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Rishi's SCC
of the tongue
(& diabetes)
Rishi�s Story � SCC of the tongue & diabetes Rishi�s Background In 1993 I was a sophomore in college. When I moved off campus to a house, I missed not having a cat around. We always had pets when I lived with my parents. One night I stopped at a local pet store just to look. I had no idea I�d be walking out with a little black fur ball who would become my best buddy for the next 10 years. Rishi moved with me from apartment to apartment and finally to a house. We�ve been in the house for almost 4 years. He loves to go out in the back yard and bird watch. He�s the sweetest cat, and I can�t even begin to describe the bond I have with him. Rishi was very healthy in the first 9 years of his life. In December of 2002, I was very surprised to come home and find him extremely hot and sluggish. I took him to an emergency vet clinic. They gave me some antibiotics; he apparently had a virus of some kind. About a week later, I noticed Rishi scratching. Patches of fur had started falling out. I combed him and discovered that he had fleas, which he is highly allergic to. I managed to get rid of the fleas with a good old bath, but his sores did not heal. The vet gave him a steroid shot, and his skin healed just fine. If your cat has ever been given a steroid shot, you know that they make the cat pee a lot. Rishi was no exception. He was extremely thirsty and hungry, and I couldn�t believe how much he had peed in his box. The vet said that it was a side effect of the steroid shot, but after about 3 months, the �side effects� had not gone away. Rishi was begging for food all of the time, and even though I fed him as much as he wanted, he was losing weight. Another appointment with the vet confirmed that he had diabetes. My 14 pound kitty was now a mere 9 pounds. I was scared at first, but I was very hopeful that he would be ok. Diabetes is treatable. We began the tedious process of determining which dose of insulin would regulate his blood sugar. He responded very well, and we ended up on 5 units, twice per day. He had to eat special cat food. It was fun trying to keep our other cat out of his food, but we managed. In no time, Rishi was back up to 14 pounds. We successfully managed his diabetes for about a year. It was no problem, and he had been given a second chance on life. He was his normal, happy self. His weight reached 16 pounds before the cancer diagnosis. March 2004 I noticed that Rishi had some drool, and wherever he took a nap, he left a wet spot behind. I didn�t think too much of it (he seemed fine otherwise) until a couple of days later when I noticed that it had a smell. I made an appointment with the vet to get his teeth cleaned. I assumed the drool was caused by a tooth problem. I got a call from the vet later that day. She said that there was a tumor under Rishi�s tongue that she discovered while cleaning his teeth. She said it might be �carcinoma�. I was completely shocked and overwhelmed by that word. She proceeded to explain that a biopsy had already been done and I could pick Rishi up. I was at work and immediately went to the bathroom and cried. When I picked him up the vet supplied me with pain medicine and an antibiotic to take away the infectious smell that the tumor was causing. The next 4-5 days were completely heart breaking as my husband and I waited for the results of the biopsy. I could barely get through the day at work. I wanted to be with Rishi at all times to pet him and make sure he was not in pain. The call came� it was indeed a squamous cell carcinoma. My husband and I went in to the vet�s office to discuss treatment options. We could take Rishi for radiation therapy or we could try a chemo drug called Piroxicam, which has had some success in some animals. The Piroxicam would not cure him, but it might slow the growth of the tumor. I seriously considered the radiation therapy. I researched it online and I spoke to someone at the radiation center. She said that Rishi would have to be put under for each treatment, and the prognosis would be anywhere from 3 months to 6 months, perhaps 1 year if the tumor responded better than expected. The test cases that I read online said that feline carcinoma of the tongue did not respond well to radiation therapy. Ultimately, I made the very tough decision not to put my kitty through the pain and stress of radiation therapy only to gain another month or two with him. I decided to try the Piroxicam and try to make his remaining days as happy and pain free as possible. April 2004 A pharmacist was able to make the Piroxicam in a trans-dermal cream that we could rub on Rishi�s ears. Rishi didn�t mind it too much. We applied it every day and, whenever he appeared to be in pain, we would give him pain medicine. Within about a week, Rishi was having trouble with hard cat food. I began giving him soft food for every meal. Other than the struggle to eat, his behavior was pretty normal. He enjoyed chasing leaves and birds in the backyard and hanging around me like usual. We kept applying the Piroxicam and hoping for the best. I started to notice blood in Rishi�s drool. I was prepared for this since I had read online that this type of tumor bleeds periodically. I had started to assist him with grooming. He was finding it difficult to bathe himself with this sticky, bloody drool. He loved to be combed, so grooming him was not only good for his fur, but it made him feel happy for awhile. The bleeding gradually became worse, and Rishi started to have trouble with soft food. It would take him 30 minutes or more to eat a small amount, and he made loud smacking sounds as he tried to maneuver the food in his mouth. This was very difficult for me to see. I knew the tumor was getting bigger. We had started to administer pain medicine to him more often. I could tell when he was in pain because he would turn his head when I tried to pet him. This was VERY unlike him. The pain medicine helped greatly. During this time, it was difficult to know how much insulin to give him. I varied the dose slightly depending on how much food he ate. I seemed to manage it ok. April 28, 2004 I woke up to find that Rishi was hiding under the bathroom sink. He was bleeding badly from the mouth. We gave him some pain medicine. He did not seem to react to it this time. I could not get him to eat anything, not even tuna juice. I became extremely worried about him. I talked to the vet, who recommended ice water for the bleeding. April 29, 2004 This is the second day that I could not get Rishi to eat. I tried baby food, cream of chicken soup, tuna juice, and pureed Fancy Feast. He seemed very interested, but physically unable to eat. This broke my heart. Knowing he was hungry but unable to do anything about it was unbearable. I tried giving him some water through a syringe, but he did not like that at all. He was hiding from us all the time now. He seemed to want to go outside at all times, and he would hide as soon as we let him out. I knew that he felt like the end was near. His face did not look the same to me anymore. He was not perky and bright-eyed, but sullen. April 30, 2004 This was the third day in a row that Rishi would not eat. Again, I tried everything. He seemed to be very thirsty. I ran water in the sink, which he would never turn down before, but it seemed that he physically could not stick his tongue out in order to drink. He hid outside again. I could tell that he was in pain. He was bleeding almost constantly now. I picked him up and put him on his back on my lap so that I could see his mouth. Although I could not see the tumor, it had grown large enough that he could not quite close his mouth over his tongue. I had to accept the fact that he was not going to get well and after almost three days with no food and very little water, the time had come to end his suffering. I could not stand by and watch my cat starve to death and live in pain. My husband called the vet for me. I knew I would not be able to get the words out. It was scheduled. The vet would come to our house that evening. I cried when I hung up the phone. I nearly called off the whole thing when I looked up and saw Rishi walking towards me. For the first time in a week, he almost looked like his old self. His eyes were brighter as he walked toward me, and he was actually purring as he rubbed his head on my leg. He had not acted this way over the last two days. Perhaps he knew what I had just done, and he was thanking me for it. I tried to get him to eat and drink in this brief period of happiness, but he could not do either one. I knew I had made the right decision. I spent the rest of the afternoon talking to him, petting him, and combing him. I could not tell him that I loved him enough. My husband took some pictures of Rishi and me together. The vet arrived around 6pm. I couldn�t believe what was about to happen. The vet was extremely nice and told us that we didn�t need to worry about doing this too soon. It was the right thing to do for Rishi�s sake. The first shot that he administered put Rishi into a euphoric state. It went far too quickly since he had not been eating. I was happy to hear Rishi purr for a minute while the shot took effect. Within minutes though, he was seemingly unconscious although his eyes remained open. I had gently rolled him onto his side so that he was lying down, and I kept petting him. After a few more minutes, the vet made sure Rishi was not feeling pain and he began to administer the second shot. He said it would work quickly. It was extremely difficult to watch, but I tried to remain strong for Rishi. In less than a minute, his breathing stopped and my best friend was gone from me. The tears rolled. He went to the other side at 6:30 pm on April 30, 2004. He was only 10 � years old. The vet took Rishi with him. I wanted his body to be cremated and the ashes returned to me. After the vet left, needless to say, it was extremely difficult. I don�t think I�ve ever felt such an incredible loss and sobbed so hard in my life. May 28, 2004 It has been 4 weeks since Rishi went to the other side. I know he�s with me in spirit and that we�ll meet again someday, but I miss him terribly. If only I could hug him and see his beautiful kitty face again! This is not something you ever recover from. You just find ways to deal with it. It is extremely difficult, but death is a fact of life, and you must reflect on the wonderful times you had with your pet. Not long before he passed on, Rishi jumped up on my chest to be petted when I got into bed, which was our nightly ritual for 10 years. That night I was taken aback by his affection. He was giving me the hardest cat kisses that he ever had, over and over again, and he was purring as loudly as ever. I think he knew at that time that he would not be with me much longer. Perhaps he was saying �thank you� and �I love you too�. Taking his fate in my own hands was the hardest decision I have ever made, but I am confident that it was the right one. Someday, when it�s my turn to go to the other side, we will meet again. I�m sure he will give me the biggest cat kiss ever on that day. I wrote this with the hope that it might give other pet owners who are facing SCC comfort in knowing they are not alone. The stories I read about other cats with SCC were heart breaking, but they helped me make decisions about treatment options. Nothing could have prepared me for how fast this disease progressed. Just one month from the diagnosis, my kitty was gone. I am not sure if the Piroxicam helped slow the growth or swelling of the tumor, but I�m sure it did not hurt to try it. Hopefully your experience will have a different outcome, and hopefully we can beat this horrible disease someday. In Memory of Rishi, Laura Becktel
