So here we are, another cat blog post written through tears. Oscar had three seizures this last week. Sunday 2am, Thursday 7.30am, Saturday 2am. Before that, we had two weeks without seizures, following a small one on the 12th, a kind of aftershock from the one on the 7th, that signalled another clear “beginning to the end”. We’d increased medication a month and a half before that following breakthrough seizures, and although the side-effects were important enough that they prompted us to decide we wouldn’t increase medication any further and make end-of-care plans, it did mean we got all that extra time, seizure-free.

But this is the end. The seizures are not going to stop or “get better”. We don’t know precisely what’s causing them but given his age and their presentation, it’s likely it’s a brain tumour, or some other brain lesion. He’s a very old man. We don’t know how old he is, because he’s a rescue, but it’s quite clear he’s very old. Eighteen, 19, 20? Even if it’s “just 17”, that’s already very old. He has old eyes, a string of old cat illnesses. He’s been through a lot and I know I’ve taken very good care of him.

If it weren’t for the seizures, he’d continue living his old man life: lots of napping, some ear-rubs, a stroll in the garden every now and again, telling Juju he’s the boss (as well as other cats if he spots them on a garden-walk), and keeping up with his little habits: this bed in the morning, that bed in the afternoon, take a little sun on the balcony, go down to the coworking space, meds 4 times a day, a rotation of wet food, trips to the litter-box, and sleeping in the crook of my arm at night.

But there are the seizures, and it’s not fair to him at this frequency. The one he had two days ago lasted a good three minutes, I got it on the surveillance camera. I don’t know about the two others, but the previous big ones were a minute. Three minutes is a long time for a grand mal seizure. He loses consciousness, he pees himself, he seizes, and then he’s out of it for hours – disoriented, uncomfortable. Then he’s OK again, like now, napping on the balcony. But that’s a lot of discomfort and hours of being unwell on top of a base quality of life that, even if it’s still acceptable, is clearly diminished. And the seizures will get worse. The more you seize, the worse it gets. The seizures breaking through the medication and increasing in intensity and frequency also indicate the underlying issue is progressing. Some of you may be wondering: no, brain surgery isn’t an option for an old cat like him, he wouldn’t survive it, and even if he did, he wouldn’t manage to recover. Even putting him under general anesthesia for an MRI is not an option.

This is the end, my friend.

When Quintus died, he was much more diminished than Oscar is. Quintus was fading away. Oscar is fighting every inch of the way. He has three legs, arthritis, and neurological issues in addition to the meds that make him wobbly. But he still wants. Wants to go out, wants to hit Juju, wants to go downstairs, wants this, wants that. He is still going ahead.

I find it really hard to be putting a cat to sleep who still has so much fight and apparent will to live in him. Of course, one mustn’t anthropomorphise. Living beings keep on going as long as they’re not suffering so much that they just want the suffering to go away. Oscar doesn’t care about his life the way I do. He doesn’t know about death, he doesn’t make plans for tomorrow or next month. He doesn’t wonder if his life is worth living or not. He just is.

It’s different for me. Since Quintus had his first pancreatitis in 2016, I’ve been living with cat death hanging over me. Tounsi and Erica died rather unexpectedly. But Quintus was already becoming old back then. We weren’t sure he’d make it. He did. In 2017 he became ill with diabetes, and it seemed like that would be it. He recovered, but from then on it was pretty clear we were living on borrowed time. Each year, I’d hope he’d make it to his next birthday, without daring to count on it. He slowly declined, year after year. Oscar joined us in 2019, already old and diabetic. Quintus died in 2020, and I almost lost Oscar in 2021. Borrowed time for him too since then. Of course, through all that borrowed time, there were stable periods – both for Quintus and Oscar. But you know it’s just a reprieve.

Caring for old sick cats also means daily medications, vet visits, and elderly-proofing the home. So much in my flat is “designed for Oscar”. There are kitty-stairs everywhere. Two feeding stations. The huge litter-box. The beddings. And since the seizures started in November, rectangular absorbent pads under each of them. When you need to give injections 12 hours apart, or anti-seizure medication 8 hours apart, that constrains your personal schedule. Being absent requires either making concessions with the treatment (which I have done at times for the insulin injections when he was doing well) or finding people to take over (which I’ve also done regularly). Then there’s the fact that having an old pet who might die pretty much any time kind of dampens the desire to be away.

Once Oscar is gone, which might be today, or sometime in the next few days, most probably, a whole lot of “stable” things my life revolves around will be gone too. No more medication schedules. Put away the kitty stairs and beddings and the feeding stations and the litter box. Sure, Juju will be coming to the flat in time (he doesn’t right now), but he won’t need all this. A bowl of water, a blanket or a small bed somewhere, but maybe even not that — he tends to prefer sleeping rough. His death will not just break my heart, as all deaths do, it will also break my living environment and my daily routines.

Then there are the vets. Oscar has had regular vet visits for years now – every four weeks, then every three weeks. His veterinary osteopath also comes by every month — she used to come for Quintus already back in the day. Juju might need some more osteo sessions, but he definitely won’t be going to the vet much. Travel is a major source of stress for him, and I have another vet who does home visits come for him. So here are two people, whom I really like and have been seing regularly for years, who will drop out of my life when Oscar dies. I won’t just be losing him, but them too. So, sure, you can drop in at the vet practice once in a while with a cake or some cookies, but it’s not like you can sit and have a cup of tea with your ex-vet every couple of months. I get it. It’s a professional relationship. But it’s a human relationship too, and I’m really sad about that too.

There will be relief of course, and freedom. But a lot of loss.

When I look at Oscar right now sleeping next to me on the pillow like he often does, it feels unreal. Life is perfectly normal in this instant, and it’s going to be upended, and I don’t yet know when, but I’m going to be making that decision soon with the vet. It feels like the moment before you tell somebody you’re breaking up with them, when they didn’t see it coming. It feels like being on the 10-metre platform and having to decide when to jump.

Edit: his vet called back. She’ll be coming Monday 5pm. I’m so grateful she can come for this – and so devastated too.
Edit again, 17:15: I don’t think we’ll last till Monday. He had another seizure a couple of hours ago. Am in contact with vet to see how we manage things.
Edit after vet call: organising it for tomorrow afternoon, 2-3pm or so.

I’m going to miss him. I feel so sad. I wish there was a way around this. But there isn’t. We all die. Everybody dies. Our pets die before we do, pretty much every time. Some part of me wishes he looked more like he was dying – but on the other hand, I don’t wish him to feel crummier than necessary for whatever time he has left. It’s clearly better for him this way, even if it’s harder for me.

As I finish writing this, he’s coming to rub his face on the corner of my screen, before heading down his kitty stairs to grab a bite – and then get on with his old-cat-day.

Comment on fait, quand le déclin est lent, progressif, irrémédiable? Comment on fait pour dire: “la semaine passé ça allait, mais maintenant ça ne va plus”? Ou le mois passé, ou hier, et aujourd’hui?

Ce sont des questions qui m’ont poursuivie concernant Quintus, et maintenant Oscar, de façon toutefois assez différente. Autre chat, autres maladies, et aussi autre contexte de vie pour moi.

Oscar est vieux, très vieux, probablement. On ne connaît pas son âge vu que c’est un “chat trouvé”. On peut juste deviner. Il cumule les pathologies, chacune gérée du mieux qu’on peut. Mais parfois, même le mieux qu’on peut ne suffit pas.

Alors aujourd’hui j’en suis là: j’ai eu une longue discussion avec sa vétérinaire pour planifier sa fin de vie. Faire des directives anticipées. Pour les différents scénarios d’évolution de sa maladie, décider ce qu’on fait, ce qu’on fait pas. Si A, alors B. Planifier la mort.

Aimer un vieil animal malade, en être responsable, c’est lourd. C’est lourd pour ce qui est des contraintes logistiques. C’est lourd émotionnellement. Et c’est lourd aussi cognitivement, j’en ai une conscience particulièrement aigüe. Tenter de faire au mieux pour cet être vivant dont on tient la vie entre les mains, c’est se poser au quotidien un milliard de questions. Et beaucoup de ces questions appartiennent à “l’arbre des questions sans réponse”.

Souffre-t-il? Sa qualité de vie est-elle encore acceptable? A-t-on raté quelque chose? Faudrait-il faire plus, faire moins? Ai-je déjà trop attendu? Est-il temps? Est-il trop tôt? Comment est-il aujourd’hui par rapport à il y a une semaine, il y a un mois? Est-ce un mauvais jour ou bien le début de la dégringolade? A quand remonte la dernière fois qu’il a fait ceci ou cela? A-t-il encore assez de positif dans sa vie? A quelle vitesse respire-t-il? Est-ce un ronron ou est-il encombré? Que veut-il? Comment puis-je améliorer son confort? Est-ce que tel soin ou traitement a un sens ou est-ce que l’acharnement pointe le bout de son nez?

A cela s’ajoute évidemment la charge mentale de l’organisation logistique: les rendez-vous de vétérinaire, sécuriser ou adapter son espace de vie, les médicaments et le matériel – gestion des stocks, horaires, les préparer et les donner, les remplacements en cas d’absence, la surveillance des sorties et de la descente des escaliers, et la surveillance tout court – qu’est-ce qu’il fait, mange-t-il, est-il allé à la caisse, est-ce que ses habitudes changent…

A la simple peur de perdre un être aimé vient se greffer, plus particulièrement cette fois au vu de mes circonstances, l’inquiétude concernant ce que ça va me faire. Je suis encore en réparation. J’ai enchainé les deuils ces dernières années. Une part non-négligeable de ma routine quotidienne et de l’aménagement de mon espace de vie est consacrée à Oscar. Evidemment, j’ai une vie à moi aussi. Mais injections et médicaments deux fois par jour depuis des années (4 fois par jour maintenant), escaliers pour monter sur les canapés et le lit, tiroirs remplis de médicaments, de nourriture et de gamelles, dodos stratégiquement placés avec alèses glissées dessous pour limiter les dégâts en cas de nouvelle crise convulsive, litière et cages de transport, donner à manger et faire la caisse, et aussi les habitudes de vieux couples chat-humain, vers telle heure on descend, comment il s’installe au creux de mon bras chaque soir pour la nuit, est-ce qu’on joue aujourd’hui…?

C’est dur de sentir la transformation du lien quand le soin finit par occuper presque toute la place.

Et puis, quelque part tapi au fond de cette énorme jungle d’anxiété et de stress, il y a encore autre chose: le souhait presque inavouable, honteux, déchirant, d’être enfin soulagée de tout ça. D’être libre. Pas pour lui, mais pour moi.

Les gens pensent bien faire en disant “tu sauras quand c’est le moment”. C’est une idée confortable, mais c’est un mythe. Les émotions contradictoires, les bons jours et les mauvais jours, la difficulté d’évaluer la souffrance, la subjectivité intervenant dans la définition d’une “qualité de vie suffisamment bonne” et les challenges pour l’évaluer, tout ça fait que c’est compliqué, et qu’il vaut la peine d’avoir des critères objectifs et d’y réfléchir. Heureux ceux qui voient avec clarté – mais ce n’est de loin pas le cas de tout le monde. En véhiculant ce genre de message bien intentionné, rajoute une grosse louche de culpabilité à la tambouille émotionnelle dans laquelle on se débat, puisqu’on sous-entend qu’il serait normal de “savoir”. Si on ne “sait” pas, alors, qu’est-ce que ça veut dire? Qu’on est défectueux? Qu’on n’aime pas son animal? Qu’on n’est pas assez à l’écoute, pas assez en lien, pas assez en contact avec ses émotions? Et de grâce, épargnez-nous la “communication animale” (j’en ai d’ailleurs bien plus à dire à ce sujet, mais ce n’est pas le moment maintenant).

Donc, c’est dur. C’est dur parce que je ne sais pas – et c’est normal que ce soit compliqué. Suivant les jours, suivant les heures, suivant mon moral, je me dis “non mais ça va” ou alors “ça ne va plus” et même, la boule au ventre, “est-ce qu’en fait ça fait longtemps que ça ne va plus et je refuse de voir?”

Je suis très douée pour m’accrocher à l’espoir, mais ça ne rend pas toujours service. Ici, ça ne me rend pas service. Oscar va mourir, bientôt, qu’aujourd’hui soit un bon jour ou pas, que la semaine prochaine ressemble à celle-ci ou non. Il a certainement une lésion cérébrale, tumeur probablement. Il s’est mis à faire des crises convulsives en novembre, et il est sous traitement depuis janvier. On a dû augmenter le traitement il y a quelques semaines. Le traitement a des effets secondaires qui ont une conséquence négative sur sa qualité de vie. Des anti-épileptiques chez un vieux chat qui était déjà “sur le fil”, ce n’est pas un détail.

Qu’est-ce qu’une bonne qualité de vie? Qu’est-ce qu’une qualité de vie acceptable? Elle est où la limite? Pour un vieux chat, pour un jeune chat? Plus le déclin est progressif, plus c’est difficile. Parce qu’on s’habitue, aussi. Insensiblement, on court le risque de glisser, d’accepter aujourd’hui ce qu’on n’aurait pas accepté il y a trois ans.

Pour ma part, j’ai un certain nombre de critères clairs. Des “non-négociables”. En plus de la question de la gestion de la douleur et des symptômes, Oscar doit pouvoir:

• utiliser sa litière de façon autonome (et être continent)
• manger en suffisance de façon autonome (pour contrôler sa courbe de poids)
• monter et descendre du lit, des canapés, de façon autonome
• accepter ses traitements “de bonne grâce”
• “vouloir” des choses: descendre, râper sur Juju, sortir, faire dodo ici plutôt que là…

Ça c’est des critères assez clairs et objectifs. Là où ça pèche un peu, c’est pour des choses moins faciles à évaluer objectivement, justement:

• combien a-t-il mal? est-il suffisamment confortable?
• quel est l’impact psychologique de ses difficultés de mobilité?
• est-ce qu’il reste suffisamment “d’intérêt” dans sa vie? est-ce de la vie ou de la survie?
• à quelle fréquence renonce-t-il à se lever ou à se déplacer parce que c’est laborieux pour lui?
• ces derniers temps, il lui est arrivé de tomber du lit en essayant de se lever, ou de rater une marche sur ses petits escaliers pour accéder au canapé, d’avoir des difficultés à rester stable en mangeant ou dans la caisse: combien est “acceptable”? comment le vit-il?
• il lui arrive de protester quand je le porte, douleur ou contrariété/frustration?
  • il ne fait presque plus sa toilette (depuis longtemps), j’arrive de moins en moins à le brosser, combien est-ce que ça réduit son confort?
  • et aussi, plusieurs de ses traitement on un effet/des effets secondaires qui ne sont pas constants au fil du temps, et donc il y a des fluctuations au fil de la journée et de la semaine qui viennent de ça, donc comment faire le tri?
  • il y a des tas de choses qui ne vont plus, mais il en veut encore et semble encore trop présent et vivant pour imaginer qu’il est au bout… mais est-ce que ça veut dire quelque chose, en vouloir encore, ou est-ce juste l’instinct de survie, un truc qui tire en avant aveuglément, malgré la souffrance?

Je pourrais continuer comme ça longtemps. Ça fait des semaines, des mois que je m’y entraine.

Mais d’ici quelques jours ou semaines, quelques mois tout au plus, il va mourir. La question c’est quand, et comment on va arriver jusque là. Donc j’ai pris rendez-vous pour discuter avec sa vétérinaire. Pour avoir un plan, et lever le pied sur les questionnements incessants au jour le jour. Plus encore qu’avec Quintus, ici c’est vraiment un “choix”.

Voici le plan, dans l’ordre:

1. on n’augmentera pas la dose de levetiracetam (son anti-épileptique), même s’il refait une crise; l’impact sur sa mobilité à la dose actuelle est déjà trop important
2. s’il n’y a pas de crise d’ici deux semaines, on fera le point côté “qualité de vie”, car les effets secondaires sur la mobilité diminuent normalement avec le temps; si on en est toujours au même point, on envisagera une très petite réduction de dose, sachant qu’il y a des chances que cela précipite une crise
3. s’il refait une crise, on évaluera si elle est “pire” que celles qu’il a eues jusqu’à maintenant; si elle est pire, on arrête
4. si la crise est “pas pire”, on verra quand est la suivante; si l’intervalle est trop proche, on arrête (et évidemment aussi si l’intensité augmente).

Il n’y a pas de sortie de secours. Les crises vont revenir. Elles vont s’intensifier. Elles vont se rapprocher. C’est une évolution inéluctable. Je sens que d’avoir posé ce cadre m’aide à sortir de la “pièce des réflexions” et à ouvrir la porte de la “pièce des émotions”. C’est le bordel là-dedans, je sais pas par où commencer. J’ai tellement envie d’un break avec la mort. Mais c’est pas pour maintenant.

Photo: Oscar qui observe les oiseaux dehors, avant-hier.

Between November 3rd and last Thursday, Oscar has had three epileptic seizures – maybe four. Whatever the underlying cause is, it’s not good. He’s an old cat with many ailments, hanging on to a life still good enough.

You need to read The Cat Who Woke Me Up (thanks, Doc). It’s beautiful in so many ways. It makes me wish I were able to write about the truth of the world like that.

I haven’t got around to sharing even a tenth of all that I have understood over the nine long months since my accident. But somewhere in there, there is writing. And there is dealing with emotions. And grief. It is our struggle as humans, inevitably, to be faced with emotions. They colour our life. Maybe helping each other, being there for one another, all has to do with emotions. Maybe it all comes down to that. Emotions as the truth of life.

Christmas is approaching, and my old cat is inching closer to the end. It could be next month, it could be next week, it could be next summer. Though honestly, I think the likelihood of the latter is slim. Winter is not good for my cats. Both Bagha and Quintus died in the time before Christmas. Tounsi just after. Erica a few months later. I’m not superstitious and I don’t believe in anything. These days are just not filled with happy feline memories. And it’s a fact that winter, like the heatwaves of the summer, is not gentle on frail, ageing bodies.

I’m struggling with my brain right now. It’s not good either, in a different way. Obviously, I keep overestimating how much “available brain” (I don’t like “energy”) I have. As soon as things get better and more normal, I end up overdoing it, without realising, and then crashing again.

I underestimated the impact my programme for Friday and Saturday would have (and forgot to factor in some wiggle room for “unknowns”, which definitely made themselves known). Saturday evening I was completely exhausted. This means: headache, buzzing brain, making mistakes with numbers, struggling to put my thoughts clearly into sentences, more misunderstandings or lost threads when listening to others, and the odd word eluding me. Oh, and leaving my keys in the door (but that was Saturday noon already).

Sunday was headache, mostly rest, a friend over for tea, cancelling a videocall with another. Today had less headache, felt quite better, but after two hours Christmas shopping this afternoon my brain is filled with pounding rain and lightening and I gave up on heading out again for the second shopping trip I had planned. Christmas preparation is going to be much more challenging than expected. I look at the coming week and can’t see when I’m going to get the downtime to recover. It’s not good, and I don’t know what to do about it. That, of course, is part of the problem.

Next Monday, I’m going to the chalet. I don’t know what state my brain or my cat will be in. There are loud bells ringing telling me it would be more reasonable not to go. There are equally loud bells telling me that I haven’t been to the chalet in a year, that I desperately need a holiday, and that I want to go back skiing because this year has already been so dreadfully frustrating for me that I just can’t bear to give up on yet another plan.

I have had to get better at letting go of things. It doesn’t mean I’m good at it. And as I am still on the road to improvement, I logically should need to let go of less and less as time goes on. I keep thinking I can relax a bit, inch closer to my “normal life”, but I keep overshooting and being all the more frustrated: because I’m disappointed, with the double whammy that when my brain is fried, managing my emotions is more difficult.

I remember, in the first hours after my accident – or maybe days? – wondering through the fog of my concussion if this accident would leave a lasting mark on my life. Would it have big consequences. Would there be a before and after. Would it change me. Would a split second on a ski slope change the trajectory of a life. It made me even more acutely aware that some split seconds end lives – I was already very much aware of this, but knowing in your mind and feeling in your body are two different things.

My recovery is not just managing my tiredness and cognitive load to remain in the sweet zone of “enough activity but not too much” that supports healing and regaining function. It’s also grappling with Big Questions regarding the meaning of life, what’s important and less important, truly understanding that my ressources are finite, not just when I’m recovering from an accident, but always, and that I want to be mindful of how I use the time and energy of this one life I’m given. It’s figuring out what I want to do and dealing with the existential anxiety of my mortality, determining how much place I give to others and to myself.

I want to write about all this. If there is meaning, to me, it lies in making our time alive a little easier for each other. And though there is no better learning than through our own lived experience, sometimes the stories of others can resonate. Sometimes we find keys in the lives or insights of others. I want to write, and it’s terribly frustrating (that word again) to not have the availability to do it in a timely manner.

I hope Oscar doesn’t die too soon. It’s hard enough and sad enough as is. Of course I won’t want to have to deal with his death. But I accept I will have to. I would just like to be in a better place (cognitively) when it happens. 2025 has brought enough grief, and the last handful of years more than their fair share.