on any medications, except for maybe 2 times (once when she had a roundworm infestation as a kitten and the other when my parents' cat scratched her on the eyeball back in 2007).

So, it looks like we're getting the definitive answer after all, although I can't even think about what would happen if the results come back positive for lymphoma. I can only take it one day at a time right now. It's been a crazy freakin' week already, between Kia's surgery on Friday, the earthquake on Tuesday (and subsequent aftershocks!) and now the impending hurricane, which forced us to cancel our 60-person camping trip at the beach this weekend. The silver lining to all that is that I no longer have to leave Kia home all weekend, plus I get my $40 deposit back, which I can put towards her food or my yet-outstanding medical bills. It's still horribly disappointing, since I was definitely looking for a chance to get away for a couple days and this trip was sure to be an awesome time. But, we're still having a hurricane-themed party/BBQ on Saturday and, for God's sake, I still have Kia here with me! That alone is enough to let me see the silver lining in all of this!