Stress him out or let him be?

In the past few weeks, my 18 year old boy has been waking me up frequently (6+ times) during the night. I did some research and found that hyperthyroidism can cause this and is a typical problem for senior cats. But since I'd be more likely to think he has hypothyroidism (he's been gaining weight like crazy), I looked that up. It seems he has symptoms from both hyper and hypo. Of course, I could be looking for something that isn't there but I worry all the time about his arthritis and obesity.

Since I don't want to stress him out at all, I emailed my vet to ask what options we had and if she'd write a script for me. A woman who works the front desk said I would have to bring him in. I'm not sure if the vet ever heard my request but I thought she'd be more sympathetic since she told me at our last visit that doing xrays on him (for another issue) would be very risky and doing blood work (to check his kidneys--he's CRF) probably wouldn't be in his best interests.

Is there really no other way to check this than bloodwork? I thought I read somewhere about a urinalysis. My guy has had so much bloodwork in his life and I can't imagine how painful it is for him. If I have no other options, is it worth the risk of taking him in or do I just let him be?

I really don't think having bloodwork done is very painful for them.  Truly I don't.  But, stress, on the other hand, is a different story.  Does he get really stressed when you put him in his carrier, or what is the problem?   I don't get why doing x-rays would be risky, unless they would have to sedate him (which very well might be the case), and having just lost my Svennie to CRF, I can honestly see why having bloodwork done might not be "necessary", which may or may not be what you were saying. 

That being said, I would think there is a BIG DIFFERENCE between hyper and hypo thyroidism, and think it's really important to get his numbers checked to know how to treat that, if that's what it is at all. 

Now, all the above being said, can you not simply CALL and ask your Vet to call you, then discuss over the phone, rather than go this the girl at the front desk?  Discuss the stress issues, etc?

for your old guy.  18 is pretty old.  Good for him! 

He usually handles vet trips just fine but since he is older, overweight, arthritic and has breathing issues, it becomes an issue when he gets even a little stressed out. They take him to the back for the xrays, not really aware of how much he hurts in certain places, and get him all worked up. The vet said she has seen several cats stop breathing during the process and doesn't want to risk it.

And I disagree about the bloodwork not being painful. He has been stuck in just about every place on his body and they often have to stick him multiple times because they can't get it in. He's got little bumps all over from this. It comes from the jugular and can be very painful and stressful for cats. I've heard of several cats having to be put on oxygen because it bothers them so much.

I'm just wondering if it's worth getting all kinds of tests done when the risk is so high and I'm not sure how big the reward is.

I wouldn't just let him be, no. He could be in pain and you'd have no idea without taking him in; and it wouldn't be fair to him to just let him suffer if that was the case.
If going to the vet doesn't stress him out but instead it's the people there, I would try to find a different vet. There is No reason why they should have to stab him multiple times to find a vein.

As far as hyper and hypothyroidism goes, here's the simple breakdown since the amount of symptoms can be overwhelming.
Hyper- weight loss, hyperactive, hungry all the time
Hypo - weight gain, sluggish, poor appetite

Another thing I would do to make him more comfortable is do an overhaul of his diet if you haven't started it already. Keep him on measured scheduled meals and if he likes wet foods (even junky ones), try to make those the main portion of his diet. (the wet food will also be good for his ageing kidneys)

mrsgreenjeens said:

I really don't think having bloodwork done is very painful for them.  Truly I don't.  But, stress, on the other hand, is a different story.  Does he get really stressed when you put him in his carrier, or what is the problem?   I don't get why doing x-rays would be risky, unless they would have to sedate him (which very well might be the case), and having just lost my Svennie to CRF, I can honestly see why having bloodwork done might not be "necessary", which may or may not be what you were saying. 

That being said, I would think there is a BIG DIFFERENCE between hyper and hypo thyroidism, and think it's really important to get his numbers checked to know how to treat that, if that's what it is at all. 

Now, all the above being said, can you not simply CALL and ask your Vet to call you, then discuss over the phone, rather than go this the girl at the front desk?  Discuss the stress issues, etc?

for your old guy.  18 is pretty old.  Good for him! 

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I agree!!! Good post!!

I know he's in pain but it's not from any thyroid issue. So I'm concerned that I'm taking him to the vet to die over something that won't kill him or is untreatable anyway.

I don't think it's the people at the vet that stress him out. It's the entire experience.

I've tried doing several overhauls on his diet. Portion control helps somewhat but he's still gaining (21 lbs. at last check) and he goes crazy if we hold back food.

"As far as hyper and hypothyroidism goes, here's the simple breakdown since the amount of symptoms can be overwhelming.
Hyper- weight loss, hyperactive, hungry all the time
Hypo - weight gain, sluggish, poor appetite"

He has most symptoms from hypo but he is hungry ALL. THE. TIME. and also hyperactive at night. So that's why I'm confused.

A lot of cats beg for food all the time so that may be normal.
Hyperactivity at night is normal.

If he's in pain all the time you have to do Something about it. It wouldn't be right to just leave him like that.

If it's not hypothyroid then it's all about calories. If he's getting too much food or his food is too high in calories, he's going to keep gaining. At 21lbs, he's at risk for heart failure, respiratory failure and diabetes. He needs to lose weight.

We've tried for several years to get him to lose weight. I don't know what else I can do. He eats 2-3 cans of Fancy Feast a day. They are always broken up into small meals. And he's never been hyperactive at night before. He would always sleep through the night up until a few weeks ago.

And it doesn't look like anything can be done about his pain. We've tried every pain medicine available to cats and even one for dogs. I'm going to take him to a new vet but I don't know that I have any options left for pain management.

Since most cats only need 5-6oz of food a day, 6-9oz is probably way too much. And if you put dry out (i wasnt sure if you did), that would be even more calories. Cut down to 2 cans a day, no dry, watch his weight and see how it goes. :nod:

I usually do 2 cans a day but he has days where he is really hungry, which is when he gets 3. I don't leave dry food out for him because his teeth hurt him too much for that.

You have to be strong for him. It doesn't matter if he 'wants' more food some days, he doesn't know whats best for him. You're his mommy; you have to make the hard decisions for him to ensure his last years are the best they can be.

But he's miserable when he can't eat. Is that really making his last years the best?

I don't know what else I can do to help with weight other than lock him in a room and I'm not doing that. I have tried for years with many, many vets to get his weight under control. Before his most recent vet visit, he was getting maybe 1.5 cans per day. But he gained two pounds.

OK, NOW my big question is...why is he in pain?  First I thought possibly arthritis, but then you said his mouth hurts too much for him to eat dry food.  So what is the issue of the pain?  Does he need dental work done??  Just how overweight IS he, because at 21 lbs, 3 cans doesn't seem that much, but is he a mainecoon, ragdoll ( a larger breed cat) or should he be around 12 lbs? 

Have you tried changing his food to something different, perhaps a grain free, so more protein, which might make him feel more full, and be better for him too.  Would probably help him lose weight too, because would be a lot less carbs (Catkins diet!)  Seriously,  that's what our Vet dedto us for our fat boy... more protein, less carbs, just like the Atkins diet for humans.

If he used to sleep thru the night and now he isn't, is he sleeping more during the day, or have his daytime habits changed too?  The Vet needs to know ALL changes, I'm thinking. 

The main source of his pain is arthritis. He has severe arthritis in his lower back, hips and front legs. He doesn't sit like a normal cat anymore - he kind of plops down on one hindquarter. He's on Adequan, and we've tried acupuncture and laser therapy but neither seemed to help. His teeth also hurt him, though I'm honestly not sure how bad. They are in terrible shape and I feel like they're too far gone to fix. He doesn't let me brush them and he can't go under for a cleaning. He CAN eat dry food but he does toss it around in his mouth. The reason he went into kidney failure was a dental cleaning and (to our surprise) extraction, which they gave him Metacam for and that started the whole thing. He had an awful reaction to the liquid Buprenex and I can't get anything else in him. He's notorious at the vet for not being able to take meds. I've literally tried everything--treats, milk, beef stock, piller, butter, mix in with food, etc.

He is a domestic shorthair (as far as I know--found him as a stray when he was 1) so he's not a bigger breed. We've tried both K/D and J/D with him for his kidney and joint issues but neither of us are a fan of Science Diet. I can't remember trying anything else other than some weight control dry foods several years ago. I searched all over for other foods to try but my vet said he's fine on Fancy Feast as far as his weight and kidneys go. What "Catkins" type food did you put your kitty on? I do have a picky eater but I'm willing to try anything!

He still sleeps through the day like he always has so I'm not sure why he's up all night. He's been better about not waking me up since I took his bag and stairs away (he woke me up with these). But I still feel like I'm forcing him to hurt himself because he tries to reach up to my bed to wake me now and that's no good for his arthritic back end.

I'm taking him to a new vet tomorrow morning. I'm hoping a fresh set of eyes will be able to help. Most vets I've taken him to would focus on different individual things and my last vet was always great about considering all the issues, which is why I stayed with her for a year. Hopefully this new guy will be able to help a lot. I've printed out every bit of his records since his issues started.

And just a note...I know it sounds like my cat is in an awful lot of pain and having many, many issues. And he is! But he also has a lot of life in him. He's still very loving and wrestles with the two 1 year old kitties we have. He also likes to go outside, eat grass and roll around in the dirt. I would absolutely put him down if he still didn't have his good days. That's what I'm trying to balance out now--how much more I can let him take before I decide it's enough and he's not happy anymore.

As to food, we went to Soulistic, which they sell at Petco only (I think)  Not sure where you are located) for a very reasonable amount.  It's grain free, and my extremely picky cats really liked it.  (this is what I used to transition them from kibble to canned).  Then I switched to Weruva (have to order on-line because it's really hard to find), and it's also grain free and as I understand it, it's less caloric than a lot of canned food.  Now we've switched to raw, and oddly, our oldest and sickest (Sven), took to it fastest!

Oh that Metacam .  Boo/Hiss.  Seems like to causes so much harm.  As far as giving him pain meds, have you tried compounding them?  Don't you ever have to give him antacids for his kidney disease?  I had to give Svennie Pepcid AC twice a day, everyday!  But I had it compounded into a liquid that tasted like tuna, so I could just mix it into his wet food for those days when I couldn't get him to eat it in a pill pocket or smooshed inside a treat of some sort.  They can do it with hundreds of meds. 

Well, hopefully this new Vet will have some new tricks up their sleeve , and maybe it's even possible to get a dental done now even with kidney problems? 

I tried compounding the (I think) Buprenex...it may have been another med we tried...and he had an even worse reaction to it. I don't know if it wasn't done properly or what, but he was drooling a bunch from his mouth and running around growling. After going back to the regular stuff, the vet then determined that it was causing some constipation. He's been okay constipation-wise since we took him off it. I'll have to discuss compounding meds with the new vet tomorrow to see if we can try another option.

I've never had to give him antacids. He had that one Metacam incident and almost died, but he's been fine since. The last time I checked his bloodwork about 6 months ago, he was at the higher end of normal but no one was concerned. We always take his kidneys into consideration when we give him anything and he drinks tons.

I'm still SO upset about the Metacam incident even though it happened 3 years ago. They gave him his first dose (which was an overdose even in dogs) and then put the rest in a baggy for us (otherwise we would have seen that it wasn't for kitties on the box!). Fortunately, my mom noticed changes in him while I was away at college, looked it up online and called the vet's office, who responded very snootily with "There's no way it's from the Metacam. He's not in kidney failure. That's why I don't read things online!" When we took him in, he was crashing so hard we had to take him elsewhere. They refused to give us any kind of a refund. Everything has spiraled downhill since then and I'm certain the issues with his teeth and arthritis could be managed MUCH more easily if his kidneys hadn't been compromised. Grrr.

Most cats whine and moan about wanting food. Thats why they beg, to make you Think they are miserable. But being 9+lbs overweight is much more miserable. Its so hard on all his organs, it makes his arthritis worse and it means he can't even clean himself properly. I know you said you've tried, but you haven't tried us yet.
I hadn't mentioned a food change because you want to be careful about changing foods in older cats. You don't want them to get too stressed out about it. However, if you have tried Everything else, I think it's time to get a new plan. A high protein, low carb wet food is what he really needs. Figure out what he Really likes and keep it on hand so if he doesn't like what you put down, maybe he'll at least eat some of it before you put his old food down. Freeze dried meats, Fortiflora and fish flakes are all winners.
And definitely get him tested for hypothyroid. If he gained weight on only 4.5oz per day, we've got a problem.

I'll definitely talk to the vet about changing foods before I go that route. That's what I was nervous about doing before and was so relieved when my old vet said Fancy Feast was fine. I worry I'll disrupt his system with new food.I've tried Fortiflora for some diarrhea in the past and he's not the biggest fan of it but he does eat it when it's mixed with the right stuff. Does that help settle his tummy in the transition over to new food?I'm going to have a huge list for the vet to go over tomorrow!

If you want to talk to a vet about changing foods, it needs to be a vet certified in pet nutrition. Regular vets do not receive any training in nutrition, besides being told to push Hill's. (Unless you are outside of the US, then I have no idea what they push.)

Fortiflora will help his tummy with the transition, yes. :nod:

xthoroughbred said:

In the past few weeks, my 18 year old boy has been waking me up frequently (6+ times) during the night. I did some research and found that hyperthyroidism can cause this and is a typical problem for senior cats.

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When you take him to the vet, besides getting his thyroid checked, have them check his eyesight and hearing. A lot of older kitties will find the darkness of nighttime to be more of a time when having impaired eyesight and/or hearing makes them feel insecure and afraid and they'll vocalize a lot more at night because of this.

Sending lots of feel better thoughts for your sweet boy!