Portrait of Contentment

Tait dropped off my order from Jasmine Pearl today so I am a very happy girl. I realised as I was sitting here that the little scene I'd created around myself was an almost perfect summation of what it takes to make me content. All that's really missing is the cats (they were too busy playing "kill the invisible carpet monster" to appear). I think I might be easy to please.

Last night was my 25th birthday party, which was wonderful. Good friends, lots of laughing, and just enough food to make everyone happy without dooming me to leftovers for days. I mean, I probably wouldn't argue with having to eat deviled eggs, spinach dip and fresh bread for a few days, but it might have some negative effects on my determination to lose that freshman 15 that has mysteriously accumulated around my backside.

In other news, Merlin is responding well to the prednisolone and sub-q fluid regimen he's been started on. I guess I never posted on the blog about it, but he'd been ramping his way up to a full on Merlin-fit over the past few weeks and I finally took him in to the vet. He's done this periodically since I've had him and it usually involves an increase in dandruff, diarrhea, a slight lethargy, itchiness and ever increasing bouts of vomiting. I was getting heartily sick of him barfing on the bed at 4am every day, and I'm sure he wasn't overly fond of it either, so we headed off to see Dr. N.

Merlin's physical went well (all the staff love him) and he handed over some blood for testing. Turns out his white blood cell count was uh....high. Normal for a cat his age would be somewhere in the 2500-8500 range and his was at 19550. This can mean a lot of things, but given his symptoms and history it seems to fit pretty nicely with the inflammatory bowel diagnosis we've been running with, if perhaps suggesting that instead of being just a little inflamed he is in fact a miserable little furry ball of unhappiness. Given that, Dr. N agreed with me on doing a short term course of corticosteroids to calm his system down to where he'll be comfortable while we switch his food to a gastro diet that has shown good results in cats with IBD. He's also been put back on omega-3 fatty acid supplements (cue unbearable litter box odors in 3..2...) and is getting sub-q fluids every other day to help with his persistent mild dehydration. So far his vomiting has decreased slightly and he seems far less itchy. He hasn't licked any new bald patches on himself since last week anyway.

There's still the spectre of small cell lymphoma looming over all of this, but I'm refusing to let it scare me. Every vet he's seen has given me that as a differential diagnosis, but his symptoms have been going on for three plus years with no real worsening. If this were lymphoma, untreated, he should be dead. Or at least far more sick than he is now. That isn't to say that small cell lymphoma isn't still a very real possibility in the future, but for now I refuse to panic. That means I'm putting my foot down and refusing to anesthetize Merlin in order to get a biopsy of his small intestine done. He's had an ultrasound (which showed no thickening or changes in the small intestine) and I just can't justify putting him through that. Besides, I've been doing some research on IBD and small cell lymphoma, and the margin of error on differentiating between them on histological samples is surprisingly high. There was a study done a few years ago where four pathologists were given slides from 20 different cats who had been diagnosed with intestinal disease. They all read the same slides and then results were compared to see what sort of consensus there was. The answer? Very little. One slide was read as normal by one, minor IBD by the second, moderate to severe IBD by the third and lymphoma by the fourth. I know that this was likely an extreme example, but it still makes me feel like there is no point in going that route.

It's funny, I sometimes feel like part of the reason I wanted to go to tech school was just so I could be a better owner and better advocate for Merlin. He has the kind of issues that are so difficult to diagnose and even more difficult to treat. Every time I learn something in school that has even some small bearing on his symptoms, I feel like I might have one more piece to a puzzle that will let me make him more comfortable. I'm not expecting to work a miracle, but maybe something I learn could make a difference for him. And if not for him, for some other pet - either mine or someone elses.

I guess that's what it really comes down to. If I ever wonder why I'm doing this, I think of Merlin, and all the other Merlins out there who mean so much to people.