A week ago, I had no idea that I’d be writing this post today.

Once again this year, my heart is in pieces. On Sunday night, we had to put Nenette down at the E.R. when it was discovered that she was suffering with end-stage cancer. It was a total shock.

Nenette had been in and out of vet clinics and E.R. facilities since October last year. She finally got onto a treatment plan in December, but (as we found out once it was too late) it was for a condition that she didn’t have.

Nenette’s doctors fucked up six ways to Sunday, treating her in accordance with their misdiagnosis of her condition while the whole time there was a malignant, lobulated mass growing into her bladder from the ventral bladder wall. Transitional Cell Carcinoma is a bladder cancer. It’s cancer of the urinary tract. It was the reason for Nenette’s bloody urine (her doctor insisted that Nenette was exhibiting a stress response, so she diagnosed Nenette with Idiopathic Interstitial Cystitis and treated her with Prozac). When Prozac seemed to be ineffective, they kept her on it and put her on a prescription canned food diet for urinary tract health. Bladder cancer was also the reason for her constipation (she was put on laxatives without further investigation). She was constipated, they said, because of dehydration, so to treat that, she was put on a strictly wet-food diet. Bladder cancer was the reason for her increased trips to the litter box, as well, and the decrease in volume of her urine. It was the reason for her vomiting. It was the reason for her lethargy. Eventually, it was the reason she lost weight, stopped grooming, and then stopped eating entirely.

Nenette’s July 11, 2023 urinalysis came back showing elevated, rafting transitional epithelium, which strongly indicated Transitional Cell Carcinoma. On the report… which I read carefully when I requested it upon the event of Nenette’s passing… the pathologist’s primary concern was neoplasia (cancer). Her secondary concern was inflammation of the bladder. The pathologist advised doctors to “pursue further evaluation of any masses or thickenings associated with the bladder or urinary tract.” So what did Nenette’s doctors do? They did the opposite. They decided that inflammation of the bladder was the primary cause, and that cancer was the secondary suspicion, “because that type of cancer is so rare, and Nenette already has cystitis, so it must be due to inflammation of her bladder.” (Again, Nenette never had cystitis. There was never any clinical evidence of it; that diagnosis was speculative.) They downplayed the indication of cancer, low-tiering it while ramping up their treatment of cystitis by adjusting Nenette’s treatment plan: More Prozac. Because, you know, Nenette was a nervous cat, and nervous cats are known to pee blood.

“Take her to an internist to check for the remote possibility of cancer if her bleeding hasn’t resolved in six-eight weeks,” they said. “The higher dosage of Fluoxetine (kitty Prozac) should work, but give it six to eight weeks.”

Wouldn’t you think that they’d call us back in to run an ultrasound scan first, to rule out cancer, as suggested by the pathologist who analyzed Nenette’s urine? After all, the pathologist’s primary concern was cancer.

As it turned out, we didn’t have six-eight weeks to find out whether the increased Prozac dosage worked. We barely had five weeks. Nenette died on Sunday night with a sizable mass in her bladder that could’ve been detected much earlier with a simple, five-minute ultrasound scan.

Nenette’s doctors started off on the wrong track, and they stubbornly stayed on the wrong track, even as months went by and she never stopped bleeding. Even as other symptoms piled on. Even after strong evidence of cancer came back on her July urinalysis. Throughout it all, from December to July, “Idiopathic Interstitial Cystitis.” “Prozac.” “Hills C/D canned food.” “Miralax.” “Wet food only.” “Increased dosage of Prozac.”

A quick swipe of an ultrasound scan, friends. That was all that was needed to find the mass in Nenette’s bladder. But they didn’t do it.

The doctors’ negligence and carelessness and, I don’t know, cluelessness…? robbed Nenette of a chance at a better end-of-life, as we could have focused on keeping her comfortable as her cancer progressed. They robbed me, her Mom, of a chance to provide this special comfort for her, and a chance to emotionally prepare for her death. They robbed us all of more quality time together as Nenette was dying.

I’m devastated. I’m livid. And I’m writing a letter. You’d better believe it.

Last photo of Nenette, minutes before her death.

Pics of Nenette over the years:

R.I.P Nenette, 2009-August 20, 2023.

Ironically, two of the dear ones I’d turn to for comfort – in this situation, especially, as they both loved and parented cats – also died this year, within weeks of each other. Nenette’s death makes me miss them even more.

Also ironically, Nenette’s passing makes me even more grateful that I lost my job. Because of that, I was able to spend more time with her and provide her with care to the extent of my knowledge… at the least.

Take-aways:
-Get a second opinion.
-Question everything.
-Request a copy of pathology reports from labs taken, so you can read the findings for yourself.
-Spend every minute with your furbaby as if it’s your last.

That’s especially what hurts… that we didn’t know that Nenette was terminally ill. If we could do it again, knowing what we know now, there’s so much we’d do differently, and so much else we would have done. We could have known about Nenette’s cancer in July had her doctors followed up her pathology report with a due-diligence ultrasound, as directed by the pathologist. Because of that failure, we were not given a chance, and neither was Nenette.

It didn’t have to be that way. We didn’t have to be blindsided. The information was right there.

I don’t know, friends. Nenette was my child. She was also my government-recognized emotional support animal, as I’m a combat veteran disabled with PTSD. She was always there for me. She got me through some of the darkest days of my life over the last seven-eight years. She was my angel baby, and I miss her so much.

Also, fuck cancer.