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When to euthanize senior cat?

post #1 of 29
Thread Starter 

I know this isn't the kind of thing people online can answer for you, but I'm really struggling. This is my first time dealing with this issue.

 

My approximately 17 year old male cat seems like he's in a lot of pain, but other days he seems just fine. To begin with, he went through kidney failure about two years back as the result of a (very stupid) vet giving him Metacam. He’s since recovered about as best a cat can, and just has the side effects of frequent drinking and urination. We monitor his blood levels frequently, and these seem to be under control quite well. He hasn’t really been the same ever since, however.

 

This has also led to us having difficulty with his weight. He is about 18 pounds. While this is probably better than him losing weight like most senior cats, he has severe arthritis in his back and hips. I’ve always wanted him to lose weight, but it’s nearly impossible with the threat of kidney failure relapse. Losing weight requires upping protein levels, which he can’t handle now with his kidneys, or cutting calories, which we’ve tried but I’m not set on reducing his quality of life like that at this point. He very much looks forward to meal time, and I’d rather have him eating than not eating.

 

The arthritis in his back and hips is quite bad. He walks and can even trot when he’s mad enough, but gingerly—his hocks kind of sink. He can go down the stairs if he kind of bunny hops, but I generally carry him up the stairs because I know it’s painful for him. We can’t touch him at all on his back because it hurts, and we have to be careful picking him up. He gets monthly Adequan injections, however, and these seem to help immediately after the injection. He’s been known to jump up on the couch by himself. This shocked us after his injections because we hadn’t seen him jump anywhere in years. He was also on Buprenex for awhile for pain. I’d like to think this helped him, but he absolutely does not tolerate taking it and it makes him act a little weird—his eyes get big and he seems wide awake, like he’s on a high. The vet has told us we may wean him off of this because...

 

He’s also on Flovent (inhaled steroids) for his asthma. He’s been doing this for about a month since we recently discovered the problem. The vet says his breathing is better, but it still sounds pretty bad and he still breathes quickly. It is better than before, though. The inhaled steroids are also supposed to be better for his system overall, so they may help his back and hips.

 

He does strain to urinate, and is starting to have problems defecating. This morning, he was groaning so loud and although he did go inside the litterbox, he also ended up (I think unknowingly) also going outside the litterbox. I’m waiting for my vet to call me back about what to do to help him, but this is another pain issue. I’ll likely be giving him milk and adding fish oil back into his diet.

 

He’s an indoor/outdoor cat. I know the issues with him going outdoors and I’m uncomfortable when he’s out there, so I’m always watching him and he generally stays on our porch and sticks close to our house. He simply is NOT happy when we try to keep him just inside since he was born a stray.

 

There are also two kittens in the house that I desperately try to keep clear of him since they make him VERY angry. I know this is stressful to him.

 

Other than the above (which I know is a lot), he acts pretty normal. He sleeps a lot, but what older cat doesn’t? He can’t groom himself too well because of his weight and arthritis, but he gets by. He’s all there in the head, and his vision and hearing seem fine. He doesn’t play much anymore just because he gets tired easily, but he will bat around a mouse if you engage him. He eats Science Diet Mature Adult, which has a high water content, and I’ll sometimes mix in Science Diet K/D for his kidneys. His teeth are bad and past the point the help (unless someone has suggestions), so sometimes it hurts him to chew hard food.

 

What I’m struggling with is that he seems perfectly happy one day and in pain the next. I’ll be in tears thinking about life without him because he struggled to do something that morning and then he’ll roll over on his belly and look at me like “what’s wrong, Mom?” I just don’t want to keep him alive with medications, and I don’t want him to be in pain. He’s had a very long, happy life and as selfish as I want to be in keeping him around longer, I owe it to him to put him out of suffering when that time comes. Any opinions would be greatly appreciated. I’m so sorry for the long post, but I am STUCK. This cat is my world. =(

post #2 of 29
OHHHH Hun...... Welcome to TCS and I am so very sorry it is under these sad circumstances. Thank you for sharing your thought's and deep love for your cat. heartpump.gif You will get a lot of support here and many people have been in your shoes. Very, very difficult. My heart goes out to you as I can tell how deeply you love this cat. Only you can really make that decision and there is no right or wrong here. You have obviously taken such wonderful, loving care of your kitty over the past years dealing as best as you can with the health issues. I know how difficult it is, what you are going through. heartpump.gif I have an older dog, my everything. You just never know day to day, is this the day bawling2.gif...... I think that if you discuss this with you vet, as well as us here, you might be able to come to your decision about, when.... Sometimes just expressing your feeling's like this will lead you to your answer. There are many here who have or are going through the same thing as you and I hope they also chime in here for you soon. hugs.gifhugs.gifhugs.gifhugs.gifhugs.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gif
post #3 of 29
Quote:
Originally Posted by Feralvr View Post

OHHHH Hun...... Welcome to TCS and I am so very sorry it is under these sad circumstances. Thank you for sharing your thought's and deep love for your cat. heartpump.gif You will get a lot of support here and many people have been in your shoes. Very, very difficult. My heart goes out to you as I can tell how deeply you love this cat. Only you can really make that decision and there is no right or wrong here. You have obviously taken such wonderful, loving care of your kitty over the past years dealing as best as you can with the health issues. I know how difficult it is, what you are going through. heartpump.gif I have an older dog, my everything. You just never know day to day, is this the day bawling2.gif...... I think that if you discuss this with you vet, as well as us here, you might be able to come to your decision about, when.... Sometimes just expressing your feeling's like this will lead you to your answer. There are many here who have or are going through the same thing as you and I hope they also chime in here for you soon. hugs.gifhugs.gifhugs.gifhugs.gifhugs.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gif

yeah.gif I don't think I could put it better than Lauren...
hugs.gifhugs.gifhugs.gif
I just wanted to add a couple of things that might add your little one heartpump.gif
For constipation, canned pumpkin works miracles agree.gif 100% pure pumpkin - the ones you get in the supermarket..... just make sure it is the blend one, no sugar added.... They usually sell it in the baking isle. Now at holiday times, it is easy to find them....
The dose is 1 TBSP a day, divided in two meals - 1/2 tbsp in the morning meal, and 1/2 in the evening meal - wet meal of course. Just mix it with the food.... If the kitty doesn't eat wet food, you can syringe feed it....
For arthritis, Hyaluronic Acid helped my RB Kitty Gracie a whole bunch - this is the brand I recommend the most: http://www.trixsyn.com/
all the vibes going your and your little one's way..... vibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gif
post #4 of 29

I can only say what Feralvr has said.  I, too, am going thru the same thing with my old guy, Sven.  If I thought he was in pain, I would let him go, but so far he doesn't seem to be. 

 

One thing about your baby's arthritis though...have you tried Cosequin?  It's sold over the counter, and many people swear by it.  We've been giving it to Sven now for a year or so, and even though he's 16, he can once again jump up on the dining room table!  ('course, being a "normal" kidney failure cat, he's not overweight, he's underweight, which makes it easier for him to jump, I'm guessing wink.gif)  Also, there is a new theory out there on kidney patients (at least some people are rethinking this) about the low protein view.  My Sven happens to be eating one of the highest protein foods available!  (and although we haven't had his BUN checked lately, the last time we had it checked, it had not increased while on the high protein food).  And actually, our Vet told us to let him have anything he will eat, just to keep weight on him, so we're completely with you on Quality versus Quantity of life.

 

hugs.gif to you as you go thru this process.  It's SO difficult. If only they could actually tell us what they want us to do for them.

post #5 of 29

A few thoughts:

 

To help with the arthritis, you might consider a heated cat bed.  K&H makes several, and they also sell just the heater so you can use it with an existing cat bed or blanket: http://www.khmfg.com/catproducts/indoor-heated-cat-beds

 

As for the weight loss, you might try feeding smaller amounts but more frequently or possible putting a little bit in several bowls so that he has to "hunt" for his food--it increases his activity level a bit and helps burn calories.  It might also encourage him to eat a little less. 

 

You may want to talk to the vet about whether low protein is really necessary.  Some of the newer research indicates that low-phosphorous is more important than low protein.  This site talks about nutritional requirements for CRF cats: http://www.felinecrf.org/nutritional_requirements.htm

It also lists phosphorous levels in canned cat food: http://www.felinecrf.org/canned_food_usa.htm#canned_usa

 

As for the asthma, how was it diagnosed?  Did the vet thoroughly examine his heart as well?  The symptoms of asthma and congestive heart failure can be confused, so it might be a good idea to ask the vet how he/she ruled out CHF.

 

Has the vet done a urinalysis to determine if he has a bladder infection?  CRF kitties are prone to infections, which can be treated with antibiotics.

 

Good luck to you--it's always hard to know when the time is right.  My parents finally put their 18 year old cat to sleep earlier this year when it became very clear that her good days were basically gone.  Before they made the decision, though, it was a roller coaster ride where she would have good days and bad ones, and they considered whether to euthanize her several times before making the final call.  Often, she would bounce back the next morning after a bad day, just to let them know she wasn't ready yet. 

post #6 of 29
The other folks offered great suggestions on how to manage some of his health issues, so I'll share something I learned from a vet many years ago, when I lost the first love of my life to cancer.

If you can push your personal emotions aside for a while and look at your baby objectively (I know, very difficult to do), a cat will tell you in no uncertain terms when it is their time to go. In order to force me to do this, my vet asked me a very simple question: are you keeping him alive for him, or are you keeping him alive for you? There is a deep meaning behind the question when you think about it.

As I age, arthritis is settling deeper and deeper into my joints. There are days when I can't open up a can of pop because my hands hurt so bad. The human side of your question is that no, I'm not ready to check out because I face the daily pain of arthritis. Take me when I have a terminal disease.

hugs.gif to you as you work through this issue.
post #7 of 29

Hi xthoroughbred,

 

I too have a very senior kitty (he'll be 19 soon) with arthritis and renal insufficiency, so I totally understand your situation. It can really put your heart through the ringer, can't it? There's a great quality of life scale that I like to reference that you might also find helpful. It was developed by an oncology vet who specializes in hospice (aka "Pawspice") care for pets. Here's the longer explanation of it: Quality of Life for Pets  And here is the Coles Notes version in chart form: The HHHHHMM Scale
 

Quote:
Originally Posted by xthoroughbred View Post

Losing weight requires upping protein levels, which he can’t handle now with his kidneys, or cutting calories, which we’ve tried but I’m not set on reducing his quality of life like that at this point. He very much looks forward to meal time, and I’d rather have him eating than not eating.

 

As mentioned in the previous posts, reduced-protein diets for kidney cats is old-school thinking (based on studies done on rats 40-50 yrs ago), and is probably responsible for killing more cats than it's helped. I actually wouldn't even discuss the food issue with your vet: they'll likely just tow the party line that they've been fed by the Hill's marketing reps. The fact is, cats NEED protein, even more so in their senior years. I feed my own cat a large variety of high quality canned and raw foods, with half an eye on the phosphorus levels. But you're absolutely right that keeping your cat eating is the most important thing, so make sure any transitions you make are at a pace he's comfortable with. 

 

 

Quote:

Originally Posted by xthoroughbred View Post

He gets monthly Adequan injections, however, and these seem to help immediately after the injection. He’s been known to jump up on the couch by himself. This shocked us after his injections because we hadn’t seen him jump anywhere in years. He was also on Buprenex for awhile for pain. I’d like to think this helped him, but he absolutely does not tolerate taking it and it makes him act a little weird—his eyes get big and he seems wide awake, like he’s on a high. The vet has told us we may wean him off of this because...

 

I also do the Adequan injections, as well as Cosequin, but the thing I found helped my guy the most was acupuncture. Not all cats are tolerant of the procedure, but if you can find a certified veterinary acupuncturist near you I highly recommend at least trying it. Can also help with the kidney issues. If you don't think he'll sit still for the 20 mins after the needles are inserted, you could try aquapuncture instead (if the vet is qualified). Instead of leaving a needle in, a series of injections of a liquid B vitamin complex are made, which stimulates the acupuncture points for quite a while afterwards.

 

Heated pet beds are awesome! I have a few sprinkled around the house and they are well used. Pet steps (can be improvised or purchased) to help your cat get on and off furniture might be something else to consider.

 

 

Quote:

Originally Posted by xthoroughbred View Post

He does strain to urinate, and is starting to have problems defecating. 

 

Constipation can be a real problem as cats age. Do you add extra water to his food? Might also be time to discuss with the vet whether administering a small amount of sub-Q fluids would help. If my cat (Aztec is his name) shows signs of poopin problems, I add about 1/4 tsp of slippery elm bark powder to his food a couple times a day, with a tbsp of extra water. He ain't a fan of pumpkin at all (I find slippery elm works better anyway). Another option is butternut squash baby food (make sure there are no extra ingredients though).

 

 

Quote:

Originally Posted by xthoroughbred View Post

There are also two kittens in the house that I desperately try to keep clear of him since they make him VERY angry. I know this is stressful to him.

 

Same here! They aren't technically kittens anymore (16 months), but they're certainly crazy rambunctious and I'm sure if Aztec could talk, he'd tell me to get them the hell outta the house. His tolerance has increased over time but if they enter his personal space they get a bop on the head. Of course the "kittens" think it's a big game to try to leap past him without a boppin. I used Feliway diffusers for many months to help ease the tension between everyone, maybe that would help your situation too? 

 

 

 

Quote:

Originally Posted by xthoroughbred View Post

He can’t groom himself too well because of his weight and arthritis, but he gets by. 

 

If you ever think he needs a little help in the grooming department, a warm damp washcloth goes a long way. Helps remove some of the dead fur and dander. I also really like Earthbath Hypo-Allergenic Grooming Foam. You don't need water, just rub it on and towel dry. No stress, no mess, and kitty is nice and fluffy and soft after.

 


Quote:

Originally Posted by xthoroughbred View Post

His teeth are bad and past the point the help (unless someone has suggestions), so sometimes it hurts him to chew hard food.

 

 

How bad are they? Abscessed teeth can contribute to kidney issues, and if they're causing him a great deal of pain it is going to affect his quality of life. I know how incredibly risky it might seem, but perhaps a dental might be necessary if every precaution possible is taken. Antibiotics and pain meds are something else to talk to the vet about. I know you said the Buprenex was making him whacked, but perhaps he just needs a smaller dose? It's unfortunate that there aren't very many safe analgesic options for cats. 

 

Anyway, I my heart goes out to you and I wish you and your kitty the best. alright.gif

post #8 of 29
Just wanted to add that Cosequin (as Sally mentioned too) or even better Dasuquin http://nutramaxlabs.com/vet/Products/Dasuquin-for-cats.aspx is an excellent idea to try. I also am using Dasuquin for one of my cat's for bladder health. Could help with the arthritis AND the bladder as well...... vibes.gifvibes.gifvibes.gifvibes.gifvibes.gif Thinking of you today hugs.gifhugs.gif
post #9 of 29
Thread Starter 

Thank you so much for all the replies!

 

We went to the vet last night and found out the poor guy is very, very constipated. They went ahead and gave me a stool softener to give him since an enema would be too painful for him with his arthritis. If the softener doesn't work, I'll definitely try adding the pumpkin in. I've also bought him a heated pet pad to sleep on. He hasn't laid on it yet...he's not a big fan of anything comfortable that we buy. I swear, if they had heated shoes or boxes, he'd be all over it! Hopefully he figures it out soon because I know it'll be great for him. cloud9.gif

 

I also just switched him over to Wellness Healthy Indulgences, which the vet thinks is fine to try. What do you all think about this food? I know it's a good quality, but there's only something like 8% protein and some of the flavors have over 1% phosphorous. Is that too much? His kidney levels are on the higher side of normal. He used to get sub-Q fluids on a weekly or as needed basis, and he got some last night at the vet, but we stopped doing that since his kidneys have balanced out. I just don't want a new food to wreak havov on his system! He's only had half a pouch so far, but he LOVES it!

 

He does get plenty of water throughout the day. He drinks like a camel since his kidney failure, and I try to make sure the wet food I give him has a high moisture content. The Science Diet we recently tried did, and the Wellness Healthy Indulgences has something like 83%. I'll also sometimes mix his dry K/D with water to soften it for him.

 

His asthma was diagnosed very thoroughly. We actually worried about heart worms and fluid in his lungs before asthma, since everything I've read says it's pretty rare.

 

We've tried Cosequin in the past, but I don't know that we kept up with it religiously before moving onto something else. I'll have to look into it, along with the other suggestions.

 

Now a couple more questions to you all...

Our vet put him on Gabapentin (painkiller) last night. She was trying to think of painkillers for him and considered Metacam (which gets a big NO from us since it threw him into kidney failure after a dental cleaning), Buprenex (which he's had before and what she also thinks caused the constipation), and Gabapentin. I asked if I should be considering euthanasia soon, and she said the Gabapentin is essentially my last option to keep him pain free. I read online, however, that it shouldn't be used in cats with reduced kidney function. I don't know if that's necessarily him...he's technically normal now...but I definitely worry still and he's very fragile in that area. Is this a good painkiller? Does anyone have experience with it? He's getting it once a day. I haven't looked at the dosage yet.

 

He's also having some litterbox issues. When he urinates, he likes to do so at the very edge of the litterbox. This presents a problem for us because he needs a low litterbox for easy access, but he needs high sides to get it all in. It's not at all a behavior or health issue (unless you're seeing something I'm not)...he'll just squat at the edge and not realize he's missing the box! I bought one that has a low side and that climbs to a high side thinking it might help, but he still pees on the low side. We have another litterbox with all high sides, and we tried to make some steps for him to get in there easier, but I'd really like to be able to use this one with the low side since it's so much easier for him to get into. Are there any suggestions for keeping the pee in there? I might just have to line the outside with a towel or put a pain under the box to catch it all...

post #10 of 29
Aw, I'm so sorry you're juggling so many issues with your kitty, but it's very clear you love him so very much. heartpump.gifhugs.gifrub.gif

I don't know about meds or diet. I just had thoughts on the heating pad, constipation, and the peeing problem.

For the peeing, there are several options. When he enters the box - does he turn around to pee? If so, you can buy a tall-sided sterlite storage container (cheap) and cut down one of the sides so it's easy to step in and out. Now - if he steps in and pees toward where he just walked in, this won't help. In that case, your best bet is to use doggie wee-wee pads. They're disposable, they're absorbent, and they provide a barrier between his pee and your floor. Either that, or as you suggest, a larger pan underneath to catch what he misses.

As to the constipation, was the medicine provided Miralax? This is really wonderful stuff to help. agree.gif It can be given to him regularly, in fact, to keep his stools soft. But if he likes pumpkin (many cats do - some eat it plain, others you can just mix it in with wet food), that is a very safe long term option. agree.gif

And the heated bed? Since he doesn't like the cushy stuff, there are heated pads. For instance http://cozywinters.com/shop/kh-3093.html We were just gifted one for our outdoor feral cats by someone previously using it for one of their feral cats - and they don't like cushy stuff, but LOVE this.

BTW, my vet recommends the Dasuquin over the Cosquin. My understanding is that it's formulated differently, and is more effective. I also understand it requires a smaller dose, so easier to consistently get in the kitty. cross.gif

Vibes for you and your boy! vibes.gifvibes.gifvibes.gifvibes.gifvibes.gif
post #11 of 29

Just thought I would say that my only experience with Gabapentin is taking it myself! It made me more of a goofball than normal, and very sleepy, so I would expect for you to notice a slightly drugged effect, at least at first, in your furbaby. 

 

As for the constipation, I swear by Miralax.  Sven has been on 1/4 teaspoon mixed in a little bit of water, mixed in his food twice a day now for over 2 years, and it is a miracle worker.  Better even than the presciption laxatives!  Problem is, if the other cats finish off his food, then they tend to have too soft of stools doh3.gif, so I have to keep a close eye to keep them away from his  food dish!

post #12 of 29
Thread Starter 

He was prescribed Lactulose. He's always been able to actually go (it was just painful for him and produced small/hard stools), so I may need to take it down a notch to the Miralax or pumpkin since it's working long term for your kitties. I really don't intend on having him on the Lactulose for too long. I'd much rather fix it in a natural way, if possible, because I usually notice immediate changes in his behavior once he's on medication. Plus, he absolutely hates taking it. The vets couldn't get it in him when we asked them to give him the first dose, and I usually only get half in him. It's very sticky liquid and is now all over him and the house (and me when I wrestle to get it in him!). He's now affectionately known as Sticky Bun.rub.gif

 

And I've already noticed the sleepy side effects of Gabapentin! Hopefully he perks up, or maybe we can get a smaller dose. He spent most of last night on a blanket and didn't even wake me up to eat like he usually does. I woke up early this morning to find him in the same place and same position that he had been when I said goodnight. I panicked just a little bit! I may need some medication soon! crazy.gif

 

Oh, and he's now got puppy pads to catch the urine outside his litterboxes. Hopefully it works!

post #13 of 29

My Sven was on Lactulose before we switched to Miralax.  Like you, we got more on the outside of him than inside laughing02.gif.  Plus we were only to give it to him after we noticed he was having problems going.  By that time, he was already uncomfortable.  With the Miralax, it keeps him from ever getting uncomfortable in the first place, and it's not sticky, and it has no taste and doesn't gel up like some OTC fiber-laxatives.  AND, it's OTC, and a lot less expensive than Lactulose!  (we actually buy the store brand of Miralax)

 

Hopefully the sluggishness from the Gabapentin will be temporary (as many side effects of drugs are) AND that it will help with his arthritic pain.  Glad the puppy pads are already in place.  That seemed like a great idea!

 

What's your old guy's name anyway?  I don't think you've ever told us, except his nickname of Sticky Bunwink.gif

post #14 of 29

Well, I don't need to mention that this is a "hard" decision.  I have some of what is called the "anger" phase of grief.  It's not real intense, but it's a part of it.  I was faced with this decision a few weeks ago.  My cat was taken in for surgery to have a cyst removed by his papa one day while I was at work.  I recieved a message while I was a work with the vets recommedation which was not to wake him up from anesthesia; that he had cancer and to euthanize that day.

 

The vet has no emotional attachment to our pet.  I immediately left work with the intention of picking the cat up from the vet and bringing him back home. As I considered the good doctors recommendation, I considered what it was that my cat would want.  I knew my cat wanted to come home and be here.  The cat did not seem to be in pain as of yet.  He was briefly irritated at times but 95% of the time a very happy camper.  The truth was that I had seen the cat much more upset when he had colds in the past.  The cat seemed to be very much at peace in fact.  Then I spoke with the vet, who metioned in a round about way something about people keeping them alive for themselves and not thinking about the pets and that he did not mean me, whatever that was supposed to mean.  But, I overlooked this graciously and together we talked about picking him up.  Now was not the time to become emotional over things I couldn't control anyways.  We braught him home.  The vet did have a very good idea about taking it day by day though.  The little sweety passed away peacefully and warm in his bed a little over a week ago.  He was not hungry or thirsty.  He purred and was able to spend time and friendship up to our last day together.  

 

I have completely and thoroughly examined my concience concerning this matter and indeed, I did what the cat would have wanted.  IF he was in great pain, hiding, crying or unable to eat and share quality friendship than the option would have been to end his suffering.  But he did not communicate this.  In his case, he wanted to be home.  I did not even think about my own grief that I have experienced throughout this ordeal. I thought of him and what he wanted.  I think they let you know what to do. In no way did I think about "myself" other than to take care of myself so I could take care of him in his old age.    

 

Friends mean well when they offer their stories about how they had to euthanise and always about how it is the "hardest thing" they ever had to do.  Well that goes without saying. 

 

I put my own grief aside for the cat.  He was a great friend for many years.  He was worth the extra time in the end and he appreciated it.  I believe that if an animal is in intense pain, he or she will really let you know.  At the very least, they are likely to hide or express this in many ways that you can find by reading articles about it.

 

What I am saying is to please consider what kitty would want.  Be very discerning when listening to advice from anyone, myself included.  If anything I say resonates with you, you and your cat are the best judges about what should be done in such a situation.  Whatever the decision, be sure that you and especially kitty are at peace with it.     

post #15 of 29

We too have an old, arthritic guy. He's 21. He is hyperthyroid and we are having quite a bit of difficulty getting it regulated of late. He gets an Adequin injection once a month, 1/4 baby aspirin every 3 days and a 1/4 Torbutrol (pain killer) every night. He's getting crankier and losing weight a little faster than we like but he isn't ready to go just yet. He still loves hanging out with us, sleeps next to my DH all day while he works and craves attention. Every so often the pain gets a bit more intense and he hisses and pants so we give him a little extra painkiller. He has heated beds and will sometimes spend all day melted in to them when other days he has absolutely no interest. At his age, we just let him do what he wants and try to keep him comfortable and happy until he tells us it's time. 

 

When we first started him on the Torbutrol he was sleeping all the time, even through meal times so we cut it back. He is already losing weight so he needs to eat as often as we can get food in to him so sleeping through meals was not an option. The lower dose does still control the pain but he is more alert and active. If your kitty is sleeping constantly, talk to the vet about lowering his pain dosage. 

 

As to knowing when it's time. They let you know. We lost a beautiful girl this past August to cancer. She fought it bravely for about a year but in June/July she stated hiding. Then she started dropping weight quickly and refused food. We did sub-q fluids and gave her an appetite stimulant. She would rebound and we'd get a good week or two out of her. Then, it would start again. When the appetite stimulant stopped working we started thinking about ending her suffering. But she still purred, still fussed at my DH when he wasn't in his office. She still rolled in catnip when we put it out. We just couldn't come to terms with the fact she was ready. Finally, one day, she looked at me when I went to give her the meds and I knew she was done. Something in her eyes. DH took a few days longer to come to terms with it. Finally, he realized she was tired. That she was being strong for him and he decided to let her go. The day we took her in, she rolled in catnip and let us kiss and love on her all day. She had a wonderful last day....we almost didn't go through with it because she seemed so normal. But we looked at a picture of her from a year previous and the changes were so glaring we had to say goodbye. Our vet uses anesthesia gas to put them in a slumber before the medicine is given. Some cats get scared or fight the administration of the gas, Cleo laid down and took several deep breaths. She was so tired, so done. 

 

Bogey's not there yet. You'll know as long as you open your heart and mind to listening. If you are posting here about it, that means you are beginning to prepare yourself. Come to peace with the life you have had with the old guy. Know how much he loves and cherishes you. But most of all, let him know when you are ready....that's when they tell you. 

 

But no matter what, it will still be hard. You will still cry 6 months later. And that hole in your heart will always pang with sadness, just a little, when you think of him. 

post #16 of 29
Thread Starter 

Thank you for all the replies. I have already cried a river over this cat since just the thought of losing him leaves me devastated. I am keeping an open mind to euthanasia, though. He seems very happy for the most part, so I don't think it's time just yet.

 

We do have yet another issue, though! The poor guy won't take his pain meds. We tried mixing the powder with food and that didn't work. We tried mixing it with tuna and tuna water, and that didn't work. We tried getting those marvelous Whisker Lickins--he LOVED those the first time. Then he caught on after two times. Now he won't touch them, even if they don't have medicine in them! We tried moist Pounce treats, and those won't work. We tried hiding the powder in turkey and pork, and that didn't work. We tried ice cream, and that didn't work. Even milk didn't work! I know Pill Pockets won't work because it's sometimes hard for him to chew regular Greenies. There just seems to be a lot of powder in these pills, so we went through about 25 treats just trying to get one pill down or had a hard time mixing it in with stuff. Ideas, please! He's a very smart cat. There's no way he will swallow a pill whole or probably even allow us to keep one consistent method. The vet was a bit hesitant when mentioning daily injections, most likely because of his kidney history, so I really don't want to have to resort to that. It's that whole 'quality of life' issue...

 

Also, is there a chance that he could drop weight from not being constipated anymore? He seems to have lost weight to me in the last week since being on Lactulose and I'm getting concerned, especially because he's still eating fine. He drinks and urinates a lot, which is the norm for him ever since his first bought of acute kidney failure, but I'm definitely worried about a relapse. I just don't want to send him to the vet at the first sign of danger since it's very stressful for him to go and get bloodwork/urinalysis. Please cross your fingers that his kidneys aren't going because that really would mean my shnookums' days are numbered...

post #17 of 29
vibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gifvibes.gif for you kitty today and and hugs.gifhugs.gifhugs.gifhugs.gif to you too biggrin.gif. Have you tried mixing the powder in a small amount of Hill's A/D and just try to syringe the meds into him? Don't know if he would allow you to do that though. A/D is very smooth and easily syringed and most cat's love the stuff. Packed with extra nutrient's too. I really do not think that NOT being constipated anymore would make his drop weight. It is great that he is eating well and drinking. Maybe just try to add a few more calories into his diet each day right now. I know the challenges you are going through, you are not alone hugs.gif

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post #18 of 29
Thread Starter 

He doesn't like syringes at all, and this stuff must taste awful (it IS a pain med...those are usually gross), but mixing it with something and putting it in a syringe is worth trying. Getting a little bit in him is better than nothing at this point.

post #19 of 29
Quote:
Originally Posted by xthoroughbred View Post

He doesn't like syringes at all, and this stuff must taste awful (it IS a pain med...those are usually gross), but mixing it with something and putting it in a syringe is worth trying. Getting a little bit in him is better than nothing at this point.



 

Yes, none of them do like syringes.  I think it's a great idea!  Water, chicken broth what ever works to get him his meds.  He will appreciate it no matter how much he acts like he doesn't.  He is lucky to have such a great friend like you.  I went through nursing a very sick cat recently and it can be time consuming, especially when every single last thing is tried to keep him happy.  Also, something important I learned was to make sure to take care of myself better, like eating well and stuff. That way I was able to be in fit shape to take care of the pet as a thank you to him for serving me as such a good friend for so many years.  You're on the right track.  Crush it up, mix it, suck it up with the syringe and down the hatch!!!  Once he get's over the initial dislike of recieving his dose, give him a hug or a pat as a "Good Boy" will make the experience less irritating for him.  My cat hated it, but I swear he somehow knew it was nessesary after a while.      

post #20 of 29

Can you ask your vet about getting the meds compounded into either a flavoured treat or liquid (like chicken or fish) or a transdermal gel? It costs more, but is well worth it if it makes drug administration easier. I did that for an icky tasting vitamin supplement that Aztec needed to take and it worked like a charm. Not all drugs can be compounded though, but I highly recommend looking into it. Less stress for everybody!

post #21 of 29

Ok, just so I understand, the Gabapentin is in powder form?  I'm guessing you are opening up the capsule to try to hide the powder in something?  If that is correct, how big is the capsule?  We have another thread on giving pills, which has all kinds of suggestions (but it seems you have tried most of them frown.gif) http://www.thecatsite.com/t/237863/ideas-for-hiding-pills, BUT the Greenies Pill Pockets are soft, not hard like regular Greenies.  Unfortunately, the "pocket" is not very big, that's why I asked how big the capsule is.  What I do, though,is just squeeze one flat, then wrap it around whatever I'm trying to hide.  (much easier to do than using a soft Whiska Lickin's)  Too bad the cat who  needs to take pills doesn't like them wink.gif, but at least the others do, so when they have to take meds, I'm set!

 

On, and as to the soft Whiska Lickin's....I learned that my boy will NOT take his pills in anything but the chicken leg treats!  Go figure.   And the trick is to get the medicine inside without any scent of it on the outside.  Very tricky.  It took several tries before I mastered it.  I take 2 treats and have them already squished down flat, then put the pill on top of one and very carefully lay the 2nd treat on top, then crimp the edges together tightly.  Once that's done, I have to reshape it to make it seem like the other treats.  Oh, the things we do for our cat laughing02.gif.  But they're worth it!!!!

 

The compounding pharmacy idea is probably your best bet.  Your Vet may not be able to do it, but they should be able to write the prescription for it.  If you can't find a local pharmacy who can do it, there are internet pharmacies that will.  If you could get this is a transdermal gel, that might be your best bet, but not all prescriptions can be done that way, and, unfortunately, not all bitter tasting drugs can be compounded to be completely bitter free.  (that's why I'm still hiding Sven's pills, rather than using the compounding pharmacy myself...they told me they could not get rid of all the bitterness in his medication.  (at least they were honest with me)

 

Worse case scenario, have you tried just pilling him?  If his medication is in strictly powder form, you can buy empty capsules to put it in (or hide it in to use the pill hiding tricks from above)

 

Keep us posted as to how things are coming along. 

post #22 of 29
Thread Starter 

Sorry I haven't been here for awhile!

 

I just asked my vet about compounding the Gabapentin, so hopefully that is an option. I haven't heard back yet.

 

The Gabapentin is a capsule, so it can be taken as a pill or the powder. I think it's pretty big...about the size of one of those turkey leg Whisker Lickin' treats--maybe longer. It has A LOT of powder though. It took about 20 Whisker Lickin' treats to get one pill's contents down him. And he simply won't swallow the pill no matter what. I got a piller from my vet last night and he won't open his mouth an inch to even get the piller in there, and he spits it right out if it's hidden in any food. He can also taste the powder in the middle of the treats that we hide it in. He'll literally be mid-chew and just let it all fall out of his mouth as soon as he gets to the powder in the middle. He went nuts over the Whisker Lickins' the first night we tried them, and now he won't even touch them WITHOUT the powder because of the times we tried using it WITH the powder. He thinks they'll always have medicine on the inside even though we alternated the medicine ones with regular ones when we gave them to him so that he wouldn't catch on.

 

So now we're kind of back at square one. He hasn't had the medicine in days... =/

post #23 of 29

Well, I know the feeling about pilling them and having them know when there's a pill in their treats wink.gif.  My Sven is wise to me too!  Compounding is a great idea.  I'm in the midst of getting Sven's meds compounded also. Just waiting for the call to tell me they are ready to pick up.  Hopefully Gabapentin can be compounded.  Don't know why not...seems like almost anything can be, and into pretty much any form. 

 

Keep us posted!  cross.gif

post #24 of 29

May I express perhaps a bit unusual opinion?

 

Your kitty is 17 - it is wonderfully advanced age and I'm happy to hear that some of others live longer still.

 

It is commonly accepted being kind that we decide to put an animal person down if they are suffering.

But what level of suffering are we talking about?

I read all of this thread and truly feel your pain.

But if it was me - I'd not consider an option of putting my cat down.

 

I've been 'there' just recently when my vets in a very gentle way were subtly suggesting the possibility of putting my injured cat (young one - 3 years old) down because there is not much they could do anymore.

Well, I told them that she is not suffering that bad and I will never ever put her down, and if she dies - she dies with me.  This of course didn't happen.  She is on a way to her recovery so I believe and hope.

 

But the thing is:  I'm thinking on terms of humans.  We have bad days and good days.  We suffer from different illnesses at times, especially when we are old.

Like my mom (80 years old) - she  suffers a lot from many health issues and she made us promise that if anything bad to happen - we will not let her be a veg on life support machines.

I myself suffer a lot from osteoporosis and at times can't walk straight.  But some people suffer even more than me.

 

I think the same for my cats.  If they are still mobile somewhat and not on life support - they would not want to be put down.

 

I can see how much you love your kitty and I only hope that time will NOT come when you will have to make such a decision.

I hope that your kitty feels better with all the loving care you give and that he lives many more years not so suffering, but when time comes - he will make a peaceful transition having lived such a wonderful life, but not before that.

 

I'm sending my best healing thoughts and vibes and prayers to you and your precious baby.

post #25 of 29
Thread Starter 

Ugh. So I've had quite the trouble with the compounded Gabapentin. The first night we got it, he took it after a bit of a fight and went outside to cool down since he was growling and very unhappy. He stayed on the porch, so I assume he didn't get into anything. When he came in, he was acting very, very weird. His pupils were dilated (which is normal for him when he's on the Gabapentin), but he was walking very slowly. He came in our kitchen and laid down right in the middle of it, which he never does since he tries to steer clear of the traffic. Then he stood up after a while and, while walking VERY slowly, began wobbling back and forth as if he were drunk and dizzy. This went on for a good hour or two before I picked him up on our couch and got him to go to sleep. His breathing was very slow and I was seriously concerned. I checked the dosage about six times to make sure I didn't overdo it. After hours and hours of sleep, he woke up the next morning seemingly okay.

 

He then got a few days off the medicine since I was out of town and my family finds it very difficult to get medicine in him. I decided to give him only half the dose this morning and after a big fight, I got it in his mouth. He acted like he had peanut butter in there and then he began slobbering like a St. Bernard with strings of saliva hanging down to the floor. He was refusing any treats I tried to give him to get the taste out of his mouth, but eventually settled down to sleep (the medicine makes him SO drowsy). He's at home (not unattended) right now, so I won't know how he's handling the medicine until I get home from work. I'm thinking I'm just going to have to go back to the pill since the compounded liquid is clearly very strong and very disgusting to taste. And I'm honestly not sure any pain medicine is worth the fight if he's just going to fall asleep for hours and hours when he does that for most of the day anyway.

 

Ambermay, thanks for your post. I've been thinking about that a lot lately, and am hoping I will only have to deal with the euthanasia if his hips give out on him and he can't walk anymore. That would be devastating for him since he loves going outside.

post #26 of 29
Quote:
Originally Posted by xthoroughbred View Post
He acted like he had peanut butter in there and then he began slobbering like a St. Bernard with strings of saliva hanging down to the floor.


eek.gif Oh no!! That doesn't sound very tasty at all! Either the Gabapentin just tastes so horrible that nothing can hide it, or whatever flavour they compounded it into doesn't agree with your boy. I agree, no pain med is worth administering if it doesn't actually improve his quality of life. Is acupuncture an option where you live?

 

post #27 of 29

Well, it doesn't sound like they really compounded this medicine if he is reacting that way after taking it, with the slobbering and whatnot...did they tell you anything about it not being something they could easily compound?  I got Sven's Pepcid in a liquid form, and I mix it into some smelly wet food, and he licks it up.  Is that an option so you don't have to fight to get it in him? What about something where you rub it on his pads or ears (transdermal I think it's called).

 

I think that after he takes it for a little while, he will get used to it, and won't sleep all the time, but could be mistaken.  It's the same with humans.  The first time I took it, I felt like I was drunk, but it didn't take me long to get used to it at all.

 

I agree with Sugarcatmom, too, that accupuncture might be an option.  Or even a heated bed would help, in all probability.

post #28 of 29
Thread Starter 

He does have a heated pad to sleep on, but he slept on it for one night and hasn't been on it since. He prefers things like old boxes and tissue paper to anything purposefully comfortable.

 

I don't know how easy it was to compound, but I know that they did it without too much fuss. My vet sent the prescription in and asked what flavor we wanted (fish) and we got it within a few days.

 

I just got off the phone with my vet who checked about a transdermal version. They can do this, but it's not as effective. It's also $28 a day. My vet knows this is outrageous, so we're going to keep trying other options throughout the week. I've attempted everything my vet could think of except for mixing the medicine with beef bouillon. Are there any other suggestions out there? I have a capsule (which can be broken open) and liquid to try. I'm desperate for something!

 

If we have no solution by the end of the week, I'll have to check into acupuncture. I'm just slightly nervous about that because the vet is pretty stressful.

post #29 of 29

Looking after a terminally ill cat is very stressful.  Very.  And if the cat has a long slow decline it's very hard to see when 'the time' has come.  That's partly why unless the cat finds it very stressful fairly regular vet visits are a good idea - it's far easier for someone who only sees the cat occasionally to see how he or she is doing than for those of us that are seeing them every day.  Thankfully my old cat suddenly went downhill over a couple of days and it was obvious, and thankfully the vet agreed.  He had suddenly lost weight, was more dehydrated than normal (he was on steroids which apparently have that effect) and along with the other things I had spotted and his general condition the vet very gently sent him on his way.

 

Personally I stopped worrying about feeding him what would be 'best' in medical terms and fed him what he would eat - quite a bit of that came from my plate!  I felt it more important he ate than he ate the 'right thing'.  I would do the same again in a similar situation without hesitation unless it was clearly making the cat's condition worse in some way.

 

To me one of the big, big problems with judging when the right time is is that cats are usually very stoic, and hide signs of pain and so on as much as they possibly can.  I always worried that my cat was actually in pain and was simply hiding it very well.  However no-one who saw him ever suggested that was an issue.

 

My own view is that it's about quality of life, not quantity.  Quantity is for me, quality is for him.

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