i should have savored the feeling that i was doing the best i could for our cat while it lasted. the PARR test which was to tell us if he had lymphoma or not came back, as the veterinary oncologist warned us it might, inconclusive, so she suggested i bring chuck in again so that we could check out his blood, she could put him on the scale (we need a scale, and i'm starting to realize how stupid it is that we don't have one), and she could do a quick, informal ultrasound to see if his spleen and lymph nodes looked any better after two weeks of chemo at home with us. a tech carried him down to the treatment floor and i settled in up at reception, where a pile of custom photo books told the stories of dogs and cats who received care through frankie's friends, a nonprofit which funds treatment for animals with cancer. fridays are a big chemo day for our specialist, so i also watched e-collared dogs and cats stream out of the office and into the night, a little squadron of cosmonauts returning to their families on earth.
chuck lost two thirds of a pound between his weigh-in three weeks ago and his weigh-in after two weeks of leukeran every other day. if the treatment had been working, our vet explained when she came up to join me, he should have been gaining weight; at the very least he shouldn't have lost any more. his spleen wasn't looking too mottled, but his lymph nodes looked the same. it could be that he's one of the 20% of cats who don't respond to leukeran, or that he needs the steroid we'd be using if we knew for sure that we're dealing with lymphoma (starting a steroid regimen, she says, is "the path of no return" for diagnosis - the cells change too much to be useful). she described another test which had a slim chance of getting us closer to an answer, something about a hollow needle which would shoot another needle and grab some of his tissue, but it sounded no more promising than the PARR test. it was time to start talking about a biopsy again.
fact: the biopsy would be laparoscopic if at all possible - one of the surgeons was downstairs measuring her tools even as we spoke, she could operate on monday after a consult - and incisions would be minimal. "we wouldn't be splitting him open from chin to belly," our vet said.
fact: oral chemo administered for large-cell lymphoma misdiagnosed as small-cell lymphoma would be useless at best and possibly harmful (because of potential side effects). i am probably the only member of the family who might be in favor of IV chemo for large-cell lymphoma.
fact: some conditions which mimic but aren't lymphoma (inflammatory conditions, infectious diseases) are exacerbated by the steroids we've been holding off on giving chuck to treat the cancer we've been assuming he has.
fact: we could pay for a biopsy by emptying our savings account and getting a loan to cover the balance. that it would be extremely difficult but not impossible for us to pay for said biopsy makes me suspect that it is a test for us, not chuck, and that if we agree to do it everything will be alright.
when i worked at an spca animal hospital just after college, i once processed a client who'd booked a PTS, put to sleep, appointment for her dog. he was a massive old rottweiler, and he hopped through our waiting room like a hobby horse, like our three-legged cat, jude - he had a shaved stump where a hind leg had been and squares of grey skin all over his back, as if he'd been parked in a rough neighborhood. cancer, maybe several cancers. his person, a short, sour-faced woman, could barely look at him. we were to give PTS families as much space and privacy as we could, but we also had to keep an eye on them; we had all seen animals abandoned and terrified, their people overwhelmed and unable to stay with them in their last moments. i thought that woman was one of those when i approached her treatment room fifteen minutes later and saw nothing in the window - i sped up - and then i saw her lying on the floor, her little arms across her dog's back. and to think i thought i knew anything about anything.