On Saturday Tisha's wound reopened. This has happened with regularity every month or so. A hole appears, fluid drips out, it's messy for a day or two. Then, the pressure relieved, the flow of fluid lessens, and the wound scabs back over temporarily. The first time this occurred back in February or March, the hole was very small, and the fluid looked more beige than anything. This weekend the hole was about the size of my pinky fingernail and wherever Tisha moved, he left gleaming drops of bright red blood swirled with whatever that beige fluid is. When I saw the first one on the carpet near our bed, I actually thought it was a button or a bead, it was so bright and round and crimson.
For the past few weeks Tisha has not eaten much. He's taken only a few bites at a time of dry food, barely touched his wet food, and eaten only half egg yolks and dribbles of broth. In the past few days he has hardly eaten at all; in fact, I'm not sure he has. When I enter the living room first thing in the morning, he's curled tightly in his bed by the window, and unless I stand directly above him, he doesn't even look up when I come in. When I feed Lyapa he doesn't stir. In the late afternoon if I reenter the room to do some exercises, he might stand, stretch, and come over to see me, but usually Lyapa butts in and he removes himself back to the bed to curl up once more. For the past few days the most activity we've seen from him all day is when I sit down after dinner in my new reading chair. Then he knows it's cuddle time, and he'll come purr on my lap for an hour or two until I get up from my seat to go to bed.
This morning we had an appointment with the surgeon, to have a look at the reopened wound (now mostly scabbed over), and when we put Tisha in his carrier he began immediately to protest, as he always does -- but his voice was raspy, his meow hoarse, even though he complained for the entire forty-minute ride. They had told us this might happen. The growth on his neck is now interfering with every possible function in that region, save respiration, and it seems obvious that that is only a matter of time.
It is basically surgery or death, the doctor told us, and it may even be surgery and death. They might be able to remove all the growth, but it's more likely that it will elude them yet again. There may be permanent damage to the nerves in the region, and they may even have to remove his jugular vein or carotid artery. And of course, he may die on the operating table; the surgeon was very clear about that. It will be up to us, he said. If it looks like further action will be impossible without the most significant risk, the decision will be ours, and they will accede to whatever we wish. If Tisha comes out of surgery alive, there will still be after-care: bandages, possibly the Cone of Shame, and two or three weeks of the medications he hates so much.
If we don't do surgery, the outlook is not much better. We have seen how quickly his health has deteriorated in the last couple of weeks. I hate to think of our tiger dying on the operating table, but equally repugnant is the thought of him emaciated, lethargic, dehydrated, and finally gasping for air once the mass begins to obstruct his airway. If you'd asked me a month ago I would have said I'm sure he can hang on a few more months, but now I have no confidence at all. It is purely a physical problem: the mass is too big, and when it gets big enough, it will kill him, one way or another.
I think we have decided on surgery, because it seems that if there's any chance at all to get the thing out, we ought to take it. He's not such an aged cat, and he's still as sweet as ever. When he curls up purring on my lap in the evenings I think, "He should get to keep doing this." But I don't know for sure. If surgery accomplishes nothing but he still lives to endure the Cone of Shame and weeks of pills, isn't living out the rest of his days in peace (be they only a week), and then euthanasia, the kinder thing for him? We have until Tuesday to think it over.
I cried in the car on the way back from the visit today, my first real tears since this whole thing began. I cried because I thought the decision would be a little more clear-cut than this, and because I didn't expect it quite so soon. Every time we've done a surgery there has been the chance of death, but that's quite a different thing than sending him into the surgery with the instructions: "Yes, do it, even if it kills him." I guess I had been thinking of this surgery as yet another step, rather than as the step, as it may well be.
The only consolation in all this is that whatever we decide, we can have no regrets. The options are all terrible, including the option of doing nothing. The surgery may be successful; that will be good. If he dies on the operating table, it will be painless (for him). If he survives unsuccessful surgery, we won't try it again, and it will only delay the do-nothing option of letting him waste away more gradually -- which will let him live out his days in the way he knows.
In the car we seemed to be on a threshold; now that we're home, everything seems just the same. Until Tuesday we will think, then, and be with Tisha, and let everything else proceed as it will.