When to euthanize senior cat?

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. 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. I have an older dog, my everything. You just never know day to day, is this the day ...... 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.

I don't think I could put it better than Lauren...

I just wanted to add a couple of things that might add your little one
For constipation, canned pumpkin works miracles 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.....

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 )  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.

 

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.

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. 

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.

to you as you work through this issue.

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
 

 

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. 

 

 

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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.

 

 

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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).

 

 

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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? 

 

 

 

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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.

 

 

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. 

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...... Thinking of you today

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.

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. 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.

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.

Vibes for you and your boy!

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 , so I have to keep a close eye to keep them away from his  food dish!

My Sven was on Lactulose before we switched to Miralax.  Like you, we got more on the outside of him than inside .  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 Bun

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.     

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. 

for you kitty today and and to you too . 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

 

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.      

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!

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 ) 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 , 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 .  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. 

Well, I know the feeling about pilling them and having them know when there's a pill in their treats .  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! 

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.

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?

 

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.

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.